Condylar Position in the Treatment of Obstructive Sleep Apnea with a Mandibular Advancement Device: A Pilot Study

Objective  To evaluate, through a tomographic analysis, the positional changes of the condyle when using a mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA), and to assess if the condylar positions influence OSA polysomnographic patterns. Materials and Methods  Ten OSA patients underwent treatment with an MAD, and polysomnographic and tomographic examinations were performed before therapy (T0) and after MAD placement (T1). Results  By comparing the T0 and T1 measurements, we observed advancement and extrusion of the condyles in all patients ( p  < 0.001), as well as a decrease in the apnea-hypopnea index (AHI) ( p  < 0.001), increases in the mean ( p  = 0.001) and minimum ( p  < 0.001) oxyhemoglobin saturation, and a significant correlation between the anterior displacement of the right ( p  = 0.003) and left ( p  = 0.015) condyles. Discussion  Condylar advancement was directly correlated with OSA improvement: the greater the advancement, the better the AHI.

Rheological evolution of straw-cattle manure (SCM) treated by dry anaerobic digestion in batch and in continuous pilot reactors

Knowledge of rheological evolution of biomass during dry anaerobic digestion (D-AD) is important in the engineering design, modeling, and operation of D-AD reactors. In this work, two methods of rheological analysis, the slump test and the shear-box, were used to measure the evolution of the yield stress, cohesion and friction angle of the straw-cattle manure (SCM) during the D-AD. Firstly, four 60 L batch leach-bed reactors (LBR) were started in parallel and stopped at different stages of the D-AD process on days 0, 10, 21 and 31. Secondly, a 500 L and 2 m length plug flow reactor (PFR) was operated with 40 days of solid retention time and samples were recovered at different positions. The solid degradation during D-AD process was monitored by analysis of the degradation of volatile solids, the fiber content and the Flash BMP. Similar degradation patterns of SCM and rheological evolution were observed in both reactors type. VS content decreased of 10.7% and 10.2% in 30 days in PFR and LBR respectively. VS degradation in both cases was well explained by hemicellulose and cellulose consuming in D-AD process. Considering the rheological analysis, the results showed that D-AD induced a reduction of the yield stress of 28.1 and 24.2% in 30 days in PFR and LBR respectively. Moreover, a similar evolution of cohesion and friction angle value for samples from both reactors was observed. This study demonstrates the close relationship between the state of degradation of the solid biomass and its rheological properties.

A10 EARLY LIFE SENSITIZATION TO GLUTEN INDUCES SUSTAINED IMMUNOPATHOLOGY IN DR3-DQ2 MICE

Background

Celiac disease (CeD) is an autoimmune T-cell mediated enteropathy, triggered by gluten, a group of proteins found in wheat, barley, and rye. The defined role of gluten as a dietary trigger, necessary genes (HLA-DQ2 and/or DQ8), and tissue transglutaminase (TG2) as the autoantigen together, are unique features of CeD. Although CeD onset can occur at any age, first dietary introduction of gluten during infancy is a critical window of exposure, especially in infants homozygous for the HLA DQ2.5 allele. While adult sensitization studies have been recently performed in DR3-DQ2 mice, the consequences of early life gluten sensitization timing remain unexplored.

Aims

Our aim was to characterize gluten-immunopathology and CeD-specific serology in specific pathogen free (SPF) DR3-DQ2 transgenic mice sensitized to gluten, 1 week before weaning.

Methods

Seven-week-old SPF DR3-DQ2 transgenic mice, kept on a gluten-free diet (GFD), were paired for breeding. At post-natal day 3, pups were standardized to 4 per litter (n=2 male, n=2 female) to ensure equal nutrition across litters. At 14 days of age, pups were sensitized with pepsin-trypsin digested gliadin and cholera toxin (CT) three times in one week (n=15). At 21 days of age, pups were weaned and placed either on a gluten-containing diet (n=7), (equivalent of 20g/d of gluten in a human diet -high dose-) or an isocaloric GFD (n=8) until 10 weeks of age. Non-sensitized controls (n=7) received only CT and were kept on the GFD. At sacrifice, serum was collected for anti-TG2 and anti-gliadin antibodies (AGA). Jejunal tissue was collected for histological analysis using villus-to-crypt (V/C) ratios and CD3+ intraepithelial lymphocytes (IEL) counts.

