Technological aids for the rehabilitation of memory and executive functioning in children and adolescents with acquired brain injury (Review).

Background The use of technology in healthcare settings is on the increase and may represent a cost-effective means of delivering rehabilitation. Reductions in treatment time, and delivery in the home, are also thought to be benefits of this approach. Children and adolescents with brain injury often experience deficits in memory and executive functioning that can negatively affect their school work, social lives, and future occupations. Effective interventions that can be delivered at home, without the need for high-cost clinical involvement, could provide a means to address a current lack of provision. We have systematically reviewed studies examining the effects of technology-based interventions for the rehabilitation of deficits in memory and executive functioning in children and adolescents with acquired brain injury. Objectives To assess the effects of technology-based interventions compared to placebo intervention, no treatment, or other types of intervention, on the executive functioning and memory of children and adolescents with acquired brain injury. Search methods We ran the search on the 30 September 2015. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic + EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), CINAHL Plus (EBSCO), two other databases, and clinical trials registers. We also searched the internet, screened reference lists, and contacted authors of included studies. Selection criteria Randomised controlled trials comparing the use of a technological aid for the rehabilitation of children and adolescents with memory or executive-functioning deficits with placebo, no treatment, or another intervention. Data collection and analysis Two review authors independently reviewed titles and abstracts identified by the search strategy. Following retrieval of full-text manuscripts, two review authors independently performed data extraction and assessed the risk of bias. Main results Four studies (involving 206 participants) met the inclusion criteria for this review. Three studies, involving 194 participants, assessed the effects of online interventions to target executive functioning (that is monitoring and changing behaviour, problem solving, planning, etc.). These studies, which were all conducted by the same research team, compared online interventions against a 'placebo' (participants were given internet resources on brain injury). The interventions were delivered in the family home with additional support or training, or both, from a psychologist or doctoral student. The fourth study investigated the use of a computer program to target memory in addition to components of executive functioning (that is attention, organisation, and problem solving). No information on the study setting was provided, however a speech-language pathologist, teacher, or occupational therapist accompanied participants. Two studies assessed adolescents and young adults with mild to severe traumatic brain injury (TBI), while the remaining two studies assessed children and adolescents with moderate to severe TBI. Risk of bias We assessed the risk of selection bias as low for three studies and unclear for one study. Allocation bias was high in two studies, unclear in one study, and low in one study. Only one study (n = 120) was able to conceal allocation from participants, therefore overall selection bias was assessed as high. One study took steps to conceal assessors from allocation (low risk of detection bias), while the other three did not do so (high risk of detection bias). Primary outcome 1: Executive functioning: Technology-based intervention versus placebo Results from meta-analysis of three studies (n = 194) comparing online interventions with a placebo for children and adolescents with TBI, favoured the intervention immediately post-treatment (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.66 to -0.09; P = 0.62; I2 = 0%). (As there is no 'gold standard' measure in the field, we have not translated the SMD back to any particular scale.) This result is thought to represent only a small to medium effect size (using Cohen’s rule of thumb, where 0.2 is a small effect, 0.5 a medium one, and 0.8 or above is a large effect); this is unlikely to have a clinically important effect on the participant. The fourth study (n = 12) reported differences between the intervention and control groups on problem solving (an important component of executive functioning). No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. The quality of evidence for this outcome according to GRADE was very low. This means future research is highly likely to change the estimate of effect. Primary outcome 2: Memory One small study (n = 12) reported a statistically significant difference in improvement in sentence recall between the intervention and control group following an eight-week remediation programme. No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. Secondary outcomes Two studies (n = 158) reported on anxiety/depression as measured by the Child Behavior Checklist (CBCL) and were included in a meta-analysis. We found no evidence of an effect with the intervention (mean difference -5.59, 95% CI -11.46 to 0.28; I2 = 53%). The GRADE quality of evidence for this outcome was very low, meaning future research is likely to change the estimate of effect. A single study sought to record adverse events and reported none. Two studies reported on use of the intervention (range 0 to 13 and 1 to 24 sessions). One study reported on social functioning/social competence and found no effect. The included studies reported no data for other secondary outcomes (that is quality of life and academic achievement). Authors' conclusions This review provides low-quality evidence for the use of technology-based interventions in the rehabilitation of executive functions and memory for children and adolescents with TBI. As all of the included studies contained relatively small numbers of participants (12 to 120), our findings should be interpreted with caution. The involvement of a clinician or therapist, rather than use of the technology, may have led to the success of these interventions. Future research should seek to replicate these findings with larger samples, in other regions, using ecologically valid outcome measures, and reduced clinician involvement.

