Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP) is of interest for health care planning and for prediction of future ability in the individual child. In 1994, a register and a health care programme for children with CP in southern Sweden was initiated. In the programme information on how the child usually sits, stands, stands up and sits down, together with use of support or assistive devices, is recorded annually.</p> <p>Methods</p> <p>A cross-sectional study was performed, analysing the most recent report of all children with CP born 1990-2005 and living in southern Sweden during 2008. All 562 children (326 boys, 236 girls) aged 3-18 years were included in the study. The degree of independence, use of support or assistive devices to sit, stand, stand up and sit down was analysed in relation to the Gross Motor Function Classification System (GMFCS), CP subtype and age.</p> <p>Result</p> <p>A majority of the children used standard chairs (57%), could stand independently (62%) and could stand up (62%) and sit down (63%) without external support. Adaptive seating was used by 42%, external support to stand was used by 31%, to stand up by 19%, and to sit down by 18%. The use of adaptive seating and assistive devices increased with GMFCS levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001). The use of support was more frequent in preschool children aged 3-6 (p < 0.001).</p> <p>Conclusion</p> <p>About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support. Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position. The GMFCS classification system is a good predictor of sitting and standing performance.</p

Combined Autologous Chondrocyte and Bone Marrow Mesenchymal Stromal Cell Implantation in the Knee: An 8-year Follow Up of Two First-In-Man Cases

Autologous chondrocyte implantation (ACI) has been used to treat cartilage defects for >20 years, with promising clinical outcomes. Here, we report two first-in-man cases (patient A and B) treated with combined autologous chondrocyte and bone marrow mesenchymal stromal cell implantation (CACAMI), with 8-year follow up. Two patients with International Cartilage Repair Society (ICRS) grade III-IV cartilage lesions underwent a co-implantation of autologous chondrocytes and bone marrow-derived mesenchymal stromal cells (BM-MSCs) between February 2008 and October 2009. In brief, chondrocytes and BM-MSCs were separately isolated and culture-expanded in a good manufacturing practice laboratory for a period of 2-4 weeks. Cells were then implanted in combination into cartilage defects and patients were clinically evaluated preoperatively and postoperatively, using the self-reported Lysholm knee score and magnetic resonance imaging (MRI). Postoperative Lysholm scores were compared with the Oswestry risk of knee arthroplasty (ORKA) scores. Patient A also had a second-look arthroscopy, at which time a biopsy of the repair site was taken. Both patients demonstrated a significant long-term improvement in knee function, with postoperative Lysholm scores being consistently higher than ORKA predictions. The most recent Lysholm scores, 8 years after surgery were 100/100 (Patient A) and 88/100 (Patient B), where 100 represents a fully functioning knee joint. Bone marrow lesion (BML) volume was shown to decrease on postoperative MRIs in both patients. Cartilage defect area increased in patient A, but declined initially for patient B, slightly increasing again 2 years after treatment. The repair site biopsy taken from patient A at 14 months postoperatively, demonstrated a thin layer of fibrocartilage covering the treated defect site. The use of a combination of cultured autologous chondrocytes and BM-MSCs appears to confer long-term benefit in this two-patient case study. Improvements in knee function perhaps relate to the observed reduction in the size of the BML

Взаємний зв'язок властивостей і структури плівкових чутливих елементів сенсорів магнітного поля

