Using Contingent Reinforcement to Augment Muscle Activation After Perinatal Brachial Plexus Injury: A Pilot Study

AIM

Examine the feasibility of increasing muscle activation with electromyographically (EMG)-triggered musical-video as reinforcement for children with perinatal brachial plexus injury (PBPI).

METHODS

Six children with PBPI (9.3 ± 6.3 months; 5 female, 1 male) and 13 typically developing (TD) controls (7.8 ± 3.5 months; 4 female, 9 males) participated. The left arm was affected in 5/6 children with PBPI. We recorded the integral (Vs) of biceps activation with surface EMG during two conditions per arm in one session: (1) 100 second (s) baseline without reinforcement and (2) 300 s reinforcement (musical-video triggered to play with biceps activation above threshold [V]). We examined the relation between the mean integral with reinforcement and hand preference.

RESULTS

Mean biceps activation significantly increased from baseline in the affected arm of the group with PBPI by the 2nd (p < .008) and 3rd (p < .0004) 100 s intervals of reinforcement. Six of 6 children with PBPI and 12/13 TD controls increased activation in at least one arm. A lower integral was linked with hand preference for the unaffected right side in the PBPI group.

CONCLUSION

This study supports contingent reinforcement as a feasible method to increase muscle activation. Future work will examine training dose and intensity to increase arm function.

Frequent mild cognitive deficits in several functional domains in elderly patients with heart failure without known cognitive disorders

BACKGROUND

The objective of the present study was to investigate whether mild cognitive deficits are present in patients with heart failure (HF) despite absence of any known cognitive disorder.

METHODS AND RESULTS

A well defined group of patients (n = 40) with heart failure completed a cognitive screening check list, a depression screening questionnaire, and a battery consisting of neuropsychological tests assessing 5 different cognitive domains: speed/attention, episodic memory, visuospatial functions, language, and executive functions. The neuropsychological results were compared with those from a group of healthy control subjects (n = 41). The patients with HF displayed cognitive impairment compared with the control group within the domains speed and attention, episodic memory, visuospatial functions, and language. Among them, 34 HF patients (85%) could be classified with mild cognitive impairment (MCI), the majority as nonamnestic MCI, ie, with no memory impairment.

CONCLUSIONS

Considering the high occurrence of mild cognitive deficits among HF patients without known cognitive disorders, closer attention should be paid to their self-care and compliance. Inadequate self-care and compliance could lead to more frequent hospitalizations. Furthermore, the HF patients may be at increased risk of dementia.

Effect of drying rate on porosity and tabletting behaviour of cellulose pellets

The purpose of this study was to investigate the effect of drying rate during static drying on certain physical properties of pellets. Pellets were prepared from microcrystalline cellulose by granulation with different agglomeration liquids (various ethanol/water ratios) and thereafter dried without agitation at different drying rates. The dry pellets were characterised with respect to their shape, porosity, and compression shear strength and the tensile strength of tablets formed from pellets with low and high drying rates was determined. Drying of the pellets occurred at a falling rate and the reduction in liquid content with time obeyed a first order type of relationship. An increased drying rate did not affect the shape and surface texture of the dried pellets and did not cause them to fracture. However, the drying conditions did affect pellet porosity, with an increased drying rate resulting in more porous pellets. Through a relationship with pellet porosity, the drying rate also affected the deformability of the pellets (as assessed from Kawakita 1/b values) and their ability to form tablets. Owing to a strong effect of porosity on pellet compactability, marked changes in tablet tensile strength with variations in drying rate may be obtained.

Drying behaviour of two sets of microcrystalline cellulose pellets

The objective was to study contraction and densification of two sets of microcrystalline cellulose pellets, prepared using water (W) or a 25/75% w/w water/ethanol (W/E) mixture, during drying. The pellets were dried on microscope slides, photographed and weighed at set times. The porosity of the dry pellets was determined by mercury pycnometry. From pellet size, weight and porosity data, contraction and densification of the pellets and the relationship of these to the liquid content of the pellets during drying were calculated. Both types of pellets contracted and densified during drying. The initial porosity was similar for both types, but the final porosity of the dry pellets was higher for the W/E pellets. Thus, the difference in final pellet porosity between the two types was caused by a difference in densification during drying rather than a different degree of densification during the pelletisation procedure. The contraction rate and the relationships between contraction and the volume of removed liquid, and contraction and the degree of liquid saturation differed between the two types of pellet. The difference in drying behaviour between the two types of pellets can be explained by a liquid related change in both contraction driving force and contraction counteracting force or by a different contraction mechanism.