Motor Output Variability Impairs Driving Ability in Older Adults

Background: The functional declines with aging relate to deficits in motor control and strength. In this study, we determine whether older adults exhibit impaired driving as a consequence of declines in motor control or strength. Methods: Young and older adults performed the following tasks: (i) maximum voluntary contractions of ankle dorsiflexion and plantarflexion; (ii) sinusoidal tracking with isolated ankle dorsiflexion; and (iii) a reactive driving task that required responding to unexpected brake lights of the car ahead. We quantified motor control with ankle force variability, gas position variability, and brake force variability. We quantified reactive driving performance with a combination of gas pedal error, premotor and motor response times, and brake pedal error. Results: Reactive driving performance was ~30% more impaired (t = 3.38; p \u3c .01) in older adults compared with young adults. Older adults exhibited greater motor output variability during both isolated ankle dorsiflexion contractions (t = 2.76; p \u3c .05) and reactive driving (gas pedal variability: t = 1.87; p \u3c .03; brake pedal variability: t = 4.55; p \u3c .01). Deficits in reactive driving were strongly correlated to greater motor output variability (R 2 = .48; p \u3c .01) but not strength (p \u3e .05). Conclusions: This study provides novel evidence that age-related declines in motor control but not strength impair reactive driving. These findings have implications on rehabilitation and suggest that interventions should focus on improving motor control to enhance driving-related function in older adults

Motor Output Variability Impairs Driving Ability in Older Adults: Reply to Stinchcombe, Dickerson, Weaver, and Bedard

Driving is a complex skill, as indicated by Stinchcombe and colleagues in their letter. It requires the integration of sensory inputs, cognitive processing, and motor execution. Although our title is broad, we clearly indicate that our findings only address a single component of driving, namely reactive driving. We also indicate that these findings are based on a simulated task and recommend that future studies should examine the contribution of motor output variability to on-road driving performance (see Considerations in the Discussion section). Thus, we share the consideration of Stinchcombe and colleagues that the current results only address a small portion of the driving complexity

An incidental finding of primary carcinoma of the fallopian tube: a case report

Primary fallopian tube carcinoma (PFTC) is a rare malignancy of female genital tract that histologically and clinically resemble epithelial ovarian cancer. Diagnosis of PFTC is difficult, especially at earlier stages. Most of the time it is an incidental finding. Careful surgical and pathological staging is important. It has worse prognosis than ovarian cancer as it is not routinely suspected, hence treatment is delayed.We, hereby, report a rare case of PFTC diagnosed incidentally while doing bilateral salpingoopherectomy for removal of ovarian cyst

Shaping leg muscles in Drosophila: role of ladybird, a conserved regulator of appendicular myogenesis

Legs are locomotor appendages used by a variety of evolutionarily distant vertebrates and invertebrates. The primary biological leg function, locomotion, requires the formation of a specialised appendicular musculature. Here we report evidence that ladybird, an orthologue of the Lbx1 gene recognised as a hallmark of appendicular myogenesis in vertebrates, is expressed in leg myoblasts, and regulates the shape, ultrastructure and functional properties of leg muscles in Drosophila. ladybird expression is progressively activated in myoblasts associated with the imaginal leg disc and precedes that of the founder cell marker dumbfounded. The RNAi-mediated attenuation of ladybird expression alters properties of developing myotubes, impairing their ability to grow and interact with the internal tendons and epithelial attachment sites. It also affects sarcomeric ultrastructure, resulting in reduced leg muscle performance and impaired mobility in surviving flies. The over-expression of ladybird also results in an abnormal pattern of dorsally located leg muscles, indicating different requirements for ladybird in dorsal versus ventral muscles. This differential effect is consistent with the higher level of Ladybird in ventrally located myoblasts and with positive ladybird regulation by extrinsic Wingless signalling from the ventral epithelium. In addition, ladybird expression correlates with that of FGF receptor Heartless and the read-out of FGF signalling downstream of FGF. FGF signals regulate the number of leg disc associated myoblasts and are able to accelerate myogenic differentiation by activating ladybird, leading to ectopic muscle fibre formation. A key role for ladybird in leg myogenesis is further supported by its capacity to repress vestigial and to down-regulate the vestigial-governed flight muscle developmental programme. Thus in Drosophila like in vertebrates, appendicular muscles develop from a specialised pool of myoblasts expressing ladybird/Lbx1. The ladybird/Lbx1 gene family appears as a part of an ancient genetic circuitry determining leg-specific properties of myoblasts and making an appendage adapted for locomotion

