USING UNDERWATER 3D KINEMATICS TO IMPROVE THE PARALYMPIC SWIMMING CLASSIFICATION SYSTEM

Swimming is a fundamental sport at the Olympic and Paralympic games, with the Paralympic classification system being the key difference between these games. To improve the accuracy of the classification system this case study investigated differences in the underwater hand kinematics of the affected and unaffected limb of an elite Para swimmer with hemiplegic cerebral palsy. In this case study, hemiplegic cerebral palsy caused impairments in strength, motor coordination and range of motion that affected hand speeds and trajectory paths during the underwater stroke phases. This work illustrates the benefit of using objective impairment and sport-specific measurements to gain insights into the impact that health conditions have on performance to guide Para swimming classification. This biomechanical analysis lays the foundations for the future improvement in international Para classification system

Bilateral Sensory Abnormalities in Patients with Unilateral Neuropathic Pain; A Quantitative Sensory Testing (QST) Study

In patients who experience unilateral chronic pain, abnormal sensory perception at the non-painful side has been reported. Contralateral sensory changes in these patients have been given little attention, possibly because they are regarded as clinically irrelevant. Still, bilateral sensory changes in these patients could become clinically relevant if they challenge the correct identification of their sensory dysfunction in terms of hyperalgesia and allodynia. Therefore, we have used the standardized quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain (DFNS) to investigate somatosensory function at the painful side and the corresponding non-painful side in unilateral neuropathic pain patients using gender- and age-matched healthy volunteers as a reference cohort. Sensory abnormalities were observed across all QST parameters at the painful side, but also, to a lesser extent, at the contralateral, non-painful side. Similar relative distributions regarding sensory loss/gain for non-nociceptive and nociceptive stimuli were found for both sides. Once a sensory abnormality for a QST parameter at the affected side was observed, the prevalence of an abnormality for the same parameter at the non-affected side was as high as 57% (for Pressure Pain Threshold). Our results show that bilateral sensory dysfunction in patients with unilateral neuropathic pain is more rule than exception. Therefore, this phenomenon should be taken into account for appropriate diagnostic evaluation in clinical practice. This is particularly true for mechanical stimuli where the 95% Confidence Interval for the prevalence of sensory abnormalities at the non-painful side ranges between 33% and 50%

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Refugees of the Arab Spring: The Syrian Refugees in Lebanon April 2011-April 2012

This review of one year influx of Syrian refugees into Lebanon is meant to reveal the political, communitarian and humanitarian factors that shape the State of Lebanon\u27s policy towards it. The Lebanese government has lately adopted a ‘disassociation’ policy regarding the Syrian conflict with the objective of preventing the spill-over of the conflict and the destabilization of the country. Regional and international powers well understand the reasons for this policy, given Lebanon\u27s geopolitical situation, its history and its \u27special ties\u27 with Syria. However, while Lebanon might be able to disassociate itself from the political entanglement of the Syrian crisis, it cannot distance itself from dealing with the growing numbers of Syrian refugees on its territory. Since the beginning of the crisis, a policy of neglect has characterized the Lebanese government’s de facto relationship to the humanitarian crisis of Syrian refugees in Lebanon. Their basic needs for shelter, education and medical assistance have been met by a combination of packages devised, without Lebanon’s participation, by the UN and the latter’s implementing partners. The Lebanese government has also allowed unsupervised religious charities to dominate refugee assistance, adding to a sectarian approach to the Syrian refugee crisis. This policy is beginning to feed back into the tensions that already divide ethnic and religious groups in the country. Against the background of these findings, this report analyzes the need for the Lebanese authorities to design an adequate refugee protection framework in consultation with the UNHCR and to devise a temporary protection status for Syrian refugees in Lebanon. A new agreement or Memorandum of Understanding between Lebanon and UNHCR should take into consideration Lebanon\u27s complex history with refugees on its territory and the political consequences of hosting refugees of a neighboring state. This approach would facilitate Lebanon\u27s obligation to abide by international refugee protection laws while, most importantly from the point of view of Lebanese sovereignty, prevent a further spillover of the Syrian conflict into Lebanon. Consequently, such a framework could provide a model for an adequate regional response to other migration flows of Arab Spring refugees in the Middle East

The one-carbon metabolism as an underlying pathway for placental DNA methylation – a systematic review

