Search results for: impaired waterbody

Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani

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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.

Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology

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Authors: K. Doi, T. Nishimura, H. Fujimoto, Y. Hoshikawa, T. Wada

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Japanese industrial standard (JIS) association established one JIS (JIS S 0021) regarding packaging accessible design for people with visual impairments and elderly people in 2000. Recently, tactile symbol on shampoo bottle has been known as one of package accessible design and more effectively used. However, it has been said that people with visual impairment have been not been in trouble with difficulty of identifying body soap bottle between three bottles such as body soap bottle, shampoo bottle, and conditioner bottle. Japanese low vision association asked JIS association to solve this problem. JIS association and Japan cosmetic industry association constituted one review team for solving the problem. The review team asked our research team to make a proposal regarding new tactile symbol on body soap bottle. We conducted user survey and maker survey regarding tactile symbol on body soap bottle with easily identification. Seven test tactile symbol marks were elected in our proposed tactile symbols. In this study, we evaluate easily identification of tactile symbol on body soap bottle. Six visual impaired subjects were participated in our experiment. These subjects were asked to identify body soap bottle between three bottles such as body soap bottle, shampoo bottle, and conditioner bottle. The test tactile symbol on body soap were presented in random order. The test tactile symbols were produced by use of our originally developed 3D raised equipment. From our study, test tactile symbol marks with easily identification were made a short list of our proposed tactile symbols. This knowledge will be helpful in revision of ISO 11156.

Keywords: tactile symbol, easily identification, body soap, people with visual impairments

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Authors: Asher John Mohan, Krishna K. L.

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Objectives: (1) To assess the extent of memory impairment induced by Phenytoin (PHT) at normal and reduced dose on temporal lobe epileptic mice. (2) To evaluate the protective effect of Levetiracetam (LEV) on aggravation of memory impairment in temporal lobe epileptic mice by PHT. Materials and Methods: Albino mice of either sex (n=36) were used for the study for a period of 64 days. Convulsions were induced by intraperitoneal administration of pilocarpine 280 mg/kg on every 6th day. Radial arm maze (RAM) was employed to evaluate the memory impairment activity on every 7th day. The anticonvulsant and memory impairment activity were assessed in PHT normal and reduced doses both alone and in combination with LEV. RAM error scores and convulsive scores were the parameters considered for this study. Brain acetylcholine esterase and glutamate were determined along with histopathological studies of frontal cortex. Results: Administration of PHT for 64 days on mice has shown aggravation of memory impairment activity on temporal lobe epileptic mice. Although the reduction in PHT dose was found to decrease the degree of memory impairment the same decreased the anticonvulsant potency. The combination with LEV not only brought about the correction of impaired memory but also replaced the loss of potency due to the reduction of the dose of the antiepileptic drug employed. These findings were confirmed with enzyme and neurotransmitter levels in addition to histopathological studies. Conclusion: This study thus builds a foundation in combining a nootropic anticonvulsant with an antiepileptic drug to curb the adverse effect of memory impairment associated with temporal lobe epilepsy. However further extensive research is a must for the practical incorporation of this approach into disease therapy.

Keywords: anti-epileptic drug, Phenytoin, memory impairment, Pilocarpine

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Authors: Dembele Dembele, Philippe

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Several Second Language Acquisition (SLA) studies have stressed the benefits of Content and Language Integrated Learning (CLIL) and shown how CLIL students outperformed their non-CLIL counterparts in many L2 skills. However, numerous experimental CLIL programs seem to have mainly targeted above-average and rather highly motivated language learners. The need to understand the impact of the student’s language proficiency on code-switching in CLIL instruction motivated this study. Therefore, determining the implications of the students’ low-language proficiency for CLIL methodology, as well as the frequency with which CLIL teachers use the main pedagogical functions of code-switching, seemed crucial for a Spanish CLIL instruction on a large scale. In the mixed-method approach adopted, ten face-to-face interviews were conducted in nine Valencian public secondary education schools, while over 30 CLIL teachers also contributed with their experience in two online survey questionnaires. The results showed the crucial role language proficiency plays in the Valencian CLIL/Plurilingual selection criteria. The presence of a substantial number of low-language proficient students in CLIL groups, which in turn implied important methodological consequences, was another finding of the study. Indeed, though the pedagogical use of L1 was confirmed as an extended practice among CLIL teachers, more than half of the participants perceived that code-switching impaired attaining their CLIL lesson objectives. Therein, the dissertation highlights the need for more extensive empirical research on how code-switching could prove beneficial in CLIL instruction involving low-language proficient students while maintaining the maximum possible exposure to the target language.

