Auditory cue based on the golden ratio can improve gait patterns in people with parkinson’s disease

The harmonic structure of walking relies on an irrational number called the golden ratio (φ): in healthy subjects, it coincides with the stride-to-stance ratio, and it is associated with a smooth gait modality. This smoothness is lost in people with Parkinson’s disease (PD), due to deficiencies in the execution of movements. However, external auditory cues seem to facilitate movement, by enabling the timing of muscle activation, and helping in initiating and modulating motor output. Based on a harmonic fractal structure of gait, can the administration of an auditory cue based on individual’s φ-rhythm improve, in acute, gait patterns in people with PD? A total of 20 participants (16 males, age 70.9 ± 8.4 years, Hoehn and Yahr stage-II) were assessed through stereophotogrammetry: gait spatio-temporal parameters, and stride-to-stance ratio were computed before, during, and after the φ-rhythm administration. Results show improvements in terms of stride length (p = 0.018), walking speed (p = 0.014), and toe clearance (p = 0.013) when comparing gait patterns before and after the stimulus. Furthermore, the stride-to-stance ratio seems to correlate with almost all spatio-temporal parameters, but it shows the main changes in the before–during rhythm comparison. In conclusion, φ-rhythm seems an effective cue able to compensate for defective internal rhythm of the basal ganglia in PD

Attività Fisica Adattata: Taiji-Quan. Una proposta di metodo di lavoro per le persone con Malattia di Parkinson

Riassunto La Malattia di Parkinson è la seconda malattia neurodegenerativa più diffusa al mondo dopo l’Alzheimer. Le persone affette sono ad alto rischio di caduta, con conseguenti disabilità fisiche e psicologiche, con aumento della paura di cadere e di uscire di casa, e riduzione dell’autonomia individuale. I disturbi dell’equilibrio rispondono in maniera incompleta al trattamento farmacologico, mentre si fanno sempre più numerose le evidenze scientifiche che dimostrano come la pratica del Taiji-Quan quale “attività fisica adattata” sia efficace nel migliorare l’equilibrio e dunque la qualità di vita delle persone con Malattia di Parkinson. Il presente lavoro vuole proporre un Programma di Allenamento Adattato di Taiji-Quan, ben definito, ripetibile, completo di significato rieducativo specifico per ogni singolo esercizio, da associare al Programma Farmacologico nel Progetto Riabilitativo Individuale delle persone con Malattia di Parkinson. Tale protocollo è attuabile anche in modalità telematica come tele-riabilitazione

The use of ultrasound in the clinical re-staging of the axilla after neoadjuvant chemotherapy (NACT).

Introduction Ultrasound (US) is the imaging modality of choice for staging the axilla prior to surgery in patients with breast cancer (BC). High pathological complete response rates in the axilla after NACT mean a more conservative approach to surgery can be considered. Radiological re-staging is important in this decision making. After the presentation of results from ACOSOG Z1071 in December 2012, formal ultrasound re-assessment of the axilla after primary therapy was specifically requested in our institution. We report on the accuracy of axillary US (aUS) for identifying residual axillary disease post-NACT.Methods Data were collected on patients who had proven axillary disease prior to NACT and underwent axillary lymph node dissection after NACT between January 2013 and December 2015. Post-chemotherapy aUS reports and axillary pathology reports were classified as positive or negative for abnormal lymph nodes and for residual disease (cCR and pCR respectively).Results The sensitivity and specificity of aUS was 71% and 88% respectively. The negative predictive value (NPV) was 83%. The false negative rate was 29%.Conclusions Axillary ultrasound provides clinically useful information post-NACT, which will guide surgical decision-making. Patients with aUS-negative axillae are likely to have a lower false negative rate of SLNB after NACT (Boughey et al.). However, aUS does not replace the need to identify and biopsy the nodes which were proven to be positive prior to NACT

Impacto de la Terapia de Alto Flujo de Oxígeno (TAFO) en un hospital pediátrico de la provincia de Buenos Aires

