Reliability of two behavioral tools to assess pain in preterm neonates.
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CONTEXT: One of the main difficulties in adequately treating the pain of neonatal patients is the scarcity of validated pain evaluation methods for this population. OBJECTIVE: To analyze the reliability of two behavioral pain scales in neonates. TYPE OF STUDY: Cross-sectional. SETTING: University hospital neonatal intensive care unit. PARTICIPANTS: 22 preterm neonates were studied, with gestational age of 34 +/- 2 weeks, birth weight of 1804 +/- 584 g, 68% female, 30 +/- 12 hours of life, and 30% intubated. PROCEDURES: Two neonatologists (A and B) observed the patients at the bedside and on video films for 10 minutes. The Neonatal Facial Coding System and the Clinical Scoring System were scored at 1, 5, and 10 minutes. The final score was the median of the three values for each observer and scale. A and B were blinded to each other. Video assessments were made three months after bedside evaluations. MAIN MEASUREMENTS: End scores were compared between the observers using the intraclass correlation coefficient and bias analysis (paired t test and signal test). RESULTS: For the Neonatal Facial Coding System, at the bedside and on video, A and B showed a significant correlation of scores (intraclass correlation score: 0.62), without bias between them (t test and signal test: p > 0.05). For the Clinical Scoring System bedside assessment, A and B showed correlation of scores (intraclass correlation score: 0.55), but bias was also detected between them: A scored on average two points higher than B (paired t test and signal test: p < 0.05). For the Clinical Scoring System video assessment, A and B did not show correlation of scores (intraclass correlation score: 0.25), and bias was also detected between them (paired t-test and signal test: p < 0.05). CONCLUSION: The results strengthen the reliability of the Neonatal Facial Coding System for bedside pain assessment in preterm neonates. (+info)
Neural correlates of laughter and humour.
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Although laughter and humour have been constituents of humanity for thousands if not millions of years, their systematic study has begun only recently. Investigations into their neurological correlates remain fragmentary and the following review is a first attempt to collate and evaluate these studies, most of which have been published over the last two decades. By employing the classical methods of neurology, brain regions associated with symptomatic (pathological) laughter have been determined and catalogued under other diagnostic signs and symptoms of such conditions as epilepsy, strokes and circumspect brain lesions. These observations have been complemented by newer studies using modern non-invasive imaging methods. To summarize the results of many studies, the expression of laughter seems to depend on two partially independent neuronal pathways. The first of these, an 'involuntary' or 'emotionally driven' system, involves the amygdala, thalamic/hypo- and subthalamic areas and the dorsal/tegmental brainstem. The second, 'voluntary' system originates in the premotor/frontal opercular areas and leads through the motor cortex and pyramidal tract to the ventral brainstem. These systems and the laughter response appear to be coordinated by a laughter-coordinating centre in the dorsal upper pons. Analyses of the cerebral correlates of humour have been impeded by a lack of consensus among psychologists on exactly what humour is, and of what essential components it consists. Within the past two decades, however, sufficient agreement has been reached that theory-based hypotheses could be formulated and tested with various non-invasive methods. For the perception of humour (and depending on the type of humour involved, its mode of transmission, etc.) the right frontal cortex, the medial ventral prefrontal cortex, the right and left posterior (middle and inferior) temporal regions and possibly the cerebellum seem to be involved to varying degrees. An attempt has been made to be as thorough as possible in documenting the foundations upon which these burgeoning areas of research have been based up to the present time. (+info)
Applicability of 3D-CT facial reconstruction for forensic individual identification.
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Computed tomography (CT) is used in several clinical dentistry applications even by axial slices and two and three-dimensional reconstructed images (2D-CT and 3D-CT). The purpose of the current study is to assess the precision of linear measurements made in 3D-CT using craniometric patterns for individual identification in Forensic Dentistry. Five cadaver heads were submitted to a spiral computed tomography using axial slices, and 3D-CT reconstructions were obtained by volume rendering technique with computer graphics tools. Ten (10) craniometric measurements were determined in 3D-CT images by two examiners independently, twice each, and the standard error of intra- and inter-examiner measurements was assessed. The results demonstrated a low standard error of those measurements, from 0.85% to 3.09%. In conclusion, the linear measurements obtained in osseous and soft tissue structures were considered to be precise in 3D-CT with high imaging quality and resolution. (+info)
Conference report: functional magnetic resonance imaging for beginners--a review of the fMRI experience IV, 13-14 May 2002, Natcher Conference Center, National Institutes of Health, Bethesda, MD.
