The use of TNF-inhibitors and/or the IL-6 receptor antagonist, tocilizumab, in rheumatoid arthritis (RA) have pleiotropic effects that also involve circulating B-cells. The main goal of this study ...was to assess the effect of TNF-inhibitors and tocilizumab on B-cell phenotype and gene expression in RA.
Blood samples were collected from untreated early RA (ERA) patients, established RA patients under methotrexate treatment, established RA patients before and after treatment with TNF-inhibitors and tocilizumab, and healthy donors. B-cell subpopulations were characterized by flow cytometry and B-cell gene expression was analyzed by real-time PCR on isolated B-cells. Serum levels of BAFF, CXCL13 and sCD23 were determined by ELISA.
The frequency of total CD19+ B cells in circulation was similar between controls and all RA groups, irrespective of treatment, but double negative (DN) IgD-CD27- memory B cells were significantly increased in ERA and established RA when compared to controls. Treatment with TNF-inhibitors and tocilizumab restored the frequency of IgD-CD27- B-cells to normal levels, but did not affect other B cell subpopulations. TACI, CD95, CD5, HLA-DR and TLR9 expression on B-cells significantly increased after treatment with either TNF-inhibitors and/ or tocilizumab, but no significant changes were observed in BAFF-R, BCMA, CD69, CD86, CXCR5, CD23, CD38 and IgM expression on B-cells when comparing baseline with post-treatment follow-ups. Alterations in B-cell gene expression of BAFF-R, TACI, TLR9, FcγRIIB, BCL-2, BLIMP-1 and β2M were found in ERA and established RA patients, but no significant differences were observed after TNF-inhibitors and tocilizumab treatment when comparing baseline and follow-ups. Serum levels of CXCL13, sCD23 and BAFF were not significantly affected by treatment with TNF-inhibitors and tocilizumab.
In RA patients, the use of TNF-inhibitors and/ or tocilizumab treatment affects B-cell phenotype and IgD-CD27- memory B cells in circulation, but not B-cell gene expression levels.
Occupational disorders considerably impact workers’ quality of life and organizational productivity, and even affect mortality worldwide. Such health issues are related to mental health and ...ergonomics risk factors. In particular, mental health may be affected by cognitive strain caused by unexpected interruptions and other attention compromising factors. Risk factors assessment associated with cognitive strain in office environments, namely related to attention states, still suffers from the lack of scientifically validated tools. In this work, we aim to develop a series of classification models that can classify attention during pre-defined cognitive tasks based on the acquisition of biosignals to create a ground truth of attention. Biosignals, such as electrocardiography, electroencephalography, and functional near-infrared spectroscopy, were acquired from eight subjects during standard cognitive tasks inducing attention. Individually tuned machine learning models trained with those biosignals allowed us to successfully detect attention on the individual level, with results in the range of 70–80%. The electroencephalogram and electrocardiogram were revealed to be the most appropriate sensors in this context, and the combination of multiple sensors demonstrated the importance of using multiple sources. These models prove to be relevant for the development of attention identification tools by providing ground truth to determine which human–computer interaction variables have strong associations with attention.
Remote ischemic conditioning (RIC) is a procedure applied in a limb for triggering endogenous protective pathways in distant organs, namely brain or heart. The underlying mechanisms of RIC are still ...not fully understood, and it is hypothesized they are mediated either by humoral factors, immune cells and/or the autonomic nervous system. Herein, heart rate variability (HRV) was used to evaluate the electrophysiological processes occurring in the heart during RIC and, in turn to assess the role of autonomic nervous system.
Healthy subjects were submitted to RIC protocol and electrocardiography (ECG) was used to evaluate HRV, by assessing the variability of time intervals between two consecutive heart beats. This is a pilot study based on the analysis of 18 ECG from healthy subjects submitted to RIC. HRV was characterized in three domains (time, frequency and non-linear features) that can be correlated with the autonomic nervous system function.
RIC procedure increased significantly the non-linear parameter SD2, which is associated with long term HRV. This effect was observed in all subjects and in the senior (> 60 years-old) subset analysis. SD2 increase suggests an activation of both parasympathetic and sympathetic nervous system, namely via fast vagal response (parasympathetic) and the slow sympathetic response to the baroreceptors stimulation.