Results

Gluten-sensitized mice placed on a gluten-containing diet post-weaning had lower V/C ratios and higher CD3+ IEL counts compared with controls (p&lt;0.01). Pre-weaning sensitized mice that were kept on a GFD post-weaning had sustained decreases in V/C ratios and higher CD3+ IEL counts (p&lt;0.01). Out of 15 sensitized mice, 7 developed positive anti-gliadin IgA (p=0.02) and 4 had positive anti-TG2 IgA antibodies (p=0.01) in intestinal contents, irrespective of gluten in the diet. None of the controls had detectable AGA or anti-TG2 antibodies.

Conclusions

Pre-weaning gluten sensitization of DR3-DQ2 mice induced prolonged gluten immunopathology that did not reverse after 5 weeks on a GFD. Our results indicate that young DR3-DQ2 mice are susceptible to gluten sensitization, with sustained immunopathology, suggesting a critical window of vulnerability in familial carriers of DQ2.5. This novel model will be useful to investigate environmental cofactors at the first time of gluten introduction to the diet.

Funding Agencies

CIHR

Artificial intelligence and colon capsule endoscopy: development of an automated diagnostic system of protruding lesions in colon capsule endoscopy

BACKGROUND

Colon capsule endoscopy (CCE) is a minimally invasive alternative for patients unwilling to undergo conventional colonoscopy, or for whom the latter exam is contraindicated. This is particularly important in the setting of colorectal cancer screening. Nevertheless, these exams produce large numbers of images, and reading them is a monotonous and time-consuming task, with the risk of overlooking important lesions. The development of automated tools based on artificial intelligence (AI) technology may improve some of the drawbacks of this diagnostic instrument.

METHODS

A database of CCE images was used for development of a Convolutional Neural Network (CNN) model. This database included anonymized images of patients with protruding lesions in the colon or patients with normal colonic mucosa or with other pathologic findings. A total of 3,387,259 frames from 24 CCE exams were retrospectively reviewed. For CNN development, 3640 images (860 protruding lesions and 2780 with normal mucosa or other findings) were ultimately extracted. Training and validation datasets were constructed for the development and testing of the CNN.

RESULTS

The CNN detected protruding lesions with a sensitivity, specificity, positive and negative predictive values of 90.7, 92.6, 79.2 and 96.9%, respectively. The area under the receiver operating characteristic curve for detection of protruding lesions was 0.97.

CONCLUSIONS

The deep learning algorithm we developed is capable of accurately detecting protruding lesions. The application of AI technology to CCE may increase its diagnostic accuracy and acceptance for screening of colorectal neoplasia.

Semiquantitative analysis of interim 18F-FDG PET is superior in predicting outcome in Hodgkin lymphoma patients compared to visual analysis

PURPOSE

To investigate the prognostic value of interim PET (PETi) in adult HL patients, comparing visual with semiquantitative analysis.

MATERIAL AND METHODS

Retrospective analysis of Hodgkin's lymphoma (HL) patients diagnosed between 2012 and 2016 in the Onco-hematology Department of Instituto Português de Oncologia - Porto (median follow-up: 46.5 months [2.6-66.4]). Fifty-eight patients with available PET at diagnosis (PET0) and PETi data were included. PETi scans were analyzed according to Deauville 5-point scale (5-PS), and cut-off values for changes in maximum standardized uptake value [SUVmax], peak SUV [SUVpeak], metabolic tumour volume [MTV] and total lesion glycolysis index [TLG] between PETi and PET0 were computed using ROC analysis. Visual and semiquantitative data were compared with each other in the prediction of patient outcomes.

RESULTS

Semiquantitative analysis obtained a higher sensitivity for persistent/relapsed disease compared to the 5-PS (70% vs. 10%, respectively), but lower specificity. It also demonstrated better predictive performance for response to first-line therapy (negative predictive value >92%). The positive predictive value was similar for all five measurements. At 60 months of follow-up, there was a significant difference between the progression free survival (PFS) curves of patients with positive and negative PETi according to ΔSUVmax (56.9% vs. 88.0%, p<0.05), ΔSUVpeak (55.9% vs. 88.1%, p<0.05), ΔMTV (35.3% vs. 88.7%, p<0.05), and ΔTLG (42.4% vs. 88.1%, p<0.05). Statistical significance was not reached when considering 5-PS results.

DISCUSSION

PETi interpretation according to a semiquantitative approach appears to discriminate HL patients better than the visual 5-PS analysis. This could allow better detection of persistent or early relapsed disease, while a negative PETi result could support de-escalating therapy intensity.

