The Effects of Orthopaedic Surgery and Dorsal Rhizotomy on Selected Gait Characteristics of Cerebral Palsy Children

Surgical management of cerebral palsy children typically involves multiple orthopaedic surgeries in order to achieve and maintain the maximum functional level of ambulation. Orthopaedic intervention to address lower extremity spasticity often includes: muscle lengthenings, muscle releases and tendon transfers. The most recent advance in management of lower extremity spasticity has been through a neurosurgical approach; selective dorsal rhizotomy. The long term effects of dorsal rhizotomy are still being investigated. Through the use of instrumented gait analysis, the specific objective results of both of these types of surgeries can be investigated. The purpose of this retrospective study was to examine the effects of multiple simultaneous orthopaedic surgeries and selective dorsal rhizotomy on gait parameters of two groups of children with spastic diplegia cerebral palsy. Nine subjects were included in this study. Four subjects had undergone multiple simultaneous orthopaedic surgeries, and five subjects had undergone selective dorsal rhizotomy. Both groups underwent gait analysis prior to surgery and approximately one year postoperatively using the Vicon five camera motion analysis system. Data was collected on a total of nineteen variables. This included sagittal plane hip, knee and ankle joint rotation angles at initial contact, midstance and foot off; sagittal plane joint excursion at the hip, knee and anlde; average stride length; velocity; single limb support; and foot progression angle at initial contact. Postoperative changes were averaged within each group and subjected to statistical analysis. Average changes were then compared between groups to determine statistically significant changes between the groups. The Wilkes-Shapiro Test determined appropriateness of statistical comparisons for either Student’s t-Test or Wilcoxon Sign Test. Statistical analysis revealed three variables of improvement in the orthopaedic group: knee joint rotation angles at initial contact, ankle joint rotation angles at initial contact and at midstance. The hip angle at foot off changed in a negative direction postoperatively. In the dorsal rhizotomy group there were five variables improved postoperatively: knee and ankle joint rotation angles at initial contact and midstance, and overall hip excursion. Variables of stride length, hip excursion and hip joint rotation angle at foot off were significantly more improved in the dorsal rhizotomy group postoperatively when compared to the orthopaedic group. Overall, there was sagittal plane improvement at the knee and ankle in both groups with a higher amount of improvement in the dorsal rhizotomy group postoperatively. Three gait parameters were more improved in the dorsal rhizotomy group postoperatively when compared to the orthopaedic group

Національно-культурні особливості українських і російських фразеологічних одиниць

Статья посвящена анализу национально-культурной семнтики собственно украинских и собственно русских фразеологических единиц. Делается вывод о том, що таке языковые единицы могут репрезентовать наиболее разнообразные сферы бытия украинского и руского народов (историю, народные обычаи и обряды, своеобразие растительного мира и прочее), отражать национальные особенности своим фразеологическим значением, отдельными компонетами, своими прототипами – генетически свободными словосочетаниями.Стаття присвячена аналізу національно-культурної семантики власне українських і власне російських фразеологічних одиниць. Робиться висновок про те, що такі мовні одиниці можуть репрезентувати найрізноманітніші сфери буття українського і російського народів (історію, народні звичаї і обряди, своєрідність рослинного світу тощо), відображати національні особливості своїм фразеологічним значенням, окремими компонетами, своїми прототипами – генетично вільними словосполученнями.The article is devoted to the analysis of national-cultural semantics of Ukrainian and Russian phraseological units. The conclusion is that such language units can represent the most different spheres of life of Ukrainian and Russian peoples (history, national customs and rituals, peculiarity of flora and other things), to reflect national peculiarities by their own phraseological meaning, separate components, their prototypes-genetic free word-combinations

Pseudomonas fluorescens CHA0 maintains carbon delivery to Fusarium graminearum-infected roots and prevents reduction in biomass of barley shoots through systemic interactions

