A Vicious Cycle of Fear of Falling Avoidance Behavior in Parkinson’s Disease: A Path Analysis

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal components analysis (PCA) composite of the Uni!ed Parkinson’s Disease Rating Scale PI and Gait Dif!culty score, Timed Up and Go test, and Berg Balance Scale); 2. balance con!dence (Activities!Speci!c Balance Con!dence Scale); 3. FOF avoidance behav- ior (PCA composite of the FOF Avoidance Behavior Questionnaire and average number of steps per day); and, 4. physical conditioning (2!Minute Step Test). Results: The path model was an excellent !t to the data, !2 (7) = 7.910, p = .341, CFI = 0.985, TLI = 0.968, RMSEA = 0.049 (90% CI: 0.000 to 0.179). The moderate to strong and uniformly signi!cant parameter esti- mates were !0.519, !0.651, !0.653, and !0.570, respectively (ps \u3c 0.01). Conclusions: PI directly and inversely predicted balance con!dence, which in turn directly and inversely pre- dicted FOF avoidance behavior. Furthermore, FOF avoidance behavior directly and inversely predicted phys- ical conditioning, which directly and inversely predicted PI, thereby closing the cycle. These !ndings highlight the downstream consequences of PI in PD and support the notion of a vicious cycle of FOF avoidance behavior

Understanding lipid rafts and other related membrane domains

Evidence in support of the classical lipid raft hypothesis has remained elusive. Data suggests that transmembrane proteins and the actin-containing cortical cytoskeleton can organize lipids into short-lived nanoscale assemblies that can be assembled into larger domains under certain conditions. This supports an evolving view in which interactions between lipids, cholesterol, and proteins create and maintain lateral heterogeneity in the cell membrane

An Innovative Use of Cortoss Bone Cement to Stabilize a Nonunion after Interbody Fusion

Abstract A 65-year-old male originally had surgery for spondylolisthesis at L5-S1 in 2008 and then went on to have an L4-5 transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation from L4 to S1 and interbody graft in 2010. Despite having two surgical procedures, he continued with intractable back pain and was told he had a failed lumbar fusion. When he was evaluated with a computerized tomography (CT) scan from April 2015, it demonstrated an erosive nonunion of the L4-5 interbody fusion without incorporation of the polyetheretherketone (PEEK) cage. In an attempt to perform a minimally invasive stabilization of the L4-5 nonunion, he underwent a percutaneous lateral foraminal approach with an injection of Cortoss® cement (Stryker®, Malvern, PA) into the L4-5 interspace and around the graft. The objective was to stabilize the nonunion, resulting in intermediate relief of pain

Widespread recombination, reassortment, and transmission of unbalanced compound viral genotypes in natural arenavirus infections.

Arenaviruses are one of the largest families of human hemorrhagic fever viruses and are known to infect both mammals and snakes. Arenaviruses package a large (L) and small (S) genome segment in their virions. For segmented RNA viruses like these, novel genotypes can be generated through mutation, recombination, and reassortment. Although it is believed that an ancient recombination event led to the emergence of a new lineage of mammalian arenaviruses, neither recombination nor reassortment has been definitively documented in natural arenavirus infections. Here, we used metagenomic sequencing to survey the viral diversity present in captive arenavirus-infected snakes. From 48 infected animals, we determined the complete or near complete sequence of 210 genome segments that grouped into 23 L and 11 S genotypes. The majority of snakes were multiply infected, with up to 4 distinct S and 11 distinct L segment genotypes in individual animals. This S/L imbalance was typical: in all cases intrahost L segment genotypes outnumbered S genotypes, and a particular S segment genotype dominated in individual animals and at a population level. We corroborated sequencing results by qRT-PCR and virus isolation, and isolates replicated as ensembles in culture. Numerous instances of recombination and reassortment were detected, including recombinant segments with unusual organizations featuring 2 intergenic regions and superfluous content, which were capable of stable replication and transmission despite their atypical structures. Overall, this represents intrahost diversity of an extent and form that goes well beyond what has been observed for arenaviruses or for viruses in general. This diversity can be plausibly attributed to the captive intermingling of sub-clinically infected wild-caught snakes. Thus, beyond providing a unique opportunity to study arenavirus evolution and adaptation, these findings allow the investigation of unintended anthropogenic impacts on viral ecology, diversity, and disease potential

Artificially Intelligent Medical Assistant Robot (AIMAR)

Healthcare providers face financial, regulatory, and logistical obstacles in supplying quality care. Applying robotics and artificial intelligence (AI) to healthcare reduces demands on providers, increases accuracy by supplementing medical diagnoses, and improves patient outcomes. Team AIMAR (Artificially Intelligent Medical Assistant Robot) has constructed a modular robotic healthcare AI system, consisting of advanced diagnostic features as supplements to a generic base. The team focused on analyzing images with machine learning to identify skin conditions. The base robot can move around the home or hospital, pick up objects, and interact with patients and doctors. The patient can log in using face authentication so that patient data is secure, and interact verbally and visually through the user interface. New features can easily be added to the base robot's existing integrated features, making AIMAR adaptable for many desired contexts.IPST/LCV Lab, Gemstone Honors Progra