Short-term reduction of ankle spasticity after surgical lengthening of the triceps surae in chronic post-stroke patients: a retrospective cohort study

IntroductionIn post-stroke patients with equinovarus foot deformity (EVFD), soft tissue rearrangements may contribute to muscle overactivity when a muscle is stretched or tension is applied. Therefore, we investigated the effects of surgically restoring the triceps surae (TS) length and lengthening ability on TS spasticity.MethodsThis retrospective study included chronic post-stroke patients who underwent neuro-orthopedic surgery inclusive of TS lengthening. TS spasticity was measured using the Modified Tardieu Scale (MTS) before and 1 month after surgery, both with the knee extended (KE) and flexed (KF). MTS variations were analyzed using the Wilcoxon test. The time from stroke onset was compared between patients with and without post-surgical spasticity using the t-test. Statistical significance was set at 5%.ResultsA total of 120 patients with EVFD, aged 57 (12) years, ranging from 1 to 36 years from stroke, were included in the study. The median MTS_KE score significantly decreased from 3 (range 0–4) to 2 (0–4) (p < 0.001) after surgery. The MTS score decreased by ≥1 point in more than half of the sample. Notably, 19 and 32 patients were completely relieved from spasticity (MTS = 0) in the KE and KF conditions, respectively. Post-surgical spasticity did not depend on the time since stroke onset (p = 0.560).DiscussionTS lengthening led to a short-term reduction of spasticity in 41% and 63% of chronic post-stroke patients in the gastro-soleus complex and soleus, respectively, with complete relief observed in 21% and 30% of the sample. Surgical lengthening can be considered an effective treatment that not only restores joint range of motion but also may reduce spasticity, even in chronic patients

Matter manipulation with extreme terahertz light: Progress in the enabling THz technology

Terahertz (THz) light has proven to be a fine tool to probe and control quasi-particles and collective excitations in solids, to drive phase transitions and associated changes in material properties, and to study rotations and vibrations in molecular systems. In contrast to visible light, which usually carries excessive photon energy for collective excitations in condensed matter systems, THz light allows for direct coupling to low-energy (meV scale) excitations of interest, The development of light sources of strong-field few-cycle THz pulses in the 2000s opened the door to controlled manipulation of reactions and processes. Such THz pulses can drive new dynamic states of matter, in which materials exhibit properties entirely different from that of the equilibrium. In this review, we first systematically analyze known studies on matter manipulation with strong-field few-cycle THz light and outline some anticipated new results. We focus on how properties of materials can be manipulated by driving the dynamics of different excitations and how molecules and particles can be controlled in useful ways by extreme THz light. Around 200 studies are examined, most of which were done during the last five years. Secondly, we discuss available and proposed sources of strong-field few-cycle THz pulses and their state-of-the-art operation parameters. Finally, we review current approaches to guiding, focusing, reshaping and diagnostics of THz pulses. (C) 2019 The Author(s). Published by Elsevier B.V

R1 dispersion contrast at high field with fast field-cycling MRI

Contrast agents with a strong R1dispersion have been shown to be effective in generating target-specific contrast in MRI. The utilization of this R1field dependence requires the adaptation of an MRI scanner for fast field-cycling (FFC). Here, we present the first implementation and validation of FFC-MRI at a clinical field strength of 3 T. A field-cycling range of ±100 mT around the nominal B0field was realized by inserting an additional insert coil into an otherwise conventional MRI system. System validation was successfully performed with selected iron oxide magnetic nanoparticles and comparison to FFC-NMR relaxometry measurements. Furthermore, we show proof-of-principle R1dispersion imaging and demonstrate the capability of generating R1dispersion contrast at high field with suppressed background signal. With the presented ready-to-use hardware setup it is possible to investigate MRI contrast agents with a strong R1dispersion at a field strength of 3 T

Table_1_Short-term effects of foot surgery on walking-related pain, function, and satisfaction in patients with Charcot–Marie–Tooth disease: a prospective cohort study.docx

IntroductionPatients with Charcot–Marie–Tooth disease (CMT) often suffer from walking-related pain (WRP), muscle weakness, foot deformities, and reduced ankle dorsiflexion (DF), which affects their ability to walk and daily activities. Functional surgery (FS) can restore foot deviations, affecting the loading ability during gait. We assessed the short-term effects of FS in patients with CMT on WRP, foot and ankle structure, and function, along with patients’ perceived improvement.MethodsThis is a prospective cohort study on CMT patients who had undergone FS and rehabilitation. We analyzed the changes after 1 month, focusing on WRP, DF, the center of pressure progression (COPP) during walking, and measures of walking ability. The non-parametric Wilcoxon test was used.ResultsTen patients were included. One month after FS, WRP reduced from 5.5 (IQR = 3.5) to 2 (IQR = 3.5), p = 0.063, with an effect size of 0.615. The highest decrease was found in patients with very high pre-surgical pain levels. DF almost reached 10° for both active and passive movements (p ConclusionFS can be effective in reducing WRP and restoring foot posture in CMT patients in the short-term, which allows them to wear shoes, and leads to a perceived improvement and satisfaction. Lack of improvement in functional skills may be due to muscle weakness typical of CMT. Studies with longer follow-ups may confirm these hypotheses.</p

Coating Effect on the 1 H-NMR Relaxation Properties of Iron Oxide Magnetic Nanoparticles

International audienceWe present a 1 H Nuclear Magnetic Resonance (NMR) relaxometry experimental investigation of two series of magnetic nanoparticles, constituted of a maghemite core with a mean diameter d TEM = 17 ± 2.5 nm and 8 ± 0.4 nm, respectively, and coated with four different negative polyelectrolytes. A full structural, morpho-dimensional and magnetic characterization was performed by means of Transmission Electron Microscopy, Atomic Force Microscopy and DC magnetometry. The magnetization curves showed that the investigated nanoparticles displayed a different approach to the saturation depending on the coatings, the less steep ones being those of the two samples coated with P(MAA-stat-MAPEG), suggesting the possibility of slightly different local magnetic disorders induced by the presence of the various polyelectrolytes on the particles' surface. For each series, 1 H NMR relaxivities were found to depend very slightly on the surface coating. We observed a higher transverse nuclear relaxivity, r 2 , at all investigated frequencies (10 kHz ≤ ν L ≤ 60 MHz) for the larger diameter series, and a very different frequency behavior for the longitudinal nuclear relaxivity, r 1 , between the two series. In particular, the first one (d TEM = 17 nm) displayed an anomalous increase of r 1 toward the lowest frequencies, possibly due to high magnetic anisotropy together with spin disorder effects. The other series (d TEM = 8 nm) displayed a r 1 vs. ν L behavior that can be described by the Roch's heuristic model. The fitting procedure provided the distance of the minimum approach and the value of the Néel reversal time (τ ≈ 3.5 ÷ 3.9·10 −9 s) at room temperature, confirming the superparamagnetic nature of these compounds

Material science: ultrafast transformation, electron–phonon coupling, multi-scale aspects: general discussion

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Optical excitation processes: general discussion

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