From a B.A. in Speech Language Pathology to Becoming an Occupational Therapist; Change is Good!

Everyone thinks college is a time for you to pick a career and decide what you are going to do with the rest of your life. This is true in a way, but it is also a time for you to find yourself and decide who you want to be as a person in the future. Day 1 of my undergrad career consisted of my switching majors from elementary education to speech-language pathology. Going through some of the pre-requisite psychology classes, I also decided I wanted to be a psychology major, so I added that in my second year of undergrad. In addition, I added on a certification in Deaf Studies. I didn’t know what I wanted to be, so I was just going to do everything. During my last year of undergrad, I applied to 7 different graduate schools in order to be a speech-language pathologist. When graduation day came in 2010, I was not accepted to any of the graduate schools, despite my good grades and great GRE score. This turned out to be the best thing that could have happened to me. I never really felt 100% committed to speech pathology, so not being accepted to grad school was a blessing in disguise. I found Occupational Therapy while observing a speech pathologist and decided that is what I was meant to do. I loved all of my graduate classes and I truly enjoy going to work every day and helping those get back to their everyday activities (i.e. occupations). I am excited and happy to share my experiences and my journey to becoming an Occupational Therapist during this presentation

Cyclotetrasiloxanes modified with silsesquioxanes - synthesis and characterization

Silicon compounds play a very important function in different areas of chemistry due to their physicochemical properties, which include being hybrid compounds and thus affect many directions of application. Among them, the Cyclosiloxanes and silsesquioxanes that are used in this work are classical examples of those systems. Both have an inorganic core of Si-O-Si bonds with organic substituents at silicon atoms, resulting in different structures. The project presents basic literature on the chemistry of cyclosiloxanes and silsesquioxanes, the main methods of functionalization, and in the experimental part, the synthesis of T8 type silsesquioxanes and the catalytic reactivity of the Si-H compound in the hydrosilylation of tetravinylcyclotetrasiloxane is demonstrated.<br /

Prawo odstąpienia podróżnego od umowy o udział w imprezie turystycznej na tle ustawy o imprezach turystycznych i powiązanych usługach turystycznych

The analysis of the article covers selected issues related to the right of withdrawal from the contract for participation in a tourist event by the traveler. The reason for taking it is the content of article 47 of the Act on tourist events and related tourist services of 24 November 2017 and references made to the content of Directive 2015/2302/EU of the European Parliament and of the Council of 25 November 2015 on tourist events and related tourist services. It seems justified to precede the main considerations with a concise presentation of legal regulations strictly referring to the nature of the contract for participation in a tourist event and to define the basic concepts related to this issue.Analiza artykułu obejmuje swym zakresem wybrane kwestie związane z prawem odstąpienia od umowy o udział w imprezie turystycznej przez podróżnego. Asumptem do jej podjęcia jest treść art. 47 ustawy o imprezach turystycznych i powiązanych usługach turystycznych z dnia 24 listopada 2017 r. oraz odesłania czynione do treści dyrektywy Parlamentu Europejskiego i Rady nr 2015/2302/UE z dnia 25 listopada 2015 r. w sprawie imprez turystycznych i powiązanych usług turystycznych. Uzasadnione przy tym wydaje się poprzedzenie głównych rozważań zwięzłym przedstawieniem regulacji prawnej odnoszącej się stricte do charakteru umowy o udział w imprezie turystycznej oraz zdefiniowanie podstawowych pojęć odnoszących się do tego zagadnienia

Reduced Expression of miRNA-27a Modulates Cisplatin Resistance in Bladder Cancer by Targeting the Cystine/Glutamate Exchanger SLC7A11

Purpose: Resistance to cisplatin-based chemotherapy is a major obstacle to bladder cancer treatment. We aimed to identify microRNAs (miRNA) that are dysregulated in cisplatin-resistant disease, ascertain how these contribute to a drug-resistant phenotype, and how this resistance might be overcome. Experimental Design: miRNA expression in paired cisplatin-resistant and -sensitive cell lines was measured. Dysregulated miRNAs were further studied for their ability to mediate resistance. The nature of the cisplatin-resistant phenotype was established by measurement of cisplatin/DNA adducts and intracellular glutathione (GSH). Candidate miRNAs were examined for their ability to (i) mediate resistance and (ii) alter the expression of a candidate target protein (SLC7A11); direct regulation of SLC7A11 was confirmed using a luciferase assay. SLC7A11 protein and mRNA, and miRNA-27a were quantified in patient tumor material. Results: A panel of miRNAs were found to be dysregulated in cisplatin-resistant cells. miRNA-27a was found to target the cystine/glutamate exchanger SLC7A11 and to contribute to cisplatin resistance through modulation of GSH biosynthesis. In patients, SLC7A11 expression was inversely related to miRNA-27a expression, and those tumors with high mRNA expression or high membrane staining for SLC7A11 experienced poorer clinical outcomes. Resistant cell lines were resensitized by restoring miRNA-27a expression or reducing SLC7A11 activity with siRNA or with sulfasalazine. Conclusion: Our findings indicate that miRNA-27a negatively regulates SLC7A11 in cisplatin-resistant bladder cancer, and shows promise as a marker for patients likely to benefit from cisplatin-based chemotherapy. SLC7A11 inhibition with sulfasalazine may be a promising therapeutic approach to the treatment of cisplatin-resistant disease

