Alien Registration- Beairsto, Joseph Dyer (Andover, Oxford County)

https://digitalmaine.com/alien_docs/18057/thumbnail.jp

Training of merit raters

Thesis (M.B.A.)--Boston Universit

L’utilisation du TENS en physiothérapie : la situation particulière des soins palliatifs oncologiques

Étude de cas / Case studyLa stimulation nerveuse électrique transcutanée (TENS) est un traitement contre la douleur qui utilise l’application d’un courant électrique. Quelques études suggèrent que le TENS permettrait de réduire les douleurs associées à certains types de cancer et ce traitement est régulièrement utilisé en physiothérapie dans des contextes de pratique interdisciplinaire spécialisée en soins palliatifs oncologiques. Cependant, l’emploi du TENS dans les cas de cancer est un sujet de controverse, son application étant contrindiquée selon les normes canadiennes encadrant la pratique de la physiothérapie. Cet article a pour objectif de présenter, au moyen d’une étude de cas, certains principes pour guider la prise de décision quant au choix de cette thérapie dans les cas de cancer. Les évidences scientifiques, les normes de pratique et les principes éthiques qui devraient guider le choix de ce traitement sont discutés. L’utilisation du TENS en soins palliatifs en physiothérapie est un exemple paradigmatique d’une situation commune: le calcul nécessaire par le professionnel de la santé entre les bénéfices et les coûts potentiels, tels que les effets néfastes possibles d’un traitement. Dans le cas du TENS, les bénéfices sont associés à la réduction de la douleur, alors qu’un effet indésirable potentiel serait l’augmentation de la prolifération tumorale. Ce difficile calcul a des répercussions pour les différents acteurs impliqués tels que les patients et les professionnels de la santé.Trans-cutaneous electrical nerve stimulation (TENS) is a treatment against pain that uses the application of an electric current. Some studies suggest that TENS would reduce the pain associated with certain types of cancer and this treatment is regularly used in therapy in contexts of interdisciplinary practice specializing in palliative oncology. However, the use of TENS in cancer cases is a matter of controversy, and its application is contraindicated by Canadian standards governing the practice of physiotherapy. This article aims to present, through a case study, some principles to guide decision making regarding the choice of this therapy in cases of cancer. Scientific evidence, standards of practice and ethical principles that should guide the choice of therapy are discussed. The use of TENS therapy in palliative care is a paradigmatic example of a common situation: the weighing by health care professionals of the benefits and potential costs, such as potential adverse effects of treatment. In the case of TENS, the benefits are associated with the reduction of pain, while a potential adverse effect would increase tumour proliferation. This difficult calculation has implications for the various stakeholders such as patients and health professionals

Abnormal coactivation of knee and ankle extensors is related to changes in heteronymous spinal pathways after stroke

<p>Abstract</p> <p>Background</p> <p>Abnormal coactivation of leg extensors is often observed on the paretic side of stroke patients while they attempt to move. The mechanisms underlying this coactivation are not well understood. This study (1) compares the coactivation of leg extensors during static contractions in stroke and healthy individuals, and (2) assesses whether this coactivation is related to changes in intersegmental pathways between quadriceps and soleus (Sol) muscles after stroke.</p> <p>Methods</p> <p>Thirteen stroke patients and ten healthy individuals participated in the study. Levels of coactivation of knee extensors and ankle extensors were measured in sitting position, during two tasks: maximal isometric voluntary contractions in knee extension and in plantarflexion. The early facilitation and later inhibition of soleus voluntary EMG evoked by femoral nerve stimulation were assessed in the paretic leg of stroke participants and in one leg of healthy participants.</p> <p>Results</p> <p>Coactivation levels of ankle extensors (mean ± SEM: 56 ± 7% of Sol EMG max) and of knee extensors (52 ± 10% of vastus lateralis (VL) EMG max) during the knee extension and the ankle extension tasks respectively were significantly higher in the paretic leg of stroke participants than in healthy participants (26 ± 5% of Sol EMG max and 10 ± 3% of VL EMG max, respectively). Early heteronymous facilitation of Sol voluntary EMG in stroke participants (340 ± 62% of Sol unconditioned EMG) was significantly higher than in healthy participants (98 ± 34%). The later inhibition observed in all control participants was decreased in the paretic leg. Levels of coactivation of ankle extensors during the knee extension task were significantly correlated with both the increased facilitation (Pearson r = 0.59) and the reduced inhibition (r = 0.56) in the paretic leg. Measures of motor impairment were more consistently correlated with the levels of coactivation of biarticular muscles than those of monoarticular muscles.</p> <p>Conclusion</p> <p>These results suggest that the heteronymous pathways linking quadriceps to soleus may participate in the abnormal coactivation of knee and ankle extensors on the paretic side of stroke patients. The motor impairment of the paretic leg is strongly associated with the abnormal coactivation of biarticular muscles.</p

