Digital measures may provide objective, sensitive, real-world measures of disease progression in Parkinson’s disease (PD). However, multicenter longitudinal assessments of such measures are few. We ...recently demonstrated that baseline assessments of gait, tremor, finger tapping, and speech from a commercially available smartwatch, smartphone, and research-grade wearable sensors differed significantly between 82 individuals with early, untreated PD and 50 age-matched controls. Here, we evaluated the longitudinal change in these assessments over 12 months in a multicenter observational study using a generalized additive model, which permitted flexible modeling of at-home data. All measurements were included until participants started medications for PD. Over one year, individuals with early PD experienced significant declines in several measures of gait, an increase in the proportion of day with tremor, modest changes in speech, and few changes in psychomotor function. As measured by the smartwatch, the average (SD) arm swing in-clinic decreased from 25.9 (15.3) degrees at baseline to 19.9 degrees (13.7) at month 12 (P = 0.004). The proportion of awake time an individual with early PD had tremor increased from 19.3% (18.0%) to 25.6% (21.4%; P < 0.001). Activity, as measured by the number of steps taken per day, decreased from 3052 (1306) steps per day to 2331 (2010; P = 0.16), but this analysis was restricted to 10 participants due to the exclusion of those that had started PD medications and lost the data. The change of these digital measures over 12 months was generally larger than the corresponding change in individual items on the Movement Disorder Society—Unified Parkinson’s Disease Rating Scale but not greater than the change in the overall scale. Successful implementation of digital measures in future clinical trials will require improvements in study conduct, especially data capture. Nonetheless, gait and tremor measures derived from a commercially available smartwatch and smartphone hold promise for assessing the efficacy of therapeutics in early PD.
1. Quality properties of breast and drumstick muscles of female broiler chickens reared under different light sources were evaluated using a total of 480 female chicks (Ross 308). 2. After hatch, the ...chicks were randomly divided into three lighting treatment groups: control (daylight; mini incandescent lamps), G-B lighting group (green light monochromatic (MC) lamps for first 3 weeks switching to blue MC lamps for remaining 3 weeks), G-GB mixed lighting group (Green MC light for first 3 weeks, switching to Green MC light + Blue MC light mixture for remaining 3 weeks). 3. Feed consumption, body weight and total muscle weight values of the muscles from G-B and G-GB mix lighting groups were significantly higher than those of incandescent (control) lighting groups. 4. The breast and drumstick muscles from control lighting groups had a lower pH and water-holding capacity, but higher cooking loss values than those from G-B and G-GB mix lighting groups. The muscles from G-GB mix lighting groups exhibited the softer structure than those from other lighting groups. 5. We suggest that G-B or G-GB mix lighting during the rearing period of female broilers would improve body and muscle growth and then meat quality properties.
One of the major complications of arsenic on human health is hypertension. Arsenic-related hypertension and negative effects of arsenic on arterial system such as oxidative stress and ...vasoconstriction/vasorelaxation imbalance may lead to impair aortic elasticity. The aim of this study was to evaluate the effects of arsenic on aortic elasticity parameters including aortic strain and distensibility. One hundred twelve (112) workers were occupationally exposed to arsenic and 60 healthy control subjects were enroled. All patients underwent transthoracic echocardiography for detecting aortic strain and aortic distensibility. There were no differences in baseline demographic and echocardiographic characteristics between the groups. Aortic strain (10.3±3.9 vs 12.1±2.7%, P=0.001) and aortic distensibility (0.45±0.17 vs 0.54±0.15 cm
per dyn, P=0.001) were decreased in arsenic-exposure group compared with controls. Urinary arsenic level was found to be negatively and significantly correlated with aortic strain (r=-0.306, P=0.001) and aortic distensibility (r=-0.259, P=0.006). Duration of arsenic exposure was also found to be negatively and significantly correlated with aortic strain (r=-0.386, P<0.001) and aortic distensibility (r=-0.333, P<0.001). This study suggests that arsenic exposure is related to impairment of aortic elasticity parameters even in subjects without overt cardiovascular disease.
