Search

According to the dynamic dominance model, the left cerebral hemisphere is specialized for the control of intersegmental dynamics and the right hemisphere for impedance control. Our aim was to test predictions from the dynamic dominance model in children by comparing performance between the right (preferred) and left hands in aiming. Three groups were compared: 4-7, 8-11, and 18-38 years old. Results showed higher movement linearity in the performance with the right hand in all age groups (

Background Continuous oscillation of the support base requires anticipatory and reactive postural adjustments to maintain a stable balance. In this context, postural control flexibility or the ability to adjust balance mechanisms following the requirements of the environment is needed to counterbalance the predictable, continuous perturbation of body balance. Considering the inflexibility of postural responses in individuals with Parkinson's disease (PD), maintaining stability in the support base's continuous oscillations may be challenging. Varying the frequency of platform oscillation is an exciting approach to assess the interactions between reactive and anticipatory adjustments. Research question This study aimed to analyze postural responses of individuals with PD on an oscillatory support base across different frequencies. Methods Thirty participants with moderate PD diagnosis (M = 64.47 years, SD = 8.59; Hoehn and Yahr scale 3) and fifteen healthy age-matched controls (M = 65.8 years, SD = 4.2) were tested. Subjects maintained a dynamic balance on a platform oscillating in sinusoidal translations. Four oscillation frequencies were evaluated in different trials that ranged from 0.2 to 0.8 Hz in steps of 0.2 Hz. Results Analysis showed similar performance between PD and healthy participants, with modulation of amplitudes of head displacement, center of pressure, center of mass and feet-head coordination to platform oscillation frequency. Discussion Our findings suggest a preserved ability of individuals with PD to dynamically control body balance on a support base with predictable oscillatory translations.

Copyright: © 2021 Duarte et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited., Wolbachia is one of the most prevalent bacterial endosymbionts, infecting approximately 40% of terrestrial arthropod species. Wolbachia is often a reproductive parasite but can also provide fitness benefits to its host, as, for example, protection against viral pathogens. This protective effect is currently being applied to fight arboviruses transmission by releasing Wolbachia-transinfected mosquitoes. Titre regulation is a crucial aspect of Wolbachia biology. Higher titres can lead to stronger phenotypes and fidelity of transmission but can have a higher cost to the host. Since Wolbachia is maternally transmitted, its fitness depends on host fitness, and, therefore, its cost to the host may be under selection. Understanding how Wolbachia titres are regulated and other aspects of Wolbachia biology has been hampered by the lack of genetic tools. Here we developed a forward genetic screen to identify new Wolbachia over-proliferative mutant variants. We characterized in detail two new mutants, wMelPop2 and wMelOctoless, and show that the amplification or loss of the Octomom genomic region lead to over-proliferation. These results confirm previous data and expand on the complex role of this genomic region in the control of Wolbachia proliferation. Both new mutants shorten the host lifespan and increase antiviral protection. Moreover, we show that Wolbachia proliferation rate in Drosophila melanogaster depends on the interaction between Octomom copy number, the host developmental stage, and temperature. Our analysis also suggests that the life shortening and antiviral protection phenotypes of Wolbachia are dependent on different, but related, properties of the endosymbiont; the rate of proliferation and the titres near the time of infection, respectively. We also demonstrate the feasibility of a novel and unbiased experimental approach to study Wolbachia biology, which could be further adapted to characterize other genetically intractable bacterial endosymbionts., L.T. received funding for this project from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement n°773260 – WOLBAKIAN, https://erc.europa.eu) and the Fundação para a Ciência e Tecnologia (grant IF/00839/2015, www.fct.pt). E.H.D. was supported by the fellowship SFRH/BD/113757/2015 from Fundação para a Ciência e Tecnologia (www.fct.pt), in the context of the Graduate Program Science for the Development. The fly work at the Fly Facility of Instituto Gulbenkian de Ciência (Oeiras, Portugal), was partially supported by the research infrastructure Congento, co-financed by Lisboa Regional Operational Programme (Lisboa2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and Fundação para a Ciência e Tecnologia (Portugal) under the project LISBOA-01-0145-FEDER-022170. The NGS analysis at the Genomics Unit of Instituto Gulbenkian de Ciência (Oeiras, Portugal), was partially supported by ONEIDA project (LISBOA-01-0145-FEDER-016417) co-funded by FEEI - "Fundos Europeus Estruturais e de Investimento" from "Programa Operacional Regional Lisboa 2020" and by national funds from FCT - "Fundação para a Ciência e a Tecnologia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Integration of genetic networks allows bacteria to rapidly adapt to changing environments. This is particularly important in bacteria that interact with multiple hosts. Erwinia carotovora is a plant pathogen that uses Drosophila melanogaster as a vector. To interact with these two hosts, Ecc15 uses different sets of virulence factors: plant cell wall-degrading enzymes to infect plants and the Erwinia virulence factor (evf) to infect Drosophila. Our work shows that, despite the virulence factors being specific for each host, both sets are coactivated by homoserine lactone quorum sensing and by the two-component GacS/A system in infected plants. This regulation is essential for Ecc15 loads in the gut of Drosophila and minimizes the developmental delay caused by the bacteria with respect to the insect vector. Our findings provide evidence that coactivation of the host-specific factors in the plant may function as a predictive mechanism to maximize the probability of transit of the bacteria between hosts., Multihost bacteria have to rapidly adapt to drastic environmental changes, relying on a fine integration of multiple stimuli for an optimal genetic response. Erwinia carotovora spp. are phytopathogens that cause soft-rot disease. Strain Ecc15 in particular is a model for bacterial oral-route infection in Drosophila melanogaster as it harbors a unique gene, evf, that encodes the Erwinia virulence factor (Evf), which is a major determinant for infection of the D. melanogaster gut. However, the factors involved in the regulation of evf expression are poorly understood. We investigated whether evf could be controlled by quorum sensing as, in the Erwinia genus, quorum sensing regulates pectolytic enzymes, the major virulence factors needed to infect plants. Here, we show that transcription of evf is positively regulated by quorum sensing in Ecc15 via acyl-homoserine lactone (AHL) signal synthase ExpI and AHL receptors ExpR1 and ExpR2. We also show that the load of Ecc15 in the gut depends upon the quorum sensing-mediated regulation of evf. Furthermore, we demonstrate that larvae infected with Ecc15 suffer a developmental delay as a direct consequence of the regulation of evf via quorum sensing. Finally, we demonstrate that evf is coexpressed with plant cell wall-degrading enzymes (PCWDE) during plant infection in a quorum sensing-dependent manner. Overall, our results show that Ecc15 relies on quorum sensing to control production of both pectolytic enzymes and Evf. This regulation influences the interaction of Ecc15 with its two known hosts, indicating that quorum sensing signaling may impact bacterial dissemination via insect vectors that feed on rotting plants.

