Efficacy of Elaborated Semantic Features Analysis in Aphasia: a quasi-randomised controlled trial

Background: Word finding difficulty is one of the most common features of aphasia. Semantic Features Analysis (SFA) directly aims to improve word finding in people with aphasia. Evidence from systematic reviews suggests that SFA leads to positive outcomes, yet the evidence comprises single case studies and case series. There is a need to evaluate the efficacy of SFA in controlled group studies/trials. Aims: To evaluate the efficacy of Elaborated Semantic Feature Analysis (ESFA) for word finding in people with aphasia. We investigated: (a) the efficacy of ESFA versus a delayed therapy/control, (b) the efficacy of two therapy approaches– individual versus a combination of individual and group therapy. Methods and procedures: We ran a multi-centre, quasi-randomised controlled trial, nested in a larger study (Thales-Aphasia). Participants were recruited from community settings. They had to be people with aphasia due to stroke at least four months post-onset. Participants were randomized to individual vs combination vs delayed therapy/control groups. Both therapy groups had three hours of ESFA per week for 12 weeks. Delayed therapy/control group had no intervention for 12 weeks and were then randomized to either individual or combination therapy. The primary outcome was confrontation naming. Secondary outcomes were the Boston Naming Test, Discourse, the Functional Assessment of Communication Skills for adults (ASHA–FACS), the Stroke and Aphasia Quality of Life scale (SAQOL-39g), the General Health Questionnaire-12 item, and the EQ-5D. Outcomes and Results: Of the 72 participants of the Thales-Aphasia project, 58 met eligibility criteria for speech-language therapy and 39 were allocated to ESFA. The critical p-value was adjusted for multiple comparisons (.005). For the therapy versus control comparison, there was a significant main effect of time on the primary outcome (p<.001, η2p=.42) and a significant interaction effect (p=.003, η2p=.21). An interaction effect for the SAQOL-39g (p=.015, η2p=.11) and its psychosocial domain (p=.013, η2p=.12) did not remain significant after Bonferroni adjustment. For the individual versus combination ESFA comparison, there were significant main effects of time on the primary outcome (p<.001, η2p=.49), the BNT (p<.001, η2p=.29) and the ASHA-FACS (p=.001, η2p=.18). Interaction and group effects were not significant. Conclusion: Though underpowered, this study provides evidence on the efficacy of ESFA to improve word finding in aphasia, with gains similar in the two therapy approaches. Trial registration: ISRCTN71455409, https://doi.org/10.1186/ISRCTN7145540

A rare case of bilateral supernumerary heads of sternocleidomastoid muscle and its clinical impact

The sternocleidomastoid muscle (SCM) functions as a landmark for physicians such as anatomists, orthopaedic surgeons, neurosurgeons, and anaesthesiologists, who intervene in the minor supraclavicular fossa located at the base of the neck. The variability of SCM anatomy may cause complications while trying to access the vital elements that are located in the minor supraclavicular fossa. This study aims to present a case of supernumerary heads of the sternocleidomastoid muscle and to discuss its clinical significance. The cervical region of an elderly male cadaver was dissected and the findings were recorded and photographed. On both sides, the SCM muscle had an additional sternal head, and simultaneously there were three additional clavicular heads, four in total. These additional heads, the sternal and the clavicular, reduced the interval between them causing significant stenosis of the minor supraclavicular fossa. Sternocleidomastoid muscle variations with regard to the number of its heads are very rare in the literature, but this variation may cause severe complications. The minor supraclavicular fossa is important for anaesthesiologists because of the anterior central venous catheterization approach. Physicians should be aware of this anatomical variation in order to prevent complication

Higher-order fem for nonlinear hydroelastic analysis of a floating elastic strip in shallow-water conditions

