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Conundrum of Cavum Septum Pellucidum in Expert Witness Testimony, Police Evidence And Neurobehavioural Consequence: Affecting Legal Practice And Criminal Justice? 专家证人证词、警方证据和神经行为后果中的透明隔隙难题:影响法律实践和刑事司法?
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-08-01 DOI: 10.33425/2692-7918.1029
S. Thompson
Cavum septum pellucidum (CSP) is a rare condition when the septum pellucidum remains open to the inner ventricles within the brain. In many cases, CSP and the associated anatomical structure cavum vergae is thought to lead to anti-social and psychotic behaviour which poses a problem to those working in legal services. Controversy surrounds the possibility of congenital versus acquired conditions when CSP is found in those with repeated traumatic brain injuries such as professional athletes, American pro-footballers and professional and amateur boxers. Collecting police evidence and presenting expert testimony in the Courts is problematical when there is confusion over the acquisition of CSP. Treatment is compounded by differing presentations often involving psychosis which makes it a challenge to correctly place individuals within health service provision and penal institutions as well as offering appropriate treatment and criminal justice.
透明隔腔(CSP)是一种罕见的情况下,当透明隔保持开放的内脑室在大脑。在许多情况下,CSP和相关的性腺腔解剖结构被认为会导致反社会和精神病行为,这对那些从事法律服务的人来说是一个问题。当CSP出现在那些反复遭受创伤性脑损伤的人身上时,比如职业运动员、美国职业足球运动员、职业和业余拳击手,围绕着先天性还是后天的可能性存在争议。当对CSP的获取存在混淆时,收集警方证据和在法庭上提出专家证词是有问题的。治疗的复杂之处在于,不同的表现往往涉及精神病,这使得正确地将个人安置在保健服务机构和刑罚机构以及提供适当的治疗和刑事司法成为一项挑战。
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引用次数: 0
Hip Fracture As A Potential Contributor To Cognitive Decline And Dementia 髋部骨折是认知能力下降和痴呆的潜在诱因
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-08-01 DOI: 10.33425/2692-7918.1030
S. Thompson
This paper reviews the possible link between hip fracture and cognitive decline and dementia. There is a growing body of clinical research literature that indicates that cognitive decline is associated with the presence of delirium and that delirium is a predictor of dementia. Hip fracture is thought to be an independent factor that may lead to cognitive decline and dementia. It is suggested that cost implications should not become an obstacle to determining the best course of rehabilitation when delirium signals the need for preventive measures to protect the welfare of patients with hip fracture.
本文综述了髋部骨折与认知能力下降和痴呆之间的可能联系。越来越多的临床研究文献表明,认知能力下降与谵妄的出现有关,而谵妄是痴呆的前兆。髋部骨折被认为是可能导致认知能力下降和痴呆的一个独立因素。当谵妄表明需要采取预防措施以保护髋部骨折患者的福利时,成本影响不应成为确定最佳康复方案的障碍。
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引用次数: 0
The patient-centered care for patients with acute myocardial infarction: what can be improved the disease management 以患者为中心的急性心肌梗死患者护理:哪些可以改善疾病管理
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-08-01 DOI: 10.33425/2692-7918.1028
Cláudia Amaro dos Santos, Telmo Pequito, A. Fonseca
Introduction: Cardiovascular diseases are presented as a set of diseases that affect the cardiovascular system because of inappropriate lifestyles or unhealthy, they are consistent in risk might be modifiable through a proper disease management factor. Aim: Assess the perceptions of patients with acute myocardial infarction about this heart disease and risk factors associated. Also, identify the risk factors that can be improved to manage the disease. Design: Observational and prospective study. Methods: The survey was conducted in a Cardiac Intensive Care Unit of a Central Hospital, with inclusion of all patients admitted on a period of two months. Nineteen patients were studied with a clinical diagnosis of Acute Myocardial Infarction. Results: The analysis of the questionnaires showed that, approach the subject has a justified and reasoned relevance. The high prevalence of risk factors that can be modified highlighted the need for intervention in patients with non-modifiable risk factors. Conclusion: Patients with acute myocardial infarction do not have a correct perception of the disease and associated factors. Many of the risk factors present in patients with acute myocardial infarction are likely to be modified by an appropriate disease management, with a patient-centred care.