Memory-centric VDF Graph Transformations for Practical FPGA Implementation

Realising memory intensive applications such as image and video processing on FPGA requires creation of complex, multi-level memory hierarchies to achieve real-time performance; however commerical High Level Synthesis tools are unable to automatically derive such structures and hence are unable to meet the demanding bandwidth and capacity constraints of these applications. Current approaches to solving this problem can only derive either single-level memory structures or very deep, highly inefficient hierarchies, leading in either case to one or more of high implementation cost and low performance. This paper presents an enhancement to an existing MC-HLS synthesis approach which solves this problem; it exploits and eliminates data duplication at multiple levels levels of the generated hierarchy, leading to a reduction in the number of levels and ultimately higher performance, lower cost implementations. When applied to synthesis of C-based Motion Estimation, Matrix Multiplication and Sobel Edge Detection applications, this enables reductions in Block RAM and Look Up Table (LUT) cost of up to 25%, whilst simultaneously increasing throughput.

Heat Activated Prestressing of Shape Memory Alloys for Active Confinement of Concrete Sections

This paper presents the results from the experimental investigation on heat activated prestressing of Shape Memory Alloy (SMA) wires for active confinement of concrete sections. Active confinement of concrete is found to be much more effective than passive confinement which becomes effective only when the concrete starts to dilate. Active confinement achieved using conventional prestressing techniques often faces many obstacles due to practical limitations. A class of smart materials that has recently drawn attention in civil engineering is the super elastic SMA which has the ability to undergo reversible hysteretic shape change known as the shape memory effect. The shape memory effect of SMAs can be utilized to develop a convenient prestressing technique for active confinement of concrete sections.
In this study a series of experimental tests are conducted to study Heat Activated Prestress (HAP) in SMAs. Three different types of tests are conducted with different loading protocol to determine parameters such as HAP, residual strain after heating and range of strain that can be used for effective active confinement after HAP. Test results show a maximum HAP of about 500 MPa can be achieved after heating and approximately 450MPa is retained at 25oC in specimens pre-strained by 6%. A substantial amount of strain recovery upon unloading and after heating the SMA wires is recorded. About 2.5% elastic strain recovery upon unloading from 6% strain level is observed. In the specimen pre-strained by 6%, a total of 4% strain is recovered when unloaded after heating. A strain range of 3% is found available for effective confinement after HAP. Test results demonstrate that SMAs have unique features that can be intelligently employed in many civil engineering applications including active confinement of concrete sections.

Interaction between glucocorticoid and adenosine A2A receptors in the hippocampus : implications for learning and memory

Tese de doutoramento, Ciências Biomédicas (Neurociências), Universidade de Lisboa, Faculdade de Medicina, 2014

Software transactional memory as a building block for parallel embedded realtime systems

The recent trends of chip architectures with higher number of heterogeneous cores, and non-uniform memory/non-coherent caches, brings renewed attention to the use of Software Transactional Memory (STM) as a fundamental building block for developing parallel applications. Nevertheless, although STM promises to ease concurrent and parallel software development, it relies on the possibility of aborting conflicting transactions to maintain data consistency, which impacts on the responsiveness and timing guarantees required by embedded real-time systems. In these systems, contention delays must be (efficiently) limited so that the response times of tasks executing transactions are upper-bounded and task sets can be feasibly scheduled. In this paper we assess the use of STM in the development of embedded real-time software, defending that the amount of contention can be reduced if read-only transactions access recent consistent data snapshots, progressing in a wait-free manner. We show how the required number of versions of a shared object can be calculated for a set of tasks. We also outline an algorithm to manage conflicts between update transactions that prevents starvation.

