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BMC Palliative Care Jun 2024Explore the feasibility of a mobile health(mHealth) and virtual reality (VR) based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer...
Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: a single-center, single-arm, prospective phase II study.
OBJECTIVE
Explore the feasibility of a mobile health(mHealth) and virtual reality (VR) based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients.
METHODS
We recruited cancer patients in the Oncology department of the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from October 2022 to April 2023. The rehabilitation program was provided by a team of medical oncologists, dietitians, psychotherapists, and oncology specialist nurses. Participants received standard anti-cancer therapy and integrated intervention including hospitalized group-based exercise classes, at-home physical activity prescription, behavior change education, oral nutrition supplements, and psychological counseling. An effective intervention course includes two consecutive hospitalization and two periods of home-based rehabilitation (8 weeks). Access the feasibility as well as changes in aspects of physical, nutritional, and psychological status.
RESULTS
At the cutoff date of April 2023, the recruitment rate was 75% (123/165). 11.4%patients were lost to follow-up, and 3.25% withdrew halfway. Respectively, the completion rate of nutrition, exercise, and psychology were 85%,55%, and 63%. Nutrition interventions show the highest compliance. The parameters in nutrition, psychology, muscle mass, and quality of life after the rehabilitation showed significant improvements (P < .05). There was no significant statistical difference (P > .05) in handgrip strength and 6-minute walking speed.
CONCLUSION
It is feasible to conduct mHealth and VR-based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients. A larger multi-center trial is warranted in the future.
TRIAL REGISTRATION
ChiCTR2200065748 Registered 14 November 2022.
Topics: Humans; Male; Middle Aged; Female; Neoplasms; Prospective Studies; Virtual Reality; Feasibility Studies; Adult; Telemedicine; Aged; Exercise; Exercise Therapy; China
PubMed: 38902684
DOI: 10.1186/s12904-024-01487-3 -
Endocrine Practice : Official Journal... Jun 2024Limited recent evidence exists regarding weight-reduction preferences among people with obesity in the United States (US). We assessed preferred magnitudes of weight...
OBJECTIVE
Limited recent evidence exists regarding weight-reduction preferences among people with obesity in the United States (US). We assessed preferred magnitudes of weight reduction among adults with obesity and how these preferences differ by participant characteristics.
METHODS
OBSERVE was a cross-sectional study assessing perceptions of obesity and anti-obesity medication (AOMs) among people with obesity, healthcare providers, and employers in the US. Adults with obesity and overweight with obesity-related complications self-reported current weight and weight they associated with 5 preferences ("dream," "goal," "happy," "acceptable," and "disappointed"). Preferred percent weight reductions for each preference were calculated. Multivariable regression analyses were performed identifying associations between weight-reduction preferences and participant characteristics.
RESULTS
The study included 1007 participants (women: 63.6%; White: 41.0%; Black or African American: 28.9%; Asian: 6.5%; Hispanic: 15.3%; median body mass index [BMI]: 34.2 kg/m2). Median preferred percent weight reductions were: dream=23.5%; goal=16.7%; happy=14.6%; acceptable=10.3%; disappointed=4.8%. Women reported higher preferred weight reductions than men. Preferred weight reductions among Black/African American participants were lower than White participants. Regression analyses indicated significant associations, with higher preferred magnitudes of weight reduction within females, higher weight self-stigma, and BMI class in Hispanic participants compared to White.
CONCLUSION
In this large, real-world study, preferred magnitudes of weight reduction exceeded outcomes typically achieved with established nonsurgical obesity treatments but may be attained with bariatric procedures and newer and emerging AOMs. Respecting patients' preferences for treatment goals with obesity management could help support shared decision-making. Evaluating for an individual's contributors to weight preferences, such as weight self-stigma, can further benefit holistic obesity care.
PubMed: 38901731
DOI: 10.1016/j.eprac.2024.06.009 -
Journal of Family Psychology : JFP :... Jun 2024Parental support is crucial in the well-being of transgender and gender diverse (TGD) youth. Research shows that parents of TGD youth often experience stigma and...
