For many vertebrate species, bite force plays an important functional role. Ecological characteristics of a species' niche, such as diet, are often associated with bite force. Previous evidence ...suggests a biomechanical trade‐off between rodents specialized for gnawing, which feed mainly on seeds, and those specialized for chewing, which feed mainly on green vegetation. We tested the hypothesis that gnawers are stronger biters than chewers. We estimated bite force and measured skull and mandible shape and size in 63 genera of a major rodent radiation (the myomorph sigmodontines). Analysis of the influence of diet on bite force and morphology was made in a comparative framework. We then used phylogenetic path analysis to uncover the most probable causal relationships linking diet and bite force. Both granivores (gnawers) and herbivores (chewers) have a similar high bite force, leading us to reject the initial hypothesis. Path analysis reveals that bite force is more likely influenced by diet than the reverse causality. The absence of a trade‐off between herbivores and granivores may be associated with the generalist nature of the myomorph condition seen in sigmodontine rodents. Both gnawing and chewing sigmodontines exhibit similar, intermediate phenotypes, at least compared to extreme gnawers (squirrels) and chewers (chinchillas). Only insectivorous rodents appear to be moving towards a different direction in the shape space, through some notable changes in morphology. In terms of diet, natural selection alters bite force through changes in size and shape, indicating that organisms adjust their bite force in tandem with changes in food items.
This study was designed to demonstrate the need of accounting for respiration (R) when causality between heart period (HP) and systolic arterial pressure (SAP) is under scrutiny. Simulations ...generated according to a bivariate autoregressive closed-loop model were utilized to assess how causality changes as a function of the model parameters. An exogenous (X) signal was added to the bivariate autoregressive closed-loop model to evaluate the bias on causality induced when the X source was disregarded. Causality was assessed in the time domain according to a predictability improvement approach (i.e., Granger causality). HP and SAP variability series were recorded with R in 19 healthy subjects during spontaneous and controlled breathing at 10, 15, and 20 breaths/min. Simulations proved the importance of accounting for X signals. During spontaneous breathing, assessing causality without taking into consideration R leads to a significantly larger percentage of closed-loop interactions and a smaller fraction of unidirectional causality from HP to SAP. This finding was confirmed during paced breathing and it was independent of the breathing rate. These results suggest that the role of baroreflex cannot be correctly assessed without accounting for R.
Background
Dopamine Replacement Therapy (DRT) represents the most effective treatment for Parkinson’s disease (PD). Nevertheless, several symptoms are unresponsive to treatment and its long-term use ...leads to serious side effects. To optimize the pharmacological management of PD, dopamine-agonists are often prescribed to “de-novo” patients. Moreover, several studies have shown the effectiveness and the synergic effect of rehabilitation in treating PD.
Objective
To evaluate the synergism between DRT and rehabilitation in treating PD, by investigating the short and the long-term effectiveness of a multidisciplinary, intensive and goal-based rehabilitation treatment (MIRT) in a group of patients treated with Rotigotine.
Materials and methods
In this multicenter, single blinded, parallel-group, 1:1 allocation ratio, randomized, non-inferiority trial, 36 “de-novo” PD patients were evaluated along 18 months: 17 were treated with Rotigotine plus MIRT; 19 were treated with Rotigotine alone (R). The primary outcome measure was the total score of Unified Parkinson’s Disease Rating Scale (UPDRS). The secondary outcomes included the UPDRS sub-sections II and III (UPDRS II-III), the 6-Minute Walk Test (6MWT), the Timed Up and Go Test (TUG) and the amount of Rotigotine. Patients were evaluated at baseline (T0), 6 months (T1), 1 year (T2), and at 18 months (T3).
Results
No differences in UPDRS scores in the two groups (total score, III part and II part,
p
= 0.48,
p
= 0.90 and
p
= 0.40, respectively) were found in the time course. Conversely, a greater improvement in Rotigotine + MIRT group was observed for 6MWT (
p
< 0.0001) and TUG (
p
= 0.03). Along time, the dosage of Rotigotine was higher in patients who did not undergo MIRT, at all observation times following T0.
Conclusions
Over the course of 18 months, the effectiveness of the combined treatment (Rotigotine + MIRT) on the patients’ global clinical status, evaluated with total UPDRS, was not inferior to that of the pharmacological treatment with Rotigotine alone. Importantly, rehabilitation allowed patients to gain better motor performances with lower DRT dosage.