Scaling In-Memory databases on multicores

Current computer systems have evolved from featuring only a single processing unit and limited RAM, in the order of kilobytes or few megabytes, to include several multicore processors, o↵ering in the order of several tens of concurrent execution contexts, and have main memory in the order of several tens to hundreds of gigabytes. This allows to keep all data of many applications in the main memory, leading to the development of inmemory databases. Compared to disk-backed databases, in-memory databases (IMDBs) are expected to provide better performance by incurring in less I/O overhead. In this dissertation, we present a scalability study of two general purpose IMDBs on multicore systems. The results show that current general purpose IMDBs do not scale on multicores, due to contention among threads running concurrent transactions. In this work, we explore di↵erent direction to overcome the scalability issues of IMDBs in multicores, while enforcing strong isolation semantics. First, we present a solution that requires no modification to either database systems or to the applications, called MacroDB. MacroDB replicates the database among several engines, using a master-slave replication scheme, where update transactions execute on the master, while read-only transactions execute on slaves. This reduces contention, allowing MacroDB to o↵er scalable performance under read-only workloads, while updateintensive workloads su↵er from performance loss, when compared to the standalone engine. Second, we delve into the database engine and identify the concurrency control mechanism used by the storage sub-component as a scalability bottleneck. We then propose a new locking scheme that allows the removal of such mechanisms from the storage sub-component. This modification o↵ers performance improvement under all workloads, when compared to the standalone engine, while scalability is limited to read-only workloads. Next we addressed the scalability limitations for update-intensive workloads, and propose the reduction of locking granularity from the table level to the attribute level. This further improved performance for intensive and moderate update workloads, at a slight cost for read-only workloads. Scalability is limited to intensive-read and read-only workloads. Finally, we investigate the impact applications have on the performance of database systems, by studying how operation order inside transactions influences the database performance. We then propose a Read before Write (RbW) interaction pattern, under which transaction perform all read operations before executing write operations. The RbW pattern allowed TPC-C to achieve scalable performance on our modified engine for all workloads. Additionally, the RbW pattern allowed our modified engine to achieve scalable performance on multicores, almost up to the total number of cores, while enforcing strong isolation.

Spatial relational learning and memory abilities do not differ between men and women in a real-world, open-field environment

This study assesses gender differences in spatial and non-spatial relational learning and memory in adult humans behaving freely in a real-world, open-field environment. In Experiment 1, we tested the use of proximal landmarks as conditional cues allowing subjects to predict the location of rewards hidden in one of two sets of three distinct locations. Subjects were tested in two different conditions: (1) when local visual cues marked the potentially-rewarded locations, and (2) when no local visual cues marked the potentially-rewarded locations. We found that only 17 of 20 adults (8 males, 9 females) used the proximal landmarks to predict the locations of the rewards. Although females exhibited higher exploratory behavior at the beginning of testing, males and females discriminated the potentially-rewarded locations similarly when local visual cues were present. Interestingly, when the spatial and local information conflicted in predicting the reward locations, males considered both spatial and local information, whereas females ignored the spatial information. However, in the absence of local visual cues females discriminated the potentially-rewarded locations as well as males. In Experiment 2, subjects (9 males, 9 females) were tested with three asymmetrically-arranged rewarded locations, which were marked by local cues on alternate trials. Again, females discriminated the rewarded locations as well as males in the presence or absence of local cues. In sum, although particular aspects of task performance might differ between genders, we found no evidence that women have poorer allocentric spatial relational learning and memory abilities than men in a real-world, open-field environment.

Mammalian Target of Rapamycin Complex 2 Controls CD8 T Cell Memory Differentiation in a Foxo1-Dependent Manner.

