Nicholas J. Taylor

Knee joint kinematics from familiarised treadmill walking can be generalised to overground walking in young unimpaired subjects

We studied the familiarisation time required for reliable sagittal-plane knee kinematics and temporal-distance gait measurements to be obtained from treadmill walking. We also studied whether knee kinematics and temporal-distance gait measurements obtained from familiarised treadmill walking can be generalised to overground walking. Sixteen subjects without pathology walked on a level overground walkway and on a treadmill. A motion measurement system was used to measure sagittal plane knee movements and temporal-distance gait parameters during overground and treadmill walking. Highly reliable knee kinematics and temporal-distance gait measurements [intraclass correlation coefficient (ICC)(2,1)>/=0.93] were found after 6 min of treadmill walking. These measurements, obtained after 6 min of treadmill walking, were highly correlated with and not significantly different to those of overground walking. Reliable measurements that can be generalised to overground walking, can be obtained from the treadmill within a familiarisation time of 6 min.

Single-event multilevel surgery in children with spastic diplegia: a pilot randomized controlled trial.

BACKGROUND Single-event multilevel surgery is considered the standard of care to improve gait and functioning of children with spastic diplegic cerebral palsy. However, the evidence base is limited. This pilot study is the first randomized controlled trial of single-event multilevel surgery, to our knowledge. METHODS Nineteen children (twelve boys and seven girls with a mean age of nine years and eight months) with spastic diplegia were enrolled. Eleven children were randomized to the surgical group and eight, to the control group. The control group underwent a program of progressive resistance strength training. The randomized phase of the trial concluded at twelve months. The control group then exited the study and progressed to surgery, whereas the surgical group continued to be followed in a prospective cohort study. The primary outcome measures were the Gait Profile Score (GPS) and the Gillette Gait Index (GGI). Secondary outcome measures were gross motor function (Gross Motor Function Measure-66 [GMFM-66]), functional mobility (Functional Mobility Scale [FMS]), time spent in the upright position, and health-related quality of life (Child Health Questionnaire [CHQ]). RESULTS A total of eighty-five surgical procedures were performed, with a mean of eight procedures per child (standard deviation, four). The surgical group had a 34% improvement in the GPS and a 57% improvement in the GGI at twelve months. The control group had a small nonsignificant deterioration in both indices. The between-group differences for the change in the GPS (-5.5; 95% confidence interval, -7.6 to -3.4) and the GGI (-218; 95% confidence interval, -299 to -136) were highly significant. The differences between the groups with regard to the secondary outcome measures were not significant at twelve months. At twenty-four months after surgery, there was a 4.9% increase in the GMFM-66 score and improvements in the FMS score, time spent in the upright position, and the physical functioning domain of the CHQ in the surgical group. CONCLUSIONS This study provides Level-II evidence that single-event multilevel surgery improves the gait of children with spastic diplegic cerebral palsy twelve months after surgery. Improvements in other domains, including gross motor function and quality of life, were not observed until twenty-four months after surgery.

Synthesis of icosahedral carboranes for second-harmonic generation. Part 2

The synthesis and non-linear optical properties of a series of Icosahedral carboranes are described. The carboranes are substituted on both carbon atoms, with a series of electron-donating and electron-withdrawing substituents. The single-crystal X-ray structure of two of the series 1,2-bis(3-nitrophenyl)-1,2-dicarba-closo-dodecaborane(12), 1, and 1-(3-nitrophenyl)-2-(4-nitrophenyl)-1,2-dicarba-closo-dodecaborane, 3, are presented. 3 crystallises in the space group P, with four molecules per unit cell with cell dimensions of a= 9.706(1)A, b= 13.798(2)A, c= 17.99(2)A, α= 109.17(1)°, β= 100.86(1)° and γ= 101.78(1)°. 1 crystallises in the space group P, with two molecules per unit cell with cell dimensions of a= 7.585(2)A, b= 11.032(3)A, c= 12.252(4)A, α= 105.29(3)°, β= 90.30(3)° and γ= 96.46(2)°. The second-harmonic generation (SHG) properties of all of the compounds prepared are described, and are related to the ZINDO-SOS calculations of molecular polarisibility, β, computed for selected examples.