ABSTRACTEpigenetic modifications, including DNA methylation, are proposed mechanisms explaining the impact of parental exposures to foetal development and lifelong health. Micronutrients including folate, choline, and vitamin B12 provide methyl groups for the one-carbon metabolism and subsequent DNA methylation processes. Placental DNA methylation changes in response to one-carbon moieties hold potential targets to improve obstetrical care. We conducted a systematic review on the associations between one-carbon metabolism and human placental DNA methylation. We included 22 studies. Findings from clinical studies with minimal ErasmusAGE quality score 5/10 (n = 15) and in vitro studies (n = 3) are summarized for different one-carbon moieties. Next, results are discussed per study approach: (1) global DNA methylation (n = 9), (2) genome-wide analyses (n = 4), and (3) gene specific (n = 14). Generally, one-carbon moieties were not associated with global methylation, although conflicting outcomes were reported specifically for choline. Using genome-wide approaches, few differentially methylated sites associated with S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), or dietary patterns. Most studies taking a gene-specific approach indicated site-specific relationships depending on studied moiety and genomic region, specifically in genes involved in growth and development including LEP, NR3C1, CRH, and PlGF; however, overlap between studies was low. Therefore, we recommend to further investigate the impact of an optimized one-carbon metabolism on DNA methylation and lifelong health

Social Robots for Reducing Mathematics Hiatuses in Primary Education, an Exploratory Field Study

Since the outbreak of COVID-19 schools have gone into lockdown and teachers have had to teach pupils online from home. When pupils go back to school, standard, contemporary learning methods do not seem to be enough to reduce incurred hiatuses. Social robots are slowly becoming an integral component of our society and have great potential as educational technology. This study explores how social robots in classrooms can contribute to reducing mathematics-related hiatuses in Dutch primary education (pupils from four till twelve years old). A social robot as a tutor is evaluated by means of a field study with children (n = 43) to compare a class working with the robot, to a class working without the robot. Multiple factors on learning effect are taken into account by using a survey. Our results demonstrate that a robot can take the role of a tutor and practice with pupils. The results are of interest to researchers in the field of human-robot interaction as well as to educational institutes who wish to understand the implications of adopting robots in education

How to deal with virus flare-ups: civilian and civil societal inp

De vaccinatiegraad neemt nog steeds toe en de druk op de zorg is de laatste maanden beheersbaar. Desondanks is er een gerede kans dat dit najaar besmettingen toe zullen nemen en ziekenhuisopnames zullen stijgen. Het tijdig uitwerken van een haalbaar en effectief oplevingsplan en bijbehorende communicatiestrategie is daarom relevant. Een dergelijk plan heeft een goede kans van slagen wanneer het breed gedragen wordt door de bevolking. Inzicht in perspectieven van burgers en ondernemers op de mogelijke opschaling van maatregelen is daarom wenselijk. Om dit inzicht te bieden zijn zowel de resultaten meegenomen van recent onderzoek naar de voorkeuren van mensen met betrekking tot mogelijke opschaling van maatregelen het komende najaar, als de resultaten van eerdere gedragsvragenlijstonderzoeken en verdiepende interviews met burgers en mensen uit het maatschappelijk middenveld

How to deal with virus flare-ups: civilian and civil societal inp

De vaccinatiegraad neemt nog steeds toe en de druk op de zorg is de laatste maanden beheersbaar. Desondanks is er een gerede kans dat dit najaar besmettingen toe zullen nemen en ziekenhuisopnames zullen stijgen. Het tijdig uitwerken van een haalbaar en effectief oplevingsplan en bijbehorende communicatiestrategie is daarom relevant. Een dergelijk plan heeft een goede kans van slagen wanneer het breed gedragen wordt door de bevolking. Inzicht in perspectieven van burgers en ondernemers op de mogelijke opschaling van maatregelen is daarom wenselijk. Om dit inzicht te bieden zijn zowel de resultaten meegenomen van recent onderzoek naar de voorkeuren van mensen met betrekking tot mogelijke opschaling van maatregelen het komende najaar, als de resultaten van eerdere gedragsvragenlijstonderzoeken en verdiepende interviews met burgers en mensen uit het maatschappelijk middenveld

Hoe om te gaan met een opleving van het virus: Input van burgers en maatschappelijk middenveld

De vaccinatiegraad neemt nog steeds toe en de druk op de zorg is de laatste maanden beheersbaar. Desondanks is er een gerede kans dat dit najaar besmettingen toe zullen nemen en ziekenhuisopnames zullen stijgen. Het tijdig uitwerken van een haalbaar en effectief oplevingsplan en bijbehorende communicatiestrategie is daarom relevant. Een dergelijk plan heeft een goede kans van slagen wanneer het breed gedragen wordt door de bevolking. Inzicht in perspectieven van burgers en ondernemers op de mogelijke opschaling van maatregelen is daarom wenselijk. Om dit inzicht te bieden zijn zowel de resultaten meegenomen van recent onderzoek naar de voorkeuren van mensen met betrekking tot mogelijke opschaling van maatregelen het komende najaar, als de resultaten van eerdere gedragsvragenlijstonderzoeken en verdiepende interviews met burgers en mensen uit het maatschappelijk middenveld