Functional electrical stimulation to aid walking in patients with adrenomyeloneuropathy: A case study and observational series

Adrenomyeloneuropathy (AMN) is a rare inherited condition where affected individuals develop slowly progressive spastic paraparesis with a gradual decline in walking ability. There is no cure for AMN and treatment focuses on supportive measures and aids. One treatment option is functional electrical stimulation (FES), a treatment, approved by The National Institute for Health and Care Excellence (NICE), for managing foot drop in upper motor neuron disorders. Limited evidence exists for its use in AMN patients. We describe the effects of FES in an individual case and more broadly within a cohort of 21 patients successfully treated with FES. Patients with AMN referred for FES typically report frequent falls (71%) and foot drop (57%) as the most common barriers to walking. When using FES, walking speed at baseline (0.70 m/s [SD = 0.2]) was maintained at the 2-year review (0.68 m/s [SD = 0.2]) with a persistent orthotic effect (improvement in walking speed when device on vs. off) seen from wearing FES over the same 2-year period (11%-19%). Patient walking satisfaction (visual analogue scale: 0 - very dissatisfied; 10 - very satisfied) was also greater when comparing no-FES versus FES over the same period (Year 1: 2.5 vs. 7.7; Year 2: 2.1 vs. 6.1). FES is not effective in all patients. Twelve patients referred found no benefit from the device; although there was no clear evidence, this was related to the degree of AMN associated peripheral neuropathy. However, FES is a safe, cost-effective treatment option and should be considered, along with assessment in a multidisciplinary clinic, for all AMN patients with walking difficulties

Improvement in overactive bladder symptoms in patients using functional electrical stimulation of the common peroneal nerve for walking

OBJECTIVE: Functional electrical stimulation is used to improve walking speed and reduces falls in people with upper motor neurone foot-drop. Following anecdotal observations of changes in bladder symptoms, an observational study was performed to explore this association further. DESIGN: A total of 47 consecutive patients attending for setup with functional electrical stimulation during a six-month period were asked to complete a questionnaire assessing bladder symptoms (ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder)) at baseline and three  months during routine appointments. SUBJECTS: In all, 35 (75%) had multiple sclerosis and the other 12 subjects had a total of 9 diagnoses including 3 with stroke. Other conditions included cerebral palsy, motor neurone disease, hereditary spastic paraparesis, meningioma and spinocerebellar ataxias. RESULTS: Improvement in overactive bladder symptoms was not significant in the whole cohort, however, was significant in patients with multiple sclerosis (n  =  35; mean change in ICIQ-OAB score 1.0, P  =  0.043). Specifically, significant improvements were seen in urgency and urge incontinence in multiple sclerosis patients. There was a significant negative correlation of moderate strength within the multiple sclerosis cohort between baseline walking speed and subsequent change in ICIQ-OAB score (correlation coefficient of r  =  −0.40, P  =  0.046). Thus, greater changes in bladder symptoms were seen with lower baseline walking speeds. CONCLUSION: The results of this exploratory study suggest that functional electrical stimulation use does improve overactive bladder symptoms in people with multiple sclerosis. Further exploration is needed to study this association and explore whether the mechanism is similar to that of percutaneous tibial nerve stimulation, a recognized treatment for the overactive bladder

Snazer: the simulations and networks analyzer

<p>Abstract</p> <p>Background</p> <p>Networks are widely recognized as key determinants of structure and function in systems that span the biological, physical, and social sciences. They are static pictures of the interactions among the components of complex systems. Often, much effort is required to identify networks as part of particular patterns as well as to visualize and interpret them.</p> <p>From a pure dynamical perspective, simulation represents a relevant <it>way</it>-<it>out</it>. Many simulator tools capitalized on the "noisy" behavior of some systems and used formal models to represent cellular activities as temporal trajectories. Statistical methods have been applied to a fairly large number of replicated trajectories in order to infer knowledge.</p> <p>A tool which both graphically manipulates reactive models and deals with sets of simulation time-course data by aggregation, interpretation and statistical analysis is missing and could add value to simulators.</p> <p>Results</p> <p>We designed and implemented <it>Snazer</it>, the simulations and networks analyzer. Its goal is to aid the processes of visualizing and manipulating reactive models, as well as to share and interpret time-course data produced by stochastic simulators or by any other means.</p> <p>Conclusions</p> <p><it>Snazer </it>is a solid prototype that integrates biological network and simulation time-course data analysis techniques.</p

'Dressed in a Little Brief Authority': Authority Before, During, and After Shakespeare's Plays

This essay discusses the concept of authority from Shakespeare’s time to our own, considers examples of Shakespeare’s own explorations of authority, and provides a concise history of the ways in which Shakespeare has been constructed as cultural authority in different historical periods. It summarises the essays contained in the book, and argues that the book illuminates not only how Shakespeare became the archetypal figure of English cultural authority, but, perhaps more interestingly, why

A survey of visualization tools for biological network analysis

The analysis and interpretation of relationships between biological molecules, networks and concepts is becoming a major bottleneck in systems biology. Very often the pure amount of data and their heterogeneity provides a challenge for the visualization of the data. There are a wide variety of graph representations available, which most often map the data on 2D graphs to visualize biological interactions. These methods are applicable to a wide range of problems, nevertheless many of them reach a limit in terms of user friendliness when thousands of nodes and connections have to be analyzed and visualized. In this study we are reviewing visualization tools that are currently available for visualization of biological networks mainly invented in the latest past years. We comment on the functionality, the limitations and the specific strengths of these tools, and how these tools could be further developed in the direction of data integration and information sharing

Measuring mangrove-fishery benefits in the Peam Krasaop Fishing Community, Cambodia

Whilst previous studies have applied economic value to the ecosystem services mangroves provide to fisheries, most quantitative studies in the peer reviewed literature have limited their measurements to the value provided through a single fishing sector, gear or particular target species group. It can be argued that present research into mangrove-fisheries has not yet represented the full complexity that mangrove-fisheries can encompass in terms of the wide range of people and activities that benefit from the mangrove ecosystem. The reported values of mangroves to fishing livelihoods are therefore likely to fall short of a full valuation. The study provides an all-encompassing value of mangrove benefits to fishing, purposefully investigating the value gained from mangroves through all fishing sectors, fishing activities and target species existing in the Peam Krasaop Fishing Community (PKFC), Koh Kong Province, southwest Cambodia. The ecosystem service value of mangroves for fishing to households in the PKFC was calculated using daily landings volumes collected through semi-structured interviews with fishers, scaled to approximated annual catches. Catch figures were converted to economic value, based on the local market prices given by respondents. Results suggested that the PKFC derives approximately 90% of fishing catch, and 85% of gross income, from mangrove-associated species. Fishing activities are diverse within households; they conduct between 1-8 different seasonal fishing activities, spread across mangrove gathering, fishing by boat and mariculture. This study provides a higher estimated proportion of mangrove-associated catches than many studies of fishing communities elsewhere. It may be the case that the PKFC does not have higher levels of mangrove dependency than other mangrove-fisheries. Rather, this study may provide a better quantification of mangrove value than has previously been achieved. Further studies along the same lines, taking a similarly holistic approach to mangrove-fishery valuation, are necessary to test this proposition