The hydroelastic response of a thin, nonlinear, elastic strip floating in shalow-water environment is studied by means of a special higher order finite element scheme. Considering non-negligible stress variation in lateral direction, the nonlinear beam model, developed by Gao, is used for the simulation of large flexural displacement. Full hydroelastic coupling between the floating strip and incident waves is assumed. The derived set of equations is intended to serve as a simplified model for tsunami impact on Very Large Floating Structures (VLFS) or ice floes. The proposed finite element method incorporates Hermite polynomials of fifth degree for the approximation of the beam deflection/upper surface elevation in the hydroelastic coupling region and 5-node Lagrange finite elements for the simulation of the velocity potential in the water region. The resulting second order ordinary differential equation system is converted into a first order one and integrated with respect to time with the Crank-Nicolson method. Two distinct cases of long wave forcing, namely an elevation pulse and an N-wave pulse, are considered. Comparisons against the respective results of the standard, linear Euler-Bernoulli floating beam model are performed and the effect of large displacement in the beam response is studied

A correlative study of Quantitative EMG and biopsy findings in 31 patients with myopathies

A direct correlation of QEMG with muscle biopsy findings might help delineate the sensitivity of QEMG in identifying muscle pathology as well as provide information on electrophysiological- histological correlations. In a study of 31 patients with a variety of myopathies we found that the sensitivity of QEMG was between 24 to 69% depending of the specific method of signal analysis. The positive predictive value of abnormal QEMG was more than 90% while its negative predictive value was only about 20%. Amplitude outlier analysis was superior especially in minimally weak muscles (MRC > 4) and was particularly sensitive at detecting increased variability in fiber size and more subtle myopathic changes

Microwave-assisted synthesis, characterization and modeling of cpo-27-mg metal-organic framework for drug delivery

The coordination polymer CPO-27-Mg was rapidly synthesized under microwave irra-diation. This material exhibits a sufficiently high drug loading towards aspirin (~8% wt.) and paracetamol (~14% wt.). The binding of these two molecules with the inner surface of the metal-organic framework was studied employing the Gaussian and Plane Wave approach of the Density Functional Theory. The structure of CPO-27-Mg persists after the adsorption of aspirin or paracetamol and their desorption energies, being quite high, decrease under solvent conditions. © 2021 by the authors. Li-censee MDPI, Basel, Switzerland

Marginal discoloration of all-ceramic restorations cemented adhesively versus nonadhesively

BACKGROUND: The authors conducted a systematic review to correlate the clinical incidence of marginal discoloration of all-ceramic restorations with the mode of cementation (adhesive versus nonadhesive). TYPES OF STUDIES REVIEWED: The authors conducted a literature search by using electronic databases, relevant references, database citations and journal hand searches for clinical studies of marginal discoloration of all-ceramic restorations with a mean follow-up time of at least five years. The search period spanned January 1990 through February 2011. The authors reported and compared summary estimates and five-year event rates. RESULTS: The authors selected 16 studies for final analysis from an initial yield of 346 articles. The mean observation time ranged between five and 10 years. The majority of studies used adhesive luting procedures for definitive cementation. In only one study did investigators report regarding the incidence of marginal discoloration of both adhesively and nonadhesively cemented all-ceramic restorations, and the difference between the luting types in terms of discoloration was not statistically significant (P = .5). CLINICAL IMPLICATIONS: The results of this systematic review showed that there is a lack of studies with findings regarding marginal discoloration rates of nonadhesively luted all-ceramic restorations. Unacceptable marginal discoloration rates of adhesively luted all-ceramic prostheses were relatively low even at 10 years of service

Patients with early rheumatoid arthritis exhibit elevated autoantibody titers against mildly oxidized low-density lipoprotein and exhibit decreased activity of the lipoprotein-associated phospholipase A(2)

