Intrathecal baclofen in cerebral palsy. A retrospective study of 25 wheelchair-assisted adults

ObjectiveTo study the efficacy and safety of intrathecal baclofen therapy (ITB) in wheelchair-dependent adults with cerebral palsy. Patients and methods A retrospective analysis and clinical examination of 25 wheelchair-assisted adults with cerebral palsy receiving ITB initiated between 1999 and 2009 in three different cities in western France. Results ITB improves spasticity and facilitates wheelchair comfort and nursing care. The therapy has an effect on motor disorders and pain. Eighty percent of the ITB patients were satisfied. Dissatisfaction was related to complications or adverse events and not lack of efficacy. Complications occurred in 32% of the patients and transient interruption of the treatment or surgical removal of the ITB pump was necessary in 16% of cases. Discussion and conclusion Wider use of ITB in this indication is likely and should lead to a better understanding of the drug\u27s pharmacological effects on motor disorders and pain. Use of the Goal Attainment Assessment Scale or Caregiver Questionnaire can help us

A multi-proxy approach to exploring Homo sapiens’ arrival, environments and adaptations in Southeast Asia

The capability of Pleistocene hominins to successfully adapt to different types of tropical forested environments has long been debated. In order to investigate environmental changes in Southeast Asia during a critical period for the turnover of hominin species, we analysed palaeoenvironmental proxies from five late Middle to Late Pleistocene faunas. Human teeth discoveries have been reported at Duoi U’Oi, Vietnam (70–60 ka) and Nam Lot, Laos (86–72 ka). However, the use of palaeoproteomics allowed us to discard the latter, and, to date, no human remains older than ~ 70 ka are documented in the area. Our findings indicate that tropical rainforests were highly sensitive to climatic changes over that period, with significant fluctuations of the canopy forests. Locally, large-bodied faunas were resilient to these fluctuations until the cooling period of the Marine Isotope Stage 4 (MIS 4; 74–59 ka) that transformed the overall biotope. Then, under strong selective pressures, populations with new phenotypic characteristics emerged while some other species disappeared. We argue that this climate-driven shift offered new foraging opportunities for hominins in a novel rainforest environment and was most likely a key factor in the settlement and dispersal of our species during MIS 4 in SE Asia

Experimental and numerical investigation of specific behaviour of fluoride ions during filtration of pure salt water solutions with titania membrane

International audienceThis work addresses the specific interactions between titania membrane and fluoride anions during ultrafiltration operation. In general, the salt transmission increases with salt concentration when pure salt-water solutions are ultrafiltrated, except for fluoride-based salts observed in our study, for which transmission decreased at low concentrations. This phenomenon was only observed with titanium dioxide membrane. A numerical tool based on a physical description of ionic mass transfer in porous material (generalized Nernst-Planck approach) was used to explore the modification-induced changes due to fluoride anions. Numerical investigations showed a modification of the electric charge of the membrane surface in the pore at low fluoride concentrations. This phenomenon screened the electric effect in a completely reversible way, and then enhanced the ion mass transfer through the porous membrane. These modifications can be explained by the substitution of oxygen atom (providing the surface electric charge) with a fluoride ion which was screening the electric charge and facilitated the ion transfer

Evolution of the Hoabinnhian techno-complex of Tam Hang rock shelter in Northeastern Laos.

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Mosaic traits of the human mandible from Tam Pa Ling, Laos at 46 ka.

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Environmental conditions framing the first evidence of modern humans at Tam Pà Ling, Laos: A stable isotope record from terrestrial gastropod carbonates

Mainland Southeast Asia is a key region to interpret modern human migrations; however, due to a scarcity of terrestrial proxies, environmental conditions are not well understood. This study focuses on the Tam Pà Ling cave site in northeast Laos, which contains the oldest evidence for modern humans in Indochina, dating back to MIS 4 (70 ± 8 ka). Snail remains of Camaena massiei found throughout the stratigraphic sequence contain a valuable oxygen and carbon isotope record of past local vegetation and humidity changes. Our data indicate that before the Last Glacial Maximum (LGM), northeast Laos was characterized by a humid climate and forested environments. With the onset of the LGM, a major climatic shift occurred, inducing a sharp decrease in precipitation and a significant decline in woodland habitats in favor of the expansion to more open landscapes. Only during the Holocene did forests return in northeast Laos, resembling present conditions. The first Homo sapiens arriving in Indochina therefore encountered landscapes dominated by woodlands with a minor proportion of open habitats

Trophic ecology of a Late Pleistocene early modern human from tropical Southeast Asia inferred from zinc isotopes

Tam Pà Ling, a cave site in northeastern Laos, has yielded the earliest skeletal evidence of Homo sapiens in mainland Southeast Asia. The reliance of Pleistocene humans in rainforest settings on plant or animal resources is still largely unstudied, mainly due to poor collagen preservation in fossils from tropical environments precluding stable nitrogen isotope analysis, the classical trophic level proxy. However, isotopic ratios of zinc (Zn) in bioapatite constitute a promising proxy to infer trophic and dietary information from fossil vertebrates, even under adverse tropical taphonomic conditions. Here, we analyzed the zinc isotope composition (66Zn/64Zn expressed as δ66Zn value) in the enamel of two teeth of the Late Pleistocene (63–46 ka) H. sapiens individual (TPL1) from Tam Pà Ling, as well as 76 mammal teeth from the same site and the nearby Nam Lot cave. The human individual exhibits relatively low enamel δ66Zn values (+0.24‰) consistent with an omnivorous diet, suggesting a dietary reliance on both plant and animal matter. These findings offer direct evidence of the broad utilization of resources from tropical rainforests by one of the earliest known anatomically modern humans in Southeast Asia

Reconstructing the environmental conditions experienced by early modern humans at Tam Pà Ling (northeast Laos) using higher plant wax biomarkers

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