Conservative treatment of type A aortic dissection following hybrid arch repair

Abstract

Objective

Type A aortic dissection (TAAD) following hybrid arch repair (HAR) is a lethal complication. Open surgical repair is the ideal treatment, but this can be difficult, as most candidates have complications and are unsuitable for the conventional open aortic repair. We herein report three cases of TAAD after HAR and assess the treatment options.

Methods

Of 261 aortic arch repair cases between April 2010 and March 2018, 38 underwent HAR using debranching of all the arch vessels followed by stent graft implantation landing proximally in zone 0 (type 1 HAR). Three cases suffered from TAAD, and their background characteristics and post-operative outcomes were studied retrospectively.

Results

The three TAAD cases were elderly with a high risk of mortality due to comorbidities. TAAD for Cases 1, 2, and 3 was detected on post-operative day (POD) 11, POD11, and during the procedure, respectively. Case 1 was complicated with both respiratory and renal failures, and Case 3 suffered from severe neurological impairment when TAAD was detected. No additional open aortic repair was performed in any cases. Case 3 died on POD5 due to aortic rupture. Cases 1 and 2 have survived for more than 50 months since their initial surgeries.

Conclusions

TAAD following HAR can be detected with post-operative imaging despite a lack of signs noted during the intra- and post-operative periods. Conservative therapy might, therefore, be an acceptable option for subacute-onset TAAD following HAR with stable hemodynamics, even though such patients do required a very careful follow-up.

http://bit.ly/2sUgtL3

High-flux thin film nanocomposite forward osmosis membrane incorporated with blue lemon polyoxometalate based open-framework

Abstract

In this study a novel type of polyoxometalate based open-frameworks (POM-OFs) by using blue lemon (BL) as POM and tetrabutylammonium bromide (TBAB) as organic cationic coordinating agent successfully synthesized (BL.TBA-OFs) and incorporated in polyamide active layer via interfacial polymerization (IP) to fabricate hydrophilic and high water permeable thin-film nanocomposite (TFN) membranes. The prepared POM-OFs and TFN membranes were fully characterized using physicochemical techniques and the effect of POM-OFs incorporation on TFN membranes performance was investigated using reverse osmosis (RO) and forward osmosis (FO) experiments with regard to the water permeability, salt rejection, and selectivity. The enhancement in hydrophilicity of TFN membranes was confirmed by contact angle measurements, which attributed to the presence of superhydrophilic BL.POM. Water flux of the TFN-BL.TBA-4 membrane (with 400 ppm BL.TBA-OFs incorporation) increased from 18.1 to 28.6 LMH in FO mode, and 23.1 to 36.3 LMH in PRO mode, in comparison with unmodified TFC membrane. Enhancement in separation performance of the modified TFN membranes was attributed to the incorporation of nanopores BL.POM, which create short water pathways. By using sodium alginate as a foulant model the novel modified membrane showed better anti-fouling propensity than the TFC one. This report opens up a new modification route in the achieving of high efficient TFN membranes for FO process.

http://bit.ly/2RsAdiE

Danke an alle Gutachter 2018

http://bit.ly/2HF7300

Erfassung von tatsächlichem Schlafverhalten und Beschwerdesymptomatik mittels Selbstrating-Diagnostikfragebogen – eine Validierung anhand von Schlaftagebüchern

Zusammenfassung

Hintergrund

In der klinischen Routine werden retrospektive Selbstbewertungsfragebögen zu schlafassoziierten Symptomen als diagnostisches Instrument eingesetzt, ihre tatsächliche Validität ist bisher dennoch kaum untersucht. Auch ein aus dem Diagnostikfragebogen gebildeter Schlafqualitätsindex könnte dem Schlafmediziner einen schnellen Zugang zur weiteren spezifischen Anamnese ermöglichen.

Fragestellung

Es wurde überprüft, ob ein Diagnostikfragebogen, welcher eigens im Schlaflabor entwickelt wurde, sowie ein daraus abgeleiteter Schlafqualitätsindex valide Abbildungen von Schlafgewohnheiten und Beschwerdesymptomatik bei Patienten mit schlafbezogener Atmungsstörung (SBAS) darstellen.

Material und Methode

Von 326 Patienten mit Verdacht auf SBAS wurden ein zweiwöchiges Schlaftagebuch sowie ein Diagnostikfragebogen bearbeitet, welcher das Schlafverhalten der vorangegangenen vier Wochen erfasste. Mittels schrittweiser generalisierter linearer Regressionen wurde untersucht, ob die Angaben des Fragebogens korrespondierende Angaben des Tagebuchs vorhersagen. Ein aus dem Diagnostikfragebogen gebildeter Schlafqualitätsindex wurde ebenfalls als Prädiktor untersucht. Personenmerkmale (Geschlecht, Alter etc.) wurden adjustiert.

Ergebnisse

Die schlafbezogenen Fragebogenitems sagten die Tagebuchangaben signifikant vorher (p < 0,001). Der Schlafqualitätsindex (10,43 ± 6,16 Punkte) zeigte sich darüber hinaus als zusätzlicher Prädiktor für das Gefühl des Erholtseins, die Tagesschläfrigkeit und Konzentrationsfähigkeit (alle p < 0,05), nicht aber für die Einschlaflatenz (p > 0,05).

Schlussfolgerung

Ein laboreigener Diagnostikfragebogen ist eine valide Methode zur Erfassung von Schlafgewohnheiten und der Beschwerdesymptomatik bei Patienten mit schlafbezogener Atmungsstörung. Der Schlafqualitätsindex vermittelt Informationen über den subjektiven Tageszustand eines Patienten, was ihn als wertvolles Werkzeug des diagnostischen Prozesses auszeichnet.

http://bit.ly/2Sn4Bjf

Bilingual Children with Hearing Loss Learn Words Better with Bilingual Instruction

A new study conducted by a team from Vanderbilt University found that bilingual children with hearing loss learned new vocabulary better when taught using bilingual instruction. The researchers evaluated the effectiveness of bilingual and monolingual teaching practices to identify which method would work best with these children who face unique but under-investigated challenges in language learning.

The idea for the study was sparked when Ana Soares, a teacher of the deaf, and Andrea Vargas, a speech-language pathologist, from Mama Lere Hearing School at Vanderbilt noticed challenges that affected Spanish-speaking families when helping their children with hearing loss learn a language. 

"There are many different ideas on how to teach children learning more than one language, and this debate includes children with hearing loss who are bilingual," explained the study's lead author Jena C. McDaniel. "An ongoing difference in opinion is whether new vocabulary should be taught in the native language, the new language, or both. More importantly, some have argued that teaching in the native language harms the ability to learn words in the new language."

Surprised with the dearth of research into this important issue, the team set out to investigate for themselves. "We recognized the need for more evidence on how to meet the language needs of children with hearing loss who are bilingual, including the language used for intervention and instruction, and wanted to be a part of generating and disseminating that knowledge," McDaniel told The Hearing Journal. "Thus, we created a clinician-researcher team with the goal of optimizing intervention services and language outcomes for children with hearing loss who are bilingual." 

The study, which involved giving alternating bilingual or monolingual language instructions to three Spanish–English-speaking children with hearing loss, provided evidence that put to question a prevalent belief in language teaching.

"When we counted words said in both languages (i.e., conceptual vocabulary), bilingual children with hearing loss showed more effective word learning when they received instruction in Spanish and English compared with being taught in English alone. We did not find any evidence of an inhibitory effect of instruction in Spanish on the children's word learning in English," noted McDaniel. "That is, there was no harmful effect when children were taught in their native language."

"These findings do not support the widespread, but understudied, recommendation to teach bilingual children with hearing loss or other disabilities exclusively in English," she added. "Our data suggest that there is no benefit to decreasing these learning opportunities by recommending that these children be taught the new language exclusively (i.e., English only)."     

This study also helps the case of families who want to stay connected with their culture and native language. McDaniel noted, "We believe these findings are important because teaching children with hearing loss in their native language maximizes opportunities to learn new words from parents, siblings, and other community members who speak the child's native language."

Moving forward, the team hopes to replicate the study with participants with more diverse hearing loss profiles and language levels. "We would also like to focus on conceptual vocabulary as the primary dependent variable, vary the details of the bilingual intervention systematically to optimize its effectiveness, and target language skills other than vocabulary," shared McDaniel.

Published: 1/30/2019 11:09:00 AM

from #Audiology via ola Kala on Inoreader http://bit.ly/2HIwwpt

Bilingual Children with Hearing Loss Learn Words Better with Bilingual Instruction

A new study conducted by a team from Vanderbilt University found that bilingual children with hearing loss learned new vocabulary better when taught using bilingual instruction. The researchers evaluated the effectiveness of bilingual and monolingual teaching practices to identify which method would work best with these children who face unique but under-investigated challenges in language learning.

