An Examination of Spasticity of the Lower Extremity among Young People with Cerebral Palsy

Background: Spasticity is the most common symptom among individuals with Cerebral Palsy (CP). Spasticity is often presented as stiff limbs often resulting in pain. Currently, clinicians are limited in diagnosing spasticity using observational tools. The purpose of this study was compare spasticity at various functional levels using dynamometry. Methods: Participants included nine adolescents (12-19) with CP and nine adolescents (age-matched) without CP. The participants participated in passive stretches delivered by the Biodex System 4 Pro Dynamometer at four different speeds (90, 120, 150, and 180 deg/s), Measurements of the quadriceps will be collected before and during passive knee extension stretches with the isokinetic dynamometer using angular displacement, torque, and angular velocity. Results: This study showed significant differences of resistive torque values (peak and mean) between controls and individuals with high CP. A significant difference of resistive torque values (peak and mean) was also shown between left and right lower extremities. A significant difference between different velocities was not found comparing mean resistive torque values but was found comparing peak resistive torque values at 180°/s to all of the other velocities. Conclusions: Dynamometry is able to detect muscle contractions that resist gravity by detecting the amount of torque present. A higher negative resistive torque value represents little to no muscle contraction present while a lower negative resistive torque value represents high muscle contraction present that was resisting gravity. Future research is needed to examine underlying mechanisms with the joint use of dynamometry and surface Electromyography (sEMG)

The Interwar Period as a Machine Age: Mechanics, The Machine, Mechanisms and The Market in Discourse

This paper examines some of the ways that machines, mechanisms and the new mechanics were treated in post World War I discourse. Spengler’s 1919 Decline of the West and Hessen’s 1931 study of Newton have usually been tied closely to Weimar culture in Germany, and Soviet politics. Linking them also to the writings of Rathenau, Simmel, Chase, Mumford, Hayek and others, as well as to Dada and film studies of the city will indicate central features of a wide-ranging, international discourse on the machine and mechanisation. I argue that machines were so thoroughly integrated into social and economic experience that we can treat this as a distinctive new phase in the cultural history of mechanics, what some contemporaries called the “machine age”: a period in which rather than the hand mill or steam engine, the city stands as an appropriate realisation (and sometimes symbol) of the significance but also ambiguities and tensions of mechanical life; and concepts of mechanisation were extended to encompass the economy and market mechanisms

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A preliminary framework for corporate real estate sustainable management

The global warming issue has motivated corporations to go green in their business operations including transforming from conventional real estate to green features real estate. However green CRE is more complex to manage due to a building’s significant impact on environmental, social and economic aspects. Thus the need to have a best practice guide or framework as reference is crucial. Unfortunately, no best practice guidelines on CRE management have been found to be sufficient as much uncertainty still exists on the sustainable performance measurement components. This research aims to explore and then summarize the present sustainable CREM practices and components relating to sustainable performance measurement integrating a sustainable theory that balances environmental, economic and social impacts. These act as indicators to measure the outcomes of the practice in the form of a generic model on sustainability preliminary framework for CRESM. The objectives of this research include identifying corporate real estate sustainable management (CRESM) practice and components of sustainable performance measurement. The research uses content analysis method to analyse data gathered from literature and previous studies. The findings will be demonstrated in the form of a framework model on CRESM that will include14 CREM strategies and 15 components derived from analysis

Cell-Cycle Markers in a Transgenic Mouse Model of Human Tauopathy : Increased Levels of Cyclin-Dependent Kinase Inhibitors p21Cip1 and p27Kip1

Recent evidence has suggested that an abnormal reactivation of the cell cycle may precede and cause the hyperphosphorylation and filament formation of tau protein in Alzheimer’s disease and other tauopathies. Here we have analyzed the expression and/or activation of proteins involved in cell-cycle progression in the brain and spinal cord of mice transgenic for mutant human P301S tau protein. This mouse line recapitulates the essential molecular and cellular features of the human tauopathies, including hyperphosphorylation and filament formation of tau protein. None of the activators and co-activators of the cell cycle tested were overexpressed or activated in 5-month-old transgenic mice when compared to controls. By contrast, the levels of cyclin-dependent kinase inhibitors p21Cip1 and p27Kip1 were increased in brain and spinal cord of transgenic mice. Both inhibitors accumulated in the cytoplasm of nerve cells, the majority of which contained inclusions made of hyperphosphorylated tau protein. A similar staining pattern for p21Cip1 and p27Kip1 was also present in the frontal cortex from a case of FTDP-17 with the P301L tau mutation. Thus, reactivation of the cell cycle was not involved in tau hyperphos-phorylation and filament formation, consistent with expression of p21Cip1 and p27Kip1 in tangle-bearing nerve cells