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INTRODUCTION: Aerobic exercise training after stroke has positive effects on quality of life, motor recovery, and aerobic endurance. The aim of this study was to investigate the effectiveness of anti-gravity treadmill gait training and underwater walking therapy on cardiorespiratory fitness, gait and balance in stroke survivors. METHODS: The study included 39 patients with a history of stroke who were admitted to our center between July 2017 and January 2018. The patients were randomly assigned to anti-gravity treadmill training, underwater walking therapy, or a control group. The aerobic capacity of the participants was evaluated with the 6-min walk test and cycle ergometer testing before and after the treatment. Balance was examined using the Berg Balance Scale (BBS). RESULTS: There was a statistically significant increase from pre- to post-treatment with regard to maximum heart rate and length of walking distance during 6-min walk test parameters in patients who underwent anti-gravity treadmill training (p < 0.05). The cycle ergometer training results showed significant improvements compared to baseline after treatment in patients who underwent anti-gravity training in terms of maximum heart rate attained during exercise stress testing, time to complete the test, rates of metabolic equivalents of task scores and peak oxygen consumption (p < 0.05). Improvements were also observed in ventricular repolarization indices including corrected QT intervals (QTc), Tp-e interval and Tp-e/QT, Tp-e/QTc ratio in the anti-gravity group (p < 0.05). BBS results showed no statistically significant difference in all groups (p > 0.05). CONCLUSION: The data of this study showed that anti-gravity treadmill training has favorable effects on cardiorespiratory fitness in stroke survivors.
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Capacidad Cardiovascular , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Capacidad Cardiovascular/fisiología , Calidad de Vida , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Terapia por Ejercicio/métodos , Caminata/fisiología , Ejercicio Físico , Resultado del TratamientoRESUMEN
Transparent, dark orange Ba[Au(N3 )4 ]2 â 4 H2 O was synthesized by reaction of Ba(N3 )2 and AuCl3 or HAuCl4 in aqueous solution. The novel barium tetraazidoaurate(III) tetrahydrate crystallizes in the monoclinic space groupâ Cc (no.â 9) with a=1813.68(17)â pm, b=1737.95(11)â pm, c=682.04(8)â pm and ß=108.849(4)°. The predominant structural features of Ba[Au(N3 )4 ]2 â 4 H2 O are two crystallographically independent discrete anions [Au(N3 )4 ]- with gold in a tetragonal planar coordination by nitrogen. Vibrational spectra show good agreement with those of other azidoaurates(III). Upon drying, this salt was shown to be a highly explosive material.
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AIM: Prescribing optimal prosthetic feet to ensure successful rehabilitation is difficult since there are no generally established clinical guidelines based on objective data. The aim of the study was to compare functional capacity, pain intensity, satisfaction level and quality of life (QoL) of high activity patients with unilateral transtibial amputation using non-articulated carbon foot (non-articulating ankle, NAA) with those of using carbon foot with hydraulic ankle (articulating hydraulic ankle, AHA). METHODS: Forty-two patients (21 with NAA and 21 with AHA) with unilateral transtibial traumatic amputation from tertiary rehabilitation center were participated in this cross-sectional study. Outcome measures were six-minute walking test (6MWT), Visual Analogue Scale (VAS) and the Short Form-36 (SF-36). The level of difficulty experienced during ambulating on different terrains was recorded on a 5-point Likert scale. RESULTS: There were no significant statistical differences in 6MWT, pain intensity, prosthetic foot satisfaction level and QoL between the two groups. The level of difficulty experienced during descending ramps was higher in the NAA group than in the AHA group (p = 0.016). The most common reason for dissatisfaction were inflexibility for the NAA group (14.3%), frequent dysfunction for the AHA group (28.6%). CONCLUSION: Our results showed that the level of difficulty experienced during descending ramps was higher in the NAA group than in the AHA group. Further studies with larger sample sizes are needed comparing microprocessor AHAs with NAA and AHA.