The idea for the study was sparked when Ana Soares, a teacher of the deaf, and Andrea Vargas, a speech-language pathologist, from Mama Lere Hearing School at Vanderbilt noticed challenges that affected Spanish-speaking families when helping their children with hearing loss learn a language. 

“There are many different ideas on how to teach children learning more than one language, and this debate includes children with hearing loss who are bilingual,” explained the study’s lead author Jena C. McDaniel. “An ongoing difference in opinion is whether new vocabulary should be taught in the native language, the new language, or both. More importantly, some have argued that teaching in the native language harms the ability to learn words in the new language.”

Surprised with the dearth of research into this important issue, the team set out to investigate for themselves. “We recognized the need for more evidence on how to meet the language needs of children with hearing loss who are bilingual, including the language used for intervention and instruction, and wanted to be a part of generating and disseminating that knowledge,” McDaniel told The Hearing Journal. “Thus, we created a clinician-researcher team with the goal of optimizing intervention services and language outcomes for children with hearing loss who are bilingual.” 

The study, which involved giving alternating bilingual or monolingual language instructions to three Spanish–English-speaking children with hearing loss, provided evidence that put to question a prevalent belief in language teaching.

“When we counted words said in both languages (i.e., conceptual vocabulary), bilingual children with hearing loss showed more effective word learning when they received instruction in Spanish and English compared with being taught in English alone. We did not find any evidence of an inhibitory effect of instruction in Spanish on the children’s word learning in English,” noted McDaniel. “That is, there was no harmful effect when children were taught in their native language.”

“These findings do not support the widespread, but understudied, recommendation to teach bilingual children with hearing loss or other disabilities exclusively in English,” she added. “Our data suggest that there is no benefit to decreasing these learning opportunities by recommending that these children be taught the new language exclusively (i.e., English only).”     

This study also helps the case of families who want to stay connected with their culture and native language. McDaniel noted, “We believe these findings are important because teaching children with hearing loss in their native language maximizes opportunities to learn new words from parents, siblings, and other community members who speak the child’s native language.”

Moving forward, the team hopes to replicate the study with participants with more diverse hearing loss profiles and language levels. “We would also like to focus on conceptual vocabulary as the primary dependent variable, vary the details of the bilingual intervention systematically to optimize its effectiveness, and target language skills other than vocabulary,” shared McDaniel.

Published: 1/30/2019 11:09:00 AM

from #Audiology via ola Kala on Inoreader http://bit.ly/2HIwwpt
via IFTTT

Bilingual Children with Hearing Loss Learn Words Better with Bilingual Instruction

A new study conducted by a team from Vanderbilt University found that bilingual children with hearing loss learned new vocabulary better when taught using bilingual instruction. The researchers evaluated the effectiveness of bilingual and monolingual teaching practices to identify which method would work best with these children who face unique but under-investigated challenges in language learning.

The idea for the study was sparked when Ana Soares, a teacher of the deaf, and Andrea Vargas, a speech-language pathologist, from Mama Lere Hearing School at Vanderbilt noticed challenges that affected Spanish-speaking families when helping their children with hearing loss learn a language. 

“There are many different ideas on how to teach children learning more than one language, and this debate includes children with hearing loss who are bilingual,” explained the study’s lead author Jena C. McDaniel. “An ongoing difference in opinion is whether new vocabulary should be taught in the native language, the new language, or both. More importantly, some have argued that teaching in the native language harms the ability to learn words in the new language.”

Surprised with the dearth of research into this important issue, the team set out to investigate for themselves. “We recognized the need for more evidence on how to meet the language needs of children with hearing loss who are bilingual, including the language used for intervention and instruction, and wanted to be a part of generating and disseminating that knowledge,” McDaniel told The Hearing Journal. “Thus, we created a clinician-researcher team with the goal of optimizing intervention services and language outcomes for children with hearing loss who are bilingual.” 

The study, which involved giving alternating bilingual or monolingual language instructions to three Spanish–English-speaking children with hearing loss, provided evidence that put to question a prevalent belief in language teaching.

“When we counted words said in both languages (i.e., conceptual vocabulary), bilingual children with hearing loss showed more effective word learning when they received instruction in Spanish and English compared with being taught in English alone. We did not find any evidence of an inhibitory effect of instruction in Spanish on the children’s word learning in English,” noted McDaniel. “That is, there was no harmful effect when children were taught in their native language.”

“These findings do not support the widespread, but understudied, recommendation to teach bilingual children with hearing loss or other disabilities exclusively in English,” she added. “Our data suggest that there is no benefit to decreasing these learning opportunities by recommending that these children be taught the new language exclusively (i.e., English only).”     

This study also helps the case of families who want to stay connected with their culture and native language. McDaniel noted, “We believe these findings are important because teaching children with hearing loss in their native language maximizes opportunities to learn new words from parents, siblings, and other community members who speak the child’s native language.”

Moving forward, the team hopes to replicate the study with participants with more diverse hearing loss profiles and language levels. “We would also like to focus on conceptual vocabulary as the primary dependent variable, vary the details of the bilingual intervention systematically to optimize its effectiveness, and target language skills other than vocabulary,” shared McDaniel.

Published: 1/30/2019 11:09:00 AM

from #Audiology via ola Kala on Inoreader http://bit.ly/2HIwwpt
via IFTTT

Optimization of Recurrence Quantification Analysis for Detecting the Presence of Multiple Sclerosis

Abstract

Purpose

The visual patterns in recurrence plots of time-series data can be quantified using recurrence quantification analysis (RQA), a phase-space-based method. The ability to quantitate recurrence plots affords the possibility of using them to solve central biomedical problems, for example detecting the presence of neurological diseases. Our goal was to assess this application by statistically comparing the values of plot-based quantifiers of electroencephalograms (EEGs) from patients having multiple sclerosis (MS) with values from the EEGs of control subjects.

Methods

First, employing a model system consisting of the addition of known deterministic signals to the EEG of normal subjects, we empirically identified the embedding conditions that facilitated detection of the effect of the addition of the signals. Second, we used the conditions thus identified to compare EEGs from 10 patients with MS and 10 age- and gender-matched control subjects, using seven standard recurrence-plot quantifiers.

Results

We identify embedding dimension of 5 points and time delay of 5 points as conditions that maximize the ability of RQA to detect the presence of deterministic activity in EEGs time series sampled at 500 Hz. The values of the RQA quantifiers computed from the EEGs of the MS patients were significantly greater than the corresponding values from the controls, indicating that the presence of the disease was associated with detectable changes in the EEG (family-wise error < 0.05%).

Conclusions

Recurrence plots detected the occurrence of alterations in EEGs associated with the presence of MS, indicating a decreased complexity (increased order) of brain electrical activity associated with brain disease.

http://bit.ly/2Tsvek5

Hearing loss and cognitive decline: Study probes link

Data from an 8-year study of 10,000 men aged 62 or older reveals a link between hearing loss and a markedly greater risk of subjective cognitive decline.

from #Audiology via ola Kala on Inoreader http://bit.ly/2G8Xi7Y
via IFTTT

Hearing loss and cognitive decline: Study probes link

Data from an 8-year study of 10,000 men aged 62 or older reveals a link between hearing loss and a markedly greater risk of subjective cognitive decline.

from #Audiology via ola Kala on Inoreader http://bit.ly/2G8Xi7Y
via IFTTT

Hearing loss and cognitive decline: Study probes link

Data from an 8-year study of 10,000 men aged 62 or older reveals a link between hearing loss and a markedly greater risk of subjective cognitive decline.

from #Audiology via ola Kala on Inoreader http://bit.ly/2G8Xi7Y

Mining frequent and top-K High Utility Time Interval-based Events with Duration patterns

Abstract

Traditional frequent sequential pattern mining only considers the time point-based item or event in the patterns. However, in many application, the events may span over multiple time points and the relations among events are also important. Time interval-based pattern mining is proposed to mine the interesting patterns of events that span over some time periods and also by considering the relations among events. Previous works of time interval-based pattern mining focused on the relations between events without considering the duration of each event. However, the same event with different time duration may cause different results. In this work, we propose two algorithms, SARA and SARS, for mining frequent time interval-based events with duration, TIED, patterns. TIED patterns not only keep the relations between two events but also reveal the time periods when each event happens and ends. For the performance evaluation, we propose a naive algorithm and modify a previous algorithm along with the implementation of SARA and SARS. The experimental results show that SARA and SARS are more efficient in terms of execution time and memory usage than other two algorithms. Moreover, we extend this work by considering utility value or importance of event in each time stamp. Therefore, we propose another new High Utility Time Interval-based Events with Duration, HU-TIED, pattern. HU-TIED incorporates the concept of utility pattern mining and TIED pattern mining. We design an algorithm, LMSpan, to mine top-K HU-TIED patterns. For the performance evaluation, we design a baseline algorithm, GenerateNCheck to compare with LMSpan. LMSpan takes less time and memory and generates less candidates than GenerateNCheck.