导论:心血管疾病是由于不适当的生活方式或不健康的生活方式而影响心血管系统的一组疾病,它们的危险性是一致的,可以通过适当的疾病管理因素加以改变。目的:评价急性心肌梗死患者对该心脏病及其相关危险因素的认识。此外,确定可以改善以控制疾病的风险因素。设计:观察性和前瞻性研究。方法:调查在某中心医院的心脏重症监护病房进行,纳入所有住院两个月的患者。本文对19例临床诊断为急性心肌梗死的患者进行了研究。结果:对问卷的分析表明,方法的主题具有合理和合理的相关性。可改变的危险因素的高流行率突出了对不可改变的危险因素患者进行干预的必要性。结论:急性心肌梗死患者对疾病及相关因素缺乏正确认识。急性心肌梗死患者中存在的许多危险因素可能通过适当的疾病管理和以患者为中心的护理来改变。
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引用次数: 0
Carbon monoxide poisoning: Recommendations for neuropsychological assessment 一氧化碳中毒:神经心理学评估的建议
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-08-01 DOI: 10.33425/2692-7918.1031
S. Thompson
Carbon monoxide poisoning is potentially significant in terms of mortality rates, and survivors can have serious deleterious neurological consequences. Diagnosis may be hampered because of symptoms that are similar to other benign conditions. Neuropsychological assessment is complicated due to the need to assess potentially global brain dysfunction. Assessment recommendations are presented and discussed together with an overview of treatment options.
一氧化碳中毒在死亡率方面具有潜在的重大意义,幸存者可能会产生严重的有害神经后果。由于症状与其他良性疾病相似,诊断可能会受到阻碍。由于需要评估潜在的全局性脑功能障碍,神经心理学评估是复杂的。评估建议和治疗方案的概述一起提出和讨论。
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引用次数: 0
Lateralized readiness potentials can identify hemisphere of recovery in stroke patients. 横向准备电位可以识别脑卒中患者的半球恢复情况。
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-05-23 DOI: 10.3233/rnn-211222
Nevine M. El Nahas, Tamer Roushdy, H. Shokri, R. Moustafa, Ahmed M. Elsayed, Randa M. Amin, A. Ashour, E. H. Abd Eldayem, G. Elhawary, Ahmed M. Elbokl
Highlights• In healthy adults, the lateralized readiness potential (LRP) is localized to the hemisphere contralateral to a moving limb.• In stroke, the LRP can lateralize contra-, or ipsilateral to the paretic limb depending on the stage of recovery.• Identification of hemisphere of recovery can guide further measures for enhancing brain plasticity.BACKGROUNDEvent related cortical potentials related to motor action are referred to as movement related cortical potentials. The late component of which is the readiness potential (RP) and its polarity is more negative in the hemisphere responsible for planning of motor action. This lateralized nature of RP during unilateral hand movement is studied as lateralized readiness potential (LRP) by calculating the contralateral-minus-ipsilateral difference wave for each hand.OBJECTIVEThe aim was to identify the hemisphere contributing to motor recovery in acute and chronic stroke patients through recording LRPs.METHODSTwenty-nine cases with cerebrovascular stroke (15 acute and 14 chronic) were included in the study. EEG was recorded in response to self-cued button presses by the paretic side to obtain the averaged LRP amplitude. The hemisphere with greater negativity was considered the side of recovery. Functional recovery was assessed by Fugl Meyer test.RESULTSIn acute cases, recovery was more related to LRP activity in the contralesional hemisphere (73% ), whereas lateralization was equal in chronic cases; 50% in either group. LRP amplitude was higher in the contralesional hemisphere (p = 0.02). Functional recovery assessed by the Fugl Meyer test (FM) was similar whether recovery was ipsi- or contralesional.CONCLUSIONSEarly after stroke, motor recovery is more likely to involve compensatory activity in the contralesional hemisphere, while in the chronic phase, the ipsilesional hemisphere may recover its function and become more active. Further research is needed to verify if the technique mentioned in our study could be used to guide customized NIBS protocols tailoring the optimal site and parameters for each patient.