Investigation of manual actions has supported the proposition that the right and left cerebral hemispheres have complementary specializations relevant for movement control. To test the extent to which hemisphere specialization affect lower limb control, we compared performance between the legs in two motor tasks. A pedal aiming task was employed to test the notion of left hemisphere specialization for dynamic control, and unipedal balance was employed to test the notion of right hemisphere specialization for impedance control. Evaluation was conducted on young adults, in the contexts of separate (Experiment 1) and integrated (Experiment 2) performance of the probing tasks. Results from the aiming task showed equivalent movement linearity toward the target between the right and left feet across experiments. Analysis of unipedal balance revealed that increased stance stability when supported on the left leg was observed when performing simultaneously the aiming task with the contralateral foot, but not in the context of isolated task performance. These results are inconsistent with the proposition of left hemisphere specialization for dynamic control in the lower limbs, and suggest that specialization of the right hemisphere for impedance control can be observed in balance control when stance is associated with voluntary movements of the contralateral lower limb.

Reactive responses to balance perturbations have been shown to be improved by training. This investigation aimed to compare the effects of block and random training perturbation schedules on stability gains of compensatory arm and leg movements in response to unpredictable large-magnitude balance perturbations. Perturbations were produced by means of sudden displacements of the support base, associating mode (rotation, translation, combined), direction, and velocity of platform motion. Healthy young participants were assigned to one of three groups: random, block, and control. For the random group, perturbation sequence was unpredictable. For the block group, each balance perturbation was repeated over blocks of four trials. Controls were tested only, serving as reference of first trial responses in the post-test. Evaluation was made through a scale rating stability of compensatory arm and leg movements (CALM). We probed immediate and persistence gains (1-week retention), in addition to generalizability to perturbations of higher velocity and to dual-tasking (mental subtraction). In the post-test both the block and random groups achieved higher leg and global scores in comparison with controls in the most challenging perturbations. In retention and transfer tests, results for the global score indicated higher values for the random than for the block and control groups. These results support the conclusion that high but not low contextual interference in perturbation-based balance training leads to enduring and generalizable increased stability gains of compensatory limb movements in response to unpredictable balance perturbations.

In daily living activities, performance of spatially accurate manual movements in upright stance depends on postural stability. In the present investigation, we aimed to evaluate the effect of the required manual steadiness (task constraint) on the regulation of dynamic postural control. A single group of young participants ( n = 20) were evaluated in the performance of a dual posturo-manual task of balancing on a platform oscillating in sinusoidal translations at 0.4-Hz (low) or 1-Hz (high) frequencies while stabilizing a cylinder on a handheld tray. Manual task constraint was manipulated by comparing the conditions of keeping the cylinder stationary on its flat or round side, corresponding to low and high manual task constraints, respectively. Results showed that in the low oscillation frequency the high manual task constraint led to lower oscillation amplitudes of the head, center of mass, and tray, in addition to higher relative phase values between ankle/hip-shoulder oscillatory rotations and between center of mass/center of pressure-feet oscillations as compared with values observed in the low manual task constraint. Further analyses showed that the high manual task constraint also affected variables related to both postural (increased amplitudes of center of pressure oscillation) and manual (increased amplitude of shoulder rotations) task components in the high oscillation frequency. These results suggest that control of a dynamic posturo-manual task is modulated in distinct parameters to attend the required manual steadiness in a complex and flexible way.NEW & NOTEWORTHY We evaluated dynamic postural control on a platform oscillating in sinusoidal translations at different frequencies while performing a manual task with low or high steadiness constraints. Results showed that high manual task constraint led to modulation of metric and coordination variables associated with greater postural stability. Our findings suggest that motor control is regulated in an integrative mode at the posturo-manual task level, with reciprocal interplay between the postural and manual components.

We evaluated the effect of repeated use of the nonpreferred hand on young children’s manual preference by positioning toys in the left hemifield in egocentric coordinates to induce right-handed 4–5-year-olds to use their left hands spontaneously. We induced motor activities in the laterally biased workspace by presenting tasks in a ludic context over different days, similar to their daily kindergarten experience. Preceding and following these lateralized experiences, the children were tested on a task requiring reaching, grasping, and inserting cards into a slot. In the 1-day retention assessment, we found that repeated use of the nonpreferred left hand in the previous phase led to increased use of the left hand to perform the probing task. Following 14 days of rest, the children with induced left-hand experiences used exclusively their left hands to manipulate the leftmost card positions. We propose that repeated use of the nonpreferred left hand leads to increased confidence to plan left-handed movements for subsequent tasks.

Walkers are commonly prescribed worldwide to individuals unable to walk independently. Walker usage leads to improved postural control and voluntary movement during step. In the present study, we aimed to provide a concept-proof on the feasibility of an event-related protocol integrating the analyses of biomechanical variables of step initiation and functional near-infrared spectroscopy (fNIRS) to measure activation of the supplementary motor area (SMA) while using a walker. Healthy young participants were tested while stepping with versus without the use of the walker. Behavioral analysis showed that anticipatory postural adjustments (APA) decreased when supporting the body weight on the walker. Delta (without-with) of activation magnitude of the muscle tibialis anterior was positively correlated to the delta of deoxyhemoglobin concentration changes in the SMA. The novelty of this study is the development of a protocol to assess brain function together with biomechanical analysis during the use of a walker. The method sheds light to the potential utility of combining fNIRS and biomechanical assessment during assistive step initiation, which can represent a new opportunity to study populations with mobility deficits.

Objective: Fast and scaled muscular activation is required to recover body balance following an external perturbation. An issue open to investigation is the extent to which the cerebral hemisphere lesioned by stroke leads to asymmetric deficits in postural reactive responses. In this experiment, we aimed to compare muscular responses to unanticipated stance perturbations between individuals who suffered unilateral stroke either to the right or to the left cerebral hemisphere. Methods: Stance perturbations were produced by releasing a load attached to the participant's trunk, inducing fast forward body oscillation. Electromyography was recorded from the gastrocnemius medialis and biceps femoris muscles. Muscular activation from age-matched healthy individuals was taken as reference. Results: Analysis indicated that damage to the right hemisphere induced delayed activation onset, and lower rate and magnitude of activation of the proximal and distal muscles of the paretic leg. Those deficits were associated with stronger activation of the nonparetic leg. Comparisons between left hemisphere damage and controls showed deficits limited to activation of the biceps femoris of the paretic leg. Manipulation of visual information led to no significant effects on muscular responses. Conclusions: These results suggest that right cerebral hemisphere damage by stroke leads to more severe deficits in the generation of reactive muscular responses to stance perturbation than damage to the left cerebral hemisphere regardless of visual information.

