Strenuous exercise can result in skeletal muscle damage, leading to the systemic mobilization, activation and intramuscular accumulation of blood leukocytes. Eicosanoid metabolites of arachidonic ...acid (ARA) are potent inflammatory mediators, but whether changes in dietary ARA intake influence exercise-induced inflammation is not known. This study investigated the effect of 4 weeks of dietary supplementation with 1.5 g/day ARA (n=9, 24 {plus minus} 1.5 years) or corn-soy oil placebo (n=10, 26 {plus minus} 1.3 years) on systemic and intramuscular inflammatory responses to an acute bout of resistance exercise (8 sets each of leg press and extension at 80% 1RM) in previously trained men. Whole EDTA blood, serum, peripheral blood mononuclear cells (PMBCs), and skeletal muscle biopsies were collected prior to exercise, immediately post-exercise and at 2, 4 and 48 h of recovery. ARA supplementation resulted in higher exercise-stimulated serum creatine kinase activity (incremental area under the curve (iAUC) p=0.046) and blood leukocyte counts (iAUC for total white cells p<0.001, neutrophils p=0.007, monocytes p=0.015). The exercise-induced fold change in PBMC mRNA expression of interleukin-1 beta ( IL1B), CD11b ( ITGAM) and neutrophil elastase ( ELANE), as well as muscle mRNA expression of the chemokines interleukin-8 ( CXCL8) and monocyte chemoattractant protein 1 ( CCL2) was also greater in the ARA group than placebo. Despite this, ARA supplementation did not influence the histological presence of leukocytes within muscle, perceived muscle soreness or the extent and duration of muscle force loss. These data show that ARA supplementation transiently increased the inflammatory response to acute resistance exercise, but did not impair recovery.
Surgical excision remains the most commonly utilized treatment for superficial basal cell carcinoma (sBCC). In the era of cost containment of healthcare, the rising incidence of BCC and the high cost ...of excision require a continuous search for efficient and cost-effective management.
Examine the feasibility of the diagnosis and treatment of low-risk sBCC in a single visit.
Retrospective chart review of sBCCs diagnosed and treated in a single visit.
The study identified 151 histologically confirmed sBCCs in 86 patients over a 5-year period, 93 (61.6%) cases of which were diagnosed as low-risk sBCC and treated in a single appointment. The majority of the cases (n = 86) were treated with curettage alone and the rest (n = 7) with a shave removal technique. The average size of the lesion was 0.82 cm located primarily on the trunk and extremities (95.7%). One recurrence on the trunk was observed in the single appointment group. Overall, diagnostic sensitivity was 95.4% and specificity was 92.0%.
Diagnosis and treatment of sBCC in a single visit is an efficient and cost-effective management option for those who are proficient in identifying low-risk sBCC.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Implantable brain-computer interfaces (BCIs), functioning as motor neuroprostheses, have the potential to restore voluntary motor impulses to control digital devices and improve functional ...independence in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction. However, reports to date have had limited clinical translation.
Two participants with amyotrophic lateral sclerosis (ALS) underwent implant in a single-arm, open-label, prospective, early feasibility study. Using a minimally invasive neurointervention procedure, a novel endovascular Stentrode BCI was implanted in the superior sagittal sinus adjacent to primary motor cortex. The participants undertook machine-learning-assisted training to use wirelessly transmitted electrocorticography signal associated with attempted movements to control multiple mouse-click actions, including zoom and left-click. Used in combination with an eye-tracker for cursor navigation, participants achieved Windows 10 operating system control to conduct instrumental activities of daily living (IADL) tasks.
Unsupervised home use commenced from day 86 onwards for participant 1, and day 71 for participant 2. Participant 1 achieved a typing task average click selection accuracy of 92.63% (100.00%, 87.50%-100.00%) (trial mean (median, Q1-Q3)) at a rate of 13.81 (13.44, 10.96-16.09) correct characters per minute (CCPM) with predictive text disabled. Participant 2 achieved an average click selection accuracy of 93.18% (100.00%, 88.19%-100.00%) at 20.10 (17.73, 12.27-26.50) CCPM. Completion of IADL tasks including text messaging, online shopping and managing finances independently was demonstrated in both participants.
We describe the first-in-human experience of a minimally invasive, fully implanted, wireless, ambulatory motor neuroprosthesis using an endovascular stent-electrode array to transmit electrocorticography signals from the motor cortex for multiple command control of digital devices in two participants with flaccid upper limb paralysis.
We examined how breast cancer-related lymphedema (BCRL) affects health-related quality of life (HRQOL), productivity, and compliance with therapeutic interventions to guide structuring BCRL screening ...programs.
