Gaming and social interactions in the rehabilitation of brain injuries: a pilot study

Physical rehabilitation of brain injuries and strokes is a time consuming and costly process. Over the past decade several studies have emerged looking at the use of highly sophisticated technologies, such as robotics and virtual reality to tap into the needs of clinicians and patients. While such technologies can be a valuable tool to facilitate intensive movement practice in a motivating and engaging environment, success of therapy also depends on self-administered therapy beyond hospital stay. With the emergence of low-cost gaming consoles such as the Nintendo Wii, new opportunities arise for home-therapy paradigms centred on social interactions and values, which could reduce the sense of isolation and other depression related complications. In this paper we examine the potential, user acceptance and usability of an unmodified Nintendo Wii gaming console as a low-cost treatment alternative to complement current rehabilitation programmes.

Olive oil and haemostasis

Olive oil is a key component of the traditional Mediterranean diet; a diet that may explain the low rate of cardiovascular disease (CVD) in Southern European. (Extra virgin) Olive oil is a good source of monounsaturated fatty acids (MUFA) and phenolic compounds, both of which have been investigated for their effects on plasma lipids and lipoproteins, measures of oxidation and factors related to thrombosis. This issue aims to summarise the current understanding of the effects of such dietary components on the haemostatic system and subsequent risk of CVD. To date, evidence suggests that diets rich in MUFA and thus in olive oil attenuate the thrombotic response via a reduction in platelet aggregation and in postprandial FVII levels. Thrombosis is a key event in causing heart attacks and strokes, which if modulated by diet could pose a cost-effective way of reducing CVD incidence in populations that adhere to MUFA/olive oil-rich diets long-term.

Targeting C-reactive protein for the treatment of cardiovascular disease

Complement-mediated inflammation exacerbates the tissue injury of ischaemic necrosis in heart attacks and strokes, the most common causes of death in developed countries. Large infarct size increases immediate morbidity and mortality and, in survivors of the acute event, larger non-functional scars adversely affect long-term prognosis. There is thus an important unmet medical need for new cardioprotective and neuroprotective treatments. We have previously shown that human C-reactive protein (CRP), the classical acute-phase protein that binds to ligands exposed in damaged tissue and then activates complement(1), increases myocardial and cerebral infarct size in rats subjected to coronary or cerebral artery ligation, respectively(2,3). Rat CRP does not activate rat complement, whereas human CRP activates both rat and human complement(4). Administration of human CRP to rats is thus an excellent model for the actions of endogenous human CRP2,3. Here we report the design, synthesis and efficacy of 1,6-bis(phosphocholine)-hexane as a specific small-molecule inhibitor of CRP. Five molecules of this palindromic compound are bound by two pentameric CRP molecules, crosslinking and occluding the ligand-binding B-face of CRP and blocking its functions. Administration of 1,6-bis(phosphocholine)-hexane to rats undergoing acute myocardial infarction abrogated the increase in infarct size and cardiac dysfunction produced by injection of human CRP. Therapeutic inhibition of CRP is thus a promising new approach to cardioprotection in acute myocardial infarction, and may also provide neuroprotection in stroke. Potential wider applications include other inflammatory, infective and tissue-damaging conditions characterized by increased CRP production, in which binding of CRP to exposed ligands in damaged cells may lead to complement-mediated exacerbation of tissue injury.

A Gentle/S approach to robot assisted neuro-rehabilitation

Movement disorders (MD) include a group of neurological disorders that involve neuromotor systems. MD can result in several abnormalities ranging from an inability to move, to severe constant and excessive movements. Strokes are a leading cause of disability affecting largely the older people worldwide. Traditional treatments rely on the use of physiotherapy that is partially based on theories and also heavily reliant on the therapists training and past experience. The lack of evidence to prove that one treatment is more effective than any other makes the rehabilitation of stroke patients a difficult task. UL motor re-learning and recovery levels tend to improve with intensive physiotherapy delivery. The need for conclusive evidence supporting one method over the other and the need to stimulate the stroke patient clearly suggest that traditional methods lack high motivational content, as well as objective standardised analytical methods for evaluating a patient's performance and assessment of therapy effectiveness. Despite all the advances in machine mediated therapies, there is still a need to improve therapy tools. This chapter describes a new approach to robot assisted neuro-rehabilitation for upper limb rehabilitation. Gentle/S introduces a new approach on the integration of appropriate haptic technologies to high quality virtual environments, so as to deliver challenging and meaningful therapies to people with upper limb impairment in consequence of a stroke. The described approach can enhance traditional therapy tools, provide therapy "on demand" and can present accurate objective measurements of a patient's progression. Our recent studies suggest the use of tele-presence and VR-based systems can potentially motivate patients to exercise for longer periods of time. Two identical prototypes have undergone extended clinical trials in the UK and Ireland with a cohort of 30 stroke subjects. From the lessons learnt with the Gentle/S approach, it is clear also that high quality therapy devices of this nature have a role in future delivery of stroke rehabilitation, and machine mediated therapies should be available to patient and his/her clinical team from initial hospital admission, through to long term placement in the patient's home following hospital discharge.

