Assessment of bulbar function in amyotrophic lateral sclerosis: validation of a self-report scale (Center for Neurologic Study Bulbar Function Scale).

BACKGROUND AND PURPOSE: Impaired bulbar functions of speech and swallowing are among the most serious consequences of amyotrophic lateral sclerosis (ALS). Despite this, clinical trials in ALS have rarely emphasized bulbar function as an endpoint. The rater-administered Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) or various quality-of-life measures are commonly used to measure symptomatic benefit. Accordingly, we sought to evaluate the utility of measures specific to bulbar function in ALS. METHODS: We assessed bulbar functions in 120 patients with ALS, with clinicians first making direct observations of the degree of speech, swallowing and salivation impairment in these subjects. Clinical diagnosis of bulbar impairment was then compared with ALSFRS-R scores, speech rate, time to swallow liquids and solids, and scores obtained when patients completed visual analog scales (VASs) and the newly-developed 21-question self-administered Center for Neurologic Study Bulbar Function Scale (CNS-BFS). RESULTS: The CNS-BFS, ALSFRS-R, VAS and timed speech and swallowing were all concordant with clinician diagnosis. The self-report CNS-BFS and ALSFRS-R bulbar subscale best predicted clinician diagnosis with misclassification rates of 8% and 14% at the optimal cut-offs, respectively. In addition, the CNS-BFS speech and swallowing subscales outperformed both the bulbar component of the ALSFRS-R and speech and swallowing VASs when correlations were made between these scales and objective measures of timed reading and swallowing. CONCLUSIONS: Based on these findings and its relative ease of administration, we conclude that the CNS-BFS is a useful metric for assessing bulbar function in patients with ALS

The Problem of Functional Boundaries in Prebiotic and Inter-Biological Systems

International audienceThe concept of organisational closure, interpreted as a set of internally produced and mutually dependent constraints, allows understanding organisms as functionally integrated systems capable of self-production and self-maintenance through the control exerted upon biosynthetic processes and the exchanges of matter and energy with the environment. One of the current challenges faced by this theoretical framework is to account for limit cases in which a robust functional closure cannot be realised from within. In order to achieve functional sufficiency and persist, prebiotic or biological systems may need to recruit external constraints or expand their network of control interactions to include other autonomous systems. These phenomena seem to contrast with the very idea of closure and the capability of living systems to specify their functional boundaries from within. This paper will analyse from an organisational perspective the role of environmental scaffolds and of different classes of intersystem interactions in prebiotic and su-pra-organismal biological scenarios, and show how the theoretical framework based on the notion of closure can account for these cases

Magnetism, FeS colloids, and Origins of Life

A number of features of living systems: reversible interactions and weak bonds underlying motor-dynamics; gel-sol transitions; cellular connected fractal organization; asymmetry in interactions and organization; quantum coherent phenomena; to name some, can have a natural accounting via $physical$ interactions, which we therefore seek to incorporate by expanding the horizons of `chemistry-only' approaches to the origins of life. It is suggested that the magnetic 'face' of the minerals from the inorganic world, recognized to have played a pivotal role in initiating Life, may throw light on some of these issues. A magnetic environment in the form of rocks in the Hadean Ocean could have enabled the accretion and therefore an ordered confinement of super-paramagnetic colloids within a structured phase. A moderate H-field can help magnetic nano-particles to not only overcome thermal fluctuations but also harness them. Such controlled dynamics brings in the possibility of accessing quantum effects, which together with frustrations in magnetic ordering and hysteresis (a natural mechanism for a primitive memory) could throw light on the birth of biological information which, as Abel argues, requires a combination of order and complexity. This scenario gains strength from observations of scale-free framboidal forms of the greigite mineral, with a magnetic basis of assembly. And greigite's metabolic potential plays a key role in the mound scenario of Russell and coworkers-an expansion of which is suggested for including magnetism.Comment: 42 pages, 5 figures, to be published in A.R. Memorial volume, Ed Krishnaswami Alladi, Springer 201

