Impact of Conductive Education on Individuals with Stroke Syndrome

The purpose of this study was to investigate the impact of Conductive Education (CE) on adults with chronic stroke, replicating and expanding upon the study at Cannon Hill House (CHH) by Brown et al. We hypothesized that completing the CE program would improve function and change neural connectivity. CE is a transdisciplinary, motor-learning based intervention which uses multiple facilitations including manual facilitation, equipment, rhythmic intention (a cadence facilitation), first person verbal articulation, and the group environment to impact a person’s motor learning and rehabilitation. An aim of this pilot study was to replicate and expanded upon a previous study examining the impact of CE as an intervention for adults with chronic stroke. The location and severity of damage to the brain after a stroke influences the extent of functional limitations experienced by the stroke survivor. After injury, measurable physiological changes can be correlated with functional clinical measures. With physical rehabilitation interventions, functional impairments can be lessened, presumably through mechanisms of neuroplasticity. Thus a person’s participation may improve as a result of improved performance. Though interventions are often effective for restoring at least partial function for individuals with stroke, little is known about what underlies the positive results for specific intervention

Impact of a Conductive Education Intervention on Supraspinal Structures in Adults with Chronic Stroke

The location and severity of damage to the brain after a stroke influences the extent of functional limitations experienced by the stroke survivor. After injury, measurable physiological changes continue that can be correlated with functional clinical measures. With physical rehabilitation interventions, functional impairments can be lessened, presumably through mechanisms of neuroplasticity. Though interventions are often effective for restoring at least partial function for individuals with stroke, little is known about what underlies the positive results for specific interventions. The purpose of this URG-funded pilot study was to assess changes in neurological structure and connectivity in adults with chronic stroke after participation in a novel cognitive-physical rehabilitation intervention program known as Conductive Education (CE). Subjects: Four adults with chronic (\u3e6mo) stroke, 5+yrs post outpatient rehabilitation. Intervention: weekly, 2-hour CE program sessions for 10 weeks. Before and after CE program participation, measures of function (via clinical assessment by a licensed physical therapist) and supraspinal neurological structures (via imaging) were obtained. Magnetic Resonance Imaging (MRI) data were collected to assess functional and structural connectivity, myelin concentration, and cerebral perfusion. Clinical assessment measures and imaging data were analyzed for pre/post intervention changes. MRI data revealed pontine-level lesions (n = 2/4) and subcortical lesions (n = 2/4). Results showed that changes in both physical function and imaging outcomes varied by individual but were similar for subjects with similar lesions. From this pilot study, we conclude that CE could be effective for adults with chronic stroke by inducing supraspinal changes measurable with emerging imaging techniques

Effects of orange by-product fiber incorporation on the functional and technological properties of pasta

The incorporation of fiber into products consumed every day by the general population is important and viable. The aim of the present work was to evaluate the impact of incorporating orange juice industry dietary fiber byproducts in fettuccini of fresh pasta. Three different fiber concentrations were added to fresh pastas (25 g/kg, 50 g/kg and 75 g/kg). The results showed a significant increase in solid loss content when the incorporation of orange fiber was greater than 50 g/kg. This difference did not occur regarding weight increase values and color parameters. The pasta with 75 g/kg orange fiber can be considered a “high fiber” product, with the total dietary fiber content of the pasta increasing by 99% compared to control pasta. The carotenoid and phenolic contents of pasta increased significantly with the incorporation of fiber at 75 g/kg, but only the pasta formulation with 25 g/kg of orange fiber did not differ from control pasta in relation to all of the sensory attributes and presented an acceptance greater than 75%. The addition of orange fiber byproducts to pastas is an interesting alternative because fiber has a high nutritional value and an abundance of antioxidants

Radiation-induced alteration of apatite on the surface of Mars: first in situ observations with SuperCam Raman onboard Perseverance

International audiencePlanetary exploration relies considerably on mineral characterization to advance our understanding of the solar system, the planets and their evolution. Thus, we must understand past and present processes that can alter materials exposed on the surface, affecting space mission data. Here, we analyze the first dataset monitoring the evolution of a known mineral target in situ on the Martian surface, brought there as a SuperCam calibration target onboard the Perseverance rover. We used Raman spectroscopy to monitor the crystalline state of a synthetic apatite sample over the first 950 Martian days (sols) of the Mars2020 mission. We note significant variations in the Raman spectra acquired on this target, specifically a decrease in the relative contribution of the Raman signal to the total signal. These observations are consistent with the results of a UV‑irradiation test performed in the laboratory under conditions mimicking ambient Martian conditions. We conclude that theobserved evolution reflects an alteration of the material, specifically the creation of electronic defects, due to its exposure to the Martian environment and, in particular, UV irradiation. This ongoing process of alteration of the Martian surface needs to be taken into account for mineralogical space mission data analysis

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Liver injury in hospitalized patients with COVID-19: An International observational cohort study

Background: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.MethodsWe included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component & GE;3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).ConclusionsLiver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes