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BMC Geriatrics Jun 2024Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an...
Group-based exercise for Parkinson's: a qualitative study of participants and partners' perceptions of an exercise class delivered through a community-university collaboration.
BACKGROUND
Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an ancillary therapeutic benefit to pharmacological management. This study explores the perceptions of exercising participants (PwP) and non-participating partners involved in an exercise class delivered through a community-university partnership.
METHODS
Two separate focus group discussions were conducted: one with class participants (PwP: n = 7, H&Y scale I to III), and the other with non-participating partners of PwP (n = 4).
RESULTS
Thematic analysis of the data identified that a range of physical, psychological and social factors were perceived to influence engagement: (1) actively taking control, (2) exercise is medicine for the mind and body, and (3) a community working together to promote exercise for parkinson's. Participants and partners felt that the support from the group, including the instructors and student volunteers, empowered and supported PwP to proactively self-manage their health, enjoy exercise in an inclusive group setting, and develop strong social connections with others in the local Parkinson's community. Support to exercise from healthcare professionals was identified as both an enabler and barrier to participation.
CONCLUSIONS
This study underscores the significance of a community-university partnership as a complementary therapeutic approach for PwP. It also provides critical reflections on its sustainability, including implications for how exercise is considered as medicine for PwP. Additionally, it offers practical recommendations to galvanise community participation and provide inclusive and viable exercise opportunities for PwP.
Topics: Humans; Parkinson Disease; Male; Female; Aged; Exercise Therapy; Qualitative Research; Middle Aged; Universities; Focus Groups; Aged, 80 and over; Exercise
PubMed: 38834963
DOI: 10.1186/s12877-024-05061-7 -
Ultrasound in Medicine & Biology Aug 2024Needle biopsy is a common technique used to obtain cell and tissue samples for diagnostics. Currently, two biopsy methods are widely used: (i) fine-needle aspiration...
OBJECTIVE
Needle biopsy is a common technique used to obtain cell and tissue samples for diagnostics. Currently, two biopsy methods are widely used: (i) fine-needle aspiration biopsy (FNAB) and (ii) core needle biopsy (CNB). However, these methods have limitations. Recently, we developed ultrasound-enhanced fine-needle aspiration biopsy (USeFNAB), which employs a needle that flexurally oscillates at an ultrasonic frequency of ∼32 kHz. The needle motion contributes to increased tissue collection while preserving cells and tissue constructs for pathological assessment. Previously, USeFNAB has been investigated only in ex vivo animal tissue. The present study was aimed at determining the feasibility of using USeFNAB in human epithelial and lymphoid tissue.
METHODS
Needle biopsy samples were acquired using FNAB, CNB and USeFNAB on ex vivo human tonsils (N = 10). The tissue yield and quality were quantified by weight measurement and blinded pathologists' assessments. The biopsy methods were then compared.
RESULTS
The results revealed sample mass increases of, on average, 2.3- and 5.4-fold with USeFNAB compared with the state-of-the-art FNAB and CNB, respectively. The quality of tissue fragments collected by USeFNAB was equivalent to that collected by the state-of-the-art methods in terms of morphology and immunohistochemical stainings made from cell blocks as judged by pathologists.
CONCLUSION
Our study indicates that USeFNAB is a promising method that could improve tissue yield to ensure sufficient material for ancillary histochemical and molecular studies for diagnostic pathology, thereby potentially increasing diagnostic accuracy.
Topics: Humans; Palatine Tonsil; Lymphoid Tissue; Biopsy, Fine-Needle; Feasibility Studies; Ultrasonography, Interventional; Image-Guided Biopsy; Epithelium
PubMed: 38834492
DOI: 10.1016/j.ultrasmedbio.2024.04.015 -
BioRxiv : the Preprint Server For... May 2024The adult mammalian heart has limited regenerative capacity following injury, leading to progressive heart failure and mortality. Recent studies have identified the...
The adult mammalian heart has limited regenerative capacity following injury, leading to progressive heart failure and mortality. Recent studies have identified the spiny mouse ( ) as a unique model for mammalian cardiac isch3emic resilience, exhibiting enhanced recovery after myocardial infarction (MI) compared to commonly used laboratory mouse strains. However, the underlying cellular and molecular mechanisms behind this unique response remain poorly understood. In this study, we comprehensively characterized the metabolic characteristics of cardiomyocytes in compared to the non-regenerative . We utilized single-nucleus RNA sequencing (snRNA-seq) in sham-operated animals and 1, 3, and 7 days post-myocardial infarction to investigate cardiomyocytes' transcriptomic and metabolomic profiles in response to myocardial infarction. Complementary targeted metabolomics, stable isotope-resolved metabolomics, and functional mitochondrial assays were performed on heart tissues from both species to validate the transcriptomic findings and elucidate the metabolic adaptations in cardiomyocytes following ischemic injury. Transcriptomic analysis revealed that cardiomyocytes inherently upregulate genes associated with glycolysis, the pentose phosphate pathway, and glutathione metabolism while downregulating genes involved in oxidative phosphorylation (OXPHOS). These metabolic characteristics are linked to decreased reactive oxygen species (ROS) production and increased antioxidant capacity. Our targeted metabolomic studies in heart tissue corroborated these findings, showing a shift from fatty acid oxidation to glycolysis and ancillary biosynthetic pathways in at baseline with adaptive changes post-MI. Functional mitochondrial studies indicated a higher reliance on glycolysis in compared to , underscoring the unique metabolic phenotype of hearts. Stable isotope tracing experiments confirmed a shift in glucose utilization from oxidative phosphorylation in . In conclusion, our study identifies unique metabolic characteristics of cardiomyocytes that contribute to their enhanced ischemic resilience following myocardial infarction. These findings provide novel insights into the role of metabolism in regulating cardiac repair in adult mammals. Our work highlights the importance of inherent and adaptive metabolic flexibility in determining cardiomyocyte ischemic responses and establishes as a valuable model for studying cardiac ischemic resilience in adult mammals.
PubMed: 38826249
DOI: 10.1101/2024.05.22.595229 -
Veterinary Medicine International 2024The application of the erythrocyte sedimentation rate (ESR) in feline medicine is currently unavailable, while in canine medicine it has been rediscovered due to the...
The application of the erythrocyte sedimentation rate (ESR) in feline medicine is currently unavailable, while in canine medicine it has been rediscovered due to the introduction of an automated ESR device. Our aims were to (1) define the reference interval (RI) of the ESR in healthy cats, (2) evaluate the ESR values between healthy and ill cats, (3) evaluate relationships between the ESR and some inflammatory markers, and (4) assess ESR changes in different durations of illness (acute, chronic, or acute-on-chronic). A prospective multicentric cohort study on 200 client-owned cats: 57 healthy cats and 143 ill cats for the other aims. Healthy cats were blood donors, or young cats underwent desexing procedures. Ill cats with full clinical medical records, hematobiochemical profiles, and diagnostic procedures to reach a final diagnosis were included. The ESR was performed with MINI-PET using the same K3-EDTA tubes used for CBC, with no additional sample required. The total leukocyte count (WBC), neutrophil-to-lymphocyte ratio (NLR), fibrinogen, serum amyloid A, and albumin/globulin ratio (A/G) were concurrently measured. Based on the clinical presentation and the final diagnosis, cats were classified as having the following: acute, chronic, and acute-on-chronic conditions. The RI of the ESR ranged between 1 and 23 mm/h. Ill cats showed a significantly higher ESR (median 29 mm/h; range 12-46 mm/h) than healthy cats (median 10 mm/h; range 1-12 mm/h; < 0.0001). The ESR was positively correlated only with fibrinogen ( < 0.001; = 0.43). Cats with acute-on-chronic diseases had the highest ESR (median 47 mm/h; range 35-56 mm/h) compared with acute (median 16 mm/h; range 14-42 mm/h; =0.003) and chronic cats (median 14 mm/h; range 10-31 mm/h; < 0.0001). Although further studies are needed, the ESR could be a useful ancillary inflammatory marker in cats, specifically in cats with acute diseases, with or without an underlying chronic condition.