Reactions of catecholatoborane with phosphinorhodium complexes: molecular structures of [RhHCl(Bcat)(PPri3)2] and [{(Pri2PCH2)2}Rh{(η6-cat)Bcat}](cat = 1,2-O2C6H4)

Addition of catecholatoborane (HBcat), 1, to [RhCl(N2)(PPri3)2] gives the first structurally characterised, unsaturated boryl complex, [RhHCl(Bcat)(PPri3)2], whereas reaction of [{(Pri2PCH2)2}Rh(η3-2-Me-allyl)] with 2 equiv. of 1 affords [{(Pri2PCH2)2Rh{(η6-cat)Bcat}]via B-substituent redistribution; both complexes catalyse the hydroboration of oct-1-ene with 1

A small group aerobic exercise programme that reduces body weight is feasible in adults with severe chronic schizophrenia: a pilot study

Purpose. To evaluate the feasibility and effects of an exercise programme on people with severe, chronic schizophrenia. Method. A single-group, pre-post pilot study incorporating a baseline familiarisation phase was followed by a 24-week, small-group aerobic exercise programme for up to 30-min each session, twice a week and a 30-min weekly walking session. Adherence was assessed by attendance, and by analysing the exercise supervisors comments in a programme diary and in each participants exercise logbook. Body weight, cardio-respiratory fitness (VO2 max), walking endurance (6-min walk test) and psychiatric symptoms (the Positive and Negative Syndrome Scale) were measured at each time point. Results. Eight participants (6 men, 2 women; mean age 45 years, 9 months (SD 10 years, 1 month); mean body mass index 27.0 (SD 4.2)) attended a mean of 73%% of the scheduled exercise sessions, and 83%% of the walking sessions, with no adverse events and no dropouts. All participants displayed positive and negative behaviours during training sessions. There were significant reductions in weight (2.4%%) and body mass index (2.2%%), but no changes in other measures. Conclusions. It was feasible and safe to conduct a small-group aerobic exercise programme for adults with severe chronic schizophrenia that reduced body weight.

Cyclobutanone mimics of penicillins: effects of substitution on conformation and hemiketal stability.

The tendency for carbocyclic analogues of penicillins to undergo hydrate and hemiketal formation is central to their ability to function as beta-lactamase inhibitors. 2-Thiabicyclo[3.2.0]heptan-6-one-4-carboxylates with alkoxy functionality at C3 have been prepared through two complementary diastereoselective substitution reactions following a highly stereoselective chlorination with sulfuryl chloride. We have found that carbocyclic analogues with 3beta substituents favor an endo envelope conformation in solution, the solid state, and the gas phase, whereas those with 3alpha substituents adopt an exo envelope. Evidence from X-ray crystal structures and ab initio calculations suggests that an anomeric effect contributes to the large conformational preference of the tetrahydrothiophene ring that favors the C3 substituent in an axial orientation. In addition, the envelope conformation of the bicycle, which is determined by the stereochemistry of the C3 substituent, has a dramatic effect on the ability of the cyclobutanone to undergo hemiketal formation in methanol-d4.

