Spontaneous electromyographic activity of the tongue in amyotrophic lateral sclerosis

Introduction: Detection of denervation in muscles in the craniobulbar area is important to assure widespread lower motor neuron involvement in the diagnosis of amyotrophic lateral sclerosis (ALS). The value of spontaneous activity analysis in needle electromyography (EMG) of the tongue has been questioned in the recent literature. Methods: Spontaneous activity in the tongue and sternocleidomastoid (SCM) muscles was reviewed retrospectively in 17 ALS patients. Results: Needle EMG showed spontaneous activity in the tongue in 14 of 17 patients (82%) and in 6 patients of 17 (35%) in SCM. Spontaneous EMG activity in the tongue was found in patients with and without bulbar symptoms. Conclusions: Needle EMG is a valuable method for assessing clinical and subclinical involvement of the tongue in patients with bulbar and limb onset ALS. Adequate relaxation of the tongue is a prerequisite for proper spontaneous activity recording. Muscle Nerve, 48: 296–298, 2013     

“It’s both a strength and a drawback.” How therapists’ personal qualities are experienced in their professional work

ABSTRACT

Objective: The aim of this study was to gain knowledge about how the integration of personal and professional experiences affects therapeutic work. Method: Therapists (N?=?14) who had been recommended by their leaders at their individual workplaces were interviewed twice with semi-structured qualitative interviews, which were then subjected to thematic and Interpretative Phenomenological Analysis. Results: All the therapists in the sample described their personal qualities as an experienced tension between their personal strengths and vulnerabilities in the therapeutic setting. This tension came to expression through four subordinate themes: (a) The tension between perceiving oneself as a helper while dealing with one’s own needs for attention and care; (b) The tension between the ability for embodied listening to the patient while tuning into oneself; (c) The tension between staying present while handling aggression and rejection from clients; and (d) The tension in striving for a constructive balance between closeness and distance. Conclusion: The results point to ways in which the personal selves of the therapists may affect their professional role performance. Drawing upon previous research and literature on the topic, the paper discusses how therapists’ personal qualities are experienced as affecting their work and suggests several implications for psychotherapy training and practice.     

The association between physical fitness level and number and severity of injury and illness in youth elite athletes

Youth elite athletes often double their training and competition load after enrollment into specialized sport academy high school programs. The least fit athletes may be exposed to an excessive and too rapid increase in training load, with negative adaptations such as injury and illness as a consequence. In this study, our aim was to determine whether these least fit athletes were at greater risk of injury or illness during their first school year. Participants were 166 youth elite athletes (72% boys) from a variety of team, technical, and endurance sports newly enrolled into specialized sport academy high schools. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to self‐report injuries and illnesses weekly for 26 weeks. Athletes completed the Ironman Jr physical fitness test battery at baseline, evaluating endurance, strength, agility, and speed properties. We ranked the athletes based on their combined test scores and identified the least fit quartile. The main outcome was the number and severity of health problems, comparing the least fit quartile of athletes to the rest of the cohort. Overall, the least fit quartile of athletes did not report more health problems (mean 3.7, 95% CI 3.0‐4.4) compared with the rest of the cohort (3.6, 3.2‐3.9). In conclusion, we demonstrated no association between low physical fitness level and number and severity of injury and illness in youth elite athletes after enrollment into a specialized sport academy high school program.     

Sensor-based gait analyses of the six-minute walk test identify qualitative improvement in gait parameters of people with multiple sclerosis after rehabilitation

Journal of Neurology - The aim of this work was to determine whether wearable inertial measurement units (IMUs) could detect gait improvements across different disability groups of people with...     

A model for an uncertainty budget for preanalytical variables in clinical chemistry analyses