Дисертацію присвячено комплексним експериментальним дослідженням особливостей структурно-фазового стану та магнітних і магніторезистивних властивостей багатошарових плівкових систем на основі Co і Cu, Co і Cr, Fe і Cr та Fe і Cu як можливих матеріалів чутливих елементів сенсорів різного призначення. У роботі встановлено взаємозв’язок між товщиною магнітних шарів і немагнітних прошарків, орієнтацією зразка у зовнішньому магнітному полі, температурою термообробки та магнітними, магніторезистивними і магнітооптичними властивостями багатошарових плівкових систем із можливим спін-залежним розсіюванням електронів. Визначені величини магнітоопору, коерцитивної сили, коефіцієнта прямокутності й чутливості плівкової системи до магнітного поля досліджуваних плівкових систем як приладових структур для формування первинних перетворювачів. Установлена кореляція між структурно-фазовим станом, магнітними та магнітооптичними властивостями тришарових плівкових систем з різним типом розчинності компонент як функціональних елементів датчиків. Запропонована схематична конструкція АМР-датчика магнітного поля для тришарових плівкових систем із спін-залежним розсіюванням електронів. У результаті проведених досліджень впливу геометрії вимірювання, температури термообробки та загальної концентрації феромагнітної компоненти в системі на магнітні й магніторезистивні властивості визначені можливі області застосування плівкових систем на основі Co і Cu або Cr та Fe і Cu або Cr.Диссертация посвящена комплексным экспериментальным исследованиям особенностей структурно-фазового состояния, магнитных магниторезистивных свойств многослойных пленочных систем на основе Co и Cu, Co и Cr, Fe и Cr и Fe и Cu в качестве возможных материалов чувствительных элементов сенсоров различного назначения. В работе установлена взаимосвязь между толщиной магнитных слоев и немагнитных прослоек, ориентацией образца во внешнем магнитном поле, температурой термообработки и магнитными, магниторезистивными и магнитооптическими свойствами многослойных пленочных систем с возможным спин-зависимым рассеянием электронов. При исследовании магнитных свойств пленочных систем на основе Fe, Co, Cu или Cr получено, что для пленочных систем на основе Fe и Cu в форме кривых гистерезиса наблюдается определенный перегиб, свидетельствующий о послойном перемагничивании слоев Fe, в то время как для систем на основе Fe и Cr петля гистерезиса имеет форму, подобную однослойным пленкам Fe, что говорит о преобладании ферромагнитной связи в системе. В пленочных структурах на основе Co и Cr или Cu магнитные свойства системы главным образом определяются состоянием слоев Со, поэтому форма кривых гистерезиса для обеих систем схожа с формой кривых для однослойных пленок Со, а небольшие значения коэрцитивной силы свидетельствуют о реализации ферромагнитной связи в системе. Все четыре системы характеризуются достаточно высоким значением коэффициента прямоугольности, которое при смене ориентации образца от 0 до 90° несколько уменьшается для систем Fe/Cu/Fe и Fe/Cr/Fe и, наоборот, растет в системах на основе Co и Cr. Определены величины магнитосопротивления, коэрцитивной силы, коэффициента прямоугольности и чувствительности пленочной системы к магнитному полю исследуемых пленочных систем как приборных структур для формирования первичных преобразователей. Установлена корреляция между структурно-фазовым состоянием, магнитными и магнитооптическими свойствами трехслойных пленочных систем с разным типом растворимости компонент в качестве функциональных элементов датчиков. Предложена схематическая конструкция АМР-датчика магнитного поля для трехслойных пленочных систем со спин-зависимым рассеянием электронов. В результате проведенных исследований влияния геометрии измерения, температуры термообработки и общей концентрации ферромагнитной компоненты в системе на магниторезистивные свойства определены возможные области применения пленочных систем на основе Co и Cu или Cr и Fe и Cu или Cr.The thesіs іs dedіcаted to the complex experіmentаl reseаrch between the structurаl-phаse stаte, magnetic and magnetoresistance propertіes of multіlаyer fіlm systems bаsed on the Co аnd Cu, Co аnd Cr, Fe аnd Cr, аnd Fe аnd Cu, аs the potential mаterіаls for sensіtіve elements of sensors for dіfferent purposes. Іn thіs thesis wаs found the correlаtіon between the thіckness of the mаgnetіc аnd nonmаgnetіc lаyers, the orіentаtіon of the sаmple іn аn externаl mаgnetіc fіeld, temperаture of heаt treаtment аnd mаgnetіc, mаgnetoresіstіve аnd mаgneto-optіcаl propertіes іn multіlаyer fіlm systems wіth possіble spіn-dependent scаtterіng of electrons. The vаlues of mаgnetoresіstаnce, coercіvіty, squаreness fаctor аnd sensіtіvіty of fіlm system to a mаgnetіc fіeld in the studіed fіlm systems аs devіce structures for the formаtіon of prіmаry converters were defined. The correlаtіon between the structurаl-phаse stаte, mаgnetіc аnd mаgneto-optіcаl propertіes of three-lаyer fіlm systems wіth dіfferent types of component solubіlіty аs functіonаl elements sensors was established. The schemаtіc sturucture of АMR sensor for three-lаyer fіlm systems wіth spіn-dependent scаtterіng of electrons was purposed. The possіble аreаs of аpplіcаtіons wаs іdentіfіed on the bаsіs of studіes of the effect of geometry meаsurement temperаture heаt treаtment аnd the totаl concentrаtіon of ferromаgnetіc components іn the system on the magnetic and mаgnetoresіstіve propertіes of fіlm-systems bаsed on Co аnd Cu, or Cr аnd Fe, аnd Cu or Cr

Metabolic Rift or Metabolic Shift? Dialectics, Nature, and the World-Historical Method

