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Scientific Reports May 2024Loss of ambulation is common and highly variable in Parkinson's disease (PD), and poorly understood from the perspectives of those with PD. Gaining insights to the...
Loss of ambulation is common and highly variable in Parkinson's disease (PD), and poorly understood from the perspectives of those with PD. Gaining insights to the anticipated perceived trajectories and their drivers, will facilitate patient-centered care. Latent class growth analysis, a person-centered mixture modelling approach, was applied to 16,863 people with PD stratified by early (N = 8612; < 3 years), mid (N = 6181; 3-10 years) and later (N = 2070; > 10 years) disease to discern clusters with similar longitudinal patterns of self-reported walking difficulty, measured by EuroQoL 5D-5L that is validated for use in PD. There were four clusters in early and mid-disease strata, with a fifth identified in later disease. Trajectories ranged from none to moderate walking difficulty, with small clusters with severe problems. The percentage of subjects with moderate (early = 17.5%, mid = 26.4%, later = 32.5%) and severe (early = 3.8%, mid = 7.4%, later = 15.4%) walking difficulty at baseline increased across disease duration groups. The trajectories tended to be stable with variability in moderate and severe groups. Across strata, clusters with moderate to severe problems were associated with more severe impairment, depression, anxiety, arthritis, higher BMI, lower income, and lower education, but no consistent race or gender differences. The findings reveal distinct longitudinal patterns in perceived difficulties in walking in PD.
Topics: Humans; Parkinson Disease; Male; Female; Aged; Middle Aged; Walking; Longitudinal Studies; Quality of Life
PubMed: 38769128
DOI: 10.1038/s41598-024-62179-9 -
Cureus Jan 2024Osteomyelitis, a significant global healthcare issue, often results from infections related to open fractures, surgery, or conditions like diabetic foot ulcers. This...
Osteomyelitis, a significant global healthcare issue, often results from infections related to open fractures, surgery, or conditions like diabetic foot ulcers. This report describes a case of osteomyelitis in a 62-year-old female with various pre-existing health conditions. The patient initially presented with swelling, pain, and difficulty walking in the right lower extremity, accompanied by systemic symptoms. Despite an initial diagnosis of cellulitis and treatment with ceftriaxone, a subsequent CT scan revealed a pretibial abscess and confirmed osteomyelitis caused by pan-sensitive . Surgical debridement was performed, and the patient received six weeks of intravenous antibiotics. Hence, a heightened level of suspicion is essential to facilitate a timely diagnosis of osteomyelitis and enhance long-term prognosis. The case underscores the importance of a multidisciplinary approach, including meticulous surgical intervention and tailored antimicrobial therapy, in achieving positive outcomes for osteomyelitis patients.
PubMed: 38425588
DOI: 10.7759/cureus.53238 -
Journal of Research in Health Sciences Sep 2023After the difficulty of the pandemic process, managing the long-term effects that may occur after the coronavirus disease 2019 (COVID-19) is among the biggest concerns...
BACKGROUND
After the difficulty of the pandemic process, managing the long-term effects that may occur after the coronavirus disease 2019 (COVID-19) is among the biggest concerns in the present era. This study aimed to explore factors affecting the physical activity level and investigate the relationship between physical activity level and stress perception of university students during the COVID-19 pandemic. A cross-sectional study.
METHODS
Study data were collected via online survey, and volunteer participants completed the survey through the survey link between October 21 and December 31, 2021. Physical activity level was evaluated by "The International Physical Activity Questionnaire- Short Form" (IPAQ-SF), and stress level was evaluated by "Perceived Stress Scale" (PSS). The participants were asked questions about barriers and motivators for physical activity before and during the pandemic.
RESULTS
The study included 444 participants (81.3% female and 18.7% male) with an average age of 21±2.95 years. The results showed a negative-significant linear relationship between perceived stress score and total physical activity, vigorous-intensity physical activity, and walking scores (r=-0.157, <0.01; r=-0.16, <0.01; r=-0.13, <0.05 respectively). During the pandemic, the perception of insufficient finance became less important as a barrier (=0.029), and healthcare professional (HCP) recommendation became more important as a motivator for physical activity than the pre-pandemic conditions (=0.035).
CONCLUSION
The findings indicated that it is possible to reduce the level of perceived stress by increasing the level of physical activity. Current research will be a key for increasing and maintaining physical activity and reducing perceived stress.
