Stable Deficits Research Articles

Continuous inter-limb coordination deficits in children with unilateral spastic cerebral palsy

BackgroundContinuous inter-limb coordination and the ability to offset perturbations to a movement pattern (i.e., stability) are important factors in efficient motor performance. Patients with movement disorders often show deficits in coordination and stability, although little is known about these features in children with cerebral palsy. The purpose of this study was to identify the continuous inter-limb coordination and stability deficits in children with cerebral palsy and determine if improvement occurs with upper extremity intervention. MethodsChildren with cerebral palsy participated in bimanual or unimanual intensive therapy. Continuous inter-limb coordination between the arms and between the more-affected arm and leg was evaluated using relative phase analysis during four gross motor tasks, including in-place marching and standing with asymmetric and symmetric arm swing. A control group of children with cerebral palsy and a group of typically developing children were also evaluated. FindingsChildren with cerebral palsy displayed coordination deficits compared to typically developing children (p<0.01), yet both groups presented similarly poor levels of stability (p=0.39). Compared to standing, adding legs to the task negatively impacted the coordination (p<0.01) and stability (p<0.01) of all children. Both groups improved coordination between the arms post-intervention (p<0.05 for all cases), however neither group improved stability (p>0.05 for all cases). InterpretationRelative phase analysis successfully provided a sensitive measurement of coordination and stability in pathologic and non-pathologic populations. Findings indicate that all children have difficulty producing consistent movement patterns and suggest that both bimanual and unimanual interventions can improve continuous coordination in children with cerebral palsy.

Neighborhood disadvantage is associated with stable deficits in neurocognitive functioning in traumatically-injured adults.

In trauma-exposed adults, the relationship between an individual's socioeconomic position (SEP) and post-traumatic stress disorder (PTSD) has been well demonstrated. One potential mechanism by which the stress associated with lower SEPs may impact trauma outcomes is through changes in neurocognition. In both healthy and clinical samples, area-level factors also appear to be independently related to neurocognition. Far less is known about how neighborhood socioeconomic disadvantage, may impact cognition in traumatically-injured adults. The current study employed hierarchical linear modeling to longitudinally investigate whether neighborhood disadvantage was associated with neurocognitive functioning in five domains: processing speed, sustained attention, controlled attention, cognitive flexibility, and response inhibition. One-hundred and ninety-five socioeconomically diverse traumatically-injured subjects (mean age=32.8, 52.8% female) were recruited from an Emergency Department. Two-weeks, three-months, and six-months post-trauma, participants completed self-report measures and a computerized test battery to evaluate neurocognition. An Area Deprivation Index (ADI) score, a measure of a neighborhood's socioeconomic disadvantage, was derived from each participants' home address. Greater neighborhood disadvantage was significantly related to lower scores in all domains. Results of hierarchical linear models revealed neighborhood disadvantage was significantly associated with processing speed, controlled attention, cognitive flexibility, and response inhibition across time, even after adjusting for individual annual household income, baseline PTSD symptoms, and previous adverse life experiences. This relationship was stable for all domains except sustained attention, which varied across time. These findings indicate neighborhood disadvantage contributes uniquely to neurocognitive functioning and, for the majority of domains, these contributions are stable across time. The relationship between area-level variables and cognitive function may underlie individual vulnerability to developing psychiatric disorders. Future work should continue to examine the interaction between socioenvironmental stressors and PTSD symptoms longitudinally.

A Longitudinal 5-Year Follow-Up Study of Cognitive Function After First Episode Major Depressive Disorder: Exploring State, Scar and Trait Effects.

Major depression (MDD) is associated with cognitive deficits in processing speed and executive function (EF) following first episode (FE). It is unclear whether deficits are state or trait related. Studies following FE MDD over longer periods are lacking, making it uncertain how cognition and symptoms develop after the initial episode. The present study assessed cognitive function and symptoms 5 years following FE MDD. In addition, the study explored relationships between MDD symptoms, rumination, and cognitive deficits with regards to the trait, state, and scar perspective. Twenty-three participants with previous FE MDD, and 20 matched control participants were compared on Delis-Kaplan Executive Function System measures of processing speed and EF, in a 5-year longitudinal follow-up study. Correlations between current symptoms- and history of MDD, rumination, cognition were investigated. Findings indicated that cognitive deficits persisted with no clear signs of exacerbation after initial episode. Inhibition appeared independent of current and previous symptoms of depression. Processing speed was related to depressive- symptoms and rumination. In conclusion, results indicated persisting, stable deficits in both EFs and processing speed. Findings further suggest that depressive symptoms could be related to deficits in processing speed, indicating state effects. There was limited support for worsening of cognition after initial episode. Some aspects of EF like Inhibition could show persistent deficits independent of depressive symptoms indicating trait effects.

