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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.
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.
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.
Background: Fundoscopy is an important component of the neurological examination, but can be challenging in uncooperative children. This study explores whether playing a video during eye examination, improves the success, duration and ease of pediatric fundoscopy. Methods: We completed a prospective, multi-clinic, block-randomized trial. Patients 1-4 years were recruited in the emergency department, neurology, spinal cord and general pediatric clinic. Patients were randomized (by eye examined) to video/non-video assisted fundoscopy. Successful exams were defined as visualizing the fundus within 60 seconds. Time to visualize optic disc was recorded and difficulty of exam was examined using a 10-point Likert scale. Results: 101 subjects were recruited, with a mean age of 2.8 years. Overall, there was a 20% absolute improvement in the success rate of visualizing the optic disc in the video versus non-video group (p<0.01). Time to visualize optic disc was also improved (Δ5.3s, p<0.01). Improvement in ease of examination with video were noted by caregivers and practitioners (p<0.01). Conclusion: Playing a video improved the ease, duration and most importantly the success of fundoscopy in younger children. This simple, inexpensive adjunct has great potential to improve the ease and efficacy of this aspect of the neurological examination.
Regenerative medicine using patient's own stem cells (SCs) to repair dysfunctional tissues is an attractive approach to complement surgical and pharmacological treatments for aging and degenerative disorders. Recently, dental SCs have drawn much attention owing to their accessibility, plasticity and applicability for regenerative use not only for dental, but also other body tissues. In ophthalmology, there has been increasing interest to differentiate dental pulp SC and periodontal ligament SC (PDLSC) towards ocular lineage. Both can commit to retinal fate expressing eye field transcription factors and generate rhodopsin-positive photoreceptor-like cells. This proposes a novel therapeutic alternative for retinal degeneration diseases. Moreover, as PDLSC shares similar cranial neural crest origin and proteoglycan secretion with corneal stromal keratoctyes and corneal endothelial cells, this offers the possibility of differentiating PDLSC to these corneal cell types. The advance could lead to a shift in the medical management of corneal opacities and endothelial disorders from highly invasive corneal transplantation using limited donor tissue to cell therapy utilizing autologous cells. This article provides an overview of dental SC research and the perspective of utilizing dental SCs for ocular regenerative medicine.
Rhabdomyosarcoma is a malignant mesenchymal neoplasm rarely diagnosed in the larynx. Traditionally, it has been treated by radical surgery (i.e. total laryngectomy), followed by radiation and/or chemotherapy. Recent advances suggest that it may be treated with combination therapy comprising high-dose radiation and pulse chemotherapy, with a high success rate.
We report the first documented case of subglottic embryonal rhabdomyosarcoma in an adolescent female treated with chemoradiation alone, and review the literature reflecting a move towards organ preservation.
While surgery has been successfully used to treat this neoplasm, combination therapy, as described in our study, also seems effective and has the added advantage of preserving laryngeal function.
We investigated an unprecedented outbreak of fulminant hepatitis B virus (HBV) that occurred in Modasa, Gujarat (India) in 2009. Genomic analysis of all fulminant hepatic failure cases confirmed exclusive predominance of subgenotype D1. A1762T, G1764A basal core promoter (BCP) mutations, insertion of isoleucine after nt 1843, stop codon mutation G1896A, G1862T transversion plus seven other mutations in the core gene caused inhibition of HBeAg expression implicating them as circulating precore/BCP mutant virus. Two rare mutations at amino acids 89 (Ile→Ala) and 119 (Leu→Ser) in addition to other mutations in the polymerase (pol) gene may have caused some alteration in either of four pol gene domains to affect encapsidation of pregenomic RNA to enhance pathogenicity. Sequence similarity among patients' sequences suggested an involvement of a single hepatitis B mutant strain/source to corroborate the finding of gross and continued usage of HBV mutant-contaminated syringes/needles by a physician which resulted in this unprecedented outbreak of fulminant hepatitis B. The fulminant exacerbation of the disease might be attributed to mutations in the BCP/precore/core and pol genes that may have occurred due to selection pressure during rapid spread/mutation of the virus.
