Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Background: Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. Methods: A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. Results: Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. Conclusion: Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery

Bond of FRP bars in air-entrained concrete : experimental and statistical study

The combined use of Fibre Reinforced Polymer (FRP) and Air-Entrained Concrete (AEC) can be an alternative to traditional steel-reinforced concrete as this system is less affected by the corrosion of the reinforcement and by the freeze-thaw cycles induced concrete degradation. However, the viability of this system hinges on the bond performance of the reinforcing bars. A total of 236 pull-out specimens were prepared and tested to study the effect of air-entraining admixtures (AEA) on the bond behaviour of FRP bars to concrete with varying compressive strengths. Failure modes and bond stress-slip curves were reported and discussed. The bond energy, calculated as the area under the bond stress-slip diagram, was also analyzed. The experimental peak bond stresses (bond strength) were compared to the theoretical ones characterized by the formula proposed for steel bars by the Model Code 2010. In addition, the statistical significance of the effect of AEA on bond characteristics was determined, yielding a reduction factor to account for the effect of AEA on bond strength. The test results show that the bond strength of FRP bars in AEC was statistically significantly lower than in normal concrete. However, the decrease is sufficiently small that could be accounted for, during the design stage, by merely increasing the reinforcement development length

Build it and they will come : maintaining students access to fabrication and testing during a pandemic

The Civil Engineering curriculum at Sheffield University offers students the opportunity to work in groups to design, build and test models. This fulfils vital learning outcomes for accreditation requirements. The onset of the pandemic restricted the amount of face-to-face teaching. Presented here are methodologies to reconfigure teaching with restricted access to allow learning outcomes to be achieved while keeping students motivated. Traditional hands-on manufacturing and testing were replaced by “service” build and test schemes that hinged around the typical relationship between a designer (students) and a contractor. With the use of screens, PPE and careful communication, fabrication activities simulated an “assembly line” relay rather than the traditional “fixed-position assembly” allowing the activity to safely run face-to-face. Students were able to engage individually and in groups on these teaching methods to execute exciting and real projects, in a way that is scalable to large class sizes (Garrard and Beck, 2018). We explore the advantages and drawbacks of these approaches and suggest elements to be retained when restrictions are lifted

Effective use of peer teaching and self-reflection for the pedagogical training of graduate teaching assistants in engineering

The use of the graduate teaching assistant (GTA) to support the teaching activities of higher education institutions has been growing over the years and it is now a well-established practice. Conventionally training sessions, consisting usually of workshops, remain general and overemphasise policies, not providing sufficient preparation for in-service teaching. This study proposes to overcome these shortcomings by introducing a new methodology that is based on the use of peer teaching and self-reflection and that is both continuous and discipline-specific. The analysis of the feedback, collected from GTAs’ teaching practical engineering sessions during a full academic year, shows that by engaging with the training, each GTA developed their reflective practice and their student-centred teaching. Interestingly, results also show that some GTA underwent a regression phase during the second semester. It is expected that only a training method that continuously supports their pedagogical development can lead these GTAs towards a recovery phase

Effect of temperature on the bond behaviour of GFRP bars in concrete

Glass Fibre Reinforced Polymer (GFRP) bars have been employed as internal reinforcement for concrete members when corrosion of the commonly used steel bars is expected to be an issue. While a good bond is anticipated between GFRP bars and concrete at ambient temperature, the bond performance at high temperature is expected to be reduced due to the physical and mechanical changes that the matrix undergoes at temperatures approaching the glass transition temperature (Tg). Up to date this phenomenon has only been marginally investigated and most of the available bond tests are performed at ambient temperatures after cooling of the heated specimens. This paper presents the results of an experimental investigation on the bond behaviour of GFRP bars in concrete and exposed to temperature levels ranging from ∼20 °C to 300 °C. The test specimens, consisting of an indented GFRP bar embedded in a cylindrical concrete block, were heated in an electric furnace. The pull-out tests were carried out within the furnace only after the temperature level, measured with thermocouples at the interface of GFRP and concrete, stabilized to the desired value. The paper discusses the effect of temperature on bond behaviour in terms of bond strength, bond stress-slip relationships and failure modes. A contactless technique measuring the free-end slip during pull-out tests at high temperatures was developed and its effectiveness demonstrated. Finally, the experimental results were used to calibrate the parameters of the two most widely used analytical models: mBPE and CMR

Effect of beam depth on shear behavior of FRP RC beams

The behavior of shear critical fiber-reinforced-polymer (FRP) RC elements is characterized by the development of comparatively large strains and crack widths, which can be strongly influenced by their relative geometrical size. This paper investigates experimentally the size effect on the shear behavior of FRP RC beams with and without shear reinforcement and with overall depth varying from 260 to 460 mm. The results confirm a considerable size effect for members without shear reinforcement, with an average reduction in normalized shear strength of about 19% and a maximum value up to 40%. It is also shown that current design provisions are overall conservative, but with nonuniform margins of safety that decrease with increasing member depth. It is anticipated that the results of this study will help improve the efficiency of future design equations for the shear strength of FRP RC