Feeding aspects of Knodus heteresthes (Eigenmann, 1908) and Moenkhausia lepidura (Kner, 1858) (Characiformes, Characidae) in the Teles Pires and Juruena Rivers, southern Amazon

The composition of the diet of two species of characids (Knodus heteresthes and Moenkhausia lepidura) was evaluated in the Teles Pires and Juruena Rivers, sampled in September and October 2016. We analyzed 226 stomachs of K. heteresthes and 425 of M. lepidura. The analysis of the stomach contents was based on volumetric and frequency of occurrence methods, applying the food importance index. For the similarity of the diets between the species we calculated the niche overlap with Pianka's index. Both species in the Juruena River have a dietary preference for arthropods (IAi > 0.95). In the Teles Pires River the diet is concentrated in three sources for both species: arthropods (IAi > 0.52), vegetables (IAi > 0.33) and fish (IAi > 0.12). The diet was dissimilar when compared to environments (ANOSIM, R ≥ 0.57, p < 0.001) with high trophic niche overlap (α > 0.97), regardless of the sampled environment. In the Teles Pires River, both species were classified as omnivorous with an insectivorous tendency and in the Juruena River the insectivorous behaviour occurs.

Dry anaerobic co-digestion of roadside grass and cattle manure at a 60 L batch pilot scale

Roadside grass cuttings and solid cattle manure are resources that are available as input for dry anaerobic co-digestion. Two series of measurements were carried out, one in June 2016 and one in October 2016. The methane potentials were determined on a laboratory scale and revealed a high degree of seasonality, 202.9 and 167.9 Nm³_CH4.t_VS^-1, respectively. Moreover, these substrates were co-digested in reactors by the dry process on a pilot scale (60 L). Two strategies for filling and optimization, as layers or as a mixture, were compared. The seasonality also determined the physicochemical parameters and the hydrodynamic properties involved in percolation of the liquid phase recirculated in the dry digestion process. The production of methane depended on the filling method, the seasonality, and the nature of the input, which in some cases resulted in inhibition of 34.8-44.4 Nm³_CH4.t_VS^-1.

Xylo-oligosaccharides display a prebiotic activity when used to supplement wheat or corn-based diets for broilers

It is now well established that exogenous β-1,4-xylanases improve the nutritive value of wheat-based diets for poultry. Among other factors, the mechanism of action of exogenous enzymes may involve a microbial route resulting from the generation of prebiotic xylo-oligosaccharides (XOS) in the birds' gastro-intestinal (GI) tract. In a series of three experiments, the effect of XOS on the performance of broilers fed wheat or corn-based diets was investigated. In experiment 1, birds receiving diets supplemented with XOS displayed an increased weight gain (P = 0.08). The capacity of XOS to improve the performance of animals during a longer trial (42 d) was investigated (Experiment 2). The data revealed that diet supplementation with XOS, tested at two incorporation rates (0.1 and 1 g/kg), or with an exogenous β-1,4-xylanase resulted in an increased nutritive value of the wheat-based diet. An improvement in animal performance was accompanied by a shift in the microbial populations colonizing the upper portions of the GI tract. XOS were also able to improve the performance of broilers fed a corn-based diet, although the effects were not apparent at incorporation rates of 10 g/kg. Together these studies suggest that in some cases the capacity of β-1,4-xylanases to improve the nutritive value of wheat-based diets is more related to their ability to produce prebiotic XOS than to their ability to degrade arabinoxylans. The extremely low quantities of XOS used in this study also challenge the depiction of a prebiotic being a quantitatively fermented substrate. These data also bring into question the validity of the "cell wall" mechanism, as XOS elicited an effect with clearly no action on endosperm cell wall integrity and yet the performance effects noted were equivalent or superior to the added enzymes.

Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review

BACKGROUND

A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team.

METHODS

A multidisciplinary team set the institutional quality indicators for the massive hemorrhage protocol review. A retrospective review of all obstetrical massive hemorrhage protocol activation events from September 2010 to January 2015 was performed. All protocol events occurred before the creation of the quality indicators. Data were retrieved from patient records.