Soil bacteria such as pseudomonads may reduce pathogen pressure for plants, both by activating plant defence mechanisms and by inhibiting pathogens directly due to the production of antibiotics. These effects are hard to distinguish under field conditions, impairing estimations of their relative contributions to plant health. A split-root system was set up with barley to quantify systemic and local effects of pre-inoculation with Pseudomonas fluorescens on the subsequent infection process by the fungal pathogen Fusarium graminearum. One root half was inoculated with F. graminearum in combination with P. fluorescens strain CHA0 or its isogenic antibiotic-deficient mutant CHA19. Bacteria were inoculated either together with the fungal pathogen or in separate halves of the root system to separate local and systemic effects. The short-term plant response to fungal infection was followed by using the short-lived isotopic tracer 11CO2 to track the delivery of recent photoassimilates to each root half. In the absence of bacteria, fungal infection diverted carbon from the shoot to healthy roots, rather than to infected roots, although the overall partitioning from the shoot to the entire root system was not modified. Both local and systemic pre-inoculation with P. fluorescens CHA0 prevented the diversion of carbon as well as preventing a reduction in plant biomass in response to F. graminearum infection, whereas the non-antibiotic-producing mutant CHA19 lacked this ability. The results suggest that the activation of plant defences is a central feature of biocontrol bacteria which may even surpass the effects of direct pathogen inhibition

Dual mechanism of brain injury and novel treatment strategy in maple syrup urine disease

Maple syrup urine disease (MSUD) is an inherited disorder of branched-chain amino acid metabolism presenting with lifethreatening cerebral oedema and dysmyelination in affected individuals. Treatment requires life-long dietary restriction and monitoring of branched-chain amino acids to avoid brain injury. Despite careful management, children commonly suffer metabolic decompensation in the context of catabolic stress associated with non-specific illness. The mechanisms underlying this decompensation and brain injury are poorly understood. Using recently developed mouse models of classic and intermediate maple syrup urine disease, we assessed biochemical, behavioural and neuropathological changes that occurred during encephalopathy in these mice. Here, we show that rapid brain leucine accumulation displaces other essential amino acids resulting in neurotransmitter depletion and disruption of normal brain growth and development. A novel approach of administering norleucine to heterozygous mothers of classic maple syrup urine disease pups reduced branched-chain amino acid accumulation in milk as well as blood and brain of these pups to enhance survival. Similarly, norleucine substantially delayed encephalopathy in intermediate maple syrup urine disease mice placed on a high protein diet that mimics the catabolic stress shown to cause encephalopathy in human maple syrup urine disease. Current findings suggest two converging mechanisms of brain injury in maple syrup urine disease including: (i) neurotransmitter deficiencies and growth restriction associated with branchedchain amino acid accumulation and (ii) energy deprivation through Krebs cycle disruption associated with branched-chain ketoacid accumulation. Both classic and intermediate models appear to be useful to study the mechanism of brain injury and potential treatment strategies for maple syrup urine disease. Norleucine should be further tested as a potential treatment to prevent encephalopathy in children with maple syrup urine disease during catabolic stress

Plasma cholesterol levels and brain development in preterm newborns.

BackgroundTo assess whether postnatal plasma cholesterol levels are associated with microstructural and macrostructural regional brain development in preterm newborns.MethodsSixty preterm newborns (born 24-32 weeks gestational age) were assessed using MRI studies soon after birth and again at term-equivalent age. Blood samples were obtained within 7 days of each MRI scan to analyze for plasma cholesterol and lathosterol (a marker of endogenous cholesterol synthesis) levels. Outcomes were assessed at 3 years using the Bayley Scales of Infant Development, Third Edition.ResultsEarly plasma lathosterol levels were associated with increased axial and radial diffusivities and increased volume of the subcortical white matter. Early plasma cholesterol levels were associated with increased volume of the cerebellum. Early plasma lathosterol levels were associated with a 2-point decrease in motor scores at 3 years.ConclusionsHigher early endogenous cholesterol synthesis is associated with worse microstructural measures and larger volumes in the subcortical white matter that may signify regional edema and worse motor outcomes. Higher early cholesterol is associated with improved cerebellar volumes. Further work is needed to better understand how the balance of cholesterol supply and endogenous synthesis impacts preterm brain development, especially if these may be modifiable factors to improve outcomes

