Newly Acquired Fear of Falling Leads to Altered Eye Movement Patterns and Reduced Stepping Safety: A Case Study

This opportune case study describes visual and stepping behaviours of an 87 year old female (P8), both prior to, and following two falls. Before falling, when asked to walk along a path containing two stepping guides positioned before and after an obstacle, P8 generally visually fixated the first stepping guide until after foot contact inside it. However, after falling P8 consistently looked away from the stepping guide before completing the step into it in order to fixate the upcoming obstacle in her path. The timing of gaze redirection away from the target (in relation to foot contact inside it) correlated with absolute stepping error. No differences in eyesight, cognitive function, or balance were found between pre- and post-fall recordings. However, P8 did report large increases in fall-related anxiety and reduced balance confidence, supporting previously suggested links between anxiety/increased fear or falling and maladaptive visual/stepping behaviours. The results represent a novel insight into how psychological and related behavioural factors can change in older adults following a fall, and provide a possible partial rationalisation for why recent fallers are more likely to fall again in the following 12 months. These findings highlight novel possibilities for falls prevention and rehabilitation.

Auditory observation of stepping actions can cue both spatial and temporal components of gait in Parkinson's disease patients

Objectives: A common behavioural symptom of Parkinson’s disease (PD) is reduced step length (SL). Whilst sensory cueing strategies can be effective in increasing SL and reducing gait variability, current cueing strategies conveying spatial or temporal information are generally confined to the use of either visual or auditory cue modalities, respectively. We describe a novel cueing strategy using ecologically-valid ‘action-related’ sounds (footsteps on gravel) that convey both spatial and temporal parameters of a specific action within a single cue.
Methods: The current study used a real-time imitation task to examine whether PD affects the ability to re-enact changes in spatial characteristics of stepping actions, based solely on auditory information. In a second experimental session, these procedures were repeated using synthesized sounds derived from recordings of the kinetic interactions between the foot and walking surface. A third experimental session examined whether adaptations observed when participants walked to action-sounds were preserved when participants imagined either real recorded or synthesized sounds.
Results: Whilst healthy control participants were able to re-enact significant changes in SL in all cue conditions, these adaptations, in conjunction with reduced variability of SL were only observed in the PD group when walking to, or imagining the recorded sounds.
Conclusions: The findings show that while recordings of stepping sounds convey action information to allow PD patients to re-enact and imagine spatial characteristics of gait, synthesis of sounds purely from gait kinetics is insufficient to evoke similar changes in behaviour, perhaps indicating that PD patients have a higher threshold to cue sensorimotor resonant responses.

Mode of insertion of the abductor hallucis muscle in human feet and its arterial supply

The abductor hallucis flap is commonly used as a pedicled flap (distally or proximally based) in the management of ankle, heel, and mid-foot lesions, where it is ideally used for closing defects. This study investigates the anatomical details of this muscle regarding its various forms of insertion and its arterial supply in 15 cadaveric feet. Four types of insertion could be distinguished: type A, insertion at the proximal phalanx of the big toe (46.7%); type B, insertion by two slips into the base of the proximal phalanx and the sesamoid bone (33.3%); type C, insertion at the sesamoid bone (6.7%); And type D, the insertion is divided into superficial tendinous and deep fleshy parts which are attached to the base of the proximal phalanx and to the metatarsophalangeal joint capsule of the big toe, respectively (13.3%). As regards the arterial supply, three patterns were noticed: pattern A (40%) where the medial plantar artery (MPA) is divided into superficial and deep branches that supplied the muscle; pattern B (53.3%) where the MPA failed to produce a deep branch but instead continued as the superficial branch supplying the two ends of the muscle; and pattern C (6.6%) where the MPA continued as a deep branch supplying the muscle. A superficial branch of MPA provided a branch to the abductor hallucis muscle from its proximal part. In two specimens (13.3%), the lateral plantar artery shared in the supply of the most proximal part of the muscle. These results can be useful in determining the appropriate flap design based on the abductor hallucis type of insertion and the pattern of its arterial supply in the patients.

How the mollusc got its scales: Convergent evolution of the molluscan scleritome

Radiation of dramatically disparate forms among the phylum Mollusca remains a key question in metazoan evolution, and requires careful evaluation of homology of hard parts throughout the deep fossil record. Enigmatic early Cambrian taxa such as Halkieria and Wiwaxia (in the clade Halwaxiida) have been proposed to represent stem-group aculiferan molluscs (Caudofoveata+Solenogastres+Polyplacophora), as complex scleritomes were considered to be unique to aculiferans among extant molluscs. The 'scaly-foot gastropod' (Neomphalina: Peltospiridae) from hydrothermal vents of the Indian Ocean, however, also carries dermal sclerites and thus challenges this inferred homology. Despite superficial similarities to various mollusc sclerites, the scaly-foot gastropod sclerites are secreted in layers covering outpockets of epithelium and are largely proteinaceous, while chiton (Polyplacophora: Chitonida) sclerites are secreted to fill an invaginated cuticular chamber and are largely calcareous. Marked differences in the underlying epithelium of the scaly-foot gastropod sclerites and operculum suggest that the sclerites do not originate from multiplication of the operculum. This convergence in different classes highlights the ability of molluscs to adapt mineralized dermal structures, as supported by the extensive early fossil record of molluscs with scleritomes. Sclerites of halwaxiids are morphologically variable, undermining the assumed affinity of specific taxa with chitons, or the larger putative clade Aculifera. Comparisons with independently derived similar structures in living molluscs are essential for determining homology among fossils and their position with respect to the enigmatic evolution of molluscan shell forms in deep time.

Ellerman Bombs with Jets: Cause and Effect

Ellerman Bombs (EBs) are thought to arise as a result of photospheric magnetic reconnection. We use data from the Swedish 1-m Solar Telescope(SST), to study EB events on the solar disk and at the limb. Both datasets show that EBs are connected to the foot-points of forming chromospheric jets. The limb observations show that a bright structure in the H$\alpha$ blue wing connects to the EB initially fuelling it,leading to the ejection of material upwards. The material moves along a loop structure where a newly formed jet is subsequently observed in the red wing of H$\alpha$. In the disk dataset, an EB initiates a jet which propagates away from the apparent reconnection site within the EB flame.The EB then splits into two, with associated brightenings in the inter-granular lanes (IGLs). Micro-jets are then observed, extending to500 km with a lifetime of a few minutes. Observed velocities of themicro-jets are approximately 5-10 km s$^{-1}$, while their chromospheric counterparts range from 50-80 km s$^{-1}$. MURaM simulations of quiet Sun reconnection show that micro-jets with similar properties to that of the observations follow the line of reconnection in the photosphere,with associated H$\alpha$ brightening at the location of increased temperature.