RESULTS

There were 17 (0.09%) protocol activations for 19 790 deliveries during the study period. All 17 (100%) patients received at least one unit of red blood cells. Overactivation, defined as the transfusion of <2 units of red blood cells, occurred in two cases (12%). Common causes of non-compliance were: 24% (4/17) temperature monitoring, 18% (3/17) lactate measurement, 41% (7/17) arterial blood gas sampling, and 18% (3/17) hemoglobin maintenance within the target range of 55-95 g/L. Admission to intensive care and peripartum hysterectomy occurred in 12 and 5 cases (71% and 29%), respectively.

CONCLUSIONS

Suboptimal compliance was found in multiple areas, which may be attributable to the low frequency of activation of our massive haemorrhage protocol in obstetrics. The quality targets identified in this report can act as a basis for other institutions developing quality indicators to evaluate performance.

Turbulence level effects on conventional reflectometry using 2D full-wave simulations

Numerical simulations are critical in improving the capabilities of microwave diagnostics. In this work, the 2D finite-difference time-domain full-wave code REFMUL was applied to broadband turbulent plasmas using the conventional reflectometry setup. Simulations were performed with O-mode waves, fixed frequency probing, and I/Q detection. The plasma density, determining O-mode propagation, was modeled as the sum of a slab background plasma with a fluctuating component following a Kolmogorov-like amplitude k-spectrum. The density turbulence level δn _e/n _e was scanned over several orders of magnitude for simulated plasma flows of constant plasma velocity in either the radial or the poloidal direction. Simulations show trends, such as spectral broadening of the complex A(t)e^iφ(t) signals and increasing fluctuations in A(t) and φ(t) with increasing δn _e/n _e, that are similar for both plasma flow directions. These together with possibilities to reconstruct a poloidal wavenumber spectrum are discussed in view of extending the measuring capabilities. The onset of non-linear effects associated with phase runaway, as previously observed with other 1D and 2D codes, as well as radial Doppler effects is also observed and discussed.

Variation in levels of non-starch polysaccharides and endogenous endo-1,4-β-xylanases affects the nutritive value of wheat for poultry

1. Endo-1,4-β-xylanase is known to improve the nutritive value of wheat-based diets for poultry by degrading dietary arabinoxylans. However, broilers' response to supplementation of wheat-based diets with exogenous endo-1,4-β-xylanase is not always observed. 2. In this study, 108 different wheat lots were analysed for levels of extract viscosity as well as for endogenous endo-1,4-β-xylanase activity, and the impact of these two variables in animal performance was tested. 3. Results revealed that endogenous endo-1,4-β-xylanase activity and extract viscosity content varied widely among different wheat lots. Thus, a trial was conducted to evaluate the efficacy of exogenous enzyme supplementation in broiler diets using wheats with different levels of extract viscosity and endogenous endo-1,4-β-xylanase activity. 4. The data revealed that exogenous enzyme supplementation was only effective when the wheat present in the diet had high levels of extract viscosity (14.8 cP) with low endogenous endo-1,4-β-xylanase activity (347.0 U/kg). Nevertheless, it is apparent that exogenous microbial xylanases reduce digesta extract viscosity and feed conversion ratio independently of the endogenous properties presented by different wheat lots. 5. The data suggest that extract viscosity and/or endogenous endo-1,4-β-xylanase activity affect the response to enzyme supplementation by poultry fed on wheat-based diets.

Hybrid mesoporous silica nanocarriers with thermovalve-regulated controlled release

Mesoporous silica nanoparticles (MSNs) are excellent nanocarriers, featuring very high cargo capacity due to their large surface area and pore volume. The particle and pore dimensions can be accurately tuned, and both the internal and external surfaces allow versatile functionalization. We developed hybrid MSNs with diameters around 140 nm, with the external surface selectively modified with a temperature-responsive biocompatible copolymer to control cargo release. The nanoparticles feature either a polymer brush or a gel-like responsive shell, produced by grafting from RAFT polymerization of PEG-acrylate macromonomers. The hybrid nanoparticles have fluorescent molecules incorporated into the inorganic network providing excellent optical properties for traceability and imaging. The cargo release profiles are explained by a temperature-controlled "pumping" mechanism: at low temperature (ca. 20 °C) the polymer shell is hydrophilic and expanded, opposing cargo diffusion out of the shell and retaining the molecules released from the mesopores; above room temperature (ca. 40-50 °C) the polymer network becomes more hydrophobic and collapses onto the silica surface, releasing the cargo by a sponge-like squeezing effect. The release kinetics depends on the polymer shell type, with better results obtained for the gel-coated nanoparticles. Our proof-of-concept system shows that by modulating the temperature, it is possible to achieve a pumping regime that increases the release rate in a controlled way.