Evaluation of brain mitochondrial glutamate and alpha-ketoglutarate transport under physiologic conditions

Some models of brain energy metabolism used to interpret in vivo (13)C nuclear magnetic resonance spectroscopic data assume that intramitochondrial alpha-ketoglutarate is in rapid isotopic equilibrium with total brain glutamate, most of which is cytosolic. If so, the kinetics of changes in (13)C-glutamate can be used to predict citric acid cycle flux. For this to be a valid assumption, the brain mitochondrial transporters of glutamate and alpha-ketoglutarate must operate under physiologic conditions at rates much faster than that of the citric acid cycle. To test the assumption, we incubated brain mitochondria under physiologic conditions, metabolizing both pyruvate and glutamate and measured rates of glutamate, aspartate, and alpha-ketoglutarate transport. Under the conditions employed (66% of maximal O(2) consumption), the rate of synthesis of intramitochondrial alpha-ketoglutarate was 142 nmol/min.mg and the combined initial rate of alpha-ketoglutarate plus glutamate efflux from the mitochondria was 95 nmol/min.mg. It thus seems that much of the alpha-ketoglutarate synthesized within the mitochondria proceeds around the citric acid cycle without equilibrating with cytosolic glutamate. Unless the two pools are in such rapid exchange that they maintain the same percent (13)C enrichment at all points, (13)C enrichment of glutamate alone cannot be used to determine tricarboxylic acid cycle flux. The alpha-ketoglutarate pool is far smaller than the glutamate pool and will therefore approach steady state faster than will glutamate at the metabolite transport rates measured

Impact of deficit irrigation on grapevine cv. ‘Touriga Nacional’ during three seasons in Douro region: an agronomical and metabolomics approach

The introduction of irrigation in vineyards of the Mediterranean basin is a matter of debate, in particular in those of the Douro Demarcated Region (DDR), due to the limited number of available studies. Here, we aimed to perform a robust analysis in three consecutive vintages (2018, 2019, and 2020) on the impact of deficit irrigation on the yield, berry quality traits, and metabolome of cv. ‘Touriga Nacional’. Results showed that in the peaks of extreme drought, irrigation at 30% crop evapotranspiration (ETc) (R30) was able to prevent a decay of up to 0.4 MPa of leaf predawn water potential (ΨPd), but irrigation at 70% ETc (R70) did not translate into additional protection against drought stress. Following three seasons of irrigation, the yield was significantly improved in vines irrigated at R30, whereas irrigation at R70 positively affected the yield only in the 2020 season. Berry quality traits at harvest were not significantly changed by irrigation, except for Total Soluble Solids (TSS) in 2018. A UPLC–MS-based targeted metabolomic analysis identified eight classes of compounds, amino acids, phenolic acids, stilbenoid DP1, stilbenoid DP2, flavonols, flavan-3-ols, di-OH- and tri-OH anthocyanins, and showed that anthocyanins and phenolic acids did not change significantly with irrigation. The present study showed that deficit irrigation partially mitigated the severe summer water deficit conditions in the DDR but did not significantly change key metabolites.This research was funded by the VISCA project (Vineyards’ Integrated Smart Climate Application), funded by European Union’s Horizon 2020 research and innovation programme under grant agreement no. 730253. The Région-Centre Val de Loire (France) supported this work under the grant agreement to Project VITI’ACTIF. The work was also supported by the “Contrato-Programa” UIDB/04050/2020 funded by Portuguese national funds through the FCT I.P. The work was also supported by FCT, CCDR-N (Norte Portugal Regional Coordination and Development Commission) and European Funds (FEDER/POCI/COMPETE2020) through the project AgriFoodXXI (NORTE01-0145-FEDER-000041) and the research projects BerryPlastid (PTDC/BIA-FBT/28165/2017 and POCI-01-0145-FEDER-028165), MitiVineDrought (PTDC/BIA-FBT/30341/2017 and POCI-01-0145- FEDER-030341), and GrapeInfectomics (PTDC/ASPHOR/28485/2017). A.T. was supported by a post-doctoral researcher contract/position within the project “BerryPlastid”. This work also benefited from the networking activities within the European COST Action CA 17111 INTEGRAPE, the CoLAB VINES & WINES, and the CoLAB 4FOOD—Collaborative Laboratory for Innovation in the Food Industry