PubMed: 38818029
DOI: 10.1155/2024/2313447 -
Journal of Cheminformatics May 2024This study describes the development and evaluation of six new models for predicting physical-chemical (PC) properties that are highly relevant for chemical hazard,...
This study describes the development and evaluation of six new models for predicting physical-chemical (PC) properties that are highly relevant for chemical hazard, exposure, and risk estimation: solubility (in water S and octanol S), vapor pressure (VP), and the octanol-water (K), octanol-air (K), and air-water (K) partition ratios. The models are implemented in the Iterative Fragment Selection Quantitative Structure-Activity Relationship (IFSQSAR) python package, Version 1.1.0. These models are implemented as Poly-Parameter Linear Free Energy Relationship (PPLFER) equations which combine experimentally calibrated system parameters and solute descriptors predicted with QSPRs. Two other ancillary models have been developed and implemented, a QSPR for Molar Volume (MV) and a classifier for the physical state of chemicals at room temperature. The IFSQSAR methods for characterizing applicability domain (AD) and calculating uncertainty estimates expressed as 95% prediction intervals (PI) for predicted properties are described and tested on 9,000 measured partition ratios and 4,000 VP and S values. The measured data are external to IFSQSAR training and validation datasets and are used to assess the predictivity of the models for "novel chemicals" in an unbiased manner. The 95% PI intervals calculated from validation datasets for partition ratios needed to be scaled by a factor of 1.25 to capture 95% of the external data. Predictions for VP and S are more uncertain, primarily due to the challenges in differentiating their physical state (i.e., liquids or solids) at room temperature. The prediction accuracy of the models for log K, log K and log K of novel, data-poor chemicals is estimated to be in the range of 0.7 to 1.4 root mean squared error of prediction (RMSEP), with RMSEP in the range 1.7-1.8 for log VP and log S. Scientific contributionNew partitioning models integrate empirical PPLFER equations and QSARs, allowing for seamless integration of experimental data and model predictions. This work tests the real predictivity of the models for novel chemicals which are not in the model training or external validation datasets.
PubMed: 38816859
DOI: 10.1186/s13321-024-00853-w -
Melanoma Management 2024Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. Six randomized case scenarios with diagnostic/clinical...
Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.
PubMed: 38812731
DOI: 10.2217/mmt-2023-0002 -
Neurological Research and Practice May 2024Depending on the underlying etiology and epilepsy type, the burden of disease for patients with seizures can vary significantly. This analysis aimed to compare direct...
A multicenter, matched case-control analysis comparing burden of illness among patients with tuberous sclerosis complex related epilepsy, generalized idiopathic epilepsy, and focal epilepsy in Germany.
BACKGROUND
Depending on the underlying etiology and epilepsy type, the burden of disease for patients with seizures can vary significantly. This analysis aimed to compare direct and indirect costs and quality of life (QoL) among adults with tuberous sclerosis complex (TSC) related with epilepsy, idiopathic generalized epilepsy (IGE), and focal epilepsy (FE) in Germany.
METHODS
Questionnaire responses from 92 patients with TSC and epilepsy were matched by age and gender, with responses from 92 patients with IGE and 92 patients with FE collected in independent studies. Comparisons were made across the main QoL components, direct costs (patient visits, medication usage, medical equipment, diagnostic procedures, ancillary treatments, and transport costs), indirect costs (employment, reduced working hours, missed days), and care level costs.
