Using Biofeedback to Reduce Spatiotemporal Asymmetry Impairs Dynamic Balance in People Post-Stroke

Background. People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective. We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods. We performed clinical balance assessments and measured wholebody angular momentum during walking using a full-body marker set in a sample of 36 people with chronic stroke. We then used a biofeedback-based approach to modify step length asymmetry in a subset of 15 of these individuals who had marked asymmetry and we measured the resulting changes in whole-body angular momentum. Results. When participants walked without biofeedback, whole-body angular momentum in the sagittal and frontal plane was negatively correlated with scores on the Berg Balance Scale and Functional Gait Assessment supporting the validity of whole-body angular momentum as an objective measure of dynamic balance. We also observed that when participants walked more symmetrically, their wholebody angular momentum in the sagittal plane increased rather than decreased. Conclusions. Voluntary reductions of step length asymmetry in people poststroke resulted in reduced measures of dynamic balance. This is consistent with the idea that after stroke, individuals might have an implicit preference not to deviate from their natural asymmetry while walking because it could compromise their balance. Clinical Trials Number: NCT03916562

Educating novice practitioners to detect elder financial abuse: A randomised controlled trial

© 2014 Harries 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 credited.This article has been made available through the Brunel Open Access Publishing Fund.Background - Health and social care professionals are well positioned to identify and intervene in cases of elder financial abuse. An evidence-based educational intervention was developed to advance practitioners’ decision-making in this domain. The objective was to test the effectiveness of a decision-training educational intervention on novices’ ability to detect elder financial abuse. The research was funded by an E.S.R.C. grant reference RES-189-25-0334. Methods - A parallel-group, randomised controlled trial was conducted using a judgement analysis approach. Each participant used the World Wide Web to judge case sets at pre-test and post-test. The intervention group was provided with training after pre-test testing, whereas the control group were purely given instructions to continue with the task. 154 pre-registration health and social care practitioners were randomly allocated to intervention (n78) or control (n76). The intervention comprised of written and graphical descriptions of an expert consensus standard explaining how case information should be used to identify elder financial abuse. Participants’ ratings of certainty of abuse occurring (detection) were correlated with the experts’ ratings of the same cases at both stages of testing. Results - At pre-test, no differences were found between control and intervention on rating capacity. Comparison of mean scores for the control and intervention group at pre-test compared to immediate post-test, showed a statistically significant result. The intervention was shown to have had a positive moderate effect; at immediate post-test, the intervention group’s ratings had become more similar to those of the experts, whereas the control’s capacity did not improve. The results of this study indicate that the decision-training intervention had a positive effect on detection ability. Conclusions - This freely available, web-based decision-training aid is an effective evidence-based educational resource. Health and social care professionals can use the resource to enhance their ability to detect elder financial abuse. It has been embedded in a web resource at http://www.elderfinancialabuse.co.uk.ESR

Improving mortality rate estimates for management of the Queensland saucer scallop fishery

This research was undertaken on the Queensland saucer scallop (Ylistrum balloti) fishery in southeast Queensland, which is an important component of the Queensland East Coast Otter Trawl Fishery (QECOTF). The research was undertaken by a collaborative team from the Queensland Department of Agriculture and Fisheries, James Cook University (JCU) and the Centre for Applications in Natural Resource Mathematics (CARM), University of Queensland and focused on 1) an annual fishery-independent trawl survey of scallop abundance, 2) relationships between scallop abundance and physical properties of the seafloor, and 3) deriving an updated estimate of the scallop’s natural mortality rate. The scallop fishery used to be one of the state’s most valuable commercially fished stocks with the annual catch peak at just under 2000 t (adductor muscle meat-weight) in 1993 valued at about $30 million, but in recent years the stock has declined and is currently considered to be overfished. Results from the study are used to improve monitoring, stock assessment and management advice for the fishery

LoCuSS: Testing hydrostatic equilibrium in galaxy clusters

We test the assumption of hydrostatic equilibrium in an X-ray luminosity selected sample of 50 galaxy clusters at $0.15<z<0.3$ from the Local Cluster Substructure Survey (LoCuSS). Our weak-lensing measurements of $M_{500}$ control systematic biases to sub-4 per cent, and our hydrostatic measurements of the same achieve excellent agreement between XMM-Newton and Chandra. The mean ratio of X-ray to lensing mass for these 50 clusters is $\beta_{\rm X}=0.95\pm0.05$, and for the 44 clusters also detected by Planck, the mean ratio of Planck mass estimate to LoCuSS lensing mass is $\beta_{\rm P}=0.95\pm0.04$. Based on a careful like-for-like analysis, we find that LoCuSS, the Canadian Cluster Comparison Project (CCCP), and Weighing the Giants (WtG) agree on $\beta_{\rm P}\simeq0.9-0.95$ at $0.15<z<0.3$. This small level of hydrostatic bias disagrees at $\sim5\sigma$ with the level required to reconcile Planck cosmology results from the cosmic microwave background and galaxy cluster counts