Keywords: CLIL methodology, low language proficiency, code switching, selection criteria, code-switching functions

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Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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Authors: Naim Izet Kajtazi

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Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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Authors: Do Khanh Vy, Vuong Cat Khanh, Osamu Ohneda

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During atherosclerosis (AS) progression, perivascular adipose tissue-derived mesenchymal stem cells (PVAT-MSCs) are exposed to the hypoxic environment due to the oxygenic deprivation which might influence the adipose tissue-derived mesenchymal stem cells (AT-MSCs) function. Additionally, it has been reported that the angiogenic ability of subcutaneous AT-MSCs (SAT-MSCs) was impaired in the AS patients. However, up to now, the effects of AS on the characteristics and function of PVAT-MSCs have not been clarified yet. In the present study, we analyzed the AS microenvironment effects on the characteristics and function of AT-MSCs. We found that there was no significant difference in cellular morphology and differentiation ability between SAT-MSCs and PVAT-MSCs in AS patients. However, the proliferation of AS-derived PVAT-MSCs was less than those of AS-derived SAT-MSCs. Importantly, the migration of AS-derived PVAT-MSCs was faster than AS-derived SAT-MSCs. Of note, AS-derived PVAT-MSCs showed the upregulation of SDF1, which is related to the homing, and VEGF, which is related to the angiogenesis compared to those of AS-derived SAT-MSCs. Consistent with these results, AS-derived PVAT-MSCs showed the higher ability to recruit EPCs and ECs than AS-derived SAT-MSCs. In addition, EPCs and ECs which cultured in the presence of AS-derived PVAT-MSC conditioned medium showed the higher angiogenic function of the tube formation compared to those cultured in AS-derived SAT-MSC conditioned medium. This result suggests that the higher paracrine effects of AS-derived PVAT-MSCs support the angiogenic function of the target cells. Our data showed the different characteristics and functions of AT-MSCs derived from different sources of tissues. Under the AS microenvironment, it seems that the characteristics and functions of PVAT-MSCs might reflect the progression of AS. Further study will be necessary to clarify the mechanism in the future.

Keywords: atherosclerosis, mesenchymal stem cells, perivascular adipose tissue, subcutaneous adipose tissue

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Authors: B. Sadek, N. Khan, D. Łażewska, K. Kieć-Kononowicz

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The effects of the non-imidazole histamine H3 receptor (H3R) antagonist DL77 in passive avoidance paradigm (PAP) and novel object recognition (NOR) task in MK801-induced cognitive deficits associated with schizophrenia (CDS) in adult male rats, and applying donepezil (DOZ) as a reference drug were investigated. The results show that acute systemic administration of DL77 (2.5, 5, and 10 mg/kg, i.p.) significantly improved MK801-induced (0.1 mg/kg, i.p.) memory deficits in PAP. The ameliorating activity of DL77 (5 mg/kg, i.p.) in MK801-induced deficits was partly reversed when rats were pretreated with the centrally-acting H2R antagonist zolantidine (ZOL, 10 mg/kg, i.p.) or with the antimuscarinic antagonist scopolamine (SCO, 0.1 mg/kg, i.p.), but not with the CNS penetrant H1R antagonist pyrilamine (PYR, 10 mg/kg, i.p.). Moreover, the memory enhancing effect of DL77 (5 mg/kg, i.p.) in MK801-induced memory deficits in PAP was strongly reversed when rats were pretreated with a combination of ZOL (10 mg/kg, i.p.) and SCO (1.0 mg/kg, i.p.). Furthermore, the significant ameliorative effect of DL77 (5 mg/kg, i.p.) on MK801-induced long-term memory (LTM) impairment in NOR test was comparable to the DOZ-provided memory-enhancing effect, and was abrogated when animals were pretreated with the histamine H3R agonist R-(α)-methylhistamine (RAMH, 10 mg/kg, i.p.). However, DL77(5 mg/kg, i.p.) failed to provide procognitive effect on MK801-induced short-term memory (STM) impairment in NOR test. In addition, DL77 (5 mg/kg) did not alter anxiety levels and locomotor activity of animals naive to elevated-plus maze (EPM), demonstrating that improved performances with DL77 (5 mg/kg) in PAP or NOR are unrelated to changes in emotional responding or spontaneous locomotor activity. These results provide evidence for the potential of H3Rs for the treatment of neurodegenerative disorders related to impaired memory function, e.g. CDS.