•在健康成人中,侧化准备电位(LRP)定位于运动肢体的对侧半球。•中风时,视恢复阶段,LRP可侧移对侧或同侧麻痹肢体。•恢复半球的识别可以指导进一步提高大脑可塑性的措施。背景:与运动动作相关的事件相关皮质电位被称为运动相关皮质电位。其后期成分是准备电位(RP),其极性在负责运动动作计划的半球中更为负。通过计算每只手的对侧-同侧差波,研究了单侧手部运动中RP的侧化性质,即侧化准备电位(LRP)。目的通过记录lrp,确定对急慢性脑卒中患者运动恢复有贡献的脑半球。方法选择急性脑血管病15例,慢性脑血管病14例,共29例。记录父侧自提示按下按钮时的脑电图,得到LRP平均幅值。负性较强的半球被认为是恢复的一面。采用Fugl Meyer试验评价功能恢复情况。结果在急性病例中,恢复主要与对侧半球LRP活性相关(73%),而在慢性病例中,侧化程度相同;两组各50%。LRP振幅在对侧半球较高(p = 0.02)。Fugl Meyer试验(FM)评估的功能恢复是相似的,无论恢复是单向的还是对偶的。结论脑卒中后早期运动恢复主要涉及对侧半球代偿活动,而慢性期同侧半球可能恢复功能并变得更加活跃。需要进一步的研究来验证我们的研究中提到的技术是否可以用于指导定制NIBS方案,为每位患者定制最佳位置和参数。
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引用次数: 3
Combined effects of cerebellar tDCS and task-oriented circuit training in people with multiple sclerosis: A pilot randomized control trial. 小脑tDCS和任务导向回路训练对多发性硬化症患者的联合作用:一项初步随机对照试验。
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-05-05 DOI: 10.3233/RNN-211245
Andrea Baroni, G. Magro, Carlotta Martinuzzi, Laura Brondi, S. Masiero, Giada Milani, G. Zani, Antonella Bergonzoni, N. Basaglia, S. Straudi
BACKGROUNDBalance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition.OBJECTIVETo test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis.METHODS16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded.RESULTSWalking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS.CONCLUSIONSTask-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.
背景:平衡和活动障碍在多发性硬化症患者中很常见,部分原因是小脑功能障碍。以任务为导向的行为方法先前被证明可以促进身体机能。在训练过程中应用的小脑经颅直流电刺激(ctDCS)有可能增加大脑的兴奋性,通过调节小脑-脑抑制来促进康复效果。目的探讨小脑ctDCS刺激联合运动训练对多发性硬化症患者活动能力和平衡能力的影响。方法在一项双盲随机临床试验中,16名受试者每天随机接受真实或虚假ctdcs和任务导向训练,持续两周。在治疗前后和两周的随访中测试了功能活动能力、平衡能力、步行表现和生活质量。同时记录了小脑刺激对心理和执行功能的影响。结果两组患者治疗后行走能力、平衡能力和生活质量均有改善,并在随访2周后保持。双向方差分析显示,平衡和步行表现存在显著的时间效应。时间处理的交互作用显著(F = 3.12, df = 2,26;p = 0.03)在接受real-ctDCS患者生活质量评估的运动方面发现。结论任务导向训练可改善多发性硬化症患者的平衡和活动能力,但ctDCS不能提高运动训练的效果。
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引用次数: 4
Scientific basis and active ingredients of current therapeutic interventions for stroke rehabilitation. 当前脑卒中康复治疗干预措施的科学基础和有效成分。
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-05-04 DOI: 10.3233/RNN-211243
R. Ranganathan, Carson Doherty, M. Gussert, Eva Kaplinski, M. Koje, C. Krishnan
BACKGROUNDDespite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific basis for different interventions as one critical factor that has led to suboptimal study outcomes.OBJECTIVETo understand the content of current therapeutic interventions in terms of their active ingredients.METHODSWe conducted an analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020.RESULTSThere were three primary findings: (i) consistent with prior reports, most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) most therapeutic interventions mentioned multiple active ingredients and there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach.CONCLUSIONThese results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.