Report second year tests, Weldon Springs experimental feedlots : cattle feedlot facilities and management

Cover title

Effets de la stimulation du nerf fémoral sur l'activité volontaire du muscle soléaire chez des sujets hémiparétiques

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal

Mécanismes neuronaux médullaires, coordination musculaire et fonction motrice chez les sujets hémiparétiques

Dans l’hémiparésie consécutive à un AVC, une coactivation anormale des extenseurs du genou et de la cheville est souvent observée à la jambe atteinte lorsque la personne tente de bouger ou encore lors de la marche. Les mécanismes sous-jacents à cette coactivation sont mal compris. Bien que l’AVC entraîne une lésion supraspinale, des évidences démontrent le dysfonctionnement de certains circuits spinaux dans l’hémiparésie. Ce projet de doctorat visait à évaluer : 1) l’excitabilité des circuits spinaux intersegmentaires projetant des extenseurs du genou aux extenseurs de la cheville et 2) si un éventuel dysfonctionnement de ces circuits dans l’hémiparésie est associé à une coactivation anormale des extenseurs du genou et de la cheville lors de contractions statiques et au cours de la marche. La première étude compare la modulation de l’activité réflexe du soléaire suite à la stimulation du nerf fémoral entre des sujets hémiparétiques et sains. Une augmentation de la facilitation hétéronyme de courte latence et une diminution de l’inhibition ultérieure du réflexe H du soléaire ont été observées chez les sujets hémiparétiques. Ces résultats démontrent un dysfonctionnement des circuits intersegmentaires propriospinaux liant le quadriceps au soléaire suite à l’AVC. La deuxième étude démontre que ces changements dans la modulation hétéronyme des sujets hémiparétiques, évaluée au moyen de la méthode complexe basée sur l’activité réflexe du soléaire, sont similaires à ceux observés lorsque la modulation est évaluée en utilisant une méthode plus simple, soit celle de l’activité volontaire du soléaire. De plus, la modulation hétéronyme évaluée par les deux méthodes est corrélée avec l’atteinte motrice à la jambe parétique. La troisième étude a permis de quantifier une augmentation de la coactivation entre les extenseurs du genou et de la cheville lors de contractions volontaires statiques chez des personnes hémiparétiques par rapport à des personnes saines. De plus, le niveau accru de la coactivation involontaire des extenseurs de la cheville lors de l’activation volontaire des extenseurs du genou s’avère corrélé avec la modulation intersegmentaire du côté parétique. La quatrième étude a utilisé un indice temporel, soit l’intervalle entre les pics d’activation électromyographique (PAI), et un indice d’amplitude de coactivation (CAI) pour quantifier une augmentation de la coactivation entre les extenseurs du genou et de la cheville lors de la marche chez des personnes hémiparétiques par rapport à des personnes saines. Ces indices sont corrélés, pour certains groupes musculaires, avec la modulation intersegmentaire modifiée du côté parétique. Finalement, des résultats préliminaires montrent que la vibration mécanique du tendon rotulien (80 Hz) réduit la facilitation intersegmentaire accrue des sujets hémiparétiques. Ce projet doctoral a permis de mettre en lumière un dysfonctionnement de circuits spinaux liant le quadriceps et le soléaire dans l’hémiparésie consécutive à un AVC. Ce changement dans les mécanismes neurophysiologiques de la moelle épinière est corrélé avec des changements fonctionnels. Ainsi, ce dysfonctionnement pourrait contribuer à la coactivation involontaire entre les extenseurs du genou et de la cheville qui fait partie intégrante de la synergie pathologique en extension souvent rencontrée à la jambe parétique lors d’efforts en statique et pendant la marche. Finalement, une étude préliminaire suggère que la vibration mécanique serait une modalité sensorielle prometteuse pour réguler l’hyperexcitabilité des circuits spinaux qui contribuerait aux atteintes motrices chez les personnes hémiparétiques.In stroke individuals, an abnormal coactivation of knee and ankle extensors is often observed when the paretic leg is voluntarily moved and during gait. The mechanisms underlying this abnormal coactivation are not well understood. Although, stroke is the result of a supraspinal lesion, studies have shown that spinal pathways might also be affected in hemiparesis. This doctoral project aims: 1) to assess intersegmental pathways projecting from knee extensors to ankle extensors in hemiparetic patients and 2) to evaluate whether a potential malfunction in these pathways after stroke is associated with an abnormal coactivation of leg extensors during static contractions and during gait. The first study of this project compares the effects of femoral nerve (FN) stimulation on soleus reflex activity in hemiparetic patients and healthy individuals. An increase of the early short-latency heteronymous facilitation and a decrease of the later inhibition of soleus H reflex induced by FN stimulation were observed in stroke patients. These results demonstrate the malfunction of intersegmental short propriospinal pathways linking quadriceps to soleus after stroke. The second study shows that these changes in the heteronymous modulation assessed with the complex method using soleus H reflex are similar to those found using a simpler method based on the modulation of soleus voluntary EMG. Moreover, changes in the propriospinal modulation observed with both methods were correlated with motor impairments of the paretic leg. The third study has quantified an increased coactivation of knee and ankle extensors during static contractions in stroke patients compared to healthy controls. Furthermore, the increased coactivation of ankle extensors during the voluntary contraction of knee extensors was related to the modified heteronymous modulation in the paretic leg. The fourth study has quantified an increased coactivation of knee and ankle extensors in hemiparetic gait using a temporal coactivation index, that was the peak activation interval (PAI) and a coactivation amplitude index (CAI). In some muscles, these indexes were correlated to the modified intersegmental modulation of soleus voluntary activity on the paretic side of stroke patients. Finally, preliminary results have shown that vibration of the patellar tendon (80 Hz) can reduce the enhanced heteronymous facilitation observed in the paretic leg. This doctoral project demonstrates the malfunction of intersegmental pathways linking quadriceps to soleus in hemiparesis following stroke. The neurophysiological alterations at the spinal level are correlated with functional changes. This malfunction could contribute to the abnormal involuntary coactivation of knee and ankle extensors often observed in the paretic leg while the person attempts to move or during gait. Finally, a preliminary study indicates that mechanical vibration could be a promising sensory modality in the regulation of the hyperexcitability of spinal reflex pathways, which is thought to participate in motor impairments after stroke

