Pyridine nucleotide metabolism in Escherichia coli. IV. Turnover

Journal ArticleThere are two pyridine nucleotide turnover pathways in Escherichia coli, the Gholson turnover cycle, with nicotinamide as an intermediate, and a second new pathway which does not involve nicotinamide. In exponentially growing cultures with a generation time of 60 min, the rates of these cycles are 39 and 102 molecules per s per cell, respectively. We suggest that this second, heretofore undescribed turnover cycle proceeds with nicotinamide mononucleotide as the first intermediate, possibly formed by the DNA ligasecatalyzed cleavage of DPN

Exergaming to improve balance and decrease the risk of falling in individuals with knee osteoarthritis

Background: The benefits of exercise to improve balance and reduce the risk of falls is well-recognised in the older-adult literature. However, little attention is paid to people with osteoarthritis (OA) of the knee. While there is evidence of an increasing number of falls in adults with knee OA, the contributing factors for falling has not been substantially investigated. Exergaming (exercise and gaming) is useful in improving balance in a range of health conditions, yet there is limited research regarding its application to people with knee OA. Aim: The primary aim of this thesis was to investigate the feasibility and acceptability of exergaming using Nintendo Wii Fit™ to improve balance and reduce the risk of falls in individuals with knee OA. Secondary aims were to identify the risk factors for falls in adults with knee OA and to examine the strength of relationship between falling and clinical characteristics such as dynamic balance, pain, instability, muscle strength, and physical function in adults with knee OA. Methods: The main study utilised a mixed-methods, explanatory sequential study design (quantitative followed by qualitative design) to determine the feasibility of exergaming. Nested in this thesis were two literature reviews and a cross-sectional study, all conducted to inform the design of the main study. A systematic review was conducted to identify published evidence on the risk factors for falls in adults with knee OA. The findings from the systematic review informed the risk factors for falls explored in the cross-sectional study. A narrative synthesis of exergaming literature using Nintendo Wii Fit™ was conducted to determine dosage and parameters of the exergaming intervention in the main study. Results: Findings from the systematic review included moderate evidence for impaired balance, decreased knee muscle strength, an increasing number of symptomatic joints, and the presence of comorbidities as risk factors for falls in individuals with knee OA Conflicting evidence was found for knee pain. Impaired proprioception, knee instability, and use of walking aids had limited evidence for being significantly associated with increasing risk for falls. In the cross-sectional study, 31 out of 63 (49%) participants with knee OA reported at least one fall in the previous 12 months. For participants with knee OA and history of falling, dynamic balance, knee muscle strength, and performance of physical function were significantly reduced when compared to participants with knee OA and no history of falling (p<0.05). Lower dynamic balance measured by the Composite Score (OR 0.86, 95% CI 0.73–0.98, p=0.049) and weaker quadriceps muscles strength (OR 0.70, 95% CI 0.44–0.91, p=0.028) showed positive association with an increased risk of falling. Whereas, poorer physical function measured with the Timed Up and Go test, showed increased risk of falling by almost two-fold (OR=1.65, 95% CI 1.85–4.21, p=0.006). The main study found that it is feasible and acceptable to use Nintendo Wii Fit™ as an exergaming tool to improve balance and decrease the risk of falling in adults with knee OA. The pre-defined feasibility criteria such as recruitment, retention, and compliance were successfully met. This was affirmed by the participants’ views on the procedures of the study in terms of the frequency and duration of the assessment and intervention sessions, which they reported to be acceptable. The study demonstrated that it is safe to use Nintendo Wii Fit™ as an exergaming tool as there were no adverse events reported throughout the study period. There were encouraging results in the key outcome measures such as increasing muscle strength, balance, and performance of physical function sufficient to support the conduct of a future randomised controlled trial (RCT). Participants enjoyed playing Wii Fit™ games and found exergaming motivating and interactive in spite of some barriers with the use of technology. Conclusion: This thesis highlights the risk factors for falls and the potential of exergaming to improve balance and decrease the risk of falling in individuals with knee OA. It is essential to understand the mechanism underlying the occurrence of falls in knee OA by identifying modifiable risk factors which can be mitigated. The potential use of exergaming as a balance tool and the assessment of knee OA symptoms that are critical to increasing falls risk can provide valuable information for both clinicians and fall prevention program developers. Findings coming from feasibility study are encouraging, and support the need to conduct a full-scale RCT