http://bit.ly/2RYG18P

Evidence for skeletal muscle fiber type-specific expressions of mechanosensors

Abstract

Mechanosensors govern muscle tissue integrity and constitute a subcellular structure known as costameres. Costameres physically link the muscle extracellular matrix to contractile and signaling 'hubs' inside muscle fibers mainly via integrins and are localized beneath sarcolemmas of muscle fibers. Costameres are the main mechanosensors converting mechanical cues into biological events. However, the fiber type-specific costamere architecture in muscles is unexplored. We hypothesized that fiber types differ in the expression of genes coding for costamere components. By coupling laser microdissection to a multiplex tandem qPCR approach, we demonstrate that type 1 and type 2 fibers indeed show substantial differences in their mechanosensor complexes. We confirmed these data by fiber type population-specific protein analysis and confocal microscopy-based localization studies. We further show that knockdown of the costamere gene integrin-linked kinase (Ilk) in muscle precursor cells results in significantly increased slow-myosin-coding Myh7 gene, while the fast-myosin-coding genes Myh1, Myh2, and Myh4 are downregulated. In parallel, protein synthesis-enhancing signaling molecules (p-mTOR^Ser2448, p < 0.05; p-P70S6K^Thr389, tendency with p < 0.1) were reduced upon Ilk knockdown. However, overexpression of slow type-inducing NFATc1 in muscle precursor cells did not change Ilk or other costamere gene expressions. In addition, we demonstrate fiber type-specific costamere gene regulation upon mechanical loading and unloading conditions. Our data imply that costamere genes, such as Ilk, are involved in the control of muscle fiber characteristics. Further, they identify costameres as muscle fiber type-specific loading management 'hubs' and may explain adaptation differences of muscle fiber types to mechanical (un)loading.

http://bit.ly/2Une8nw

Modeling Nanoparticle Transport in Porous Media in the Presence of a Foam

Abstract

Nano-remediation is a promising in situ remediation technology. It consists in injecting reactive nanoparticles (NPs) into the subsurface for the displacement or the degradation of contaminants. However, due to the poor mobility control of the reactive nanoparticle suspension, the application of nano-remediation has some major challenges, such as high mobility of the particles, which may favor override of the contamination, and particle aggregation, which can lead to a limited distance of influence. Previous experimental studies show the potential of combining nano-remediation with foam flooding to overcome these issues. However, in order to design and optimize the process, a model which couples nanoparticle and foam transport is necessary. In this paper, a mechanistic model to describe the transport of NPs with and by a foam is presented. The model considers the delivery of nanoscale zero-valent iron (nZVI) and accounts for the processes of aggregation, attachment/detachment, and generation/destruction. Simulations show that when NPs are dispersed in the liquid phase, even in the presence of a foam, they may travel much slower than the NPs carried by the foam bubbles. This is because the nanoparticles in suspension are affected by the attachment onto the rock walls and straining at the pore throats. When the nanoparticle surface is, instead, modified in order to favor their adsorption onto the gas bubbles, NPs are carried by the foam without retardation, except for the small fraction suspended in the liquid phase. Moreover, very stable high-quality foam ( \(f_\mathrm{g}\) ), i.e., 80–90 vol% of gas, can be attained using properly surface-modified nZVI (i.e., a nanoparticle-stabilized foam), allowing a significant reduction of water for the operation, while increasing the efficiency of nZVI delivery, even in a low-permeability medium within the shallow subsurface.

http://bit.ly/2HHveLr

Geographic Inequities in Coverage of Maternal and Child health Services in Haryana State of India

Abstract

Introduction India aims to achieve universal health coverage, with a focus on equitable delivery of services. There is significant evidence on extent of inequities by income status, gender and caste. In this paper, we report geographic inequities in coverage of reproductive, maternal and child health (MCH) services in Haryana state of India. Methods Cross-sectional data on utilization of maternal, child health and family planning services were collected from 12,191 women who had delivered a child in the last one year, 10314 women with 12–23 months old child, and 45864 eligible couples across all districts in Haryana state. Service coverage was assessed based on eight indicators − 6 for maternal health, one for child health and one for family planning. Inter- and intra-district inequalities were compared based on four and three indicators respectively. Results Difference in coverage of full ante-natal care, full immunization and contraceptive prevalence rate between districts performing best and worst was found to be 54%, 65% and 63% respectively. More than one-thirds of the sub-centres (SCs) in Panchkula, Ambala, Gurgaon and Mewat districts had their ante-natal care coverage less than 50% of the respective district average. Similarly, a significant proportion of SCs in Mewat, Panipat and Hisar districts had full immunization rate below 50% of the district average. Conclusion Widespread inter- and intra-district inequities in utilization of MCH services exist. A comprehensive geographical targeting to identify poor performing districts, community development blocks and SCs could result in significant equity gains, besides contributing to quick achievement of sustainable development goals.

http://bit.ly/2GbqbjT

Reoperation following lumbar spinal surgery: costs and outcomes in a UK population cohort study using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES)

Abstract

Purpose

To assess the likelihood of persistent postoperative pain (PPP) following reoperation after lumbar surgery and to estimate associated healthcare costs.

Methods

This is a retrospective cohort study using two linked UK databases: Hospital Episode Statistics and UK Clinical Practice Research Datalink. Costs and outcomes associated with reoperation were evaluated over a 2-year postoperative period using multivariate logistic regression for cases who underwent reoperation and controls who did not, based on demographics, index surgery type, smoking status, and pre-index comorbidities using propensity score matching.

Results

Risk factors associated with reoperation included younger age and the presence of diabetes with complications or rheumatic disease. The rate of PPP after reoperation was much higher than after index surgery, with 79 of 200 (39.5%; 95% CI 32.5%, 46.5%) participants experiencing ongoing pain compared with 983 of 5022 (19.5%; 95% CI 18.5%, 20.7%) after index surgery. Mean costs in the 2 years following reoperation were £1889 higher (95% CI £2, £3809) than for patients with PPP who did not undergo repeat surgery over an equivalent follow-up period. With the cost of reoperation itself included, the mean cost difference for patients who underwent reoperation compared with matched controls rose to £7221 (95% CI £5273, £9206).

Conclusions

High rates of PPP and associated healthcare costs suggest that returning to the operating room is a complex and challenging decision. Spinal surgeons should review whether the potential benefits of additional surgery are justified when other approaches to managing and relieving chronic pain have demonstrated superior outcomes.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

http://bit.ly/2RUDwEm

Streptococcus macedonicus strains isolated from traditional fermented milks: resistance to gastrointestinal environment and adhesion ability

Abstract

In this study, Streptococcus macedonicus (S. macedonicus) strains were identified from Algerian traditional fermented milks (Lben and Rayeb). Important prerequisites of probiotic interest such as acidity, bile salts tolerance, and adhesion ability to epithelial cells were investigated. A combination of phenotypic (ability to grow on Bile Esculin Azide medium, BEA; on high salt content medium NaCl 6.5%; on alkaline medium pH 9.6) and genotypic approaches (16S rRNA, ITS genes sequencing and MLST technique) allowed to identify four genetically distinct strains of S. macedonicus. These four strains and two references, Streptococcus thermophilus LMD-9 and Lactobacillus rhamnosus GG (LGG), were tested for their capacity to survive at low pH values, and at different concentrations of an equimolar bile salts mixture (BSM). Two different cell lines, Caco-2 TC7 and HT29-MTX, were used for the adhesion study. The results show that S. macedonicus strains selected constitute a distinct genetic entity from the Greek strain S. macedonicus ACA-DC-198. They were able to survive up to pH 3 and could tolerate high concentrations of bile salts (10 mM), unlike LMD-9 and LGG strains. Our strains also display in vitro adhesion similar to the LGG strain on Caco-2 TC7 and higher adhesion than the LMD-9 strain to Caco-2 TC7 and HT29-MTX cell models. This first characterization allows considering S. macedonicus as a potential candidate for possible probiotic effects that need to be investigated.

http://bit.ly/2MKGhT6

Geographic Inequities in Coverage of Maternal and Child health Services in Haryana State of India

