Assessing the cervical range of motion in infants with positional plagiocephaly

Purpose: To determine if infants with positional plagiocephaly have limitations of active and passive cervical range of motion measured with simple and reliable methods. Methods: The examiners assessed bilateral active and passive cervical rotations and passive cervical lateral flexion. Cervical assessment was performed twice by 2 different physicians to assess intertester reliability. To assess intratester reliability the first investigator performed a second examination 48 hours after the first one. Results: One-hundred nine subjects were analyzed; 70.7% of the sample had head positional preference on the right, while 29.3% had head positional preference on the left (x2 35.52, P <0.001). Cervical rotations and lateral flexion showed reliable levels of agreement for intra and intertester reliability. Conclusions: The most limited range of motion in infants with positional plagiocephaly was cervical active rotation which affected more than 90% of patients. Passive cervical rotations and lateral flexion were limited in more than 60% of patient

Anatomical shape reconstruction and manufacturing: solving topological changes of lumen vessel trough geometric approach

Over the last years there has been an increasing growth of interest in Rapid Prototyping (RP) techniques applied to various fields of medicine. RP makes it possible, in vascular surgery, to produce accurate anatomic replicas of patient vessels. These replicas can help the customization of surgical invasive interventions such as in situ stent-graft insertion in carotid region. The main goal of this work is to obtain high quality in lumen reconstruction and manufacturing replicas by RP technique. This goal is achieved through the complete control of each phase of the generating process. We present a semi-automatic method for carotid lumen reconstruction based on Boundary Representation (BRep). All parameters influencing the quality of the shape reconstruction are presented and discussed: shape acquisition, shape reconstruction and shape manufacturing. The shape acquisition starts by extracting the points belonging to the boundary of the lumen vessel, from Computer Tomography (CT) images. These points, parameterised in a vector, are the input data of the shape reconstruction algorithm based on B-Spline interpolation. The B-Spline type for representing curves and surfaces were chosen because of their properties of continuity and local control. In the shape reconstruction stage we had to face problems due to the topological change on the vessel structure. For vessel regions where there are not changes of topology, we use the closed B-Spline curves (belonging to adjacent acquisition planes) as generating curves to build a B-Spline surface. For vessel regions with at least a change of topology (ex. bifurcation region) our algorithm split automatically the involved curves to obtain three rectangular B-Spline patches. Such patches are joined together to obtain the bifurcation vessel lumen. The set of lumen surfaces is then inserted in a Boundary Representation in order to get a valid solid. To analyse the quality of the reconstructed shapes, the final object is compared with the acquisition image. This solid is correctly tessellated in triangles to produce the data format used by the RP devices (STL)

Effects of Physical Rehabilitation Integrated with Rhythmic Auditory Stimulation on Spatio-Temporal and Kinematic Parameters of Gait in Parkinson's Disease

Movement rehabilitation by means of physical therapy represents an essential tool in the management of gait disturbances induced by Parkinson's disease (PD). In this context, the use of rhythmic auditory stimulation (RAS) has been proven useful in improving several spatio-temporal parameters, but concerning its effect on gait patterns, scarce information is available from a kinematic viewpoint. In this study, we used three-dimensional gait analysis based on optoelectronic stereophotogrammetry to investigate the effects of 5\u2009weeks of supervised rehabilitation, which included gait training integrated with RAS on 26 individuals affected by PD (age 70.4\u2009\ub1\u200911.1, Hoehn and Yahr 1-3). Gait kinematics was assessed before and at the end of the rehabilitation period and after a 3-month follow-up, using concise measures (Gait Profile Score and Gait Variable Score, GPS and GVS, respectively), which are able to describe the deviation from a physiologic gait pattern. The results confirm the effectiveness of gait training assisted by RAS in increasing speed and stride length, in regularizing cadence and correctly reweighting swing/stance phase duration. Moreover, an overall improvement of gait quality was observed, as demonstrated by the significant reduction of the GPS value, which was created mainly through significant decreases in the GVS score associated with the hip flexion-extension movement. Future research should focus on investigating kinematic details to better understand the mechanisms underlying gait disturbances in people with PD and the effects of RAS, with the aim of finding new or improving current rehabilitative treatments

Rhythmic Auditory Stimulation (RAS) and motor rehabilitation in Parkinson\u2019s disease: New frontiers in assessment and intervention protocols

Previous studies have demonstrated that physical therapy accompanied by Rhythmic Auditory Stimulation (RAS) can improve the motor skills of patients with Parkinson\u2019s disease and, in particular, their gait disturbances. In the present work we describe the neurological bases and perceptual-motor deficits generally associated with Parkinson\u2019s disease, with a specific focus on gait disturbances. Within this framework, we review the role of auditory cueing in the modulation of patients\u2019 gait, addressing this issue from the cognitive, neurological and biomechanical perspectives. In particular, we focus on the new frontiers of both assessment and intervention. With regards to the assessment, we describe the advantages of the three-dimensional quantitative multifactorial gait analysis. As concerns the intervention, we illustrate the potential impact of the administration of ecological footstep sounds as rhythmic cues