Contains fulltext : 208625.pdf (Publisher’s version ) (Open Access) Following unpredictable large-magnitude stance perturbations diverse patterns of arm and leg movements are performed to recover balance stability. Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46-0.53) for inter-rater reliability in the arm and global scores, to very high (0.87-0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction.

Decline of motor performance in older individuals affects their quality of life. Understanding the contribution of sport-related training in advanced ages might help to attenuate motor performance decay as one gets older. The purpose of our study was to evaluate the extent to which long-lasting training in running or sport-specific skills during old age preserves motor performance in different motor tasks.Older runners and tennis players with at least 10 years of training were assessed as were age-matched and young exercisers. Performance was evaluated for 6 motor tasks requiring different functions of sensorimotor control expected to decline with aging.Analysis revealed that runners had increased aerobic fitness in comparison with the other older participants and that they presented similar performance to older exercisers in the motor tasks. Tennis players outperformed the other groups of older participants on coincident timing and simple reaction time and achieved similar performance to the young group on the timing task.These results suggest selective maintenance of task-specific processing through extensive practice of tennis-related motor skills in older adults.

Freezing of gait (FoG) in Parkinson’s disease (PD) is an incapacitating transient phenomenon, followed by continuous postural disorders. Spinal cord stimulation (SCS) is a promising intervention for FoG in patients with PD, however, its effects on distinct domains of postural control is not well known. The aim of this study is to assess the effects of SCS on FoG and distinct domains of postural control. Four patients with FoG were implanted with SCS systems in the upper thoracic spine. Anticipatory postural adjustment (APA), reactive postural responses, gait and FoG were biomechanically assessed. In general, the results showed that SCS improved FoG and APA. However, SCS failed to improve reactive postural responses. SCS seems to influence cortical motor circuits, involving the supplementary motor area. On the other hand, reactive posture control to external perturbation that mainly relies on neuronal circuitries involving the brainstem and spinal cord, is less influenced by SCS.

Contextual cueing advancing the characteristics of an impending balance perturbation has been thought to induce optimized automatic postural responses. In this investigation, we aimed to disambiguate the cognitive and adaptive components of cueing a balance perturbation through the direction sequence of a series of base of support translations. We compared three experimental conditions: (a) block, with one perturbation cueing that the following one would be in the same direction; (b) serial, with one perturbation cueing that the following one would be in the opposite direction; and (c) random, representing a control uncued condition. Participants were instructed about the perturbation sequences. With this arrangement, at the cognitive level there was no directional uncertainty both in the block and serial sequences, while at the non-cognitive level only the block sequence was expected to lead to optimized responses in comparison to the random sequence. Results showed that the block sequence led to the generation of more stable automatic postural responses in comparison to the serial and random sequences, as indicated by lower amplitudes of body sway and lower velocity of center of pressure displacement. Increased balance stability in the block sequence was associated with longer delays of activation onset of leg distal muscles. Comparisons between the serial and random perturbation sequences failed to show any significant differences. These results indicate that optimized postural responses in the block sequence are due to adaptive processes underlying repetitive perturbations over trials rather than to processing of contextual cues at the cognitive level reducing uncertainty about characteristics of an impending perturbation.

Our aim in this investigation was to assess the relative importance of each cerebral hemisphere in quiet and perturbed balance, based on uni-hemispheric lesions by stroke. We tested the hypothesis of right cerebral hemisphere specialization for balance control. Groups of damage either to the right (RHD, n = 9) or the left (LHD, n = 7) cerebral hemisphere were compared across tasks requiring quiet balance or body balance recovery following a mechanical perturbation, comparing them to age-matched nondisabled individuals (controls, n = 24). They were evaluated in conditions of full and occluded vision. In Experiment 1, the groups were compared in the task of quiet standing on (A) rigid and (B) malleable surfaces, having as outcome measures center of pressure (CoP) amplitude and velocity sway. In Experiment 2, we evaluated the recovery of body balance following a perturbation inducing forward body oscillation, having as outcome measures CoP displacement, peak hip and ankle rotations and muscular activation of both legs. Results from Experiment 1 showed higher values of CoP sway velocity for RHD in comparison to LHD and controls in the anteroposterior (rigid surface) and mediolateral (malleable surface) directions, while LHD had lower balance stability than the controls only in the mediolateral direction when supported on the rigid surface. In Experiment 2 results showed that RHD led to increased values in comparison to LHD and controls for anteroposterior CoP displacement and velocity, time to CoP direction reversion, hip rotation, and magnitude of muscular activation in the paretic leg, while LHD was found to differ in comparison to controls in magnitude of muscular activation of the paretic leg and amplitude of mediolateral sway only. These results suggest that damage to the right as compared to the left cerebral hemisphere by stroke leads to poorer postural responses both in quiet and perturbed balance. That effect was not altered by manipulation of sensory information. Our findings suggest that the right cerebral hemisphere plays a more prominent role in efferent processes responsible for balance control.

Cerebral damage provoked by stroke may lead to deficits of quiet balance control and of the recovery of body equilibrium following an unanticipated postural perturbation. In this investigation we aimed to evaluate the effect of light touch (LT) of an earth-fixed surface on balance stability in individuals with post-stroke hemiparesis, taking performance of age-matched healthy participants as reference. Evaluations were made in conditions of full and no visual information. Analysis of quiet balance showed that LT induced higher balance stability, with reduced amplitude and velocity of postural sway. Evaluation of the effect of LT on automatic postural responses was made in the task of recovering body equilibrium following a mechanical perturbation of balance leading to fast forward body sway. Results showed that LT led to reduced amplitude of center of mass displacement following the perturbation, in addition to reduced amplitude and velocity of center of pressure under the feet, and lower activation of the lower legs muscles. Those effects of LT were observed in both the post-stroke and control groups, and did not interact with vision availability. Our results indicated then that individuals who suffered a cerebral stroke can stabilize perturbed and non-perturbed postural responses by lightly touching a stable surface to a similar extent of healthy older individuals.

