Improvement of Gait in Patients with Stroke Using Rhythmic Sensory Stimulation: A Case-Control Study

Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI).

Impacts of COVID-19 on the Catch of Small-Scale Fishers and Their Families Due to Restriction Policies in Davao Gulf, Philippines

COVID-19 was declared a global pandemic by the World Health Organization in 2020 with countries putting up several measures to mitigate and flatten the curve of hospitalizations and death from travel bans to home confinements and local lockdowns. This pandemic created health and economic crises, leading to increased incidence of poverty and food crisis especially on both agriculture and the fisheries in many developing nations including the Philippines. The specific objectives of this study were to assess the impact of COVID-19 restrictions on the catch per unit effort (CPUE) of small-scale fishers and to determine what factors could influence the volume of their catch during this time of pandemic. Moreover, this also investigated the impact of COVID-19 restrictions to fishers and their families. To do that we surveyed N = 200 small-scale fishers around the Davao gulf using semi-structured questionnaire and inquired on the impact of the COVID-19 to their fishing operation, catch, fishing costs, and their families. The collected socioeconomic variables, including emotional responses to the pandemic were then related to the CPUE and the volume of catch. The results show that fishers were highly affected by the pandemic due to the lockdown policy imposed in the fishing villages during the earlier phases of restrictions by the government. Fishers were affected in terms of the volume of their catch, also fishing costs, and emotionally as they were also frustrated due to the impacts of the hard lockdown. The restricted fishing access was found to have important and major set-back on the fishing operations of fishers and the same was experienced also by the middlemen given the low fish price and reduced mobility of the fish traders. COVID-19 also impacted the fishers, and their families through lack of mobility, food inadequacy, travel restrictions and their children’s education.

Mobility Patterns and Mode Choice Preferences during the COVID-19 Situation

The empirical research on the COVID-19 epidemic’s consequences suggests a major drop in human mobility and a significant shift in travel patterns across all forms of transportation. We can observe a shift from public transport and an increase in car use, and in some cases also increase of cycling and (less often) walking. Furthermore, it seems that micromobility and, more generally, environmentally friendly and comanaged mobility (including shared services), are gaining ground. In previous research, much attention was paid to the mode choice preferences during lockdown, or early stages of the SARS-CoV-2 situation. The blind spot, and aim of this work, is how long observed changes in mode choice last and when or if we can expect the mode choice to shift back to the situation before the SARS-CoV-2 episodes. The research sample consisted of 636 cases; in total, 10 countries contributed to the sample examined in this study. The data were collected in two phases: the first in the spring of 2020 and the second in the fall of the same year. Results showed that respondents reduced mobility by car, local public transport and walking, but not bicycling during the lockdown, compared to the time before the pandemic started. When the easing came, respondents assessed their own use of the car and walking as almost back to normal. They also reported an increase in the use of public transport, but not reaching the level prior the pandemic by far. It seems that cycling was affected least by the pandemic; use of a bicycle hardly changed at all. As for the implication of our study, it is evident that special attention and actions will be needed to bring citizens back to public transport, as it seems that the impact of the pandemic on public transport use will last much longer than the pandemic itself.

The Amazon River plume, a barrier to animal dispersal in the Western Tropical Atlantic

The dispersal of marine organisms can be restricted by a set of isolation mechanisms including hard barriers or hydrological features. In the Western Atlantic Ocean, the Amazon River discharge has been shown to act as a biogeographical barrier responsible for the differences in reef fish communities between Caribbean Sea and Northeast Brazil continental shelves. Here, we compare the diversity of all Animalia phyla from biogeographic ecoregions along the Tropical Western Atlantic continental shelf to test the hypothesis that the Amazon River plume spatially structures species diversity. For that, we used beta diversity estimators and multivariate ecological analysis on a database of species occurrence of the whole animal kingdom including 175,477 occurrences of 8,375 species from six ecoregions along the Western Tropical Atlantic. Results of the whole animal kingdom and the richest phyla showed that the Caribbean Sea and Tropical Brazil ecoregions are isolated by the Amazon River Plume, broadening and confirming the hypothesis that it acts as a soft barrier to animal dispersal in the Western Tropical Atlantic. Species sharing is larger northwestwards, in direction of the Caribbean than the opposite direction. Beyond species isolation due to local characteristics such as low salinity and high turbidity, our results suggest the dominant northwestward currents probably play a major role in animal dispersion: it enhances the flux of larvae and other planktonic organisms with reduced mobility from Brazil to Caribbean and hinders their contrary movement. Thus, the Amazon area is a strong barrier for taxa with reduced dispersal capacity, while species of pelagic taxa with active swimming may transpose it more easily.

