Oro‐facial impairment in stroke patients Schimmel, M.; Ono, T.; Lam, O. L. T. ...
Journal of oral rehabilitation,
April 2017, Letnik:
44, Številka:
4
Journal Article
Recenzirano
Summary
Stroke is considered one of the leading causes of death and acquired disability with a peak prevalence over the age of 80 years. Stroke may cause debilitating neurological deficiencies that ...frequently result in sensory deficits, motor impairment, muscular atrophy, cognitive deficits and psychosocial impairment. Oro‐facial impairment may occur due to the frequent involvement of the cranial nerves’ cortical representation areas, central nervous system pathways or motoneuron pools. The aim of this narrative, non‐systematic review was to discuss the implications of stroke on oro‐facial functions and oral health‐related quality of life (OHRQoL). Stroke patients demonstrate an impaired masticatory performance, possibly due to reduced tongue forces and disturbed oral sensitivity. Furthermore, facial asymmetry is common, but mostly discrete and lip restraining forces are reduced. Bite force is not different between the ipsi‐ and contra‐lesional side. In contrast, the contra‐lesional handgrip strength and tongue–palate contact during swallowing are significantly impaired. OHRQoL is significantly reduced mainly because of the functional impairment. It can be concluded that impaired chewing efficiency, dysphagia, facial asymmetry, reduced lip force and OHRQoL are quantifiable symptoms of oro‐facial impairment following a stroke. In the absence of functional rehabilitation, these symptoms seem not to improve. Furthermore, stroke affects the upper limb and the masseter muscle differently, both, at a functional and a morphological level. The rehabilitation of stroke survivors should, therefore, also seek to improve the strength and co‐ordination of the oro‐facial musculature. This would in turn help improve OHRQoL and the masticatory function, subsequently preventing weight loss and malnutrition.
The understanding of mechanisms linking psychological stress to disease risk depend on reliable stress biomarkers. Circulating cell-free DNA (cfDNA) has emerged as a potential biomarker of cellular ...stress, aging, inflammatory processes, and cell death. Recent studies indicated that psychosocial stress and physical exercise might also influence its release. We compared the effects of acute psychosocial and physical exercise stress on cfDNA release by exposing 20 young, healthy men to both an acute psychosocial laboratory stressor and an acute physical exercise stressor. Venous blood and saliva samples were collected before and after stress exposure. Cell-free DNA was extracted from plasma and quantified by qPCR. Furthermore, cfDNA fragment length was analyzed and cfDNA methylation patterns were assayed across time. In addition, release of stress hormones and subjective stress responses were measured. Results showed a twofold increase of cfDNA after TSST and fivefold increase after exhaustive treadmill exercise, with an overabundance of shorter cfDNA fragments after physical exhaustion. Interestingly, cell-free mitochondrial DNA showed similar increase after both stress paradigms. Furthermore, cfDNA methylation signatures-used here as a marker for diverse cellular origin-were significantly different post stress tests. While DNA methylation decreased immediately after psychosocial stress, it increased after physical stress, suggesting different cellular sources of active DNA release. In summary, our results suggest stimulus and cell-specific regulation of cfDNA release. Whereas the functional role of stress-associated cfDNA release remains elusive, it might serve as a valuable biomarker in molecular stress research as a part of the psychophysiological stress response.
The extent of tumor-infiltrating lymphocytes (TILs), along with immunomodulatory ligands, tumor-mutational burden and other biomarkers, has been demonstrated to be a marker of response to ...immune-checkpoint therapy in several cancers. Pathologists have therefore started to devise standardized visual approaches to quantify TILs for therapy prediction. However, despite successful standardization efforts visual TIL estimation is slow, with limited precision and lacks the ability to evaluate more complex properties such as TIL distribution patterns. Therefore, computational image analysis approaches are needed to provide standardized and efficient TIL quantification. Here, we discuss different automated TIL scoring approaches ranging from classical image segmentation, where cell boundaries are identified and the resulting objects classified according to shape properties, to machine learning-based approaches that directly classify cells without segmentation but rely on large amounts of training data. In contrast to conventional machine learning (ML) approaches that are often criticized for their "black-box" characteristics, we also discuss explainable machine learning. Such approaches render ML results interpretable and explain the computational decision-making process through high-resolution heatmaps that highlight TILs and cancer cells and therefore allow for quantification and plausibility checks in biomedical research and diagnostics.
