The physical characteristics underpinning performance of wheelchair fencing athletes: a Delphi study of Paralympic coaches

Wheelchair Fencing (WF) is a Paralympic sport which is practiced by athletes with physical disabilities and is classified into three categories according to the degree of activity limitation the impairment causes in the sport. All Paralympic sports are requested to develop their own evidence-based classification system to enhance the confidence in the classification process however, this is yet to be achieved in WF. Research within WF is scarce therefore, the aim of this study was to reach expert consensus on the physical characteristics that underpin performance of athletes competing in the sport as this is known as one of the initial steps required to achieve an evidence-based classification system. Sixteen Paralympic WF coaches were invited to take part in a 3-round Delphi study, with experts drawing consensus on qualities of speed, strength, power, flexibility and motor control of the trunk and fencing arm being associated with increased athletic success. The required qualities of the non-fencing arm led to diverging opinions across the expert panel. This study provides clear guidance of the physical qualities to be developed to maximise athletic performance while also providing the initial framework to guide future WF classification research

The ventrolateral medulla and medullary raphe in sudden unexpected death in epilepsy

Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. One hypothesis proposes that sudden death is mediated by post-ictal central respiratory depression, which could relate to underlying pathology in key respiratory nuclei and/or their neuromodulators. Our aim was to investigate neuronal populations in the ventrolateral medulla (which includes the putative human pre-Bötzinger complex) and the medullary raphe. Forty brainstems were studied comprising four groups: 14 SUDEP, six epilepsy controls, seven Dravet syndrome cases and 13 non-epilepsy controls. Serial sections through the medulla (from obex 1 to 10 mm) were stained for Nissl, somatostatin, neurokinin 1 receptor (for pre-Bötzinger complex neurons) and galanin, tryptophan hydroxylase and serotonin transporter (neuromodulatory systems). Using stereology total neuronal number and densities, with respect to obex level, were measured. Whole slide scanning image analysis was used to quantify immunolabelling indices as well as co-localization between markers. Significant findings included reduction in somatostatin neurons and neurokinin 1 receptor labelling in the ventrolateral medulla in sudden death in epilepsy compared to controls (P < 0.05). Galanin and tryptophan hydroxylase labelling was also reduced in sudden death cases and more significantly in the ventrolateral medulla region than the raphe (P < 0.005 and P < 0.05). With serotonin transporter, reduction in labelling in cases of sudden death in epilepsy was noted only in the raphe (P ≤ 0.01); however, co-localization with tryptophan hydroxylase was significantly reduced in the ventrolateral medulla. Epilepsy controls and cases with Dravet syndrome showed less significant alterations with differences from non-epilepsy controls noted only for somatostatin in the ventrolateral medulla (P < 0.05). Variations in labelling with respect to obex level were noted of potential relevance to the rostro-caudal organization of respiratory nuclear groups, including tryptophan hydroxylase, where the greatest statistical difference noted between all epilepsy cases and controls was at obex 9-10 mm (P = 0.034), the putative level of the pre-Bötzinger complex. Furthermore, there was evidence for variation with duration of epilepsy for somatostatin and neurokinin 1 receptor. Our findings suggest alteration to neuronal populations in the medulla in SUDEP with evidence for greater reduction in neuromodulatory neuropeptidergic and mono-aminergic systems, including for galanin, and serotonin. Other nuclei need to be investigated to evaluate if this is part of more widespread brainstem pathology. Our findings could be a result of previous seizures and may represent a pathological risk factor for SUDEP through impaired respiratory homeostasis during a seizure

Spinal afferent neurons projecting to the rat lung and pleura express acid sensitive channels

