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BackgroundRobot-assisted therapy (RT) is a widely used intervention approach to enhance motor recovery in patients after stroke, but its effects on functional improvement remained uncertain. Neuromuscular electrical stimulation (NMES) is one potential adjuvant intervention approach to RT that could directly activate the stimulated muscles and improve functional use of the paretic hand.MethodsThis was a randomized, double-blind, sham-controlled study. Thirty-nine individuals with chronic stroke were randomly assigned to the RT combined with NMES (RT + ES) or to RT with sham stimulation (RT + Sham) groups. The participants completed the intervention 90 to 100 minutes/day, 5 days/week for 4 weeks. The outcome measures included the upper extremity Fugl-Meyer Assessment (UE-FMA), modified Ashworth scale (MAS), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale 3.0 (SIS). All outcome measures were assessed before and after intervention, and the UE-FMA, MAL, and SIS were reassessed at 3 months of follow-up.ResultsCompared with the RT + Sham group, the RT + ES group demonstrated greater improvements in wrist flexor MAS score, WMFT quality of movement, and the hand function domain of the SIS. For other outcome measures, both groups improved significantly after the interventions, but no group differences were found.ConclusionRT + ES induced significant benefits in reducing wrist flexor spasticity and in hand movement quality in patients with chronic stroke.Trial registrationClinicalTrials.gov. NCT01655446

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Our results suggest that downhill walking training is beneficial for improving gait performance in patients with Parkinson's disease and may contribute to maintenance of thoracic posture in these subjects.

Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages.

Organic fluorescent nanoparticles, excitation-dependent photoluminescence, hydrogen-bonded clusters and lysobisphosphatidic acid are four interesting individual topics in materials and biological sciences. They have attracted much attention not only because of their unique properties and important applications, but also because the nature of their intriguing phenomena remained unclear. Here we report a new type of organic fluorescent nanoparticles with intense blue and excitation-dependent visible fluorescence in the range of 410–620 nm. The nanoparticles are composed of ten bis(monoacylglycerol)bisphenol-A molecules and the self-assembly occurs only in elevated concentrations of 2-monoacylglycerol via radical-catalysed 3,2-acyl migration from 3-monoacylglycerol in neat conditions. The excitation-dependent fluorescence behaviour is caused by chromophores composed of hydrogen-bonded monoacylglycerol clusters, which are linked by an extensive hydrogen-bonding network between the ester carbonyl groups and the protons of the alcohols with collective proton motion and HO···C=O (n→π*) interactions.

The priming effect of mirror visual feedback can be simply provided by inexpensive mirror therapy (MT), which exhibits beneficial effects on sensorimotor recovery in stroke. The present study was a single-blind pretest-posttest study that examined whether the priming effect of mirror visual feedback on bilateral task practice would render better outcomes. Twenty-three patients with chronic stroke were randomized to receive hospital-based task-oriented MT or bilateral arm training (BAT) for 4 weeks at 90 minutes/day, 3 days/week and a home practice for 30-40 minutes/day, 5 days/week. There was the potential trend for MT to improve temperature sense as measured by the revised Nottingham Sensory Assessment (Cohen's d = 1.00; 95% confidence interval, -0.09 to 2.09), and MT increased the Stroke Impact Scale 3.0 total score (d = 0.89; 0.003 to 1.71). MT also showed a trend for greater improvements in the Motor Activity Log (amount of use: d = 0.62; -0.24 to 1.44; quality of movement: d = 0.50; -0.35 to 1.31). MT involving bilateral movement practice with the priming effect of mirror visual feedback may render beneficial effects. The unilateral approach or MT augmented by extra feedback might be appropriate modifications.