Fiscal institutions: different classifications and their effectiveness

Fiscal institutions have been increasingly recognized as being useful for improving fiscal performance. These institutions are defined in different ways, but when a narrower definition is used, they correspond to independent fiscal institutions (IFIs), also called fiscal councils. In this paper, we employ three different classifications of fiscal institutions: from the European Commission, the International Monetary Fund, and one adapted from Calmfors and Wren-Lewis. Our main aim is to assess the impact of fiscal institutions on fiscal performance within a panel composed of the 28 countries of the European Union during the period of 1999–2016, using the bias-corrected least squares dummy variable dynamic panel estimator. We also explore the complementarity between fiscal institutions and the other elements of fiscal governance: numerical fiscal rules, medium-term budgetary frameworks, and the Stability and Growth Pact deficit and debt rules. The results confirm that fiscal institutions improve the discretionary implementation of fiscal policy: policy measures are less procyclical and more concerned with the sustainability of public debt. We also conclude that there is a complementary relationship between IFIs and the Stability and Growth Pact deficit rule, and that the performance of discretionary fiscal policy seems higher in countries with fiscal institutions than in countries with a predisposition for fiscal prudence.

Chronic impairments of static postural stability associated with history of concussion.

Postural stability deficits are commonly observed in cases of concussion. However, the objective duration in which impairments of standing postural stability remain following a concussion is often inconclusive. The present study was conducted to determine if prior history of concussion is associated with deficits in postural stability beyond the clinical determination of recovery. It was hypothesized that concussion history would be associated with decreases in static stability compared to individuals that have never sustained a concussion. Fifty-four healthy adults were recruited based on whether they reported sustaining one or more prior concussions (n = 27) or no history of concussion (n = 27). Participants were instructed to stand on a force platform to track center-of-pressure (CoP) during standing for thirty seconds under four conditions based on stance and number of tasks: (1) bipedal, single-task, (2) bipedal, dual-task, (3) unipedal, single-task, and (4) unipedal, dual-task. Results revealed that individuals with a history of concussion demonstrate significantly reduced postural stability under dual-task conditions as evidenced by increases in average displacements and elliptical area of postural sway as well as reductions in CoP sample entropy. However, there were no significant differences in CoP displacement or elliptical area between groups under single task conditions. Overall, these findings indicate that concussion is associated with impairments of maintaining standing postural stability that remain evident approximately 7 years following clinical resolution of the initial injury. The exacerbation of these impairments under dual-task conditions indicate that concussion can result in a reduced capacity to allocate proper attention resources to multiple concurrent objectives.

Rambling-trembling analysis of postural control in children aged 3-6 years diagnosed with developmental delay during infancy

BackgroundPreschool age is fundamental for the development of gross motor skills. Timely detection of postural stability deficits using objective methods would facilitate early implementation of therapeutic strategies. Research questionWhat are the age- and gender-related differences in postural control between preschool children diagnosed with developmental delay in their first year of life and children with typical development? MethodsThe study group consisted of 59 children diagnosed with developmental delay during infancy, who had received physiotherapy in the first year of their life for disorders of postural control and prone locomotion as well as abnormal distribution and magnitude of postural tone. The control group comprised 66 nursery school children with typical development and no history of postural control or movement deficits and no physiotherapy interventions in the first year of their life. The study and control groups were subdivided into four subgroups based on age (3–4 years, 5–6 years) and gender (boys, girls).The data were collected during quiet standing using a force plate. Three 30-second trials were recorded. Stabilographic recordings were analysed using the rambling-trembling approach. ResultsThree-way ANOVA revealed a gender effect on all measured variables (p < 0.05). The Tukey HSD (honest significant difference) post-hoc test showed that some of the values of sway range and mean velocity of COP, rambling and trembling in sagittal and frontal plane were significantly greater in control boys aged 3–4 years compared to other subgroups (p < 0.05). SignificanceLong-term postural control monitoring by a pediatrician and/or physiotherapist seems justified and not only in children with a history of infantile developmental delay but also in their healthy peers, especially boys.

