Alien Registration- Johnson, Walter D. (Auburn, Androscoggin County)

https://digitalmaine.com/alien_docs/31088/thumbnail.jp

Global Neurosurgery: The Unmet Need

Globally, the lack of access to basic surgical care causes 3 times as much deaths as HIV/AIDS, tuberculosis, and malaria combined. The magnitude of this unmet need has been described recently, and the numbers are startling. Major shifts in global health agenda have highlighted access to essential and emergency surgery as a high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths, particularly in the realm of training; however, the demand grossly outstrips the supply; most people in low-income countries do not have access to basic surgical care, either due to lack of availability or affordability. Projects that help create a robust and resilient health system within low- and middle-income countries require urgent implementation. In this context, concurrent scale-up of human resources, investments in capacity building, local data collection, and analysis for accurate assessment are essential. In addition, through process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever

Hair cell maturation is differentially regulated along the tonotopic axis of the mammalian cochlea

Sound amplification within the mammalian cochlea depends upon specialized hair cells, the outer hair cells (OHCs), which possess both sensory and motile capabilities. In various altricial rodents, OHCs become functionally competent from around postnatal day 7 (P7), before the primary sensory inner hair cells (IHCs), which become competent at about the onset of hearing (P12). The mechanisms responsible for the maturation of OHCs and their synaptic specialization remain poorly understood. We report that spontaneous Ca2+ activity in the immature cochlea, which is generated by CaV1.3 Ca2+ channels, differentially regulates the maturation of hair cells along the cochlea. Under near‐physiological recording conditions we found that, similar to IHCs, immature OHCs elicited spontaneous Ca2+ action potentials (APs), but only during the first few postnatal days. Genetic ablation of these APs in vivo, using CaV1.3−/− mice, prevented the normal developmental acquisition of mature‐like basolateral membrane currents in low‐frequency (apical) hair cells, such as IK,n (carried by KCNQ4 channels), ISK2 and IACh (α9α10nAChRs) in OHCs and IK,n and IK,f (BK channels) in IHCs. Electromotility and prestin expression in OHCs were normal in CaV1.3−/− mice. The maturation of high‐frequency (basal) hair cells was also affected in CaV1.3−/− mice, but to a much lesser extent than apical cells. However, a characteristic feature in CaV1.3−/− mice was the reduced hair cell size irrespective of their cochlear location. We conclude that the development of low‐ and high‐frequency hair cells is differentially regulated during development, with apical cells being more strongly dependent on experience‐independent Ca2+ APs

Development of a Telemetry Unit for Wireless Monitoring of Bone Strain

Computational Infrastructure and Informatics Poster SessionA telemetry unit designed to monitor strain in bones is presented. This unit allows studying the relationship between bone load and bone mass in scenarios that were not possible with current setup. The current measuring setup employs a bench top load instrument and a data acquisition unit to read the output of strain gage sensors attached to the ulna of a mouse. Although precise, this setup is bulky and requires complete immobilization of the mouse. The telemetry unit developed by the authors replaces the data acquisition unit in the current setup and is able to wirelessly transmit the readings of the strain gage to a remote computer. The telemetry unit makes possible the collection of bone strain data in scenarios where the mouse is free to move or while performing fatigue-inducing exercises. The unit has been designed around an ultra low-power microcontroller (MSP430). The microcontroller makes the design highly flexible and programmable. The telemetry unit also includes a high-performance instrumentation amplifier to amplify the strain gage output. The gain and offset of the amplifier are digitally set by the microcontroller eliminating the use of manual potentiometers. The board has an expansion connector that allows up to 16 additional strain gages to be connected to the unit and incorporates a low-power radio transceiver operating in the 2.4 GHz ISM band. The data transmitted by the unit is received by a base station connected to a computer via a USB cable. The telemetry unit has been tested in a lab setting and is able to transmit the strain data at distances greater than 20 m while consuming less than 30 mW of power. This low power consumption allows the unit to be powered by a micro-battery weighting less than 3 grams. The telemetry unit can be used in other biomedical applications such as in the monitoring of orthopedic implants and can be easily configured to use other type of sensors

Understanding implementation and usefulness of electronic clinical decision support (eCDS) for melanoma in English primary care: a qualitative investigation.