BACKGROUND: We sought a practical method to calculate preanalytical uncertainties. In clinical chemistry measurements, the combined preanalytical uncertainty is a function of the magnitude and probability distribution of the different uncertainty sources and the number of such sources. METHODS: Results from an optimal practice for handling of the blood samples (termed the standard method) were compared with alternative methods that deviate from the standard method but are used in current practice. For categorically distributed uncertainty sources (e.g., use of different kinds of blood tubes), alternative treatments were modeled discretely using a known probability distribution for each alternative. For continuously distributed sources (e.g., clotting time), we assumed a rectangular distribution. We calculated the expectation, variance, and SD of differences between results from current practice and the standard method. We tabulated uncertainty budgets for the differences between current practice and the standard method for each uncertainty source. The expected individual biases and variances were summed to obtain the combined expected bias and variance. RESULTS: The combined expected bias (SD) for glucose was -0.15 (0.130) mmol/L, with prolonged clotting time giving the greatest contribution. The combined expected bias (SD) for calcium was -0.011 (0.0182) mmol/L, for magnesium 0.006 (0.026) mmol/L, and for creatinine 0.5 (1.81) micromol/L. CONCLUSION: By comparing a standard method for preanalytical sample handling to alternative methods used in current practice, and considering the distribution of alternative methods, our modeling approach allows the development of an uncertainty budget for preanalytical variables in clinical chemistry analyses.     

Blick in und Wünsche für die Zukunft der Unfallchirurgie

Die Unfallchirurgie -     

Intraoperative fluid balance during cardiopulmonary bypass: effects of different mean arterial pressures

INTRODUCTION: This study investigated whether two levels of mean arterial pressure (MAP) during cardiopulmonary bypass did influence per-operative fluid shifts. METHODS: Sixteen pigs underwent 60 minutes of normothermic cardiopulmonary bypass (CPB) followed by 90 minutes of hypothermic CPB. Eight animals had a MAP of 60-80mmHg by norepinephrine (HP group). Another 8 animals had a MAP of 40-45 mmHg by phentolamine (LP group). Blood chemistry, plasma/interstitial colloid osmotic pressures, plasma volume, fluid balance, fluid extravasation rate and tissue water content were measured or calculated. RESULTS: The plasma volume was significantly lower in the HP group compared with the LP group after 60 minutes of CPB. Net fluid balance was 0.18 (0.05) ml x kg(-1) x min(-1) in the HP group and 0.21 ml x kg(-1) x min(-1) in the LP group (P > 0.05) while fluid extravasation rate was 1.18 (0.5) and 1.13 (0.4) ml x kg(-1) x min(-1) in the HP group and the LP group during CPB (P > 0.05). CONCLUSION: Net fluid balance and fluid extravasation rate were similar in the animals with elevated and with lowered MAP during CPB.     

Distinct Subsets of Noncoding RNAs Are Strongly Associated With BMD and Fracture,Studied in Weight-Bearing and Non–Weight-Bearing Human Bone

We investigated mechanisms resulting in low bone mineral density (BMD) and susceptibility to fracture by comparing noncoding RNAs (ncRNAs) in biopsies of non–weight-bearing (NWB) iliac (n = 84) and weight bearing (WB) femoral (n = 18) postmenopausal bone across BMDs varying from normal (T-score > −1.0) to osteoporotic (T-score ≤ −2.5). Global bone ncRNA concentrations were determined by PCR and microchip analyses. Association with BMD or fracture, adjusted by age and body mass index, were calculated using linear and logistic regression and least absolute shrinkage and selection operator (Lasso) analysis. At 10% false discovery rate (FDR), 75 iliac bone ncRNAs and 94 femoral bone ncRNAs were associated with total hip BMD. Eight of the ncRNAs were common for the two sites, but five of them (miR-484, miR-328-3p, miR-27a-5p, miR-28-3p, and miR-409-3p) correlated positively to BMD in femoral bone, but negatively in iliac bone. Of predicted pathways recognized in bone metabolism, ECM-receptor interaction and proteoglycans in cancer emerged at both sites, whereas fatty acid metabolism and focal adhesion were only identified in iliac bone. Lasso analysis and cross-validations identified sets of nine bone ncRNAs correlating strongly with adjusted total hip BMD in both femoral and iliac bone. Twenty-eight iliac ncRNAs were associated with risk of fracture (FDR < 0.1). The small nucleolar RNAs, RNU44 and RNU48, have a function in stabilization of ribosomal RNAs (rRNAs), and their association with fracture and BMD suggest that aberrant processing of rRNAs may be involved in development of osteoporosis. Cis-eQTL (expressed quantitative trait loci) analysis of the iliac bone biopsies identified two loci associated with microRNAs (miRNAs), one previously identified in a heel-BMD genomewide association study (GWAS). In this comprehensive investigation of the skeletal genetic background in postmenopausal women, we identified functional bone ncRNAs associated to fracture and BMD, representing distinct subsets in WB and NWB skeletal sites. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.