Twenty crossbred lactating multiparous cows were used in a 28-day study to compare dry matter intake (DMI), milk yield, milk composition and Bacillus thuringiensis (Bt) protein concentrations in plasma when fed diets containing Bollgard II® cottonseed (BGII) or a control non-genetically modified isogenic cottonseed (CON). Bollgard II cottonseed contains the Cry1Ac and Cry2Ab insecticidal proteins that protect cotton plants from feeding damage caused by certain lepidopteran insects. Cows were assigned randomly to the BGII or CON treatments after a 2-week adjustment period. Cows consumed a concentrate containing 40% crushed cottonseed according to milk yield and green maize forage ad libitum. All cows received the same diet but with different crushed cottonseed sources. Cottonseed was included to provide approximately 2.9 kg per cow daily (dry matter basis). The ingredient composition of the concentrate was 40% crushed cottonseed, 15% groundnut cake, 20% corn, 22% wheat bran, 1% salt and 2% mineral mixture. Milk and blood plasma were analyzed for Cry1Ac and Cry2Ab proteins. DMI, BW, milk yield and milk components did not differ between cows on the BGII and CON treatments. Although milk yield and milk fat percentage were not affected by treatment, 4% fat-corrected milk (FCM) production and FCM/kg DMI for cows on the BGII treatment (14.0 kg/cow per day, 1.12 kg/kg) were significantly improved compared with cows on the CON treatment (12.1 kg/cow per day, 0.97 kg/kg). Gossypol contents in BGII cottonseed and conventional cottonseed were similar. Cry1Ac and Cry2Ab2 proteins in Bollgard II cottonseed were 5.53 and 150.8 μg/g, respectively, and were not detected in the milk or plasma samples. The findings suggested that Bollgard II cottonseed can replace conventional cottonseed in dairy cattle diets with no adverse effects on performance and milk composition.
Although Injury is being looked into as a major public health problem in India, most of the data coming is mortality related data from the National Crime Records Bureau and projections based on that data. There is complete absence if injury related data both surveillance data as well as outcome based data. Apex Trauma Center, All India Institute of Medical Sciences, New Delhi is one of the pioneering centers to understand the need to record the injury related data of all trauma cases which are admitted to the Apex Center, thus establishing a first of its kind hospital based Trauma Registry in India. This trauma registry will serve as a means for collating trauma data that will further help in the evaluation, prevention, and research of trauma care and can be used for quality control and planning future research and injury prevention activities, in India. Later, the center has an objective of networking all regional hospitals for data collection with an aim to establish a National Trauma Registry. Although several trauma registry software's exist from Western hemisphere but the Apex Trauma Center decided to formulate and designed its own Trauma Registry form and develop the related software which includes: Basic Identification; Demographic profile; Brought by personnel and vehicle; Condition at time of arrival; ED Interventions; Detailed Diagnosis; Definitive Procedures; Disposition/ Outcome The Trauma registry is being maintained, under the leadership of a Faculty and the data is collected and entered by the Trauma Nurse Coordinators, who follow the patient from admission to discharge. The data collection for the JPNATC Trauma Registry had started w.e.f. April 2009, but initially there were usual problems of data loss and non-availability of data. This has been overcome gradually and we hope that the registry will attain its full potential in another year or so.
There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide.
A retrospective study of patients with maxillofacial fractures seen and treated at the Jai Parkash Narayan Apex Trauma Center, AIIMS, New Delhi, India between January 2007 to June 2010. Data extracted from the patients' records include aetiology, age, sex, types and sites of fractures, treatment modality and concomitant injuries.
There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (56.8%) was the most common aetiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 years to 75 years (mean = 34.7) with a peak incidence in the 3rd decade with a male–female sex ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615(77%) and middle third 205(23%). With regards to mandibular fractures, the body (29.6%) was the commonest sites, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%) and Lefort III (3.3%). Majority of the patients were treated by Open reduction and internal fixation (70.6). Concomitant injuries were 10.8% with orthopaedic injuries accounting for the majority (63.9%). Head injury was associated with 16.3 % of cases.
Maxillofacial fractures are on the increase. We advocate the establishment of regionalized trauma centers with basic training available to all surgical residents for initial emergency room management.