Abstract Background and aims Nutritional status (NS) is not routinely assessed in HF. We sought to evaluate whether NS may be additive to a comprehensive pre-discharge evaluation based on a clinical ...score that includes BMI (MAGGIC) and on an index of functional capacity (six minute walking test, 6mWT) in HF patients. Methods and results The CONUT (Controlling Nutritional Status) score (including serum albumin level, total cholesterol and lymphocyte count) was computed in 466 consecutive patients (mean age 61 ± 11 years, NYHA class 2.6 ± 0.6, LVEF 34 ± 11%, BMI 27.2 ± 4.5) who had pre-discharge MAGGIC and 6MWT. The endpoint was all-cause mortality. Mild or moderate undernourishment was present in 54% of patients with no differences across BMI strata. The 12-month event rate was 7.7%. Deceased patients had a more compromised NS (CONUT 2.8 ± 1.5 vs 1.7 ± 1.3, p < 0.0001), and a more advanced HF (MAGGIC 28.2 ± 6.0 vs 22.0 ± 6.6, p < 0.0001; 6MWT 311.1 ± 102.2 vs. 408.9 ± 95.9 m, p < 0.0001). The 12-month mortality rate varied from 4% for well-nourished to 11% for undernourished patients (p = 0.008). At univariate analysis, the CONUT was predictive for all-cause mortality with a Hazard Ratio of 1.701 95% CI 1.363–2.122, p < 0.0001. Multivariable analysis showed that the CONUT significantly added to the combination of MAGGIC and 6MWT and improved predictive discrimination and risk classification (c-index 0.82 95% CI 0.75–0.88, integrated discrimination improvement 0.028 95% CI 0.015–0.081). Conclusions In HF patients assessment of NS, significantly improves prediction of 12-month mortality on top of the information provided by clinical evaluation and functional capacity and should be incorporated in the overall assessment of HF patients.
Idiopathic retroperitoneal fibrosis (IRF) is a rare disease often causing obstructive uropathy. We evaluated the clinicopathologic features of 24 patients with IRF to characterize the histopathology ...of the disease and to provide a framework for the differential diagnosis with other retroperitoneal fibrosing conditions. Retroperitoneal specimens were analyzed by light and electron microscopy and by immunohistochemistry. Most patients presented with abdominal/lumbar pain, constitutional symptoms, and high acute-phase reactants. Overall, 20 had ureteral involvement and 13 developed acute renal failure. The retroperitoneal tissue consisted of a fibrous component and a chronic inflammatory infiltrate with the former characterized by myofibroblasts within a type-I collagen matrix. The infiltrate displayed perivascular and diffuse patterns containing lymphocytes, macrophages, plasma cells, and eosinophils. The perivascular aggregates had a central core of CD20+ cells and a mantle of CD3+ cells in equal proportions. In the areas of diffuse infiltrate, CD3+ cells outnumbered the CD20+ cells. Most plasma cells were positive for the IgG4 isotype. Small vessel vasculitis was found in the specimens of 11 patients. Our study indicates that a sclerotic background with myofibroblasts associated with a diffuse and perivascular infiltrate mainly consisting of T and B lymphocytes may be a pathological hallmark of IRF.
In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to ...describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III-IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions (
=0.0004, odds ratio =0.796, 95% CI =0.701, 0.903;
=0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and
=0.05, odds ratio =2.361, 95% CI =0.995, 5.627 respectively). In COPD patients, focusing on pharmacological and nonpharmacological adherence enhance the possibility of tailored pulmonary rehabilitation programs.
The original version of this article unfortunately contained a mistake. The funding information was incorrect. The corrected funding information is given below.
For rodents that live underground, digging in highly compacted soils requires a higher energy expenditure than digging in poorly compacted soils. We tested how soil hardness affects the bite force as ...well as the shape and size of the skulls and mandibles of tuco‐tucos. Our hypothesis is that species that inhabit harder soils would show a stronger bite force, which should be reflected in the shape of the skull and mandible, while species living in softer soils should have a weaker bite force. We used 24 species of the genus Ctenomys to estimate bite force (through the incisor strength formula) and quantify the shape and size of the skull and mandible. Information on soil bulk density in the regions occupied by each species was obtained from the literature. We used a combination of geometric morphometric and comparative methods to test our hypothesis. A phylogenetic linear regression (PGLS) between bite force (N) and centroid size was used to account for the dependence of bite force on size. We employed a series of two‐block partial least‐squares analyses to uncover the covariation between bite force and the shape of the skull and mandible. Finally, we ran five independent PGLS analyses to assess the influence of bulk density on bite force, skull shape and mandible shape, taking into account phylogenetic non‐independence. Species with higher bite forces tend to inhabit more‐compact soils. However, for most species, the relationship between bite force and soil bulk density was unclear, resulting in a low overall correlation. Nonetheless, differences in skull and mandible shapes were generally associated with bite force (r = 0.60). In denser soils, species with high and low bite forces occur, whereas in lower density soils, we found only species with weak bite forces. Differences in the excavation strategies among species may be responsible for this pattern.