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Amputados , Miembros Artificiales , Amputación Quirúrgica , Fenómenos Biomecánicos , Estudios Transversales , Marcha , Humanos , Dimensión del Dolor , Satisfacción del Paciente , Satisfacción Personal , Diseño de Prótesis , Calidad de Vida , CaminataRESUMEN
Objectives: The study aimed to demonstrate the level of kinesiophobia in patients with traumatic lower limb amputation (LLA) and to investigate the correlation between kinesiophobia and associated factors. Patients and methods: This cross-sectional study included 52 male patients (mean age: 37.8±8.7 years; range, 18 to 65 years) with traumatic LLA between March 2021 and July 2021. Kinesiophobia level was measured with the Tampa Scale for Kinesiophobia. Pain intensity and prosthesis satisfaction were evaluated with the Visual Analog Scale. The Falls Efficacy Scale-International was used for the assessment of fear of falling. The Nottingham Health Profile was used to evaluate the quality of life. Results: The percentage of the patients with a high level of kinesiophobia was 40.4%. Kinesiophobia was significantly correlated with residual limp pain intensity (r=0.317, p=0.022), the number of falls (r=0.284, p=0.041), fear of falling (r=0.495, p=0.001), and quality of life (r=0.512, p=0.001). No significant correlations between kinesiophobia and intact limb pain intensity, low back pain intensity, or prosthesis satisfaction were detected. Regression analysis showed that the physical activity subscale score of the Nottingham Health Profile was a statistically significant predictor of high kinesiophobia scores. Conclusion: The findings suggest that limitations in physical activity were independently associated with kinesiophobia in patients with traumatic LLA. Fear and avoidance behaviors, which may limit physical activity, should be considered in the evaluation of individuals with LLA.
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Temperature variation-through time and across climatic gradients-affects individuals, populations, and communities. Yet how the thermal response of biological systems is altered by environmental stressors is poorly understood. Here, we quantify two key features-optimal temperature and temperature breadth-to investigate how temperature responses vary in the presence of antibiotics. We use high-throughput screening to measure growth of Escherichia coli under single and pairwise combinations of 12 antibiotics across seven temperatures that range from 22°C to 46°C. We find that antibiotic stress often results in considerable changes in the optimal temperature for growth and a narrower temperature breadth. The direction of the optimal temperature shifts can be explained by the similarities between antibiotic-induced and temperature-induced damage to the physiology of the bacterium. We also find that the effects of pairs of stressors in the temperature response can often be explained by just one antibiotic out of the pair. Our study has implications for a general understanding of how ecological systems adapt and evolve to environmental changes. IMPORTANCE The growth of living organisms varies with temperature. This dependence is described by a temperature response curve that is described by an optimal temperature where growth is maximized and a temperature range (termed breadth) across which the organism can grow. Because an organism's temperature response evolves or acclimates to its environment, it is often assumed to change over only evolutionary or developmental timescales. Counter to this, we show here that antibiotics can quickly (over hours) change the optimal growth temperature and temperature breadth for the bacterium Escherichia coli. Moreover, our results suggest a shared-damage hypothesis: when an antibiotic damages similar cellular components as hot (or cold) temperatures do, this shared damage will combine and compound to more greatly reduce growth when that antibiotic is administered at hot (or cold) temperatures. This hypothesis could potentially also explain how temperature responses are modified by stressors other than antibiotics.
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The rapid increase of multi-drug resistant bacteria has led to a greater emphasis on multi-drug combination treatments. However, some combinations can be suppressive-that is, bacteria grow faster in some drug combinations than when treated with a single drug. Typically, when studying interactions, the overall effect of the combination is only compared with the single-drug effects. However, doing so could miss "hidden" cases of suppression, which occur when the highest order is suppressive compared with a lower-order combination but not to a single drug. We examined an extensive dataset of 5-drug combinations and all lower-order-single, 2-, 3-, and 4-drug-combinations. We found that a majority of all combinations-54%-contain hidden suppression. Examining hidden interactions is critical to understanding the architecture of higher-order interactions and can substantially affect our understanding and predictions of the evolution of antibiotic resistance under multi-drug treatments.
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Branching in vascular networks and in overall organismic form is one of the most common and ancient features of multicellular plants, fungi and animals. By combining machine-learning techniques with new theory that relates vascular form to metabolic function, we enable novel classification of diverse branching networks-mouse lung, human head and torso, angiosperm and gymnosperm plants. We find that ratios of limb radii-which dictate essential biologic functions related to resource transport and supply-are best at distinguishing branching networks. We also show how variation in vascular and branching geometry persists despite observing a convergent relationship across organisms for how metabolic rate depends on body mass.