Keywords: histamine H3 receptor, antagonist, learning, memory impairment, passive avoidance paradigm, novel object recognition

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Authors: Sungpyo Kim, Changseok Oh, Ga-Young Lee, Hyun-Man Kim

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Intercellular junction of keratinocytes is crucial for epithelia to build an epithelial barrier. Junctional epithelium (JE) seals the interfaces between tooth and gingival tissue. Keratinocytes of JE attach to surfaces roughened by abrasion or erosion with aging. Thus behavior of oral keratinocytes on the rough substrates may help understand the epithelial seal of JE of which major intercellular junction is E-cadherin junction (ECJ). The present study investigated the influence of various substrate roughnesses on the development of ECJ between normal human gingival epithelial keratinocytes, HOK-16B cells. HOK-16B cells were slow in the development of ECJ on the rough substrates compared to on the smooth substrates. Furthermore, oral keratinocytes on the substrates of higher roughnesses were delayed in the development of E-cadherin junction than on the substrates of lower roughnesses. Delayed development of E-cadherin junction on the rough substrates was ascribed to the impaired spreading of cells and its higher JNK activity. Cells on the smooth substrates rapidly spread wide cytoplasmic extensions around cells. However, cells on the rough substrates slowly extended narrow cytoplasmic extensions of which number was limited due to the substrate irregularity. As these cytoplasmic extensions formed ECJ when met with the extensions of neighboring cells, thus, the present study demonstrated that a limited chance of contacts between cytoplasmic extensions due to the limited number of cytoplasmic extensions and slow development of cytoplasmic extensions brought about a delayed development of ECJ in oral keratinocytes on the rougher substrates. Sealing between cells was not complete because only part of cell membrane contributes to the formation of intercellular junction between cells on the substrates of higher roughnesses. Interestingly, inhibition of JNK activity promoted the development of ECJ on the rough substrates, of which mechanism remains to be studied further.

Keywords: substrate roughness, E-cadherin junction, oral keratinocyte, cell spreading, JNK

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Authors: Paolo Lenzuni

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Cost-effectiveness of noise abatement treatments at the workplace has not yet received adequate consideration. Furthermore, most of the published work is focused on productivity, despite the poor correlation of this quantity with noise levels. There is currently no tool to estimate the social benefit associated to a specific noise abatement treatment, and no comparison among different options is accordingly possible. In this paper, we present an algorithm which has been developed to predict the cost-effectiveness of any planned noise control treatment in a workplace. This algorithm is based the estimates of hearing threshold shifts included in ISO 1999, and on compensations that workers are entitled to once their work-related hearing impairments have been certified. The benefits of a noise abatement treatment are estimated by means of the lower compensation costs which are paid to the impaired workers. Although such benefits have no real meaning in strictly monetary terms, they allow a reliable comparison between different treatments, since actual social costs can be assumed to be proportional to compensation costs. The existing European legislation on occupational exposure to noise it mandates that the noise exposure level be reduced below the upper action limit (85 dBA). There is accordingly little or no motivation for employers to sustain the extra costs required to lower the noise exposure below the lower action limit (80 dBA). In order to make this goal more appealing for employers, the algorithm proposed in this work also includes an ad-hoc element that promotes actions which bring the noise exposure down below 80 dBA. The algorithm has a twofold potential: 1) it can be used as a quality index to promote cost-effective practices; 2) it can be added to the existing criteria used by workers’ compensation authorities to evaluate the cost-effectiveness of technical actions, and support dedicated employers.

Keywords: cost-effectiveness, noise, occupational exposure, treatment

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Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh

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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.