RESULTS
Across all three cohorts, mean total direct costs (TSC: €7602 [median €2620]; IGE: €1919 [median €446], P < 0.001; FE: €2598 [median €892], P < 0.001) and mean total indirect costs due to lost productivity over 3 months (TSC: €7185 [median €11,925]; IGE: €3599 [median €0], P < 0.001; FE: €5082 [median €2981], P = 0.03) were highest among patients with TSC. The proportion of patients with TSC who were unemployed (60%) was significantly larger than the proportions of patients with IGE (23%, P < 0.001) or FE (34%, P = P < 0.001) who were unemployed. Index scores for the EuroQuol Scale with 5 dimensions and 3 levels were significantly lower for patients with TSC (time-trade-off [TTO]: 0.705, visual analog scale [VAS]: 0.577) than for patients with IGE (TTO: 0.897, VAS: 0.813; P < 0.001) or FE (TTO: 0.879, VAS: 0.769; P < 0.001). Revised Epilepsy Stigma Scale scores were also significantly higher for patients with TSC (3.97) than for patients with IGE (1.48, P < 0.001) or FE (2.45, P < 0.001). Overall Quality of Life in Epilepsy Inventory-31 items scores was significantly lower among patients with TSC (57.7) and FE (57.6) than among patients with IGE (66.6, P = 0.004 in both comparisons). Significant differences between patients with TSC and IGE were also determined for Neurological Disorder Depression Inventory for Epilepsy (TSC: 13.1; IGE: 11.2, P = 0.009) and Liverpool Adverse Events Profile scores (TSC: 42.7; IGE: 37.5, P = 0.017) with higher score and worse results for TSC patients in both questionnaires.
CONCLUSIONS
This study is the first to compare patients with TSC, IGE, and FE in Germany and underlines the excessive QoL burden and both direct and indirect cost burdens experienced by patients with TSC.
PubMed: 38812055
DOI: 10.1186/s42466-024-00323-6 -
Journal of Neuroengineering and... May 2024Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of...
BACKGROUND
Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of available smoothness metrics have been poorly assessed in this group. We aimed to measure the reliability, responsiveness and construct validity of several smoothness metrics.
METHODS
This ancillary study of the REM-AVC trial included 31 participants with hemiparesis in the subacute phase of stroke (median time since stroke: 38 days). Assessments performed at inclusion (Day 0, D0) and at the end of a rehabilitation program (Day 30, D30) included the UE Fugl Meyer Assessment (UE-FMA), the Action Research Arm Test (ARAT), and 3D motion analysis of the UE during three reach-to-point movements at a self-selected speed to a target located in front at shoulder height and at 90% of arm length. Four smoothness metrics were computed: a frequency domain smoothness metric, spectral arc length metric (SPARC); and three temporal domain smoothness metrics (TDSM): log dimensionless jerk (LDLJ); number of submovements (nSUB); and normalized average rectified jerk (NARJ).
RESULTS
At D30, large clinical and kinematic improvements were observed. Only SPARC and LDLJ had an excellent reliability (intra-class correlation > 0.9) and a low measurement error (coefficient of variation < 10%). SPARC was responsive to changes in movement straightness (r=0.64) and to a lesser extent to changes in movement duration (r=0.51) while TDSM were very responsive to changes in movement duration (r>0.8) and not to changes in movement straightness (non-significant correlations). Most construct validity hypotheses tested were verified except for TDSM with low correlations with clinical metrics at D0 (r<0.5), ensuing low predictive validity with clinical metrics at D30 (non-significant correlations).
CONCLUSIONS
Responsiveness and construct validity of TDSM were hindered by movement duration and/or noise-sensitivity. Based on the present results and concordant literature, we recommend using SPARC rather than TDSM in reaching movements of uncontrolled duration in individuals with spastic paresis after stroke.
TRIAL REGISTRATION
NCT01383512, https://clinicaltrials.gov/ , June 27, 2011.
Topics: Humans; Male; Female; Upper Extremity; Middle Aged; Movement; Aged; Biomechanical Phenomena; Stroke; Stroke Rehabilitation; Reproducibility of Results; Paresis; Adult; Recovery of Function
PubMed: 38812037
DOI: 10.1186/s12984-024-01382-1 -
Nursing Reports (Pavia, Italy) Apr 2024Music evokes positive emotions and reduces stress and anxiety. Operating room (OR) staff face various challenges which can lead to high levels of stress. The aim of the...