Graded and pan-neural disease phenotypes of Rett Syndrome linked with dosage of functional MeCP2

Rett syndrome (RTT) is a progressive neurodevelopmental disorder, mainly caused by mutations in MeCP2 and currently with no cure. We report here that neurons from R106W MeCP2 RTT human iPSCs as well as human embryonic stem cells after MeCP2 knockdown exhibit consistent and long-lasting impairment in maturation as indicated by impaired action potentials and passive membrane properties as well as reduced soma size and spine density. Moreover, RTT-inherent defects in neuronal maturation could be pan-neuronal and occurred in neurons with both dorsal and ventral forebrain features. Knockdown of MeCP2 led to more severe neuronal deficits as compared to RTT iPSC-derived neurons, which appeared to retain partial function. Strikingly, consistent deficits in nuclear size, dendritic complexity and circuitry-dependent spontaneous postsynaptic currents could only be observed in MeCP2 knockdown neurons but not RTT iPSC-derived neurons. Both neuron-intrinsic and circuitry-dependent deficits of MeCP2-deficient neurons could be fully or partially rescued by re-expression of wild type or T158M MeCP2, strengthening the dosage dependency of MeCP2 on disease phenotypes and also the partial function of the mutant. Our findings thus reveal stable neuronal maturation deficits and unexpectedly, graded sensitivities of neuron-inherent and neural transmission phenotypes towards the extent of MeCP2 deficiency, which is informative for future therapeutic development.

Fall-related measures in elderly individuals and Parkinson's disease subjects.

Falls pose a serious problem in elderly and clinical populations. Most often, they lead to a loss of mobility and independence. They might also be an indirect cause of death. The aim of this study was to determine an objective predictor of the fear of falling and falls in elderly subjects (ESs) and Parkinson's disease (PD) subjects. Thirty-two ESs were examined in this study, of whom sixteen were diagnosed with PD. The testing procedures comprised force plate measurements (limit of stability test-LOS test) and clinical tests (Berg Balance Scale, Functional Reach Test, Timed Up and Go test, Tinetti test). The Falls Efficacy Scale International (FES-I) was used to evaluate the fear of falling. The range of the maximum forward lean was normalized to the length from the ankle joint to the head of the first metatarsal bone and was named the functional forward stability indicator (FFSI). The FFSI, derived from the LOS test, allowed us to demonstrate the real deficit in functional stability and individual safety margins. Moreover, the FFSI was highly correlated with the FES-I score and almost all clinical test results in elderly subjects (r>0,6; p<0.05). In PD subjects, the FFSI was poorly correlated with the fear of falling, the BBS score and the FR distance; however, a high correlation with the Tinetii test (r>0,6, p<0.05) was noted. The PD subjects presented a different balance strategy when close to their stability limits, which was also reflected in the lower values of sample entropy (t = (-2.40); p<0.05; d = 0.87). The FFSI might be a good predictor of the fear of falling in the group of elderly people. Additionally, the FFSI allows us to show real balance deficits both in PD subjects and in their healthy peers without the need for a reference group and norms. In conclusion, it is postulated that the popular clinical assessments of postural balance in PD subjects should be accompanied by reliable posturography measurements.

Vestibular, Spatial Cognition And Mental Fatigue Status Of Female Soccer Players Before A Competitive Season