Effect of computer therapy in aphasia: a systematic review

Background: Speech pathologists face the clinical obstacle of providing an intensive service for individuals with aphasia. Computer therapy potentially offers a solution to the dilemma of increasing therapy frequency while maintaining or reducing the load on therapists’ resources. Aims: This systematic review of the literature aimed to determine the effect of computer therapy both in comparison to no therapy and in comparison to clinician-delivered therapy in individuals with aphasia. Seventeen terms encompassing three main concepts (aphasia, technology, and rehabilitation) were used to search four electronic databases. Two reviewers independently screened titles and abstracts against inclusion/exclusion criteria. Data extraction for included studies was completed by one reviewer and confirmed by the second reviewer. Main Contribution: Seven studies were included, with six studies suitable for determining the effectiveness of computer therapy in comparison to no therapy, and three studies suitable for determining the effectiveness of computer therapy in comparison to clinician-delivered therapy. Two studies were suitable for answering both questions. The studies ranged in quality and were analysed descriptively. Meta-analysis was unable to be completed due to heterogeneity in methods, study types, computer programs, and outcome measures. All six studies investigating computer therapy in comparison to no therapy reported statistically significant improvements within the computer group. Five out of six studies reported statistically significant differences in language outcomes between the computer therapy and control group. All three studies comparing computer- and clinician-delivered therapy reported improvements in both the clinician and computer-delivered interventions with no statistically significant differences in language outcomes between the two treatment groups. One study reported no statistically significant differences in number of sessions needed to reach therapy criterion, whereas another reported an observed increase in the number of computer-delivered sessions over clinician-delivered sessions required to reach the therapy criterion for several treatment levels. Conclusions: This review provides evidence that computer therapy is effective when compared to no therapy and provides preliminary evidence that computer-delivered therapy may be as effective as clinician-delivered therapy for a specific population of individuals with aphasia. However, the quality of the evidence is low due to the small number of studies included. This review highlights the need for further research investigating the effectiveness of computer therapy in comparison to clinician-delivered therapy in a larger sample to enable the exploration of factors such as the type of aphasia and severity and the role of feedback and cueing hierarchies on treatment success.

Habitual physical activity can be increased in people with cerebral palsy: a systematic review

Objective: To determine if habitual physical activity could be increased in people with cerebral palsy. Data sources: We searched electronic databases until February 2010 using key words related to concepts of cerebral palsy and physical activity. This search was supplemented with citation tracking. Methods: Studies had to include participants with cerebral palsy who have habitual physical activity measured over at least one day after a therapy intervention. Two reviewers independently assessed study quality with the PEDro scale (quantitative studies) and Critical Appraisal Checklist for Qualitative Research (qualitative studies). For quantitative studies standardized mean differences were calculated and meta-analysis conducted. Qualitative data were synthesized thematically. Results: Three randomized controlled trials (96 participants) and two qualitative studies (21 participants) were reviewed. Four studies evaluated exercise programmes, and one study an online educational and support programme. Meta-analysis showed that exercise programmes could increase habitual physical activity (δ = 1.0; 95% confidence interval (CI) 0.28 to 1.72). This result was reinforced by reports of increased daily activity in two qualitative studies. The online programme increased weekly minutes of moderate to vigorous physical activity (d = 0.81; 95% CI 0.17 to 1.45), and weekly step counts (d = 0.62; 95% CI 0.0 to 1.25). Positive effects were not maintained after programmes stopped. There was insufficient evidence to determine if demographic factors or programme characteristics, such as intensity and setting, were associated with outcomes. Conclusion: Preliminary evidence suggests that exercise programmes and online support programmes can increase habitual physical activity in people with cerebral palsy, but effects are not maintained when programmes stop.

Accuracy of clinical tests to diagnose superior labral anterior and posterior (SLAP) lesions

Abstract Numerous clinical tests to diagnose superior labral anterior and posterior (SLAP) lesions of the glenoid labrum have been described. The current systematic review of the relevant literature was undertaken to ascertain the accuracy of these tests as determined by likelihood ratios. Searching of electronic databases yielded 16 papers that had reported test accuracy on a total of 16 separate clinical tests for SLAP lesions, and some combinations of these tests. Although many tests appeared to be highly accurate when initially reported, all tests that had been evaluated by authors other than those who devised the test typically showed poor levels of accuracy in subsequent studies. The results of this review suggest that no one clinical test can be recommended for use in clinical practice to diagnose accurately the presence or absence of a SLAP lesion. It is possible that further investigations into the anatomical basis of these tests may explain the variability in accuracy.

A biogenetically-inspired synthesis of a ring-D model of kinamycin F: insights into the conformation of ring D.

An efficient three-step construction of the highly oxygenated D-ring of the kinamycin antibiotics is reported for a simple model system. A comparison of the spectroscopic characteristics of the synthetic models with those of natural kinamycin F, which is suspected to be the bioactive form of the kinamycins, leads to the conclusion that the favored D-ring conformation of kinamycin F differs from that of the other partially or fully acylated variants.