Klasyczne leczenie modyfikujące oraz leczenie biologiczne a ryzyko rozwoju nowotworów w reumatologii

  W leczeniu chorób reumatycznych jednym z problemów jest ryzyko rozwoju nowotworów, zarówno w kontekście wysokiej aktywności zapalnej, jak i w odniesieniu do nowoczesnych terapii. Współcześnie coraz szersze stosowanie leków modyfikujących przebieg choroby, a także nowych leków biologicznych, nasuwa pytanie o bezpieczeństwo takiej terapii. Ta publikacja jest próbą odpowiedzi na pytanie, czy w świetle publikowanych danych terapie biologiczne mają związek z większym ryzykiem rozwoju nowotworów. Znacząca większość dostępnych danych informuje o dużym profilu bezpieczeństwa stosowania leków biologicznych. Wykazują one, że ryzyko rozwoju nowotworów nie różni się istotnie od ryzyka populacyjnego. Forum Reumatol. 2016, tom 2, nr 1, 32–38 Słowa kluczowe: leki biologiczne; nowotwory; ryzyko nowotworu

A diagnostic framework to identify vestibular involvement in multi-sensory neurological disease

BACKGROUND AND PURPOSE: Identifying vestibular causes of dizziness and unsteadiness in multi-sensory neurological disease can be challenging, with problems typically attributed to central or peripheral nerve involvement. Acknowledging vestibular dysfunction as part of the presentation provides an opportunity to access targeted vestibular rehabilitation, for which extensive evidence exists. A diagnostic framework was developed and validated to detect vestibular dysfunction, benign paroxysmal positional vertigo or vestibular migraine. The specificity and sensitivity of the diagnostic framework was tested in patients with primary mitochondrial disease. METHODS: Adults with a confirmed diagnosis of primary mitochondrial disease were consented, between September 2020 and February 2022. Participants with and without dizziness or unsteadiness underwent remote physiotherapy assessment and had in-person detailed neuro-otological assessment. The six framework question responses were compared against objective neuro-otological assessment or medical notes. The output was binary, with sensitivity and specificity calculated. RESULTS: Seventy-four adults completed the study: age range 20-81 years (mean 48 years, ±SD 15.05 years); ratio 2:1 female to male. The framework identified a vestibular diagnosis in 35 participants, with seven having two diagnoses. The framework was able to identify vestibular diagnoses in adults with primary mitochondrial disease, with a moderate (40-59) to very high (90-100) sensitivity and positive predictive value, and moderate to high (60-74) to very high (90-100) specificity and negative predictive value. CONCLUSIONS: Overall, the clinical framework identified common vestibular diagnoses with a moderate to very high specificity and sensitivity. This presents an opportunity for patients to access effective treatment in a timely manner, to reduce falls and improve quality of life

Home-based multi-sensory and proximal strengthening program to improve balance in Charcot–Marie–Tooth disease Type 1A: A proof of concept study

Introduction/Aims: People with Charcot–Marie–Tooth Disease (CMT) frequently report problems with balance, which lead to an increased risk of falls. Evidence is emerging of training interventions to improve balance for people with CMT, but to date all have relied on clinic-based treatment and equipment. This proof-of-concept study explored whether a multi-modal program of proprioceptive rehabilitation and strength training can be delivered at home, to improve balance performance in people with CMT Type 1A. Methods: Fourteen participants with CMT Type 1A were recruited into this randomized, two-arm study. Baseline assessments included measures of disease severity, posturography, physical function, and patient-reported outcome measurements. All participants received one falls education session. Participants were randomized to either 12 weeks of balance training or 12 weeks of usual activities. The intervention comprised a home-based, multi-sensory balance training and proximal strengthening program, supported by three home visits from a physiotherapist. Results: Thirteen participants completed the study. The intervention was successfully implemented and well tolerated, with high participation levels. Functional measures of balance and walking showed strong effect sizes in favor of the training group. Posturography testing demonstrated moderate improvements in postural stability favoring the intervention group. Inconsistent changes were seen in lower limb strength measures. Discussion: The intervention was feasible to implement and safe, with some evidence of improvement in balance performance. This supports future studies to expand this intervention to larger trials of pragmatic, home-delivered programs through current community rehabilitation services and supported self-management pathways

