Physical Therapy Interventions for Multiple Sclerosis and Diplegia

Background and Purpose – It is estimated that approximately 2.5 million people world-wide suffer from multiple sclerosis (MS). MS is a neurological disease that impacts messages from the brain to motor and sensory nerves. This disruption can cause loss of sensation and motion to a specific region of the body. The purpose of this case study is to identify interventions used for a person with multiple sclerosis. Case Description – The Patient is a 40-year-old male who has been suffering from MS for 27 years. He has lost the use of his lower extremities and had contractures at his knees and ankles. Intervention – Interventions for this patient include active assistive range of motion (AAROM) and active range of motion (AROM), stretching, transfer training, proprioceptive neuromuscular facilitation (PNF), gait and pre-gait training, and strengthening. Outcomes – The patient increased range of motion and strength in his lower extremities, improved sitting balance statically and dynamically, and was able to ambulate a functional distance with assistance. Discussion – The patient was very pleased overall with his gains in activities of daily living because of the time and effort he put forth in physical therapy. There is currently not a lot of research done on chronic MS accompanied by loss of function in the lower extremities

Effect of Waste Discharges into a Silt-laden Estuary: A Case Study of Cook Inlet, Alaska

Cook Inlet is not well known. Although its thirty-foot tidal range is widely appreciated, its other characteristics, such as turbulence, horizontal velocities of flow, suspended sediment loads, natural biological productivity, the effects of fresh water inflows, temperature, and wind stresses, are seldom acknowledged. The fact that the Inlet has not been used for recreation nor for significant commercial activity explains why the average person is not more aware of these characteristics. Because of the gray cast created by the suspended sediments in the summer and the ice floes in the winter, the Inlet does not have the aura of a beautiful bay or fjord. The shoreline is inhospitable for parks and development, the currents too strong for recreational activities, and, because of the high silt concentration, there is little fishing. Yet, Cook Inlet, for all its negative attributes, can in no way be considered an unlimited dumping ground for the wastes of man. It may be better suited for this purpose than many bays in North America, but it does have a finite capacity for receiving wastes without unduly disturbing natural conditions. This report was written for the interested layman by engineers and scientists who tried to present some highly technical information in such a manner that it could be understood by environmentalists, concerned citizens, students, decision makers, and lawmakers alike. In attempting to address such a diverse audience, we risked failing to be completely understood by any one group. However, all too often research results are written solely for other researchers, a practice which leads to the advancement of knowledge but not necessarily to its immediate use by practicing engineers nor to its inclusion in social, economic, and political decision-making processes. We hope this report will shorten the usual time lag between the acquisition of new information and its use. Several additional reports will be available for a limited distribution. These will be directed to technicians who wish to know the mathematical derivations, assumptions, and other scientific details used in the study. Technical papers by the individual authors, published in national and international scientific and engineering journals, are also anticipated.The work upon which this report is based was supported in part by funds (Proj. B-015-ALAS) provided by the United States Department of the Interior, Office of Water Resources Research, as authorized under the Water Resources Act of 1964, as amended

Head and Neck Manifestations of Eosinophilic Granulomatosis with Polyangiitis: A Systematic Review.

OBJECTIVE: To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist. DATA SOURCES: PubMed, Cochrane Library, Scopus, and LILACS. REVIEW METHODS: A systematic review of the aforementioned sources was conducted per the PRISMA guidelines. RESULTS: From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group of patients detailed in case reports describing patients presenting with head and neck manifestations, patients on average fulfilled 4.6 diagnostic criteria per the American College of Rheumatology. Furthermore, 95.8% of reported cases were responsive to steroids, and 60% required additional therapy. CONCLUSION: Otolaryngologists are in a unique position for the early diagnosis and prevention of late complications of eosinophilic granulomatosis with polyangiitis. The American College of Rheumatology criteria should be relied on in the diagnostic workup. Close surveillance of these patients in a multidisciplinary fashion and with baseline complete blood counts, chest radiographs, and autoimmune laboratory tests is often necessary. Such patients with head and neck manifestations of the disease are nearly always responsive to steroids and often require additional immunosuppressive therapy or surgical intervention in cases of cranial neuropathies, temporal bone involvement, and refractory symptoms

Endo- vs. Exo-genous shocks and relaxation rates in book and music "sales"