Background Patients with solid tumours are at risk for acute kidney injury (AKI), however, epidemiological data are limited. Methods We conducted a study that included patients with solid tumours admitted to a single-centre intensive care unit (ICU) from January 2011 to December 2015. We analysed factors associated with the occurence of AKI, ICU and Day-90 mortality. Results Two-hundred and four patients were included. The incidence of AKI was 59%, chiefly related to sepsis (80%), hypovolaemia (40%) and outflow tract obstruction (17%). Renal replacement therapy was implemented in 12% of the patients, with a hospital mortality of 39%. Independent predictors of AKI were: Simplified Acute Physiological Score II (SAPS II) [odds ratio (OR) 1.05; 95% confidence interval (95% CI) 1.02-1.07; P

Processing of predictive contextual cues of an impending perturbation is thought to induce adaptive postural responses. Cueing in previous research has been provided through repeated perturbations with a constant foreperiod. This experimental strategy confounds explicit predictive cueing with adaptation and non-specific properties of temporal cueing. Two experiments were performed to assess those factors separately. To perturb upright balance, the base of support was suddenly displaced backwards in three amplitudes: 5, 10 and 15 cm. In Experiment 1, we tested the effect of cueing the amplitude of the impending postural perturbation by means of visual signals, and the effect of adaptation to repeated exposures by comparing block versus random sequences of perturbation. In Experiment 2, we evaluated separately the effects of cueing the characteristics of an impending balance perturbation and cueing the timing of perturbation onset. Results from Experiment 1 showed that the block sequence of perturbations led to increased stability of automatic postural responses, and modulation of magnitude and onset latency of muscular responses. Results from Experiment 2 showed that only the condition cueing timing of platform translation onset led to increased balance stability and modulation of onset latency of muscular responses. Conversely, cueing platform displacement amplitude failed to induce any effects on automatic postural responses in both experiments. Our findings support the interpretation of improved postural responses via optimized sensorimotor processes, at the same time that cast doubt on the notion that cognitive processing of explicit contextual cues advancing the magnitude of an impending perturbation can preset adaptive postural responses.

This study aimed at assessing the interaction between subjective error estimation and frequency of extrinsic feedback in the learning of the basketball free shooting pattern by children. 10- to 12-year olds were assigned to 1 of 4 groups combining subjective error estimation and relative frequency of extrinsic feedback (33% × 100%). Analysis of performance was based on quality of movement pattern. Analysis showed superior learning of the group combining error estimation and 100% feedback frequency, both groups receiving feedback on 33% of trials achieved intermediate results, and the group combining no requirement of error estimation and 100% feedback frequency had the poorest learning. Our results show the benefit of subjective error estimation in association with high frequency of extrinsic feedback in children’s motor learning of a sport motor pattern.

Knowledge of brain correlates of postural control is limited by the technical difficulties in performing controlled experiments with currently available neuroimaging methods. Here we present a system that allows the measurement of anticipatory postural adjustment of human legs to be synchronized with the acquisition of functional magnetic resonance imaging data. The device is composed of Magnetic Resonance Imaging (MRI) compatible force sensors able to measure the level of force applied by both feet. We tested the device in a group of healthy young subjects and a group of elderly subjects with Parkinson’s disease using an event-related functional MRI (fMRI) experiment design. In both groups the postural behavior inside the magnetic resonance was correlated to the behavior during gait initiation outside the scanner. The system did not produce noticeable imaging artifacts in the data. Healthy young people showed brain activation patterns coherent with movement planning. Parkinson’s disease patients demonstrated an altered pattern of activation within the motor circuitry. We concluded that this force measurement system is able to index both normal and abnormal preparation for gait initiation within an fMRI experiment.

Effect of arm visibility on immediate manual preference was evaluated in 5-month-old infants on the task of reaching for a toy. Manual preference was assessed under full vision, and then in consecutive intervals in which vision of the preferred arm was occluded. Results showed that preferred arm visual occlusion led to reduced frequency of its use, with weakened persistence of that effect in the ensuing reestablishment of full vision. These results reveal that visual contact with the arms modulates their selection to perform reaching movements.

This investigation aimed to assess the effect of feet orientation angle in upright stance on automatic postural responses (APRs) to mechanical perturbations of different magnitudes. Perturbation was produced by releasing suddenly a load attached to the participant's trunk, leading to forward body sway. We evaluated APRs to loads corresponding to 5% (low) and 10% (high) of the participant's body weight, comparing the following feet orientations: parallel, preferred (M=10.46°), 15° and 30° for each foot regarding the body midline. Results showed that APRs were sensitive to perturbation magnitude, with the high load leading to increased amplitudes of center of pressure displacement and joints rotation, in addition to stronger and earlier muscular responses. Feet orientation at 30° led to a greater amplitude of center of pressure displacement than the other feet orientations. The low perturbation magnitude led to similar responses both at the hip and ankle across feet orientations, whereas the high load induced increased rotation amplitudes in both joints for feet orientation at 30°. Our results suggest that APRs are generated by the nervous system taking into consideration the biomechanical constraints in the response production. Relevant for standardization of feet placement in evaluations of balance recovery, our results indicated that a moderate range of outward feet orientation angles in stance lead to comparable APRs, while increased outward feet orientation angles lead to distinct postural responses.

In the present experiment, we aimed to evaluate the interactive effect of performing a cognitive task simultaneously with a manual task requiring either high or low steadiness on APRs. Young volunteers performed the task of recovering upright balance following a mechanical perturbation provoked by unanticipatedly releasing a load pulling the participant's body backwards. The postural task was performed while holding a cylinder steadily on a tray. One group performed that task under high (cylinder' round side down) and another one under low (cylinder' flat side down) manual steadiness constraint. Those tasks were evaluated in the conditions of performing concurrently a cognitive numeric subtraction task and under no cognitive task. Analysis showed that performance of the cognitive task led to increased body and tray displacement, associated with higher displacement at the hip and upper trunk, and lower magnitude of activation of the GM muscle in response to the perturbation. Conversely, high manual steadiness constraint led to reduced tray velocity in association with lower values of trunk displacement, and decreased rotation amplitude at the ankle and hip joints. We found no interactions between the effects of the cognitive and manual tasks on APRs, suggesting that they were processed in parallel in the generation of responses for balance recovery. Modulation of postural responses from the manual and cognitive tasks indicates participation of higher order neural structures in the generation of APRs, with postural responses being affected by multiple mental processes occurring in parallel.

This experiment was designed to evaluate the effects of pure motor imagery training (MIT) and its combination with physical practice on learning an aiming task with the more affected arm in adolescents suffering from cerebral palsy. Effect of MIT was evaluated as a function of side of hemiparesis. The experiment was accomplished by 11- to 16-year-old participants (M = 13.58 years), who suffered left (n = 16) or right (n = 15) mild hemiparesis. They were exposed to pure MIT (day 1) followed by physical practice (day 2) on an aiming task demanding movement accuracy and speed. Posttraining movement kinematics of the group receiving MIT were compared with movement kinematics of the control group after receiving recreational activities (day 1) and physical practice (day 2). Kinematic analysis showed that MIT led to decreased movement time and straighter hand displacements to the target. Performance achievements from MIT were increased with further physical practice, leading to enhanced effects on motor learning. Retention evaluation indicated that performance improvement from pure MIT and its combination with physical practice were stable over time. Performance achievements were equivalent between adolescents with either right or left hemiparesis, suggesting similar capacity between these groups to achieve performance improvement from pure imagery training and from its association with physical practice. Our results suggest that motor imagery training is a procedure potentially useful to increase motor learning achievements in individuals suffering from cerebral palsy.