PURPOSE: To examine visual-vestibular interaction and the relationship to visuospatial cognition, mental fatigue, and concussion history in female soccer players before the start of a competitive season. METHODS: Twenty-four NCAA Division 1 women’s soccer athletes participated in the study. All players completed medical history including dates and number of prior concussions. Vestibular and visual interaction was assessed using the Dynamic Visual Acuity Test (DVAT) which examines the loss in visual acuity when the head is moving in the yaw plane at 85 deg/sec or more compared to head stationary. Visuospatial cognition was assessed using the Symbol Digit Modalities Test (SDMT) and the Ray-Osterrieth Complex Figure (ROCF) while current fatigue level was assessed using the Mental Fatigue Scale (MFS). Spearman's correlations examined the correlations between DVAT loss and MFS, SDMT, and ROCF. Comparison of MFS, SDMT score, and ROCF score between groups based based on number of concussions was completed using t-tests. RESULTS: Of the 24 participants (mean age 19.3 ± 1.3), 15 had a prior history of concussion (range 1-7). Mean loss of visual acuity in the pitch plane in logMAR upwards was 0.14 ± 0.08 and downwards was 0.19 ± 0.1, and in the yaw plane was 0.15 ± 0.08 to the right and 0.14 ± 0.1 to the left (normative values for this age group are 0.08 ± 0.17 logMAR). The SDMT score was 59.88 ± 6.7, ROCF score was 29.9 ± 5.4, and MFS score was 6.9 ± 5.8. Spearman’s correlations showed significant relationships between DVAT loss to the right (p=0.04) and mental fatigue (p=0.04). Comparisons of athletes who had sustained 2 or more concussions compared to those with 0-1 showed significant differences in the MFS (p=0.03). CONCLUSIONS: Greater loss of dynamic visual acuity was seen in female soccer players before the start of a competitive season. Gaze stability deficits are correlated with higher mental fatigue and athletes who had 2 or more concussions had more mental fatigue.

Influence of multiple sclerosis on dynamic gait stability

Falls are a serious health threat for people with multiple sclerosis (MS). Dynamic gait stability has been identified as a key risk factor of falls. The development of effective interventions for preventing falls requires a sound understanding of how MS affects dynamic gait stability. The purpose of the study was to compare dynamic gait stability within the framework of Feasible Stability Region between people with and without MS during level walking at a self-selected speed. Twenty adults with MS and 25 age- and sex-matched healthy individuals were recruited. Dynamic gait stability at touchdown and liftoff on both the strong and weak sides was assessed as the primary outcome measurement. Spatiotemporal gait parameters, including step times, step length, step frequency, and foot landing angle, were determined as explanatory variables. People with MS exhibited lower stability at both gait events bilaterally than their healthy counterparts. The lower stability was mainly attributable to the slower gait speed in MS than in the healthy control. To compensate for the dynamic gait stability deficit resulting from the slow gait speed, individuals with MS adopted a short step length to shift the center of mass motion state closer to the feasible stability region. For people with MS, the stability value was higher on the weak side than on the strong side at touchdown, but not liftoff. The findings from this study could provide insight into the impact of MS on the control of dynamic gait stability.

If Not Now, When? An Absence of Neurocognitive and Postural Stability Deficits in Collegiate Athletes with One or More Concussions

A history of concussion has been associated with decreased neurocognitive function and postural control. The purpose of our study was to compare neurocognitive function and postural control in collegiate athletes with and without varying histories of concussion. Collegiate athletes were divided into groups based on 0 (n = 129), 1 (n = 91), 2 (n = 52), and 3+ (n = 34) prior concussions. Participants in each group were carefully matched by sport, sex, height, weight, and age. Athletes were administered the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT™) and the Sensory Organization Test (SOT) as part of a standard of care pre-season assessment. Group ImPACT (Verbal and Visual Memory, Visual Motor Speed, and Reaction Time) and SOT (Equilibrium Score and Somatosensory, Visual, and Vestibular sensory ratios) outcome scores were compared using one-way analyses of variance (ANOVAs). Coefficients of variation (CVs) were also calculated for each outcome score and were compared using two-sample tests with 95% confidence intervals (CIs). Participants with and without a history of concussion were not significantly different for any ImPACT or SOT outcome score (p's > 0.10). Groups (0, 1, 2, and 3+ previous concussions) were not different from each other for any ImPACT or SOT outcome score (p's ≥ 0.11). Likewise, the CVs associated with each ImPACT and SOT outcome score did not vary significantly between outcome scores for any group comparison (p ≥ 0.09). Our findings suggest that a history of one or more concussions does not influence neurocognitive performance or postural stability in collegiate athletes at their pre-season baseline assessment.