A modified method for COD determination of solid waste, using a commercial COD kit and an adapted disposable weighing support

The chemical oxygen demand (COD) is an essential parameter in waste management, particularly when monitoring wet anaerobic digestion processes. An adapted method to determine COD was developed for solid waste (total solids >15%). This method used commercial COD tubes and did not require sample dilution. A homemade plastic weighing support was used to transfer the solid sample into COD tubes. Potassium hydrogen phthalate and glucose used as standards showed an excellent repeatability. A small underestimation of the theoretical COD value (standard values around 5% lower than theoretical values) was also observed, mainly due to the intrinsic COD of the weighing support and to measurement uncertainties. The adapted COD method was tested using various solid wastes in the range of 1-8 mg_COD, determining the COD of dried and ground cellulose, cattle manure, straw and a mixed-substrate sample. This new adapted method could be used to monitor and design dry anaerobic digestion processes.

Analysis of uni and bi-parental markers in mixture samples: Lessons from the 22nd GHEP-ISFG Intercomparison Exercise

Since 1992, the Spanish and Portuguese-Speaking Working Group of the ISFG (GHEP-ISFG) has been organizing annual Intercomparison Exercises (IEs) coordinated by the Quality Service at the National Institute of Toxicology and Forensic Sciences (INTCF) from Madrid, aiming to provide proficiency tests for forensic DNA laboratories. Each annual exercise comprises a Basic (recently accredited under ISO/IEC 17043: 2010) and an Advanced Level, both including a kinship and a forensic module. Here, we show the results for both autosomal and sex-chromosomal STRs, and for mitochondrial DNA (mtDNA) in two samples included in the forensic modules, namely a mixture 2:1 (v/v) saliva/blood (M4) and a mixture 4:1 (v/v) saliva/semen (M8) out of the five items provided in the 2014 GHEP-ISFG IE. Discrepancies, other than typos or nomenclature errors (over the total allele calls), represented 6.5% (M4) and 4.7% (M8) for autosomal STRs, 15.4% (M4) and 7.8% (M8) for X-STRs, and 1.2% (M4) and 0.0% (M8) for Y-STRs. Drop-out and drop-in alleles were the main cause of errors, with laboratories using different criteria regarding inclusion of minor peaks and stutter bands. Commonly used commercial kits yielded different results for a micro-variant detected at locus D12S391. In addition, the analysis of electropherograms revealed that the proportions of the contributors detected in the mixtures varied among the participants. In regards to mtDNA analysis, besides important discrepancies in reporting heteroplasmies, there was no agreement for the results of sample M4. Thus, while some laboratories documented a single control region haplotype, a few reported unexpected profiles (suggesting contamination problems). For M8, most laboratories detected only the haplotype corresponding to the saliva. Although the GHEP-ISFG has already a large experience in IEs, the present multi-centric study revealed challenges that still exist related to DNA mixtures interpretation. Overall, the results emphasize the need for further research and training actions in order to improve the analysis of mixtures among the forensic practitioners.

Methane production improvement by modulation of solid phase immersion in dry batch anaerobic digestion process: Dynamic of methanogen populations

Several 60L dry batch anaerobic digestion (AD) reactors were implemented with or without liquid reserve on cattle manure. The immersed part modulation of cattle manure increased the methane flow of about 13%. The quantitative real time PCR and the optimized DNA extraction were implemented and validated to characterize and quantify the methanogen dynamic in dry batch AD process. Final quantities of methanogens converged toward the same level in several inocula at the end of AD. Methanogen dynamic was shown by dominance of Methanosarcinaceae for acetotrophic methanogens and Methanobacteriales for the hydrogenotrophic methanogens. Overall, methanogens populations were stabilized in liquid phase, except Methanosaetaceae. Solid phase was colonized by Methanomicrobiales and Methanosarcinaceae populations giving a support to biofilm development. The methane increase could be explained by a raise of Methanosarcinaceae population in presence of a total contact between solid and liquid phases. Methanosarcinaceae was a bio-indicator of the methane production.