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Aprendizaje Automático , Plantas , Animales , MatemáticaRESUMEN
Understanding how stressors combine to affect population abundances and trajectories is a fundamental ecological problem with increasingly important implications worldwide. Generalisations about interactions among stressors are challenging due to different categorisation methods and how stressors vary across species and systems. Here, we propose using a newly introduced framework to analyse data from the last 25 years on ecological stressor interactions, for example combined effects of temperature, salinity and nutrients on population survival and growth. We contrast our results with the most commonly used existing method - analysis of variance (ANOVA) - and show that ANOVA assumptions are often violated and have inherent limitations for detecting interactions. Moreover, we argue that rescaling - examining relative rather than absolute responses - is critical for ensuring that any interaction measure is independent of the strength of single-stressor effects. In contrast, non-rescaled measures - like ANOVA - find fewer interactions when single-stressor effects are weak. After re-examining 840 two-stressor combinations, we conclude that antagonism and additivity are the most frequent interaction types, in strong contrast to previous reports that synergy dominates yet supportive of more recent studies that find more antagonism. Consequently, measuring and re-assessing the frequency of stressor interaction types is imperative for a better understanding of how stressors affect populations.
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Salinidad , TemperaturaRESUMEN
OBJECTIVES: This study aims to investigate the effect of rehabilitation on functional level of traumatic brain injury (TBI) patients and to examine the associated factors on functional gain in this patient population. PATIENTS AND METHODS: Between October 2010 and November 2015, a total of 71 patients (63 males, 8 females; mean age 26.6±8.1 years; range, 18 to 56 years) who were admitted to our rehabilitation clinic with moderate-to-severe TBI were retrospectively analyzed. Functional recovery was assessed using the Functional Independence Measure (FIM) and Functional Ambulation Classification (FAC) scales. The patients were divided into two groups according to time from TBI to the initiation of rehabilitation: early (<6 months) and late (≥6 months). Possible predictive factors associated with FIM gain were evaluated. RESULTS: There was a significant improvement in the FIM scores from admission to discharge (p<0.001). There was a statistically significant difference in the FIM gain and FIM efficiency between the patient groups according to the initiation of rehabilitation (p<0.001). The FAC scores increased from admission to discharge, showing statistical significance (p<0.001). Duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis were found to be significant factors associated with FIM gain (p<0.001). CONCLUSION: Our study results suggest that rehabilitation is effective for functional gain, particularly in the early period in patients with moderate- to-severe TBI and duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis are also predictors of functional improvement.
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Environmental factors like temperature, pressure, and pH partly shaped the evolution of life. As life progressed, new stressors (e.g., poisons and antibiotics) arose as part of an arms race among organisms. Here we ask if cells co-opted existing mechanisms to respond to new stressors, or whether new responses evolved de novo. We use a network-clustering approach based purely on phenotypic growth measurements and interactions among the effects of stressors on population growth. We apply this method to two types of stressors-temperature and antibiotics-to discover the extent to which their cellular responses overlap in Escherichia coli. Our clustering reveals that responses to low and high temperatures are clearly separated, and each is grouped with responses to antibiotics that have similar effects to cold or heat, respectively. As further support, we use a library of transcriptional fluorescent reporters to confirm heat-shock and cold-shock genes are induced by antibiotics. We also show strains evolved at high temperatures are more sensitive to antibiotics that mimic the effects of cold. Taken together, our results strongly suggest that temperature stress responses have been co-opted to deal with antibiotic stress.
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Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Temperatura , Evolución Biológica , Escherichia coli/fisiología , Biblioteca de Genes , Estrés FisiológicoRESUMEN
BACKGROUND: The study investigated the fracture resistance of root-filled maxillary premolars with class II cavities restored by different restorations. METHODS: A total of 55 intact maxillary premolar teeth were included (n = 11). G1 as positive control group, 44 teeth underwent root canal treatment, and MOD cavities were prepared. (G2) no restoration, (G3) direct composite restoration, (G4) direct composite strengthened with buccal to lingual pre-impregnated glass-fibers and (G5) ceramic inlay restoration. After thermocycling, fracture resistance test was performed and fracture type was recorded. Data were analyzed with one-way ANOVA and Chisquare test. RESULTS: The mean fracture resistance was as follows: G1 had the highest fracture resistance, G2 had the lowest (p < 0.05). There were no significant differences between the fracture resistance values of the groups that underwent different restorations (G3, G4, G5) (p > 0.05). According to fracture type, the groups showed similar results (p > 0.05). A significant level of unrestorable fracture was detected in G5 (ceramic inlay) (p < 0.05). CONCLUSIONS: All of the restoration techniques investigated herein increased the fracture strength of teeth; however, all of these values were lower than the fracture resistance of intact teeth. There were no significant differences between the fracture resistance values of the groups that underwent different restorations.