Keywords: latent tuberculosis infection, systematic review, active smoking, model

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Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: JiYoung Park, SueGoo Rhee, HyunAe Woo

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In liver regeneration, quiescent hepatocytes need to be primed to fully respond to growth factors such as hepatocyte growth factor. To understand the priming process, it is necessary to analyze patterns of gene expression that occur during liver regeneration after partial hepatectomy (PHx). Recently, tyrosine phosphorylation of signal transducer and activator of transcription 3 (pYSTAT3) has been shown to play an important role in initiating liver regeneration. In order to evaluate the role of pYSTAT3 on liver regeneration after PHx, we used an intrabody which can selectively inhibit pYSTAT3. In our previous studies, an intrabody had been shown that it bound specifically to the pYSTAT3. Adenovirus-mediated expression of the intrabody in HepG2 cells, as well as mouse liver, blocked both accumulation of pYSTAT3 in the nucleus and downstream target of pYSTAT3. In this study, PHx was performed on intrabody-expressing mice and the expression levels of liver regeneration-related genes were analyzed. We also measured liver/body weight ratios and the related cellular signaling pathways were analyzed. Acute phase response genes were reduced in an intrabody-expressing mice during liver regeneration than in control virus-injected mice. However, the time course of liver mass restoration in intrabody-expressing mice was similar to that observed in control virus-injected mice. We also observed that the expression levels of anti-apoptotic genes, such as Bcl2 and Bcl-xL were decreased in intrabody-expressing mice whereas the expression of cell cycle-related genes such as cyclin D1, and c-myc was increased. Liver regeneration after PHx was partially impaired by the selective inhibition of pYSTAT3 with a phosphorylation site-specific intrabody and these results indicated that pYSTAT3 might have limited role in liver mass recovery.

Keywords: STAT3, pYSTAT3, liver regeneration, intrabody

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Authors: Allen Seylani

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Lysosome-dependent autophagy is a nutrient-deprivation-induced evolutionarily conserved intracellular recycling program that sequestrates intracellular cargo into autophagosomes (AP), which then fuse with lysosomes to form autolysosomes (ALs) for cargo digestion. To restore free lysosomes, autophagic lysosome reformation (ALR) is initiated by extrusion of tubular structures from autolysosomes at the final stage of autophagy, in a process called lysosomal tubulation (LT). This project aimed to investigate the molecular mechanism of GCN5L1 in LT and the following lysosomal signaling. GCN5L1 belongs to the BORC multiprotein complexes and is involved in controlling lysosomal trafficking; however, the effect of GCN5L1 on lysosome tubulation remains largely unknown. Genetic ablation of GCN5L1 in the mouse primary hepatocytes showed dramatically increased autolysosomes (ALs), decreased lysosome regeneration and absence of lysosomal tubulation. This phenotype suggests the possibility of disruption in lysosome tubulation, which results in the disturbance of the overall lysosome homeostasis. The formation of tubulars from ALs requires kinesin motor protein KIF5B. Immunoprecipitation was employed and confirmed the interaction of GCN5L1 with the ARL8B-KIF5B complex, which recruited KIF5B to ALs. At the same time, GCN5L1 interacted with WHAMM, which promotes the actin nucleation factor, which brings actin cytoskeleton to ALs and initiates LT. Furthermore, impaired LT in GCN5L1 deficient hepatocytes was restored by overexpression of GCN5L1, and this rescue effect was attenuated by knockdown of KIF5B. Additionally, lysosomal mTORC1 activity was upregulated in GCN5L1-/- hepatocytes, while inhibition of mTORC1 abrogated the GCN5L1 mediated rescue of LT in knockout hepatocytes. Altogether these findings revealed a novel mechanism of ALR, in which a simultaneous interaction of GCN5L1 with KIF5B and WHAMM is required for LT and downstream mTORC1 signaling.

