Striding out with Parkinson disease: evidence-based physical therapy for gait disorders

Although Parkinson disease (PD) is common throughout the world, the evidence for physical therapy interventions that enable long-term improvement in walking is still emerging. This article critiques the major physical therapy approaches related to gait rehabilitation in people with PD: compensatory strategies, motor skill learning, management of secondary sequelae, and education to optimize physical activity and reduce falls. The emphasis of this review is on gait specifically, although balance and falls are of direct importance to gait and are addressed in that context. Although the researchers who have provided the evidence for these approaches grounded their studies on different theoretical paradigms, each approach is argued to have a valid place in the comprehensive management of PD generally and of gait in particular. The optimal mix of interventions for each individual varies according to the stage of disease progression and the patient's preferred form of exercise, capacity for learning, and age

Rural living and health-related quality of life in Australians with Parkinson\u27s disease

Introduction: The motor and non-motor symptoms associated with idiopathic Parkinson’s disease (PD) may compromise the health-related quality of life (HRQOL) of some individuals living with this debilitating condition. Although growing evidence suggests that PD may be more prevalent in rural communities, there is little information about the life quality of these individuals. This study examines whether HRQOL ratings vary in relation to rural and metropolitan life settings. Methods: An analytic cross-sectional study was conducted to compare the HRQOL of two separate samples of people with PD living in metropolitan Melbourne and rural Victoria. The metropolitan sample consisted of 210 individuals who had participated in the baseline assessment for an existing clinical trial. The rural sample comprised 24 participants who attended community-based rehabilitation programs and support groups in rural Victoria. Health-related quality of life was quantified using the Parkinson’s Disease Questionnaire-39 (PDQ-39). Results: The HRQOL of participants in rural Australia differed from individuals living in a large metropolitan city (p=0.025). Participants in rural Australia reported worse overall HRQOL, after controlling for differences in disease duration. Their overall HRQOL was lower than for city dwellers. Rural living was also found to be a significant negative predictor of HRQOL (β=0.14; 95% CI -1.27 to -0.08; p=0.027).Conclusion: The findings of this study suggest that some people with PD living in rural Victoria perceive their HRQOL to be relatively poor. In order to minimise the debilitating consequences of this disease, further studies examining the factors that may contribute to the HRQOL of individuals living in rural and remote areas are required

Intrinsic high aerobic capacity protects against lipid induced hepatic insulin resistance [abstract]

Hepatic steatosis is commonly linked to hepatic insulin resistance. However, recent studies have found that increased hepatic triacylglycerol (TAG) accumulation is not always associated with impaired hepatic insulin signaling, leading to a hypothesis that partitioning of lipids into TAG in the liver matched with high rates of fatty acid oxidation (FAO) under high lipid exposure conditions may protect against hepatic insulin resistance. We examined this hypothesis in the livers of high and low capacity running (HCR/LCR) rats which were created by artificial selection based on differences in intrinsic aerobic capacity

Thermodynamics of non-local materials: extra fluxes and internal powers

The most usual formulation of the Laws of Thermodynamics turns out to be suitable for local or simple materials, while for non-local systems there are two different ways: either modify this usual formulation by introducing suitable extra fluxes or express the Laws of Thermodynamics in terms of internal powers directly, as we propose in this paper. The first choice is subject to the criticism that the vector fluxes must be introduced a posteriori in order to obtain the compatibility with the Laws of Thermodynamics. On the contrary, the formulation in terms of internal powers is more general, because it is a priori defined on the basis of the constitutive equations. Besides it allows to highlight, without ambiguity, the contribution of the internal powers in the variation of the thermodynamic potentials. Finally, in this paper, we consider some examples of non-local materials and derive the proper expressions of their internal powers from the power balance laws.Comment: 16 pages, in press on Continuum Mechanics and Thermodynamic

Increased aerobic capacity reduces susceptibility to acute high‐fat diet‐induced weight gain

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134165/1/oby21564.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134165/2/oby21564_am.pd

Global modeling of the nitrate radical (NO3) for present and pre-industrial scenarios