One-Year Stability of Frontoparietal Cognitive Control Network Connectivity in Recent Onset Schizophrenia: A Task-Related 3T fMRI Study.

Kraepelinian theory posits that schizophrenia (SZ) is a degenerative disorder that worsens throughout the lifespan. Behavioral studies of cognition have since challenged that viewpoint, particularly in the early phases of illness. Nonetheless, the extent to which cognition remains functionally stable during the early course of illness is unclear, particularly with regard to task-associated connectivity in cognition-related brain networks. In this study, we examined the 1-year stability of the frontoparietal control network during the AX-Continuous Performance Task (AX-CPT) from a new baseline sample of 153 participants scanned at 3T, of which 29 recent onset individuals with SZ and 42 healthy control (HC) participants had follow-up data available for analysis. Among individuals that had both baseline and follow-up data, reduced functional connectivity in SZ was observed between the dorsolateral prefrontal cortex (DLPFC) and superior parietal cortex (SPC) during the high control (B cue) condition. Furthermore, this deficit was stable over time, as no significant time × diagnosis interaction or effects of time were observed and intraclass correlation coefficients were greater than 0.6 in HCs and SZ. Previous 1.5T findings showing stable deficits with no evidence of degeneration in performance or DLPFC activation in an independent SZ sample were replicated. Overall, these results suggest that the neuronal circuitry supporting cognitive control is stably impaired during the early course of illness in SZ across multiple levels of analysis with no evidence of functional decline.

Does fatigue expose functional deficits in chronic lateral ankle sprain?

[Purpose] The purpose of this study was to examine whether functionally induced fatigue affects balance and vertical jump performance more severely in individuals with a history of unilateral lateral ligament injury to the ankle joint. [Participants and Methods] Twenty-three participants volunteered for the study with the experimental group (EG n=12) comprising injured participants with stability deficits and lack of physiotherapy treatment tested against healthy controls (CG n=11). Balance was assessed via a single leg balance test with open eyes on a force platform. The Center-of-Pressure (COP) excursion on the anteroposterior (Y-axis) and the mediolateral (X-axis) were recorded. Additionally, maximal single-leg vertical jump height (VJH) was assessed on a specific platform. Ankle fatigue was induced through performing the modified Square-hop test until exhaustion. [Results] Patients exhibited significant interaction for Time X Group for the COP on the X-axis. COP-X which did not differ between groups, pre-fatigue, while post-fatigue, it increased significantly in the EG. VJH demonstrated significant pre-fatigue differences between groups, suggesting that deficits in this variable were evident without the need to fatigue the muscles involved. [Conclusion] Fatigue can be useful when balance is tested, since post-fatigue deficits, otherwise obscured in the baseline measurement, can become significant.

US-China trade conflict: causes and consequences

At the present stage of development of international economic relations special attention is paid to the study of the relations between the countries that are the world leaders in terms of GDP and foreign trade – the USA and China. This is due to the fact that in recent years the US have introduced a number of measures to counteract the growth of Chinese exports, which has led to backlash from China. The subject of the study is the foreign trade relations of the USA and China. The goal is to analyze the influence of protectionist measures applied by the US and China on the development of their foreign economic relations. The following objectives are set: to determine the level of economic interdependence of the USA and the PRC, to investigate their impact on mutual trade flows and to analyze the dynamics of bilateral trade of countries under restrictive measures. The following methods are: comparative analysis, systematization and generalization, construction of regression models. The results of the analysis revealed that the US and PRC current accounts show reverse dynamics: the United States demonstrates stable deficit, while China has had surplus for many years. Moreover, the structures of the current accounts do differ a lot as well: the US is totally services-oriented country, whereas China is a major exporter of goods. It can be observed that both countries have experienced a recession of foreign economic activity since 2018, as far as their current account balances decreased substantially, which is likely to be the consequence of tariff barriers imposed by the US and PRC. Furthermore, due to trade confrontation, bilateral trade between these countries declines significantly as well, so that now China and the United States are forced to look for new export markets. The results of the regression models allow concluding that import from China is indeed having a negative impact on US exports, which has led to the US restrictions on imports from China. However, the introduction of mutual restrictions did not lead to an improvement of the US foreign trade.