Keywords: autophagy, autolysosome, GCN5L1, lysosome

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Authors: Adi Goldiner

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Historically, the social model of disability has played a pivotal role in bringing rights discourse into the disability debate. Against this backdrop, the paper explores the conceptual alignment between the social model’s account of disability and the nature of rights. Specifically, the paper examines the possibility that the social model conceptualizes disability in a way that aligns with the nature of rights and thus motivates the invocation of disability rights. Methodologically, the paper juxtaposes the literature on the social model of disability, primarily the work of the Union of the Physically Impaired Against Segregation in the UK and related scholarship, with theories of moral rights. By focusing on the interplay between the social model of disability and rights, the paper provides a conceptual explanation for the rise of disability rights. In addition, the paper sheds light on the nature of rights, their function and limitations, in the context of disability rights. The paper concludes that the social model’s conceptualization of disability is hospitable to rights, because it opens up the possibility that there are duties that correlate with disability rights. Under the social model, disability is a condition that can be eliminated by the removal of social, structural, and attitudinal barriers. Accordingly, the social model dispels the idea that the actions of others towards disabled people will have a marginal impact on their interests in not being disabled. Equally important, the social model refutes the idea that in order to significantly serve people's interest in not being disabled, it is necessary to cure bodily impairments, which is not always possible. As rights correlate with duties that are possible to comply with, as well as those that significantly serve the interests of the right holders, the social model’s conceptualization of disability invites the reframing of problems related to disability in terms of infringements of disability rights. A possible objection to the paper’s argument is raised, according to which the social model is at odds with the invocation of disability rights because disability rights are ineffective in realizing the social model's goal of improving the lives of disabled by eliminating disability. The paper responds to this objection by drawing a distinction between ‘moral rights,’ which, conceptually, are not subject to criticism of ineffectiveness, and ‘legal rights’ which are.

Keywords: disability rights, duties, moral rights, social model

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Authors: Jasmin Glock

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Media plays a significant role in terms of shaping and influencing people’s perception of various themes, including disability. Although recent examples indicate progressive attitudes in society, programs across genres continue to portray disability in a negative and stereotypical way. Such a one-sided or stereotypical portrayal of disabled people can further reinforce their marginalized position by turning them into the other. The common trope of the blind or visually impaired woman, for example, marks the character as particularly vulnerable. These stereotypes are easily absorbed and left unquestioned, especially by younger audiences. As a result, the presentation of disability as problematic or painful can instill a subconscious fear of disability in viewers at a very young age. Now the question arises, how can disability be portrayed to children in a more positive way? This paper focuses on the portrayal of physical disability in children’s programming. Using disabled characters from Nickelodeon’s Avatar: The Last Airbender and Avatar: The Legend of Korra, the paper will show that the chosen animated characters have the potential to challenge and subvert disability-based bias and to contribute to the normalization of disability on screen. Analyzing blind protagonist Toph Beifong, recurring support character and wheelchair user Teo, and villain Ming Hua who has prosthetic limbs, this paper aims at highlighting that these disabled characters are far more than mere stereotyped tokens. Instead, they are crucial to the outcome of the story. They are strong and confident while still being allowed to express their insecurities in certain situations. The paper also focuses on how these characters can make disability issues relatable to disabled and non-disabled young audiences alike and how they can thereby contribute to the reduction of prejudice. Finally, they will serve as an example of what inclusive, nuanced, and even empowering disability representation in animated television series can look like.

Keywords: Children, disability, representation, television

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Authors: Austin Jiang, Richard M. Salmon, Nicholas W. Morrell, Wei Li

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BMP10 is highly expressed in the developing heart and plays essential roles in cardiogenesis. BMP10 deletion in mice results in embryonic lethality due to impaired cardiac development. In adults, BMP10 expression is restricted to the right atrium, though ventricular hypertrophy is accompanied by increased BMP10 expression in a rat hypertension model. However, reports of BMP10 activity in the circulation are inconclusive. In particular it is not known whether in vivo secreted BMP10 is active or whether additional factors are required to achieve its bioactivity. It has been shown that high-affinity binding of the BMP10 prodomain to the mature ligand inhibits BMP10 signaling activity in C2C12 cells, and it was proposed that prodomain-bound BMP10 (pBMP10) complex is latent. In this study, we demonstrated that the BMP10 prodomain did not inhibit BMP10 signaling activity in multiple endothelial cells, and that recombinant human pBMP10 complex, expressed in mammalian cells and purified under native conditions, was fully active. In addition, both BMP10 in human plasma and BMP10 secreted from the mouse right atrium were fully active. Finally, we confirmed that active BMP10 secreted from mouse right atrium was in the prodomain-bound form. Our data suggest that circulating BMP10 in adults is fully active and that the reported vascular quiescence function of BMP10 in vivo is due to the direct activity of pBMP10 and does not require an additional activation step. Moreover, being an active ligand, recombinant pBMP10 may have therapeutic potential as an endothelial-selective BMP ligand, in conditions characterized by loss of BMP9/10 signaling.

