Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis

Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: −0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: −0.43, 95% CI = −0.79 to −0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.

Myocardial fibrosis reversion via rhACE2-electrospun fibrous patch for ventricular remodeling prevention

Myocardial fibrosis and ventricular remodeling were the key pathology factors causing undesirable consequence after myocardial infarction. However, an efficient therapeutic method remains unclear, partly due to difficulty in continuously preventing neurohormonal overactivation and potential disadvantages of cell therapy for clinical practice. In this study, a rhACE2-electrospun fibrous patch with sustained releasing of rhACE2 to shape an induction transformation niche in situ was introduced, through micro-sol electrospinning technologies. A durable releasing pattern of rhACE2 encapsulated in hyaluronic acid (HA)—poly(L-lactic acid) (PLLA) core-shell structure was observed. By multiple in vitro studies, the rhACE2 patch demonstrated effectiveness in reducing cardiomyocytes apoptosis under hypoxia stress and inhibiting cardiac fibroblasts proliferation, which gave evidence for its in vivo efficacy. For striking mice myocardial infarction experiments, a successful prevention of adverse ventricular remodeling has been demonstrated, reflecting by improved ejection fraction, normal ventricle structure and less fibrosis. The rhACE2 patch niche showed clear superiority in long term function and structure preservation after ischemia compared with intramyocardial injection. Thus, the micro-sol electrospun rhACE2 fibrous patch niche was proved to be efficient, cost-effective and easy-to-use in preventing ventricular adverse remodeling.

The mechanics of sawing granite with diamond wire

Today, wire sawing of natural stone is undergoing widespread commercialization. In addition to rock extraction and processing with single wires, composed of a multitude of diamond-impregnated beads mounted onto a steel rope, this technology is increasingly used for slabbing of granite blocks on multi-wire machines. Evolving sophistication of stone sawing equipment dictates novel tool designs and formulations. For technologists specifying bead compositions, it is a common habit to instinctively follow the circular saw segment design guidelines. A poor tool performance is often an undesirable consequence of such an approach. To meet that challenge, theoretical models of sawing granite by means of a diamond wire saw and a diamond circular saw have been presented and contrasted with respect to diamond loading conditions. The analytical treatments are supported by scarcely available industrial quantitative assessments and qualitative observations. The evaluation of cutting forces and the identification of system characteristics affecting wire vibration and wire rotation are instrumental in both machine design and tool formulation. For practitioners working with granite, the provided knowledge is also essential to diagnose and prevent problems inherent in wire sawing, such as the high incidence of wire breakage, unsatisfactory tool life and cutting capability and eccentric bead wear. Graphical abstract

ANALYSIS OF THE INFLUENCE OF TOOL ELECTRODE WEAR ON SURFACE QUALITY IN DIE-SINKING EDM TECHNOLOGY

During the electro-erosive process, metal particles are gradually removed not only from the machined material but also from the tool electrode. Here, the removal of material from the tool electrode is generally considered to be an undesirable consequence of the electro-erosive process. The extent of this wear can be relatively accurately quantified using several indicators. Of these, the percentage of loss of the working part of the tool electrode has the highest informative value. The resulting quality of the eroded area after die-sinking EDM also depends on the magnitude of the given parameter. Therefore, based on experimental measurements, the paper aimed to describe the performed analysis of the influence of the wear of the shaped tool electrode on the quality of the machined surface after die-sinking EDM in terms of surface roughness parameters. The wear of the shape tool electrode in terms of volume loss was measured by the indirect method through weight loss. Experimental results showed that when machining tool steel with a finishing operation, a much lower wear rate of the shape tool electrode was recorded compared to the roughing operation. At the same time, it was found that when the shape tool electrode wear exceeds the level of about 8%, there is a significant deterioration of all qualitative indicators of the machined surface.

Generalised Predictions of Particle-Vane Retention Probability in Gas Turbine Engines

The ingestion of airborne particulate into aircraft engines is an undesirable consequence of their operations, particularly in and out of arid locations which leads to reduced time between overhaul. Predicting the maintenance burden in environments rich in airborne particulate is made difficult by the large number of parameters which influence the likelihood of retention of the particles on nozzle guide vanes. In this contribution we propose a new, reduced-order model which can predict the probability of particle retention as a function of a reduced set of independent variables relating to both the carrier gas flow and particle. Two-dimensional CFD simulations of particle deposition are performed on the General Electric E3 nozzle guide vane using the existing, energy-based EBFOG particle deposition model. Results from the model are compared with experimental observations of particle deposition and show good agreement with the mass fraction retained by a vane. We introduce a function which allows the probability of retention to be calculated for a range of engine operating states and architectures by defining a new dimensionless parameter, the generalised thermal Stokes number. This parameter normalises the thermal response of a particle for all gas and particle softening temperatures allowing the retention probability function to be applied universally. Finally, we demonstrate a practical use of this model by showing its use in calculating the accumulation factor for a particle size distribution.

The brain in motion: How ensemble fluidity drives memory-updating and flexibility

While memories are often thought of as flashbacks to a previous experience, they do not simply conserve veridical representations of the past but must continually integrate new information to ensure survival in dynamic environments. Therefore, ‘drift’ in neural firing patterns, typically construed as disruptive ‘instability’ or an undesirable consequence of noise, may actually be useful for updating memories. In our view, continual modifications in memory representations reconcile classical theories of stable memory traces with neural drift. Here we review how memory representations are updated through dynamic recruitment of neuronal ensembles on the basis of excitability and functional connectivity at the time of learning. Overall, we emphasize the importance of considering memories not as static entities, but instead as flexible network states that reactivate and evolve across time and experience.