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The fourth fMRI Experience meeting was held at the Bethesda, Maryland campus of the National Institutes of Health on May 13th and 14th, 2002. The purpose of the meeting was to provide a platform for students working with functional magnetic resonance imaging (fMRI) to pres ent their research to an international audience of peers. This year"s meeting featured special lectures from Dr. Leslie Ungerleider ("Imaging Mechanisms of Visual Attention") and Dr. Daniel Weinberger ("Genetic Variation and fMRI Response"). (+info)
Muscles of facial expression in Otolemur, with a comparison to lemuroidea.
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Gross and histologic aspects of facial expression muscles are presented here for Otolemur spp. (suborder Prosimii, family Lorisidae) and are compared with those of lemuroids. Muscles of facial expression are involved in social signaling among primates, and are a primary means by which close-proximity nonverbal communication is achieved. These muscles have been well described in catarrhines and many of the lemuroids; however, their arrangement is not well known in the lorisids. In the present study we examined muscles of facial expression in Otolemur by dissecting preserved faces. The arrangement and appearance of the muscles were noted, and samples were gathered from each muscle for histologic processing. The results showed 17 muscles of facial expression in Otolemur, as compared to seven reported in previous studies. Histologically, muscles of the ear region were arranged in tight, dense fascicles, while muscles of the orbital region were arranged more loosely. Grossly, the facial expression muscles in Otolemur were very similar in morphology and attachments to those in the lemuroids, with some differences in the ear region. Otolemur garnettii had several muscles that appeared to be more robust than in the larger O. crassicaudatus. This may be due to dietary and/or social differences between the species. In previous studies it was concluded that, relative to lemuroids, Otolemur has a primitive arrangement of facial expression muscles. The current results do not support that conclusion, and in fact support a far greater similarity between Otolemur and lemuroids in general. These results underscore the need for a reexamination of facial musculature in prosimians in general, and may have taxonomic value as regards the position of Otolemur with lemuroids and other galagos. (+info)
Amygdala, affect and cognition: evidence from 10 patients with Urbach-Wiethe disease.
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Patients with Urbach-Wiethe disease constitute a unique nature experiment as more than half have bilaterally symmetrical damage in the amygdaloid region. Ten such patients were studied neuropsychologically and, nine of them, neuroradiologically with static (CT) and functional imaging techniques [single-photon emission computed tomography (SPECT) and PET]. Their principal bilateral amygdala damage was confirmed. Neuropsychologically, the patients showed cognitively little deviation from normal subjects, while they differed emotionally. This was evident in their judgement of all emotions in facial expressions, in an odour-figure association test as well as in remembering negative and positive pictures. This suggests that the human amygdala influences both negative and positive emotional processing. (+info)
Effects of smoking opportunity on cue-elicited urge: a facial coding analysis.
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The authors analyzed smokers' facial expressions using the Facial Action Coding System (P. Ekman & W. V. Friesen, 1978) under varyingsmoking opportunity conditions. In Experiment 1, smokers first were told that they either could (told-yes) or could not (told-no) smoke during the study. Told-yes smokers reported higher urges than did told-no smokers. Unexpectedly, told-yes smokers became increasingly likely to manifest expressions related to negative affect and less likely to evince expressions related to positive affect, compared with told-no smokers. In Experiment 2, smokers were more likely to show positive affect-related expressions if the delay was 15 s than if it was 60 s. Craving may be related to both a desire to use and an impatient desire to use immediately. (+info)
Does sexual dimorphism in human faces signal health?
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Evolutionary psychologists suggest that a preference for sexually dimorphic traits in human faces is an adaptation for mate choice, because such traits reflect health during development. For male faces, this claim rests on the immunocompetence-handicap hypothesis, which states that the increased testosterone levels needed to develop large masculine traits stress the immune system. We examined whether masculine traits in adolescent male faces are associated with health during development, and also whether feminine traits in adolescent female faces signal health. Feminine traits are attractive, but it is less clear whether they should signal health. Rated masculinity in adolescent male faces correlated modestly with actual health, and was perceived as healthy, but not as attractive. Rated femininity in adolescent female faces did not correlate with actual health, although it was perceived as healthy and attractive. These results support the immunocompetence-handicap hypothesis for male faces in that masculine traits signalled health during adolescence. However, they suggest that any health-related evolutionary benefits obtained from preferences for attractive facial traits may be weak. (+info)