BACKGROUND: The acid sensitive ion channels TRPV1 (transient receptor potential vanilloid receptor-1) and ASIC3 (acid sensing ion channel-3) respond to tissue acidification in the range that occurs during painful conditions such as inflammation and ischemia. Here, we investigated to which extent they are expressed by rat dorsal root ganglion neurons projecting to lung and pleura, respectively. METHODS: The tracer DiI was either injected into the left lung or applied to the costal pleura. Retrogradely labelled dorsal root ganglion neurons were subjected to triple-labelling immunohistochemistry using antisera against TRPV1, ASIC3 and neurofilament 68 (marker for myelinated neurons), and their soma diameter was measured. RESULTS: Whereas 22% of pulmonary spinal afferents contained neither channel-immunoreactivity, at least one is expressed by 97% of pleural afferents. TRPV1(+)/ASIC3(- )neurons with probably slow conduction velocity (small soma, neurofilament 68-negative) were significantly more frequent among pleural (35%) than pulmonary afferents (20%). TRPV1(+)/ASIC3(+ )neurons amounted to 14 and 10% respectively. TRPV1(-)/ASIC3(+ )neurons made up between 44% (lung) and 48% (pleura) of neurons, and half of them presumably conducted in the A-fibre range (larger soma, neurofilament 68-positive). CONCLUSION: Rat pleural and pulmonary spinal afferents express at least two different acid-sensitive channels that make them suitable to monitor tissue acidification. Patterns of co-expression and structural markers define neuronal subgroups that can be inferred to subserve different functions and may initiate specific reflex responses. The higher prevalence of TRPV1(+)/ASIC3(- )neurons among pleural afferents probably reflects the high sensitivity of the parietal pleura to painful stimuli

Excitability of Aβ sensory neurons is altered in an animal model of peripheral neuropathy

<p>Abstract</p> <p>Background</p> <p>Causes of neuropathic pain following nerve injury remain unclear, limiting the development of mechanism-based therapeutic approaches. Animal models have provided some directions, but little is known about the specific sensory neurons that undergo changes in such a way as to induce and maintain activation of sensory pain pathways. Our previous studies implicated changes in the Aβ, normally non-nociceptive neurons in activating spinal nociceptive neurons in a cuff-induced animal model of neuropathic pain and the present study was directed specifically at determining any change in excitability of these neurons. Thus, the present study aimed at recording intracellularly from Aβ-fiber dorsal root ganglion (DRG) neurons and determining excitability of the peripheral receptive field, of the cell body and of the dorsal roots.</p> <p>Methods</p> <p>A peripheral neuropathy was induced in Sprague Dawley rats by inserting two thin polyethylene cuffs around the right sciatic nerve. All animals were confirmed to exhibit tactile hypersensitivity to von Frey filaments three weeks later, before the acute electrophysiological experiments. Under stable intracellular recording conditions neurons were classified functionally on the basis of their response to natural activation of their peripheral receptive field. In addition, conduction velocity of the dorsal roots, configuration of the action potential and rate of adaptation to stimulation were also criteria for classification. Excitability was measured as the threshold to activation of the peripheral receptive field, the response to intracellular injection of depolarizing current into the soma and the response to electrical stimulation of the dorsal roots.</p> <p>Results</p> <p>In control animals mechanical thresholds of all neurons were within normal ranges. Aβ DRG neurons in neuropathic rats demonstrated a mean mechanical threshold to receptive field stimulation that were significantly lower than in control rats, a prolonged discharge following this stimulation, a decreased activation threshold and a greater response to depolarizing current injection into the soma, as well as a longer refractory interval and delayed response to paired pulse electrical stimulation of the dorsal roots.</p> <p>Conclusions</p> <p>The present study has demonstrated changes in functionally classified Aβ low threshold and high threshold DRG neurons in a nerve intact animal model of peripheral neuropathy that demonstrates nociceptive responses to normally innocuous cutaneous stimuli, much the same as is observed in humans with neuropathic pain. We demonstrate further that the peripheral receptive fields of these neurons are more excitable, as are the somata. However, the dorsal roots exhibit a decrease in excitability. Thus, if these neurons participate in neuropathic pain this differential change in excitability may have implications in the peripheral drive that induces central sensitization, at least in animal models of peripheral neuropathic pain, and Aβ sensory neurons may thus contribute to allodynia and spontaneous pain following peripheral nerve injury in humans.</p

Functional Changes in Muscle Afferent Neurones in an Osteoarthritis Model: Implications for Impaired Proprioceptive Performance

Impaired proprioceptive performance is a significant clinical issue for many who suffer osteoarthritis (OA) and is a risk factor for falls and other liabilities. This study was designed to evaluate weight-bearing distribution in a rat model of OA and to determine whether changes also occur in muscle afferent neurones.Intracellular recordings were made in functionally identified dorsal root ganglion neurones in acute electrophysiological experiments on the anaesthetized animal following measurements of hind limb weight bearing in the incapacitance test. OA rats but not naïve control rats stood with less weight on the ipsilateral hind leg (P = 0.02). In the acute electrophysiological experiments that followed weight bearing measurements, action potentials (AP) elicited by electrical stimulation of the dorsal roots differed in OA rats, including longer AP duration (P = 0.006), slower rise time (P = 0.001) and slower maximum rising rate (P = 0.03). Depolarizing intracellular current injection elicited more APs in models than in naïve muscle afferent neurones (P = 0.01) indicating greater excitability. Axonal conduction velocity in model animals was slower (P = 0.04).The present study demonstrates changes in hind limb stance accompanied by changes in the functional properties of muscle afferent neurones in this derangement model of OA. This may provide a possible avenue to explore mechanisms underlying the impaired proprioceptive performance and perhaps other sensory disorders in people with OA

Heat transfer analysis coupled to saturation during the impregnation of porous media: Application aux procédés LCM

Transportation industries, especially aeronautics and automotive industries, are facing more than ever energy-saving issues, which imply weight reduction of structures. Within this context, composite materials appear to be appropriate candidates, due to their outstanding “strength to weight” ratio. Liquid Composite Molding (LCM) and particularly Resin Transfer Molding (RTM) are becoming increasingly important for a wide range of industrial applications involving complex structural parts. The quality of LCM products strongly depends on the impregnation of the fiber preform during the mold-filling stage. During this step, a partiallysaturated zone emerges in the flow, and induces consequently the formation of porosities, which drastically affect mechanical performances. This study presents an original approach in which heat transfers are used to quantify the saturation profile. In a first step, the effective thermal conductivity of a model composite material have been measured by several methods. A homogenization methodology based on asymptotic expansion has been performed at dual-scale in order to predict the thermal properties of the composite as a function of saturation. Several heat flux sensors and thermocouples were integrated in an experimental bench, which allows the injection of a model fluid into a textile preform. Finally, an alternative numerical approach is proposed bymodeling a multi-phase flow, proving the feasibility of identifying the relative permeabilities of each phase through thermal analysis.Les industries du transport, en particulier les industries automobile et aéronautique, font face plus que jamais à une problématique d’économie d’énergie, qui passe nécessairement par un allègement des structures.Dans ce contexte, les matériaux composites semblent être des candidats idéaux, en raison de l’exceptionnel compromis masse/performance qu’ils présentent. Les procédés LCM (Liquid Composite Molding) et plus particulièrement RTM (Resin Transfer Molding) sont très utilisés pour produire des pièces structurelles complexes de hautes performances. La qualité des pièces ainsi produites dépend fortement de la phase d’imprégnation des renforts fibreux, durant laquelle l’écoulement de la résine induit la création d’une zone non-saturée, provoquant par conséquent la formation de porosités qui affectent les propriétés mécaniques. Les travaux présentés dans cette thèse s’attachent à détecter et à quantifier la saturation du renfort par le biais d’une analyse des transferts de chaleur. Dans un premier temps, le tenseur de conductivité thermique d’un matériau modèle a été caractérisé à l’aide d’un large panel de dispositifs expérimentaux. Une méthode d’homogénéisation a été mise en place afin de prédire les propriétés thermiques du composite en fonction de la nature des vides rencontrés. Par la suite, un banc expérimental doté d’une métrologie thermique adaptée est conçu, permettant l’imprégnation d’un renfort par un fluide modèle. L’identification de la saturation est rendue possible par un modèle simplifié d’écoulement. Enfin, une approche par modélisation diphasique est proposée, démontrant la faisabilité de l’identification des perméabilités relatives de chacune des phases par la thermique

Heat transfer analysis coupled to saturation during the impregnation of porous media: Application aux procédés LCM