3D-Printed Hand Controlled by Arm Gestures to Verify the Robustness and Reliability of a Low Cost Surface Electromyography System

The study focuses on the development of a low-cost surface electromyography and 3D-printed hand gesture-recognition system. The complete system captures four (4) channels of EMG data through sEMG amplifier circuits interfaced to an Arduino prototyping board. This data is sent to a workstation wherein the graphical user interface shows the pre-processed signal. The gestures are used as control for the movements of the 3D-printed arm

Arnis-based Exercise Program for Balance Control in Community-Dwelling Older Adults: Study Protocol for a Pilot Randomized Controlled Trial

Background: Aging causes impairment in balance and increases the prevalence of falls in older adults. Martial arts are now incorporated into exercise programs to improve balance. Arnis, a Filipino Martial Art, can improve the balance control of older adults. Objectives: This study primarily aims to determine the effects of an Arnis-based exercise program on balance control of healthy community-dwelling older adults. This study also aims to describe its effect on older adults’ concerns about falling and lower limb functional strength. Methods:This will be a single-blind, pilot randomized controlled trial. Participants will be randomly allocated to either the intervention or control group. The intervention group will perform an Arnis-based exercise program for 40-60 minutes per session thrice a week for 12 weeks. The control group will continue to do their usual activities for the duration of the study. Participants will be measured at baseline and 12 weeks after for balance, concern for falling, and lower limb strength using the Berg Balance Scale, Timed-Up and Go Test, Falls Efficacy Scale-International Filipino, and the 30-second Chair Sit-to-stand Test, respectively. Data will be analysed through independent and paired t-tests. A p-value Expected Results: Significant improvements in the balance scores in the intervention group are expected after 12 weeks of the Arnis-based exercise program, along with its effects on concerns for falling and lower extremity strength. The pilot study will provide data on the effectiveness of Arnis as a reference for future larger experimental studies

The use of the Nintendo Wii in motor rehabilitation for virtual reality interventions:a literature review

Several review articles have been published on the use of Virtual Reality (VR) in motor rehabilitation. The majority of these focus on the effectiveness of VR on improving motor function using relatively expensive commercial tools and technologies including robotics, cybergloves, cybergrasps, joysticks, force sensors and motion capture systems. However, we present the case in this chapter that game sensors and VR technologies which can be customized and reconfigured, such as the Nintendo Wii, provide an alternative and affordable VR intervention for rehabilitation. While the performance of many of the Wii based interventions in motor rehabilitation are currently the focus of investigation by researchers, an extensive and holistic discussion on this subject does not yet exist. As such, the purpose of this chapter is to provide readers with an understanding of the advantages and limitations of the Nintendo Wii game sensor device (and its associated accessories) for motor rehabilitation and in addition, to outline the potential for incorporating these into clinical interventions for the benefit of patients and therapists

Migration of wear debris of polyethylene depends on bone microarchitecture

The mechanism of hip arthroplasties loosening is related to the migration of wear debris throughout the implant environment. In vivo, polyethylene particles (PE) were shown to infiltrate the bone implant interface and the medullary spaces of the cancellous bone. Our test hypothesis was that polyethylene particle migration is correlated to bone porosity. Bone samples with a high or low trabecular volume and microarchitecture were harvested in 20 calves and 20 human cadavers. They were extensively washed to remove marrow cells. Bone cylinders were filled with a light-curing monomer having the same viscosity as bone marrow. PE particles (7 and 33 μm) were deposited at the surface of the polymer. The bone cylinders were agitated during 7 days on an orbital shaker and the gel was left to polymerize at day light. X-ray microtomography was performed to characterize bone volume and microarchitecture. Cylinders were sectioned and observed under polarized light. The migration distance and rate were determined. Migration of PE particles strongly depended on trabecular bone volume and microarchitecture. We found a linear relationship (r = 0.61) between speed migration and bone volume and an exponential relationship between speed migration and bone architecture. The present in vitro model confirmed our hypothesis about the key role of bone microarchitecture in the migration of large PE wear particles. This is an explanation for the development of inflammatory reaction at distance from a prosthesis although our study did not include submicron particles

Exergaming to improve balance and decrease the risk of falling in individuals with knee osteoarthritis