Abstract In the flowering of Red-Green Thought over the past two decades, metabolic rift thinking is surely one of its most colorful varieties. The metabolic rift has captured the imagination of critical environmental scholars, becoming a shorthand for capitalism’s troubled relations in the web of life. This article pursues an entwined critique and reconstruction: of metabolic rift thinking and the possibilities for a post-Cartesian perspective on historical change, the world-ecology conversation. Far from dismissing metabolic rift thinking, my intention is to affirm its dialectical core. At stake is not merely the mode of explanation within environmental sociology. The impasse of metabolic rift thinking is suggestive of wider problems across the environmental social sciences, now confronted by a double challenge. One of course is the widespread—and reasonable—sense of urgency to evolve modes of thought appropriate to an era of deepening biospheric instability. The second is the widely recognized—but inadequately internalized—understanding that humans are part of nature

Balloon kyphoplasty in the treatment of metastatic disease of the spine: a 2-year prospective evaluation

There is currently little data on the longer term efficacy and safety of balloon kyphoplasty (BKP) in patients with metastatic vertebral compression fractures (VCFs). To prospectively assess the long-term efficacy and safety of BKP in treating thoracic and lumbar spinal metastatic fractures that result in pain or instability. Sixty-five patients (37 men, mean age: 66 years) underwent 99 BKP procedures. Patient-related outcomes of pain visual analogue scale (VAS) and Oswestry Disability Index were assessed pre- and post-operatively and after 3, 6, 12 and 24 months. Correction of vertebral height and kyphotic deformity were assessed by radiographic measurements. Mean pain VAS and Oswestry Disability Index significantly improved from pre- to post-treatment (P < 0.0001), this improvement being sustained up to 24-month follow up. A gain in height restoration and a reduction of the post-operative kyphotic angle were seen post-operatively and at 3 months although these radiographic outcomes returned to pre-operative levels at 12 months. BKP was associated with a rate of cement leakage and incidence vertebral fracture of 12 and 8%, respectively. No symptomatic cement leaks or serious adverse events were seen during the 24 months of follow up. BKP is a minimally invasive procedure that provides immediate and long-term pain relief and improvement in functional ability in selected patients with metastatic VCFs. The procedure appears to have good long-term safety

The DCDC2 deletion is not a risk factor for dyslexia

Dyslexia is a specific impairment in learning to read and has strong heritability. An intronic deletion within the DCDC2 gene, with ~8% frequency in European populations, is increasingly used as a marker for dyslexia in neuroimaging and behavioral studies. At a mechanistic level, this deletion has been proposed to influence sensory processing capacity, and in particular sensitivity to visual coherent motion. Our re-assessment of the literature, however, did not reveal strong support for a role of this specific deletion in dyslexia. We also analyzed data from five distinct cohorts, enriched for individuals with dyslexia, and did not identify any signal indicative of associations for the DCDC2 deletion with reading-related measures, including in a combined sample analysis (N=526). We believe we conducted the first replication analysis for a proposed deletion effect on visual motion perception and found no association (N=445 siblings). We also report that the DCDC2 deletion has a frequency of 37.6% in a cohort representative of the general population recruited in Hong Kong (N=220). This figure, together with a lack of association between the deletion and reading abilities in this cohort, indicates the low likelihood of a direct deletion effect on reading skills. Therefore, on the basis of multiple strands of evidence, we conclude that the DCDC2 deletion is not a strong risk factor for dyslexia. Our analyses and literature re-evaluation are important for interpreting current developments within multidisciplinary studies of dyslexia and, more generally, contribute to current discussions about the importance of reproducibility in science

Two independent proteomic approaches provide a comprehensive analysis of the synovial fluid proteome response to Autologous Chondrocyte Implantation