We tested how soil hardness affects the bite force as well as the shape and size of the skulls and mandibles of tuco‐tucos. Our hypothesis is that species that inhabit harder soils would show a stronger bite force, which should be reflected in the shape of the skull and mandible; while species living in softer soils should have a weaker bite force. We used a combination of geometric morphometric and comparative methods to test our hypothesis. Our results pointed that species with higher bite forces tend to inhabit more‐compact soils. However, for most species, the relationship between bite force and soil bulk density was unclear. In denser soils, species with high and low bite forces occur; whereas in lower density soils we found only species with weak bite forces. Differences in the excavation strategies among species may be responsible for this pattern.
In cardiovascular variability analysis, the significance of the coupling between two time series is commonly assessed by setting a threshold level in the coherence function. While traditionally used ...statistical tests consider only the parameters of the adopted estimator, the required zero-coherence level may be affected by some features of the observed series. In this study, three procedures, based on the generation of surrogate series sharing given properties with the original but being structurally uncoupled, were considered: independent identically distributed (IID), Fourier transform (FT), and autoregressive (AR). IID surrogates maintained the distribution of the original series, while FT and AR surrogates preserved the power spectrum. The ability of the three methods to define the threshold for zero coherence was validated and compared by computer simulations reproducing typical cardiovascular interactions. While the IID threshold depended only on record length and design parameters of the coherence estimator, FT and AR thresholds were frequency-dependent with peaks corresponding to the local maxima of the estimated coherence. FT and AR surrogates were able to compensate spurious coherence peaks due to equal-frequency but independent oscillations in the two series. The benefit of frequency-dependent thresholds was evident for short series with narrow-band oscillations. Thus, surrogates preserving the power spectrum of the original series are recommended to avoid false coupling detections in the presence of oscillations occurring at nearby frequencies but produced by different mechanisms, as may frequently happen in cardiovascular and cardiorespiratory regulation.
Physical modalities such as vibration has been suggested as possible non-pharmacological way to control spasticity.
The hypotheses tested were: 1) can a selective vibration of the upper limb flexor ...antagonist, triceps brachii, reduce the spasticity of the flexor biceps brachii muscle; 2) is its association with physiotherapy better than physiotherapy alone in reducing spasticity and improving function, 3) can this possible effect last for longer than the stimulation period.
Randomized double-blind study.
Rehabilitation Institute, inward patients.
Thirty hemiplegic patients affected by upper limb spasticity.
(VIB + PT) group received physiotherapy plus vibration by means of a pneumatic vibrator applied over the belly of the triceps brachii of the spastic side (contact surface 2 cm2; frequency 100 Hz; amplitude 2 mm; mean pressure 250 mBar). (SHAM + PT) group received physiotherapy and sham vibration. Both groups had 60 minutes of physiotherapy (Kabat techniques) for 5 days a week (from Monday to Friday) for 2 weeks.
Ashworth modified scale for spasticity and robot-aided motor tasks changes for functional modifications were evaluated before starting treatment (T0), 48 hours after the fifth session (T1) and 48 hours after the last session (T2).
Fisher's exact test showed a statistically significant greater improvements in the (VIB + PT) group (P=0.0001) compared to in the (SHAM + PT) group after 1 week, as well as after 2 weeks of treatment (P=0.0078) at the Ashworth scale.
1) 100 Hz vibration applied to the triceps brachii of a spastic upper limb in association with physiotherapy is able to reduce the spasticity of the flexor agonist, biceps brachii; 2) this association is better than physiotherapy alone in controlling spasticity and improving function; 3) this clinically perceivable reduction of spasticity and function improvement extends (for at least 48 hours) beyond the period of application of the vibration, supporting its possible role in the rehabilitation of spastic hemiplegia.
100 Hz antagonist muscle vibration, a non-pharmacological treatment, can help physiotherapy to reduce flexors spasticity and improve functions in the rehabilitation of upper limb spasticity.
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