Response to Letter to the Editor

This is a letter responding to a a reply to a literature review about tardive dyskinesia-like syndromes due to drugs that do not block dopamine receptors. The authors are skeptical that many primary dystonias are being misdiagnosed, but certainly think it possible, and agree that dystonia must be considered in the differential diagnosis

Understanding Refugees\u27 Perspectives on Health Care

Introduction. Burlington, Vermont accepts refugees from around the world. These individuals face unique barriers to accessing healthcare due to language, culture and finances. Research suggests that cultural beliefs about healthcare can affect ability or willingness to seek medical care. Gaining a better understanding of refugee perspectives of the healthcare system may offer insight into how to rectify this issue. Objectives. The goal of this study was to learn about refugee perspectives of the healthcare system and assess their use of services. Methods. We surveyed a convenience sample of 24 refugees to learn more about thoughts and practices surrounding healthcare and the use of the medical system. Results. Survey findings suggested that refugees who had been living in the US for longer than one year access healthcare resources differently from more recent arrivals. Most respondents agreed that reasons for going to a healthcare provider revolved around the diagnosis and treatment of current ailments. Regardless of time spent in the U.S., most respondents were unlikely to seek out preventive care. Refugees who had been in the U.S. longer than one year were less likely to seek out emergency services for acute symptoms that would be better served by a visit with their PCP. Conclusions. Recent arrivals used the emergency room for primary care needs more than those living in the U.S. longer than one year, suggesting the efficacy of provided health education. Study data suggests an important area for improvement may be increased education for refugees about the importance of preventive care.https://scholarworks.uvm.edu/comphp_gallery/1250/thumbnail.jp

Non-Motor Symptoms and Associated Factors in Parkinson’s Disease Patients in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

BACKGROUND: Non-motor symptoms (NMSs) of Parkinson’s disease (PD) were often overlooked and less studied. Little is known about NMSs in Ethiopia. The aim of the study was to determine the prevalence of NMSs and associated factors.METHODS: A multi-center cross-sectional observational study was conducted. NMS questionnaire was used to screen for the NMSs. Both descriptive and analytical statistics were used to analyze the data.RESULTS: Total of 123 PD patients with median of 4 years were investigated. The mean age of PD patients was 62.9 years. The mean age of PD onset was 58.3 years. In 23.6% the age of onset was below age 50. Males accounted 72.4%. Majority of the patients were on Levodopa alone and 31.7% were on levodopa plus trihexyphenidyl. Longer duration of illness was associated with frequent occurrence of NMSs. Constipation was the commonest NMS (78%), followed by urinary urgency (67.5%) and nocturia (63.4%). An unexplained pain was reported by 45.5%, cognitive impairment (45.5%), and sleep disturbance was reported by 45.5% of the study participants. Neurophysciatric symptoms were reported by small proportion of the patients. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness.CONCLUSION: The prevalence of NMS was high among PD patients in Ethiopia. Constipation was the commonest NMS. Longer duration of illness was associated with frequent occurrence of NMSs. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness

Anomalies, Dualities, and Topology of D=6 N=1 Superstring Vacua

We consider various aspects of compactifications of the Type I/heterotic $Spin(32)/\Z_2$ theory on K3. One family of such compactifications includes the standard embedding of the spin connection in the gauge group, and is on the same moduli space as the compactification of the heterotic $E_8\times E_8$ theory on K3 with instanton numbers (8,16). Another class, which includes an orbifold of the Type I theory recently constructed by Gimon and Polchinski and whose field theory limit involves some topological novelties, is on the moduli space of the heterotic $E_8\times E_8$ theory on K3 with instanton numbers (12,12). These connections between $Spin(32)/\Z_2$ and $E_8\times E_8$ models can be demonstrated by T duality, and permit a better understanding of non-perturbative gauge fields in the (12,12) model. In the transformation between $Spin(32)/\Z_2$ and $E_8\times E_8$ models, the strong/weak coupling duality of the (12,12) $E_8\times E_8$ model is mapped to T duality in the Type I theory. The gauge and gravitational anomalies in the Type I theory are canceled by an extension of the Green-Schwarz mechanism.Comment: 48 page

Reduction of freezing of gait in Parkinson's disease by repetitive robot-assisted treadmill training: a pilot study

<p>Abstract</p> <p>Background</p> <p>Parkinson's disease is a chronic, neurodegenerative disease characterized by gait abnormalities. Freezing of gait (FOG), an episodic inability to generate effective stepping, is reported as one of the most disabling and distressing parkinsonian symptoms. While there are no specific therapies to treat FOG, some external physical cues may alleviate these types of motor disruptions. The purpose of this study was to examine the potential effect of continuous physical cueing using robot-assisted sensorimotor gait training on reducing FOG episodes and improving gait.</p> <p>Methods</p> <p>Four individuals with Parkinson's disease and FOG symptoms received ten 30-minute sessions of robot-assisted gait training (Lokomat) to facilitate repetitive, rhythmic, and alternating bilateral lower extremity movements. Outcomes included the FOG-Questionnaire, a clinician-rated video FOG score, spatiotemporal measures of gait, and the Parkinson's Disease Questionnaire-39 quality of life measure.</p> <p>Results</p> <p>All participants showed a reduction in FOG both by self-report and clinician-rated scoring upon completion of training. Improvements were also observed in gait velocity, stride length, rhythmicity, and coordination.</p> <p>Conclusions</p> <p>This pilot study suggests that robot-assisted gait training may be a feasible and effective method of reducing FOG and improving gait. Videotaped scoring of FOG has the potential advantage of providing additional data to complement FOG self-report.</p