Learning Objectives After completing this course, the reader will be able to: Describe prognostic factors in metastatic colorectal cancer.Estimate prognostic score with a simple model using only PS and LDH as parameters. This article is available for continuing medical education credit at CME.TheOncologist.com Background. The present study was done to establish a prognostic model for patients and trials using an oxaliplatin-based or irinotecan-based first-line chemotherapy in metastatic colorectal cancer. Patients and Methods. Eight hundred three patients treated with FOLFOX or FOLFIRI in three prospective trials were randomly separated into learning (n = 535) and validation (n = 268) samples. Eleven baseline variables were evaluated in univariate and multivariate analysis as prognostic factors for overall survival, and a prognostic score was developed. Results. Independent prognostic factors identified in multivariate analysis for overall survival were performance status (PS) (p < .001), serum lactate dehydrogenase (LDH) (p < .001), and number of metastatic sites (p = .005). A prognostic score based on these three variables was found efficient (Harrell's C index 0.61). This new model was improved by selecting only PS and LDH (Harrell's C index 0.64). Three risk groups for death could be identified: a low-risk group (n = 184; median overall survival [OS] 29.8 months), an intermediate-risk group (n = 223; median OS 19.5 months), and a high-risk group (n = 128; median OS 13.9 months). Median survival for the low-, intermediate-, and high-risk groups were 26.8, 21.1, and 16.5 months, respectively, in the validation sample (Harrell's C index 0.63). Conclusions. Serum LDH level was the main prognostic factor in predicting survival, followed by WHO PS. We identified three risk groups for death depending on these two baseline parameters. This simple prognostic model can be useful for clinician's use and patient stratification in future clinical trials.

The objective of the study was to investigate the role of endothelin-1 in the pathogenesis of scleroderma renal crisis in patients with systemic sclerosis. We used immunohistochemical analysis with anti-endothelin-1 and anti-von Willebrand factor antibodies in comparing kidney biopsies from patients with systemic sclerosis and scleroderma renal crisis (n = 14); from normal kidneys (n = 5); and from patients with typical hemolytic uremic syndrome and thrombotic microangiopathy (n = 5), antiphospholipid syndrome (n = 6), diabetic nephropathy (n = 5), minimal change disease with cyclosporine toxicity (n = 5), or nephroangiosclerosis (n = 5). Kidney biopsies from all systemic sclerosis patients presented specific lesions: glomerular lesions with thickened capillary walls (n = 6, 42.8%), mesangiolysis (n = 3, 21.4%), fibrin thrombi (n = 3, 21.4%), hypertrophy of juxtaglomerular apparatus (n = 5, 35.7%), arteriolar lesions showing mucinous intimal thickening and lumen mucoid occlusions (n = 13, 92.8%), proliferation of intimal cells (ie, "onion-skin" lesions; n = 13, 92.8%), fibrinoid necrosis (n = 3, 21.4%), and fibrin thrombosis (n = 4, 28.6%). Chronic lesions in large arteries showed modifications such as fibrous intimal thickening (n = 13, 92.8%). The pattern of endothelial staining for endothelin-1 in both glomeruli and arteriolar lesions appears to be specific for scleroderma renal crisis. Glomerular endothelin-1 staining without arteriolar staining was seen in hemolytic uremic syndrome; and isolated arteriolar staining (without glomerular staining) was seen in a number of conditions including antiphospholipid nephropathy, cyclosporine toxicity, and diabetic nephropathy. Endothelin-1 is overexpressed in glomeruli and arterioles of patients with scleroderma renal crisis, which suggests that endothelin-1 might be a therapeutic target in this condition.

The effect of lateralized practice on manual preference was investigated in right-handed children. Probing tasks required reaching and grasping a pencil at distinct eccentricities in the right and left hemifields (simple), and its transportation and insertion into a small hole (complex). During practice, the children experienced manipulative tasks different from that used for probing, using the left hand only. Results showed that before practice the children used almost exclusively the right hand in the right hemifield and at the midline position. Following lateralized practice frequency of use of the left hand increased in most lateral positions. A more evident effect of lateralized practice on shift of manual preference was detected in the complex task. Implications for lateralization of behavior in a developmental timescale are discussed on the basis of the proposition of amplification and diffusion of manual preference from lateralized practice. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 723–730, 2010.

Strength of leg preference and interlateral asymmetry in kinematics of kicking a ball for power were assessed in 6- to 10-year-old right-footed soccer player children. Leg preference was evaluated separately for three task categories: balance stabilization, soccer related mobilization, and general mobilization. The results showed that while both categories of mobilization tasks were featured by a consistent preference for the right leg, in stabilization tasks we observed lower scores and greater interindividual variability of leg preference. No effect of age was detected on leg preference. Analysis of peak foot velocity revealed similar increment of performance of the right and left legs from the ages 6-8 to 10 years. This finding supports the notion of stable magnitude of interlateral asymmetries of performance during motor development.

Objective:To determine the frequency and risk factors of venous thromboembolic events (VTE) in Wegener’s granulomatosis (WG), microscopic polyangiitis (MPA) and, the so far unstudied, Churg–Strauss syndrome (CSS) and polyarteritis nodosa (PAN).Methods:Retrospective, systematic analysis and comparisons were made between the characteristics of patients in the VTE group and non-VTE group. 1130 patients with WG, MPA, CSS or PAN were identified from the French Vasculitis Study Group cohort.Results:During a mean follow-up of 58.4 (45.8) months, 83 VTE occurred in 74 (6.5%) patients, with a median vasculitis–VTE diagnosis interval of 5.8 months (−3 to +156). VTE occurred in seven of 285 (2.5%) patients with PAN, 19 of 232 (8.2%) with CSS, 30 of 377 (8%) with WG and 18 of 236 (7.6%) with MPA. Multivariate analysis retained age, male sex or previous VTE or stroke with motor deficit as being associated with a higher VTE risk. The adjusted odds ratio (95% confidence interval) for VTE was 2.88 (1.27 to 6.50) for patients with WG, MPA or CSS compared with PAN (p = 0.01).Conclusions:Our results suggest that, like WG and MPA, patients with CSS are at a greater risk of VTE, than those with PAN. The reasons for this difference remain to be elucidated.

