Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: a randomized controlled trial.

STUDY DESIGN: Randomized parallel group comparative trial with a 1-year follow-up period. OBJECTIVE: To compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up. SUMMARY OF BACKGROUND DATA: Controlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration. METHODS: A total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847). RESULTS: In both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group. CONCLUSION: Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs

Harvesting Electricity with Geobacter bremensis Isolated from Compost

Electrochemically active (EA) biofilms were formed on metallic dimensionally stable anode-type electrode (DSA), embedded in garden compost and polarized at +0.50 V/SCE. Analysis of 16S rRNA gene libraries revealed that biofilms were heavily enriched in Deltaproteobacteria in comparison to control biofilms formed on non-polarized electrodes, which were preferentially composed of Gammaproteobacteria and Firmicutes. Among Deltaproteobacteria, sequences affiliated with Pelobacter and Geobacter genera were identified. A bacterial consortium was cultivated, in which 25 isolates were identified as Geobacter bremensis. Pure cultures of 4 different G. bremensis isolates gave higher current densities (1400 mA/m2 on DSA, 2490 mA/m2 on graphite) than the original multi-species biofilms (in average 300 mA/m2 on DSA) and the G. bremensis DSM type strain (100–300 A/m2 on DSA; 2485 mA/m2 on graphite). FISH analysis confirmed that G. bremensis represented a minor fraction in the original EA biofilm, in which species related to Pelobacter genus were predominant. The Pelobacter type strain did not show EA capacity, which can explain the lower performance of the multi-species biofilms. These results stressed the great interest of extracting and culturing pure EA strains from wild EA biofilms to improve the current density provided by microbial anodes

Photometric stereo endoscopy

While color video endoscopy has enabled wide-field examination of the gastrointestinal tract, it often misses or incorrectly classifies lesions. Many of these missed lesions exhibit characteristic three-dimensional surface topographies. An endoscopic system that adds topographical measurements to conventional color imagery could therefore increase lesion detection and improve classification accuracy. We introduce photometric stereo endoscopy (PSE), a technique which allows high spatial frequency components of surface topography to be acquired simultaneously with conventional two-dimensional color imagery. We implement this technique in an endoscopic form factor and demonstrate that it can acquire the topography of small features with complex geometries and heterogeneous optical properties. PSE imaging of ex vivo human gastrointestinal tissue shows that surface topography measurements enable differentiation of abnormal shapes from surrounding normal tissue. Together, these results confirm that the topographical measurements can be obtained with relatively simple hardware in an endoscopic form factor, and suggest the potential of PSE to improve lesion detection and classification in gastrointestinal imaging.This work has been financially supported by the Comunidad de Madrid through the Madrid-MIT M+Visión Consortium

Desarrollo de lista corta para la evaluación del desempeño en alimentación-deglución en niños entre 1 y 5 años de edad con parálisis cerebral

Tesis (Fonoaudiólogo)La alimentación dentro de nuestra sociedad cumple un rol importante, ya sea, dentro de la dinámica familiar así como en las relaciones sociales, ya que, la comida genera momentos de diálogo y encuentro, es por esta razón, que es fundamental buscar la integración y un manejo adecuado durante el proceso de alimentación. Sin embargo, los niños con parálisis cerebral presentan numerosas dificultades frente a este proceso, por lo tanto, lo principal es no aislar al menor durante estas situaciones, sino que se debe manejar el contexto de manera óptima donde sea placentero para el niño, el cuidador y su entorno y de esta forma mejorar su calidad de vida. La investigación expuesta a continuación tiene dos propósitos, el primero es contar con un instrumento que permita valorar el desempeño de alimentación - deglución en niños con Parálisis Cerebral entre 1 y 5 años y el segundo, es lograr crear perfiles cualitativos, basándose en la Clasificación Internacional del Funcionamiento y la Discapacidad (CIF), esta permite integrar los componentes de actividad y participación, los cuales son fundamentales para los terapeutas que se desenvuelve en el área de la rehabilitación, esperando que los niños con Parálisis Cerebral obtengan mayor funcionalidad e integración en la sociedad. Es necesario tener en cuenta que en este estudio, los menores no presentan autonomía durante el acto de alimentación y esto genera un grado de dependencia de un tercero, es por esto que el fonoaudiólogo cumple un rol importante en la rehabilitación de la alimentación- deglución, siendo necesario conocer los factores en función de la CIF que influyen durante la alimentación, para así encasillar el rendimiento del menor durante la alimentación y conocer sus fortalezas, potenciandolas al máximo y compensando las debilidades. Por lo tanto, el objetivo de esta tesis es diseñar una lista corta para la evaluación del desempeño en la alimentación en el rango etario mencionado anteriormente, para caracterizar el desempeño del evaluado y crear perfiles cualitativos que guíen la futura intervención. Además, de poder comparar cuantitativamente el desempeño según las siguientes variables: tipo de parálisis cerebral, vía de alimentación y consistencias de los alimentos. Sin embargo, debido al corto tiempo asignado para esta investigación, la tesis abordará el primer propósito que consiste en la creación del instrumento. Por lo tanto, la base de este estudio es dar a conocer los procedimientos y análisis de la creación de este. Por consiguiente, se deja abierta la posibilidad de continuar con esta investigación para finalizar el segundo propósito. Los dejamos invitados a revisar esta investigación, ya que como terapeutas es de vital importancia conocer anticipadamente el desarrollo de la evolución de la alimentación en los niños con distintos tipos de PC y así poder abordar la intervención de manera más integral