Rheumatoid arthritis is a chronic inflammatory disease, associated with an excess of cardiovascular morbidity and mortality due to accelerated atherosclerosis. Oxidized low-density lipoprotein (oxLDL), the antibodies against oxLDL and the lipoprotein-associated phospholipase A(2 )(Lp-PLA(2)) may play important roles in inflammation and atherosclerosis. We investigated the plasma levels of oxLDL and Lp-PLA(2 )activity as well as the autoantibody titers against mildly oxLDL in patients with early rheumatoid arthritis (ERA). The long-term effects of immunointervention on these parameters in patients with active disease were also determined. Fifty-eight ERA patients who met the American College of Rheumatology criteria were included in the study. Patients were treated with methotrexate and prednisone. Sixty-three apparently healthy volunteers also participated in the study and served as controls. Three different types of mildly oxLDL were prepared at the end of the lag, propagation and decomposition phases of oxidation. The serum autoantibody titers of the IgG type against all types of oxLDL were determined by an ELISA method. The plasma levels of oxLDL and the Lp-PLA(2 )activity were determined by an ELISA method and by the trichloroacetic acid precipitation procedure, respectively. At baseline, ERA patients exhibited elevated autoantibody titers against all types of mildly oxLDL as well as low activity of the total plasma Lp-PLA(2 )and the Lp-PLA(2 )associated with the high-density lipoprotein, compared with controls. Multivariate regression analysis showed that the elevated autoantibody titers towards oxLDL at the end of the decomposition phase of oxidation and the low plasma Lp-PLA(2 )activity are independently associated with ERA. After immunointervention autoantibody titers against all types of oxLDL were decreased in parallel to the increase in high-density lipoprotein-cholesterol and high-density lipoprotein-Lp-PLA(2 )activity. We conclude that elevated autoantibody titers against oxLDL at the end of the decomposition phase of oxidation and low plasma Lp-PLA(2 )activity are feature characteristics of patients with ERA, suggesting an important role of these parameters in the pathophysiology of ERA as well as in the accelerated atherosclerosis observed in these patients

Responses of the Mediterranean seagrass Cymodocea nodosa to combined temperature and salinity stress at the ionomic, transcriptomic, ultrastructural and photosynthetic levels

Acknowledgements We are particularly grateful to David E. Salt and John M.C. Danku (University of Aberdeen, now at the University of Nottingham) for providing facilities and guidance for the ionomics work within the framework of this study. This research was funded by the European Commission (European Social Fund – ESF; grant no. 375425) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) - Research Funding Program: THALES - Investing in knowledge society through the European Social Funds (Project Acronym: MANTOLES). We would also like to thank the TOTAL Foundation (Project “Diversity of brown algae in the Eastern Mediterranean”), the European Commission under its Horizon 2021 Research and Innovation Programme (grants ZEROBRINE, grant agreement No. 730390, and WATERMINING, grant agreement No. 869474) and the UK Natural Environment Research Council for their Supplort to FCK (program Oceans 2025 – WP 4.5 and grants NE/D521522/1 and NE/J023094/1). The MASTS pooling initiative (Marine Alliance for Science and Technology for Scotland, funded by the Scottish Funding Council and contributing institutions; grant reference HR09011) is gratefully acknowledged.Peer reviewedPostprin

Coupling XFEM and Peridynamics for Brittle Fracture Simulation - Part II: Adaptive Relocation Strategy

An adaptive relocation strategy for a coupled XFEM–Peridynamic (PD) model is introduced. The motivation is to enhance the efficiency of the coupled model and demonstrate its applicability to complex brittle fracture problems. The XFEM and PD approximation domains can be redefined during the simulation, to ensure that the computationally expensive PD model is applied only where needed. To this end a two-step expansion/contraction process, allowing the PD patch to adaptively change its shape, size and location, following the propagation of the crack, is employed. No a priori knowledge of the crack path or re-meshing is required, and the methodology can automatically switch between PD and XFEM. Three 2D fracture examples are presented to highlight the performance of the methodology and the ability to follow multiple crack tips. Results indicate significant computational savings. Furthermore, the characteristic length scale of PD theory bestows a nonlocal and multiscale component to the methodology

A Case of Meningococcal and HSV-2 Meningitis in a Patient Being Treated with Ustekinumab for Pityriasis Rubra Pilaris

Pityriasis rubra pilaris (PRP) is a rare chronic inflammatory papulosquamous dermatosis affecting both adults and children. Six subtypes of PRP have been described. Recently, the management of PRP with biologic immunosuppressive agents regularly used in psoriasis has been supported by several case reports and series. Ustekinumab is an anti-IL12/23 IgG1 kappa human monoclonal antibody. It has been approved for the treatment of Crohn’s disease, plaque psoriasis, psoriatic arthritis and ulcerative colitis. It has also been reported to be effective as an off-label treatment for PRP. Current data are equivocal regarding infectious disease risk with ustekinumab administration. We describe a case of meningococcal and HSV-2 infection of the central nervous system in a patient being treated with ustekinumab for PRP