Abstract

Introduction India aims to achieve universal health coverage, with a focus on equitable delivery of services. There is significant evidence on extent of inequities by income status, gender and caste. In this paper, we report geographic inequities in coverage of reproductive, maternal and child health (MCH) services in Haryana state of India. Methods Cross-sectional data on utilization of maternal, child health and family planning services were collected from 12,191 women who had delivered a child in the last one year, 10314 women with 12–23 months old child, and 45864 eligible couples across all districts in Haryana state. Service coverage was assessed based on eight indicators − 6 for maternal health, one for child health and one for family planning. Inter- and intra-district inequalities were compared based on four and three indicators respectively. Results Difference in coverage of full ante-natal care, full immunization and contraceptive prevalence rate between districts performing best and worst was found to be 54%, 65% and 63% respectively. More than one-thirds of the sub-centres (SCs) in Panchkula, Ambala, Gurgaon and Mewat districts had their ante-natal care coverage less than 50% of the respective district average. Similarly, a significant proportion of SCs in Mewat, Panipat and Hisar districts had full immunization rate below 50% of the district average. Conclusion Widespread inter- and intra-district inequities in utilization of MCH services exist. A comprehensive geographical targeting to identify poor performing districts, community development blocks and SCs could result in significant equity gains, besides contributing to quick achievement of sustainable development goals.

http://bit.ly/2GbqbjT

Early Menstrual Factors Are Associated with Adulthood Cardio-Metabolic Health in a Survey of Mexican Teachers

Abstract

Objectives To evaluate whether age at menarche and time to menstrual regularity were related to cardio-metabolic risk factors in Mexican women. Methods The study population comprised 54,921 women from the 2008–2010 wave of the Mexican Teacher's Cohort. A modified Poisson approach was used; exposures were age at menarche and time to menstrual regularity (< 1 year vs. ≥1 year), and outcomes were prevalent obesity, type 2 diabetes, high blood pressure, and high cholesterol. Results Mean (SD) age of women was 42.1 (7.6) years, and mean (SD) menarcheal age was 12.5 (1.5) years. Compared to women with menarche age 13 years, those with menarche < 9 years had a 65% (95% CI 43–90%); 27% (95% CI 4–55%); and 23% (95% CI 1–49%) higher prevalence of obesity, high blood pressure, and high cholesterol, respectively. For diabetes, there was a U-shaped association; compared to menarche age 13 years, those with menarche < 9 years had an 89% higher prevalence of diabetes (95% CI 39–156%), and those with menarche ≥ 17 years had a 65% higher prevalence (95% CI 16–134%). Among women with regular cycles (n = 43,113), a longer time to menstrual regularity was associated with diabetes (PR = 1.11 with 95% CI 1.02–1.22), high blood pressure (PR = 1.11 with 95% CI 1.06–1.17), and high cholesterol (PR = 1.09 with 95% CI 1.04–1.14). Conclusions for practice Mexican women with earlier and later ages at menarche and/or longer time to menstrual regularity may have higher risk of cardio-metabolic disease in adulthood.

http://bit.ly/2ShaoXl

Komplementärmedizinische Behandlungsansätze bei oraler Mukositis und Xerostomie

Zusammenfassung

Hintergrund

Patienten mit Tumoren im Kopf-Hals-Bereich leiden oft an einer iatrogenen Mukositis und Mundtrockenheit, die auch langfristig zu einer erheblichen Beeinträchtigung der Ernährung führen können.

Methode

Es erfolgte eine Zusammenstellung klinisch bereits geprüfter komplementärmedizinischer Behandlungsansätze und eine ergänzende Auflistung phytotherapeutischer Möglichkeiten aus dem Kanon der Traditionellen Europäischen Medizin.

Ergebnisse

Sowohl zur Behandlung der akuten Stomatitis und Mukositis als auch der akuten Xerostomie gibt es eine Reihe medikamentöser und nichtmedikamentöser Behandlungsansätze, die der Onkologe kennen und beachten sollte. Europäische Phytotherapeutika sind bisher relativ selten einer klinischen Prüfung unterzogen worden.

Schlussfolgerungen

Die Nutzung komplementärmedizinischer Maßnahmen kann für die Behandlung der Mukositis und der Xerostomie im Einzelfall sinnvoll sein. Forschungsbedarf besteht insbesondere auf dem Gebiet der traditionellen europäischen Heilkräuter, da diese eine hohe Akzeptanz bei den Patienten haben.

http://bit.ly/2B9mE2w

Early Menstrual Factors Are Associated with Adulthood Cardio-Metabolic Health in a Survey of Mexican Teachers

Abstract

Objectives To evaluate whether age at menarche and time to menstrual regularity were related to cardio-metabolic risk factors in Mexican women. Methods The study population comprised 54,921 women from the 2008–2010 wave of the Mexican Teacher's Cohort. A modified Poisson approach was used; exposures were age at menarche and time to menstrual regularity (< 1 year vs. ≥1 year), and outcomes were prevalent obesity, type 2 diabetes, high blood pressure, and high cholesterol. Results Mean (SD) age of women was 42.1 (7.6) years, and mean (SD) menarcheal age was 12.5 (1.5) years. Compared to women with menarche age 13 years, those with menarche < 9 years had a 65% (95% CI 43–90%); 27% (95% CI 4–55%); and 23% (95% CI 1–49%) higher prevalence of obesity, high blood pressure, and high cholesterol, respectively. For diabetes, there was a U-shaped association; compared to menarche age 13 years, those with menarche < 9 years had an 89% higher prevalence of diabetes (95% CI 39–156%), and those with menarche ≥ 17 years had a 65% higher prevalence (95% CI 16–134%). Among women with regular cycles (n = 43,113), a longer time to menstrual regularity was associated with diabetes (PR = 1.11 with 95% CI 1.02–1.22), high blood pressure (PR = 1.11 with 95% CI 1.06–1.17), and high cholesterol (PR = 1.09 with 95% CI 1.04–1.14). Conclusions for practice Mexican women with earlier and later ages at menarche and/or longer time to menstrual regularity may have higher risk of cardio-metabolic disease in adulthood.

http://bit.ly/2ShaoXl

Editorial Board

Publication date: 1 March 2019

Source: Hearing Research, Volume 373

Author(s):

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Editorial Board

Publication date: 1 March 2019

Source: Hearing Research, Volume 373

Author(s):

from #Audiology via ola Kala on Inoreader http://bit.ly/2WuV1da

Editorial Board

Publication date: 1 March 2019

Source: Hearing Research, Volume 373

Author(s):

from #Audiology via ola Kala on Inoreader http://bit.ly/2WuV1da
via IFTTT

Transient thermal boundary value problems in the half-space with mixed convective boundary conditions

Abstract

Numerous problems in thermal engineering give rise to problems with abrupt changes in boundary conditions particularly as regards structural and construction applications. There is a continual need for improved analytical and numerical techniques for the study and analysis of such canonical problems. The present work considers transient heat propagation in a two-dimensional half-space with mixed boundary conditions of the Dirichlet and the Robin (convective) type. The exact temperature field is obtained in double integral form by applying the Wiener–Hopf technique, and this integral is then efficiently evaluated numerically with the help of numerical algorithms developed for the present problem and by exploiting the properties of the integrand. The results are then compared to the numerical solutions using finite element methods, and excellent agreement is shown. Some potential application areas of the theory are also discussed, specifically in the regime where edge effects can influence thermal convection processes.

http://bit.ly/2ThRtca

Data-driven efficient network and surveillance-based immunization

Abstract

Given a contact network and coarse-grained diagnostic information such as electronic Healthcare Reimbursement Claims (eHRC) data, can we develop efficient intervention policies from data to control an epidemic? Immunization is an important problem in multiple areas, especially epidemiology and public health. However, most existing studies rely on assuming prior epidemiological models to develop pre-emptive strategies, which may fail to adapt to the change in new epidemiological patterns and the availability of rich data such as eHRC. In practice, disease spread is usually complicated, hence assuming an underlying model may deviate from true spreading patterns, leading to possibly inaccurate interventions. Additionally, the abundance of health care surveillance data (such as eHRC) makes it possible to study data-driven strategies without too many restrictive assumptions. Hence, such a data-driven intervention approach can help public-health experts take more practical decisions. In this paper, we take into account propagation log and contact networks for controlling propagation. Different from previous model-based approaches, our solutions are solely data driven in a sense that we develop immunization strategies directly from the network and eHRC without assuming classical epidemiological models. In particular, we formulate the novel and challenging data-driven immunization problem. To solve it, we first propose an efficient sampling approach to align surveillance data with contact networks, then develop an efficient algorithm with the provably approximate guarantee for immunization. Finally, we show the effectiveness and scalability of our methods via extensive experiments on multiple datasets, and conduct case studies on nation-wide real medical surveillance data.