RIC procedure modulates both parasympathetic and sympathetic autonomic nervous system. Furthermore, this modulation is more pronounced in the senior subset of subjects. Therefore, the autonomic nervous system regulation could be one of the mechanisms for RIC therapeutic effectiveness.
Back pain is regularly associated with biomechanical changes in the spine. The traditional methods to assess spine biomechanics use ionising radiation. Vertebral Metrics (VM) is a non-invasive ...instrument developed by the authors in previous research that assesses the spinous processes’ position. However, the spine model used by VM is not accurate. To overcome it, the present paper proposes a pioneering and simple articulated model of the spine built through the data collected by VM. The model is based on the spring–mass system and uses the Levenberg–Marquardt algorithm to find the arrangement of vertebral bodies. It represents the spine as rigid geometric transformations from one vertebra to the other when the extremity vertebrae are stationary. The validation process used the Bland–Altman method to compare the Cobb and the intervertebral angles computed by the model with the radiographic exams of eight patients diagnosed with Ankylosing Spondylitis. The results suggest that the model is valid; however, previous clinical information would improve outcomes by customising the lower and upper vertebrae positions, since the study revealed that the C6 rotation slightly influences the computed angles. Applying VM with the new model could make a difference in preventing, monitoring, and early diagnosing spinal disorders.
In this paper, we evaluate the effects of mindfulness meditation training in electrophysiological signals, recorded during a concentration task. Longitudinal experiments have been limited to the ...analysis of psychological scores through
depression, anxiety, and stress state
(DASS) surveys. Here, we present a longitudinal study, confronting DASS survey data with electrocardiography (ECG), electroencephalography (EEG), and electrodermal activity (EDA) signals. Twenty-five university student volunteers (mean age = 26, SD = 7, 9 male) attended a 25-h mindfulness-based stress reduction (MBSR) course, over a period of 8 weeks. There were four evaluation periods: pre/peri/post-course and a fourth follow-up, after 2 months. All three recorded biosignals presented congruent results, in line with the expected benefits of regular meditation practice. In average, EDA activity decreased throughout the course, −64.5%, whereas the mean heart rate displayed a small reduction, −5.8%, possibly as a result of an increase in parasympathetic nervous system activity. Prefrontal (AF3) cortical alpha activity, often associated with calm conditions, saw a very significant increase, 148.1%. Also, the number of stressed and anxious subjects showed a significant decrease, −92.9% and −85.7%, respectively. Easy to practice and within everyone’s reach, this mindfulness meditation can be used proactively to prevent or enhance better quality of life.
Graphical abstract
25 volunteers attended a Mindfulness-Based Stress Reduction (MBSR) course in 4 evaluation periods: Pre/Peri/Post-course and a fourth follow-up after two months. A Depression, Anxiety and Stress State (DASS) survey is completed in each period. Electrodermal Activity (EDA), Electrocardiography (ECG) and Electroencephalography (EEG) are also recorded and processed. By integrating self-reported surveys and electrophysiological recordings there is strong evidence of evolution in wellbeing. Mindfulness meditation can be used proactively to prevent or enhance better quality of life.
While performing orthopedic surgeries, surgeons stand for long hours, carrying out repetitive and/or forceful movements, in sustained awkward postures, increasing the risk of work-related ...musculoskeletal disorders (WRMSD).
Nonetheless, the literature addressing the risk factors, prevalence and symptoms of lower limb WRMSD remains dispersed and lacks a comprehensive synthesis. However, considering the critical role of lower limbs in maintaining surgical stability and balance, WRMSD affecting lower limbs could significantly compromise precision and motor skills, potentially impacting surgery outcomes.
This systematic review addresses this gap by consolidating evidence on lower limb WRMSD incidence and symptoms among orthopedic surgeons, while identifying the underlying risk factors.
The selection of the papers for this systematic review follows the PRISMA methodology and includes articles from Scopus, PubMed, and Web of Science published between 2013 and 2023. Among 320 articles initially identified, 14 met the inclusion criteria.