Assessment of Ear Nose and Throat morbidities prevalent in the school going children aged 5-14 years in rural area of Jamnagar

Background: India is home to more than 400 million children forming about 35% of its total population. Upper respiratory tract infections predispose a child to complications such as otitis media, tonsillitis, and sinusitis that further contribute to morbidity leading to hearing impairment and learning disability & even RHD. Unfortunately these morbidities are either not detected or remain untreated making situation worse. Aims and objectives:1. To assess the prevalence of common Ear Nose and Throat symptoms among children aged 5-14 years and to study its relationship with socio-demographic factors 2. To know regarding health seeking behavior in relations to Ear Nose and Throat morbidities. Materials and method: A cross-sectional study was done over a period of 2 months among 300 school children aged 5-14 years of six government schools of Jamnagar district. Assessment was done through clinical examination and oral questioners. Results: Prevalence of Ear Nose and Throat morbidity was 46.66%; Ear (14.33%), Nose(28.66%) and Throat(10%).Common Ear Nose and Throat problems were– common cold(23%), cough(9.67%), sore throat(8.34%) and ear ache(8.67%). Associations of Ear Nose and Throat morbidity with age and religion were statistically significant. Only 31.40% of children had taken treatment for the problems. Mother’s education had statistically significant association on health seeking behavior of school children. Conclusion: Prevalence of Ear Nose and Throat morbidity was very high among school children, only 1/3 children had taken treatment, indicating negligence towards problems on the part of parents as well as teachers suggesting strong need for sensitization of parents and teachers

Strength or Motor Control: What Matters in High-Functioning Stroke?

Background: The two primary motor impairments that hinder function after stroke are declines in strength and motor control. The impact of motor impairments on functional capacity may vary with the severity of stroke motor impairments. In this study, we focus on high-functioning stroke individuals who experience mild to moderate motor impairments and often resume prior activities or return to work. These tasks require the ability to move independently, placing high demands on their functional mobility. Therefore, the purpose of this study was to quantify impairments in strength and motor control and their contribution to functional mobility in high-functioning stroke.Methods:Twenty-one high-functioning stroke individuals (Fugl Meyer Lower Extremity Score = 28.67 ± 4.85; Functional Activity Index = 28.47 ± 7.04) and 21 age-matched healthy controls participated in this study. To examine motor impairments in strength and motor control, participants performed the following tasks with the paretic ankle (1) maximum voluntary contractions (MVC) and (2) visuomotor tracking of a sinusoidal trajectory. Strength was quantified as the maximum force produced during ankle plantarflexion and dorsiflexion. Motor control was quantified as (a) the accuracy and (b) variability of ankle movement during the visuomotor tracking task. For functional mobility, participants performed (1) overground walking for 7 meters and (2) simulated driving task. Functional mobility was determined by walking speed, stride length variability, and braking reaction time.Results: Compared with the controls, the stroke group showed decreased plantarflexion strength, decreased accuracy, and increased variability of ankle movement. In addition, the stroke group demonstrated decreased walking speed, increased stride length variability, and increased braking reaction time. The multiple-linear regression model revealed that motor accuracy was a significant predictor of the walking speed and braking reaction time. Further, motor variability was a significant predictor of stride length variability. Finally, the dorsiflexion or plantarflexion strength did not predict walking speed, stride length variability or braking reaction time.Conclusions: The impairments in motor control but not strength predict functional deficits in walking and driving in high-functioning stroke individuals. Therefore, rehabilitation interventions assessing and improving motor control will potentially enhance functional outcomes in high-functioning stroke survivors

SAT approach for decomposition methods

We are always trying to nd the best way to solve any computational problem. But, sometimes the most natural way to solve a given problem may not be very practical. Computer scientists have been trying to nd practical ways for solving hard problems. One of the major technology, that was developed to solve hard problems, is decompositions. Decompositions allow one to decompose a given problem instance in small parts. There are various techniques that use decompositions to solve a problem, but these techniques rely heavily on the quality of the decompositions. In this thesis, we develop SAT-based techniques to nd \good" decompositions. Satis ability (SAT) is one of the most central problem in computer science and SAT-solvers, tools that can solve this problem, have improved drastically over the last years. Current SAT-solvers can solve some SAT instances, of several MB in size, in a matter of milliseconds. A SAT- encoding is the transformation of a computational problem to SAT. We make use of the speed and eciency of the SAT based techniques for nding good decompositions. In this thesis we develop SAT-encodings for nding good decompositions. One of the major hurdle for SAT-encodings is the size of the SAT formula. Most of the SAT-encodings are at least cubic is the size of problem instance, which puts a hard limit on the size of the problem instance that can be solved. We overcome this restriction by developing a new SAT-based local improvement technique, where given a decomposition we try to improve parts of it using SAT-encodings. We propose a new characterization for branch decompositions and used it for a SAT-encoding for nding branchwidth. We develop local improvement approach for nding better branch decompositions, which we later used for tree decompositions as well. We develop two dierent characterizations for special tree decomposition and path decomposition, and compare them empirically. We also develop an SMT-encoding for nding fractional hypertree decompositions.15