http://bit.ly/2BcGOZe

Rangeland vulnerability to state transition under global climate change

Abstract

The rapid pace of global climate change necessitates tools for prioritizing limited climate-adaptation resources in the face of imperfect knowledge regarding plant community responses to changing climate. In addition, global climate change often leads to novel shifts in plant communities which are difficult to anticipate with detailed models based on current system dynamics, which are often greatly altered under novel climates. In order to identify nonforested plant communities that are highly susceptible to state transitions under global climate change, we examined differences between the historical climate envelopes and end-of-century projections. We developed a vulnerability index based on the realized climate envelope for a given plant community relative to future climate exposure under two different climate-forcing models. To provide an approach to prioritizing climate-change adaptation resources at smaller scales, we used scenario analysis to determine the probability of falling outside of the historical climate envelope for each vegetation type present in a given management unit. The large-scale index consistently identified several areas as highly vulnerable to ecosystem state transition under future global climate change. South and north central Texas, the northwestern Great Plains and Rocky Mountain regions, eastern Kansas, and large portions of central and western Texas appear most vulnerable under both climate models. Scenarios identified thresholds of potential state shift for every vegetation type in the small-scale management areas investigated. Our study identifies a simple method for determining the relative vulnerability of nonforested plant communities to state shifts, providing a robust approach for prioritizing limited climate-adaptation resources at multiple scales.

http://bit.ly/2GbfLAN

Evodiamine ameliorates paclitaxel-induced neuropathic pain by inhibiting inflammation and maintaining mitochondrial anti-oxidant functions

Abstract

Chemotherapy-induced neuropathic pain (CINP) is a common and debilitating side effect of cancer treatment. Evodiamine, a major effective compound isolated from Evodia rutaecarpa, has been associated with anti-inflammatory and anti-nociceptive effects, an important therapeutic strategy for the treatment of neuropathic pain. However, the effects of evodiamine on CINP remain unknown. Thus, this study aims to investigate the pharmacological potential of evodiamine in attenuating paclitaxel-induced peripheral neuropathy. The results showed that evodiamine enhanced but not reduced the sensitivity of cancer cells to paclitaxel treatment. In a rat model of paclitaxel-induced peripheral neuropathy, evodiamine significantly ameliorated the development of mechanical and thermal hypersensitivity. Moreover, paclitaxel-induced the loss of intraepidermal nerve fibers was markedly inhibited by evodiamine administration. This inhibitory effect was accompanied with the decrease in inflammatory and chemoattractant cytokines level in dorsal root ganglia (DRG), such as interleukin (IL)-1β, IL-6, tumor necrosis factor-α and monocyte chemoattractant protein-1. In addition, evodiamine administration limited paclitaxel-induced elevation of oxidative stress in DRG tissues. The mitochondrial dysfunction evoked by paclitaxel was also remarkably improved in evodiamine-treated rats, evidenced by restoration of peroxisome proliferator-activated receptor gamma coactivator 1-α (PGC-1α), uncoupling protein 2 (UCP2), and superoxide dismutase 2 (SOD2) expression. In in vitro studies, we found that evodiamine prevented paclitaxel-induced the loss of mitochondrial membrane potential and PGC-1α, UCP2 and SOD2 expression in DRG cells. In conclusion, our study demonstrates that evodiamine ameliorates paclitaxel-induced neuropathic pain by inhibiting inflammatory response and maintaining mitochondrial anti-oxidant functions, indicating that evodiamine may be a promising therapeutic agent for CINP treatment.

http://bit.ly/2MHdhvw

Water resource system risk and adaptive management of the Chinese Heihe River Basin in Asian arid areas

Abstract

Water scarcity is a challenging environmental problem in global arid regions in the twenty-first century. Global climate change and urban economic development exacerbate the problem of limited water supply and water shortage. In Asian arid areas, water has been being an important economic lifeline to maintain a healthy and sustainable oasis system. This study took the Heihe River Basin (HRB) in China's north-western arid area as a typical case region, identified an analytic framework of water resource system risk (WRSR) and analysed systematically the WRSR degree from the different perspectives. The results indicated that the runoff from mountainous watershed showed an increasing trend, but the total amount of watershed water resource showed a decreasing trend in the HRB in the past 50 years. Besides serious drought risk in recent 20 years, the WRSR is mainly from excessive water use in agriculture irrigation. Overall, the WRSR has increased from the year 2000 onward and is expected to increase and fluctuate in the future. Similarly, the potential WRSR is also huge in some arid watersheds relied heavily on glacial runoff in the world. In order to reduce water scarcity risk, it is necessary to implement and carry out effectively the watershed management policies of water resource; coordinate with the balance between the river and tributaries, surface water and groundwater and water quantity and quality to ensure the reasonable water supply in the different regions and water sectors; and promote rational industry structure adjustment and the innovations and applications of water saving and conservancy science and technology.

http://bit.ly/2Sk621w

Hydroxychloroquine is a safe and effective steroid-sparing agent for immune checkpoint inhibitor–induced inflammatory arthritis

Abstract

Immunotherapy for cancer treatment continues to evolve, and immune checkpoints have proven successful therapeutic targets. With success has come the challenge of managing the commonly associated immune-related toxicities. Arthralgias and arthritis are a common immune-related adverse event (IrAE), well described in the literature (Pardoll Nat Rev Cancer 12:252–264, 2012; Diesendruck and Benhar Drug Resist Updat 30:39–47, 2017; Cappelli et al. Arthritis Care Res 69:1751–1763, 2017; Brahmer et al. J Clin Oncol 36:1714–1768, 2018; Smith and Bass (2017). The optimal management of immune checkpoint inhibitor (ICI)–induced arthritis remains unclear. We describe the first series using hydroxychloroquine as a first-line disease-modifying antirheumatic drug (DMARD) for patients without pre-existing autoimmune disease, who developed arthritis secondary to ICI's. This was a single-center retrospective observational study reporting all patients evaluated by rheumatologists affiliated with the University of Alberta, a large tertiary health care center in Northern Alberta, Canada, deemed to have inflammatory arthritis (IA) following ICIs. We identified 11 patients, without pre-existing autoimmune disease, who developed IA following ICIs. Most patients presented with a symmetrical polyarthritis with both large and small joint involvement. All patients were treated according to the outlined treatment protocol with hydroxychloroquine as a first-line steroid-sparing agent: either as monotherapy or in combination with tapering doses of systemic corticosteroids (3) or intra-articular steroid injections (6). One patient required the addition of methotrexate to control symptoms and none required biologic therapy. There were no reported adverse effects from hydroxychloroquine. Inflammatory arthritis is an important complication of ICIs leading to significant impact on patient quality of life. In our experience, in patients without pre-existing autoimmune disease, hydroxychloroquine is an effective first-line therapy for IA secondary to ICI therapy.

http://bit.ly/2SgFJcC

Plasmonic gold chips for the diagnosis of Toxoplasma gondii , CMV, and rubella infections using saliva with serum detection precision

Abstract

Sampling the blood compartment by an invasive procedure such as phlebotomy is the most common approach used for diagnostic purposes. However, phlebotomy has several drawbacks including pain, vasovagal reactions, and anxiety. Therefore, alternative approaches should be tested to minimize patient's discomfort. Saliva is a reasonable compartment; when obtained, it generates little or no anxiety. We setup a multiplexed serology assay for detection of Toxoplasma gondii IgG and IgM, rubella IgG, and CMV IgG, in serum, whole blood, and saliva using novel plasmonic gold (pGOLD) chips. pGOLD test results in serum, whole blood, and saliva were compared with commercial kits test results in serum. One hundred twenty serum/saliva sets (Lyon) and 28 serum/whole blood/saliva sets (Nice) from France were tested. In serum and whole blood, sensitivity and specificity of multiplex T. gondii, CMV, and rubella IgG were 100% in pGOLD when compared to commercial test results in serum. In saliva, sensitivity and specificity for T. gondii and rubella IgG were 100%, and for CMV IgG, sensitivity and specificity were 92.9% and 100%, respectively, when compared to commercial test results in serum. We were also able to detect T. gondii IgM in saliva with sensitivity and specificity of 100% and 95.4%, respectively, when compared to serum test results. Serological testing by multiplex pGOLD assay for T. gondii, rubella, and CMV in saliva is reliable and likely to be more acceptable for systematic screening of pregnant women, newborn, and immunocompromised patients.

http://bit.ly/2HS1DPJ

First-year weight loss with androgen-deprivation therapy increases risks of prostate cancer progression and prostate cancer-specific mortality: results from SEARCH

Abstract

Purpose

We aimed to study the associations between androgen-deprivation therapy (ADT)-induced weight changes and prostate cancer (PC) progression and mortality in men who had undergone radical prostatectomy (RP).

