Effects of exergaming on hippocampal volume and brain-derived neurotrophic factor levels in Parkinson's disease.

BACKGROUND AND OBJECTIVE: Cognitive impairment is among the most burdensome non-motor symptoms in Parkinson's disease (PD) and has been associated with hippocampal atrophy. Exercise has been reported to enhance neuroplasticity in the hippocampus in correlation with an improvement of cognitive function. We present data from the Training-PD study, which was designed to evaluate effects of an "" training protocol on neuronal plasticity in PD. METHODS: We initiated a 6-week exergaming training program, combining visually stimulating computer games with physical exercise in 17 PD patients and 18 matched healthy controls. Volumetric segmentation of hippocampal subfields on T1- and T2-weighted magnetic resonance imaging and brain-derived neurotrophic factor (BDNF) serum levels were analyzed before and after the training protocol. RESULTS: The PD group showed a group-dependent significant volume increase of the left hippocampal subfields CA1, CA4/dentate gyrus (DG) and subiculum after the 6-week training protocol. The effect was most pronounced in the left DG of PD patients, who showed a significantly smaller percentage volume compared to healthy controls at baseline, but not at follow-up. Both groups had a significant increase in serum BDNF levels after training. CONCLUSIONS: The results of the present study indicate that exergaming might be a suitable approach to induce hippocampal volume changes in PD patients. Further and larger studies are needed to verify our findings.

Effects of Levodopa on quality of sleep and nocturnal movements in Parkinson's Disease.

BACKGROUND: Sleep disturbances are common in Parkinson's Disease (PD), with nocturnal akinesia being one of the most burdensome. Levodopa is frequently used in clinical routine to improve nocturnal akinesia, although evidence is not well proven. METHODS: We assessed associations of Levodopa intake with quality of sleep and perception of nocturnal akinesia in three PD cohorts, using the Parkinson's Disease Sleep Scale (PDSS-2) in two cohorts and a question on nocturnal immobility in one cohort. In one cohort also objective assessment of mobility during sleep was performed, using mobile health technology. RESULTS: In an independent analysis of all three cohorts (in total n = 1124 PD patients), patients taking Levodopa CR reported a significantly higher burden by nocturnal akinesia than patients without Levodopa. Higher Levodopa intake and MDS-UPDRS part IV scores (indicating motor fluctuations) predicted worse PDSS-2 and higher subjective nocturnal immobility scores, while disease duration and severity were not predictive. Levodopa intake was not associated with objectively changed mobility during sleep. CONCLUSION: Our results showed an association of higher Levodopa intake with perception of worse quality of sleep and nocturnal immobility in PD, indicating that Levodopa alone might not be suitable to improve subjective feeling of nocturnal akinesia in PD. In contrast, Levodopa intake was not relevantly associated with objectively measured mobility during sleep. PD patients with motor fluctuations may be particularly affected by subjective perception of nocturnal mobility. This study should motivate further pathophysiological and clinical investigations on the cause of perception of immobility during sleep in PD.

Effects of Exergaming on Attentional Deficits and Dual-Tasking in Parkinson's Disease.

Introduction: Impairment of dual-tasking, as an attention-based primary cognitive dysfunction, is frequently observed in Parkinson's Disease (PD). The Training-PD study investigated the efficiency of exergaming, as a novel cognitive-motor training approach, to improve attention-based deficits and dual-tasking in PD when compared to healthy controls. Methods: Eighteen PD patients and 17 matched healthy controls received a 6-week home-based training period of exergaming. Treatment effects were monitored using quantitative motor assessment of gait and cognitive testing as baseline and after 6 weeks of training. Results: At baseline PD patients showed a significantly worse performance in several quantitative motor assessment parameters and in two items of cognitive testing. After 6 weeks of exergames training, the comparison of normal gait vs. dual-tasking in general showed an improvement of stride length in the PD group, without a gait-condition specific improvement. In the direct comparison of three different gait conditions (normal gait vs. dual-tasking calculating while walking vs. dual-tasking crossing while walking) PD patients showed a significant improvement of stride length under the dual-tasking calculating condition. This corresponded to a significant improvement in one parameter of the D2 attention test. Conclusions: We conclude, that exergaming, as an easy to apply, safe technique, can improve deficits in cognitive-motor dual-tasking and attention in PD.

Transport of carbon colloid supported nanoscale zero-valent iron in saturated porous media.

Injection of nanoscale zero-valent iron (nZVI) has recently gained great interest as emerging technology for in-situ remediation of chlorinated organic compounds from groundwater systems. Zero-valent iron (ZVI) is able to reduce organic compounds and to render it to less harmful substances. The use of nanoscale particles instead of granular or microscale particles can increase dechlorination rates by orders of magnitude due to its high surface area. However, classical nZVI appears to be hampered in its environmental application by its limited mobility. One approach is colloid supported transport of nZVI, where the nZVI gets transported by a mobile colloid. In this study transport properties of activated carbon colloid supported nZVI (c-nZVI; d50=2.4µm) are investigated in column tests using columns of 40cm length, which were filled with porous media. A suspension was pumped through the column under different physicochemical conditions (addition of a polyanionic stabilizer and changes in pH and ionic strength). Highest observed breakthrough was 62% of the injected concentration in glass beads with addition of stabilizer. Addition of mono- and bivalent salt, e.g. more than 0.5mM/L CaCl2, can decrease mobility and changes in pH to values below six can inhibit mobility at all. Measurements of colloid sizes and zeta potentials show changes in the mean particle size by a factor of ten and an increase of zeta potential from -62mV to -80mV during the transport experiment. However, results suggest potential applicability of c-nZVI under field conditions.

