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Motor imagery (MI) has become an increasingly popular rehabilitation tool for individuals with motor impairments. However, it has been proposed that individuals with Parkinson’s Disease (PKD) may not benefit from MI due to impairments in motor learning.
This case series study investigated the effects of a 4-week MI training protocol on MI ability in three male individuals with PKD, with an emphasis on examining changes in brain responses.
Training was completed primarily at home, via audio recordings, and emphasized the imagination of functional tasks. MI ability was assessed pre and post-training using subjective and objective imagery questionnaires, alongside an electroencephalographic (EEG) recording of a functional MI task. EEG analysis focused on the mu rhythm, as it has been proposed that suppression in the mu rhythm may reflect MI success and motor learning. Previous research has indicated that mu suppression is impaired in individuals with PKD, and may contribute to the disease’s associated deficits in motor learning.
Following training, all three participants improved in MI accuracy, but reported no notable improvements in MI vividness. Greater suppression in the mu rhythm was also exhibited by all three participants post-training.
These results suggest the participants learned from the training protocol and that individuals with PKD are responsive to MI training. Further research on a larger scale is needed to verify the findings and determine if this learning translates to improvements in motor function.
To evaluate whether Kawasaki disease predisposes to premature atherosclerosis and to assess status of coronary artery abnormalities at least 10 years after diagnosis.
Material and methods:
A prospective study was carried out on 21 patients who were diagnosed with Kawasaki disease at least 10 years back and are on regular follow-up. The study was conducted on 128 Slice Dual Source computed tomography scanner with electrocardiography-triggered radiation optimised protocols for assessment of coronary artery abnormalities and calcifications.
Study cohort had 21 subjects – 15 males and 6 females (age range: 11–23 years; mean: 15.76 + 3.72 years). Mean age at time of diagnosis was 3.21 + 2.48 years. Mean time interval from diagnosis of Kawasaki disease to computed tomography coronary angiography was 12.59 + 2.89 years. Four children had evidence of coronary artery abnormalities on transthoracic echocardiography at time of diagnosis. Of these, two had persistent abnormalities on computed tomography coronary angiography. One subject (4.76%) had coronary calcification that was localised to abnormal coronary artery segment. Four coronary artery abnormalities (one saccular; three fusiform aneurysms) were noted in two subjects.
Prevalence of coronary artery calcification is low and, if present, is localised to abnormal segments. This calcification is likely dystrophic rather than atherosclerotic. It appears that coronary artery abnormalities can persist for several years after acute episode of Kawasaki disease. Periodic follow-up by computed tomography coronary angiography is now a feasible non-invasive imaging modality for long term surveillance of patients with Kawasaki disease who had coronary artery abnormalities at time of diagnosis.
Past studies using the positive deviance (PD) approach in the field of infection prevention and control (IPC) have primarily focused on impacts on healthcare-associated infection rates. This research aimed to determine if health professionals who exhibit PD behaviours have distinctive socio-cognitive profiles compared to non-PD professionals, and to examine the impact of a PD intervention on healthcare professionals’ (HPs) behavioural changes in maintaining IPC guidelines. In a cross-sectional study among 135 HPs, respondents first filled out a socio-cognitive characteristics questionnaire, and after 5 months were requested to complete a self-reported behavioural change questionnaire. The main findings indicate that socio-cognitive variables such as external locus of control, perceived threat and social learning were significant predictors of a person exhibiting PD behaviours. Almost 70% of HPs reported behavioural change and creating social networks as a result of the PD intervention in maintaining IPC guidelines, 16.9% of them are a ‘PD boosters’ (a new group of HPs who have adopted the positive practices of PDs that were originally identified, and also added additional practices of their own). Social networks can contribute to internalizing and raising personal accountability even among non-PD professionals, by creating a mind map that makes each person believe they are an important node in the network, regardless of their status and role. Health intervention programmes should purposely make visible and prominent social network connections in the hospital system.