This systematic review shows knee WRMSD symptoms as the most prevalent, followed by foot/ankle and hip/thigh symptoms. The prevalence of foot/ankle WRMSD was the highest, followed by knee/lower leg and hip/thigh WRMSD. Additionally, the main risk factors reported as contributing to the development of these disorders included prolonged standing, static postures, higher body mass index, aging, smoking, and years of experience.
The findings of this systematic review highlight the substantial prevalence of lower limb WRMSD and symptoms among orthopedic surgeons and shed light on the associated risk factors. Understanding these factors is crucial for devising preventive measures and ergonomic interventions, ultimately enhancing the well-being of surgeons, and improving patient care.
•Existing literature lacks a comprehensive synthesis of lower limb WRMSD prevalence and risk factors among orthopedic surgeons.•Using PRISMA, the systematic review analyzes 14 studies from three databases, published between 2013 and 2023.•Knee WRMSD symptoms are most prevalent, followed by foot/ankle and hip/thigh. Foot/ankle WRMSD has the highest prevalence.•Risk factors include prolonged standing, sustained postures, higher BMI, aging, smoking, and cumulative years of experience.
To identify the occupational participation pattern of institutionalized elderly people in Portugal, a non-experimental investigation with a descriptive correlational and inferential basis was ...undertaken. The 42 participants, 21 from the Associação de Bem Estar Social dos Reformados e Idosos de Canhestros and 21 from the Santa Casa da Misericórdia de Ferreira do Alentejo in Portugal were assessed using the Occupational Questionnaire. From the total sample, 73.8% (n = 31) were female and 26.2% (n = 11) were male, in the age range 68 and 94 years. Data analysis was carried out using SPSS® v. 24 software. It was found that the participants perform a smaller number of occupations during the night, mostly related to sleeping preparation. From their perspective, resting occupations represent 46.8% of the day. They attributed higher feelings of self-efficacy and satisfaction to the occupations performed in the afternoon. There were no statistically significant differences in the average scores for the independent variables schooling or gender, with the exception of Average Degree of Satisfaction, which showed that women were more satisfied. The dependent variables positively influenced each other, that is, as one dependent variable increased the other dependent variables also increased.
Healthcare professionals are exposed to multiple physical risk factors related to the development of work-related musculoskeletal disorders (WRMSD), which significantly affect their quality of life. ...Several ergonomic methods have been developed for identifying risk factors in the workplace. Among these, wearable devices that perform direct measurements have demonstrated outstanding potential in recent years to provide reliable, non-invasive, and continuous exposure assessment. Therefore, this systematic review aims to describe the use of wearable technology for the ergonomic risk assessment of healthcare professionals. Twenty-nine publications were selected following PRISMA guidelines based on the inclusion and exclusion criteria set. Most of the articles were published in the last three years, confirming a growing trend in the research on this topic. Most wearable devices, which were used isolated or combined, consist of inertial sensors used to measure and assess the exposure to awkward postures and sEMG sensors, which provide the measurement of muscle activity parameters related to the force applied while performing work activities. The main results and respective analyses provided insights into the strengths and limitations of using wearable technology to acquire data on several work activities performed by healthcare professionals. Future research is needed to widen and validate the applicability of wearable technology in support of ergonomic interventions aimed at preventing the development of WRMSD among healthcare professionals.
•Overview of wearable devices to ergonomic risk assessment of healthcare professionals.•Most are inertial sensors.•Technologies revealed the potential for performing risk assessments and supporting the guidance of corrective actions.•There are barriers to the application in the heathcare context.
Congenital limb defects occur when a limb does not develop normally during pregnancy. The quality of each person's everyday life is significantly impacted by any of these defects and there is no ...concrete treatment. 3D modeling and printing, enables the creation and customization of precise virtual and/or physical models, including models of the human anatomy. These technologies provide a novel method of producing new devices with optimized design and production time, improving adaptability, and incorporating functionality. To this end, we propose a method of designing and producing 3D printed assistive devices and we also present an example of an assistive device, done in the 3D Printing Center for Health, as well as its impact on the patient's daily life. With this device, the patient became able to play the guitar and hold a knife, thus helping on these two activities.
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