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Caries Dental/terapia , Materiales Dentales , Restauración Dental Permanente , Fracturas de los Dientes , Grabado Ácido Dental , Análisis de Varianza , Diente Premolar , Cerámica , Resinas Compuestas , Preparación de la Cavidad Dental , Análisis del Estrés Dental , Vidrio , Humanos , Técnicas In Vitro , Raíz del DienteRESUMEN
Interactions and emergent processes are essential for research on complex systems involving many components. Most studies focus solely on pairwise interactions and ignore higher-order interactions among three or more components. To gain deeper insights into higher-order interactions and complex environments, we study antibiotic combinations applied to pathogenic Escherichia coli and obtain unprecedented amounts of detailed data (251 two-drug combinations, 1512 three-drug combinations, 5670 four-drug combinations, and 13608 five-drug combinations). Directly opposite to previous assumptions and reports, we find higher-order interactions increase in frequency with the number of drugs in the bacteria's environment. Specifically, as more drugs are added, we observe an elevated frequency of net synergy (effect greater than expected based on independent individual effects) and also increased instances of emergent antagonism (effect less than expected based on lower-order interaction effects). These findings have implications for the potential efficacy of drug combinations and are crucial for better navigating problems associated with the combinatorial complexity of multi-component systems.
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BACKGROUND: In drug-drug interactions, there are surprising cases in which the growth inhibition of bacteria by a single antibiotic decreases when a second antibiotic is added. These interactions are termed suppressive and have been argued to have the potential to limit the evolution of resistance. Nevertheless, little attention has been given to suppressive interactions because clinical studies typically search for increases in killing efficiency and because suppressive interactions are believed to be rare based on pairwise studies. RESULTS: Here, we quantify the effects of single-, double-, and triple-drug combinations from a set of 14 antibiotics and 3 bacteria strains, totaling 364 unique three-drug combinations per bacteria strain. We find that increasing the number of drugs can increase the prevalence of suppressive interactions: 17% of three-drug combinations are suppressive compared to 5% of two-drug combinations in this study. Most cases of suppression we find (97%) are "hidden" cases for which the triple-drug bacterial growth is less than the single-drug treatments but exceeds that of a pairwise combination. CONCLUSIONS: We find a surprising number of suppressive interactions in higher-order drug combinations. Without examining lower-order (pairwise) bacterial growth, emergent suppressive effects would be missed, potentially affecting our understanding of evolution of resistance and treatment strategies for resistant pathogens. These findings suggest that careful examination of the full factorial of drug combinations is needed to uncover suppressive interactions in higher-order combinations.
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Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Combinación de Medicamentos , Interacciones Farmacológicas , Farmacorresistencia Bacteriana Múltiple , Escherichia coli/efectos de los fármacos , Escherichia coli/crecimiento & desarrollo , Pruebas de Sensibilidad Microbiana , Modelos Biológicos , Staphylococcus epidermidis/efectos de los fármacos , Staphylococcus epidermidis/crecimiento & desarrolloRESUMEN
Modern models that derive allometric relationships between metabolic rate and body mass are based on the architectural design of the cardiovascular system and presume sibling vessels are symmetric in terms of radius, length, flow rate, and pressure. Here, we study the cardiovascular structure of the human head and torso and of a mouse lung based on three-dimensional images processed via our software Angicart. In contrast to modern allometric theories, we find systematic patterns of asymmetry in vascular branching, potentially explaining previously documented mismatches between predictions (power-law or concave curvature) and observed empirical data (convex curvature) for the allometric scaling of metabolic rate. To examine why these systematic asymmetries in vascular branching might arise, we construct a mathematical framework to derive predictions based on local, junction-level optimality principles that have been proposed to be favored in the course of natural selection and development. The two most commonly used principles are material-cost optimizations (construction materials or blood volume) and optimization of efficient flow via minimization of power loss. We show that material-cost optimization solutions match with distributions for asymmetric branching across the whole network but do not match well for individual junctions. Consequently, we also explore random branching that is constrained at scales that range from local (junction-level) to global (whole network). We find that material-cost optimizations are the strongest predictor of vascular branching in the human head and torso, whereas locally or intermediately constrained random branching is comparable to material-cost optimizations for the mouse lung. These differences could be attributable to developmentally-programmed local branching for larger vessels and constrained random branching for smaller vessels.