Two configurations of a modified feather-shaped antenna element are proposed for super wideband (SWB) multiple-input multiple-output (MIMO) applications. The antenna element geometry comprises of a circular slot-loaded feather-shaped radiator and rectangular notch-loaded quarter elliptical coplanar waveguide ground plane. An operating bandwidth of 4.4–51.5 GHz with inter-port isolation, S21 ≥ 15 dB for spatial diversity configuration, and 3.8–51.5 GHz with S21 ≥ 15 dB in pattern diversity configuration are achieved. The footprints of the antenna configurations are 17 × 33 and 31 × 31 mm2. Both configurations exhibited an envelope correlation coefficient of <−20 dB. The proposed MIMO configurations are fabricated and experimentally validated. The designed antenna configurations are SWB and compact.
New whole-rock geochemical analyses along with laser ablation multi-collector inductively coupled plasma mass spectrometry U–Pb zircon ages of the granite–rhyolite from the Karakoram Batholith, exposed along the Shyok Valley, NW India, have been performed to understand the timing and geochemical evolution of these magmatic bodies and their implications for the geodynamic evolution of the Karakoram Batholith. New geochronological data on granites and rhyolites along with previously published geochronological data indicate that the Karakoram Batholith evolved during Albian time (~110–100 Ma) owing to the subduction of Tethys oceanic lithosphere along the Shyok Suture Zone. This region witnessed a period of no magmatism during ~99–85 Ma. Following this, the Kohistan–Ladakh arc and Karakoram Batholith evolved as a single entity in Late Cretaceous and early Palaeogene times. Late Cretaceous (~85 Ma) rhyolite intrusions within the Karakoram Batholith show calc-alkaline subduction-related signatures with a highly peraluminous nature (molar A/CNK = 1.42–1.81). These intrusions may have resulted from c. ~13.8 % to ~34.5 % assimilation of pre-existing granites accompanied by fractional crystallization during the ascent of the magma. The contamination of mantle wedge-derived melts with crust of the active continental margin of the Karakoram most likely enhanced the high peraluminous nature of the rhyolite magma, as has been constrained by assimilation fractional crystallization modelling. Two granite samples from the contact of the Shyok Metamorphic Complex and Karakoram Batholith indicate that the post-collisional Miocene magmatism was not only confined along the Karakoram Fault zone but also extends ~30 km beyond the Shyok–Muglib strand.
Background: Lumbar puncture (LP) is a low-risk procedure performed on pediatric patients for a variety of indications. There are no published studies of the nature of the concerns of parents in North America, and no studies examining a process to improve pediatric lumbar puncture consent. Methods: 72 patient-parent dyads were enrolled in a randomized control trial to receive standard consent with or without an educational video. A survey was provided to determine parent self-rated understanding of the procedure, their perception of its safety, their perception of the painfulness and their overall comfort with their child undergoing LP. In addition, demographic characteristics and qualitative information about parent concerns were collected. Results: Viewing the video significantly increased parent understanding of the procedure (p=0.015) and their perception of its safety (p=0.021) compared to controls. Parent comfort with the procedure increased after viewing the video (p = 0.002). Variability of answers was reduced in the video group (p = 0.03). Parents’ top three concerns were pain, infection, and neurologic injury. Conclusions: Pediatric lumbar puncture consent can be significantly improved with a short educational video to address the parental concerns and standardize consent.
Unilateral interruption of pulmonary artery is a rare congenital anomaly which is usually associated with other congenital heart disease. Even more rarely it may occur in isolation. Most of the cases are incidentally detected in adulthood. Some cases develop pulmonary hypertension for yet unknown reasons; such cases usually present in infancy with right heart failure. Surgical correction in such cases is associated with adverse outcomes. Heart lung transplantation should be considered in such patients. We report a 3-year-old boy with interruption of right pulmonary artery with severe pulmonary hypertension and right heart failure who was considered for heart lung transplantation.