Keywords: bone morphogenetic protein 10 (BMP10), endothelial cell, signal transduction, transforming growth factor beta (TGF-B)

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Authors: Sugandhi, Parteek Kumar, Sanmeet Kaur

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Sign Language (SL) is used by deaf and other people who cannot speak but can hear or have a problem with spoken languages due to some disability. It is a visual gesture language that makes use of either one hand or both hands, arms, face, body to convey meanings and thoughts. SL automation system is an effective way which provides an interface to communicate with normal people using a computer. In this paper, an avatar based dictionary has been proposed for text to Indian Sign Language (ISL) generation system. This research work will also depict a literature review on SL corpus available for various SL s over the years. For ISL generation system, a written form of SL is required and there are certain techniques available for writing the SL. The system uses Hamburg sign language Notation System (HamNoSys) and Signing Gesture Mark-up Language (SiGML) for ISL generation. It is developed in PHP using Web Graphics Library (WebGL) technology for 3D avatar animation. A multilingual ISL dictionary is developed using HamNoSys for both English and Hindi Language. This dictionary will be used as a database to associate signs with words or phrases of a spoken language. It provides an interface for admin panel to manage the dictionary, i.e., modification, addition, or deletion of a word. Through this interface, HamNoSys can be developed and stored in a database and these notations can be converted into its corresponding SiGML file manually. The system takes natural language input sentence in English and Hindi language and generate 3D sign animation using an avatar. SL generation systems have potential applications in many domains such as healthcare sector, media, educational institutes, commercial sectors, transportation services etc. This research work will help the researchers to understand various techniques used for writing SL and generation of Sign Language systems.

Keywords: avatar, dictionary, HamNoSys, hearing impaired, Indian sign language (ISL), sign language

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Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Golnar Hasheminasab, Mehrdad Faizi, Mona Khoramjouy

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Introduction: Benzodiazepines (BZDs) have pharmacological effects, including anxiolytic, sedative-hypnotic, anticonvulsant, and muscle relaxant properties. However, they have adverse effects such as interaction with alcohol, ataxia, impaired learning, and psychological and physical dependence. According to the structure of zolpidem and on the basis of the structure-activity relationship of BZD receptor ligands, six novel derivatives of 2-fluorobenzyloxy 4,6- diphenylpyramidin-2-ol have been synthesized. We studied the hypnotic, sedative, and anticonvulsant effects of the novel compounds. Method: In this study, we used male mice (18 to 25 g). All the substances were injected intraperitoneally. The hypnotic effect of the compounds was examined by pentobarbital induced sleeping test. The locomotor activities and sedative effects of the novel compounds were evaluated by open field and loss of righting reflex test, respectively. The anticonvulsant effects of the novel compounds were assessed by PTZ and MES tests. Results: In the pentobarbital induced sleeping and open field tests, compound 4-(2-((2-fluorobenzyl)oxy)phenyl)-6-(p-tolyl) pyrimidine-2-ol with ED50=14.20 mg/kg and ED50=47.88 mg/kg, respectively, was the most effective compound. None of the novel compounds showed a significant anticonvulsant effect in the PTZ test. In MES test, compound 4-(2-((2-fluorobenzyl)oxy)phenyl)-6-(p-tolyl)pyrimidine-2-ol with ED50=12.92 mg/kg was the most effective compound. Flumazenil blocked the sedation and hypnosis of all the compounds. Conclusion: All of the novel derivatives showed significant sedative-hypnotic activities and caused the reduction of locomotor activities. The results show that the methyl lipophilic substitutes on the phenyl ring of 4,6-diphenylpyramidin-2-ol derivatives can increase the sedative and hypnotic effects of the derivatives. Flumazenil antagonized the sedative, and the hypnotic effects of the compounds indicate that BZD receptors are involved in the effects.

Keywords: BZD, sedative, hyptonic, anticonvulsant, zolpidem, MES, PTZ, benzodiazepine, locomotor activities, pentobarbital induced sleeping tests

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Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

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Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger

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Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.

Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke

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Authors: Gunjita Shami, Noopur Anand

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The pilot run of 50 days was undertaken to test employability potential of people with visual and hearing & speech impairment. Various roles in an apparel manufacturing set up like spreading of fabric for cutting, folding, sealing and labeling cartons, pasting size barcode stickers on packed garments, removing tickets from the garments in the finishing stage were studied. Their performance was quantified basis timesheets for all the days and improvement per day was quantified. Their final day output was compared to that of the able-bodied worker. For example in the carton making activity on day one visually impaired worker was making one box every three minutes which improved to four boxes per minute on day 28 displaying 91.6% improvement compared or an improvement of 3.6% per day which was comparable to the able-bodied seasoned workers, who were making 5 boxes per minute. The performance of persons with hearing and speech impairment in the finishing department was 10% higher than that of able-bodied seasoned workers in the same process. Overall in all the activities the differently abled showed day to day improvement of 65% while able bodied displayed improvement of 52%. On the first day performance of able-bodied worker was 75% better than that of differently abled while on the 50th day it was only 20% better. Therefore the performance of persons with disabilities was found comparable to the able bodied person. The results, though on a small scale, showed a big promise of employment of persons with disability in the apparel industry. Armed with the promising result a full-scale study has been undertaken to identify the roles suitable for certain kind of disability in apparel production, work-aids required to assist the differently abled to improve performance and measures to be undertaken to make production floor 'friendlier' for them. The results have been discussed in this paper which opens doors for integrating differently abled into the world projected and assumed for only able-bodied.

Keywords: apparel sector, differently abled, employability, performance, work-aid

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Authors: Shazia Anwer

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The current TV Talk Shows, especially on domestic politics in Pakistan are following the Aristotelian techniques, including deductive reasoning, three modes of persuasion, and guidelines for communication. The application of “Approximate Truth is also seen when Talk Show presenters create doubts against political personalities or national issues. Mainstream media of Pakistan, being a key carrier of narrative construction for the sake of the primary function of national consensus on regional and extended public diplomacy, is failing the purpose. This paper has highlighted the Aristotelian communication methodology, its purposes and its limitations for a serious discussion, and its connection to the mistrust among the Pakistani population regarding fake or embedded, funded Information. Data has been collected from 3 Pakistani TV Talk Shows and their analysis has been made by applying the Aristotelian communication method to highlight the core issues. Paper has also elaborated that current media education is impaired in providing transparent techniques to train the future journalist for a meaningful, thought-provoking discussion. For this reason, this paper has given an overview of HEC’s (Higher Education Commission) graduate-level Mass Com Syllabus for Pakistani Universities. The idea of ethos, logos, and pathos are the main components of TV Talk Shows and as a result, the educated audience is lacking trust in the mainstream media, which eventually generating feelings of distrust and betrayal in the society because productions look like the genre of Drama instead of facts and analysis thus the line between Current Affairs shows and Infotainment has become blurred. In the last section, practical implication to improve meaningfulness and transparency in the TV Talk shows has been suggested by replacing the Aristotelian communication method with the cognitive semiotic communication approach.

Keywords: Aristotelian techniques of communication, current affairs talk shows, drama, Pakistan

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Authors: Dessie Tegegne Tibebu, Kirsi Mononen, Ari Pappinen