Investigations on mobility of carbon colloid supported nanoscale zero-valent iron (nZVI) in a column experiment and a laboratory 2D-aquifer test system.

Nanoscale zero-valent iron (nZVI) has recently gained great interest in the scientific community as in situ reagent for installation of permeable reactive barriers in aquifer systems, since nZVI is highly reactive with chlorinated compounds and may render them to harmless substances. However, nZVI has a high tendency to agglomerate and sediment; therefore it shows very limited transport ranges. One new approach to overcome the limited transport of nZVI in porous media is using a suited carrier colloid. In this study we tested mobility of a carbon colloid supported nZVI particle "Carbo-Iron Colloids" (CIC) with a mean size of 0.63 µm in a column experiment of 40 cm length and an experiment in a two-dimensional (2D) aquifer test system with dimensions of 110 × 40 × 5 cm. Results show a breakthrough maximum of 82 % of the input concentration in the column experiment and 58 % in the 2D-aquifer test system. Detected residuals in porous media suggest a strong particle deposition in the first centimeters and few depositions in the porous media in the further travel path. Overall, this suggests a high mobility in porous media which might be a significant enhancement compared to bare or polyanionic stabilized nZVI.

State estimation for large-scale wastewater treatment plants.

Many relevant process states in wastewater treatment are not measurable, or their measurements are subject to considerable uncertainty. This poses a serious problem for process monitoring and control. Model-based state estimation can provide estimates of the unknown states and increase the reliability of measurements. In this paper, an integrated approach is presented for the optimization-based sensor network design and the estimation problem. Using the ASM1 model in the reference scenario BSM1, a cost-optimal sensor network is designed and the prominent estimators EKF and MHE are evaluated. Very good estimation results for the system comprising 78 states are found requiring sensor networks of only moderate complexity.

Polyfluoroalkyl compounds in the East Greenland Arctic Ocean.

Polyfluoroalkyl compounds (PFCs) can be found ubiquitously in the marine environment. The transport of PFCs to remote locations is assumed to be by direct transport via oceanic water currents or indirectly via atmospheric transport of volatile precursor compounds. This study investigates the influence of ocean currents and atmospheric transport to the East Greenland Arctic Ocean (67.5-80.4 degrees N). In this study, 38 water samples were collected in the Arctic summer in 2009 and analyzed by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). Concentrations of three PFC classes could be quantified (i.e., perfluoroalkyl carboxylic acids (PFCAs), perfluoroalkyl sulfonates (PFSAs) and perfluoroalkyl sulfonamides) predominantly in a low pg L(-1) range. Dominating compounds were PFOSA and PFOA with mean concentrations of 61 pg L(-1) and 51 pg L(-1), respectively. Statistically significant higher concentrations for PFOSA and PFHxA in the samples taken north of 75 degrees N indicate an atmospheric influence on the concentrations found in the water samples. Significant differences in concentrations of PFHxS, PFHxA, PFHpA and PFOA for samples taken in coastal areas indicate an influence from the Greenlandic mainland.

Polyfluoroalkyl compounds in landfill leachates.

Polyfluoroalkyl compounds (PFCs) are widely used in industry and consumer products. These products could end up finally in landfills where their leachates are a potential source for PFCs into the aqueous environment. In this study, samples of untreated and treated leachate from 22 landfill sites in Germany were analysed for 43 PFCs. SigmaPFC concentrations ranged from 31 to 12,819 ng/L in untreated leachate and 4-8060 ng/L in treated leachate. The dominating compounds in untreated leachate were perfluorobutanoic acid (PFBA) (mean contribution 27%) and perfluorobutane sulfonate (PFBS) (24%). The discharge of PFCs into the aqueous environment depended on the cleaning treatment systems. Membrane treatments (reverse osmosis and nanofiltrations) and activated carbon released lower concentrations of PFCs into the environment than cleaning systems using wet air oxidation or only biological treatment. The mass flows of summation operatorPFCs into the aqueous environment ranged between 0.08 and 956 mg/day.

Epidermolysis bullosa acquisita and neuroendocrine pancreatic cancer - Coincidence or patho-genetic relationship?

The etiology of epidermolysis bullosa acquisita (EBA) is unknown. EBA may be associated with other autoimmune systemic diseases; it also has been described in connection with different malignant tumors, showing complete remission after successful treatment of the tumor. In such cases, EBA may be regarded as a paraneo-plastic dermatosis. We detected a highly differentiated neuroendocrine pancreatic cancer in a 78-year-old woman with EBA. Even thought her tumor was completely removed and the patient has been disease-free for over seven years, a complete regression of her autoimmune bullous dermatosis could not be induced. By using intravenous immunoglobulins in combination with mycophenolate mofetil, further blister formation could be ameliorated.