Rupture of the ilio-psoas tendon after a total hip arthroplasty: an unusual cause of radio-lucency of the lesser trochanter simulating a malignancy

Avulsion fracture or progressive radiolucency of lesser trochanter is considered a pathognomic finding in patients with malignancies. Although surgical release of the iliopsoas tendon may be required during a total hip arthroplasty (THA), there is no literature on spontaneous rupture of the ilio-psoas tendon after a THA causing significant functional impairment. We report here such a case, which developed progressive radiolucency of the lesser trochanter over six years after a THA, simulating a malignancy. The diagnosis was confirmed by MRI. Because of the chronic nature of the lesion, gross retraction of the tendon into the pelvis, and low demand of our patient, he was treated by physiotherapy and gait training. Injury to the ilio-psoas tendon can occur in various steps of the THA and extreme care should be taken to avoid this injury. Prevention during surgery is better, although there are no reports of repair in the THA setting. This condition should be considered in patients who present with progressive radioluceny of the lesser trochanter, especially in the setting of a hip/pelvic surgery. Awareness and earlier recognition of the signs and symptoms of this condition will aid in diagnosis and will direct appropriate management

LoCuSS: Testing hydrostatic equilibrium in galaxy clusters

We test the assumption of hydrostatic equilibrium in an X-ray luminosity selected sample of 50 galaxy clusters at $0.15<z<0.3$ from the Local Cluster Substructure Survey (LoCuSS). Our weak-lensing measurements of $M_{500}$ control systematic biases to sub-4 per cent, and our hydrostatic measurements of the same achieve excellent agreement between XMM-Newton and Chandra. The mean ratio of X-ray to lensing mass for these 50 clusters is $\beta_{\rm X}=0.95\pm0.05$, and for the 44 clusters also detected by Planck, the mean ratio of Planck mass estimate to LoCuSS lensing mass is $\beta_{\rm P}=0.95\pm0.04$. Based on a careful like-for-like analysis, we find that LoCuSS, the Canadian Cluster Comparison Project (CCCP), and Weighing the Giants (WtG) agree on $\beta_{\rm P}\simeq0.9-0.95$ at $0.15<z<0.3$. This small level of hydrostatic bias disagrees at $\sim5\sigma$ with the level required to reconcile Planck cosmology results from the cosmic microwave background and galaxy cluster counts

Small Stem Total Hip Arthroplasty in Hypoplasia of the Femur

Total hip arthroplasty in hypoplastic femurs is technically difficult and the incidence of complications and aseptic loosening is relatively high. Cemented, uncemented, off-the-shelf, and custom-made stems all have been advocated in these cases. From 1978 to 1997, we performed 86 total hip arthroplasties in 77 patients with a hypoplastic femur using a cemented, off-the-shelf, small, curved, cobalt-chromium stem. We hypothesized results equaled those of the identical but larger-sized stems in normal-sized femora which were used as comparisons. Clinical and radiographic evaluations were performed. Minimum followup was 4.2 years (mean, 12 years; range, 4.2–20.3 years); mean Harris hip score was 88, and mean hip flexion was 104°. Six stems were revised: four because of aseptic loosening, one after a femoral fracture, and one because of malpositioning. Complications included one perforation and one fracture of the femur, one fracture, one nonunion of the greater trochanter, and one deep infection. Implant survivorship for all hips at 15 years with aseptic revision of the stem as the end point was 90% (confidence interval, 82–99) which equaled results of the larger stems. The small off-the-shelf cemented Weber stem has a high long-term survival and a low complication rate. Survival compares favorably with other small-sized total hip systems

Fixation of the Cemented Stem: Clinical Relevance of the Porosity and Thickness of the Cement Mantle

The aim of this review paper is to define the fixation of the cemented stem. Polymethyl methacrylate, otherwise known as “bone cement”, has been used in the fixation of hip implants since the early 1960s. Sir John Charnley, the pioneer of modern hip replacement, incorporated the use of cement in the development of low frictional torque hip arthroplasty. In this paper, the concepts of femoral stem design and fixation, clinical results, and advances in understanding of the optimal use of cement are reviewed. The purpose of this paper is to help understanding and discussions on the thickness and the porosity of the cement mantle in total hip arthroplasty. Cement does not act as an adhesive, as sometimes thought, but relies on an interlocking fit to provide mechanical stability at the cement–bone interface, while at the prosthesis– cement interface it achieves stability by optimizing the fit of the implant in the cement mantle, such as in a tapered femoral stem

Global Regulator SATB1 Recruits β-Catenin and Regulates TH2 Differentiation in Wnt-Dependent Manner

Chromatin organizer SATB1 and Wnt transducer β-catenin form a complex and regulate expression of GATA3 and TH2 cytokines in Wnt-dependent manner and orchestrate TH2 lineage commitment