Regaining Motor Control in Musician's Dystonia by Restoring Sensorimotor Organization

Professional musicians are an excellent human model of long term effects of skilled motor training on the structure and function of the motor system. However, such effects are accompanied by an increased risk of developing motor abnormalities, in particular musician's dystonia. Previously we found that there was an expanded spatial integration of proprioceptive input into the hand area of motor cortex (sensorimotor organisation, SMO) in healthy musicians as tested with a transcranial magnetic stimulation (TMS) paradigm. In musician's dystonia, this expansion was even larger, resulting in a complete lack of somatotopic organisation. We hypothesised that the disordered motor control in musician's dystonia is a consequence of the disordered SMO. In the present paper we test this idea by giving pianists with musician's dystonia 15 min experience of a modified proprioceptive training task. This restored SMO towards that seen in healthy pianists. Crucially, motor control of the affected task improved significantly and objectively as measured with a MIDI piano, and the amount of behavioural improvement was significantly correlated to the degree of sensorimotor re-organisation. In healthy pianists and non-musicians, the SMO and motor performance remained essentially unchanged. These findings suggest a link between the differentiation of SMO in the hand motor cortex and the degree of motor control of intensively practiced tasks in highly skilled individuals

Kiloparsec-Scale Simulations of star formations in disk galaxies. III. Structure and dynamics of filaments and clumps in giant molecular clouds

We present hydrodynamic simulations of self-gravitating dense gas in a galactic disk, exploring scales ranging from 1 kpc down to ~0.1 pc. Our primary goal is to understand how dense filaments form in giant molecular clouds (GMCs). These structures, often observed as infrared dark clouds (IRDCs) in the Galactic plane, are thought to be the precursors to massive stars and star clusters, so their formation may be the rate-limiting step controlling global star formation rates in galactic systems as described by the Kennicutt–Schmidt relation. Our study follows on from Van Loo et al., which carried out simulations to 0.5 pc resolution and examined global aspects of the formation of dense gas clumps and the resulting star formation rate. Here, using our higher resolution, we examine the detailed structural, kinematic, and dynamical properties of dense filaments and clumps, including mass surface density (Σ) probability distribution functions, filament mass per unit length and its dispersion, lateral Σ profiles, filament fragmentation, filament velocity gradients and infall, and degree of filament and clump virialization. Where possible, these properties are compared to observations of IRDCs. By many metrics, especially too large mass fractions of high ${\Sigma }\gt 1\;{\rm g}\;{\rm c}{{{\rm m}}^{-2}}$ material, too high mass per unit length dispersion due to dense clump formation, too high velocity gradients, and too high velocity dispersion for a given mass per unit length, the simulated filaments differ from observed IRDCs. We thus conclude that IRDCs do not form from global fast collapse of GMCs. Rather, we expect that IRDC formation and collapse are slowed significantly by the influence of dynamically important magnetic fields, which may thus play a crucial role in regulating galactic star formation rates

Kiloparsec-scale Simulations of Star Formation in Disk Galaxies. IV. Regulation of Galactic Star Formation Rates by Stellar Feedback

Star formation from the interstellar medium of galactic disks is a basic process controlling the evolution of galaxies. Understanding the star formation rate in a local patch of a disk with a given gas mass is thus an important challenge for theoretical models. Here we simulate a kiloparsec region of a disk, following the evolution of self-gravitating molecular clouds down to subparsec scales, as they form stars that then inject feedback energy by dissociating and ionizing UV photons and supernova explosions. We assess the relative importance of each feedback mechanism. We find that H2-dissociating feedback results in the largest absolute reduction in star formation compared to the run with no feedback. Subsequently adding photoionization feedback produces a more modest reduction. Our fiducial models that combine all three feedback mechanisms yield, without fine-tuning, star formation rates that are in excellent agreement with observations, with H2-dissociating photons playing a crucial role. Models that only include supernova feedback—a common method in galaxy evolution simulations—settle to similar star formation rates, but with very different temperature and chemical states of the gas, and with very different spatial distributions of young stars

Decision-Making for Rewilding: An Adaptive Governance Framework for Social-Ecological Complexity