Methods

Data from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort were used to study the associations between weight change approximately 1-year post-ADT initiation and metastases, castration-resistant prostate cancer (CRPC), all-cause mortality (ACM), and PC-specific mortality (PCSM) in 357 patients who had undergone RP between 1988 and 2014. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) using covariate-adjusted Cox regression models for associations between weight loss, and weight gains of 2.3 kg or more, and PC progression and mortality post-ADT.

Results

During a median (IQR) follow-up of 81 (46–119) months, 55 men were diagnosed with metastases, 61 with CRPC, 36 died of PC, and 122 died of any cause. In multivariable analysis, weight loss was associated with increases in risks of metastases (HR 3.13; 95% CI 1.40–6.97), PCSM (HR 4.73; 95% CI 1.59–14.0), and ACM (HR 2.16; 95% CI 1.25–3.74) compared with mild weight gains of ≤ 2.2. Results were slightly attenuated but remained statistically significant in analyses that accounted for competing risks of non-PC death. Estimates for the associations between weight gains of ≥ 2.3 kg and metastases (HR 1.58; 95% CI 0.73–3.42), CRPC (HR 1.33; 95% CI 0.66–2.66), and PCSM (HR 2.44; 95% CI 0.84–7.11) were elevated, but not statistically significant.

Conclusions

Our results suggest that weight loss following ADT initiation in men who have undergone RP is a poor prognostic sign. If confirmed in future studies, testing ways to mitigate weight loss post-ADT may be warranted.

http://bit.ly/2Rr1zFX

The correct measurement of oxygen saturation at high altitude

Abstract

Background

Compared to measurements at sea level, measurement of oxygen saturation by pulse oximetry (SpO₂) at altitude differs fundamentally because of the cyclical course of SpO₂, caused by periodic breathing. Therefore, the determination of a representative SpO₂ value is difficult. In the literature, recommendations for a standardized measurement procedure are missing; different studies measure SpO₂ in different ways.

Key question

Does the visually determined SpO₂ value correlate with the actual average of the measurement interval?

Methods

Four participants of an expedition (6013 m; Pakistan), familiar with pulse oximetry at altitude, wrote down the representative value of the measurement interval of 3 min (SpO_2visual) according to their individual observation. The used pulse oximeter saved the value for SpO₂ every 4 s. Based on this, the calculated mean (SpO_2memory) was compared to SpO_2visual after finishing the expedition (128 measurements > 2500 m).

Results

The spread of the single values within the measurement interval is high (in single cases up to 17%-points) in case of insufficient acclimatization. With increasing acclimatization, the measured values stabilize. SpO_2visual differs only marginally (− 0.4%-points; ± 0.8) compared to SpO_2memory.

Conclusions

The correct pulse oximetric determination of SpO₂ at high altitude requires a standardized measurement procedure; the investigator is familiar and trained. Anyway, the measurements have to be done in the continuous mode of the pulse oximeter over a sufficient timeframe (3 SpO₂-fluctuation cycles; 2–3 min). We recommend to record the maximum and the minimum value of the measurement interval and to use a pulse oximeter device with memory function.

http://bit.ly/2SdyhiB

Emerging Role of SGLT-2 Inhibitors for the Treatment of Obesity

Abstract

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are glucose-lowering drugs that reduce plasma glucose levels by inhibiting glucose and sodium reabsorption in the kidneys, thus resulting in glucosuria. Their effects consequently include reductions in HbA1c, blood glucose levels, and blood pressure, but also reductions in body weight and adiposity. The ability to reduce body weight is consistently observed in individuals taking SGLT2 inhibitors, but this weight loss is moderate due to counter-regulatory mechanisms striving to maintain body weight. This has prompted exploration of SGLT2 inhibitors in combination with other agents acting via decreased food intake, e.g., glucagon-like peptide 1 receptor agonists (GLP1-RAs). The bodyweight effects are promising, and together with the signs of prevention of cardiovascular and renal events, such combinations including SGLT2 inhibitors are appealing. The weight loss is clinically important, as most individuals with type 2 diabetes are overweight or obese, but also because there is an unmet need for safe, effective, and durable weight loss interventions in obese individuals without diabetes.

http://bit.ly/2B9GN8D

Institutional Guidelines for Resistance Exercise Training in Cardiovascular Disease: A Systematic Review

Abstract

Background

Institutional position stands are useful for practitioners when designing exercise routines for specific populations. Resistance training has been included in programs for patients with cardiovascular disease.

Objective

The objective of this systematic review was to analyze institutional guidelines providing recommendations for resistance training applied to cardiovascular disease.

Methods

PubMed, Web of Science, and Scopus databases were searched from inception until 30 April, 2018.

Results

Of 994 articles initially found, 13 position stands were retained. Consensual indications occurred only for number of sets (one to three sets) and training frequency (two to three sessions/week). Recommendations concerning other major training variables were discordant regarding workload (none or loads ranging from < 30% up to 80% 1 repetition maximum) and exercise order (none or vaguely indicating alternation of muscle groups or circuit format), or insufficient regarding intervals between sets and exercises or number and type of exercises. Overall, guidelines lack recommendations of specific procedures for each type of disease at different severity levels, cardiovascular risk during exercise, or criteria for training progression.

Conclusions

Recommendations provided by institutional guidelines appear to be insufficient to support adequate resistance training prescription in the context of cardiovascular disease.

http://bit.ly/2sUpfso

Foot-ground clearance characteristics in women: A comparison across different ages

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Darlan Martins Ribeiro, Guilherme Augusto Santos Bueno, Flavia Martins Gervásio, Ruth Losada de Menezes

Abstract

Background

Tripping is a common event leading to falls amongst elderly. Minimum foot clearance (MFC) is a critical swing phase control factor associated with tripping and falls.

Research question

Are there differences in MFC characteristics among three age groups of women and are there association between MFC and lower limb kinematics?

Methods

Cross-sectional observational study. Three-dimensional gait analysis of 55 healthy women. ANOVA was used to compare (p<0.05) MFC characteristics among young, middle-aged and elderly groups. Multiple Linear Regression Analysis was used to test prediction over MFC.

Results

Elderly women walked slower, with lower MFC and lower maximum foot velocity during swing (MFV) than young and middle-aged women. There were more hip flexion and less ankle dorsiflexion during MFC among elderly. There is a strong positive relationship between dorsiflexion and MFC. And ankle dorsiflexion was the most predictive variable over MFC.

Significance

Elderly women walk slower with lower MFC value and less ankle dorsiflexion than gender-matched young controls. Increased hip flexion may represent a gait adaptation to avoid tripping. Gait speed had no effect on those findings.

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The conventional gait model, an open-source implementation that reproduces the past but prepares for the future

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): F. Leboeuf, R. Baker, A. Barré, J. Reay, R. Jones, M. Sangeux

Abstract

Background

The Conventional Gait Model (CGM), known by a variety of different names, is widely used in clinical gait analysis. We present pyCGM2, an open-source implementation of the CGM with two versions. The first, CGM1.0, is a clone of Vicon Plug In Gait (PiG) with all its variants. CGM1.0 provides a platform to test the effect of modifications to the CGM on data collected and processed retrospectively or to provide backward compatibility. The second version, CGM1.1, offers some practical modifications and includes three well documented improvements.

Research question

How do improvements of the conventional gait model affect joint kinematics and kinetics?

Method

The practical modifications include the possibility to use a medial knee epicondyle marker, during static calibration only, to define the medio-lateral axis of the femur in place of the knee alignment device. The three improvements correspond to the change of pelvis angle decomposition sequence, the adoption of a single tibia coordinate system, and the default decomposition of the joint moments in the joint coordinate system. We validated the outputs of version CGM1.0 against Vicon-PiG, and estimated the effect of the modifications included in version CGM1.1 using gait data collected in 16 healthy participants.

Results

Kinematics and kinetics of CGM1.0 were superimposed with that of Vicon-PiG, with root mean square differences less than 0.04° for kinematics and less than 0.05 N.m.kg-1 for kinetics.

Significance

The differences between the CGM1.1 and CGM1.0 were minimal in the healthy participant cohort but we discussed the expected difference in participants with different gait pathologies. We hope that the pyCGM2 will facilitate the systematic testing and the use of improved processing methods for the conventional gait model.