Purification and functional characterisation of Rhinocerase, a novel serine protease from the venom of Bitis gabonica rhinoceros

Background: Serine proteases are a major component of viper venoms and are thought to disrupt several distinct elements of the blood coagulation system of envenomed victims. A detailed understanding of the functions of these enzymes is important both for acquiring a fuller understanding of the pathology of envenoming and because these venom proteins have shown potential in treating blood coagulation disorders. Methodology/Principal Findings: In this study a novel, highly abundant serine protease, which we have named rhinocerase, has been isolated and characterised from the venom of Bitis gabonica rhinoceros using liquid phase isoelectric focusing and gel filtration. Like many viper venom serine proteases, this enzyme is glycosylated; the estimated molecular mass of the native enzyme is approximately 36kDa, which reduces to 31kDa after deglycosylation. The partial amino acid sequence shows similarity to other viper venom serine proteases, but is clearly distinct from the sequence of the only other sequenced serine protease from Bitis gabonica. Other viper venom serine proteases have been shown to exert distinct biological effects, and our preliminary functional characterization of rhinocerase suggest it to be multifunctional. It is capable of degrading α and β chains of fibrinogen, dissolving plasma clots and of hydrolysing a kallikrein substrate. Conclusions/Significance: A novel multifunctional viper venom serine protease has been isolated and characterised. The activities of the enzyme are consistent with the known in vivo effects of Bitis gabonica envenoming, including bleeding disorders, clotting disorders and hypotension. This study will form the basis for future research to understand the mechanisms of serine protease action, and examine the potential for rhinocerase to be used clinically to reduce the risk of human haemostatic disorders such as heart attacks and strokes.

Adobe Devanagari typeface

Typeface design: collaborative work commissioned by Adobe Inc. Published but unreleased. The Adobe Devanagari typefaces were commissioned from Tiro Typeworks and collaboratively designed by Tim Holloway, Fiona Ross and John Hudson, beginning in 2005. The types were officially released in 2009. The design brief was to produce a typeface for modern business communications in Hindi and other languages, to be legible both in print and on screen. Adobe Devanagari was designed to be highly readable in a range of situations including quite small sizes in spreadsheets and in continuous text setting, as well as at display sizes, where the full character of the typeface reveals itself. The construction of the letters is based on traditional penmanship but possesses less stroke contrast than many Devanagari types, in order to maintain strong, legible forms at smaller sizes. To achieve a dynamic, fluid style the design features a rounded treatment of distinguishing terminals and stroke reversals, open counters that also aid legibility at smaller sizes, and delicately flaring strokes. Together, these details reveal an original hand and provide a contemporary approach that is clean, clear and comfortable to read whether in short or long passages of text. This new approach to a traditional script is intended to counter the dominance of rigid, staccato-like effects of straight verticals and horizontals in earlier types and many existing fonts. OpenType Layout features in the fonts provide both automated and discretionary access to an extensive glyph set, enabling sophisticated typography. Many conjuncts preferred in classical literary texts and particularly in some North Indian languages are included; these literary conjuncts may be substituted by specially designed alternative linear forms and fitted half forms. The length of the ikars—ि and ी—varies automatically according to adjacent letter or conjunct width. Regional variants of characters and numerals (e.g. Marathi forms) are included as alternates. Careful attention has been given to the placements of all vowel signs and modifiers. The fonts include both proportional and tabular numerals in Indian and European styles. Extensive kerning covers several thousand possible combinations of half forms and full forms to anticipate arbitrary conjuncts in foreign loan words. _____

An enhancement of the ionospheric sporadic‐E layer in response to negative polarity cloud‐to‐ground lightning

Lightning data, collected using a Boltek Storm Tracker system installed at Chilton, UK, were used to investigate the mean response of the ionospheric sporadic-E layer to lightning strokes in a superposed epoch study. The lightning detector can discriminate between positive and negative lightning strokes and between cloud-to-ground ( CG) and inter-cloud ( IC) lightning. Superposed epoch studies carried out separately using these subsets of lightning strokes as trigger events have revealed that the dominant cause of the observed ionospheric enhancement in the Es layer is negative cloud-to-ground lightning.