Topics: Humans; Female; Male; Adolescent; Young Adult; Adult; COVID-19; Cross-Sectional Studies; Pandemics; Exercise; Perception
PubMed: 38315900
DOI: 10.34172/jrhs.2023.120 -
Annals of Medicine and Surgery (2012) Jul 2023Cerebellopontine angle (CPA) meningioma is a slowly growing benign tumor of the brain that may compress adjacent neural structures. It has variable clinical...
UNLABELLED
Cerebellopontine angle (CPA) meningioma is a slowly growing benign tumor of the brain that may compress adjacent neural structures. It has variable clinical presentations that progress very slowly depending on its growth pattern and associated mass effect. A sudden onset clinical presentation is unusual and should prompt consideration of other potential etiologies.
CASE PRESENTATION
Here, the authors present a 66-year-old male patient with diabetes, hypertension, and hyperlipidemia who presented to the emergency department of our hospital with sudden onset walking difficulty (ataxia). On examination, the patient was fully conscious. There was no associated cranial nerve deficit, hearing loss, or focal/lateralizing weakness. All sensory modalities were intact. However, the patient had a gait impairment. Romberg and tandem gait tests were positive with the tendency to sway to the left. The patient was admitted with suspicion of acute cerebrovascular disease. The initial noncontrast brain computed tomography and subsequent diffusion MRI were inconclusive. A later brain MRI with contrast revealed a homogeneously contrast enhancing meningioma in the left CPA.
CLINICAL DISCUSSION
The differential diagnosis of sudden onset ataxia is broad and should include the assessment of a possible CPA lesion. Sudden onset ataxia by a CPA meningioma is very rare as meningiomas grow very slowly. A brain MRI with contrast is essential for its diagnosis.
CONCLUSION
Although stroke is the main cause of sudden onset ataxia in a patient with cerebrovascular risk factors, yet other less common causes may be found as in this case of CPA meningioma.
PubMed: 37427233
DOI: 10.1097/MS9.0000000000000928 -
BMC Geriatrics Dec 2023Process evaluations of randomized controlled trials (RCTs) of community exercise programs are important to help explain the results of a trial and provide evidence of... (Randomized Controlled Trial)
Randomized Controlled Trial
A park-based group mobility program for older adults with difficulty walking outdoors: a quantitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial.
BACKGROUND
Process evaluations of randomized controlled trials (RCTs) of community exercise programs are important to help explain the results of a trial and provide evidence of the feasibility for community implementation. The objectives of this process evaluation for a multi-centre RCT of outdoor walking interventions for older adults with difficulty walking outdoors, were to determine: 1) implementation fidelity (the extent to which elements of the intervention were delivered as specified in the original protocol) and 2) participant engagement (the receipt of intervention components by the participants) in the Getting Older Adults Outdoors (GO-OUT) trial.
METHODS
GO-OUT participants attended an active 1-day workshop designed to foster safe, outdoor walking skills. After the workshop, 190 people at 4 sites were randomized to an outdoor walk group (OWG) (n = 98) which met 2x/week for 10 weeks, or the weekly reminders (WR) group (n = 92) which received a phone reminder 1x/week for 10 weeks. The OWG had 5 components - warm-up, continuous distance walk, task-oriented walking activities, 2 continuous distance walk, and cool-down. Data on implementation fidelity and participant engagement were gathered during the study through site communications, use of standardized forms, reflective notes of the OWG leaders, and accelerometry and GPS assessment of participants during 2 weeks of the OWG.
RESULTS
All sites implemented the workshop according to the protocol. Participants were engaged in all 8 activity stations of the workshop. WR were provided to 96% of the participants in the WR intervention group. The 5 components of the OWG sessions were implemented in over 95% of the sessions, as outlined in the protocol. Average attendance in the OWG was not high - 15% of participants did not attend any sessions and 64% of participants in the OWG attended > 50% of the sessions. Evaluations with accelerometry and GPS during week 3 and 9 OWG sessions suggest that participants who attended were engaged and active during the OWG.
CONCLUSIONS
This process evaluation helps explain the main study findings and demonstrates the flexibility required in the protocol for safe and feasible community implementation. Future research could explore the use of additional behaviour change strategies to optimize attendance for community implementation.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.
Topics: Aged; Humans; Exercise; Exercise Therapy; Mobility Limitation; Walking
PubMed: 38082248
DOI: 10.1186/s12877-023-04524-7 -
Journal of Aging and Health Jun 2024To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure...