In this paper, we analyze the response of music and book sales to an external field and to buyer herding. We distinguish endogenous and exogenous shocks. We focus on some case studies, whose data have been collected from ranking on amazon.com. We show that an ensemble of equivalent systems quantitatively respond in a similar way to a similar ''external shock'', indicating roads to universality features. In contrast to Sornette et al. [Phys. Rev. Lett. {93}, 228701 (2004)] who seemed to find power law behaviors, in particular at long times, - a law interpreted in terms of an epidemic activity, we observe that the relaxation process can be as well seen as an exponential one that saturates toward an asymptotic state, itself different from the pre-shock state. By studying an ensemble of 111 shocks, on books or records, we show that exogenous and endogenous shocks are discriminated by their short-time behaviour: the relaxation time seems to be twice shorter in endogenous shocks than in exogenous ones. We interpret the finding through a simple thermodynamic model with a dissipative force.Comment: to be published in physica

Biphenotypic Sinonasal Sarcoma-Case Report and Review of Clinicopathological Features and Diagnostic Modalities.

Background Biphenotypic sinonasal sarcoma is a recently described malignancy showing dual differentiation with both myogenic and neural elements. Due to its histologic similarities to other sinonasal malignancies, it is a diagnostic challenge. Objective The main purpose of this article is to report a case of biphenotypic sinonasal sarcoma and to consolidate data and provide a comprehensive review regarding pathological differences between biphenotypic sarcoma and other sinonasal malignancies and diagnostic modalities used for biphenotypic sarcoma. Material and Methods A systematic review of all cases of biphenotypic sinonasal sarcoma was performed using electronic databases (PubMed and Medline). Data collected included age, gender, symptoms, sub-site of origin, immunophenotyping, metastasis, recurrence, treatment, duration of follow-up, and survival outcomes. Results Ninety-five cases of biphenotypic sarcoma were found with mean age at diagnosis of 52.36 years (range, 24-87 years). Female to male ratio was 2.27:1. Extra-sinonasal extension was present in 28%. Immunophenotyping revealed that S-100 and SMA (smooth muscle actin) were consistently positive, while SOX-10 was consistently negative. PAX3-MAML3 fusion [t (2; 4) (q35; q31.1)] was the most common genetic rearrangement. Surgical excision with or without adjuvant radiotherapy was the most frequent treatment modality used. Recurrence was observed in 32% of cases with follow-up. None of the cases reported metastasis. Three patients had died at the time of publication that included one case with intracranial extension. Conclusion Biphenotypic sarcoma is distinct sinonasal malignancy with unique clinicopathological features. Testing involving a battery of myogenic and neural immunomarkers is essential for diagnostic confirmation and is a clinically useful endeavor when clinical suspicion is high. © 2019 Georg Thieme Verlag KG Stuttgart. New York

Sulfur and Iron Speciation in Gas-rich Impact-melt Glasses from Basaltic Shergottites Determined by Microxanes

Sulfur is abundantly present as sulfate near Martian surface based on chemical and mineralogical investigations on soils and rocks in Viking, Pathfinder and MER missions. Jarosite is identified by Mossbauer studies on rocks at Meridian and Gusev, whereas MgSO4 is deduced from MgO - SO3 correlations in Pathfinder MER and Viking soils. Other sulfate minerals such as gypsum and alunogen/ S-rich aluminosilicates and halides are detected only in martian meteorites such as shergottites and nakhlites using SEM/FE-SEM and EMPA techniques. Because sulfur has the capacity to occur in multiple valence states, determination of sulfur speciation (sulfide/ sulfate) in secondary mineral assemblages in soils and rocks near Mars surface may help us understand whether the fluid-rock interactions occurred under oxidizing or reducing conditions. To understand the implications of these observations for the formation of the Gas-rich Impact-melt (GRIM) glasses, we determined the oxidation state of Fe in the GRIM glasses using Fe K micro-XANES techniques