BACKGROUND
Music evokes positive emotions and reduces stress and anxiety. Operating room (OR) staff face various challenges which can lead to high levels of stress. The aim of the study is to assess whether listening to music during intraoperative phases improves the work environment by reducing anxiety and stress in the entire surgical team.
METHODS
A prospective observational study was conducted from February to September 2023, involving medical personnel, nursing staff, and nursing students. They were divided into two groups: Group 1 with music during surgical procedures, and Group 2 without music. Participants were administered two validated instruments: the Zung Anxiety Self-Assessment Scale (SAS) to measure anxiety, and the Positive and Negative Affect Schedule to assess emotions generating stress. Additional items were included for demographics, job satisfaction, and the organization method.
RESULTS
Music did not impact anxiety, but increased positive emotions while reducing negative ones. Music had an ancillary effect, highlighting the need for significant organizational interventions aimed at increasing operator satisfaction, including offering voluntary instead of mandatory assignments to nursing staff.
CONCLUSIONS
Music appears to reduce stress in the intraoperative team when supported by a positive work environment in which assigned operators have chosen to work in the OR.
PubMed: 38804415
DOI: 10.3390/nursrep14020082 -
Diagnostic Pathology May 2024Current diagnostic criteria of adrenocortical neoplasms are mostly based on morphology. The utility of immunohistochemistry (IHC) and histochemistry is limited.
BACKGROUND
Current diagnostic criteria of adrenocortical neoplasms are mostly based on morphology. The utility of immunohistochemistry (IHC) and histochemistry is limited.
MATERIALS AND METHODS
To evaluate the diagnostic and prognostic utility of clinicopathological features, morphology, ancillary biomarkers, and reticular histochemistry in adrenocortical neoplasms. We examined 28 adrenocortical carcinomas (ACCs) and 50 adrenocortical adenomas (ACAs) obtained from pathology archives. Clinical data were retrieved from medical records. Two pathologists independently assessed hematoxylin and eosin-stained slides, employing modified Weiss criteria for all tumors and Lin-Weiss-Bisceglia criteria for oncocytic variants. Immunohistochemical markers (Calretinin, alpha-inhibin, MelanA, SF-1, Ki-67, PHH3, IGF-2, β-catenin, P53, CYP11B1, CYP11B2, MLH1, MSH2, MSH6, PMS2, EPCAM) and Gomori's Silver histochemistry were applied. Statistical analysis utilized SPSS Statistics 26.
RESULTS
ACCs exhibited larger tumor sizes (P<0.001) and symptomatic presentations (P = 0.031) compared to ACAs. Parameters of modified Weiss criteria and angioinvasion demonstrated diagnostic value for ACCs. Six immunohistochemical antibodies((MelanA, Ki-67, IGF-2, β-catenin, P53 and CYP11B1) and reticulin framework alterations showed diagnostic value. Notably, Ki-67 and reticulin staining were most recommended. Evident reticulin staining was frequently present in ACCs (P<0.001). Ki-67 was significantly higher in ACCs (P<0.001). Twenty-one conventional and seven oncocytic entities showed different necrosis frequencies. Symptoms and Ki-67 index ≥ 30% were prognostic for ACCs, correlating with shorter survival.
CONCLUSIONS
This study emphasizes the diagnostic value of reticulin framework alterations and a high Ki-67 index. Markers such as CYP11B1, IGF2, P53, β-catenin and MelanA also contribute to the diagnosis of ACCs. Symptoms and Ki-67 index ≥ 30% predict shorter survival. These findings encourges the use of ancillary markers such as reticulin histochemistry and Ki-67 in the workup of evaluations of adrenocortical neoplasms.
Topics: Humans; Adrenal Cortex Neoplasms; Adrenocortical Carcinoma; Male; Female; Biomarkers, Tumor; Middle Aged; Immunohistochemistry; Adult; Prognosis; Aged; Young Adult; Adolescent; Adrenocortical Adenoma; Child
PubMed: 38802933
DOI: 10.1186/s13000-024-01496-z