To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor recreation and cultural activities at baseline and follow-up were studied in community-dwelling persons ( = 848) aged 75-90. A walkability index, calculated using a geographic information system, was categorized into tertiles (lowest, middle, highest). Residence in the highest walkability areas was associated with higher participation in cultural activities and lower participation in outdoor recreation, while the latter was most frequently reported by residents in the lowest walkability areas. Those reporting no difficulties were more likely than those reporting difficulties to participate in all studied activities. Residence in the middle or highest walkability areas predicted higher participation in cultural activities at follow-up. Older persons activity profiles associate with neighborhood walkability and walking difficulties.
Topics: Humans; Aged; Aged, 80 and over; Cross-Sectional Studies; Follow-Up Studies; Environment Design; Walking; Leisure Activities; Residence Characteristics
PubMed: 37482698
DOI: 10.1177/08982643231191444 -
BMC Public Health Nov 2023A major societal trend of the twenty-first century is the rapidly ageing population as a consequence of the decline in fertility and increase in life expectancy. Along...
BACKGROUND
A major societal trend of the twenty-first century is the rapidly ageing population as a consequence of the decline in fertility and increase in life expectancy. Along with the rise in ageing population, the burden of obesity and related non-communicable diseases is also equally rising. In this study, we aimed to investigate the potential gender-specific determinants of overweight and obesity among older adults in India.
SUBJECTS AND METHODS
The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 25,952 older adults (≥ 60 years) was selected for the study. Descriptive statistics, bivariate chi-square test, and logistic regression estimation were applied to accomplish the study objectives. Body mass index (BMI) has been classified in this study according to the WHO criteria.
RESULTS
The prevalence of overweight was higher among women (18.15% in rural areas and 46.62% in urban areas) compared to men (12.9% in rural areas and 30.61% in urban areas). Similarly, obesity was higher among women than men who were residing in urban areas (17.07% vs. 5.37%), had secondary or above education (32.38% vs. 6.1%) belonged to richest strata (16.37% vs. 4.50%), or had mobility impairment (9.2% vs. 2.8%). Despite adjustment for several confounders, women were more likely to be overweight (OR: 2.18; CI: 1.86, 2.55) and obese (OR: 3.79; CI: 2.86, 5.03) than men. However, among both the elderly men and women, those who were highly educated were 2.29 times (OR: 2.29; CI: 1.80, 4.11) and 2.71 times (OR: 2.71; CI: 1.78, 4.11), respectively more likely to be overweight than their illiterate counterparts. Older adults living in urban areas were more likely to suffer from obesity compared to rural men (OR: 1.47; CI: 1.07, 2.02) and women (OR: 2.58; CI: 1.85, 3.60). Both men and women, who were highly educated were 2.64 times (OR: 2.64; CI: 1.71, 4.09) and 2.94 times (OR: 2.94; CI: 1.40, 6.20), respectively, more likely to be obese than their illiterate counterparts. Older men and women who were richest (OR: 1.60; CI: 1.19, 2.14 & OR: 2.12; CI: 1.63,2.76), or had mobility impairment (OR: 1.33; CI: 1.09,1.61 & OR: 1.72; CI: 1.42,2.08) were more likely to be overweight than their counterparts who were poorest or did not have any mobility limitation, respectively.
CONCLUSIONS
This study found increased vulnerability of overweight and obesity among older women than men irrespective of their socioeconomic, demographic, and health status. The present study suggests that introducing preventative measures such as campaigns to encourage physical activity, and community awareness may help reduce the high burden of overweight and obesity. Finally, the findings are important for better functioning of any public health programme and suitable intervention techniques to maintain a healthy body in order to lower the prevalence and risk factors of non-communicable diseases in later life.
Topics: Male; Female; Humans; Aged; Overweight; Cross-Sectional Studies; Noncommunicable Diseases; Health Surveys; Obesity; Risk Factors; Body Mass Index; India; Prevalence
PubMed: 37993827
DOI: 10.1186/s12889-023-17156-8 -
European Journal of Translational... Aug 2023Overweight and obesity is a multifactorial, multisystem disease declared a global epidemic by the World Health Organization (WHO) as early as in 1997. At least 30% of...
Overweight and obesity is a multifactorial, multisystem disease declared a global epidemic by the World Health Organization (WHO) as early as in 1997. At least 30% of the working-age population in Russia is overweight. Only the use of physical activity as an integral (basic) part of obesity treatment and maintenance of the body weight achieved in the course of treatment can achieve durable and long-lasting treatment results as well as significant changes in the body structure (fat/non-fat body weight ratio). Terrainkur (therapeutic walking) is a method of spa treatment that combines climatotherapy and physical therapy. One of the problems in physical activity in obese people is the difficulty they experience in exercising due to the impaired walking pattern caused by imbalances in the muscle chains, including pelvic region, cervical region, which reduces endurance and commitment to physical activity. The study found that the exposure group (Terrainkur) showed lower values of "total fat", "metabolic age", "basic caloric value" compared to initial results and the control group; the exposure group (Terrainkur) showed a decrease in the deviation of the centre of body axis projection from the proper axis, the percentage of non-compliance with the proper fluctuations of the foot underextension. These changes contributed to the elimination of terrainkur restrictions and, as a result, improved the patient compliance during the terrainkur exercises.