Deep Venous Thrombosis (DVT) risk assessment on routine hemodialysis patient using Padua prediction score

Introduction: Hemodialysis requires invasive vascular access (VA) procedure which could emerge deep venous thrombosis (DVT) complication. Apart from VA, other risk factors, either modifiable or unmodifiable, could increase DVT risk. Those factors can be assessed by Padua Prediction Score (PPS). This study aims to assess which risk factors in PPS increase the risk of developing DVT in routine hemodialysis patients at BHCC main clinic. Methods: This research is a descriptive observational study with simple random sampling. The participants were 58 routine hemodialysis patients in BHCC. The inclusion criteria of this study were the ages above 17 years old, had history hemodialysis more than one, the patient willing to become of the sample subject. The patient that incompletely fulfills the questionnaire were already treated with anticoagulation were admitted for VTE, and had a history of discontinuing hemodialysis were excluded. The data were gathered using a questionnaire according to PPS. The data was analyzed by using SPP 25.0. The descriptive data was provided in a table and pie chart. Results: Based on the results of the PPS, 11 patients (18.96%) were among the high risk, and 47 patients (81.04%) were at low risk. The most potent risk factor in increasing the risk of DVT is reduced mobility with a risk priority number (RPN) of 30 (severity=3, occurrence=10). Recent (≤one month) trauma and surgery entail on second with an RPN of 24 (severity=2, occurrence=12). The third is occupied by heart and/or respiratory failure with a RPN of 14 (severity=1, occurrence=14). Previous VTE history with a RPN of 12 (severity=3, occurrence=4) placed fourth, followed by age≥ 70 (RPN=8, severity=1, occurrence=8) and obesity (BMI>= 30) with a RPN of 4 (severity=1, occurrence=4) at fifth and sixth respectively. Conclusion: "Reduced mobility" is the most prominent risk factor to increase DVT risk in routine hemodialysis patients, followed by other risk factors. Reduced mobility and obesity are modifiable risk factors that should be eliminated by educating routine hemodialysis patients.

Product design for people with Rheumatoid Arthritis and its relationship with stakeholder’s expectations

Approximately 6.2% of the Brazilian population has some disability, from which 1.3% declare to have some physical disability. Rheumatoid Arthritis (RA) is a systemic and autoimmune disease that affects about 0.4% to 1.3% of the world population, being more common in women. In advanced stages, the disease can cause severe impairment in small joints, limiting individuals' movements and impairing their independence and autonomy. Assistive Technology (AT) aims to promote actions that enable People with Disabilities or Reduced Mobility to execute their daily activities in the most normal and independent manner possible. However, studies show high rates of abandonment of AT devices for reasons generally related to the effectiveness of the product itself. Thus, this study aims to carry out data collection, organization, and analysis to understand the expectations of stakeholders about the development of new AT devices for individuals with RA. For this, the technical research procedures were segmented as follows: Phase 1 – Theoretical Foundation; Phase 2 – Selection of Target Audience and Sampling; Phase 3 – Data Survey; and Phase 4 – Data Organization and Analysis. Through the procedures adopted, it was possible to verify that there are significant differences between the expectations of stakeholders concerning the development of new AT products for individuals with RA, which can directly imply user satisfaction, consequently generating the abandonment of these devices if they do not meet the expectations.