Characterization of chenopodin isoforms from quinoa seeds and assessment of their potential anti-inflammatory activity in Caco-2 cells

Several food-derived molecules, including proteins and peptides, can show bioactivities toward the promotion of well-being and disease prevention in humans. There is still a lack of information about the potential effects on immune and inflammatory responses in mammalian cells following the ingestion of seed storage proteins. This study, for the first time, describes the potential immunomodulation capacity of chenopodin, the major protein component of quinoa seeds. After characterizing the molecular features of the purified protein, we were able to separate two different forms of chenopodin, indicated as LcC (Low charge Chenopodin, 30% of total chenopodin) and HcC (High charge Chenopodin, 70% of total chenopodin). The biological effects of LcC and HcC were investigated by measuring NF-\u3baB activation and IL-8 expression studies in undifferentiated Caco-2 cells. Inflammation was elicited using IL-1\u3b2. The results indicate that LcC and HcC show potential anti-inflammatory activities in an intestinal cell model, and that the proteins can act differently, depending on their structural features. Furthermore, the molecular mechanisms of action and the structural/functional relationships of the protein at the basis of the observed bioactivity were investigated using in silico analyses and structural predictions

Hepatobiliary disease resection in patients with advanced epithelial ovarian cancer: prognostic role and optimal cytoreduction

Objective: The purpose of this study was to evaluate the feasibility and safety in terms of prognostic significance and perioperative morbidity and mortality of cytoreduction in patients affected by advance ovarian cancer and hepato-biliary metastasis. Methods: Patients with a least one hepatobiliary metastasis who have undergone surgical treatment with curative intent of were considered for the study. Perioperative complications were evaluated and graded with Accordion severity Classification. Five-year PFS and OS were estimated using the Kaplan–Meier curve. Results: Sixty-seven (20.9%) patients had at least one metastasis to the liver, biliary tract, or porta hepatis. Forty-four (65.7%) and 23 (34.3%) patients underwent respectively high and intermediate complexity surgery according. Complete cytoreduction was achieved in 48 (71.6%) patients with hepato-biliary disease. In two patients (2.9%) severe complications related to hepatobiliary surgery were reported. The median PFS for the patients with hepato-biliary involvement (RT = 0 vs. RT > 0) was 19 months [95% confidence interval (CI) 16.2–21.8] and 8 months (95% CI 6.1–9.9). The median OS for the patients with hepato-biliary involvement (RT = 0 vs. RT > 0) 45 months (95% CI 21.2–68.8 months) and 23 months (95% CI 13.9–32.03). Conclusions: Hepatobiliary involvement is often associated with high tumor load and could require high complex multivisceral surgery. In selected patients complete cytoreduction could offer survival benefits. Morbidity related to hepatobiliary procedures is acceptable. Careful evaluation of patients and multidisciplinary approach in referral centers is mandatory

Toxicity of thallium at low doses: A review

A mini review of the toxicity of Thallium (Tl) at low doses is herein presented. Thallium has severe toxicity. Although its acute biological effects have been widely investigated and are well known, its biological effects on human health and in cell cultures at low doses (<100 µg/L) due, for example, to Tl chronic exposure via consumption of contaminated water or foods, have often been overlooked or underestimated. Relatively few papers have been published on this topic and are herein reviewed to provide a focused scientific opinion in the light of current worldwide regulatory issues

A structure-based approach for novel immunodiagnostics targeting Trypanosoma cruzi and Schistosoma spp.

The tropical diseases Chagas Disease and Schistosomiasis, caused by the parasites Trypanosoma cruzi and Schistosoma spp, respectively, are often misdiagnosed and if untreated can be fatal. Indeed, their diagnosis presents a current challenge, due to difficulties in recognizing clinical symptoms and the lack of specific and reliable diagnostic tools. Highest prevalence is respectively in Latin America and Central Africa. However, massive human migration from endemic areas and travelling to tropical regions, contribute to the diffusion of these diseases in non-endemic areas, increasing the need of rapid diagnostic tools and prevention strategies. The aim of this project is to develop rapid, peptide-based microarrays that present multiple immunoreactive epitopes predicted from 3D protein structures of antigens from several pathogens, to be applied in point-of-care diagnostic kits for use in the Lombardy area of Italy. This approach showed promising results when applied to antigens from bacterial pathogens, in particular Burkholderia pseudomallei that led to the identification of epitopes with both diagnostic and therapeutic potential. Putative antigens selected from both parasites will be overexpressed, purified and crystallized for 3D structure studies. Based on the determined 3D protein structures, Molecular Dynamics (MD) analyses will be carried out and epitope predictions will be made on output MD structures using the Matrix of Local Coupling Energies method that detects residues located in conformationally dynamic regions of the protein surface. Predicted reactive epitopes will be synthetized as peptides, tested for immunoreactivity against immune sera from infected patients and used for antibody production. Selected immunoreactive synthetic peptides will be immobilised in specific orientations, using click chemistry, on a polymeric coated microarray chip. Sensitivity and specificity of the chip will be evaluated with sera of infected patients