Bimanual control differs between force generation and force release

Background: Everyday bimanual activities require increasing and decreasing forces to manipulate objects, for example, buttoning a shirt or tying a shoelace. Optimal coordination of increasing and decreasing bimanual forces is quintessential to achieve the overall goal of the bimanual task. However, little is known about differences in force control in bimanual force increment and decrement. Purpose: The purpose of our study was to 1) investigate whether bimanual task performance and force coordination differ in force increment versus force decrement and 2) identify the contribution of force coordination in bimanual task performance while increasing and decreasing forces. Methods: Seventeen right-handed young adults (24.10±3.09 years) performed following tasks involving isometric index finger flexion: 1) maximum voluntary contractions and 2) visually guided force tracking involving gradual force increment and force decrement. Each task was performed in unimanual with the right hand only i.e., control condition and bimanual with both hands together i.e., experimental condition. The force tracking task involved controlled force increment and decrement while tracking a trapezoid trajectory as accurately as possible. We quantified task performance with accuracy and variability of the total force in increment and decrement phases. We measured force coordination of the two forces by computing the time-series cross-correlation coefficient and amplitude of coherence in 0-1Hz. Results: We found reduced accuracy and increased the variability of the total force in force decrement compared with force increment. Further, the peak correlation and coherence amplitude was greater during force decrement than force increment. Finally, the peak correlation coefficient and coherence in 0.5-1Hz predicted total force accuracy and variability across the two phases. Conclusions: We provide evidence that performance (force accuracy and steadiness) in bimanual force decrement is reduced compared with force increment, highlighting that force release is more challenging than force generation in bimanual tasks. Overall, improved bimanual task performance is contributed by reduced coordination of two forces indicating that reduced constraint between the hands facilitates error compensation. However, the implicit strategy is to produce highly coordinated forces while executing controlled force release, impacting the task performance. Clinical implications: Considering the significance of increasing and decreasing forces to manipulate objects, our study provides insight into the fundamental differences in bimanual task performance and force coordination during dynamic force manipulation requiring increasing and decreasing forces. These findings can form the basis to understand how aging and neurological conditions impact bimanual function. Future endeavors should be targeted to evaluate more deep understanding of upper limb motor control and invent protocols for the rehabilitation

Motor Impairments in Transient Ischemic Attack Increase the Odds of a Subsequent Stroke: A Meta-Analysis

Background and purposeTransient ischemic attack (TIA) increases the risk for a subsequent stroke. Typical symptoms include motor weakness, gait disturbance, and loss of coordination. The association between the presence of motor impairments during a TIA and the chances of a subsequent stroke has not been examined. In the current meta-analysis, we examine whether the odds of a stroke are greater in TIA individuals who experience motor impairments as compared with those who do not experience motor impairments.MethodsWe conducted a systematic search of electronic databases as well as manual searches of the reference lists of retrieved articles. The meta-analysis included studies that reported an odds ratio relating motor impairments to a subsequent stroke, or the number of individuals with or without motor impairments who experienced a subsequent stroke. We examined these studies using rigorous meta-analysis techniques including random effects model, forest and funnel plots, I2, publication bias, and fail-safe analysis.ResultsTwenty-four studies with 15,129 participants from North America, Australia, Asia, and Europe qualified for inclusion. An odds ratio of 2.11 (95% CI, 1.67–2.65, p = 0.000) suggested that the chances of a subsequent stroke are increased by twofolds in individuals who experience motor impairments during a TIA compared with those individuals who have no motor impairments.ConclusionThe presence of motor impairments during TIA is a significantly high-risk clinical characteristic for a subsequent stroke. The current evidence for motor impairments following TIA relies exclusively on the clinical reports of unilateral motor weakness. A comprehensive examination of motor impairments in TIA will enhance TIA prognosis and restoration of residual motor impairments