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In areas with forest management, agricultural, and industrial activity, sediments and biomass are accumulated in lakes through drainage system, which might be a cause for biodiversity loss and health problems. One possible solution can be utilization of lake bottom biomass and sediments for biogas production. The main objective of this study was to investigate the potentials of lake bottom materials for production of biogas by anaerobic digestion and to study the effect of pretreatment methods for feed materials on biogas yield. In order to study the potentials of biogas production lake bottom materials were collected from two sites, Likokanta and Kutunjärvi lake. Lake bottom materials were mixed with straw-horse manure to produce biogas in a laboratory scale reactor. The results indicated that highest yields of biogas values were observed when feeds were composed of 50% lake bottom materials with 50% straw horse manure mixture-while with above 50% lake bottom materials in the feed biogas production decreased. CH4 content from Likokanta lake materials with straw-horse manure and Kutunjärvi lake materials with straw-horse manure were similar values when feed consisted of 50% lake bottom materials with 50% straw horse manure mixtures. However, feeds with lake bottom materials above 50%, the CH4 concentration started to decrease, impairing gas process. Pretreatment applied on Kutunjärvi lake materials showed a slight negative effect on the biogas production and lowest CH4 concentration throughout the experiment. The average CH4 production (ml g-1 VS) from pretreated Kutunjärvi lake materials with straw horse manure (208.9 ml g-1 VS) and untreated Kutunjärvi lake materials with straw horse manure (182.2 ml g-1 VS) were markedly higher than from Likokanta lake materials with straw horse manure (157.8 ml g-1 VS). According to the experimental results, utilization of 100% lake bottom materials for biogas production is likely to be impaired negatively. In the future, further analyses to improve the biogas yields, assessment of costs and benefits is needed before utilizing lake bottom materials for the production of biogas.

Keywords: anaerobic digestion, biogas, lake bottom materials, sediments, pretreatment

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Authors: Helen Pluut, Remus Ilies, Nikos Dimotakis, Maral Darouei

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This study aims to examine recovery from work as an important daily activity with implications for workplace behavior. Building on affective events theory and the stressor-detachment model as frameworks, this paper proposes and tests a comprehensive within-individual model that uncovers the role of recovery processes at home in linking workplace demands (e.g., workload) and stressors (e.g., workplace incivility) to next-day organizational citizenship behaviors (OCBs). Our sample consisted of 126 full-time employees in a large Midwestern University. For a period of 16 working days, these employees were asked to fill out 3 electronic surveys while at work. The first survey (sent out in the morning) measured self-reported sleep quality, recovery experiences the previous day at home, and momentary effect. The second survey (sent out close to the end of the workday) measured job demands and stressors as well as OCBs, while the third survey in the evening assessed job strain. Data were analyzed using Hierarchical Linear Modeling (HLM). Results indicated that job demands and stressors at work made it difficult to unwind properly at home and have a good night’s sleep, which had repercussions for next day’s morning effect, which, in turn, influenced OCBs. It can be concluded that processes of recovery are vital to an individual’s daily effective functioning and behavior at work, but recovery may become impaired after a hard day’s work. Thus, our study sheds light on the potentially persistent nature of strain experienced as a result of work and points to the importance of recovery processes to enable individuals to avoid such cross-day spillover. Our paper will discuss this implication for theory and practice as well as potential directions for future research.

Keywords: affect, job demands, organizational citizenship behavior, recovery, strain

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Authors: Dhanya Nair, Nicholas Mirchandani

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Musical haptic systems can enhance a listener’s musical experience while providing an alternative platform for the hearing impaired to experience music. Current music tactile technologies focus on representing tactile metronomes to synchronize performers or encoding musical notes into distinguishable (albeit distracting) tactile patterns. There is growing interest in the development of musical haptic systems to augment the auditory experience, although the haptic-music relationship is still not well understood. This paper represents a tactile music interface that provides vibrations to multiple fingertips in synchronicity with auditory music. Like an audio equalizer, different frequency bands are filtered out, and the power in each frequency band is computed and converted to a corresponding vibrational strength. These vibrations are felt on different fingertips, each corresponding to a different frequency band. Songs with music from different spectrums, as classified by their energy and valence, were used to test the effectiveness of the system and to understand the relationship between music and tactile sensations. Three participants were trained on one song categorized as sad (low energy and low valence score) and one song categorized as happy (high energy and high valence score). They were trained both with and without auditory feedback (listening to the song while experiencing the tactile music on their fingertips and then experiencing the vibrations alone without the music). The participants were then tested on three songs from both categories, without any auditory feedback, and were asked to classify the tactile vibrations they felt into either category. The participants were blinded to the songs being tested and were not provided any feedback on the accuracy of their classification. These participants were able to classify the music with 100% accuracy. Although the songs tested were on two opposite spectrums (sad/happy), the preliminary results show the potential of utilizing a vibrotactile equalizer, like the one presented, for augmenting musical experience while furthering the current understanding of music tactile relationship.

Keywords: haptic music relationship, tactile equalizer, tactile music, vibrations and mood

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Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

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Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

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