Background: The benefits of exercise to improve balance and reduce the risk of falls is well-recognised in the older-adult literature. However, little attention is paid to people with osteoarthritis (OA) of the knee. While there is evidence of an increasing number of falls in adults with knee OA, the contributing factors for falling has not been substantially investigated. Exergaming (exercise and gaming) is useful in improving balance in a range of health conditions, yet there is limited research regarding its application to people with knee OA. Aim: The primary aim of this thesis was to investigate the feasibility and acceptability of exergaming using Nintendo Wii Fit™ to improve balance and reduce the risk of falls in individuals with knee OA. Secondary aims were to identify the risk factors for falls in adults with knee OA and to examine the strength of relationship between falling and clinical characteristics such as dynamic balance, pain, instability, muscle strength, and physical function in adults with knee OA. Methods: The main study utilised a mixed-methods, explanatory sequential study design (quantitative followed by qualitative design) to determine the feasibility of exergaming. Nested in this thesis were two literature reviews and a cross-sectional study, all conducted to inform the design of the main study. A systematic review was conducted to identify published evidence on the risk factors for falls in adults with knee OA. The findings from the systematic review informed the risk factors for falls explored in the cross-sectional study. A narrative synthesis of exergaming literature using Nintendo Wii Fit™ was conducted to determine dosage and parameters of the exergaming intervention in the main study. Results: Findings from the systematic review included moderate evidence for impaired balance, decreased knee muscle strength, an increasing number of symptomatic joints, and the presence of comorbidities as risk factors for falls in individuals with knee OA Conflicting evidence was found for knee pain. Impaired proprioception, knee instability, and use of walking aids had limited evidence for being significantly associated with increasing risk for falls. In the cross-sectional study, 31 out of 63 (49%) participants with knee OA reported at least one fall in the previous 12 months. For participants with knee OA and history of falling, dynamic balance, knee muscle strength, and performance of physical function were significantly reduced when compared to participants with knee OA and no history of falling (p<0.05). Lower dynamic balance measured by the Composite Score (OR 0.86, 95% CI 0.73–0.98, p=0.049) and weaker quadriceps muscles strength (OR 0.70, 95% CI 0.44–0.91, p=0.028) showed positive association with an increased risk of falling. Whereas, poorer physical function measured with the Timed Up and Go test, showed increased risk of falling by almost two-fold (OR=1.65, 95% CI 1.85–4.21, p=0.006). The main study found that it is feasible and acceptable to use Nintendo Wii Fit™ as an exergaming tool to improve balance and decrease the risk of falling in adults with knee OA. The pre-defined feasibility criteria such as recruitment, retention, and compliance were successfully met. This was affirmed by the participants’ views on the procedures of the study in terms of the frequency and duration of the assessment and intervention sessions, which they reported to be acceptable. The study demonstrated that it is safe to use Nintendo Wii Fit™ as an exergaming tool as there were no adverse events reported throughout the study period. There were encouraging results in the key outcome measures such as increasing muscle strength, balance, and performance of physical function sufficient to support the conduct of a future randomised controlled trial (RCT). Participants enjoyed playing Wii Fit™ games and found exergaming motivating and interactive in spite of some barriers with the use of technology. Conclusion: This thesis highlights the risk factors for falls and the potential of exergaming to improve balance and decrease the risk of falling in individuals with knee OA. It is essential to understand the mechanism underlying the occurrence of falls in knee OA by identifying modifiable risk factors which can be mitigated. The potential use of exergaming as a balance tool and the assessment of knee OA symptoms that are critical to increasing falls risk can provide valuable information for both clinicians and fall prevention program developers. Findings coming from feasibility study are encouraging, and support the need to conduct a full-scale RCT

Speech-language Pathologists and Behavior Analysts: How Is Collaboration Viewed among Their Professions?

The purpose of this qualitative, phenomenological study is to explore the perspectives of Speech-Language Pathologists (SLPs) and Behavior Analysts (BAs) related to their scopes of practice and their influence on collaboration. A methodological overview of qualitative, phenomenological interviewing will be described. Based on a collective analysis of the participants’ responses, several themes emerged related to barriers to collaboration between SLPs and BAs such as the following: (a) Influence of schedules and personality characteristics; (b) Lack of consensus of the relationship between behavior and communication; (c) Professional territorialism; (d) Perception of other professional’s level of competency; (5) Different theoretical backgrounds; and (e) Perceived inequities about insurance approval for therapy. The perspectives of SLPs and BAs are reported within each barrier to collaboration in order to provide further insight between these two professionals. Lastly, the importance of an interprofessional approach to collaboration when treating individuals with Autism Spectrum Disorders is reviewed