Parental support is crucial in the well-being of transgender and gender diverse (TGD) youth. Research shows that parents of TGD youth often experience stigma and negative mental health outcomes as a result of being exposed to cissexist settings as they advocate and seek services for their child. Yet, there is a lack of research on the experiences of parents of TGD youth in the United States. This study explores the reported hopes of 990 parents ( = 48.6 years; = 6.7; 88.1% White; 67.3% heterosexual; 89.4% cisgender women) of TGD youth for their children (youth ages 3-18 years) in the United States. Radical hope framework is applied to unpack narratives of hopes by parents of TGD youth as a critical component of resistance and motivation toward healing from oppression. For this study, the following open-ended question was analyzed using thematic analysis: ? Four main themes and 11 subthemes of parental hopes emerged: (1) living authentically (freely expressing themselves, developing self-love, living a happy and normal life), (2) interpersonal connections (finding community, building social networks and friendships, developing romantic relationships, building their own family, and loved by others), (3) meeting life milestones (career and employment, achieving goals and dreams, and becoming an advocate), and (4) acceptance by society. We provide clinical recommendations grounded on the tenets of radical hope such as collective ways in which parents of TGD youth can engage in both resisting systemic oppression and building strong loving relationships with their child. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38900543
DOI: 10.1037/fam0001239 -
BioRxiv : the Preprint Server For... Jun 2024Prostate cancer is a heterogenous disease, but once it becomes metastatic it eventually becomes treatment resistant. One mechanism of resistance to AR-targeting therapy...
BACKGROUND
Prostate cancer is a heterogenous disease, but once it becomes metastatic it eventually becomes treatment resistant. One mechanism of resistance to AR-targeting therapy is lineage plasticity, where the tumor undergoes a transformation to an AR-indifferent phenotype, most studied in the context of neuroendocrine prostate cancer (NEPC). However, activation of additional de- or trans-differentiation programs, including a gastrointestinal (GI) gene expression program, has been suggested as an alternative method of resistance. In this study, we explored the previously identified GI prostate cancer phenotype (PCa-GI) in a large cohort of metastatic castration-resistant prostate cancer (mCRPC) patient biopsy samples.
METHODS
We analyzed a dataset of 634 mCRPC samples with batch effect corrected gene expression data from the West Coast Dream Team (WCDT), the East Coast Dream Team (ECDT), the Fred Hutchinson Cancer Research Center (FHCRC) and the Weill Cornell Medical center (WCM). Survival data was available from the WCDT and ECDT cohorts. We calculated a gene expression GI score using the sum of z-scores of genes from a published set of PCa-GI-defining genes (N=38). Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression with endpoint overall survival from time of biopsy to death of any cause.
RESULTS
We found that the PCa-GI score had a bimodal distribution, identifying a distinct set of tumors with an activated GI expression pattern. Approximately 35% of samples were classified as PCa-GI high, which was concordant with prior reports. Liver metastases had the highest median score but after excluding liver samples, 29% of the remaining samples were still classified as PCa-GI high, suggesting a distinct phenotype not exclusive to liver metastases. No correlation was observed between GI score and proliferation, AR signaling, or NEPC scores. Furthermore, the PCa-GI score was not associated with genomic alterations in or However, tumors with amplifications showed significantly higher GI scores (p=0.0001). Patients with PCa-GI tumors had a shorter survival (HR=1.5 [1.1-2.1], p=0.02), but this result was not significant after adjusting for the liver as metastatic site (HR=1.2 [0.82-1.7], p=0.35). Patients with PCa-GI low samples had a better outcome after androgen receptor signaling inhibitors (ASI, abiraterone or enzalutamide) than other therapies (HR=0.37 [0.22-0.61], p=0.0001) while the benefit of ASI was smaller and non-significant for PCa-GI high samples (HR=0.55 [0.29-1.1], p=0.07). A differential pathway analysis identified FOXA2 signaling to be upregulated PCa-GI high tumors (FDR = 3.7 × 10).
CONCLUSIONS
The PCa-GI phenotype is prevalent in clinical mCRPC samples and may represent a distinct biological entity. PCa-GI tumors may respond less to ASI and could offer a strategy to study novel therapeutic targets.