Electrical resistivity tomography to quantify in situ liquid content in a full-scale dry anaerobic digestion reactor

The electrical resistivity tomography (ERT) method is a non-intrusive method widely used in landfills to detect and locate liquid content. An experimental set-up was performed on a dry batch anaerobic digestion reactor to investigate liquid repartition in process and to map spatial distribution of inoculum. Two array electrodes were used: pole-dipole and gradient arrays. A technical adaptation of ERT method was necessary. Measured resistivity data were inverted and modeled by RES2DINV software to get resistivity sections. Continuous calibration along resistivity section was necessary to understand data involving sampling and physicochemical analysis. Samples were analyzed performing both biochemical methane potential and fiber quantification. Correlations were established between the protocol of reactor preparation, resistivity values, liquid content, methane potential and fiber content representing liquid repartition, high methane potential zones and degradations zones. ERT method showed a strong relevance to monitor and to optimize the dry batch anaerobic digestion process.

Quantifying physical structure changes and non-uniform water flow in cattle manure during dry anaerobic digestion process at lab scale: Implication for biogas production

The aim of this study was to investigate and quantify non-uniform water flow during dry AD and its implication for biogas production. Laboratory tracer experiments were performed on cattle manure over the course of AD. The evolution of the permeability, the dry bulk density, the dry porosity, the total and volatile solid contents of cattle manure at different stages of AD, revealed waste structure changes, impacting water flow and methane production. Tracer experiments and numerical modeling performed by using a physical non-equilibrium model indicated non-uniform preferential flow patterns during degradation. According to literature, the increase of inoculum recirculation frequency improved methane production rate. However, these results demonstrated that this improvement occurs only at the beginning of manure degradation. After 19 days of degradation the inoculum recirculation and the flow patterns modification had no effect on methane production rate.

Effect of reduced dietary protein and supplementation with a docosahexaenoic acid product on broiler performance and meat quality

1. Chicken breast meat is a lean meat due to its low content of intramuscular fat (IMF) resulting in an overall lower acceptability by consumers due to a decrease in juiciness, flavour and increased chewiness. Recently, studies performed in pigs suggested the possibility of increasing IMF by decreasing dietary crude protein (CP) content, an effect possibly mediated through an increased lipogenesis. 2. Dietary supplementation with lipids rich in omega 3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) may modulate an increase in the content of these fatty acids in meat from monogastric animals and, thus, promote the daily intake of n-3 LC-PUFA by humans. 3. LC-PUFA are very susceptible to oxidation, resulting in off-flavours that affect meat quality and consumers' acceptability. 4. This trial was conducted to assess the effect of reducing dietary CP, from 21% to 17%, on chicken's meat IMF content and, simultaneously, to evaluate if a complementary supplementation with a proprietary n-3 LC-PUFA source (DHA Gold™) could improve meat quality. These effects were assessed by measuring productive performance and meat quality, oxidative stability, sensory traits and fatty acid profile. 5. A reduction in CP content of broiler diets, from 21% to 17%, balanced for lysine, improved performance while it was not sufficient to increase IMF content in chicken meat. In contrast, DHA Gold™ supplementation had a positive impact both in broiler productive parameters and in meat fatty acid profile. 6. In addition, incorporation of 7.4% of DHA Gold™ in the diet promoted carcass yield but negatively affected chicken meat acceptability by consumers, due to a decrease of meat oxidative stability. 7. Overall the data suggest that neither a dietary supplementation with DHA Gold™ nor a reduction in CP have a direct positive effect in the levels of IMF present in broiler meat.

Influence of visual and auditory biofeedback on partial body weight support treadmill training of individuals with chronic hemiparesis: a randomized controlled clinical trial

BACKGROUND

Stroke is an important causal factor of deficiency and functional dependence worldwide.

OBJECTIVE

To determine the immediate effects of visual and auditory biofeedback, combined with partial body weight supported (PBWS) treadmill training on the gait of individuals with chronic hemiparesis.

DESIGN

Randomized controlled trial.

SETTING

Outpatient rehabilitation hospital.

POPULATIONS

Thirty subjects with chronic hemiparesis and ability to walk with some help.

METHODS

Participants were randomized to a control group that underwent only PBWS treadmill training; or experimental I group with visual biofeedback from the display monitor, in the form of symbolic feet as the subject took a step; or experimental group II with auditory biofeedback associated display, using a metronome at 115% of the individual's preferred cadence. They trained for 20 minutes and were evaluated before and after training. Spatio-temporal and angular gait variables were obtained by kinematics from the Qualisys Motion Analysis system.

RESULTS

Increases in speed and stride length were observed for all groups over time (speed: F=25.63; P<0.001; stride length: F=27.18; P<0.001), as well as changes in hip and ankle range of motion - ROM (hip ROM: F=14.43; P=0.001; ankle ROM: F=4.76; P=0.038), with no time*groups interaction. Other spatio-temporal and angular parameters remain unchanged.