Transportation industries, especially aeronautics and automotive industries, are facing more than ever energy-saving issues, which imply weight reduction of structures. Within this context, composite materials appear to be appropriate candidates, due to their outstanding “strength to weight” ratio. Liquid Composite Molding (LCM) and particularly Resin Transfer Molding (RTM) are becoming increasingly important for a wide range of industrial applications involving complex structural parts. The quality of LCM products strongly depends on the impregnation of the fiber preform during the mold-filling stage. During this step, a partiallysaturated zone emerges in the flow, and induces consequently the formation of porosities, which drastically affect mechanical performances. This study presents an original approach in which heat transfers are used to quantify the saturation profile. In a first step, the effective thermal conductivity of a model composite material have been measured by several methods. A homogenization methodology based on asymptotic expansion has been performed at dual-scale in order to predict the thermal properties of the composite as a function of saturation. Several heat flux sensors and thermocouples were integrated in an experimental bench, which allows the injection of a model fluid into a textile preform. Finally, an alternative numerical approach is proposed bymodeling a multi-phase flow, proving the feasibility of identifying the relative permeabilities of each phase through thermal analysis.Les industries du transport, en particulier les industries automobile et aéronautique, font face plus que jamais à une problématique d’économie d’énergie, qui passe nécessairement par un allègement des structures.Dans ce contexte, les matériaux composites semblent être des candidats idéaux, en raison de l’exceptionnel compromis masse/performance qu’ils présentent. Les procédés LCM (Liquid Composite Molding) et plus particulièrement RTM (Resin Transfer Molding) sont très utilisés pour produire des pièces structurelles complexes de hautes performances. La qualité des pièces ainsi produites dépend fortement de la phase d’imprégnation des renforts fibreux, durant laquelle l’écoulement de la résine induit la création d’une zone non-saturée, provoquant par conséquent la formation de porosités qui affectent les propriétés mécaniques. Les travaux présentés dans cette thèse s’attachent à détecter et à quantifier la saturation du renfort par le biais d’une analyse des transferts de chaleur. Dans un premier temps, le tenseur de conductivité thermique d’un matériau modèle a été caractérisé à l’aide d’un large panel de dispositifs expérimentaux. Une méthode d’homogénéisation a été mise en place afin de prédire les propriétés thermiques du composite en fonction de la nature des vides rencontrés. Par la suite, un banc expérimental doté d’une métrologie thermique adaptée est conçu, permettant l’imprégnation d’un renfort par un fluide modèle. L’identification de la saturation est rendue possible par un modèle simplifié d’écoulement. Enfin, une approche par modélisation diphasique est proposée, démontrant la faisabilité de l’identification des perméabilités relatives de chacune des phases par la thermique

Rôle du pharmacien d'officine dans l'accompagnement des patientes prises en charge dans un centre d'assistance médicales à la procréation (Étude d'une cohorte de 115 patientes réalisée à la clinique Mathilde à Rouen)

Aujourd hui en France, un couple sur sept consulte un médecin, au moins une fois, pour une difficulté à concevoir un enfant. L assistance médicale à la procréation (AMP) est une des réponses médicales que peut donner une équipe pluridisciplinaire de professionnels de santé à un couple infertile. Les couples sont de plus en plus nombreux à y avoir recours ; l AMP permet actuellement la naissance de plus de 20 000 enfants chaque année. Après avoir étudié la situation médicale et personnelle du couple, le médecin propose la technique d AMP la plus appropriée : insémination artificielle (IA), fécondation in vitro avec ou sans assistance à la fécondation (FIV classique ou ICSI), allant jusqu au don d embryons. Les traitements utilisés suivent des protocoles précis et nécessitent une surveillance stricte et régulière. Ils peuvent, en effet, exposer les patientes à des complications potentiellement graves, notamment le syndrome d hyperstimulation ovarienne (SHO). Outre les contraintes physiques du traitement, les techniques d AMP s accompagnent d une lourde charge émotionnelle et psychologique pour le couple. Le pharmacien d officine a un rôle important à jouer, en complément des autres professionnels de santé, auprès de ces patientes afin de minimiser les contraintes du traitement. Cependant, les traitements et les protocoles utilisés restent encore assez méconnus à l officine. La mise en place de procédures de délivrance ainsi qu une formation de l équipe officinale peuvent permettre d améliorer les compétences du pharmacien dans ce domaine. Son accessibilité peut faire de lui un interlocuteur privilégié pour les patientes en quête d écoute et d informations. MOTROUEN-BU Médecine-Pharmacie (765402102) / SudocSudocFranceF