Background: There is compelling evidence showing that achieving good glycaemic control reduces the risk of microvascular complications in people with type 1 and type 2 diabetes. Likewise, there is ...clear evidence to show that achieving good glycaemic control reduces the risk of macrovascular complications in type 1 diabetes. The UKPDS 10‐year follow up suggests that good glycaemic control also reduces the risk of macrovascular complications in type 2 diabetes. Despite this, recent results from ACCORD, ADVANCE and VADT present conflicting results and data from the ACCORD trial appear to suggest that very low HbA1c targets (<6.0%) may, in fact, be dangerous in certain patient populations.
Aim: To review recent results from ACCORD, ADVANCE and VADT and provide clear guidance on the clinical significance of the new data and their implications for the practising physician treating patients with type 2 diabetes.
Methods: A Pubmed search was used to identify major randomised clinical trials examining the association between glycaemic control and diabetes‐associated complications. The data was reviewed and discussed by the GTF through a consensus meeting. The recommendations for clinical practice in this statement are the conclusions of these analyses and discussions.
Results: Evidence from ACCORD, ADVANCE, VADT and UKPDS suggests that certain patient populations, such as those with moderate diabetes duration and/or no pre‐existing CVD, may benefit from intensive blood glucose control. These trials highlight the benefit of a multifactorial treatment approach to diabetes. However, ACCORD results indicate that aggressive HbA1c targets (<6.0%) may not be beneficial in patients with existing CVD and a longer duration of diabetes.
Conclusions: Glycaemic control remains a very important component of treatment for type 2 diabetes and contrasting results from the ACCORD, ADVANCE and VADT should not discourage physicians from controlling blood glucose levels.
Objective: Percutaneous catheter pulmonary vein isolation (PVI) has been the preferred choice for invasive treatment of symptomatic, drug-refractory lone atrial fibrillation (AF). Incomplete ablation ...lines, procedure-related morbidity and long-term success remain, however, a problem. A minimally invasive surgical approach can provide an attractive and secure alternative. Surgery offers an epicardial, bipolar approach under direct vision, but the invasiveness of surgery remains a problem. Therefore, we developed a completely thoracoscopic procedure. The objective of this study was to assess the feasibility, safety and effectiveness of a completely thoracoscopic surgical procedure to cure lone AF. Methods: Bilateral ‘video-assisted thoracoscopy’ was performed to isolate the bilateral pairs of pulmonary veins using bipolar RF-energy, to ablate the ganglionic plexus (GP) and to amputate the left atrial appendage. Preoperative, in-hospital and follow-up data were collected for our first 30 patients. Results: AF was paroxysmal in 63%, persistent in 27% and permanent in 10% of cases. The mean (±SD) left atrial diameter was 42.1 ± 7.4 mm and the mean duration of AF was 79.0 ± 63.9 months. Freedom from AF was obtained in 77% of the patients during a mean follow-up of 11.6 months. Forty-three percent of the patients had previously undergone a percutaneous PVI and were all free from AF during follow-up. Mean operation time was 137.4 ± 24.7 min. All patients were extubated in the operating room and left the recovery room within 12 h. The mean hospital stay was 5.1 ± 1.8 days. Two patients ultimately underwent a median sternotomy. No CVAs or pacemaker implantation were identified and none of the patients died. Conclusion: We report our initial experience of a completely thoracoscopic PVI with GP-ablation and amputation of the left atrial appendage and demonstrate that the procedure is feasible, safe and effective for the treatment of lone AF.
Results of studies in animals and human beings suggest that type 1 diabetes is preventable. Nicotinamide prevents autoimmune diabetes in animal models, possibly through inhibition of the DNA repair ...enzyme poly-ADP-ribose polymerase and prevention of β-cell NAD depletion. We aimed to assess whether high dose nicotinamide prevents or delays clinical onset of diabetes in people with a first-degree family history of type 1 diabetes.
We did a randomised double-blind placebo-controlled trial of nicotinamide in 552 relatives with confirmed islet cell antibody (ICA) levels of 20 Juvenile Diabetes Federation (JDF) units or more, and a non-diabetic oral glucose tolerance test. Participants were recruited from 18 European countries, Canada, and the USA, and were randomly allocated oral modified release nicotinamide (1·2 g/m2) or placebo for 5 years. Random allocation was done with a pseudorandom number generator and we used size balanced blocks of four and stratified by age and national group. Primary outcome was development of diabetes, as defined by WHO criteria. Analysis was done on an intention-to-treat basis.