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Vasos Sanguíneos/anatomía & histología , Vasos Sanguíneos/crecimiento & desarrollo , Tipificación del Cuerpo/fisiología , Modelos Anatómicos , Modelos Cardiovasculares , Modelos Estadísticos , Animales , Humanos , RatonesRESUMEN
Understanding how multiple stressors interact is needed to predict the dynamical outcomes of diverse biological systems, ranging from drug-resistant pathogens that are combated and treated with combination drug therapies to ecosystems impacted by environmental toxicants or disturbances. Nevertheless, extensive studies of higher-order (more than two component) interactions have been lacking. Here, we conduct experiments using 20 three-drug combinations and their effects on the bacterial growth of Escherichia coli We report our measurements of growth rates in single, pairwise and triple-drug combinations. To uncover emergent interactions, we derive a simple framework to calculate expectations for three-way interactions based on the measured impact of each individual stressor and of each pairwise interaction. Using our framework, we find that (i) emergent antagonisms are more common than emergent synergies and (ii) emergent antagonisms are more common and emergent synergies are more rare than would be inferred from measures of net effects that do not disentangle pairwise interactions from three-way interactions.
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Antibacterianos/farmacología , Escherichia coli/crecimiento & desarrollo , Modelos Biológicos , Estrés Fisiológico/efectos de los fármacosRESUMEN
Interactions among drugs play a critical role in the killing efficacy of multi-drug treatments. Recent advances in theory and experiment for three-drug interactions enable the search for emergent interactions-ones not predictable from pairwise interactions. Previous work has shown it is easier to detect synergies and antagonisms among pairwise interactions when a rescaling method is applied to the interaction metric. However, no study has carefully examined whether new types of normalization might be needed for emergence. Here, we propose several rescaling methods for enhancing the classification of the higher order drug interactions based on our conceptual framework. To choose the rescaling that best separates synergism, antagonism and additivity, we conducted bacterial growth experiments in the presence of single, pairwise and triple-drug combinations among 14 antibiotics. We found one of our rescaling methods is far better at distinguishing synergistic and antagonistic emergent interactions than any of the other methods. Using our new method, we find around 50% of emergent interactions are additive, much less than previous reports of greater than 90% additivity. We conclude that higher order emergent interactions are much more common than previously believed, and we argue these findings for drugs suggest that appropriate rescaling is crucial to infer higher order interactions.
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Antibacterianos/farmacología , Escherichia coli/crecimiento & desarrollo , Antagonismo de Drogas , Evaluación Preclínica de Medicamentos , Sinergismo FarmacológicoRESUMEN
The expression of three ribosome binding proteins namely; polyadenylate-binding protein, splicing factor RNPS1 and ATP-dependent RNA helicase of Phanerochaete chrysosporium exposed to lead were analyzed by real-time PCR. The mRNA level of splicing factor RNPS1 showed 2.7 (p < 0.05), 2.6 (p < 0.05) and 4.9-fold (p < 0.001) increase when the cells were exposed to 25, 50 and 100 µM lead, respectively. 50 and 100 µM lead exposure resulted in almost 2-fold (p < 0.01and p < 0.05, respectively) increase in the expression of ATP-dependent RNA helicase. Polyadenylate-binding protein mRNA levels did not reveal any significant increase when cells exposed to the concentrations of lead employed. However, the mRNA level of polyadenylate-binding protein and splicing factor RNPS1 within a period of 1 and 2 h temporal exposure to 100 µM lead showed 2.5 (p < 0.001) and 3.4-fold (p < 0.001) increase, respectively. Expression level of ATP-dependent RNA helicase was not affected from the period of exposure to this metal.