背景尽管在中风的治疗和管理方面取得了巨大进展,但中风后恢复运动和功能结果仍然是一个重大的临床挑战。鉴于运动康复中使用的方法范围广泛,一些评论强调,不同干预措施缺乏明确的科学依据,这是导致研究结果不理想的一个关键因素。目的了解当前治疗干预措施的有效成分。方法:我们对2019-2020年2年期间中风康复的随机对照试验进行了分析。结果有三个主要发现:(i)与之前的报道一致,大多数研究没有提供为什么该治疗有效的明确理由,(ii)大多数治疗干预措施都提到了多种活性成分,并且所提到的活性成分与研究中测量的活性成分之间没有密切的对应关系,以及(iii)涉及一种以上治疗方法的多模式方法往往以特别的方式结合在一起,这表明缺乏有针对性的方法。结论这些结果强调了加强基础科学和临床研究之间跨学科联系的必要性,以及结构化开发和测试治疗方法以寻找更有效的治疗干预措施的必要性。
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引用次数: 1
Complex housing partially mitigates low dose radiation-induced changes in brain and behavior in rats. 复杂的住房部分减轻了低剂量辐射引起的大鼠大脑和行为的变化。
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-04-30 DOI: 10.3233/RNN-211216
Anna Kovalchuk, R. Mychasiuk, A. Muhammad, S. Hossain, Abhijit Ghose, C. Kirkby, E. Ghasroddashti, O. Kovalchuk, B. Kolb
PURPOSEIn recent years, much effort has been focused on developing new strategies for the prevention and mitigation of adverse radiation effects on healthy tissues and organs, including the brain. The brain is very sensitive to radiation effects, albeit as it is highly plastic. Hence, deleterious radiation effects may be potentially reversible. Because radiation exposure affects dendritic space, reduces the brain's ability to produce new neurons, and alters behavior, mitigation efforts should focus on restoring these parameters. To that effect, environmental enrichment through complex housing (CH) and exercise may provide a plausible avenue for exploration of protection from brain irradiation. CH is a much broader concept than exercise alone, and constitutes exposure of animals to positive physical and social stimulation that is superior to their routine housing and care conditions. We hypothesized that CHs may lessen harmful neuroanatomical and behavioural effects of low dose radiation exposure.METHODSWe analyzed and compared cerebral morphology in animals exposed to low dose head, bystander (liver), and scatter irradiation on rats housed in either the environmental enrichment condos or standard housing.RESULTSEnriched condo conditions ameliorated radiation-induced neuroanatomical changes. Moreover, irradiated animals that were kept in enriched CH condos displayed fewer radiation-induced behavioural deficits than those housed in standard conditions.CONCLUSIONSAnimal model-based environmental enrichment strategies, such as CH, are excellent surrogate models for occupational and exercise therapy in humans, and consequently have significant translational possibility. Our study may thus serve as a roadmap for the development of new, easy, safe and cost-effective methods to prevent and mitigate low-dose radiation effects on the brain.
目的近年来,人们在制定预防和减轻辐射对健康组织和器官(包括大脑)不利影响的新战略方面做了大量工作。尽管大脑具有高度的可塑性,但它对辐射的影响非常敏感。因此,有害的辐射效应可能是潜在可逆的。由于辐射暴露会影响树突空间,降低大脑产生新神经元的能力,并改变行为,因此缓解措施应侧重于恢复这些参数。为此,通过复合住房(CH)和锻炼来丰富环境可能为探索脑辐射保护提供了一种可行的途径。CH是一个比单独运动更广泛的概念,它包括使动物暴露于积极的身体和社会刺激,这优于它们日常的住房和护理条件。我们假设CHs可能减轻低剂量辐射暴露对神经解剖和行为的有害影响。方法对饲养在环境富集公寓和标准住房的大鼠进行低剂量头部、旁观者(肝脏)和散射辐射照射后的脑形态进行分析和比较。结果丰富的公寓条件改善了辐射引起的神经解剖改变。此外,与饲养在标准条件下的动物相比,饲养在富含CH的公寓中的受辐射动物表现出较少的辐射引起的行为缺陷。结论基于动物模型的环境富集策略,如CH,是人类职业和运动治疗的优秀替代模型,因此具有重要的转化可能性。因此,我们的研究可以作为开发新的、简单的、安全的、经济有效的方法来预防和减轻低剂量辐射对大脑的影响的路线图。
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引用次数: 0
Management of gunshot wounds to the spine at Parakou University Teaching Hospital In Benin Republics 贝宁共和国帕拉库大学教学医院脊柱枪伤的处理
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1024
Quenum Kisito, Coulibaly Oumar, Yakhya Cisse, Padonou Christian, Quenum Hountondji Bernice, F. O. Holden
Objective: Describe the clinical features and bullet removal in gunshot wound (GSW) to the spine. Patients and methods: From 2015 to 2021 we present Case series of consecutive five cases of GSW with spinal cord injury treated at a single center of parakou university neurosurgery department. Results: Patient ages ranged from 16 to 40 yr (mean: 27.4 yr). All the patients were male. Three had complete thoracic spinal cord injury (ASIA A), two had lumbar level injury with cauda equina syndrome in one case. Surgical and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the thoracic spine. Decompression and bullet removal were performed using an open surgery. The patient with thoracic spinal cord lesion associated with extended injuries related to bullet fragmentation have a poor prognosis. The patients with incomplete injuries had a good follow-up and neurologic recovery. There were no postoperative wound infections, cerebrospinal fluid (CSF) fistulas, or other complications related to the procedure. Conclusion: Surgical decompression and bullet removal is a safe technique that may help reduce the risk of postoperative infections and CSF fistulas in patients with GSW to the thoracic and lumbar spine.