Cognitive impairments reported across psychiatric conditions (ie, major depressive disorder, bipolar disorder, schizophrenia, and posttraumatic stress disorder) strongly impair the quality of life of patients and the recovery of those conditions. There is therefore a great need for consideration for cognitive dysfunction in the management of psychiatric disorders. The redundant pattern of cognitive impairments across such conditions suggests possible shared mechanisms potentially leading to their development. Here, we review for the first time the possible role of inflammation in cognitive dysfunctions across psychiatric disorders. Raised inflammatory processes (microglia activation and elevated cytokine levels) across diagnoses could therefore disrupt neurobiological mechanisms regulating cognition, including Hebbian and homeostatic plasticity, neurogenesis, neurotrophic factor, the HPA axis, and the kynurenine pathway. This redundant association between elevated inflammation and cognitive alterations across psychiatric disorders hence suggests that a cross-disorder approach using pharmacological and nonpharmacological (ie, physical activity and nutrition) anti-inflammatory/immunomodulatory strategies should be considered in the management of cognition in psychiatry.
Graphene oxide (GO)/MnO2 nanocomposites were synthesized by adding KMnO4 in a solution of water and ethanol (3:1), containing 10 mg of GO. Brown precipitates were obtained after a continuous stirring for 1 hr. The precipitates were then washed with deionized water (DI) water and dried to obtain the MnO2-GO nanocomposites. Pure MnO2 was also synthesized using the same method without GO for the comparison. X-ray diffraction pattern confirm δ-MnO2 type of MnO2 with birnessite type MnO2 structure. The TEM images show the average diameter of MnO2 nanorods as 15 nm. Electrochemical characterizations were carried out in an aqueous solution of 3M KOH. Charge-discharge studies were carried out between 1A/g to 20 A/g current range. The MnO2-GO nanocomposites showed improved electrochemical performances. The capacitance of MnO2 and MnO2-GO electrodes was found to be as 300 F/g, and 350 F/g, respectively at a current of 0.5 A/g.
Kα X-ray sources generated from the interaction of ultra-short laser pulses with solids are compact and low-cost source of ultra-short quasi-monochromatic X-rays compared with synchrotron radiation source. Development of collimated ultra-short Kα X-ray source by the interaction of 45 fs Ti:sapphire laser pulse with Cu wire target is presented in this paper. A study of the Kα source with laser parameters such as energy and pulse duration was carried out. The observed Kα X-ray photon flux was ~2.7 × 108 photons/shot at the laser intensity of ~2.8 × 1017 W cm−2. A model was developed to analyze the observed results. The Kα radiation was coupled to a polycapillary collimator to generate a collimated low divergence (0.8 mrad) X-ray beam. Such sources are useful for time-resolved X-ray diffraction and imaging studies.
Background: Wearable activity trackers are an innovative tool for measuring sleep and physical activity. The Resident Activity Tracker Evaluation (RATE) is a prospective observational study evaluating the impact of work-hours, sleep, and physical activity on resident well-being, burnout, and job satisfaction. Methods: Residents were recruited from: 1. general surgery and orthopedics (SURG), 2. internal medicine and neurology (MED) and 3. anesthesia and radiology (RCD). Groups 1 and 2 do not enforce on-call duration restrictions and group 3 had 12-hour restricted-call durations (RCD). Participants wore FitBit activity trackers for 14 days and completed four validated surveys assessing self-reported health, sleepiness, burnout, and job satisfaction. Results: Fifty-nine residents completed the study. 778 days of activity and 244 on-call periods were tracked. Surgical residents worked 24 more hours per week than non-surgical residents (84.3 vs 60.7). Surgical residents had 7 less hours of sleep per week and reported significantly higher Epworth Sleepiness scores. Nearly two-thirds of participants (61%) scored high burnout on the Maslach depersonalization subscore. Total steps per day and self-reported well-being, burnout, and job satisfaction were comparable between the groups. Conclusions: Despite a positive correlation between work-hours and sleepiness, burnout and well-being were similar among residents. Physical activity did not prevent burnout. These findings are relevant to work-hours policies.