Rewilding can be defined as the reorganisation or regeneration of wildness in an ecologically degraded landscape with minimal ongoing intervention. While proposals for rewilding are increasingly common, they are frequently controversial and divisive amongst stakeholders. If implemented, rewilding initiatives may alter the social-ecological systems within which they are situated and thus generate sudden and unforeseen outcomes. So far, however, much of the discourse on the planning and implementation of rewilding has focused on identifying and mitigating ecological risks. There has been little consideration of how rewilding could alter the human components of the social-ecological systems concerned, nor governance arrangements that can manage these dynamics. This paper addresses this gap by proposing a generic adaptive governance framework tailored to the characteristics of rewilding, based on principles of managing complex social-ecological systems. We integrate two complementary natural resource governance approaches that lend themselves to the contentious and unpredictable characteristics of rewilding. First, adaptive co-management builds stakeholder adaptive capacity through iterative knowledge generation, collaboration and power-sharing, and cross-scale learning networks. Second, social licence to operate establishes trust and transparency between project proponents and communities through new public-private partnerships. The proposed framework includes structural and process elements which incorporate a boundary organisation, a decision-into-practise social learning exercise for planning and design, and participatory evaluation. The latter assesses rewilding outcomes and pre-conditions for the continuation of adaptive governance and conservation conflict resolution

Cross-cultural adaptation and validation of the “spinal cord injury-falls concern scale” in the Italian population

Study design: Psychometrics study. Objective: The objective of this study was to develop an Italian version of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) and examine its reliability and validity. Setting: Multicenter study in spinal units in Northern and Southern Italy. The scale also was administered to non-hospitalized outpatient clinic patients. Methods: The original scale was translated from English to Italian using the “Translation and Cultural Adaptation of Patient-Reported Outcomes Measures” guidelines. The reliability and validity of the culturally adapted scale were assessed following the “Consensus-Based Standards for the Selection of Health Status Measurement Instruments” checklist. The SCI-FCS-I internal consistency, inter-rater, and intra-rater reliability were examined using Cronbach’s alpha coefficient and the intraclass correlation coefficient, respectively. Concurrent validity was evaluated using Pearson’s correlation coefficient with the Italian version of the short form of the Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon-M-I-short form). Results: The Italian version of the SCI-FCS-I was administered to 124 participants from 1 June to 30 September 2017. The mean ± SD of the SCI-FCS-I score was 16.73 ± 5.88. All SCI-FCS items were either identical or similar in meaning to the original version’s items. Cronbach’s α was 0.827 (p < 0.01), the inter-rater reliability was 0.972 (p < 0.01), and the intra-rater reliability was 0.973 (p < 0.01). Pearson’s correlation coefficient of the SCI-FCS-I scores with the WheelCon-M-I-short form was 0.56 (p < 0.01). Conclusions: The SCI-FCS-I was found to be reliable and a valid outcome measure for assessing manual wheelchair concerns about falling in the Italian population

Large-scale air mass characteristics observed over the remote tropical Pacific Ocean during March-April 1999: Results from PEM-Tropics B field experiment

Eighteen long-range flights over the Pacific Ocean between 38° S to 20° N and 166° E to 90° W were made by the NASA DC-8 aircraft during the NASA Pacific Exploratory Mission (PEM) Tropics B conducted from March 6 to April 18, 1999. Two lidar systems were flown on the DC-8 to remotely measure vertical profiles of ozone (O3), water vapor (H2O), aerosols, and clouds from near the surface to the upper troposphere along their flight track. In situ measurements of a wide range of gases and aerosols were made on the DC-8 for comprehensive characterization of the air and for correlation with the lidar remote measurements. The transition from northeasterly flow of Northern Hemispheric (NH) air on the northern side of the Intertropical Convergence Zone (ITCZ) to generally easterly flow of Southern Hemispheric (SH) air south of the ITCZ was accompanied by a significant decrease in O3, carbon monoxide, hydrocarbons, and aerosols and an increase in H2O. Trajectory analyses indicate that air north of the ITCZ came from Asia and/or the United States, while the air south of the ITCZ had a long residence time over the Pacific, perhaps originating over South America several weeks earlier. Air south of the South Pacific Convergence Zone (SPCZ) came rapidly from the west originating over Australia or Africa. This air had enhanced O3 and aerosols and an associated decrease in H2O. Average latitudinal and longitudinal distributions of O3 and H2O were constructed from the remote and in situ O3 and H2O data, and these distributions are compared with results from PEM-Tropics A conducted in August-October 1996. During PEM-Tropics B, low O3 air was found in the SH across the entire Pacific Basin at low latitudes. This was in strong contrast to the photochemically enhanced O3 levels found across the central and eastern Pacific low latitudes during PEM-Tropics A. Nine air mass types were identified for PEM-Tropics B based on their O3, aerosols, clouds, and potential vorticity characteristics. The data from each flight were binned by altitude according to air mass type, and these results showed the relative observational frequency of the different air masses as a function of altitude in seven regions over the Pacific. The average chemical composition of the major air mass types was determined from in situ measurements in the NH and SH, and these results provided insight into the origin, lifetime, and chemistry of the air in these regions. Copyright 2001 by the American Geophysical Union