Upon infection, antigen-specific naive CD8 T cells are activated and differentiate into short-lived effector cells (SLECs) and memory precursor cells (MPECs). The underlying signaling pathways remain largely unresolved. We show that Rictor, the core component of mammalian target of rapamycin complex 2 (mTORC2), regulates SLEC and MPEC commitment. Rictor deficiency favors memory formation and increases IL-2 secretion capacity without dampening effector functions. Moreover, mTORC2-deficient memory T cells mount more potent recall responses. Enhanced memory formation in the absence of mTORC2 was associated with Eomes and Tcf-1 upregulation, repression of T-bet, enhanced mitochondrial spare respiratory capacity, and fatty acid oxidation. This transcriptional and metabolic reprogramming is mainly driven by nuclear stabilization of Foxo1. Silencing of Foxo1 reversed the increased MPEC differentiation and IL-2 production and led to an impaired recall response of Rictor KO memory T cells. Therefore, mTORC2 is a critical regulator of CD8 T cell differentiation and may be an important target for immunotherapy interventions.

Predicting performance on fluid intelligence from speed of processing, working memory, and controlled attention

Fluid inteliigence has been defined as an innate ability to reason which is measured commonly by the Raven's Progressive Matrices (RPM). Individual differences in fluid intelligence are currently explained by the Cascade model (Fry & Hale, 1996) and the Controlled Attention hypothesis (Engle, Kane, & Tuholski, 1999; Kane & Engle, 2002). The first theory is based on a complex relation among age, speed, and working memory which is described as a Cascade. The alternative to this theory, the Controlled Attention hypothesis, is based on the proposition that it is the executive attention component of working memory that explains performance on fluid intelligence tests. The first goal of this study was to examine whether the Cascade model is consistent within the visuo-spatial and verbal-numerical modalities. The second goal was to examine whether the executive attention component ofworking memory accounts for the relation between working memory and fluid intelligence. Two hundred and six undergraduate students between the ages of 18 and 28 completed a battery of cognitive tests selected to measure processing speed, working memory, and controlled attention which were selected from two cognitive modalities, verbalnumerical and visuo-spatial. These were used to predict performance on two standard measures of fluid intelligence: the Raven's Progressive Matrices (RPM) and the Shipley Institute of Living Scales (SILS) subtests. Multiple regression and Structural Equation Modeling (SEM) were used to test the Cascade model and to determine the independent and joint effects of controlled attention and working memory on general fluid intelligence. Among the processing speed measures only spatial scan was related to the RPM. No other significant relations were observed between processing speed and fluid intelligence. As 1 a construct, working memory was related to the fluid intelligence tests. Consistent with the predictions for the RPM there was support for the Cascade model within the visuo-spatial modality but not within the verbal-numerical modality. There was no support for the Cascade model with respect to the SILS tests. SEM revealed that there was a direct path between controlled attention and RPM and between working memory and RPM. However, a significant path between set switching and RPM explained the relation between controlled attention and RPM. The prediction that controlled attention mediated the relation between working memory and RPM was therefore not supported. The findings support the view that the Cascade model may not adequately explain individual differences in fluid intelligence and this may be due to the differential relations observed between working memory and fluid intelligence across different modalities. The findings also show that working memory is not a domain-general construct and as a result its relation with fluid intelligence may be dependent on the nature of the working memory modality.

The effect of motor-encoding activities on memory and performance in a grade one reading program