Background: Tuberous sclerosis complex (TSC) is a neurocutaneous disorder with a wide spectrum of manifestations. Recent consensus recommendations stress the importance of multidisciplinary management of children with TSC. The objective of this study was to examine the manifestations of TSC at a large referral centre to determine the care needs of this population. Methods: A retrospective, systematic chart review was performed of children with TSC managed at British Columbia Children’s Hospital. Patients were identified through epilepsy and clinical neurophysiology databases. Results: The study population comprised 81 patients, born between 1987 and 2014, who were a median of 10 years (range, 0.2-23.2) at most recent follow-up. Epilepsy occurred in 91% of patients, including 32% with a history of infantile spasms. Nineteen patients underwent epilepsy surgery, nine (47%) of whom were seizure-free at most recent follow-up. Overall, 61% of epilepsy patients had been seizure-free for at least 1 year at the time of last follow-up. Neuropsychiatric disorders were diagnosed in 49% of children, with autism (25%), attention deficit hyperactivity order (19%) and anxiety (16%) being the most common. Cardiac rhabdomyomata occurred in 35% of children and renal angiomyolipomas were seen in 43%. A total of 91% had skin manifestations. Conclusion: This study outlines the multisystem manifestations of TSC, observed through a large pediatric referral center. Epilepsy and neuropsychiatric disorders are the major source of morbidity in this age group and provide many challenges to the treating clinician. Because a subset of the study population is still quite young, the prevalence of neuropsychiatric disorders is likely underestimated.
Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is currently being used for rapid and reproducible identification of bacteria, viruses and fungi in clinical microbiological laboratories. However, some studies have also reported the use of MALDI-TOF MS for identification of parasites, like Leishmania, Giardia, Cryptosporidium, Entamoeba, ticks and fleas. The present review collates all the information available on the use of this technique for parasites, in an effort to assess its applicability and the constraints for identification/diagnosis of parasites and diseases caused by them. Though MALDI-TOF MS-based identification of parasites is currently done by reference laboratories only, in future, this promising technology might surely replace/augment molecular methods in clinical parasitology laboratories.
We analyze the effect of functionalization in the surface of zinc oxide crystal structure by 3-mercaptopropionic acid. X-ray powder diffraction data and extended x-ray absorption fine structure studies confirms a wurtzite structure. However, the morphology of the surface seems to be reduced and shows a film-like surface as demonstrated by x-ray absorption near edge structure and scanning electron microscopy. As a result of surface functionalization, the energy levels of the semiconductor were shifted toward reductive potentials (by 50 mV) as determined by diffuse reflectance and cyclic voltammetry.
Non-communicable diseases (NCD) and atherosclerotic CVD in particular, are the most important health problems of the 21st century. Already in every world region except Africa, NCD account for greater mortality than communicable, maternal, perinatal and nutritional conditions combined. Although modifiable lifestyle factors in adults are the main determinants, substantial evidence now suggests that factors in early life also have a major role in the development of NCD; commonly referred to as the Developmental Origins of Health and Disease hypothesis. Factors in utero, early postnatal life and throughout childhood, have been shown to affect NCD by influencing risk factors for CVD such as obesity, diabetes, hypertension and dyslipidaemia. Infant nutrition (e.g. breastfeeding rather than bottle feeding) and a slower pattern of infant weight gain have been shown to be particularly protective against later risk of obesity and CVD in both low- and high-income countries. The mechanisms involved are poorly understood, but include epigenetic changes; effects on endocrine systems regulating body weight, food intake and fat deposition; and changes in appetite regulation. As a consequence, strategies to optimise early life nutrition could make a major contribution to stemming the current global epidemic of NCD. This review will consider the role of early life factors in the development of NCD, focusing on the impact of infant nutrition/growth on obesity and CVD. The review will highlight the experimental (randomised) evidence where available, briefly summarise the underlying mechanisms involved and consider the implications for public health.
This study aimed to develop a functional model of subglottic stenosis by inducing direct airway irritation in transplanted mouse laryngotracheal complexes.
Laryngotracheal complexes from C57BL/6 mice were harvested and divided into three groups: uninjured, mechanically injured and chemically injured. Donor laryngotracheal complexes from each group were placed in dorsal subcutaneous pockets of recipient mice. Each week, the transplanted laryngotracheal complexes were harvested, and tissues were fixed, sectioned, and stained with haematoxylin and eosin. Representative slides were reviewed by a blinded pathologist, to determine the formation of granulation tissue, and graded as to the degree of granulation formation.
Direct airway irritation induced granulation tissue formation under the disrupted epithelium of airway mucosa; this was seen as early as two weeks after chemical injury.
Results indicate that granulation tissue formation in a murine model may be an efficient tool for investigating the development and treatment of subglottic stenosis.