Background: Autologous chondrocyte implantation (ACI) has a failure rate of approximately 20%, but it is yet to be fully understood why. Biomarkers are needed that can pre-operatively predict in which patients it is likely to fail, so that alternative or individualised therapies can be offered. We previously used label-free quantitation (LF) with a dynamic range compression proteomic approach to assess the synovial fluid (SF) of ACI responders and non-responders. However, we were able to identify only a few differentially abundant proteins at baseline. In the present study, we built upon these previous findings by assessing higher-abundance proteins within this SF, providing a more global proteomic analysis on the basis of which more of the biology underlying ACI success or failure can be understood. Methods: Isobaric tagging for relative and absolute quantitation (iTRAQ) proteomic analysis was used to assess SF from ACI responders (mean Lysholm improvement of 33; n = 14) and non-responders (mean Lysholm decrease of 14; n = 13) at the two stages of surgery (cartilage harvest and chondrocyte implantation). Differentially abundant proteins in iTRAQ and combined iTRAQ and LF datasets were investigated using pathway and network analyses. Results: iTRAQ proteomic analysis confirmed our previous finding that there is a marked proteomic shift in response to cartilage harvest (70 and 54 proteins demonstrating ≥ 2.0-fold change and p < 0.05 between stages I and II in responders and non-responders, respectively). Further, it highlighted 28 proteins that were differentially abundant between responders and non-responders to ACI, which were not found in the LF study, 16 of which were altered at baseline. The differential expression of two proteins (complement C1s subcomponent and matrix metalloproteinase 3) was confirmed biochemically. Combination of the iTRAQ and LF proteomic datasets generated in-depth SF proteome information that was used to generate interactome networks representing ACI success or failure. Functional pathways that are dysregulated in ACI non-responders were identified, including acute-phase response signalling. Conclusions: Several candidate biomarkers for baseline prediction of ACI outcome were identified. A holistic overview of the SF proteome in responders and non-responders to ACI  has been profiled, providing a better understanding of the biological pathways underlying clinical outcome, particularly the differential response to cartilage harvest in non-responders

Characterizing low affinity epibatidine binding to α4β2 nicotinic acetylcholine receptors with ligand depletion and nonspecific binding

<p>Abstract</p> <p>Background</p> <p>Along with high affinity binding of epibatidine (<it>K</it>_d1≈10 pM) to α4β2 nicotinic acetylcholine receptor (nAChR), low affinity binding of epibatidine (<it>K</it>_d2≈1-10 nM) to an independent binding site has been reported. Studying this low affinity binding is important because it might contribute understanding about the structure and synthesis of α4β2 nAChR. The binding behavior of epibatidine and α4β2 AChR raises a question about interpreting binding data from two independent sites with ligand depletion and nonspecific binding, both of which can affect equilibrium binding of [³H]epibatidine and α4β2 nAChR. If modeled incorrectly, ligand depletion and nonspecific binding lead to inaccurate estimates of binding constants. Fitting total equilibrium binding as a function of total ligand accurately characterizes a single site with ligand depletion and nonspecific binding. The goal of this study was to determine whether this approach is sufficient with two independent high and low affinity sites.</p> <p>Results</p> <p>Computer simulations of binding revealed complexities beyond fitting total binding for characterizing the second, low affinity site of α4β2 nAChR. First, distinguishing low-affinity specific binding from nonspecific binding was a potential problem with saturation data. Varying the maximum concentration of [³H]epibatidine, simultaneously fitting independently measured nonspecific binding, and varying α4β2 nAChR concentration were effective remedies. Second, ligand depletion helped identify the low affinity site when nonspecific binding was significant in saturation or competition data, contrary to a common belief that ligand depletion always is detrimental. Third, measuring nonspecific binding without α4β2 nAChR distinguished better between nonspecific binding and low-affinity specific binding under some circumstances of competitive binding than did presuming nonspecific binding to be residual [³H]epibatidine binding after adding a large concentration of cold competitor. Fourth, nonspecific binding of a heterologous competitor changed estimates of high and low inhibition constants but did not change the ratio of those estimates.</p> <p>Conclusions</p> <p>Investigating the low affinity site of α4β2 nAChR with equilibrium binding when ligand depletion and nonspecific binding are present likely needs special attention to experimental design and data interpretation beyond fitting total binding data. Manipulation of maximum ligand and receptor concentrations and intentionally increasing ligand depletion are potentially helpful approaches.</p

Synchronous diversification of Sulawesi's iconic artiodactyls driven by recent geological events

The high degree of endemism on Sulawesi has previously been suggested to have vicariant origins, dating back to 40 Ma. Recent studies, however, suggest that much of Sulawesi's fauna assembled over the last 15 Myr. Here, we test the hypothesis that more recent uplift of previously submerged portions of land on Sulawesi promoted diversification and that much of its faunal assemblage is much younger than the island itself. To do so, we combined palaeogeographical reconstructions with genetic and morphometric datasets derived from Sulawesi's three largest mammals: the babirusa, anoa and Sulawesi warty pig. Our results indicate that although these species most likely colonized the area that is now Sulawesi at different times (14 Ma to 2-3 Ma), they experienced an almost synchronous expansion from the central part of the island. Geological reconstructions indicate that this area was above sea level for most of the last 4 Myr, unlike most parts of the island. We conclude that emergence of land on Sulawesi (approx. 1-2 Myr) may have allowed species to expand synchronously. Altogether, our results indicate that the establishment of the highly endemic faunal assemblage on Sulawesi was driven by geological events over the last few million years