CONCLUSIONS

Visual biofeedback and auditory biofeedback had no influence on PBWS treadmill training of individuals with chronic hemiparesis, in short term. Additional studies are needed to determine whether, in long term, the biofeedback will promote additional benefit to the PBWS treadmill training.

CLINICAL REHABILITATION IMPACT

The findings of this study indicate that visual and auditory biofeedback does not bring immediate benefits on PBWS treadmill training of individuals with chronic hemiparesis. This suggest that, for additional benefits are achieved with biofeedback, effects should be investigated after long-term training, which may determine if some kind of biofeedback is superior to another to improve the hemiparetic gait.

Direct supplementation of diet is the most efficient way of enriching broiler meat with n-3 long-chain polyunsaturated fatty acids

1. Concentrations of beneficial omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) in poultry meat can be improved by increasing the concentration of n-3 PUFA in poultry diets. 2. A decrease in flavour quality is, however, usually associated with the dietary supplementation with n-3 PUFA, which is due to the susceptibility of PUFA to oxidation. 3. This experiment was conducted to study the effects of introducing two different n-3 fatty acid sources (extruded linseed and DHA Gold™, a proprietary algal product rich in docosahexaenoic acid), either separately or together, on broiler productive performance, and meat quality, oxidative stability, sensory traits and LC-PUFA profile. 4. Birds given the algal product displayed better productive performances than animals from other groups. 5. The data revealed an improvement in the fatty acid nutritional value of meat from birds receiving the algal product and an inefficient conversion of α-linolenic acid (LNA) into LC-PUFA. 6. Metabolisation of LNA in vivo is not sufficient to improve meat quality in n-3 LC-PUFA and direct supplementation of the diet with n-3 LC-PUFA is a better alternative to modulate an increase in beneficial fatty acids of broiler meat. 7. The overall acceptability of meat was negatively affected by the dietary supplementation with 7.4% of DHA, in contrast to the supplementation with 3.7% of DHA, which showed to be efficient in improving LC-PUFA meat content without affecting its sensory properties.

Influence of the structural features of commercial mannoproteins in white wine protein stabilization and chemical and sensory properties

The cloudy aspect formed in white wines due to protein instability is a visual defect. Sodium bentonite is the most commonly used fining agent to treat this instability, but has usually a negative impact on the wine's physicochemical and sensory characteristics. Aiming to find suitable alternatives, eleven commercial mannoproteins were chemically characterized concerning their sugar composition and protein content, and their effectiveness on wine protein stabilization. Also, their effect on the amount and nature of phenolic compounds, browning potential, chromatic and sensory characteristic was evaluated. Protein stabilization effectiveness was related to their chemical composition, namely their high mannose to glucose ratio. Additionally, some mannoproteins decreased the browning potential. Thus, mannoproteins could be an effective alternative for protein stabilization, preserving or even improving wine quality.

Levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain

The adverse health effects of airborne particles have been subjected to intense investigation in recent years; however, more studies on the chemical characterization of particles from pollution emissions are needed to (1) identify emission sources, (2) better understand the relative toxicity of particles, and (3) pinpoint more targeted emission control strategies and regulations. The main objective of this study was to assess the levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain. Instrumental and biomonitoring techniques were integrated and analytical methods for k0 instrumental neutron activation analysis and particle-induced x-ray emission were used to determine element content in aerosol filters and lichens. Results indicated that in general local industry contributed to the emissions of As, Sb, Cu, V, and Ni, which are associated with combustion processes. In addition, the steelwork emitted significant quantities of Fe and Mn and the cement factory was associated with Ca emissions. The spatial distribution of Zn and Al also indicated an important contribution of two industries located outside the studied area.

Asymptomatic bilateral elongated and mineralized stylohyoid complex: report of one case

The stylohyoid process is a cylindrical bony structure surrounded by important anatomical structures including vessels and nerves. Calcification and elongation of the stylohyoid ligament complex over 30 mm may be associated with neck and facial pain, known as Eagle's syndrome. However, a bilateral ossified and elongated stylohyoid complex may be devoid of symptoms. We report a 79-year-old symptom-free female who presented on a routine conventional dental radiographic exam an 80.96 mm pseudoarticulated stylohyoid complex in the left side and an 75.85 mm on the other. On CAT scan, both processes were calcified.