Shape memory polymers (SMPs) are increasingly being considered for use in minimally invasive medical devices. For safe deployment of implanted devices it is important to be able to precisely control the actuation temperature of the device. In this study we report the effect of varying monomer composition on the glass transitions/actuation temperatures (Tg) of novel low density shape memory foams. The foams were based on hexamethylenediisocyanate (HDI), triethanolamine (TEA) and tetrakis (2-hydroxyl propyl) ethylenediamine (HPED), and were produced via a combination of chemical and physical blowing process. The process for post-foaming cleaning was also varied. Foams were characterized by DSC, DMA, and for shape memory. No clear trends were observed for foam samples without cleaning, and this was attributed to process chemicals acting as plasticizers. In foams cleaned via washing and/or sonication, the Tg was observed to decrease for compositions that were higher in the TEA content. Also, no change in shape memory behavior was observed for varying compositions. This work demonstrates the ability to tailor actuation transition temperature while maintaining shape memory behavior for low density foams suitable for aneurysm treatment.
Our experience with shape memory polymers (SMP) began with a project to develop an embolic coil release actuator in 1996. This was the first known SMP device to enter human trials. Recent progress with the SMP devices include multiple device applications (stroke treatments, stents, other interventional devices), functional animal studies, synthesis and characterization of new SMP materials, in vivo and in vitro biocompatibility studies and device-tissue interactions for the laser, resistive, or magnetic-field activated actuators. We describe several of our applied SMP devices.
In the hilly areas of eastern Gujarat, western Madhya Pradesh and southern Rajasthan, in western India, farmers are very resource-poor and cultivate small and fragmented land holdings. Maize is their main rainy season (kharif) cereal and it is grown as a rainfed crop in low-fertility fields, often on sloping land that is vulnerable to soil erosion. Its productivity is very low, averaging below 1 t ha−1. New farm technologies to increase this productivity have to be low cost to be attractive to farmers who have limited access to purchased inputs and few means to purchase them. From observations of local farming practices, intercropping of maize with legumes was identified as an attractive option because the only additional input needed is seed of the legume crop. Participatory research was conducted on intercropping of maize with improved varieties of horsegram (Macrotyloma uniflorum). Many farmers who tried this intercropping adopted it in subsequent years, while others preferred to grow the new horsegram varieties as a sole crop. Farmers reported that less weeding was required in the intercrop as the horsegram smothered weeds. All farmers used the dry stover from the horsegram as a fodder for their animals. Farmers used the whole seed as dal, which provided additional protein in their diet. Farmers also sold the grain, but it fetched a low price in the poorly developed market for horsegram. Previously intercropping had been tried with local landraces, but the acceptance of intercropping was higher with new varieties such as AK-42 that yielded over 60% more grain. Participatory trials in which only one entry was compared with the local variety did not show a difference between AK-21 and AK-42 as in all cases both were preferred over the local variety. When they were directly compared with each other, farmers' perceptions showed a significant preference for AK-42. Variety IVH-2 was found to be better than AK-42: it matured 15 days earlier, better matching the maturity of the maize, had superior grain quality and yielded about the same. The greater uptake of improved horsegram varieties for sole and intercropping is likely to be limited by the lack of seed supply.
Neel S. Singhal, University of Pennsylvania, School of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism Philadelphia, Pennsylvania 19104, USA,
Rexford S. Ahima, University of Pennsylvania, School of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism Philadelphia, Pennsylvania 19104, USA
The hypothalamus is a critical integrator of peripheral and central signals that mediate energy homeostasis. Over the last two decades, substantial progress has been made in elucidating the details of how neural, hormonal and nutrient signals from the gut and adipose tissue act on specific hypothalamic pathways to control energy balance and various physiologic processes. These hypothalamic circuits affect not only appetite, but through their diverse projections to the autonomic nervous system, brainstem and higher centers also influence motivational and motor function, and the endocrine system via the pituitary gland. Although the details of the interacting factors and effector mechanisms remain an area of active research, it is clear that neuropeptides at the level of the hypothalamus modulate key aspects of feeding behavior, energy expenditure and neuroendocrine function (Grill & Kaplan, 2002). In this chapter, we provide an overview of the hypothalamic circuitry within a framework for understanding its role as a sensor, integrator and effector of energy homeostasis and diverse physiologic processes.
Classical role of the hypothalamus in feeding regulation
A crucial involvement of the base of the diencephalon in energy homeostasis was first suggested by clinical observations in patients with pituitary tumors associated with excessive fat deposition and hypogonadism (Bramwell, 1888; Frolich, 1901). Several animal studies confirmed the importance of this region in body weight regulation, but it was not until the experiments of Hetherington and Ranson that the role of the hypothalamus rather than that of the pituitary gland was firmly established.