Evaluation of pediatric rheumatology telehealth satisfaction during the COVID-19 pandemic

Background: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients. Methods: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total and sub-scale (usefulness, ease of use, effectiveness, satisfaction) scores were calculated and classified as positive based on responses of agree or strongly agree on a 5-point Likert scale. Results were analyzed using standard descriptive statistics and Wilcoxon signed rank testing. The association between demographic and clinical characteristics with TUQ scores was assessed using univariate linear regression. Results: 597 patients/caregivers met inclusion criteria, and the survey response rate was 42% (n = 248). Juvenile idiopathic arthritis was the most common diagnosis (33.5%). The majority of patients were diagnosed greater than 6 months previously (72.6%) and were prescribed chronic medications (59.7%). The median total TUQ score was 4 (IQR: 4-5) with positive responses in 81% of items. Of the subscales, usefulness scores were lowest (median: 4, p \u3c 0.001). Telehealth saves time traveling was the highest median item score (median = 5, IQR: 4-5). Within subscales, items that scored significantly lower included convenience, providing for needs, seeing rheumatologist as well as in person, and being an acceptable way to receive rheumatology services (all p \u3c 0.001). There were no significant demographic or clinical features associated with TUQ scores. Conclusions: Our results suggest telehealth is a promising mode of healthcare delivery for pediatric rheumatic diseases but also identifies opportunities for improvement. Innovation and research are needed to design a telehealth system that delivers high quality and safe care that improves healthcare outcomes. Since telehealth is a rapidly emerging form of pediatric rheumatology care, improved engagement and training of patients, caregivers, and providers may help improve the patient experience in the future

Neuroglial metabolism in the awake rat brain: CO2 fixation increases with brain activity

Glial cells are thought to supply energy for neurotransmission by increasing nonoxidative glycolysis; however, oxidative metabolism in glia may also contribute to increased brain activity. To study glial contribution to cerebral energy metabolism in the unanesthetized state, we measured neuronal and glial metabolic fluxes in the awake rat brain by using a double isotopic-labeling technique and a two-compartment mathematical model of neurotransmitter metabolism. Rats (n = 23) were infused simultaneously with 14C-bicarbonate and [1-13C]glucose for up to 1 hr. The 14C and 13C labeling of glutamate, glutamine, and aspartate was measured at five time points in tissue extracts using scintillation counting and 13C nuclear magnetic resonance of the chromatographically separated amino acids. The isotopic 13C enrichment of glutamate and glutamine was different, suggesting significant rates of glial metabolism compared with the glutamate-glutamine cycle. Modeling the 13C-labeling time courses alone and with 14C confirmed significant glial TCA cycle activity (V(PDH)((g)), approximately 0.5 micromol x gm(-1) x min(-1)) relative to the glutamate-glutamine cycle (V(NT)) (approximately 0.5-0.6 micromol x gm(-1) x min(-1)). The glial TCA cycle rate was approximately 30% of total TCA cycle activity. A high pyruvate carboxylase rate (V(PC), approximately 0.14-0.18 micromol x gm(-1) x min(-1)) contributed to the glial TCA cycle flux. This anaplerotic rate in the awake rat brain was severalfold higher than under deep pentobarbital anesthesia, measured previously in our laboratory using the same 13C-labeling technique. We postulate that the high rate of anaplerosis in awake brain is linked to brain activity by maintaining glial glutamine concentrations during increased neurotransmission