Comparison of embedded and added motor imagery training in patients after stroke: Results of a randomised controlled pilot trial

Copyright @ 2012 Schuster et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Motor imagery (MI) when combined with physiotherapy can offer functional benefits after stroke. Two MI integration strategies exist: added and embedded MI. Both approaches were compared when learning a complex motor task (MT): ‘Going down, laying on the floor, and getting up again’. Methods: Outpatients after first stroke participated in a single-blinded, randomised controlled trial with MI embedded into physiotherapy (EG1), MI added to physiotherapy (EG2), and a control group (CG). All groups participated in six physiotherapy sessions. Primary study outcome was time (sec) to perform the motor task at pre and post-intervention. Secondary outcomes: level of help needed, stages of MT-completion, independence, balance, fear of falling (FOF), MI ability. Data were collected four times: twice during one week baseline phase (BL, T0), following the two week intervention (T1), after a two week follow-up (FU). Analysis of variance was performed. Results: Thirty nine outpatients were included (12 females, age: 63.4 ± 10 years; time since stroke: 3.5 ± 2 years; 29 with an ischemic event). All were able to complete the motor task using the standardised 7-step procedure and reduced FOF at T0, T1, and FU. Times to perform the MT at baseline were 44.2 ± 22s, 64.6 ± 50s, and 118.3 ± 93s for EG1 (N = 13), EG2 (N = 12), and CG (N = 14). All groups showed significant improvement in time to complete the MT (p < 0.001) and degree of help needed to perform the task: minimal assistance to supervision (CG) and independent performance (EG1+2). No between group differences were found. Only EG1 demonstrated changes in MI ability over time with the visual indicator increasing from T0 to T1 and decreasing from T1 to FU. The kinaesthetic indicator increased from T1 to FU. Patients indicated to value the MI training and continued using MI for other difficult-to-perform tasks. Conclusions: Embedded or added MI training combined with physiotherapy seem to be feasible and benefi-cial to learn the MT with emphasis on getting up independently. Based on their baseline level CG had the highest potential to improve outcomes. A patient study with 35 patients per group could give a conclusive answer of a superior MI integration strategy.The research project was partially funded by the Gottfried und Julia Bangerter-Rhyner Foundation

Reducing unnecessary prescriptions of antibiotics for acute cough: Adaptation of a leaflet aimed at Turkish immigrants in Germany

<p>Abstract</p> <p>Background</p> <p>The reduction in the number of unnecessary prescriptions of antibiotics has become one of the most important objectives for primary health care. German GPs report that they are under "pressure to prescribe" antibiotics particularly in consultations with Turkish immigrants. And so a qualitative approach was used to learn more about the socio-medical context of Turkish patients in regard to acute coughs. A German leaflet designed to improve the doctor-patient communication has been positively tested and then adapted for Turkish patients.</p> <p>Methods</p> <p>The original leaflet was first translated into Turkish. Then 57 patients belonging to 8 different GPs were interviewed about the leaflet using a semi-standardised script. The material was audio recorded, fully transcribed, and analysed by three independent researchers. As a first step a comprehensive content analysis was performed. Secondly, elements crucial to any Turkish version of the leaflet were identified.</p> <p>Results</p> <p>The interviews showed that the leaflets' messages were clearly understood by all patients irrespective of age, gender, and educational background. We identified no major problems in the perception of the translated leaflet but identified several minor points which could be improved. We found that patients were starting to reconsider their attitudes after reading the leaflet.</p> <p>Conclusion</p> <p>The leaflet successfully imparted relevant and new information to the target patients. A qualitative approach is a feasible way to prove general acceptance and provides additional information for its adaptation to medico-cultural factors.</p