Introducción: Las infecciones respiratorias agudas bajas (IRAB), representan la causa más frecuente de consulta e internación en los meses de invierno. La insuficiencia respiratoria aguda es la complicación que motiva la internación de los pacientes y la necesidad de Unidad Terapia Intensiva (UTI). El objetivo del trabajo fue describir los resultados de la implementación de la Terapia de Alto Flujo (TAFO) en pacientes con IRAB grave internados en Terapia Intermedia. Métodos: Estudio prospectivo y descriptivo que incluyó pacientes de 1 a 36 meses internados en Terapia Intermedia en el Hospital Sor María Ludovica de la ciudad de La Plata, desde junio de 2018 a septiembre de 2019. Se ingresaron a TAFO pacientes sin respuesta al tratamiento con oxígeno a bajo flujo. El ingreso a UTI se consideró fracaso de la TAFO. Resultados: De 760 pacientes internados con IRAB, 91(11,9%) ingresaron a TAFO de los cuales 59 (64,8 %) tuvieron respuesta favorable con disminución de la frecuencia respiratoria (FR), frecuencia cardiaca (FC) y mejoría de la mecánica respiratoria; el resto (35,2%) pasó a UTI por fracaso terapéutico. Presentaron complicaciones a la TAFO el 5,5% de los pacientes. Conclusión: La TAFO fue una terapéutica segura, de fácil utilización que, a través de un aporte de oxígeno conocido, permitió la corrección de la hipoxemia, logrando la disminución de la FR, FC y mejoría de la mecánica respiratoria, dándole mayor comodidad al paciente durante su enfermedad.Introduction: Respiratory infections remain the major cause of outpatient consultation and hospital admissions during the winter season. Lower respiratory illness may cause severe acute respiratory insufficiency and hypoxemic respiratory failure, thus determining the need for hospitalization and eventual intensive care (ICU). The purpose of this paper is to describe the results of High Flow Oxygen Therapy (HFOT) implementation for patients with acute lower respiratory infections (ALRI) admitted to intermediate therapy unit. Methods: Prospective and descriptive study which included patients from age 1 to 36 months, hospitalized at intermediate therapy care unit at “Sor María Ludovica”, Hospital, in La Plata, from June, 2018 to September, 2019. Patients who did not show any improvement to low flow oxygen therapy were the subjects of this study. Further submission to ICU was considered as HFOT failure. Results: From 760 patients hospitalized with ALRI, 91 (11.9%) were admitted to TAFO. Fifty nine, (64.8%) had a favorable response with decreased respiratory and heart frequency rate, and an improvement of the work of breathing. The rest (35.1%) went to ICU due to therapeutic failure. Five point five percent of patients presented complications to TAFO. Conclusion: HFOT was a safe, easy to implement therapy treatment which improved the hypoxemic respiratory failure. This therapy reduced the respiratory and heart rate, and yielded a better and lower respiratory work, making patients more comfortable during illness

Remnants of an ancient forest provide ecological context for Early Miocene fossil apes

The lineage of apes and humans (Hominoidea) evolved and radiated across Afro-Arabia in the early Neogene during a time of global climatic changes and ongoing tectonic processes that formed the East African Rift. These changes probably created highly variable environments and introduced selective pressures influencing the diversification of early apes. However, interpreting the connection between environmental dynamics and adaptive evolution is hampered by difficulties in locating taxa within specific ecological contexts: time-averaged or reworked deposits may not faithfully represent individual palaeohabitats. Here we present multiproxy evidence from Early Miocene deposits on Rusinga Island, Kenya, which directly ties the early ape Proconsul to a widespread, dense, multistoried, closed-canopy tropical seasonal forest set in a warm and relatively wet, local climate. These results underscore the importance of forested environments in the evolution of early apes

A smog chamber comparison of a microfluidic derivatisation measurement of gas-phase glyoxal and methylglyoxal with other analytical techniques