Movement, Habitat Use, and Population Dynamics of Blue Sucker in the Southern Great Plains

Freshwater migratory fishes are among the most imperiled taxa in the world. However, mobile life histories make the study and conservation of migratory fishes challenging. The undefined scope of movement and habitat use often limit conservation efforts for the species. Fishes occupying large rivers are inherently difficult to capture and problematic to evaluate. Blue Sucker Cycleptus elongatus is an emblematic large-river migratory fish with a broad spatial distribution and considered a species of conservation concern in North America. I evaluated the movement patterns, habitat use, population dynamics, and the effect of variable flow and temperature on the recruitment and somatic growth of Blue Suckers. I determined that both resident and migratory populations exist within my study area. Blue Suckers were more likely to return to spawn during wet years and displayed spawning-site fidelity more frequently than they strayed. Blue Suckers that strayed, most often selected the only undammed tributary in the system. Additionally, I determined that Blue Suckers were most likely to spawn in conjunction with high flows that occurred in the late winter and early spring. I found that Blue Suckers were most likely to occur near riffles in the tributaries during the spawning season. My assessment of population dynamics of Blue Suckers in two flow-regulated streams indicated that the population was stable at one location and declining at the other location. In my assessment of the effects of flow and temperature on the recruitment and somatic growth of Blue Sucker, I estimated that growing seasons with high flows followed by declining flows resulted in strong recruitment the following spring. This indicates that summer conditions in the Red River were important for gonadal growth, although I did not detect a relationship between environmental conditions and somatic growth. Finally, I found a relationship between conditions in the undammed tributary and recruitment in the Red River. This indicates that preserving the natural flow of that tributary and its connectivity with the Red River is important to the conservation of Blue Sucker.Natural Resource Ecology and Managemen

Sexual reproduction of human fungal pathogens

We review here recent advances in our understanding of sexual reproduction in fungal pathogens that commonly infect humans, including Candida albicans, Cryptococcus neoformans/gattii, and Aspergillus fumigatus. Where appropriate or relevant, we introduce findings on other species associated with human infections. In particular, we focus on rapid advances involving genetic, genomic, and population genetic approaches that have reshaped our view of how fungal pathogens evolve. Rather than being asexual, mitotic, and largely clonal, as was thought to be prevalent as recently as a decade ago, we now appreciate that the vast majority of pathogenic fungi have retained extant sexual, or parasexual, cycles. In some examples, sexual and parasexual unions of pathogenic fungi involve closely related individuals, generating diversity in the population but with more restricted recombination than expected from fertile, sexual, outcrossing and recombining populations. In other cases, species and isolates participate in global outcrossing populations with the capacity for considerable levels of gene flow. These findings illustrate general principles of eukaryotic pathogen emergence with relevance for other fungi, parasitic eukaryotic pathogens, and both unicellular and multicellular eukaryotic organisms