Protector: A Permanent Fault Resilient Router Architecture for Network on Chip

The decreasing size of the transistor has increased the vulnerability towards faults. Increasing number of cores on a single chip has made the concept of Network on Chip (NoC) a standard communication backbone among cores. This facility comes with vulnerability of faults in the system due to decreasing size of transistors. A permanent fault in the network leads to undesirable consequence such as permanent blocking of flits or failure of the whole router. Preserving the router in the operational state has a significant impact on the reliability of the system. Permanent fault in buffers and pipeline stages of the router has a high impact on performance. The proposed router architecture Protector provides faults protection to both buffers and pipelines stages by exploiting the concepts of borrowing from other resources, using bypass paths and by creating multiple paths to reach output. The proposed router incurred an area overhead of 30% as compared to the baseline design. Reliability analysis using Silicon Protection Factor indicates that the proposed router has better fault tolerance efficiency as compared to state of the art. Latency analysis using PARSEC and SPLASH-2 benchmarks indicates proposed router incurs 13% and 16% latency overhead in the presence of faults.

Smart Bearing Sensor

The recent increase in vessel shaftline bearing incidents indicates that a static shaft alignment design may not be suitable for all operational shaftline loading conditions. Hull deflections caused by vessel loading or propeller loads initiated by interaction with the wakefield have become important considerations in modern vessel design. Jack-up tests, typically used as a bearing load verification method, can only be accomplished under static shaft conditions and cannot verify the shaft dynamic behavior under running operational conditions. A newly developed sensor using strain gauge technology measures the bearing load and the shaft misalignment angle through the bearing housing's deformation-induced strain. It effectively converts the bearing housing into a weighing machine by mapping the bearing housing strain onto the bearing load. Unlike jack-up tests, this method allows for the continuous measurement of the bearing load and misalignment angle under all shaftline operational conditions. It is envisaged that this technologically simple system will allow for the earliest possible diagnosis of shaft alignment-related problems, such as bearing unloading, bearing overloading, or excessive shaft-bearing misalignment. This provides a much earlier warning indicator when compared with the bearing temperature alarm. The subject technology has been tested on intermediate bearings and is considered for future application into stern tube bearings. 1. Introduction In post-IMO's (International Maritime Organization) Energy Efficiency Design Index vessel designs, the propulsion shafting arrangements become increasingly sensitive to shaft alignment with lower tolerances and margins, increasing the risk of stern tube bearing failures (Leontopoulos 2016a). This change is due to the wider use of more efficient, larger diameter propellers with increased cantilevered load on the shafting system and shorter shaftlines as a result of maximizing cargo space and minimizing engine room length. Widespread application of the single stern tube bearing design (an arrangement without a forward stern tube bearing) has also highlighted a decreased tolerance to eccentric propeller thrust and propeller forces in general. Reduced tolerance to shaft alignment sighting errors, bearing offset inaccuracies and other shaft installation errors, also affects the integrity of the shafting system and can result in complete bearing wiping with the consequence of vessel propulsion immobilization. This undesirable consequence has increased, particularly during the years 2013–2017.

Fitness to drive in seizure and epilepsy: A protocol for Iranian clinicians

Driving restriction is a well-known undesirable consequence of epilepsy and causes significant problems regarding independence and employment for epileptic patients. Many countries all over the world have provided comprehensive protocols in this regard with the aim of providing the possibility of less restricted, but safe driving for epileptic patients and also providing the opportunity for uniform decision-making for clinicians. However, the available fitness to drive protocol in Iran still lacks sufficient details and clinicians might encounter serious problems in terms of the driving issue in epileptic patients. In order to provide a uniform protocol containing adequate practical data, a systematic review of literature addressing guidelines about driving and epilepsy and driving laws of different countries for epileptic patients was performed and, after consideration of cultural issues, a practical protocol for Iranian neurologists was suggested. Introduction The negative impact of seizures on the quality of life (QOL) of epileptic patients has been acknowledged. Seizures particularly influence the social aspects of life including work, driving, interpersonal relations, and education.1-10 One of the most restricting factors of epilepsy is prohibition of driving that might have adverse effects on QOL, independence, and working capabilities.11-15 The main rationale behind limited rules for driving in epileptic patients is obviously the risk of occurrence of seizure during driving that might lead to significant injuries in patients and others. The first traffic accident due to a seizure has been reported in 1906,16 and for a few decades after that, a permanent driving ban law was enforced for all epileptic patients.17 Gradually, with the initiation of diagnostic advances and more common use of first antiepileptic drugs (AEDs), the conditional driving license in certain circumstances was allowed and some countries started to provide a comprehensive protocol to cover different types of seizures with the aim of providing the

Are ultra-diffuse galaxies Milky Way-sized?

Now almost 70 years since its introduction, the effective or half-light radius has become a very popular choice for characterising galaxy size. However, the effective radius measures the concentration of light within galaxies and thus does not capture our intuitive definition of size which is related to the edge or boundary of objects. For this reason, we aim to demonstrate the undesirable consequence of using the effective radius to draw conclusions about the nature of faint ultra-diffuse galaxies (UDGs) when compared to dwarfs and Milky Way-like galaxies. Instead of the effective radius, we use a measure of galaxy size based on the location of the gas density threshold required for star formation. Compared to the effective radius, this physically motivated definition places the sizes much closer to the boundary of a galaxy. Therefore, considering the sizes and stellar mass density profiles of UDGs and regular dwarfs, we find that the UDGs have sizes that are within the size range of dwarfs. We also show that currently known UDGs do not have sizes comparable to Milky Way-like objects. We find that, on average, UDGs are ten times smaller in extension than Milky Way-like galaxies. These results show that the use of size estimators sensitive to the concentration of light can lead to misleading results.