Photoactive yellow protein (PYP) is a small cytosolic photoreceptor that actuates the negative phototactic response in its host organism Halorhodospira halophila. It has an optical absorption maximum at 446 nm (blue light). We report an initial study of the photocycle of PYP at the single molecule level using “high enhancement factor” surface-enhanced Raman scattering (SERS)-active nanostructures with 514 nm laser excitation. The SERS-active “nanometal-on-semiconductor” structures are prepared employing a redox technique on thin germanium films, coated on glass slides. Single molecule spectra are observed in terms of sudden appearance of discernable Raman peaks with spectral fluctuations. The single molecule spectra capture protonation, photo-isomerization, and H-bond breaking - the steps that are instrumental in the photocycle of PYP. This is indicative of single PYP molecules diffusing to high-enhancement-factor SERS sites, and undergoing photo-cycle under 514 nm excitation.
Thin films of 8 mol% yttria-stabilized zirconia (YSZ) of thickness ranging from 15nm-500nm have been deposited on Si3N4(90nm)/Si substrates by RF sputtering at room temperature. These samples have been studied using in situ ion scattering techniques including Rutherford backscattering spectrometry (RBS) and nuclear reaction analysis (NRA) to analyze the oxygen distribution and defect chemistry as a function of annealing in various oxidizing and reducing ambient upto 500°C. In addition, the structural quality of these films after long time annealing has been investigated using grazing incidence X-ray diffraction (GIXRD). Temperature dependent X-ray absorption spectroscopy (XAS) has been performed to study the unoccupied density of states and chemical nature of YSZ. In this paper, we will discuss in detail the effects of annealing in different ambient on the defect chemistry, structure and stability of films in these materials systems.
LiMn1.5Ni0.5O4 cathode material was prepared by sol-gel method and annealed at 850°C for 15 hrs. The prepared powder was coated with ZnO by dissolving zinc acetate in methanol and LiMn1.5Ni0.5O4 powder was mixed in this solution followed by the continuous stirring for 4 hr. The LiMn1.5Ni0.5O4 and ZnO coated LiMn1.5Ni0.5O4 powder was characterized using X-ray diffraction, TEM and Raman spectroscopy. The coin cell was fabricated using LiMn1.5Ni0.5O4 and ZnO coated LiMn1.5Ni0.5O4 as cathode materials, LiPF6, dissolved in EC/DMC (1:1 wt ratio) as electrolyte, and Li foil as anode. The cyclic voltammetric and charge-discharge characteristics were carried out for the coin cell using LiMn1.5Ni0.5O4 and ZnO coated LiMn1.5Ni0.5O4 cathode materials. It was found that the ZnO coated LiMn1.5Ni0.5O4 cathode materials showed improved discharge capacity (∼146mAh/g) as compared to the pure LiMn1.5Ni0.5O4 (∼140mAh/g). The discharge capacity retention after 50 cycles was found to be about 94% and 97% for LiMn1.5Ni0.5O4 and ZnO coated LiMn1.5Ni0.5O4 cathode materials, respectively.
Nickel-substituted Bi4Ti3O12 (i.e., Bi4-xNixTi3O12) were synthesized by sol-gel process for different compositions. Thin films were deposited on Pt (i.e., Pt/TiO2/SiO2/Si) substrate by spin coating. Materials were characterized by x-ray diffraction and Raman spectroscopy. This study indicates that the material makes a solid solution for the compositions: x = 0.00, 0.05, 0.10, 0.15, 0.20, and 0.30, where a Ni ion replaces the Bi site. The prominent effect of Ni substitution was observed in low-frequency Raman modes. Sol-gel derived thin films of Bi4-xNixTi3O12 on a Pt substrate and post annealed at 700°C were tested for ferroelectric response which showed high remnant polarization (Pr = 22 μC/cm2 for x = 0.15). The leakage current (less then 10−7 A/cm2) at low field was observed in the film with composition x = 0.15 .The polarization of the BNiT (x = 0.15) film decreased to 83% of the initial value after 1×109 switching cycles These results indicate the potential application of Ni substituted bismuth titanate films in non-volatile ferroelectric memories.