The location of lightning affecting the ionospheric sporadic-E layer as evidence for multiple enhancement mechanisms

We present a study of the geographic location of lightning affecting the ionospheric sporadic-E (Es) layer over the ionospheric monitoring station at Chilton, UK. Data from the UK Met Office's Arrival Time Difference (ATD) lightning detection system were used to locate lightning strokes in the vicinity of the ionospheric monitoring station. A superposed epoch study of this data has previously revealed an enhancement in the Es layer caused by lightning within 200km of Chilton. In the current paper, we use the same data to investigate the location of the lightning strokes which have the largest effect on the Es layer above Chilton. We find that there are several locations where the effect of lightning on the ionosphere is most significant statistically, each producing different ionospheric responses. We interpret this as evidence that there is more than one mechanism combining to produce the previously observed enhancement in the ionosphere.

Advances in upper limb stroke rehabilitation: a technology push

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. Visual cues can also be used to control the information sent to the patient about exercise performance and to potentially address psychosomatic variables influencing therapy. This paper overviews the current state-of-the-art on upper limb robot-mediated therapy with a focal point on the technical requirements of robotic therapy devices leading to the development of upper limb rehabilitation techniques that facilitate reach-to-touch, fine motor control, whole-arm movements and promote rehabilitation beyond hospital stay. The reviewed literature suggest that while there is evidence supporting the use of this technology to reduce functional impairment, besides the technological push, the challenge ahead lies on provision of effective assessment of outcome and modalities that have a stronger impact transferring functional gains into functional independence.

Sarkar Bengali typeface

Fiona Ross, Tim Holloway (co-designers) were commissioned by the renowned newspaper and publishing house Anandabazar Patrika (ABP) to design a new low-contrast typeface in a contemporary style for print and screen use in its publications. Ross and Holloway designed ABP's Bengali house typeface (Linotype Bengali - the first digital Bengali font) that has been in daily use in its newspaper since 1982. The design team was augmented by Neelakash Kshetrimayum; OpenType production undertaken by John Hudson. This Bengali typeface is the first fully functional OpenType design for the script. It demonstrates innovative features that resolve problems which hitherto hindered the successful execution of low-contrast Bengali text fonts: this connecting script of over 450 characters has deep verticals, spiralling strokes, wide characters, and intersecting ascenders. The new design has solutions to overcome the necessity to implement wide interlinear spacing and sets more words to the line than has yet been possible. This project therefore combines the use of aesthetic, technical and linguistic skills and is highly visible in newspapers of the largest newspaper group and publishing house in West Bengal in print and on-line. The design and development of Sarkar has positive implications for other non-Latin script designs, just as the Linotype Bengali typeface formed the blueprint for new non-Latin designs three decades ago. Sarkar was released on 31 August 2012 with the launch of Anandabazar Patirka's new newspaper Ebela.

Tracing troposphere-to-stratosphere transport above a mid-latitude deep convective system

Within the project SPURT (trace gas measurements in the tropopause region) a variety of trace gases have been measured in situ in order to investigate the role of dynamical and chemical processes in the extra-tropical tropopause region. In this paper we report on a flight on 10 November 2001 leading from Hohn, Germany (52�N) to Faro, Portugal (37�N) through a strongly developed deep stratospheric intrusion. This streamer was associated with a large convective system over the western Mediterranean with potentially significant troposphere-to-stratosphere transport. Along major parts of the flight we measured unexpectedly high NOy mixing ratios. Also H2O mixing ratios were significantly higher than stratospheric background levels confirming the extraordinary chemical signature of the probed air masses in the interior of the streamer. Backward trajectories encompassing the streamer enable to analyze the origin and physical characteristics of the air masses and to trace troposphere-to-stratosphere transport. Near the western flank of the streamer features caused by long range transport, such as tropospheric filaments characterized by sudden drops in the O3 and NOy mixing ratios and enhanced CO and H2O can be reconstructed in great detail using the reverse domain filling technique. These filaments indicate a high potential for subsequent mixing with the stratospheric air. At the south-western edge of the streamer a strong gradient in the NOy and the O3 mixing ratios coincides very well with a sharp gradient in potential vorticity in the ECMWF fields. In contrast, in the interior of the streamer the observed highly elevated NOy and H2O mixing ratios up to a potential temperature level of 365K and potential vorticity values of maximum 10 PVU cannot be explained in terms of resolved troposphere-to-stratosphere transport along the backward trajectories. Also mesoscale simulations with a High Resolution Model reveal no direct evidence for convective H2O injection up to this level. Elevated H2O mixing ratios in the ECMWF and HRM are seen only up to about tropopause height at 340 hPa and 270 hPa, respectively, well below flight altitude of about 200 hPa. However, forward tracing of the convective influence as identified by satellite brightness temperature measurements and counts of lightning strokes shows that during this part of the flight the aircraft was closely following the border of an air mass which was heavily impacted by convective activity over Spain and Algeria. This is evidence that deep convection at mid-latitudes may have a large impact on the tracer distribution of the lowermost stratosphere reaching well above the thunderstorms anvils as claimed by recent studies using cloud-resolving models.