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Characterizing slip-like responses during gait using an entire support surface perturbation: Comparisons to previously established slip methods

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Andrew H. Huntley, Roshanth Rajachandrakumar, Alison Schinkel-Ivy, Avril Mansfield

Abstract

Background

The characteristics of experimentally induced slips (low-friction surfaces and non-motorized platforms) in laboratory settings are influenced by participant gait velocity, contact surface area, and level of friction between the foot and surface. However, motorized platforms that could account for these factors during slip-like paradigms have not been extensively used.

Research question

How does slip-like perturbations evoked via a motorized platform change gait characteristics and postural stability during overground walking?

Methods

Ten healthy young adults performed 4 overground, self-paced walking trials, with the 4^th trial including an unexpected forward support surface translation at heel-strike during steady state walking. Kinematic and kinetic data were collected, with step characteristics (time, distance, velocity) and postural stability calculated to compare between normal gait and slip-like trials. Slip foot characteristics were also determined.

Results

Peak slipping foot velocity variability was considerably smaller compared to previously reported low-friction and non-motorized perturbations. The centre of mass was shifted more posteriorly (thus in a less stable location) by the end of the platform acceleration phase compared to the same time point post-heel strike during normal gait trials. Participants successfully responded to every slip-like perturbation by significantly increasing step time, decreasing step distance, and decreasing step velocity.

Significance

Our results demonstrate the repeatability and consistency of a motorized support surface paradigm to induce slip-like perturbations. Furthermore, stability and step characteristic results confirm posterior shifts in stability and appropriate stepping responses, mimicking how participants would react if responding to a real world slip.

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Foot-ground clearance characteristics in women: A comparison across different ages

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Darlan Martins Ribeiro, Guilherme Augusto Santos Bueno, Flavia Martins Gervásio, Ruth Losada de Menezes

Abstract

Background

Tripping is a common event leading to falls amongst elderly. Minimum foot clearance (MFC) is a critical swing phase control factor associated with tripping and falls.

Research question

Are there differences in MFC characteristics among three age groups of women and are there association between MFC and lower limb kinematics?

Methods

Cross-sectional observational study. Three-dimensional gait analysis of 55 healthy women. ANOVA was used to compare (p<0.05) MFC characteristics among young, middle-aged and elderly groups. Multiple Linear Regression Analysis was used to test prediction over MFC.

Results

Elderly women walked slower, with lower MFC and lower maximum foot velocity during swing (MFV) than young and middle-aged women. There were more hip flexion and less ankle dorsiflexion during MFC among elderly. There is a strong positive relationship between dorsiflexion and MFC. And ankle dorsiflexion was the most predictive variable over MFC.

Significance

Elderly women walk slower with lower MFC value and less ankle dorsiflexion than gender-matched young controls. Increased hip flexion may represent a gait adaptation to avoid tripping. Gait speed had no effect on those findings.

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via IFTTT

The conventional gait model, an open-source implementation that reproduces the past but prepares for the future

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): F. Leboeuf, R. Baker, A. Barré, J. Reay, R. Jones, M. Sangeux

Abstract

Background

The Conventional Gait Model (CGM), known by a variety of different names, is widely used in clinical gait analysis. We present pyCGM2, an open-source implementation of the CGM with two versions. The first, CGM1.0, is a clone of Vicon Plug In Gait (PiG) with all its variants. CGM1.0 provides a platform to test the effect of modifications to the CGM on data collected and processed retrospectively or to provide backward compatibility. The second version, CGM1.1, offers some practical modifications and includes three well documented improvements.

Research question

How do improvements of the conventional gait model affect joint kinematics and kinetics?

Method

The practical modifications include the possibility to use a medial knee epicondyle marker, during static calibration only, to define the medio-lateral axis of the femur in place of the knee alignment device. The three improvements correspond to the change of pelvis angle decomposition sequence, the adoption of a single tibia coordinate system, and the default decomposition of the joint moments in the joint coordinate system. We validated the outputs of version CGM1.0 against Vicon-PiG, and estimated the effect of the modifications included in version CGM1.1 using gait data collected in 16 healthy participants.

Results

Kinematics and kinetics of CGM1.0 were superimposed with that of Vicon-PiG, with root mean square differences less than 0.04° for kinematics and less than 0.05 N.m.kg-1 for kinetics.

Significance

The differences between the CGM1.1 and CGM1.0 were minimal in the healthy participant cohort but we discussed the expected difference in participants with different gait pathologies. We hope that the pyCGM2 will facilitate the systematic testing and the use of improved processing methods for the conventional gait model.

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via IFTTT

Characterizing slip-like responses during gait using an entire support surface perturbation: Comparisons to previously established slip methods

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Andrew H. Huntley, Roshanth Rajachandrakumar, Alison Schinkel-Ivy, Avril Mansfield

Abstract

Background

The characteristics of experimentally induced slips (low-friction surfaces and non-motorized platforms) in laboratory settings are influenced by participant gait velocity, contact surface area, and level of friction between the foot and surface. However, motorized platforms that could account for these factors during slip-like paradigms have not been extensively used.

Research question

How does slip-like perturbations evoked via a motorized platform change gait characteristics and postural stability during overground walking?

Methods

Ten healthy young adults performed 4 overground, self-paced walking trials, with the 4^th trial including an unexpected forward support surface translation at heel-strike during steady state walking. Kinematic and kinetic data were collected, with step characteristics (time, distance, velocity) and postural stability calculated to compare between normal gait and slip-like trials. Slip foot characteristics were also determined.

Results

Peak slipping foot velocity variability was considerably smaller compared to previously reported low-friction and non-motorized perturbations. The centre of mass was shifted more posteriorly (thus in a less stable location) by the end of the platform acceleration phase compared to the same time point post-heel strike during normal gait trials. Participants successfully responded to every slip-like perturbation by significantly increasing step time, decreasing step distance, and decreasing step velocity.

Significance

Our results demonstrate the repeatability and consistency of a motorized support surface paradigm to induce slip-like perturbations. Furthermore, stability and step characteristic results confirm posterior shifts in stability and appropriate stepping responses, mimicking how participants would react if responding to a real world slip.

from #Audiology via ola Kala on Inoreader http://bit.ly/2MGQP5I
via IFTTT

Foot-ground clearance characteristics in women: A comparison across different ages

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Darlan Martins Ribeiro, Guilherme Augusto Santos Bueno, Flavia Martins Gervásio, Ruth Losada de Menezes

Abstract

Background

Tripping is a common event leading to falls amongst elderly. Minimum foot clearance (MFC) is a critical swing phase control factor associated with tripping and falls.

Research question

Are there differences in MFC characteristics among three age groups of women and are there association between MFC and lower limb kinematics?

Methods

Cross-sectional observational study. Three-dimensional gait analysis of 55 healthy women. ANOVA was used to compare (p<0.05) MFC characteristics among young, middle-aged and elderly groups. Multiple Linear Regression Analysis was used to test prediction over MFC.

Results

Elderly women walked slower, with lower MFC and lower maximum foot velocity during swing (MFV) than young and middle-aged women. There were more hip flexion and less ankle dorsiflexion during MFC among elderly. There is a strong positive relationship between dorsiflexion and MFC. And ankle dorsiflexion was the most predictive variable over MFC.

Significance

Elderly women walk slower with lower MFC value and less ankle dorsiflexion than gender-matched young controls. Increased hip flexion may represent a gait adaptation to avoid tripping. Gait speed had no effect on those findings.

from #Audiology via ola Kala on Inoreader http://bit.ly/2MG0Wrj

The conventional gait model, an open-source implementation that reproduces the past but prepares for the future

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): F. Leboeuf, R. Baker, A. Barré, J. Reay, R. Jones, M. Sangeux

Abstract

Background

The Conventional Gait Model (CGM), known by a variety of different names, is widely used in clinical gait analysis. We present pyCGM2, an open-source implementation of the CGM with two versions. The first, CGM1.0, is a clone of Vicon Plug In Gait (PiG) with all its variants. CGM1.0 provides a platform to test the effect of modifications to the CGM on data collected and processed retrospectively or to provide backward compatibility. The second version, CGM1.1, offers some practical modifications and includes three well documented improvements.

Research question

How do improvements of the conventional gait model affect joint kinematics and kinetics?

Method

The practical modifications include the possibility to use a medial knee epicondyle marker, during static calibration only, to define the medio-lateral axis of the femur in place of the knee alignment device. The three improvements correspond to the change of pelvis angle decomposition sequence, the adoption of a single tibia coordinate system, and the default decomposition of the joint moments in the joint coordinate system. We validated the outputs of version CGM1.0 against Vicon-PiG, and estimated the effect of the modifications included in version CGM1.1 using gait data collected in 16 healthy participants.