Multilevel percutaneous vertebroplasty: safety, efficacy and long-term outcomes

<p><strong>Background:</strong> The pain in vertebral compression fractures is severe, leading to reduced mobility and quality of life. Percutaneous vertebroplasty is a minimally invasive procedure for treating various spinal pathologies. This study evaluated the usefulness and safety of multilevel PVP (two to three vertebrae) in managing VCF.</p><p><strong>Methods:</strong> This retrospective study evaluated 59 vertebral levels in 28 patients with VCF who had been operated on for multilevel PVP (two to three levels). There were 22 females and six males, and their ages ranged from 36 to 79 years, with a mean age of 68.95 years. We had injected two levels in 25 patients and three levels in 3 patients. The visual analogue scale was used for pain intensity measurement, and plain X-ray films, computed tomography scan and magnetic resonance imaging was used for radiological assessment. The mean follow-up period was 13.8 months (range, 11-19).</p><p><strong>Results:</strong> Significant pain improvement was recorded in 26 patients (92.85%). More remarkable improvement in pain was noticed in the immediate postoperative period than in the subsequent follow-ups. Asymptomatic bone cement leakage anteriorly and into the disk spaces in two patients. Isolated anterior leakage has occurred in one patient. There was no encounter of pulmonary embolism.</p><p><strong>Conclusions:</strong> Multilevel PVP for the treatment of VCF is a safe and effective procedure that can significantly reduce pain and improve patient condition without any significant morbidity. It is considered a cost-effective procedure allowing a rapid restoration of patient mobility.</p><p> </p>

Functional Verification of Novel ELMO1 Variants by Live Imaging in Zebrafish

ELMO1 (Engulfment and Cell Motility1) is a gene involved in regulating cell motility through the ELMO1-DOCK2-RAC complex. Contrary to DOCK2 (Dedicator of Cytokinesis 2) deficiency, which has been reported to be associated with immunodeficiency diseases, variants of ELMO1 have been associated with autoimmune diseases, such as diabetes and rheumatoid arthritis (RA). To explore the function of ELMO1 in immune cells and to verify the functions of novel ELMO1 variants in vivo, we established a zebrafish elmo1 mutant model. Live imaging revealed that, similar to mammals, the motility of neutrophils and T-cells was largely attenuated in zebrafish mutants. Consequently, the response of neutrophils to injury or bacterial infection was significantly reduced in the mutants. Furthermore, the reduced mobility of neutrophils could be rescued by the expression of constitutively activated Rac proteins, suggesting that zebrafish elmo1 mutant functions via a conserved mechanism. With this mutant, three novel human ELMO1 variants were transiently and specifically expressed in zebrafish neutrophils. Two variants, p.E90K (c.268G&gt;A) and p.D194G (c.581A&gt;G), could efficiently recover the motility defect of neutrophils in the elmo1 mutant; however, the p.R354X (c.1060C&gt;T) variant failed to rescue the mutant. Based on those results, we identified that zebrafish elmo1 plays conserved roles in cell motility, similar to higher vertebrates. Using the transient-expression assay, zebrafish elmo1 mutants could serve as an effective model for human variant verification in vivo.

Investigation of the Combined Effects of Rising Temperature and Pesticide Contamination on the Swimming Behaviour of Alpine Chironomids

Some pollutants can be transported through the atmosphere and travel medium–long distances to be deposited in glaciers at high altitude and latitude. The increase in the rate of glacier melting due to global warming can release these pollutants in alpine streams. This study investigated the combined effects of rising temperatures and chlorpyrifos (CPF) contamination on the swimming behaviour of alpine chironomids collected in a shrinking alpine glacier. We assessed the individual and interaction effects of rising temperatures (2–11 °C) and CPF concentrations (0–110 ng L−1) on the swimming behaviour of Diamesa zernyi (Chironomidae) larvae. Distance (mm) and speed (mm s−1) were recorded using a video-tracking system after 24–72 h of treatment. The two stressors caused different effects on distance and speed, with increasing temperature generally causing hyperactivity and CPF from hyperactivity to reduced mobility. Two interactions were detected between stressors when combined: (i) CPF superimposed the effect of temperature on both behavioural endpoints i.e., with 110 ng L−1 of CPF, at 11 °C, larvae moved less; (ii) warming (11 °C) magnified the negative effect of CPF: the smallest distance and slowest speed were recorded at the highest values of the two stressors after 72 h. Our results suggest that water contamination by CPF, even at sub-lethal concentrations, might increase the sensitivity of chironomids to warming, and vice versa, raising concerns about freshwater biodiversity conservation under climate change.