This study examined the effectiveness of motor-encoding activities on memory and performance of students in a Grade One reading program. There were two experiments in the study. Experiment 1 replicated a study by Eli Saltz and David Dixon (1982). The effect of motoric enactment (Le., pretend play) of sentences on memory for the sentences was investigated. Forty Grade One students performed a "memory-for-sentences" technique, devised by Saltz and Dixon. Only the experimental group used motoric enactment of the sentences. Although quantitative findings revealed no significant difference between the mean scores of the experimental group versus the control group, aspects of the experimental design could have affected the results. It was suggested that Saltz and Dixon's study could be replicated again, with more attention given to variables such as population size, nature of the test sentences, subjects' previous educational experience and conditions related to the testing environment. The second experiment was an application of Saltz and Dixon's theory that motoric imagery should facilitate memory for sentences. The intent was to apply this theory to Grade One students' ability to remember words from their reading program. An experimental gym program was developed using kinesthetic activities to reinforce the skills of the classroom reading program. The same subject group was used in Experiment 2. It was hypothesized that the subjects who experienced the experimental gym program would show greater signs of progress in reading ability, as evidenced by their scores on Form G of the Woodcock Reading Mastery Test--Revised. The data from the WRM--R were analyzed with a 3-way split-plot analysis of variance in which group (experimental vs. control) and sex were the between subjects variables and test-time (pre-test vs. post-test) was the within-subjects variable. Findings revealed the following: (a) both groups made substantial gains over time on the visual-auditory learning sub-test and the triple action of group x sex x time also was significant; (b) children in the experimental and control groups performed similarly on both the pre- and post-test of the letter identification test; (c) time was the only significant effect on subjects' performance on the word identification task; (d) work attack scores showed marked improvement in performance over time for both the experimenta+ and control groups; (e) passage comprehension scores indicated an improvement in performance for both groups over time. Similar to Experiment 1, it is suggested that several modifications in the experimental design could produce significant results. These factors are addressed with suggestions for further research in the area of active learning; more specifically, the effect of motor-encoding activities on memory and academic performance of children.

Early Development of Auditory-Verbal and Visual-Spatial Short-Term Memory: Age and Sex Effects

Memory is a multi-component cognitive ability to retain and retrieve information presented in different modalities. Research on memory development has shown that the memory capacity and the processes improve gradually from early childhood to adolescence. Findings related to the sex-differences in memory abilities in early childhood have been inconsistent. Although previous research has demonstrated the effects of the modality of stimulus presentation (auditory versus verbal) and the type of material to be remembered (visual/spatial versus auditory/verbal) on the memory processes and memory organization, the recent research with children is rather limited. The present study is a secondary analysis of data, originally collected from 530 typically developing Turkish children and adolescents. The purpose of the present study was to examine the age-related developments and sex differences in auditory-verbal and visual-spatial short-term memory (STM) in 177 typically developing male and female children, 5 to 8 years of age. Dot-Locations and Word-Lists from the Children's Memory Scale were used to measure visual-spatial and auditory-verbal STM performances, respectively. The findings of the present study suggest age-related differences in both visual-spatial and auditory-verbal STM. Sex-differences were observed only in one visual-spatial STM subtest performance. Modality comparisons revealed age- and task-related differences between auditory-verbal and visual-spatial STM performances. There were no sex-related effects in terms of modality specific performances. Overall, the results of this study provide evidence of STM development in early childhood, and these effects were mostly independent of sex and the modality of the task.

Disambiguating the Effects of Social Instability Stress in Adolescence on Learning and Memory Tasks that Involve the Medial Prefrontal Cortex and Hippocampus

Exposure to chronic stress can alter the structure and function of brain regions involved in learning and memory, and these effects are typically long-lasting if the stress occurs during sensitive periods of development. Until recently, adolescence has received relatively little attention as a sensitive period of development, despite marked changes in behaviour, heightened reactivity to stressors, and cognitive and neural maturation. Therefore, the purpose of the present study was to investigate the long-term effects of chronic stress in adolescence on two spatial learning and memory tasks (Morris water maze and Spatial Object Location test) and on a working memory task (Delayed Alternation task). Male rats were randomly assigned to chronic social instability stress (SS; daily 1 hour isolation and subsequent change of cage partner between postnatal days 30 and 45) or to a no-stress control group (CTL). During acquisition learning in the Morris water maze task, SS rats demonstrated impaired long-term memory for the location of the hidden escape platform compared to CTL rats, although the impairment was only seen after the first day of training. Similarly, SS rats had impaired long-term memory in the Spatial Object Location test after a long delay (240 minutes), but not after shorter delays (15 or 60 minutes) compared to CTL rats. On the Delayed Alternation task, which assessed working memory across delays ranging from 5 to 90 seconds, no group differences were observed. These results are partially in line with previous research that revealed adult impairment on spatial learning and memory tasks after exposure to chronic social instability stress in adolescence. The observed deficits, however, appear to be limited to long-term memory as no group differences were observed during brief periods of retention.

