The Arm Motion (AMD) Detection Test

Stroke can lead to sensory deficits that impair functional control of arm movements. Here we describe a simple test of arm motion detection (AMD) that provides an objective, quantitative measure of movement perception related proprioceptive capabilities in the arm. Seven stroke survivors and thirteen neurologically intact control subjects performed the AMD test. In a series of ten trials that took less than 15 minutes to complete, participants used a two-button user interface to adjust the magnitude of hand displacements produced by a horizontal planar robot until the motions were just perceptible (i.e. on the threshold of detection). The standard deviation of movement detection threshold was plotted against the mean and a normative range was determined from the data collected with control subjects. Within this normative space, subjects with and without intact proprioception could be discriminated on a ratio scale that is meaningful for ongoing studies of degraded motor function. Thus, the AMD test provides a relatively fast, objective and quantitative measure of upper extremity proprioception of limb movement (i.e. kinesthesia)

Tactile Proprioceptive Input in Robotic Rehabilitation after Stroke

Stroke can lead to loss or impairment of somatosensory sensation (i.e. proprioception), that reduces functional control of limb movements. Here we examine the possibility of providing artificial feedback to make up for lost sensory information following stroke. However, it is not clear whether this kind of sensory substitution is even possible due to stroke-related loss of central processing pathways that subserve somatosensation. In this paper we address this issue in a small cohort of stroke survivors using a tracking task that emulates many activities of daily living. Artificial proprioceptive information was provided to the subjects in the form of vibrotactile cues. The goal was to assist participants in guiding their arm towards a moving target on the screen. Our experiment indicates reliable tracking accuracy under the effect of vibrotactile proprioceptive feedback, even in subjects with impaired natural proprioception. This result is promising and can create new directions in rehabilitation robotics with augmented somatosensory feedback

Methotrexate Encephalopathy: Two Cases in Adult Cancer Patients, Who Recovered with Pathophysiologically Based Therapy

Background/Objectives: Neurotoxicity is a serious and sometimes fatal adverse effect that can occur following methotrexate treatment. We describe two adult patients with hematological malignancies with methotrexate encephalopathy who recovered with dextromethorphan therapy. Results: Case 1 : A 24-year-old male with acute lymphoblastic leukemia developed the acute onset of bilateral facial weakness and slurred speech after his first treatment with high-dose intravenous methotrexate. The clinical scenario and a head magnetic resonance imaging supported a diagnosis of methotrexate encephalopathy. Treatment with dextromethorphan was coincident with recovery. Case 2 : A 65-year-old female with recurrent diffuse large B-cell lymphoma was treated with high- dose intravenous methotrexate. Two weeks after a cycle, she developed hypoactive delirium, marked lethargy, ocular ataxia, and a right-sided facial weakness. Within 2 days of starting dextromethorphan, there was improvement with clinical recovery. Conclusions: These two cases suggest that N -methyl d -aspartate receptor activation by homocysteine may play an important role in the pathogenesis of methotrexate neurotoxicity

Combining QCD Matrix Elements at Next-to-Leading Order with Parton Showers in Electroproduction

We present a method to combine next-to-leading order (NLO) matrix elements in QCD with leading logarithmic parton showers by applying a suitably modified version of the phase-space-slicing method. The method consists of subsuming the NLO corrections into a scale-dependent phase-space-slicing parameter, which is then automatically adjusted to cut out the leading order, virtual, soft and collinear contributions in the matrix element calculation. In this way a positive NLO weight is obtained, which can be redistributed by a parton shower algortihm. As an example, we display the method for single-jet inclusive cross sections at O(alpha_s) in electroproduction. We numerically compare the modified version of the phase-space-slicing method with the standard approach and find very good agreement on the percent level.Comment: 21 pages, 2 eps figures. Revised section 2. To appear in PR

Sorghum and Millets Diseases A Second World Review

This book is the product of an international workshop held at Harare, Zimbabwe, in Mar 1988. Progress made on sorghum diseases since the first global workshop held in India in 1978 is reviewed; research needs and goals for the next decade are identified; and the strengthening of working relationships among pathologists studying sorghum and millets diseases discussed. Also included are recommendations made by workshop participants and reports on group discussions