We prospectively followed consecutive breast cancer patients who underwent axillary lymph node dissection (ALND) with arm volume screening and measures assessing patient-reported health-related quality of life (HRQOL) and perceptions of BCRL care. Comparisons by BCRL status were made with Mann-Whitney U, Chi-square, Fisher's exact, or t tests. Trends over time from ALND were assessed with linear mixed-effects models.
With a median follow-up of 8 months in 247 patients, 46% self-reported ever having BCRL, a proportion that increased over time. About 73% reported fear of BCRL, which was stable over time. Further in time from ALND, patients were more likely to report that BCRL screening reduced fear. Patient-reported BCRL was associated with higher soft tissue sensation intensity, biobehavioral, and resource concerns, absenteeism, and work/activity impairment. Objectively measured BCRL had fewer associations with outcomes. Most patients reported performing prevention exercises, but compliance decreased over time; patient-reported BCRL was not associated with exercise frequency. Fear of BCRL was positively associated with performing prevention exercises and using compressive garments.
Both incidence and fear of BCRL were high after ALND for breast cancer. Fear was associated with improved therapeutic compliance, but compliance decreased over time. Patient-reported BCRL was more strongly associated with worse HRQOL and productivity than was objective BCRL. Screening programs must support patients’ psychological needs and aim to sustain long-term compliance with recommended interventions.
•Both incidence and fear of BCRL were high after ALND for breast cancer.•Fear of BCRL was associated with improved therapeutic compliance.•Compliance with preventive/therapeutic interventions decreased over time.•Patient-reported BCRL is more strongly associated than objective BCRL with HRQOL.•Screening programs must support psychological needs to sustain long-term compliance.
Hydrogen (H
) measurement in exhaled breath is a reliable and non-invasive method to diagnose carbohydrate malabsorption. Currently, breath H
measurement is typically limited to clinic-based ...equipment. A portable breath analyser (AIRE, FoodMarble Digestive Health Limited, Dublin, Ireland) is a personalised device marketed for the detection and self-management of food intolerances, including lactose malabsorption (LM). Currently, the validity of this device for breath H
analysis is unknown. Individuals self-reporting dairy intolerance (six males and six females) undertook a lactose challenge and a further seven individuals (all females) underwent a milk challenge. Breath samples were collected prior to and at frequent intervals post-challenge for up to 5 h with analysis using both the AIRE and a calibrated breath hydrogen analyser (BreathTracker, QuinTron Instrument Company Inc., Milwaukee, WI, USA). A significant positive correlation (
< 0.001, r > 0.8) was demonstrated between AIRE and BreathTracker H
values, after both lactose and milk challenges, although 26% of the AIRE readings demonstrated the maximum score of 10.0 AU. Based on our data, the cut-off value for LM diagnosis (25 ppm H
) using AIRE is 3.0 AU and it is effective for the identification of a response to lactose-containing foods in individuals experiencing LM, although its upper limit is only 81 ppm.
Dietary strategies to promote successful aging are divergent. Higher-protein diets are recommended to preserve skeletal muscle mass and physical function. Conversely, increased B-vitamin intake, ...supporting one-carbon (1C) metabolism, reduces the risk of cognitive decline and cardiovascular disease. On the hypothesis that higher protein intake through animal-based sources will benefit 1C regulation by the supply of B vitamins (folate, riboflavin, and vitamins B6 and B12) and methyl donors (choline) despite higher methionine intake, this study explored the effect of a higher-protein diet on 1C metabolite status in older men compared to current protein recommendations.
Older men (age, 74 ± 3 y) were randomized to receive a diet for 10 wk containing either the recommended dietary allowance (RDA) of protein (0.8 g/kg body weight/d, n = 14), or double that amount (2RDA, n = 15), with differences in protein accounted for by modifying carbohydrate intake. Intervention diets were matched to each individual's energy requirements based on the Harris–Benedict equation and adjusted fortnightly as required depending on physical activity and satiety. Fasting plasma 1C metabolite concentrations were quantified by liquid chromatography coupled with mass spectrometry at baseline and after 10 wk of intervention.
Plasma homocysteine concentrations were reduced from baseline to follow-up with both diets. Changes in metabolite ratios reflective of betaine-dependent homocysteine remethylation were specific to the RDA diet, with an increase in the betaine-to-choline ratio and a decrease in the dimethylglycine-to-betaine ratio. Comparatively, increasing folate intake was positively associated with a change in choline concentration and inversely with the betaine-to-choline ratio for the 2RDA group.
Adding to the known benefits of higher protein intake in older people, this study supports a reduction of homocysteine with increased consumption of animal-based protein, although the health effects of differential response of choline metabolites to a higher-protein diet remain uncertain.