Evidence for solar wind modulation of lightning

The response of lightning rates over Europe to arrival of high speed solar wind streams at Earth is investigated using a superposed epoch analysis. Fast solar wind stream arrival is determined from modulation of the solar wind V y component, measured by the Advanced Composition Explorer spacecraft. Lightning rate changes around these event times are determined from the very low frequency arrival time difference (ATD) system of the UK Met Office. Arrival of high speed streams at Earth is found to be preceded by a decrease in total solar irradiance and an increase in sunspot number and Mg II emissions. These are consistent with the high speed stream's source being co-located with an active region appearing on the Eastern solar limb and rotating at the 27 d period of the Sun. Arrival of the high speed stream at Earth also coincides with a small (~1%) but rapid decrease in galactic cosmic ray flux, a moderate (~6%) increase in lower energy solar energetic protons (SEPs), and a substantial, statistically significant increase in lightning rates. These changes persist for around 40 d in all three quantities. The lightning rate increase is corroborated by an increase in the total number of thunder days observed by UK Met stations, again persisting for around 40 d after the arrival of a high speed solar wind stream. This result appears to contradict earlier studies that found an anti-correlation between sunspot number and thunder days over solar cycle timescales. The increase in lightning rates and thunder days that we observe coincides with an increased flux of SEPs which, while not being detected at ground level, nevertheless penetrate the atmosphere to tropospheric altitudes. This effect could be further amplified by an increase in mean lightning stroke intensity that brings more strokes above the detection threshold of the ATD system. In order to remove any potential seasonal bias the analysis was repeated for daily solar wind triggers occurring during the summer months (June to August). Though this reduced the number of solar wind triggers to 32, the response in both lightning and thunder day data remained statistically significant. This modulation of lightning by regular and predictable solar wind events may be beneficial to medium range forecasting of hazardous weather.

A reappraisal of Baskerville's Greek types

Ιn the eighteenth century the printing of Greek texts continued to be central to scholarship and discourse. The typography of Greek texts could be characterised as a continuation of French models from the sixteenth century, with a gradual dilution of the complexity of ligatures and abbreviations, mostly through printers in the Low Countries. In Britain, Greek printing was dominated by the university presses, which reproduced conservatively the continental models – exemplified by Oxford's Fell types, which were Dutch adaptations of earlier French models. Hindsight allows us to identify a meaningful development in the Greek types cut by Alexander Wilson for the Foulis Press in Glasgow, but we can argue that in the middle of the eighteenth century Baskerville was considering Greek printing the typographic environment was ripe for a new style of Greek types. The opportunity to cut the types for a New Testament (in an twin edition that included a generous octavo and a large quarto version) would seem perfect for showcasing Baskerville's capacity for innovation. His Greek type maintained the cursive ductus of earlier models, but abandoned complex ligatures and any hint of scribal flourish. He homogenised the modulation of the letter strokes and the treatment of terminals, and normalised the horizontal alignments of all letters. Although the strokes are in some letters too delicate, the narrow set of the style composes a consistent, uniform texture that is a clean break from contemporaneous models. The argument is made that this is the first Greek typeface that can be described as fully typographic in the context of the technology of the time. It sets a pattern that was to be followed, without acknowledgement, by Richard Porson nearly a century and a half later. The typeface received little praise by typographic historians, and was condemned by Victor Scholderer in his retrospective of Greek typography. A survey of typeface reviews in the surrounding decades establishes that the commentators were mostly reproducing the views of an arbitrary typographic orthodoxy, for which only types with direct references to Renaissance models were acceptable. In these comments we detect a bias against someone considered an arriviste in the scholarly printing establishment, as well as a conservative attitude to typographic innovation.