Do Grade II Ankle Sprains Have Chronic Effects on the Functional Ability of Ballet Dancers Performing Single-Leg Flat-Foot Stance? An Observational Cross-Sectional Study

Ballet dancers have a higher risk than the general population of ankle sprains. Ankle proprioception is of the utmost importance for executing static and dynamic positions typical of ballet dancing. Ankle sprains can create changes in functional ability that may affect ballet performance. The aim of this cross-sectional observational study is to evaluate if non-professional ballet dancers that were previously injured with a grade II ankle sprain carry a long-term stability deficit in ballet specific positions (passé, arabesque) and in single-leg flat-foot stance, thereby affecting ballet performance. We enrolled 22 amateur female ballet dancers, 11 who previously had a grade II ankle injury and 11 who had no history of ankle injury. Stabilometric data (Center of Pressure Speed and Elipse Area) were assessed with the postural electronic multisensory baropodometer in normal, arabesque, and passè positions with both open and closed eyes. Using an unpaired t-test, we compared healthy and pathological feet of the ankle injury group for a standard monopodalic position and two ballet-specific positions. No difference between pathological and healthy feet of non-professional ballet dancers who suffered grade II ankle injury was detected. According to the parameters considered in this study, grade II ankle sprains seem to have a favorable prognosis in the sample that we evaluated.

Feet deformities and their close association with postural stability deficits in children aged 10\u201315\u2009years

BackgroundChildren and young people make up an age group most vulnerable to falls. Various stability disorders may become instrumental in sustaining more frequent falls and resultant fractures. Correct morphological structure impacts overall efficiency of the foot, as well as offers significant diagnostic potential. Even minor foot disorders may affect the entire bio kinematic chain, also impacting the foot’s motility. Structural alterations within a foot may also impair balance in the standing position, and contribute to more frequent injuries. The study aimed to assess the relationship between feet deformities and postural stability deficits in schoolchildren prone to sustain accidental falls.MethodsThe study involved 200 children (101 girls and 99 boys) aged 10–15 years,randomly selected from primary schools. A 2D podoscan was used to assess the plantar part of the foot, while stabilometric examination was aided by the FreeMed dynamometric platform.ResultsCorrelation between respective variables was reflected by Spearman’s rank coefficient. The subjects’ age negatively correlated with the COP range of movement along the Y axis, and the COP surface area, while their BMI negatively correlated with the COP trajectory’s length. Step regression analysis indicated that the width of the left foot, the left foot Wejsflog index, the left foot Clark’s angle, the hallux valgus angle were the essential predictors of stabilometric variables in girls. In boys, though, predictive value was associated with Clarke’s angle of the left and right foot, Wejsflog index of the right foot, and the width of both the left and right foot.ConclusionsThere is a statistically significant correlation between morphological variables of the foot and postural stability. When assessing the key variables of the foot and their interrelationship with postural stability, the Clarke’s angle, Wejsflog index, hallux valgus angle, and foot width, should be granted due prominence in the girls. As regards the boys, the following variables were established as predictive in assessing postural stability: Clarke’s angle, Wejsflog index, and foot width.

Are biomechanical stability deficits during unplanned single-leg landings related to specific markers of cognitive function?

ObjectivesCognitive skills such as working memory or inhibitory control are suggested to have an impact on injury risk during time-constrained athletic movements. Thus, the aim of this study was to gain further insights into the cognitive processes associated with biomechanical stability in unplanned jump-landings. DesignCross-sectional. MethodsTwenty male participants (27±4years) performed 70 counter-movement jumps with single-leg landings on a pressure plate. Equally balanced and in randomized order, these were to be performed either planned (landing leg indicated before take-off) or unplanned (visual cue during flight). Biomechanical stability was estimated from vertical peak ground reaction force (pGRF), time to stabilization (TTS), center of pressure path length (COP), and the number of standing errors (ground touch with free leg). In addition, decision-making was assessed as the amount of landing errors (wrong/both feet) in the unplanned condition. Cognitiive function was measured using computerized as well as pen-and-paper-testing. ResultsUnplanned landings produced higher COP values (p<0.001, d=1.1) and more standing errors (p<0.001, d=0.9) than the pre-planned condition. Decreased postural stability (COP) was related to lower inhibitory control (p=0.036, r=0.48). There was a correlation between the increase in standing errors and better cognitive flexibility/working memory (p=0.037, r=−0.48) and short-term memory (p=0.028, r=0.50). The opposite was found for the unplanned landing errors: poor decision-making was associated with deficits in cognitive flexibility/working memory (p=0.022, r=0.54) and short-term memory (p=0.019, r=−0.55). ConclusionsCognitive function may be an important, but under-researched moderator of unplanned jump-landing safety. Further research should elucidate the development of training methods aiming to improve movement-related decision-making and landing stability under time constraints.