PubMed: 37565256
DOI: 10.4081/ejtm.2023.11495 -
Animals : An Open Access Journal From... Jan 2024Behavior recognition in beef cattle is a crucial component of beef cattle behavior warning and intelligent farming. Traditional beef cattle behavior recognition faces...
Behavior recognition in beef cattle is a crucial component of beef cattle behavior warning and intelligent farming. Traditional beef cattle behavior recognition faces challenges in both difficulty in identification and low accuracy. In this study, the YOLOv8n_BiF_DSC (Fusion of Dynamic Snake Convolution and BiFormer Attention) algorithm was employed for the non-intrusive recognition of beef cattle behavior. The specific steps are as follows: 45 beef cattle were observed using a fixed camera (A LINE OF DEFENSE) and a mobile phone (Huawei Mate20Pro) to collect and filter posture data, yielding usable videos ranging from 1 to 30 min in length. These videos cover nine different behaviors in various scenarios, including standing, lying, mounting, fighting, licking, eating, drinking, walking, and searching. After data augmentation, the dataset comprised 34,560 samples. The convolutional layer (CONV) was improved by introducing variable convolution and dynamic snake-like convolution modules. The dynamic snake-like convolution, which yielded the best results, expanded the model's receptive field, dynamically perceived key features of beef cattle behavior, and enhanced the algorithm's feature extraction capability. Attention mechanism modules, including SE (Squeeze-and-Excitation Networks), CBAM (Convolutional Block Attention Module), CA (Coordinate Attention), and BiFormer (Vision Transformer with Bi-Level Routing Attention), were introduced. The BiFormer attention mechanism, selected for its optimal performance, improved the algorithm's ability to capture long-distance context dependencies. The model's computational efficiency was enhanced through dynamic and query-aware perception. Experimental results indicated that YOLOv8n_BiF_DSC achieved the best results among all improved algorithms in terms of accuracy, average precision at IoU 50, and average precision at IoU 50:95. The accuracy of beef cattle behavior recognition reached 93.6%, with the average precision at IoU 50 and IoU 50:95 being 96.5% and 71.5%, respectively. This represents a 5.3%, 5.2%, and 7.1% improvement over the original YOLOv8n. Notably, the average accuracy of recognizing the lying posture of beef cattle reached 98.9%. In conclusion, the YOLOv8n_BiF_DSC algorithm demonstrates excellent performance in feature extraction and high-level data fusion, displaying high robustness and adaptability. It provides theoretical and practical support for the intelligent recognition and management of beef cattle.
PubMed: 38338110
DOI: 10.3390/ani14030466 -
Cureus Jul 2023Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder that primarily affects the central nervous system (CNS). It is characterized by...
Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder that primarily affects the central nervous system (CNS). It is characterized by an acute inflammatory response targeting the myelin sheath surrounding nerve fibers in the brain and spinal cord. The exact mechanism of ADEM is not fully understood, but it is believed to involve an abnormal immune response that leads to the activation of immune cells and subsequent inflammation within the CNS. This immune-mediated attack results in the destruction of myelin, impairing the transmission of nerve signals and causing a wide range of neurological symptoms. This is a case of a six-year-old girl with no notable medical history presented with complaints of a fever and headache for the last month, in addition to difficulty walking for 20 days and speaking for 14 days. On CNS examination, the right upper and lower limbs' power was reduced, and the Babinski sign was seen in both lower limbs. Both sides of the triceps and knee showed increased reflexes, whereas both sides of the ankle showed decreased reflexes. Magnetic resonance imaging (MRI) showed multiple T1 hypointensities and T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) hyperintensities in the subcortical white matter of the bilateral frontal and parietal lobes, bilateral cerebellar peduncles, corpus callosum, pons, and midbrain. Our case report aims to raise awareness and aid in the early recognition of ADEM because prompt recognition, accurate diagnosis, and appropriate management are essential to minimizing neurological damage and promoting favorable outcomes in affected individuals.
PubMed: 37602096
DOI: 10.7759/cureus.42070