Results

Kinematics and kinetics of CGM1.0 were superimposed with that of Vicon-PiG, with root mean square differences less than 0.04° for kinematics and less than 0.05 N.m.kg-1 for kinetics.

Significance

The differences between the CGM1.1 and CGM1.0 were minimal in the healthy participant cohort but we discussed the expected difference in participants with different gait pathologies. We hope that the pyCGM2 will facilitate the systematic testing and the use of improved processing methods for the conventional gait model.

from #Audiology via ola Kala on Inoreader http://bit.ly/2sX9hOo

Characterizing slip-like responses during gait using an entire support surface perturbation: Comparisons to previously established slip methods

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Andrew H. Huntley, Roshanth Rajachandrakumar, Alison Schinkel-Ivy, Avril Mansfield

Abstract

Background

The characteristics of experimentally induced slips (low-friction surfaces and non-motorized platforms) in laboratory settings are influenced by participant gait velocity, contact surface area, and level of friction between the foot and surface. However, motorized platforms that could account for these factors during slip-like paradigms have not been extensively used.

Research question

How does slip-like perturbations evoked via a motorized platform change gait characteristics and postural stability during overground walking?

Methods

Ten healthy young adults performed 4 overground, self-paced walking trials, with the 4^th trial including an unexpected forward support surface translation at heel-strike during steady state walking. Kinematic and kinetic data were collected, with step characteristics (time, distance, velocity) and postural stability calculated to compare between normal gait and slip-like trials. Slip foot characteristics were also determined.

Results

Peak slipping foot velocity variability was considerably smaller compared to previously reported low-friction and non-motorized perturbations. The centre of mass was shifted more posteriorly (thus in a less stable location) by the end of the platform acceleration phase compared to the same time point post-heel strike during normal gait trials. Participants successfully responded to every slip-like perturbation by significantly increasing step time, decreasing step distance, and decreasing step velocity.

Significance

Our results demonstrate the repeatability and consistency of a motorized support surface paradigm to induce slip-like perturbations. Furthermore, stability and step characteristic results confirm posterior shifts in stability and appropriate stepping responses, mimicking how participants would react if responding to a real world slip.

from #Audiology via ola Kala on Inoreader http://bit.ly/2MGQP5I

Control theory in biology and medicine

Abstract

From September–December 2017, the Mathematical Biosciences Institute at Ohio State University hosted a series of workshops on control theory in biology and medicine, including workshops on control and modulation of neuronal and motor systems, control of cellular and molecular systems, control of disease / personalized medicine across heterogeneous populations, and sensorimotor control of animals and robots. This special issue presents tutorials and research articles by several of the participants in the MBI workshops.

http://bit.ly/2sSHZsl

Socio-technical scenarios for energy-intensive industries: the future of steel production in Germany

Abstract

Relocating energy-intensive industries to another country may help to meet national greenhouse gas reduction targets. However, this can lead to rising global emissions if production in the country that receives the shifted industries is associated with higher specific emissions ("carbon leakage"). The relocation of industries and thus the possible emergence of carbon leakage depends largely on cost advantages in the country of destination and the level of transport costs. In this study, we consider the example of relocations in the iron and steel industries of China and Germany in order to ascertain effects on CO₂-emissions. We develop different scenarios for 2030 using a multilevel cross-impact-balance (CIB) approach and analyse these scenarios in a technology-based cost model. Since all scenarios show high specific cost for reducing global CO₂-emissions by preferring crude steel produced in Germany to steel from China, we conclude that avoiding carbon leakage is not necessarily a cost-efficient measure for reducing global CO₂-emissions.

http://bit.ly/2B9EeTQ

Merkelzellkarzinom

Zusammenfassung

Das Merkelzellkarzinom ist ein seltener, hoch aggressiver Hauttumor des älteren Menschen. Er besitzt neuroendokrine Eigenschaften. Die Pathogenese ist mit chronischer UV-Licht-Exposition und dem Merkelzell-Polyomavirus assoziiert. Klinisch fällt das Merkelzellkarzinom durch einen solitären, kutan oder subkutan gelegenen, roten bis bläulichen Knoten auf. Da der Tumor frühzeitig lymphogen metastasiert, sind zum Zeitpunkt der Diagnosestellung in etwa 30 % der Fälle bereits lokoregionäre Metastasen vorhanden. Die häufigen Lokalrezidive sowie die regionäre und ferne Metastasierung zeigen sich meist innerhalb der ersten 2 bis 3 Jahre nach Erstdiagnose. Die erste Therapie nach Diagnosestellung besteht in der vollständigen operativen Entfernung des Primärtumors mit weitem Sicherheitsabstand sowie einer Sentinellymphknotenbiopsie. Anschließend sollte eine adjuvante Radiatio des Tumorbetts erfolgen. Durch eine zusätzliche Bestrahlung der regionären Lymphknotenstationen kann die Rate lokoregionärer Rezidive gesenkt werden. Für die systemische Therapie des fortgeschrittenen Merkelzellkarzinoms haben sich gegen die PD-1/PD-L1-Achse gerichtete Checkpoint-Inhibitoren als gut und dauerhaft wirksam erwiesen. Die vormals häufig eingesetzte Chemotherapie zeigt hingegen zwar mäßige bis gute Ansprechraten, diese sind jedoch in der Regel von sehr kurzer Dauer.

http://bit.ly/2UnAx40

Effects of intermittent hypoxia training on leukocyte pyruvate dehydrogenase kinase 1 (PDK-1) mRNA expression and blood insulin level in prediabetes patients

Abstract

Purpose

Intermittent hypoxia training/treatment (IHT) is an emerging therapeutic approach to alleviate chronic diseases, such as diabetes. The present study investigated the effects of IHT on blood leucocyte pyruvate dehydrogenase kinase 1 (PDK-1) mRNA expression and its relationship with the changes in blood insulin level.

Methods

Seven adult healthy volunteers and 11 prediabetic patients participated in this study. A 3-week course of IHT consisted of a 40-min session of 4 cycles of 5-min 12% O₂ and 5-min room air breathing per day, 3 sessions per week for 3 weeks (i.e., total 9 sessions of IHT). Plasma insulin levels and leukocyte PDK-1 mRNA expression were determined at various time points either under fasting condition or following oral glucose tolerance test (OGTT). Correlation between the IHT-induced changes in PDK-1 mRNA and insulin or glucose levels in the same serological samples was analyzed.

Results

At pre-IHT baseline, PDK-1 mRNA expression was two times higher in prediabetes than control subjects. IHT resulted in significant augmentation in PDK-1 mRNA expression (> twofold) in prediabetes at the end of 3-week IHT and remained elevated 1 month after IHT, which was correlated with a significantly reduced insulin release and lower blood glucose after glucose loading with OGTT.

Conclusion

IHT can trigger beneficial effects in normalizing blood insulin levels in prediabetic patients under oral glucose load, which were closely correlated with an enhanced mRNA expression of PDK-1 in leukocytes. Further clinical trials are warranted to validate the utility of IHT as a non-invasive complementary therapy against diabetes-associated pathologies.

http://bit.ly/2RZ51gc

Ovarialkarzinom

http://bit.ly/2FWzyon

Integrative Onkologie – auch eine ethische Aufgabe

http://bit.ly/2G8hcQA

Bedeutung der adjuvanten und palliativen Chemotherapie – inklusive Immuntherapie

Zusammenfassung

Hintergrund

Die Systemtherapie des rezidivierten bzw. metastasierten Kopf-Hals-Plattenepithelkarzinoms (RM-SCCHN) ist aktuell im Wandel. Neben Chemotherapie und Inhibitoren des epidermalen Wachstumsfaktorrezeptors (EGFR) stehen mittlerweile auch Checkpointinhibitoren (CPI) in der Klinik zur Verfügung.

Fragestellung

Wie fügen sich die aktuellen Daten in die Behandlungsrealität des RM-SCCHN ein?

Material und Methoden

Es erfolgte eine Literaturrecherche zur Systemtherapie des RM-SCCHN.

Ergebnisse

CPI sind ein Standard bei der Behandlung nach Platin-Versagen beim RM-SCCHN. Aktuelle Studien belegen den Stellenwert dieser neuen Therapieoption in der Erstlinie und werden in Kürze zu einem Umdenken in der Behandlungsrealität führen.

Schlussfolgerung

CPI sind das Rückgrat der Systemtherapie des RM-SCCHN und werden sich zukünftig auch in frühen Stadien der Behandlung wiederfinden.

http://bit.ly/2FYOHp4