We present a new approach for automatic registration of X-ray mammograms and MR images. Multimodal breast cancer diagnosis is supported by automatic localization of small lesions, which are only ...visible in the mammograms or in the MR image. To cope with the huge deformation of the breast during mammography, a finite element model of the deformable behavior of the breast is applied during the registration. An evaluation of the registration with six clinical data sets resulted in an accurate localization with a mean displacement of 4.3 mm (/spl plusmn/1 mm) and 3.9 mm (/spl plusmn/1.7 mm) for predicting the lesion position in mammograms and in the MR images, respectively.
•Probabilistic particle tracking by multi-sensor data fusion and Bayesian smoothing.•Integration of multiple measurements from separate measurement processes.•Past and future information exploited by ...smoothing and covariance intersection.•Motion information employed in the cost function for correspondence finding.•Improved results for microscopy image data of different types of viruses.
Automatic tracking of viral structures displayed as small spots in fluorescence microscopy images is an important task to determine quantitative information about cellular processes. We introduce a novel probabilistic approach for tracking multiple particles based on multi-sensor data fusion and Bayesian smoothing methods. The approach exploits multiple measurements as in a particle filter, both detection-based measurements and prediction-based measurements from a Kalman filter using probabilistic data association with elliptical sampling. Compared to previous probabilistic tracking methods, our approach exploits separate uncertainties for the detection-based and prediction-based measurements, and integrates them by a sequential multi-sensor data fusion method. In addition, information from both past and future time points is taken into account by a Bayesian smoothing method in conjunction with the covariance intersection algorithm for data fusion. Also, motion information based on displacements is used to improve correspondence finding. Our approach has been evaluated on data of the Particle Tracking Challenge and yielded state-of-the-art results or outperformed previous approaches. We also applied our approach to challenging time-lapse fluorescence microscopy data of human immunodeficiency virus type 1 and hepatitis C virus proteins acquired with different types of microscopes and spatial-temporal resolutions. It turned out, that our approach outperforms existing methods.
The electron spin degree of freedom can play a significant role in relativistic scattering processes involving intense laser fields. In this contribution we discuss the influence of the electron spin ...on (i) Kapitza-Dirac scattering in an x-ray laser field of high intensity, (ii) photo-induced electron-positron pair production in a strong laser wave and (iii) multiphoton electron-positron pair production on an atomic nucleus. We show that in all cases under consideration the electron spin can have a characteristic impact on the process properties and their total probabilities. To this end, spin-resolved calculations based on the Dirac equation in the presence of an intense laser field are performed. The predictions from Dirac theory are also compared with the corresponding results from the Klein-Gordon equation.
Background Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care–associated ...infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Methods Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Results Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Conclusion Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary.
A thermodynamic finite-strain model describing the pseudoelastic response of shape memory alloys is proposed. The model is based on a self-consistent Eulerian theory of finite deformations using the ...logarithmic rate. Purely elastic material response is derived from a hyperelastic potential. The mass fraction of martensite is introduced as internal state variable to indicate the thermomechanical state of the phase transforming material. The evolution of martensite is governed by a kinetic law which is derived from the Helmholtz free energy of the two-phase solid and takes the heat generated during phase transition into account. The material model is implemented into a finite element code in an updated Lagrangian scheme and calibrated to experimental data. Simulations under different loading conditions illustrate the characteristics of the model.
The analytical platform (AP) provides means to coordinate analyses of experts and to communicate their insights to the public community in case of a nuclear emergency. The AP is realized as web ...application based on the third-party content management system Liferay, enhanced by specific tools in respect to the needs of radiological experts. The content management system was equipped with site and page templates thus allowing fast and structured setup of incident specific contents in case of an emergency. The tools fulfil a wide variety of purposes like e.g. the web-crawling service analysing the requests of the public community to allow the experts to be ahead of future concerns of the public. Also, a knowledge database of historic events to analyze the current situation and predict the potential development is included. As installing and configuring of the web content management system and its additional tools is tedious and error-prone, a simplification of the setup process is desirable. Hence, the platform is realized as a virtual machine, basically providing a full web-server environment including all required services by simply copying and installing one single file.
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