Hypermethylation of CpG islands and shores around specific microRNAs and mirtrons is associated with the phenotype and presence of bladder cancer

PURPOSE To analyze the role and translational potential for hypermethylation of CpG islands and shores in the regulation of small RNAs within urothelial cell carcinoma (UCC). To examine microRNAs (miR) and mirtrons, a new class of RNA located within gene introns and processed in a Drosha-independent manner. EXPERIMENTAL DESIGN The methylation status of 865 small RNAs was evaluated in normal and malignant cell lines by using 5-azacytidine and microarrays. Bisulfite sequencing was used for CpG regions around selected RNAs. Prognostic and diagnostic associations for epigenetically regulated RNAs were examined by using material from 359 patients, including 216 tumors and 121 urinary samples (68 cases and 53 controls). Functional analyses examined the effect of silencing susceptible RNAs in normal urothelial cells. RESULTS Exonic/UTR-located miRs and mirtons are most susceptible to epigenetic regulation. We identified 4 mirtrons and 16 miRs with CpG hypermethylation across 35 regions in normal and malignant urothelium. For several miRs, hypermethylation was more frequent and dense in CpG shores than islands (e.g., miRs-9/149/210/212/328/503/1224/1227/1229), and was associated with tumor grade, stage, and prognosis (e.g., miR-1224 multivariate analysis OR = 2.5; 95% CI, 1.3-5.0; P = 0.006). The urinary expression of epigenetically silenced RNAs (miRs-152/328/1224) was associated with the presence of UCC (concordance index, 0.86; 95% CI, 0.80-0.93; ANOVA P < 0.016). CONCLUSIONS Hypermethylation of mirtrons and miRs is common in UCC. Mirtrons appear particularly susceptible to epigenetic regulation. Aberrant hypermethylation of small RNAs is associated with the presence and behavior of UCC, suggesting potential roles as diagnostic and prognostic biomarkers

Home-based multi-sensory and proximal strengthening program to improve balance in Charcot–Marie–Tooth disease type 1A: a proof of concept study

Introduction/Aims People with Charcot–Marie–Tooth Disease (CMT) frequently report problems with balance, which lead to an increased risk of falls. Evidence is emerging of training interventions to improve balance for people with CMT, but to date all have relied on clinic-based treatment and equipment. This proof-of-concept study explored whether a multi-modal program of proprioceptive rehabilitation and strength training can be delivered at home, to improve balance performance in people with CMT Type 1A. Methods Fourteen participants with CMT Type 1A were recruited into this randomized, two-arm study. Baseline assessments included measures of disease severity, posturography, physical function, and patient-reported outcome measurements. All participants received one falls education session. Participants were randomized to either 12 weeks of balance training or 12 weeks of usual activities. The intervention comprised a home-based, multi-sensory balance training and proximal strengthening program, supported by three home visits from a physiotherapist. Results Thirteen participants completed the study. The intervention was successfully implemented and well tolerated, with high participation levels. Functional measures of balance and walking showed strong effect sizes in favor of the training group. Posturography testing demonstrated moderate improvements in postural stability favoring the intervention group. Inconsistent changes were seen in lower limb strength measures. Discussion The intervention was feasible to implement and safe, with some evidence of improvement in balance performance. This supports future studies to expand this intervention to larger trials of pragmatic, home-delivered programs through current community rehabilitation services and supported self-management pathways

Community exercise is feasible for neuromuscular diseases and can improve aerobic capacity

Objective: The aim of this phase 2 trial was to ascertain the feasibility and effect of community based aerobic exercise training for people with two of the more common neuromuscular diseases: Charcot-Marie-Tooth disease type 1A (CMT) and Inclusion Body Myositis (IBM). Methods: A randomised single blinded cross over trial design was used to compare a 12-week aerobic training programme using recombinant exercise bicycles compared to a control period. The training occurred three times per week in community gyms local to the participants. Support was available from trained gym staff and a research physiotherapist. The two disease groups were analysed separately. The primary outcome measure was peak oxygen uptake (VO2 peak) during a maximal exercise test, with secondary measures of muscle strength, function and patient reported measures. Results: Data from 23 people with CMT and 17 people with IBM was included in the analysis. Both disease groups had high levels of participation and demonstrated improvements in VO2 peak, with a moderate effect size in the CMT participants (Cohen’s d = 0.53) and a strong effect size in the IBM group (Cohen’s d = 1.72). No major changes were observed in the secondary outcome measures. Qualitative interviews revealed that participants valued the support of gym instructors and the research physiotherapists in overcoming challenges to participation. Conclusion: Twelve weeks of aerobic training in community gyms was feasible, safe and improved aerobic capacity in people with CMT and IBM. Classification of Evidence: This study provides Class II evidence that for patients with CMT type 1A and IBM, an aerobic training program increases aerobic capacity