•Plasma homocysteine was reduced by the provision of diets either meeting the current protein recommendations or with double the protein recommendations with greater animal-based food intake.•Dietary B vitamin adequacy was achieved, and choline sparing demonstrated at higher folate intakes only in response to the high-protein diet.•Ratios of betaine to choline and dimethylglycine to betaine increased, suggesting regulatory adaptation to declining vitamin B12 intake in those consuming a diet meeting protein recommendations.•Implications for DNA methylation status and long-term health remain to be established.
Knowledge of fecundity in fishes is important for understanding life history, modeling population dynamics, developing fisheries management and determining conservation status. Sturgeon species are ...known for their high fecundity but to date only two populations of Atlantic sturgeon (Acipenser oxyrinchus Mitchill, 1815) have been examined for this aspect of their biology. The species is protected in most regions of eastern North America but the Saint John River, New Brunswick supports one of the two remaining commercial fisheries in Canada. Sixty females selected by this fishery were sampled for total length, weight, age, gonad weight and egg number. Absolute fecundity ranged from 153,630 to 1,306,626 eggs, with a mean fecundity of 582,832 ± 261,806 eggs. Absolute fecundity exhibited a significant positive relationship to increasing body weight but not to total length or age. Relative fecundity ranged from 129 to 216 eggs/g gonad weight and although it declined with both increasing body size and age the relationships were not significant. The Gonadosomatic Index (GSI) ranged from 1.3% to 27.0% with a mean of 7.8% ± 4.94 SD. Relative fecundity found in this study was higher and mean GSI lower than reported for other Atlantic sturgeon populations and other sturgeon species. Differences were probably due to location of the fishery downstream from spawning sites and selection of pre‐spawning females by the commercial fishery.
Purpose
Mild breast cancer-related lymphedema (BCRL) is clinically diagnosed as a 5%–10% increase in arm volume, typically measured no earlier than 3–6 months after locoregional treatment. Early BCRL ...treatment is associated with better outcomes, yet amid increasing evidence that lymphedema exists in a latent form, treatment is typically delayed until arm swelling is obvious. In this study, we investigated whether near-infrared fluorescence lymphatic imaging (NIRF-LI) surveillance could characterize early onset of peripheral lymphatic dysfunction as a predictor of BCRL.
Methods
In a prospective, longitudinal cohort/observational study (NCT02949726), subjects with locally advanced breast cancer who received axillary lymph node dissection and regional nodal radiotherapy (RT) were followed serially, between 2016 and 2021, before surgery, 4–8 weeks after surgery, and 6, 12, and 18 months after RT. Arm volume was measured by perometry, and lymphatic (dys) function was assessed by NIRF-LI.
Results
By 18 months after RT, 30 of 42 study subjects (71%) developed mild–moderate BCRL (i.e., ≥ 5% arm swelling relative to baseline), all manifested by “dermal backflow” of lymph into lymphatic capillaries or interstitial spaces. Dermal backflow had an 83% positive predictive value and 86% negative predictive value for BCRL, with a sensitivity of 97%, specificity of 50%, accuracy of 83%, positive likelihood ratio of 1.93, negative likelihood ratio of 0.07, and odds ratio of 29.00. Dermal backflow appeared on average 8.3 months, but up to 23 months, before the onset of mild BCRL.
Conclusion
BCRL can be predicted by dermal backflow, which often appears months before arm swelling, enabling early treatment before the onset of edema and irreversible tissue changes.
Abstract Depression and suicidality are prevalent in youth and are associated with a range of negative outcomes. The current study aimed to evaluate a measurement-based care (MBC) software (VitalSign ...6 ) tool to improve the screening and treatment of depression and suicidality in youth aged 8–17 years within a rural, underserved population. To assess for depression and suicidality, the Patient Health Questionnaire-2 was administered as an initial screen, and the Patient Health Questionnaire-9 Modified for Adolescents (PHQ-9-A) was administered if the initial screen was positive. Data were collected at medical clinics over one year, and descriptive statistics and t-tests or Wilcoxon-Mann-Whitney tests were conducted. A total of 1,984 youth were initially screened (mean age of 13 years; 51.6% female); 24.2% screened positive for depression, and 14.9% endorsed suicidality. Of those who screened positive, the mean PHQ-9-A score was 12.8; 66.9% had PHQ-9-A scores in the moderate to severe range, and 44.2% endorsed suicidality. Almost half of the youth who screened positive for depression had at least one follow-up assessment, and about one quarter achieved remission 4 months after initial screening. Adolescents (12–17 years) had higher PHQ-9-A scores, higher suicidality, and more follow-up assessments than younger youth (8–11 years). Younger youth had higher rates of remission. The widespread use of MBC was feasible in this setting. It is important to utilize MBC to identify and treat youth with depression and suicidality and to do so in younger populations to improve their trajectory over time; VitalSign 6 is one tool to help achieve these goals.
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