Oxidation States of Grim Glasses in EET79001 Based on Vanadium Valence

Gas-rich impact-melt (GRIM) glasses in SNC meteorites are very rich in Martian atmospheric noble gases and sulfur suggesting a possible occurrence of regolith-derived secondary mineral assemblages in these samples. Previously, we have studied two GRIM glasses, 506 and 507, from EET79001 Lith A and Lith B, respectively, for elemental abundances and spatial distribution of sulfur using EMPA (WDS) and FE-SEM (EDS) techniques and for sulfur-speciation using K-edge XANES techniques. These elemental and FE-SEM micro-graph data at several locations in the GRIM glasses from Shergotty (DBS), Zagami 994 and EET79001, Lith B showed that FeO and SO3 are positively correlated (SO3 represents a mixture of sulfide and sulfate). FE-SEM (EDS) study revealed that the sulfur-rich pockets in these glasses contain numerous micron-sized iron-sulfide (Fe-S) globules sequestered throughout the volume. However, in some areas (though less frequently), we detected significant Fe-S-O signals suggesting the occurrence of iron sulfate. These GRIM glasses were studied by K-edge microXANES techniques for sulfur speciation in association with iron in sulfur-rich areas. In both samples, we found the sulfur speciation dominated by sulfide with minor oxidized sulfur mixed in with various proportions. The abundance of oxidized sulfur was greater in 506 than in 507. Based on these results, we hypothesize that sulfur initially existed as sulfate in the glass precursor materials and, on shock-impact melting of the precursor materials producing these glasses, the oxidized sulfur was reduced to predominately sulfide. In order to further test this hypothesis, we have used microXANES to measure the valence states of vanadium in GRIM glasses from Lith A and Lith B to complement and compare with previous analogous measurements on Lith C (note: 506 and 507 contain the largest amounts of martian atmospheric gases but the gas-contents in Lith C measured by are unknown). Vanadium is ideal for addressing this re-dox issue because it has multiple valence states and is a well-studied element. Ferrous-dominated iron valences determined by microXANES on the Lith A and Lith B glasses provide little redox sensitivity. Vanadium valence measurements for impact glass in Lith C at three different locations yielded valence values of 3.1, 3.2 and 3.4 with inferred fO2 values of IW-0.7, IW-0.1 and IW+0.7, respectively. This range of oxygen-fugacity values is understandable because the glasses are shock-molten impact glasses which are heterogeneous in nature. Oxygen fugacity values obtained from the analysis of Fe-Ti oxides and Eu partitioning in pyroxenes from EET79001 Lith A and Lith B (host lithologies) were in the range of IW+0.3 to IW+1.9 suggesting that V in the Lith C impact glass was reduced in the impact process. Here, we examine whether the 506 from Lith A and 507 from Lith B GRIM glasses yield similar or different fO2 values from those of Lith C using the vanadium K-edge microXANES technique

The azimuth structure of nuclear collisions -- I

We describe azimuth structure commonly associated with elliptic and directed flow in the context of 2D angular autocorrelations for the purpose of precise separation of so-called nonflow (mainly minijets) from flow. We extend the Fourier-transform description of azimuth structure to include power spectra and autocorrelations related by the Wiener-Khintchine theorem. We analyze several examples of conventional flow analysis in that context and question the relevance of reaction plane estimation to flow analysis. We introduce the 2D angular autocorrelation with examples from data analysis and describe a simulation exercise which demonstrates precise separation of flow and nonflow using the 2D autocorrelation method. We show that an alternative correlation measure based on Pearson's normalized covariance provides a more intuitive measure of azimuth structure.Comment: 27 pages, 12 figure

On Free-Electron Laser Growing Modes and their Bandwidth

Free-electron lasers play an increasing role in science, from generating unique femtosecond X- ray pulses for single short recording of the protein structures to amplifying feeble interactions in advanced cooling systems for high-energy hadron colliders. While modern Free-electron laser codes can describe their amplification mechanism, a deep analytical understanding of the mechanism is of extreme importance for a number of applications. Mode competition, their growth rates and amplification bandwidth are among the most important parameters of a free-electron laser. A dispersion relation, which defines these important characteristics, can be solved analytically only for a very few simple cases. In this letter we show that for a typical bell-shape energy distribution in electron beam there is no more that one growing mode. We also derive an analytical expression which determines the bandwidth of the free-electron laser.Comment: 4 pages, submitted to PR

Sulfur Isotopes in Gas-rich Impact-Melt Glasses in Shergottites

Large impact melt glasses in some shergottites contain huge amounts of Martian atmospheric gases and they are known as gas-rich impact-melt (GRIM) glasses. By studying the neutron-induced isotopic deficits and excesses in Sm-149 and Sm-150 isotopes resulting from Sm-149 (n,gamma) 150Sm reaction and 80Kr excesses produced by Br-79 (n,gamma) Kr-80 reaction in the GRIM glasses using mass-spectrometric techniques, it was shown that these glasses in shergottites EET79001 and Shergotty contain regolith materials irradiated by a thermal neutron fluence of approx.10(exp 15) n/sq cm near Martian surface. Also, it was shown that these glasses contain varying amounts of sulfates and sulfides based on the release patterns of SO2 (sulfate) and H2S (sulfide) using stepwise-heating mass-spectrometric techniques. Furthermore, EMPA and FE-SEM studies in basaltic-shergottite GRIM glasses EET79001, LithB (,507& ,69), Shergotty (DBS I &II), Zagami (,992 & ,994) showed positive correlation between FeO and "SO3" (sulfide + sulfate), whereas those belonging to olivine-phyric shergottites EET79001, LithA (,506, & ,77) showed positive correlation between CaO/Al2O3 and "SO3"