PubMed: 38895460
DOI: 10.1101/2024.06.02.595931 -
The British Journal of Educational... Jun 2024Countries have been implementing inclusive educational practices for children with special educational needs and disabilities (SEND) for at least 30 years.
BACKGROUND
Countries have been implementing inclusive educational practices for children with special educational needs and disabilities (SEND) for at least 30 years.
AIMS
Some issues continue to present as unresolved and will be examined in this paper with possible ways forward suggested. 1. There is still a lack of clarity around the definition of inclusion, its theoretical underpinnings, its implementation in practice and evaluation of success. 2. Teachers often still report the same problems of insufficient resources and express the same concerns about lack of skills and knowledge as reported in the early days. 3. A key question is, do children with SEND achieve better outcomes in inclusive educational settings?
DISCUSSION AND CONCLUSIONS
The paper argues that an overarching executive framework applied to the education of children with SEND is needed to provide a common frame of reference that can be shared by educators, policymakers and researchers. New ways of resourcing inclusion are discussed including supporting collaboration between mainstream and special schools to better utilize the expertise located in special schools. The paper examines the evidence for improved academic and social outcomes for learners with SEND in inclusive schools and proposes that psychological outcomes now need to be measured too. It further suggests that future research needs to drill down to the level of teacher classroom instruction rather than rely on the broader mainstream school-special school comparison.
PubMed: 38890011
DOI: 10.1111/bjep.12701 -
ELife Jun 2024Rapid eye movement sleep (REMs) is characterized by activated electroencephalogram (EEG) and muscle atonia, accompanied by vivid dreams. REMs is homeostatically...
Rapid eye movement sleep (REMs) is characterized by activated electroencephalogram (EEG) and muscle atonia, accompanied by vivid dreams. REMs is homeostatically regulated, ensuring that any loss of REMs is compensated by a subsequent increase in its amount. However, the neural mechanisms underlying the homeostatic control of REMs are largely unknown. Here, we show that GABAergic neurons in the preoptic area of the hypothalamus projecting to the tuberomammillary nucleus (POA→TMN neurons) are crucial for the homeostatic regulation of REMs in mice. POA→TMN neurons are most active during REMs, and inhibiting them specifically decreases REMs. REMs restriction leads to an increased number and amplitude of calcium transients in POA→TMN neurons, reflecting the accumulation of REMs pressure. Inhibiting POA→TMN neurons during REMs restriction blocked the subsequent rebound of REMs. Our findings reveal a hypothalamic circuit whose activity mirrors the buildup of homeostatic REMs pressure during restriction and that is required for the ensuing rebound in REMs.
Topics: Animals; Preoptic Area; Sleep, REM; Homeostasis; Mice; GABAergic Neurons; Male; Electroencephalography; Hypothalamic Area, Lateral
PubMed: 38884573
DOI: 10.7554/eLife.92095 -
National Science Review Jul 2024Room-temperature superconductivity has been a long-held dream of mankind and a focus of considerable interest in the research field of superconductivity. Significant... (Review)
Review
Room-temperature superconductivity has been a long-held dream of mankind and a focus of considerable interest in the research field of superconductivity. Significant progress has recently been achieved in hydrogen-based superconductors found in superhydrides (hydrides with unexpectedly high hydrogen contents) that are stabilized under high-pressure conditions and are not capturable at ambient conditions. Of particular interest is the discovery of a class of best-ever-known superconductors in clathrate metal superhydrides that hold the record for high superconductivity (e.g. = 250-260 K for LaH) among known superconductors and have great promise to be those that realize the long-sought room-temperature superconductivity. In these peculiar clathrate superhydrides, hydrogen forms unusual 'clathrate' cages containing encaged metal atoms, of which such a kind was first reported in a calcium hexa-superhydride (CaH) showing a measured high of 215 K under a pressure of 170 GPa. In this review, we aim to offer an overview of the current status of research progress on the clathrate metal superhydride superconductors, discuss the superconducting mechanism and highlight the key features (e.g. structure motifs, bonding features, electronic structure, etc.) that govern the high-temperature superconductivity. Future research direction along this line to find room-temperature superconductors will be discussed.