Cryo-XPS for Surface Characterization of Nanomedicines

Nanoparticles used for medical applications commonly possess coatings or surface functionalities intended to provide specific behavior in vivo, for example, the use of PEG to provide stealth properties. Direct, quantitative measurement of the surface chemistry and composition of such systems in a hydrated environment has thus far not been demonstrated, yet such measurements are of great importance for the development of nanomedicine systems. Here we demonstrate the first use of cryo-XPS for the measurement of two PEG-functionalized nanomedicines: a polymeric drug delivery system and a lipid nanoparticle mRNA carrier. The observed differences between cryo-XPS and standard XPS measurements indicate the potential of cryo-XPS for providing quantitative measurements of such nanoparticle systems in hydrated conditions.acceptedVersio

The Mars Microphone onboard SuperCam

The Mars Microphone is one of the five measurement techniques of SuperCam, an improved version of the ChemCam instrument that has been functioning aboard the Curiosity rover for several years. SuperCam is located on the Rover's Mast Unit, to take advantage of the unique pointing capabilities of the rover's head. In addition to being the first instrument to record sounds on Mars, the SuperCam Microphone can address several original scientific objectives: the study of sound associated with laser impacts on Martian rocks to better understand their mechanical properties, the improvement of our knowledge of atmospheric phenomena at the surface of Mars: atmospheric turbulence, convective vortices, dust lifting processes and wind interactions with the rover itself. The microphone will also help our understanding of the sound signature of the different movements of the rover: operations of the robotic arm and the mast, driving on the rough floor of Mars, monitoring of the pumps, etc ... The SuperCam Microphone was delivered to the SuperCam team in early 2019 and integrated at the Jet Propulsion Laboratory (JPL, Pasadena, CA) with the complete SuperCam instrument. The Mars 2020 Mission launched in July 2020 and landed on Mars on February 18th 2021. The mission operations are expected to last until at least August 2023. The microphone is operating perfectly.Comment: 40 page

High-Fidelity Simulation Nurse Training Reduces Unplanned Interruption of Continuous Renal Replacement Therapy Sessions in Critically Ill Patients: The SimHeR Randomized Controlled Trial

