Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke

OBJECTIVE: Impairments in balance can be a consequence of changes in the motor, sensory, and integrative aspects of motor control. Abnormal sensory reweighting, i.e., the ability to select the most appropriate sensory information to achieve postural stability, may contribute to balance impairment. The Sensory Organization Test is a component of Computerized Dynamic Posturography that evaluates the impact of visual, vestibular, and somatosensory inputs, as well as sensory reweighting, under conditions of sensory conflict. The aim of this study is to compare balance control in hemiparetic patients during the first year post-stroke and in age-matched neurologically normal subjects using the Berg Balance Scale and Computerized Dynamic Posturography. METHODS: We compared the Berg Balance Scale and Sensory Organization Test scores in 21 patients with hemiparesis after first-ever ischemic stroke and in 21 age-matched, neurologically normal subjects. An equilibrium score was defined for each Sensory Organization Test condition. RESULTS: Berg Balance Scale scores were significantly lower in the patients than in the neurologically normal subjects. Equilibrium scores were significantly lower in the patients than in the neurologically normal subjects for those Sensory Organization Test conditions that did not provide appropriate somatosensory information and under conditions of sensory conflict. A history of falls was more frequent in patients with lower equilibrium scores. CONCLUSION: During the first year after a stroke, defective sensory reweighting significantly impacts balance control in hemiparetic patients. These results are important for the planning of effective rehabilitation interventions

Beyond power:unbridging Foucault and Weber

Today, very few would doubt that there are plenty of reasons to liken Weber’s and Foucault’s theories of power. Nevertheless, their respective works have divergent ethical and ontological preoccupations which should be reconsidered. This paper explores Foucault’s account of a historical episode in Discipline and Punish and Weber’s theory of life spheres, uncovering evidence that there is a need to reassess the conceptual bridges which have been built so far. The exploration reveals a radical difference between a monological theory of power (Foucault) and a multidimensional approach to power (Weber). Yet by unbridging the two thinkers and focusing on other aspects of their theories along with their ideas about power, we also find that alternative links between the two frameworks may offer a more promising critical theory

Substâncias húmicas da matéria orgânica do solo em cultivo de café com enriquecimento atmosférico de CO2.

Os possíveis efeitos da mudança climática devido ao aumento da concentração de CO2 atmosférico podem alterar as aptidões agrícolas nas áreas de regiões tropicais, podendo haver redução na produtividade de determinadas culturas (Solomom et al., 2007). Pesquisa agronômica tendem a investigar o efeito aumento da concentração do CO2 para plantas, pois o CO2 constitui um substrato primário para a fotossíntese e sua elevação pode estimular a produção de biomassa pela planta, consequentemente aumentar teores de carbono orgânico do solo, o que contribui para o aumento da matéria orgânica (Hungate et al., 2009). Entretanto, a dinâmica da matéria orgânica e dos nutrientes em solo cultivado sob elevada concentração de CO2 ainda é pouco estudada e compreendida, principalmente no Brasil. Os estudos envolvendo o enriquecimento atmosférico com CO2 são relativamente novos e permitem uma ampla investigação sobre o tema. Conduzidos em diferentes países em com as mais diversas plantas, os experimentos do tipo FACE (Free-Air Carbon Dioxide Enrichment) têm se mostrado uma importante fonte de conhecimento para antecipar possíveis problemas nos sistemas ecológicos e de produção agrícola (Lenhart et al., 2016). O objetivo deste trabalho foi verificar os possíveis efeitos de enriquecimento atmosférico de CO2 através do experimento FACE com os teores de C nas substâncias húmicas da matéria orgânica do solo (MOS) nas camadas superficiais e também uma quantificação do grau de humificação da MOS

Mortality among over 6 million internal and international migrants in Brazil: a study using the 100 Million Brazilian Cohort

BACKGROUND: To understand if migrants living in poverty in low and middle-income countries (LMICs) have mortality advantages over the non-migrant population, we investigated mortality risk patterns among internal and international migrants in Brazil over their life course. METHODS: We linked socio-economic and mortality data from 1st January 2011 to 31st December 2018 in the 100 Million Brazilian Cohort and calculated all-cause and cause-specific age-standardised mortality rates according to individuals' migration status for men and women. Using Cox regression models, we estimated the age- and sex-adjusted mortality hazard ratios (HR) for internal migrants (i.e., Brazilian-born individuals living in a different Brazilian state than their birth) compared to Brazilian-born non-migrants; and for international migrants (i.e., people born in another country) compared to Brazilian-born individuals. FINDINGS: The study followed up 45,051,476 individuals, of whom 6,057,814 were internal migrants, and 277,230 were international migrants. Internal migrants had similar all-cause mortality compared to Brazilian non-migrants (aHR = 0.99, 95% CI = 0.98-0.99), marginally higher mortality for ischaemic heart diseases (aHR = 1.04, 95% CI = 1.03-1.05) and higher for stroke (aHR = 1.11, 95% CI = 1.09-1.13). Compared to Brazilian-born individuals, international migrants had 18% lower all-cause mortality (aHR = 0.82, 95% CI = 0.80-0.84), with up to 50% lower mortality from interpersonal violence among men (aHR = 0.50, 95% CI = 0.40-0.64), but higher mortality from avoidable causes related to maternal health (aHR = 2.17, 95% CI = 1.17-4.05). INTERPRETATION: Although internal migrants had similar all-cause mortality, international migrants had lower all-cause mortality compared to non-migrants. Further investigations using intersectional approaches are warranted to understand the marked variations by migration status, age, and sex for specific causes of death, such as elevated maternal mortality and male lower interpersonal violence-related mortality among international migrants. FUNDING: The Wellcome Trust

Transcranial magnetic stimulation in mild to severe hemiparesis early after stroke: a proof of principle and novel approach to improve motor function

Abstract Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the unaffected hemisphere can enhance function of the paretic hand in patients with mild motor impairment. Effects of low-frequency rTMS to the contralesional motor cortex at an early stage of mild to severe hemiparesis after stroke are unknown. In this pilot, randomized, double-blind clinical trial we compared the effects of low-frequency rTMS or sham rTMS as add-on therapies to outpatient customary rehabilitation, in 30 patients within 5-45 days after ischemic stroke, and mild to severe hand paresis. The primary feasibility outcome was compliance with the interventions. The primary safety outcome was the proportion of intervention-related adverse events. Performance of the paretic hand in the JebsenTaylor test and pinch strength were secondary outcomes. Outcomes were assessed at baseline, after ten sessions of treatment administered over 2 weeks and at 1 month after end of treatment. Baseline clinical features were comparable across groups. For the primary feasibility outcome, compliance with treatment was 100% in the active group and 94% in the sham group. There were no serious intervention-related adverse events. There were significant improvements in performance in the Jebsen-Taylor test (mean, 12.3% 1 month after treatment) and pinch force (mean, 0.5 Newtons) in the active group, but not in the sham group. Low-frequency rTMS to the contralesional motor cortex early after stroke is feasible, safe and potentially effective to improve function of the paretic hand, in patients with mild to severe hemiparesis. These promising results will be valuable to design larger randomized clinical trials