BACKGROUND: Timely diagnosis of the serious skin cancer melanoma can improve patient outcomes. Clinical guidelines suggest that GPs use checklists, such as the 7-point checklist (7PCL), to assess pigmented lesions. In 2016, the 7PCL was disseminated by EMIS as an electronic clinical decision support (eCDS) tool. AIM: To understand GP and patient perspectives on the implementation and usefulness of the eCDS. DESIGN & SETTING: Semi-structured interviews with GPs and patients were undertaken. The interviews took place in four general practices in the south east of England following consultations using the eCDS for suspicious pigmented lesions. METHOD: Data were collected from semi-structured face-to-face interviews with GPs and from telephone interviews with patients. They were recorded and transcribed verbatim. The Consolidated Framework for Implementation Research (CFIR) underpinned the analysis using thematic approaches. RESULTS: A total of 14 interviews with GPs and 14 interviews with patients were undertaken. Most GPs reported that, as the eCDS was embedded in the medical record, it was useful, easy to use, time-efficient, and could facilitate patient-GP communication. They were less clear that it could meet policy or patient needs to improve early diagnosis, and some felt that it could lead to unnecessary referrals. Few felt that it had been sufficiently implemented at practice level. More felt confident with their own management of moles, and that the eCDS could be most useful for borderline decision-making. No patients were aware that the eCDS had been used during their consultation. CONCLUSION: Successful implementation of a new tool, such as eCDS for melanoma, requires GPs to perceive its value and understand how it can best be integrated into clinical practice. Disseminating a tool without such explanations is unlikely to promote its adoption into routine practice.NIH

Factors influencing xanthine oxidase activity in rat skin

1. 1. A method is described for preparing skin extracts which show reasonably consistent xanthine oxidase activities.2. 2. Levels of xanthine oxidase in skin do not change significantly during the first 21 days after birth. A marked increase in skin xanthine oxidase activity occurs during the period from 21 to 28 days, corresponding to the first 7 days on a stock diet. The effect of the change in diet on liver xanthine oxidase activity was less marked, results indicating a gradual increase in activity with increasing age.3. 3. Fasting for 72 hr. did not affect the level of xanthine oxidase in rat skin extracts. Liver xanthine oxidase was markedly depleted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32527/1/0000627.pd

Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer\u27s Disease: Part I - Cane

BACKGROUND: People with Alzheimer\u27s disease (AD) exhibit balance and walking impairments that increase falls risk. Prescription of a mobility aid is done to improve stability, yet also requires increased cognitive resources. Single-point canes require unique motor sequencing for safe use. The effect of learning to use a single-point cane has not been evaluated in people with AD. OBJECTIVES: In people with AD and healthy adult controls: 1) examine changes in gait while using a cane under various walking conditions; and 2) determine the cognitive and gait costs associated with concurrent cane walking while multi-tasking. METHODS: Seventeen participants with AD (age 82.1±5.6 years) and 25 healthy controls (age 70.8±14.1 years) walked using a single-point cane in a straight (6 meter) and a complex (Figure of 8) path under three conditions: single-task (no aid), dual-task (walking with aid), and multi-task (walking with aid while counting backwards by ones). Velocity and stride time variability were recorded with accelerometers. RESULTS: Gait velocity significantly slowed for both groups in all conditions and stride time variability was greater in the AD group. Overall, multi-tasking produced a decrease in gait and cognitive demands for both groups, with more people with AD self-prioritizing the cognitive task over the gait task. CONCLUSION: Learning to use a cane demands cognitive resources that lead to detrimental changes in velocity and stride time variability. This was most pronounced in people with mild to moderate AD. Future research needs to investigate the effects of mobility aid training on gait performance

Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer\u27s Disease: Part II - 4-Wheeled Walker.

BACKGROUND: Cognitive deficits and gait problems are common and progressive in Alzheimer\u27s disease (AD). Prescription of a 4-wheeled walker is a common intervention to improve stability and independence, yet can be associated with an increased falls risk. OBJECTIVES: 1) To examine changes in spatial-temporal gait parameters while using a 4-wheeled walker under different walking conditions, and 2) to determine the cognitive and gait task costs of walking with the aid in adults with AD and healthy older adults. METHODS: Twenty participants with AD (age 79.1±7.1 years) and 22 controls (age 68.5±10.7 years) walked using a 4-wheeled walker in a straight (6 m) and Figure of 8 path under three task conditions: single-task (no aid), dual-task (walking with aid), and multi-task (walking with aid while counting backwards by ones). RESULTS: Gait velocity was statistically slower in adults with AD than the controls across all conditions (all p values CONCLUSION: Learning to use a 4-wheeled walker is cognitively demanding and any additional tasks increases the demands, further adversely affecting gait. The increased cognitive demands result in a decrease in gait velocity that is greatest in adults with AD. Future research needs to investigate the effects of mobility aid training on gait performance

Flexible Carbon Nanotube-Based Strain Gage Sensors

Jump Starting Technologies, Patent Issues, & Translational Medicine Poster SessionAging brings about dramatic changes in the skeleton and other organ systems. Major skeletal diseases associated with aging include osteoporosis and attendant fractures (hip, spine and wrist or Collies) and osteoarthritis and its resulting need for various joint replacements. The prosthetic joint market in the United Sates is between $4-5 billion annually and estimates have suggested that this number will increase by upwards of 10$780. Equipment and lab facilities are available at UMKC. Carbon nanotubes are commercially available from NanoLab Inc. Copper nanoparticles and other chemicals can be acquired from Sigma-Aldrich. A timeline of one year will be needed to fine tune the fabrication process and characterize the strain gages