目的:探讨脊柱枪伤的临床特点及取出子弹的方法。患者和方法:从2015年到2021年,我们报告了在parakou大学神经外科单一中心连续治疗的5例GSW伴脊髓损伤的病例系列。结果:患者年龄16 ~ 40岁(平均27.4岁)。所有患者均为男性。3例完全性胸段脊髓损伤(ASIA A), 2例腰椎水平损伤伴马尾综合征。一例胸椎高速枪伤致持续性脊髓损伤患者的外科和康复治疗及其结果。采用开放手术进行减压和取出子弹。胸椎脊髓病变伴延伸性损伤的患者预后较差。不完全性损伤患者随访良好,神经功能恢复良好。术后无伤口感染、脑脊液(CSF)瘘或其他与手术相关的并发症。结论:手术减压和取出子弹是一种安全的技术,可以帮助降低胸腰椎GSW患者术后感染和脑脊液瘘的风险。
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引用次数: 0
Impact of Social Support on Mental Wellbeing among Internet Users In Nigeria During Covid-19 Pandemic 2019冠状病毒病大流行期间社会支持对尼日利亚互联网用户心理健康的影响
IF 2.8 4区 医学 Q4 NEUROSCIENCES Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1023
Emmanuel Sochukwuma Ezaka,, M. F. Asiegbu, O. P. Chibuike, Okpara Titus Chukwubuzo, Chime Peter Ekpunobi, Ozougwu Augustine Obumneme, Ofojebe Chukwuma Philip, Okoli Alexander Chinwike
This study investigated the role of social support on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria. A total of one hundred and six (106) participants (55 (51.9%) females, and 51 (48.9%) males participated in the study. The participant ages ranged from 19-29 years with a mean age of 28.68 and standard deviation of 8.14. Participants were drawn using convenience sampling technique and data were collated using the online Google form method. The link to the survey was shared across different platforms such: as Facebook, Whatsapp, and email list. The participants gave their consent and willingness to participate by checking a box in the online survey. Two instruments were used in data collection namely; a 15-item COVID-19 social support questionnaire (COVID-19- SSQ) and Warwick-Edinburgh Mental Well-being Scale (AWEMWBS). Two hypotheses were tested. The study adopted cross sectional design, while regression was employed for data analysis. The findings indicate that the presence of social support has significant influence on existence of mental wellbeing. It is recommended that social support factor should be sustained because of its buffer effect on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria.
本研究调查了尼日利亚互联网用户在COVID-19大流行期间社会支持对心理健康的作用。共有106名参与者(女性55名(51.9%),男性51名(48.9%))参加了这项研究。参与者年龄19-29岁,平均年龄28.68岁,标准差8.14岁。参与者采用方便抽样法抽取,数据采用在线谷歌表格法整理。该调查的链接在不同的平台上共享,如Facebook、Whatsapp和电子邮件列表。参与者通过在在线调查中勾选一个方框来表示他们同意并愿意参与。数据收集使用了两种仪器,分别是;15项社会支持问卷(COVID-19- SSQ)和华威-爱丁堡心理健康量表(AWEMWBS)。测试了两个假设。本研究采用横断面设计,数据分析采用回归分析。研究结果表明,社会支持的存在对心理健康的存在有显著影响。建议维持社会支持因素,因为它对尼日利亚互联网用户在COVID-19大流行期间的心理健康具有缓冲作用。
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引用次数: 1
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Restorative neurology and neuroscience
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