There was no difference in the development of diabetes between the treatment groups. Of 159 participants who developed diabetes in the course of the trial, 82 were taking nicotinamide and 77 were on placebo. The unadjusted hazard ratio for development of diabetes was 1·07 (95% CI 0·78–1·45; p=0·69), and the hazard ratio adjusted for age-at-entry, baseline glucose tolerance, and number of islet autoantibodies detected was 1·01 (0·73–1·38; p=0·97). Of 168 (30·4%) participants who withdrew from the trial, 83 were on placebo. The number of serious adverse events did not differ between treatment groups. Nicotinamide treatment did not affect growth in children or first-phase insulin secretion.
Large-scale controlled trials of interventions designed to prevent the onset of type 1 diabetes are feasible, but nicotinamide was ineffective at the dose we used.
The purpose of the study was to determine DTI properties of brain metastases in subjects with Non-Small Cell Lung Carcinoma (NSCLC) to evaluate whether there was a correlation between DTI findings ...and Programmed Cell Death Ligand-1 (PD-L1).
The study population (n:22) was assigned to PD-L1 negative (Group 1: PD-L1 expression<% 50) (n=11) or positive (Group 2: PD-L1 expression ≥%50) (n=11). We compared ADC and FA values measured from the enhanced solid metastases and peritumoral edema area with PD-L1 protein status.
The mean ADC values were lower in group 2 compared to group 1. The peritumoral ADC values were higher in group 2 compared to group 1. Mean peritumoral edema FA values were lower in group 2 compared to group 1. The peritumoral edema nADC values were higher in group 2 compared to group 1. As PD-L1 expression frequency increased, ADC values in the peritumoral edema area increased and FA values decreased.
We thought that the existence of PD-L1 protein does not affect ADC and FA values of brain metastasis (BM) originating from NSCLC. DTI characteristics of the peritumoral edema area could be a guide in determining the PD-L1 protein status of brain metastases of NSCLC. The relationship between PD-L1 expression status and DTI features in BM from NSCLC could help us to have an idea regarding the response to immunotherapy.
The current treatment of type 1 diabetes consists of insulin administration. Transplantation of islets of Langerhans is considered very favorable because the full effect of insulin treatment cannot ...be obtained in severe cases. Although agents such as omega-3 (ω3) and vitamin D3 (Vit D3) are known to contribute to the success of islet allo-transplantation (ITX), in this study we aimed to experimentally determine their effects on glycemia and TNF-α production. Wistar albino rats, which were used as recipients, were given ω3, Vit D3, and islets by gavage, and intraperitoneal- and intraportal injections, respectively. Daclizumab (DAC) was used for immunosuppression. Glycemia levels decreased in rats treated with ω3 and vit D3. TNF-α increased in all groups due to application of STZ. After ITX (day +1), the weakest increase was observed in the ω3 + Vit D3 group. In the ITX+DAC group, compared with that of ITX only, DAC was shown to decrease levels of TNF- α following ITX, only in control group, however, similar levels of TNF-α were observed in other groups. The values in the treated groups were already lower than those of the controls in the ITX group and also remained almost equal in the ITX+DAC group. We suggest that the use of ω3 and Vit D3 together will improve the pro-inflammatory aspect encountered during and after ITXs, and contribute to the reduction of the dose of immunosuppressants in these procedures.
The Cd, Pb, Mn, Zn, Ni, Co, Fe, Cr and Cu content were determined in various teas available in local markets of Jeddah and Jazan, Saudi Arabia. Concentrations of the trace metals were measured after ...acid digestion using a flame atomic absorption spectrometer. Validation of the digestion procedure was performed by the analysis of a certified reference material. The cadmium, lead, manganese, zinc, nickel, cobalt, iron, chromium and copper concentrations were found in the range of below the detection limit (BDL)—0.7 μg/g, BDL—8.7 μg/g, 48–859 μg/g, 6.6–120 μg/g, BDL—16.9 μg/g, BDL—3.1 μg/g, 46–348 μg/g, BDL—4.9 μg/g and 5.2–21.6 μg/g respectively. The values found in this study were compared with literature values.
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