BACKGROUND: Although continuous renal replacement therapy (CRRT) is common, unplanned interruptions (UI) often limit its usefulness. In many units, nurses are responsible for CRRT management. We hypothesized that a nurse training program based on high-fidelity simulation would reduce the rate of interrupted sessions. METHODS: We performed a 2-phase (training and evaluation), randomized, single-center, open study: During the training phase, intensive care unit nurses underwent a 6-hour training program and were randomized to receive (intervention) or not (control) an additional high-fidelity simulation training (6 hours). During the evaluation phase, management of CRRT sessions was randomized to either intervention or control nurses. Sessions were defined as UI if they were interrupted and the interruption was not prescribed in writing more than 3 hours before. RESULTS: Study nurses had experience with hemodialysis, but no experience with CRRT before training. Intervention nurses had higher scores than control nurses on the knowledge tests (grade, median [Q1-Q3], 14 [10.5-15] vs 11 [10-12]/20; P = .044). During a 13-month period, 106 sessions were randomized (n = 53/group) among 50 patients (mean age 70 ± 13 years, mean simplified acute physiology II score 69 [54-96]). Twenty-one sessions were not analyzed (4 were not performed and 17 patients died during sessions). Among the 42 intervention and 43 control sessions analyzed, 25 (59%) and 38 (88%) were labeled as UI (relative risk [95% CI], 0.67 [0.51-0.88]; P = .002). Intervention nurses required help significantly less frequently (0 [0-1] vs 3 [1-4] times/session; P < .0001). The 2 factors associated with UI in multilevel mixed-effects logistic regression were Sequential Organ Failure Assessment score (odds ratio [95% CI], 0.81 [0.65-99]; P = .047) and the intervention group (odds ratio, 0.19 [0.05-0.73]; P = .015). CONCLUSIONS: High-fidelity simulation nurse training reduced the rate of UI of CRRT sessions and the need for nurses to request assistance. This intervention may be particularly useful in the context of frequent nursing staff turnover

Membrane Surface Nanostructures and Adhesion Property of T Lymphocytes Exploited by AFM

The activation of T lymphocytes plays a very important role in T-cell-mediated immune response. Though there are many related literatures, the changes of membrane surface nanostructures and adhesion property of T lymphocytes at different activation stages have not been reported yet. However, these investigations will help us further understand the biophysical and immunologic function of T lymphocytes in the context of activation. In the present study, the membrane architectures of peripheral blood T lymphocytes were obtained by AFM, and adhesion force of the cell membrane were measured by acquiring force–distance curves. The results indicated that the cell volume increased with the increases of activation time, whereas membrane surface adhesion force decreased, even though the local stiffness for resting and activated cells is similar. The results provided complementary and important data to further understand the variation of biophysical properties of T lymphocytes in the context of in vitro activation

Quality assessment of LNP-RNA therapeutics with orthogonal analytical techniques

The availability of analytical methods for the characterization of lipid nanoparticles (LNPs) for in-vivo intracellular delivery of nucleic acids is critical for the fast development of innovative RNA therapies. In this study, analytical protocols to measure (i) chemical composition, (ii) drug loading, (iii) particle size, concentration, and stability as well as (iv) structure and morphology were evaluated and compared based on a comprehensive characterization strategy linking key physical and chemical properties to in-vitro efficacy and toxicity. Furthermore, the measurement protocols were assessed either by testing the reproducibility and robustness of the same technique in different laboratories, or by a correlative approach, comparing measurement results of the same attribute with orthogonal techniques. The characterization strategy and the analytical measurements described here will have an important role during formulation development and in determining robust quality attributes ultimately supporting the quality assessment of these innovative RNA therapeutics.publishedVersio

Impact of 18F-fluoro-deoxy-glucose positron emission tomography (FDG-PET) in recurrent colorectal cancer

Purpose: The aim of the study was to evaluate the diagnostic performance, the prognosis factors and the therapeutic impact of 18F-FDG positron emission tomography (FDG-PET) in the detection of recurrent colorectal cancers. Methods: Sixty PET/CT with 18F-FDG and CT were performed in 52 patients, at the Paul Papin cancer center between 2003 and 2005, following suspicion of colorectal cancer relapse. The FDG-PET impact on the clinical management was studied by examination of multidisciplinary concertations results. Survival analysis were realized with a mean follow up of 2.2 years. Results: Recurrence was confirmed for 50 explorations by histologic (n = 32), radiologic (n = 14) or clinical (n = 4) findings. Twenty patients died during the time of the study. On a patient based analysis, FDG-PET sensitivity, specificity and overall accuracy were 90, 90, 90% respectively compared with 74, 50 and 70% for CT. FDG-PET changed the clinical management in 18 cases (30%). A positive FDG-PET signal, more than one hepatic lesion, more than two lymph node lesions detected on FDG-PET and more than two hepatic lesions on CT were characterized as bad prognostic factors for survival. Multivariate analysis showed that the only independent bad prognostic factor was the FDG-PET detection of more than two liver lesions. Conclusion: These results confirmed the important impact of FDG-PET in the clinical management of patients with a suspected recurrence of colorectal cancer