Living with Focal Task-Specific Dystonia: The Musician’s Perspective

Background: Focal task-specific dystonia, known as musician’s dystonia, is a motor disorder that affects approximately 1% of professional musicians. Symptoms of musician’s dystonia include the loss of fine motor control and dexterity of repetitive, highly trained movements, which for a professional musician can be career ending. There is limited research on the unique experiences and perspectives of professional musicians with focal task-specific dystonia. Methods: A qualitative approach was chosen to explore the lived experiences of professional musicians with focal task-specific dystonia, specifically a phenomenological research tradition. Eleven musicians fitting the targeted criteria were recruited and interviewed. Four interviews were selected for analysis in this thesis. Each participant completed two online surveys, including the QuickDASH (Disability of Arm, Shoulder, Hand) self-report survey addressing functional limitations related to upper extremity injury. Each musician participated in a semi-structured interview of broad, open-ended questions. Interviews were transcribed and individually analyzed using a modified version of Moustaka’s data analysis approach (Cresswell & Poth, 2017). Significant statements were identified, grouped by meaning, and labeled. Grouped statements were then coded to facilitate the identification of emergent themes significant to the individual. Once individual themes were coded, common themes across participants were identified using cross-case analysis. Results: Six primary themes emerged amongst all participants: singularity of identity, practice as primary reaction, secrecy and shame, independent problem solving with trusted support, trauma response, and negative experiences with medical services. The themes illustrate meaningful areas of shared experiences amongst musicians with musician’s dystonia, including significant experiences of loss, isolation, and struggle to find adequate support through healthcare. Conclusions: These findings suggest areas in which healthcare providers may improve their support of professional musicians with focal task-specific dystonia. Consistent across all participants were areas of unique strength in abilities of self-assessment, analyses, and modification. These strengths represent an opportunity for healthcare providers to employ a collaborative approach when working with professional musicians with musician’s dystonia, in order to provide the best care for this population

Understanding immunopathology of severe dengue: lessons learnt from sepsis

Endothelial dysfunction leading to vascular permeability and plasma leakage are characteristic features of severe dengue and sepsis. However, the mechanisms underlying these immune-pathologies remain unclear. The risk of severe dengue and sepsis development depend on patient-related and pathogen-related factors. Additionally, comorbidities increase the risk of severe disease and their incidence hampers correct diagnosis and treatments. To date, there is no efficient therapy to combat severe dengue and sepsis. Here, we discuss the differences and similarities between the pathogenesis of severe dengue and that of bacterial sepsis. We identify gaps in knowledge that need to be better understood in order to move towards the rational development and/or usage of therapeutic strategies to ameliorate severe dengue disease

Application of Differential Pulse Voltammetry to Determine the Efficiency of Stripping Tocopherols from Commercial Fish Oil

There has been an increase in the use of electrochemical methods for monitoring antioxidant levels in a variety of disciplines due to the sensitivity, low detection limits, ease of use, low cost and rapid analysis time offered by these techniques. One technique that has received specific attention is differential pulse voltammetry. We describe a novel application of differential pulse voltammetry to quantitatively and qualitatively determine the efficiency of removing tocopherols from commercial fish oil via column chromatographic separation. The relative limits of detection and quantitation of differential pulse voltammetry are compared to HPLC for determining the removal of tocopherols from commercial fish oil. It was determined that differential pulse voltammetry can monitor the separation of commercially added antioxidants from the bulk sample via a decrease in antioxidant oxidation currents. Furthermore, the limits of detection and quantitation were found to be comparable with values obtained using HPLC for tocopherol identification and quantitation.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141339/1/aocs0527.pd

Identification of LPS-Activated Endothelial Subpopulations With Distinct Inflammatory Phenotypes and Regulatory Signaling Mechanisms

Sepsis is a life-threatening condition caused by a dysregulated host response to infection. Endothelial cells (EC) are actively involved in sepsis-associated (micro)vascular disturbances and subsequent organ dysfunction. Lipopolysaccharide (LPS), a Gram-negative bacterial product, can activate EC leading to the expression of pro-inflammatory molecules. This process is molecularly regulated by specific receptors and distinct, yet poorly understood intracellular signaling pathways. LPS-induced expression of endothelial adhesion molecules E-selectin and VCAM-1 in mice was previously shown to be organ- and microvascular-specific. Here we report that also within renal microvascular beds the endothelium expresses different extents of E-selectin and VCAM-1. This heterogeneity was recapitulated in vitro in LPS-activated human umbilical vein EC (HUVEC). Within 2 h after LPS exposure, four distinct HUVEC subpopulations were visible by flow cytometric analysis detecting E-selectin and VCAM-1 protein. These encompassed E-selectin−/VCAM-1− (–/–), E-selectin+/VCAM-1− (E-sel+), E-selectin+/VCAM-1+ (+/+), and E-selectin−/VCAM-1+ (VCAM-1+) subpopulations. The formation of subpopulations was a common response of endothelial cells to LPS challenge. Using fluorescence-activated cell sorting (FACS) we demonstrated that the +/+ subpopulation also expressed the highest levels of inflammatory cytokines and chemokines. The differences in responsiveness of EC subpopulations could not be explained by differential expression of LPS receptors TLR4 and RIG-I. Functional studies, however, demonstrated that the formation of the E-sel+ subpopulation was mainly TLR4-mediated, while the formation of the +/+ subpopulation was mediated by both TLR4 and RIG-I. Pharmacological blockade of NF-κB and p38 MAPK furthermore revealed a prominent role of their signaling cascades in E-sel+ and +/+ subpopulation formation. In contrast, the VCAM-1+ subpopulation was not controlled by any of these signaling pathways. Noteworthy is the existence of a “quiescent” subpopulation that was devoid of the two adhesion molecules and did not express cytokines or chemokines despite LPS exposure. Summarizing, our findings suggest that LPS activates different signaling mechanisms in EC that drive heterogeneous expression of EC inflammatory molecules. Further characterization of the signaling pathways involved will enhance our understanding of endothelial heterogeneous responses to sepsis related stimuli and enable the future design of effective therapeutic strategies to interfere in these processes to counteract sepsis-associated organ dysfunction