Objectives: To describe presentation and outcome of patients with scleroderma renal crisis (SRC). Methods: SRC was defined as rapidly progressive oliguric renal insufficiency and/or rapidly progressive arterial hypertension occurring during the course of systemic sclerosis (SSc). Chronic dialysis-free survival was analysed using multivariate Cox proportional hazards regression models. The risk for developing SRC associated with corticosteroid (CS) exposure during the preceding 1- or 3-month periods was analysed according to a case–crossover design. Results: A total of 50 SSc patients aged 53.3 (14.5) (mean (SD)) years were included in the study. SRC occurred between 1979 and 2003, after a mean (SD) disease duration of 27.7 (49.1) months. A total of 43 (86%) patients had diffuse SSc, 5 (10%) had limited cutaneous SSc and 2 (4%) had SSc sine scleroderma. At the time of SRC, 10 (20%) patients were taking angiotensin converting enzyme inhibitors, and mean creatininaemia was 468 (293) μmol/l. A total of 28 (56%) patients required haemodialysis. In all, 11 patients underwent a renal biopsy, all of them had specific vascular lesions of SRC. Multivariate analyses retained age >53 years and normal blood pressure as independent predictors of decreased dialysis-free survival. Exposure to CS prior to SRC was identified in 30 (60%) patients. The odds ratios for developing SRC associated with CS exposure during the preceding 1- or 3-month periods were 24.1 (95% CI 3.0–193.8) and 17.4 (95% CI 2.1–144.0), respectively. Conclusion: SRC remains associated with severe morbidity and mortality. CS might increase the risk of developing SRC. Further studies are needed to confirm these results.

summary. Acquired haemophilia is a factor VIII (FVIII) deficiency due to autoantibodies directed against FVIII that can be responsible for severe haemorrhage. The therapeutic approach, in addition to the treatment of bleeding episodes with clotting factor infusion, relies on corticosteroids (CS), cyclophosphamide (CYC), and/or high-dose intravenous immunoglobulins (IVIg). However, the efficacy of IVIg is limited, and CS and CYC may cause a number of adverse effects. Recently, rituximab has been proposed, alone or in combination with CS and immunosuppressants in a small number of patients with acquired anti-FVIII antibodies with a good efficacy. We report here on two patients, aged 74 and 81, respectively, who developed acquired haemophilia, with high titre FVIII inhibitors and severe haemorrhage, in the absence of a detectable cause. Both of them received rituximab as a first line therapy with a marked and prolonged efficacy.

Interlateral transfer of learning was investigated in timing tasks holding different levels of motor complexity. The tasks required hitting a hemiball at the end of an electronic trackway simultaneously with the end of displacement of a visual stimulus. The hemiball was to be hit with the palm of one hand (simple task), or through a forehand drive with a racquet (complex task). Four experimental conditions were compared, which resulted from the combination between direction of transfer for complexity, and direction of transfer for hand. The results evidenced partial interlateral transfer of timing control, and that performance on the transfer task was temporally biased by the practised task. Additionally, there was not a consistent advantage for a single direction of transfer of learning, which means symmetric capacity of intermanual transfer. Such findings indicate that in synchronisation tasks motor learning takes place at two levels: at a higher level independent of the effector system, and at a lower effector-specific level.

The time course of movement timing reprogramming was examined in a task requiring temporal coincidence of the conclusion of a forehand drive with the arrival of a moving luminous target at the end of an electronic trackway. The moving target departed from one end of the trackway at a constant velocity of 2 m (.) s(-1), and for a part of the trials its velocity was increased to 3 m (.) s(-1). Target velocity was modified at different moments during stimulus displacement, producing times-to-arrival after velocity increment (TAVIs) from 100 to 600 ms. The effect of specific practice on movement reprogramming was also examined. The results showed early adjustments to the action (TAVIs = 100 - 200 ms) that seemed to be stereotyped, while feedback-based corrections were implemented only at TAVIs of 300 ms or longer. Temporal accuracy was progressively increased as longer TAVIs were provided up to 600 ms. Skill training led to an overall increment of temporal accuracy, but no effect of specific practice was found. The results indicate that timing reprogramming in interceptive actions is a continuous process limited mainly by intrinsic factors: latency to initiate more effective adjustments to the action, and rate-of-movement timing reprogramming.

Objectives. Recently published findings suggested that antineutrophil cytoplasmic antibodies (ANCA), particularly those with a cytoplasmic (C-ANCA) labelling pattern and targeting proteinase 3 (anti-PR3), might be markers of tuberculosis (TB). This is a critical issue, because C-ANCA/anti-PR3 were considered to be a highly specific hallmark of Wegener’s granulomatosis or microscopic polyangiitis and because TB may clinically mimic Wegener’s granulomatosis. We therefore undertook a study with the aim of investigating further the prevalence and specificity of ANCA in TB. Methods. We evaluated serum samples from 67 patients diagnosed with culture-proven TB and 10 previously untested control samples from patients known to be ANCA positive (four Wegener’s granulomatosis and two microscopic polyangiitides) or negative. All 77 sera were screened for ANCA using commercially available indirect immunofluorescence (IIF) and enzymelinked immunosorbent assay (ELISA) for anti-PR3 and antimyeloperoxidase (MPO). IIF-positive and anti-PR3- and antiMPO-negative sera were also tested for bactericidal/permeability-increasing protein, lactoferrin, elastase and cathepsin G specificities with commercially available ELISA. Results. IIF detected ANCA in seven (10%) of the TB sera, including three C-ANCA and four atypical perinuclear-labelling ANCA. Only one IIF-negative specimen was anti-PR3 positive in ELISA. ANCA testing of the control sera yielded IIF and ELISA results concordant with previous findings, except for one borderline ELISA. Conclusion. Our results indicate that TB is associated with low ANCA seroprevalence and poor specificity, with no test serum showing combined C-ANCA/anti-PR3 activity. In a clinical setting of Wegener’s granulomatosis/TB mimicry, such combined reactivity would seem to be more suggestive of Wegener’s granulomatosis.

Many cells store neutral lipids, as triacylglycerol and sterol esters, in droplets. PAT-domain proteins form a conserved family of proteins that are localized at the surface of neutral lipid droplets. Two mammalian members of this family, Perilipin and adipose differentiation-related protein, are involved in lipid storage and regulate lipolysis. Here, we describe the Drosophila PAT-family member Lsd2. We showed that Lsd2 is predominantly expressed in tissues engaged in high levels of lipid metabolism, the fat body and the germ line of females. Ultrastructural analysis in the germ line showed that Lsd2 localizes to the surface of lipid droplets. We have generated an Lsd2 mutant and described its phenotype. Mutant adults have a reduced level of neutral lipid content compared to wild type, showing that Lsd2 is required for normal lipid storage. In addition, ovaries from Lsd2 mutant females exhibit an abnormal pattern of accumulation of neutral lipids from mid-oogenesis, which results in reduced deposition of lipids in the egg. Consistent with its expression in the female germ line, we showed that Lsd2 is a maternal effect gene that is required for normal embryogenesis. This work demonstrates that Lsd2 has an evolutionarily conserved function in lipid metabolism and establishes Drosophila melanogaster as a new in vivo model for studies on the PAT-family of proteins.