Working Memory in the Junior/Intermediate Classroom

This research project explored the connection between working memory and children’s learning. The project created a resource titled Working Memory Strategies for the Junior/ Intermediate Educator: A Handbook based on a literature review, the deconstruction of theoretical and empirical studies, teacher resources, and findings from a needs assessment completed by teachers that together show there is insufficient support for teachers working with students who have deficits in working memory along with other common classroom learning disabilities. As learning disabilities become more common in the classroom that increasingly affect working memory in a majority of cases, teachers must be prepared not only to address specific symptoms of the conditions, but also to help students learn how to navigate and become aware of their working memory ability. The handbook thus was developed as a useful resource for teachers looking to expand their knowledge about how learning occurs. A needs assessment completed by junior and intermediate division teachers in Ontario helped determine what educators found most important for inclusion in the handbook, and the same teachers were offered the opportunity to review the completed handbook. Teacher participants provided constructive feedback and indicated that the handbook would be a valuable resource for them and their colleagues when working with students who have working memory issues. It was suggested that the handbook would be useful when creating students’ Individual Education Plans and that the assessment checklist included in the handbook would be an excellent resource for teachers collecting data regarding students’ working memory and ability to learn.

Characterization of in vivo vertebral growth modulation by shape memory alloy staples on a porcine model for the correction of the scoliosis

La recherche de nouvelles voies de correction de la scoliose idiopathique a une longue histoire. Le traitement conventionnel de la scoliose idiopathique est présenté par le port du corset ou par la correction opératoire de la déformation. Depuis leur introduction, les deux méthodes ont prouvé leur efficacité. Cependant, malgré des caractéristiques positives évidentes, ces méthodes peuvent causer un nombre important d'effets indésirables sur la santé du patient. Les techniques sans fusion pour le traitement de la scoliose semblent être une alternative perspective de traitement traditionnel, car ils apportent moins de risques et des complications chirurgicales que les méthodes conventionnelles avec la conservation de la mobilité du disque intravertébral. Cependant, l'utilisation de techniques mentionnées exige une connaissance profonde de la modulation de croissance vertébrale. L'objectif principal de la présente étude est d'estimer le potentiel d'agrafes à l’AMF de moduler la croissance des vertèbres porcines en mesurant la croissance osseuse sur la plaque de croissance de vertèbres instrumentées en comparaison avec le groupe contrôle. La méthode est basée sur la loi de Hueter-Volkmann. Nous avons choisi NiTi agrafes à l’AMF pour notre étude et les porcs de race Landrace comme un animal expérimental. Les agrafes ont été insérés sur 5 niveaux thoracique de T6 à T11. En outre, les radiographies ont été prises toutes les 2 semaines. La présence d'agrafes en alliage à mémoire de forme a produit la création de courbes scoliotiques significatives dans 4 de 6 animaux chargés et le ralentissement considérable de la croissance osseuse (jusqu'à 35,4%) comparativement aux groupes contrôle et sham. L'étude a démontré in vivo le potentiel d'agrafes en alliage à mémoire de formes de moduler la croissance des vertèbres en créant des courbes scoliotiques sur les radiographies et en ralentissant le taux de croissance sur les plaques de croissance instrumenté. La position précise de l'agrafe est essentielle pour la modulation de croissance osseuse et le développement de la scoliose expérimentale.

On the stability of the bcc phase in Cu-Al-Mn shape memory alloys

Measurements of the entropy change at the martensitic transition of two composition-related sets of Cu-Al-Mn shape-memory alloys are reported. It is found that most of the entropy change has a vibrational origin, and depends only on the particular close-packed structure of the low-temperature phase. Using data from the literature for other Cu-based alloys, this result is shown to be general. In addition, it is shown that the martensitic structure changes from 18R to 2H when the ratio of conduction electrons per atom reaches the same value as the eutectoid point in the equilibrium phase diagram. This finding indicates that the structure of the metastable low-temperature phase is reminiscent of the equilibrium structure.