A microfluidic lab-on-a-chip derivatisation technique has been developed to measure part per billion (ppbV) mixing ratios of gaseous glyoxal (GLY) and methylglyoxal (MGLY), and the method is compared with other techniques in a smog chamber experiment. The method uses-(2, 3, 4, 5, 6-pentafluorobenzyl) hydroxylamine (PFBHA) as a derivatisation reagent and a microfabricated planar glass micro-reactor comprising an inlet, gas and fluid splitting and combining channels, mixing junctions, and a heated capillary reaction microchannel. The enhanced phase contact area-to-volume ratio and the high heat transfer rate in the micro-reactor resulted in a fast and highly efficient derivatisation reaction, generating an effluent stream ready for direct introduction to a gas chromatograph-mass spectrometer (GC-MS). A linear response for GLY was observed over a calibration range 0.7 to 400 ppbV, and for MGLY of 1.2 to 300 ppbV, when derivatised under optimal reaction conditions. The analytical performance shows good accuracy (6.6% for GLY and 7.5% for MGLY), suitable precision (<12.0%) with method detection limits (MDLs) of 75 pptV for GLY and 185 pptV for MGLY, with a time resolution of 30 min. These MDLs are below or close to typical concentrations of these compounds observed in ambient air. The feasibility of the technique was assessed by applying the methodology to quantify α-dicarbonyls formed during the photo-oxidation of isoprene in the EUPHORE chamber. Good correlations were found between microfluidic measurements and Fourier Transform InfraRed spectroscopy (FTIR) with a correlation coefficient (2) of 0.84, Broadband Cavity Enhanced Absorption Spectroscopy (BBCEAS) (2 Combining double low line 0.75), solid phase micro extraction (SPME) (2 Combining double low line 0.89), and a photochemical chamber box modelling calculation (2 Combining double low line 0.79) for GLY measurements. For MGLY measurements, the microfluidic technique showed good agreement with BBCEAS (2 Combining double low line 0.87), SPME (2 Combining double low line 0.76), and the modeling simulation (2 Combining double low line 0.83), FTIR (2 Combining double low line 0.72) but displayed a discrepancy with Proton-Transfer Reaction Time-of-Flight Mass Spectrometry (PTR-ToF-MS) with 2 value of 0.39

Terrestrial laser scanning survey in support of unstable slopes analysis. The case of Vulcano Island (Italy)

The capability to measure at distance dense cloud of 3D point has improved the relevance of geomatic techniques to support risk assessment analysis related to slope instability. This work focuses on quantitative analyses carried out to evaluate the effects of potential failures in the Vulcano Island (Italy). Terrestrial laser scanning was adopted to reconstruct the geometry of investigated slopes that is required for the implementation of numerical modeling adopted to simulate runout areas. Structural and morphological elements, which influenced past instabilities or may be linked to new events, were identified on surface models based on ground surveying. Terrestrial laser scanning was adopted to generate detailed 3D models of subvertical slopes allowing to characterize the distribution and orientation of the rock discontinuities that affect instability mechanism caused by critical geometry. Methods for obtaining and analyzing 3D topographic data and to implement simulation analyses contributing to hazard and risk assessment are discussed for two case studies (Forgia Vecchia slope and Lentia rock walls)

Exploring the affordances of smart toys and connected play in practice

What does children’s play look like in the smart toy era? What conceptual frameworks help make sense of the changing practices of children’s connected play worlds? Responding to these questions, this article re-frames discussions about children’s smart toy play within wider theoretical debates about the affordances of new digital materialities. To understand recent transformations of children’s play practices, we propose it is necessary to think of toys as increasingly media-like in their affordances and as connected to wider digital material ecosystems. To demonstrate the potential of this conceptual approach, we explore illustrative examples of two popular smart ‘care toys’. Our analysis identifies three examples of affordances that smart care toys share with other forms of mobile and robotic media: liveliness, affective stickiness and portability. We argue that locating discussions of smart toys within wider conceptual debates about digital materialities can provide new insights into the changing landscape of children’s play

Quantification of uncertainties in fossil leaf aleoaltimetry: does leaf size matter?

The utility of multivariate foliar physiognomy, specifically the Climate Leaf Analysis Multivariate Program (CLAMP), to yield reliable estimates of enthalpy and hence paleoelevation has been demonstrated by comparison with other proxies, yet concerns have arisen regarding uncertainties arising from 1) apparent ambiguities in the scoring regime and 2) the way leaf size is scored. Regarding 1) scoring ambiguities are examined by reporting on scoring tests with novice users and inter-laboratory comparisons. The uncertainties were found to be less than those arising from the statistical methodology underpinning CLAMP. In respect of 2) the effect of removing all size data both from modern test sites and fossil data was tested. Specifically the effect of removing leaf size data from the 15 Ma Namling data set from south central Tibet, was investigated. Removal of all size data from modern sites demonstrated that size data contributes little to estimates of MAT (Mean Annual Temperature) and enthalpy. Similarly the removal of leaf size information from the Namling data set alone, but with calibration unchanged, and from both the Namling site and calibration sites, this time with recalibration, still yield paleoelevation estimates that have been independently matched by oxygen isotope techniques. Moreover the removal of all leaf size information results in only small increases in uncertainty (± 52 m)