Lateral asymmetries of manual, pedal, and ocular preferences, and motor asymmetry in the performance of the forceful overarm throw were analyzed in 71 children aged 4 to 10 years old. Performance with each side of the body was assessed on the basis of qualitative analysis, as proposed by M. A. Roberton and L. Halverson (1984) for identification of developmental stages by components of the task. Lateral preference was indicated by the frequency the children used the right or the left side of their body to carry out different manual, pedal, and ocular tasks. The overarm throw movement pattern was developed with both sides of the body but at different levels. Development of the nondominant side lagged behind that of the dominant side at all ages; a significant asymmetry in performance detected in the 4-year-olds was stable up to the age of 10 years. Indices of asymmetry for lateral preference and performance were found to be specific because no consistent correlations were observed among them throughout the age periods studied. Those results show the multidimensional character of human laterality and imply a property of motor development that prevents asymmetry of performance from increasing because of unilateral practice.

Light fingertip touch of a static bar generates extra somatosensory information used by the postural control system to reduce body sway. While the effect of light touch has been studied in quiet stance, less attention has been given to its potential benefit for reactive postural responses. In the present study, we tested the effect of light fingertip touch of a stable surface on recovery of postural stability from a mechanical perturbation. Participants stood upright on a force plate touching a static rigid bar while being pulled backward by a load. Unpredictable release of the load induced fast anterior body sway, requiring a reactive response to recover balance. Effect of light touch on postural responses was assessed as a function of vision and malleability of the support surface, analyzing different epochs ranging from the pre-perturbation period to recovery of a relatively stable quiet stance. Results showed that light touch induced lower magnitude of muscular activation in all epochs. Center of pressure (CoP) displacement/sway was affected by interaction of light touch with manipulation of the other sensory information. For the periods associated with quiet stance, light touch led to decreased CoP sway in the malleable surface in the pre-perturbation epoch, and in the condition combining no vision and malleable surface in the balance restabilization and follow-up quiet stance epochs. For the fast reactive response epoch, light touch induced smaller amplitude of CoP displacement across conditions, and lower CoP maximum velocity in the condition combining no vision and rigid surface. These results showed that light touch modulates postural responses in all epochs associated with an unanticipated mechanical perturbation, with a more noticeable effect in conditions manipulating sensory information relevant for balance control.

Foot preference was assessed in 5- to 20-year-old participants separately for mobilization and stabilization task categories through observation of performance. Results revealed different laterality profiles of pedal preference between task categories. Interindividual consistency and strong preference for the right foot in mobilization tasks contrasted to large interindividual variability and weak pedal preference in stabilization tasks. Strength of pedal preference for each task category was stable across age groups. These findings suggest that daily living experiences over years of use do not modify the footedness profile observed in childhood.

Acute moderate intensity continuous aerobic exercise can improve specific cognitive functions, such as short-term memory and selective attention. Moreover, high-intensity interval training (HIT) has been recently proposed as a time-efficient alternative to traditional cardiorespiratory exercise. However, considering previous speculations that the exercise intensity affects cognition in a U-shaped fashion, it was hypothesized that a HIT session may impair cognitive performance. Therefore, this study assessed the effects of an acute HIT session on selective attention and short-term memory tasks. 22 healthy middle-aged individuals ( M age = 53.7 yr.) engaged in both (1) a HIT session, 10 1 min. cycling bouts at the intensity corresponding to 80% of the reserve heart rate interspersed by 1 min. active pauses cycling at 60% of the reserve heart rate and (2) a control session, consisting of an active condition with low-intensity active stretching exercise. Before and after each experimental session, cognitive performance was assessed by the Victoria Version of the Stroop test (a selective attention test) and the Digit Span test (a short-term memory test). Following the HIT session, the time to complete the Stroop “Color word” test was significantly lower when compared with that of the control session. The performances in the other subtasks of the Stroop test as well as in the Digit Span test were not significantly different. A HIT session can improve cognitive function.

Manual preference and intermanual performance asymmetry have been approached from a multidimensional and dynamic perspective. A point of interest from that approach is the role of lateralized motor experiences on handedness. In this study, intermanual performance asymmetry in sport-specific movements and manual preference in daily living tasks were compared between Kung Fu athletes and novices. Analysis of movement time in the performance of interlaterally symmetric and asymmetric movement patterns showed smaller intermanual performance asymmetry in experts. Analysis of manual preference using the Edinburgh Handedness Inventory indicated that experts presented predominantly weak or moderate strength of right hand preference. Novices, conversely, were found to have predominantly strong right hand preference. These results suggest that extensive bimanual training by experts leads to a global shift of manual preference, affecting hand selection in distinct tasks.

Interlateral performance asymmetry in upright balance control was evaluated in this investigation by comparing unipedal stance on the right versus the left leg. Participants were healthy young adults, hand-foot congruent preference for the right body side. Balance performance was evaluated in unperturbed quiet stance and in the recovery of balance stability following a mechanical perturbation induced by unexpected load release. Evaluation was made under availability of full sensory information, and under deprivation of vision combined with distortion of sensory inputs from the feet soles. Results from perturbed posture revealed that muscular response latency and postural sway were symmetric between the legs. Unipedal stance was more stable when the body was supported on the right as compared with the left leg. No interaction was found between leg and sensory condition. Our findings are interpreted as resulting from specialization of the sensorimotor system controlling the right leg for continuous low-magnitude postural adjustments, while corrections to large-scale stance sway are symmetrically controlled between body sides.

Specificity of visuomotor maps was investigated in the acquisition of a task of grasping a moving ball. Performance was initially assessed in four visual conditions of full vision, visual occlusion of 100 msec, 200 msec, and 300 msec. preceding contact between the ball and hand. During acquisition one group practiced under full vision and another one with visual occlusion of 300 msec. A posttest was performed with the same visual conditions as the pretest, and in a subsequent transfer phase the groups reversed their visual conditions. The analysis of proportion of prehensions and movement kinematics indicated that practice in either experimental condition resulted in transfer to performance in different visual conditions.

This study compared intermanual performance asymmetry between adults and children of different ages in timing components of an aiming task. Participants manipulated a computer mouse with either hand, aiming to rapidly reach targets of different widths with a pointer on a monitor. Results showed longer deceleration movements with the left hand in children, leading to increased intermanual performance asymmetry when aiming at narrower targets. Increased intermanual performance asymmetry in children is conceptualized to derive from planning to minimize trajectory variability when controlling the nondominant hand.