The State of Theory in LGBTQ Aging: Implications for Gerontological Scholarship

Social research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) aging is a rapidly growing field, but an examination of the use of theory has not yet been conducted for its impact on the field’s direction. We conducted a systematic review of empirical articles published in LGBTQ aging in the years 2009–2017 (N = 102). Using a typology of theory use in scholarly articles, we analyzed these articles for the types of theories being used, the degree to which theories were used in each article, and the analytical function they served. We found that 52% of articles consistently applied theory, 23% implied or partially applied theory, and 25% presented as atheoretical. A wide range of theories were used and served multiple analytical functions such as concept development and explanation of findings. We discuss the strengths and weaknesses of theory use in this body of literature, especially with respect to implications for future knowledge development in the field

Comparative effectiveness of dual-action versus single-action antidepressants for the treatment of depression in people living with HIV/AIDS

Background Depression is the most common psychiatric comorbidity among people living with HIV/AIDS (PLWHA). Little is known about the comparative effectiveness between different types of antidepressants used to treat depression in this population. We compared the effectiveness of dual-action and single-action antidepressants in PLWHA for achieving remission from depression. Methods We used data from the Centers for AIDS Research Network of Integrated Clinic Systems to identify 1175 new user dual-action or single-action antidepressant treatment episodes occurring from 2005 to 2014 for PLWHA diagnosed with depression. The primary outcome was remission from depression defined as a Patient Health Questionnaire-9 (PHQ-9) score <5. Mean difference in PHQ-9 depressive symptom severity was a secondary outcome. The main approach was an intent-to-treat (ITT) evaluation complemented with a per protocol (PP) sensitivity analysis. Generalized linear models were fitted to estimate treatment effects. Results In ITT analysis, 32% of the episodes ended in remission for both dual-action and single-action antidepressants. The odds ratio (OR) of remission was 1.02 (95%CI=0.63,1.67). In PP analysis, 40% of dual-action episodes ended in remission compared to 32% in single-action episodes. Dual-action episodes had 1.33 times the odds of remission (95%CI=0.55,3.21), however the result was not statistically significant. Non-significant differences were also observed for depressive symptom severity. Limitations Missing data was common but was addressed with inverse probability weights. Conclusions Results suggest that single-action and dual-action antidepressants are equally effective in PLWHA. Remission was uncommon highlighting the need to identify health service delivery strategies that aid HIV providers in achieving full remission of their patients’ depression

Trajectories of Depressive Symptoms Among a Population of HIV-Infected Men and Women in Routine HIV Care in the United States

Depressive symptoms vary in severity and chronicity. We used group-based trajectory models to describe trajectories of depressive symptoms (measured using the Patient Health Questionnaire-9) and predictors of trajectory group membership among 1493 HIV-infected men (84%) and 292 HIV-infected women (16%). At baseline, 29% of women and 26% of men had depressive symptoms. Over a median of 30 months of follow-up, we identified four depressive symptom trajectories for women (labeled “low” [experienced by 56% of women], “mild/moderate” [24%], “improving” [14%], and “severe” [6%]) and five for men (“low” [61%], “mild/moderate” [14%], “rebounding” [5%], “improving” [13%], and “severe” [7%]). Baseline antidepressant prescription, panic symptoms, and prior mental health diagnoses were associated with more severe or dynamic depressive symptom trajectories. Nearly a quarter of participants experienced some depressive symptoms, highlighting the need for improved depression management. Addressing more severe or dynamic depressive symptom trajectories may require interventions that additionally address mental health comorbidities

Fertility, Living Arrangements, Care and Mobility

There are four main interconnecting themes around which the contributions in this book are based. This introductory chapter aims to establish the broad context for the chapters that follow by discussing each of the themes. It does so by setting these themes within the overarching demographic challenge of the twenty-first century – demographic ageing. Each chapter is introduced in the context of the specific theme to which it primarily relates and there is a summary of the data sets used by the contributors to illustrate the wide range of cross-sectional and longitudinal data analysed

Intergenerational Education: The significance of 'reciprocity' and 'place'

In this article, the case is made for greater clarity in the definition of intergenerational practice and intergenerational education. Theoretically, the effects of all-age reciprocity and the significance of attending to 'place' are explored. Taken together, they help point to what is distinctive about the scope and purpose of intergenerational education. The author argues that any intergenerational practice must always involve an educative element that is focused, at least in part, on the on-going reciprocal production of new relations between generations through the way challenges are purposefully responded to in some specific place