AbstractIncreasing the complexity of the chemistry scheme in the global chemistry transport model STOCHEM to STOCHEM-CRI (Utembe et al., 2010) leads to an increase in NOx as well as ozone resulting in higher NO3 production over forested regions and regions impacted by anthropogenic emission. Peak NO3 is located over the continents near NOx emission sources. NO3 is formed in the main by the reaction of NO2 with O3, and the significant losses of NO3 are due to the photolysis and the reactions with NO and VOCs. Isoprene is an important biogenic VOC, and the possibility of HOx recycling via isoprene chemistry and other mechanisms such as the reaction of RO2 with HO2 has been investigated previously (Archibald et al., 2010a). The importance of including HOx recycling processes on the global budget of NO3 for present and pre-industrial scenarios has been studied using STOCHEM-CRI, and the results are compared. The large increase (up to 60% for present and up to 80% for pre-industrial) in NO3 is driven by the reduced lifetime of emitted VOCs because of the increase in the HOx concentration. The maximum concentration changes (up to 15ppt) for NO3 from pre-industrial to present day are found at the surface between 30oN and 60oN because of the increase in NOx concentrations in the present day integrations

Persuasive Technology for Human Well-Being: Setting the Scene

In this short paper we aim to give a brief introduction to persuasive technology, especially as it pertains to human well-being. We discuss a number of current research opportunities in areas of healthcare, environmental conservation, and education. We conclude by highlighting what we regard as the key research challenges that need to be addressed, focusing on context sensing and appropriate feedback, the need for longitudinal user studies, and ethical concerns

Metric to quantify white matter damage on brain magnetic resonance images

PURPOSE: Quantitative assessment of white matter hyperintensities (WMH) on structural Magnetic Resonance Imaging (MRI) is challenging. It is important to harmonise results from different software tools considering not only the volume but also the signal intensity. Here we propose and evaluate a metric of white matter (WM) damage that addresses this need. METHODS: We obtained WMH and normal-appearing white matter (NAWM) volumes from brain structural MRI from community dwelling older individuals and stroke patients enrolled in three different studies, using two automatic methods followed by manual editing by two to four observers blind to each other. We calculated the average intensity values on brain structural fluid-attenuation inversion recovery (FLAIR) MRI for the NAWM and WMH. The white matter damage metric is calculated as the proportion of WMH in brain tissue weighted by the relative image contrast of the WMH-to-NAWM. The new metric was evaluated using tissue microstructure parameters and visual ratings of small vessel disease burden and WMH: Fazekas score for WMH burden and Prins scale for WMH change. RESULTS: The correlation between the WM damage metric and the visual rating scores (Spearman ρ > =0.74, p  =0.72, p < 0.0001). The repeatability of the WM damage metric was better than WM volume (average median difference between measurements 3.26% (IQR 2.76%) and 5.88% (IQR 5.32%) respectively). The follow-up WM damage was highly related to total Prins score even when adjusted for baseline WM damage (ANCOVA, p < 0.0001), which was not always the case for WMH volume, as total Prins was highly associated with the change in the intense WMH volume (p = 0.0079, increase of 4.42 ml per unit change in total Prins, 95%CI [1.17 7.67]), but not with the change in less-intense, subtle WMH, which determined the volumetric change. CONCLUSION: The new metric is practical and simple to calculate. It is robust to variations in image processing methods and scanning protocols, and sensitive to subtle and severe white matter damage

Exact multilocal renormalization on the effective action : application to the random sine Gordon model statics and non-equilibrium dynamics

We extend the exact multilocal renormalization group (RG) method to study the flow of the effective action functional. This important physical quantity satisfies an exact RG equation which is then expanded in multilocal components. Integrating the nonlocal parts yields a closed exact RG equation for the local part, to a given order in the local part. The method is illustrated on the O(N) model by straightforwardly recovering the $\eta$ exponent and scaling functions. Then it is applied to study the glass phase of the Cardy-Ostlund, random phase sine Gordon model near the glass transition temperature. The static correlations and equilibrium dynamical exponent $z$ are recovered and several new results are obtained. The equilibrium two-point scaling functions are obtained. The nonequilibrium, finite momentum, two-time $t,t'$ response and correlations are computed. They are shown to exhibit scaling forms, characterized by novel exponents $\lambda_R \neq \lambda_C$, as well as universal scaling functions that we compute. The fluctuation dissipation ratio is found to be non trivial and of the form $X(q^z (t-t'), t/t')$. Analogies and differences with pure critical models are discussed.Comment: 33 pages, RevTe

One loop photon-graviton mixing in an electromagnetic field: Part 2

In part 1 of this series compact integral representations had been obtained for the one-loop photon-graviton amplitude involving a charged spin 0 or spin 1/2 particle in the loop and an arbitrary constant electromagnetic field. In this sequel, we study the structure and magnitude of the various polarization components of this amplitude on-shell. Explicit expressions are obtained for a number of limiting cases.Comment: 31 pages, 3 figure