PubMed: 38883291
DOI: 10.1093/nsr/nwad270 -
ArXiv Jun 2024Electrical waves in the heart form rotating spiral or scroll waves during life-threatening arrhythmias such as atrial or ventricular fibrillation. The wave dynamics are...
Electrical waves in the heart form rotating spiral or scroll waves during life-threatening arrhythmias such as atrial or ventricular fibrillation. The wave dynamics are typically modeled using coupled partial differential equations, which describe reaction-diffusion dynamics in excitable media. More recently, data-driven generative modeling has emerged as an alternative to generate spatio-temporal patterns in physical and biological systems. Here, we explore denoising diffusion probabilistic models for the generative modeling of electrical wave patterns in cardiac tissue. We trained diffusion models with simulated electrical wave patterns to be able to generate such wave patterns in unconditional and conditional generation tasks. For instance, we explored the diffusion-based i) parameter-specific generation, ii) evolution and iii) inpainting of spiral wave dynamics, including reconstructing three-dimensional scroll wave dynamics from superficial two-dimensional measurements. Further, we generated arbitrarily shaped bi-ventricular geometries and simultaneously initiated scroll wave patterns inside these geometries using diffusion. We characterized and compared the diffusion-generated solutions to solutions obtained with corresponding biophysical models and found that diffusion models learn to replicate spiral and scroll waves dynamics so well that they could be used for data-driven modeling of excitation waves in cardiac tissue. For instance, an ensemble of diffusion-generated spiral wave dynamics exhibits similar self-termination statistics as the corresponding ensemble simulated with a biophysical model. However, we also found that diffusion models {produce artifacts if training data is lacking, e.g. during self-termination,} and `hallucinate' wave patterns when insufficiently constrained.
PubMed: 38883235
DOI: No ID Found -
Journal of Clinical Sleep Medicine :... Jun 2024Brunner syndrome is a recessive X-linked disorder characterized by intellectual disability and impulsive aggressiveness associated with Monoamine Oxidase-A (MAOA)...
Brunner syndrome is a recessive X-linked disorder characterized by intellectual disability and impulsive aggressiveness associated with Monoamine Oxidase-A (MAOA) deficiency leading to increased monoaminergic activity. We report the presence of REM sleep behavior disorder (RBD) in a 46-year-old patient with Brunner syndrome due to a c.1438A>G/iVS14-2 A>G mutation of the gene. He suffered from mild intellectual disability and psychotic disturbances. He presented a 15-year history of nightmares (chase, attacks and fights), sleep-related vocalizations and motor behaviors characterized by talking, screaming, crying, gesturing, punching, and kicking. Video-polysomnography showed RBD characterized by excessive tonic and phasic muscle activity in the mentalis and limb muscles with dream enacting behaviors during REM sleep. Clonazepam achieved a significant reduction of RBD symptomatology. We conclude that RBD can be a manifestation of Brunner syndrome probably due to an increased monoaminergic neurotransmission occurring in this rare genetic disorder.
PubMed: 38881510
DOI: 10.5664/jcsm.11230 -
Bulletin of the History of Medicine 2024Jean-Martin Charcot (1825-1893), the leading neurologist of his time, is best remembered for his studies on hysteria presented in clinical lectures at the Paris...
Jean-Martin Charcot (1825-1893), the leading neurologist of his time, is best remembered for his studies on hysteria presented in clinical lectures at the Paris Salpêtrière hospital. Developing the concept of traumatic male hysteria after accidents in which patients suffered slight physical damage led him to advance a psychological explanation for hysteria. Traumatic hysteria is the context for a close reading of Charcot's "last words" based upon a final unpublished lesson in 1893. This case history concerns a seventeen-year-old Parisian artisan whose various signs of hysteria developed following a dream in which he imagined himself the victim of a violent assault. Charcot identifies the dream/nightmare as the "original" feature determining traumatic hysteria. The dream sets in motion an overwhelming consciousness followed by a susceptibility to "autosuggestion" producing somatic signs of hysteria. Charcot's final lesson on dreams thus culminates his study of the psychological basis of traumatic hysteria.
Topics: Hysteria; Dreams; History, 19th Century; Humans; Male; Neurology; Paris; Neurologists; Adolescent
PubMed: 38881468
DOI: 10.1353/bhm.2024.a929782