Purpose Oxaliplatin combined with fluoropyrimidine improves survival in patients with stage III colon cancer. However, adjuvant chemotherapy with oxaliplatin is controversial in stage II and elderly patients. Patients and Methods We performed subgroup analyses of stage II and elderly patients randomly assigned fluorouracil with leucovorin (FL) ± oxaliplatin (FOLFOX4) in the Multicenter International Study of Oxaliplatin/Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer study. Comorbidities, severe adverse events, second cancers, management of relapse and death as a result of causes than other colon cancer were studied. Results Two thousand two hundred forty-six patients were enrolled. Overall, 899 patients had stage II disease, including 330 low-risk and 569 high-risk patients. A total of 315 patients were ages 70 to 75 years. For stage II patients, the hazard ratio (HR) for comparing FOLFOX4 with FL was 0.84 (95% CI, 0.62 to 01.14) for disease-free survival (DFS), 0.70 (95% CI, 0.49 to 0.99) for time to recurrence (TTR), and 1.00 (95% CI, 0.70 to 1.41) for overall survival (OS). There was no interaction between treatment and stage or age. Low-risk stage II patients did not benefit from oxaliplatin. In high-risk stage II patients, the HR comparing FOLFOX4 with FL was 0.72 (95% CI, 0.51 to 1.01) for DFS, 0.62 (95% CI, 0.41 to 0.92) for TTR, and 0.91 (95% CI, 0.61 to 1.36) for OS. In elderly patients, the HR comparing FOLFOX4 with FL was 0.93 (95% CI, 0.64 to 1.35) for DFS, 0.72 (95% CI, 0.47 to 1.11) for TTR, and 1.10 (95% CI, 0.73 to 1.65) for OS. Conclusion The results of these subset analyses show no statistically significant benefit (OS and DFS) for the addition of oxaliplatin to FL as adjuvant treatment for either stage II and elderly patients.

In the present study we evaluated the relationship between manual preference and intermanual performance asymmetry in reaching of 5-month-old infants. Manual preference was assessed through frequency of reaches toward toys presented at midline, left or right in egocentric coordinates. Intermanual performance asymmetry was evaluated through kinematic analysis. Results showed that performance was predominantly symmetric between hands. Lateral toy positions induced predominance of ipsilateral reaching, while the midline position led to equivalent distribution between right and left handed reaches. No significant correlation between manual preference and intermanual performance asymmetry was observed. These results converge against the notion that manual preference derives from a genetically determined advantage of movement control favoring the right hand.

de Lima-Pardini AC, Papegaaij S, Cohen RG, Teixeira LA, Smith BA, Horak FB. The interaction of postural and voluntary strategies for stability in Parkinson's disease. J Neurophysiol 108: 1244-1252, 2012. First published June 6, 2012; doi:10.1152/jn.00118.2012.-This study assessed the effects of stability constraints of a voluntary task on postural responses to an external perturbation in subjects with Parkinson's disease (PD) and healthy elderly participants. Eleven PD subjects and twelve control subjects were perturbed with backward surface translations while standing and performing two versions of a voluntary task: holding a tray with a cylinder placed with the flat side down [low constraint (LC)] or with the rolling, round side down [high constraint (HC)]. Participants performed alternating blocks of LC and HC trials. PD participants accomplished the voluntary task as well as control subjects, showing slower tray velocity in the HC condition compared with the LC condition. However, the latency of postural responses was longer in the HC condition only for control subjects. Control subjects presented different patterns of hip-shoulder coordination as a function of task constraint, whereas PD subjects had a relatively invariant pattern. Initiating the experiment with the HC task led to 1) decreased postural stability in PD subjects only and 2) reduced peak hip flexion in control subjects only. These results suggest that PD impairs the capacity to adapt postural responses to constraints imposed by a voluntary task.

Objective. Scleroderma renal crisis (SRC) is a severe manifestation of SSc, whose prognosis remains severe, despite treatment with angiotensin-converting-enzyme inhibitor and dialysis. This study was undertaken to describe SRC characteristics, prognosis and outcome, and evaluate the responsibility of CSs in its occurrence.Methods. Analysis concerned 91 SSc patients with SRC who were compared with 427 non-SRC–SSc patients taken as controls.Results. Among the 91 SRC patients, 71 (78.0%) had high blood pressure, 53 (58.2%) hypertensive encephalopathy and 51 (56.0%) thrombotic microangiopathy; 64 (70.3%) had received CSs before or concomitantly with SRC vs 156 (36.5%) non-SRC–SSc patients (P < 0.001). Treated SRC patients also received more prednisone 29.3 (28.4) vs 3.6 (9.9) mg than controls (P < 0.001). SRC clinical outcomes were poor: 49 (53.8%) patients required dialysis, which was definitive for 38. Thirty-seven (40.7%) SRC patients died vs 10.8% of the controls (P < 0.001). Death was most frequent among dialysed patients who never recovered renal function (22 vs 2) and 13 never-dialysed SRC patients died.Conclusions. Although SRC prognosis has improved markedly, SRC remains a severe manifestation of SSc, despite treatment with angiotensin-converting enzyme inhibitor and dialysis. CSs contributed significantly to SRC occurrence.

To examine the effect of long lasting practice on pedal behavior in sport, we compared experienced adult soccer players and nonsoccer players on leg preference in motor tasks requiring general mobilization, soccer related mobilization, and body balance stabilization. We also evaluated performance asymmetry between the right and left legs in static and dynamic unipedal body balance, based on center of pressure displacement, and correlated that with leg preference in balance stabilization tasks. Results revealed (a) a distinct leg preference between mobilization and stabilization tasks, which were significantly different between players and nonplayers, (b) similar balance stability between the right and left legs, (c) greater stability of experienced players compared with nonplayers in static and dynamic balance, and (d) absence of a significant leg preference correlation with interlateral balance asymmetry. These results suggest an effect of extensive soccer skill practice on establishing leg preference for specific mobilization tasks and overall balance control.

In this investigation we assessed the extent to which young and elderly individuals become dependent on the specific visual situation present during practice of an interceptive task. Young and elderly participants practiced extensively a task of intercepting a virtually moving target under full vision or visual occlusion of the last 600 ms of target displacement. Before and after practice they were assessed in four visual conditions varying the time interval of visual display. The results showed that the elderly practicing under full vision had a progressive increase of temporal errors as a function of the period of visual occlusion after task acquisition. The elderly practicing under visual occlusion, conversely, achieved improved performance only in the visual condition experienced during task acquisition. Young individuals showed greater adaptability, presenting similar performance across visual conditions. Development of specific visuomotor integration only for the elderly seems to be related with the higher status that vision holds for movement control at this age.