Freezing of Gait in Parkinson’s Disease: A Perceptual Cuase for a Motor Impairment?

While freezing of gait (FOG) is typically considered a motor impairment, the fact that it occurs more frequently in confined spaces suggests that perception of space might contribute to FOG. The present study evaluated how doorway size influenced characteristics of gait that might be indicative of freezing. Changes in spatiotemporal aspects of gait were evaluated while walking through three different-sized doorways (narrow (0.675 m wide X 2.1 m high), normal (0.9 m wide X 2.1 m high) and wide (1.8 m wide X 2.1 m high)) in three separate groups: 15 individuals with Parkinson’s disease confirmed to be experiencing FOG at the time of test; 16 non-FOG individuals with Parkinson’s disease and 16 healthy age-matched control participants. Results for step length indicated that the FOG group was most affected by the narrow doorway and was the only group whose step length was dependent on upcoming doorway size as indicated by a significant interaction of group by condition (F(4,88)=2.73, p\u3c0.034). Importantly, the FOG group also displayed increased within-trial variability of step length and step time, which was exaggerated as doorway size decreased (F(4,88)=2.99, p\u3c0.023). A significant interaction between group and condition for base of support measures indicated that the non-FOG participants were also affected by doorway size (similar to Parkinson’s disease FOG) but only in the narrow doorway condition. These results support the notion that some occurrences of freezing may be the result of an underlying perceptual mechanism that interferes with online movement planning

Evaluating the Contributors of Dynamic Flow to Freezing Gait in Parkinson’s Disease

Although visual cues can improve gait in Parkinson’s disease (PD), their underlying mechanism is poorly understood. Previous research suggests that cues contribute optical flow that is essential to elicit gait improvement. The present study manipulated how optic flow was provided, and how this might influence freezing of gait (FOG) in PD. Therefore, three groups; 15 PD FOG, 16 PD non-FOG, and 16 healthy controls were tested in 3 narrow doorway conditions; baseline (Narrow), ground lines (Ground), and laser (Laser). Step length indicated that the PD FOG group was only able to improve with ground lines, while the laser increased gait variability and double support time. These results suggest that optic flow in itself is not enough to elicit gait improvement in PD. When PD patients use visual cues, gait becomes less automatically controlled and hence preplanned conscious control may be an important factor contributing to gait improvement

The Relationship Between Motor Planning and Freezing of Gait in Parkinson’s Disease

Objective: To examine how a cued change in motor plan influences Parkinson’s disease (PD) patients with freezing of gait (FOG) (PD FOG; n=10), compared with those without FOG (PD non-FOG; n=10) and healthy controls (n=10). Methods: Participants walked through a doorway in three experimental conditions: no cue; cue before gait initiation; and cue after gait initiation. The light cue was presented at the end of the pathway and signified that individuals must walk to the cue, turn around and return to starting position. Results: Step-to-step variability (a known precursor to FOG) revealed a significant main effect of group (F2,27=32.83, p\u3c0.001), where PD FOG walked with greater step length variability than PD non-FOG and the control group. A significant interaction (F4,54=3.035, p=0.025) demonstrated that only the PD FOG group was most variable when the cue was present before gait initiation. Conclusion: This study concludes that motor planning deficits affect gait, specifically in individuals who experience FOG. This may have important implications for the design of therapeutic interventions in PD FOG

Leading the Way?: Maine's Initial Experience in Expanding Coverage Through Dirigo Health Reforms

Examines interim indicators -- enrollment of the previously uninsured, responses from small firms and the working poor, and the impact on costs -- of Maine's progress in providing affordable health insurance through the Dirigo Health program

Developing Relations of the United States with the Communist World

Paper by Quincy Wright, Visiting Professor in Political Science at Rice University, 1966-196

Investigation of the pathological function of PGC1B in the retinal pigment epithelium and its implications for age-related macular degeneration

Age-Related Macular Degeneration (AMD) is a retinal eye disease that is the leading cause of blindness in those over 50 years of age throughout the developed world. Oxidative and metabolic dysfunction of the retinal pigment epithelium (RPE) has been shown to play an important role in AMD. However, the mechanism of dysfunction in the RPE is poorly understood. The peroxisome proliferator-activated receptor-gamma coactivator 1α and β (PGC1A and PGC1B) are coactivators that interact with transcription factors to regulate mitochondria metabolism. In a previous study, it was demonstrated that one of the isoforms, PGC1A, protects RPE cells from oxidative stress through the upregulation of transcription factors that regulate important antioxidant enzymes. There is experimental and clinical evidence that demonstrates that PGC1B may play a deleterious role in the RPE cell. The objective of this study is to characterize the pathological effect of PGC1B on the RPE cell. PGC1B was overexpressed in the human retinal pigment epithelium cell line (ARPE-19) and expression of the PGC1 isoforms and their main gene targets was evaluated using quantitative polymerase chain reaction (qPCR). Cell death was evaluated under basal and pro-oxidant conditions by quantification of lactate dehydrogenase (LDH) release from the RPE cell. The effect of PGC1B gain of function on the RPE pro-angiogenic function was evaluated using the choroid explant sprouting assay and by testing the proliferative, migratory, and tube formation potential of RPE-derived conditioned media on the rhesus monkey chorioretinal cell line (RF/6A). Quantitative PCR analysis showed that overexpression of PGC1B in ARPE-19 cells leads to increased mitochondrial metabolism and decreased antioxidant enzyme expression, causing oxidative stress. After treatment with H2O2, PGC1B overexpression caused ARPE-19 cells to become more susceptible to cytotoxicity. The ex vivo choroid sprouting assay demonstrated that PGC1B overexpression in RPE is pro-angiogenic. However, cell proliferation as measured by MTT and the cell migration assay provided conflicting results on the pro-angiogenic effect of PGC1B. Previous research has demonstrated that oxidative stress in the RPE cell plays a role in AMD progression. It has been demonstrated in this study that PGC1B expression leads to increased mitochondrial metabolism and repression of antioxidant enzymes needed to prevent oxidative stress and dysfunction in the RPE cell. While experiments to test the effect of PGC1B on angiogenesis provided conflicting results, a different endothelial cell model may be better suited in demonstrating the pro-angiogenic effect of PGC1B. The hope is that the information provided from this study may be used to further our understanding of AMD and lead to the development of therapeutic targets to combat the effects of AMD

Long Term Implementation of a 100 Percent Checked Baggage Screening System: A Value Focused Thinking Approach

The terrorist attacks of 11 September 2001, carried out via aircraft hijackings, clearly demonstrated the massive destruction potential when vulnerabilities in the aviation system are exploited. Airport security measures have since been strengthened and new measures have been set in place. With the passage of the Aviation Transportation and Security Act (ATSA) of 2001 the checked baggage systems at U.S. Airports are now required to screen all checked bags with explosive detection devices. This is a significant increase from the small percentage of bags that were previously screened. The original 2009 deadline was changed to 31 December 2002 and this change forced airports to implement interim screening systems. These systems can impact the efficient processing of passengers and baggage. A long term solution is needed for a 100 percent checked baggage system that provides the required security while minimizing negative impacts to aviation stakeholders including the airport operators, airlines, passengers, and the Transportation Security Administration. This thesis, focusing on the Dayton International Airport, uses a Value Focused Thinking methodology to build a value model for evaluating potential long term solutions for 100 percent checked baggage system alternatives