Effects of treadmill training with partial body weight support and the proprioceptive neuromuscular facilitation method on hemiparetic gait: a randomized controlled study

BACKGROUND

Gait disturbance is common after stroke; however, there is no consensus regarding the optimal therapeutic rehabilitation of hemiparetic gait.

AIM

To compare the effects of the treadmill training with partial body-weight support (TPBWS) and Proprioceptive Neuromuscular Facilitation (PNF) method on gait of subjects with chronic stroke.

DESIGN

Randomized clinical trial, comparing two experimental groups (comparative study).

SETTING

Laboratory for Human Movement Analysis of UFRN.

POPULATION

Twenty-three subjects, with a mean age of 56.7±8.0 years and a mean time since the onset of the stroke of 27.7±20.3 months, able to walk with personal assistance or assistive devices.

METHODS

Two experimental groups underwent gait training based on PNF method (N.=11) or using the TPBWS (N.=12), for twelve sessions. Evaluation of motor function (using the STREAM and motor FIM), and kinematic gait analysis were carried out before and after the interventions.

RESULTS

Increases in the STREAM scores (F=49.189, P<0.001) and in motor FIM scores (F=7.093, P=0.016), as well as improvement in symmetry ratio-swing time of the paretic leg/swing time of non-paretic leg--(F=7.729, P=0.012), were observed for both groups. Speed, stride length and double-support time showed no change after training. Differences between groups were observed only for the maximum ankle dorsiflexion over the swing phase (F=6.046, P=0.024), which showed an increase for the PNF group. Other angular parameters remain unchanged.

CONCLUSION

Improvement in motor function and in gait symmetry was observed for both groups, suggesting similarity of interventions. However, the sample size should be carefully considered in generalizing the results to other populations.

CLINICAL REHABILITATION IMPACT

The results showed some equivalence between these two approaches with regard to motor recovery, functionality and temporal symmetry of hemiparetic gait, suggesting that the cost-effectiveness of each treatment may have a important role in this choice.

Levels of endogenous β-glucanase activity in barley affect the efficacy of exogenous enzymes used to supplement barley-based diets for poultry

To improve the nutritive value of barley-based diet for broilers, 2 experiments using 2 different barley lots were performed to evaluate the capacity of a mesophilic cellulase when fused to a β-glucan specific family 11 carbohydrate-binding module. The data revealed that the recombinant β-glucanase derivatives were not appropriate for feed supplementation because of a lack of stability at acidic pH levels. However, under the same experimental conditions, a commercial enzyme mixture improved the nutritive value of 1 of the cereal lots used. Analysis of the nutritive value of the 2 barleys revealed intrinsic differences in the levels of endogenous β-glucanase activity. These differences were extensively evident when the studies were expanded to a range of 64 barley lots. Thus, to clarify the effect of endogenous cellulases on the efficacy of exogenous β-glucanases used to supplement barley-based diets for poultry, 2 barley lots presenting low and high levels of endogenous plant cell wall-degrading enzymes were selected. These lots were used to prepare 2 barley-based diets, which were supplemented with or without a commercial enzyme product and fed to broiler chicks. The data revealed that the exogenous enzymes were effective when the basal diet presented low levels of endogenous β-glucanases but were unable to improve the nutritive value of the barley lot displaying higher β-glucanase activity. Thus, these studies suggest that levels of endogenous β-glucanases may affect the efficacy of exogenous enzymes used to improve the nutritive value of barley-based diets for broilers. The development of a quick β-glucanase assay that could be applied for cereal-based feeds may help identify those barley-based diets that are more responsive to the action of feed enzymes.

Optimisation of a microwave pretreatment of wheat straw for methane production

This study aims at the optimisation of a microwave pretreatment for wheat straw solubilisation and anaerobic biodegradability. The maximum yield of methane production was obtained at 150°C with an improvement of 28% compared to an untreated sample. In addition, at this temperature, the time to reach 80% of the methane volume obtained from untreated straw was about 35%. The study of ramp time and holding time at targeted temperature showed that they had no improvement effect. Thus, the best conditions are the highest heating rate for a final temperature 150°C without any holding time. The reading of energy consumed by pretreatment and energy overproduced by pretreated samples showed that increasing tVS amount and heating rate led to a saving of energy consumption. Nevertheless, to obtain a positive energy balance, a microwave device should consume less than 2.65 kJ/g(tVS).