ORGANIZATION OF THE EMISSION OF THE BONDED LOAN OF THE PENSION FUND OF RUSSIA AS A WAY OF FINANCING ITS BUDGET DEFICIT

In recent years, revenues and expenditures of the PFR budget are constantly growing, and their growth is about the same magnitude. The decrease in revenues in 2014 was due to a decrease in allocations from the Federal budget, as well as a change in the legislation on compulsory pension insurance, in accordance with which it was decided to send all insurance contributions at the individual rate to finance the insurance part of the labor pension. Since 2014, there has been a stable deficit. According to forecast data, the budget for the next years is also planned to be deficit. Taking into account that the state pension provision is planned and financed by the target method at the expense of allocations, it can be stated that the deficit of the PFR budget is associated with a shortage of incoming insurance contributions for the payment of insurance pensions. This may be due to the following reasons: a significant increase in the number of old-age pensioners with a relatively stable working-age population; insufficient income in the form of insurance contributions (informal wages, shadow business); lack of alternative sources of funding. With the first problem, the Russian Government decided to fight by an unpopular method - to reduce the increase in the number of pensioners by increasing the retirement age. This, in our view, exacerbates the existing problem of public distrust in the pension system in general and in the pension policy in particular. That in turn, among other factors, is the cause of the second problem - the growth of "gray" wages and unpaid insurance premiums. Thus, these problems need to be solved radically, which requires considerable time and a serious elaborated pension policy of the Government of the Russian Federation. It is proposed to use the issue of a pension bond loan as a measure in the operational management of the pension cash gap and strategic management of the budget deficit of the PFR.

Gaze Stability Deficits Persist Long After Concussion Injury

To examine if gaze stability deficits persist for at least one year after a concussion. A secondary objective was to examine the relationship between gaze stability, sleep, and psychological symptoms.

BLAST paradigm: A new test to assess brief attentional fluctuations in children with epilepsy, ADHD, and normally developing children

BackgroundPure attentional deficits are still underdiagnosed in children with epilepsy. While attention-deficit hyperactivity disorder (ADHD) is historically the most studied cause of attentional disorders, an important number of children with epilepsy and attentional complaints do not fully meet the DSM-V (Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition) criteria for ADHD and may be excluded from specific care. Clinical tools currently available are insufficient to detect more subtle but clinically relevant attentional fluctuations. Objective/methodsThe recently developed Bron–Lyon Attention Stability Test (BLAST) was used to evaluate brief attentional fluctuations with a high temporal precision. Drawing on two new attentional indices, we evaluated spontaneous fluctuations of response accuracy and timing, underlying attentional stability. The main objective was to assess attentional stability in children with i) epilepsy with comorbid ADHD, ii) epilepsy without comorbid ADHD, iii) ADHD not medicated and without epilepsy, and iv) normal development. Further objectives were to assess the main determinants of attentional stability in those groups, including the effect of factors related to the epileptic condition. ResultsIn 122 children with epilepsy (67 with comorbid ADHD), 52 children with ADHD, and 53 healthy controls, we demonstrated lower attentional stability in both the groups with epilepsy and ADHD compared with healthy children. In children with epilepsy, BLAST scores were negatively associated with earlier seizure onset and AED (antiepileptic drug) polytherapy, while the seizure frequency, epilepsy duration, or type did not influence BLAST scores. ConclusionsThis study demonstrates that attentional stability is impaired in children with epilepsy and/or ADHD. Bron–Lyon Attention Stability Test seems to be a sensitive test to detect attentional stability deficit in children with epilepsy and with attentional complaints who did not meet all criteria of ADHD.We propose that BLAST could be a useful clinical neuropsychological tool to assess attentional disorders in children.