Effects of physical rehabilitation integrated with rhythmic auditory stimulation on spatio-temporal and kinematic parameters of gait in parkinsons's disease

Movement rehabilitation by means of physical therapy represents an essential tool in the management of gait disturbances induced by Parkinson’s disease (PD). In this context, the use of Rhythmic Auditory Stimulation (RAS) has been proven useful in improving several spatio-temporal parameters, but concerning its effect on gait patterns scarce information is available from a kinematic viewpoint. In this study we used three-dimensional gait analysis based on optoelectronic stereophotogrammetry to investigate the effects of 5 weeks of intensive rehabilitation, which included gait training integrated with RAS on 26 individuals affected by PD (age 70.4±11.1, Hoehn & Yahr 1-3). Gait kinematics was assessed before and at the end of the rehabilitation period and after a three-month follow-up, using concise measures (Gait Profile Score and Gait Variable Score, GPS and GVS, respectively), which are able to describe the deviation from a physiologic gait pattern. The results confirm the effectiveness of gait training assisted by RAS in increasing speed and stride length, in regularizing cadence and correctly reweighting swing/stance phase duration. Moreover, an overall improvement of gait quality was observed, as demonstrated by the significant reduction of the GPS value, which was created mainly through significant decreases in the GVS score associated with the hip flexion-extension movement. Future research should focus on investigating kinematic details to better understand the mechanisms underlying gait disturbances in people with PD and the effects of RAS, with the aim of finding new or improving current rehabilitative treatments

Quantitative assessment of gait parameters in people with Parkinson's disease in laboratory and clinical setting: Are the measures interchangeable?

This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead to inaccurate patient’s evaluations

[AuIII(N^N)Br2](PF6): A Class of Antibacterial and Antibiofilm Complexes (N^N = 2,2'-Bipyridine and 1,10-Phenanthroline Derivatives)

A series of new complexes of general formula [AuIII(N^N)Br2](PF6) (N^N = 2,2'-bipyridine and 1,10-phenanthroline derivatives) were prepared and characterized by spectroscopic, electrochemical, and diffractometric techniques and tested against Gram-positive and Gram-negative bacterial strains (Staphylococcus aureus, Streptococcus intermedius, Pseudomonas aeruginosa, and Escherichia coli), showing promising antibacterial and antibiofilm properties

Fermi Large Area Telescope Constraints on the Gamma-ray Opacity of the Universe

The Extragalactic Background Light (EBL) includes photons with wavelengths from ultraviolet to infrared, which are effective at attenuating gamma rays with energy above ~10 GeV during propagation from sources at cosmological distances. This results in a redshift- and energy-dependent attenuation of the gamma-ray flux of extragalactic sources such as blazars and Gamma-Ray Bursts (GRBs). The Large Area Telescope onboard Fermi detects a sample of gamma-ray blazars with redshift up to z~3, and GRBs with redshift up to z~4.3. Using photons above 10 GeV collected by Fermi over more than one year of observations for these sources, we investigate the effect of gamma-ray flux attenuation by the EBL. We place upper limits on the gamma-ray opacity of the Universe at various energies and redshifts, and compare this with predictions from well-known EBL models. We find that an EBL intensity in the optical-ultraviolet wavelengths as great as predicted by the "baseline" model of Stecker et al. (2006) can be ruled out with high confidence.Comment: 42 pages, 12 figures, accepted version (24 Aug.2010) for publication in ApJ; Contact authors: A. Bouvier, A. Chen, S. Raino, S. Razzaque, A. Reimer, L.C. Reye

Gamma-ray and radio properties of six pulsars detected by the fermi large area telescope

We report the detection of pulsed γ-rays for PSRs J0631+1036, J0659+1414, J0742-2822, J1420-6048, J1509-5850, and J1718-3825 using the Large Area Telescope on board the Fermi Gamma-ray Space Telescope (formerly known as GLAST). Although these six pulsars are diverse in terms of their spin parameters, they share an important feature: their γ-ray light curves are (at least given the current count statistics) single peaked. For two pulsars, there are hints for a double-peaked structure in the light curves. The shapes of the observed light curves of this group of pulsars are discussed in the light of models for which the emission originates from high up in the magnetosphere. The observed phases of the γ-ray light curves are, in general, consistent with those predicted by high-altitude models, although we speculate that the γ-ray emission of PSR J0659+1414, possibly featuring the softest spectrum of all Fermi pulsars coupled with a very low efficiency, arises from relatively low down in the magnetosphere. High-quality radio polarization data are available showing that all but one have a high degree of linear polarization. This allows us to place some constraints on the viewing geometry and aids the comparison of the γ-ray light curves with high-energy beam models