Impact of the California Lead Ammunition Ban on Reducing Lead Exposure in Golden Eagles and Turkey Vultures

Predatory and scavenging birds may be exposed to high levels of lead when they ingest shot or bullet fragments embedded in the tissues of animals injured or killed with lead ammunition. Lead poisoning was a contributing factor in the decline of the endangered California condor population in the 1980s, and remains one of the primary factors threatening species recovery. In response to this threat, a ban on the use of lead ammunition for most hunting activities in the range of the condor in California was implemented in 2008. Monitoring of lead exposure in predatory and scavenging birds is essential for assessing the effectiveness of the lead ammunition ban in reducing lead exposure in these species. In this study, we assessed the effectiveness of the regulation in decreasing blood lead concentration in two avian sentinels, golden eagles and turkey vultures, within the condor range in California. We compared blood lead concentration in golden eagles and turkey vultures prior to the lead ammunition ban and one year following implementation of the ban. Lead exposure in both golden eagles and turkey vultures declined significantly post-ban. Our findings provide evidence that hunter compliance with lead ammunition regulations was sufficient to reduce lead exposure in predatory and scavenging birds at our study sites

Temporal bone verrucous carcinoma: outcomes and treatment controversy

Verrucous carcinoma is a rare tumor that presents in the head and neck with the most common sites being the oral cavity and larynx. Fourteen cases of verrucous carcinoma of the temporal bone have been described in literature; this study aims to examine treatment outcomes and discuss the controversy surrounding postoperative radiation. The study design included a literature review along with individual case report in the setting of a tertiary care medical center. Outcome analysis of all cases of verrucous carcinoma of the temporal bone, which are documented in the English literature, and presentation of a single patient report including gross, histologic and radiologic analyses were performed. The longest recorded survival for verrucous carcinoma of the temporal bone occurs in patients treated with surgery alone. Poorer outcomes for patients treated with adjuvant (chemo)radiation may be due to more advanced stage of disease at the time of treatment. Early reports of radiation leading to tumor dedifferentiation or early recurrence are not supported by more recent studies. Whether adjuvant radiation therapy is indicated in verrucous carcinoma of the temporal bone remains controversial

The problem of functional boundaries in prebiotic and inter-biological systems

The concept of organisational closure, interpreted as a set of internally pro-duced and mutually dependent constraints, allows understanding organisms as functionally integrated systems capable of self-production and self-maintenance through the control exerted upon biosynthetic processes and the exchanges of matter and energy with the environment. One of the current challenges faced by this theoretical framework is to account for limit cases in which a robust functional closure cannot be realised from within. In order to achieve functional sufficiency and persist, prebiotic or biological systems may need to recruit external constraints or expand their network of control in-teractions to include other autonomous systems. These phenomena seem to contrast with the very idea of closure and the capability of living systems to specify their functional boundaries from within. This paper will analyse from an organisational perspective the role of environmental scaffolds and of dif-ferent classes of intersystem interactions in prebiotic and supra-organismal biological scenarios, and show how the theoretical framework based on the notion of closure can account for these cases

Is technology optimism justified? A discussion towards a comprehensive narrative

This paper is based on a discussion developed by one of the thematic working groups at the Biennial International Workshop Advances in Energy Studies (BIWAES) 2017 hold in Naples, Italy. The topic was the role of technology in energy transition and global problems. Owing to the heterogeneity of the participants in the working group, different viewpoints were put together, leading to some shared conclusions. In particular, the role played by the different narratives used in discussing the role of technology in facing global problems was pointed out as the origin of cognitive dissonance. The presented reflections address some conceptual weaknesses in the current debate on technology and global issues, framed in global policies that appear incapable to obtain tangible results. The technology optimism seems, in fact, to be based on the elusive use of both the concepts of technology and sustainability, that are put together for narrative purposes without an explicit conceptual assessment. On one hand, the factual role of technology and its beneficiary are almost never clearly addressed in the debate. On the other hand, the fact that any new technology will serve the cause of sustainability is not questioned whatsoever, without taking into account the social, political and ethical framework in which technology is supposed to be operated