Abstract Background Assessment of fall risk in an individual with Parkinson disease (PD) is a critical yet often time consuming component of patient care. Recently a simple clinical prediction tool ...based only on fall history in the previous year, freezing of gait in the past month, and gait velocity <1.1 m/s was developed and accurately predicted future falls in a sample of individuals with PD. METHODS: We sought to externally validate the utility of the tool by administering it to a different cohort of 171 individuals with PD. Falls were monitored prospectively for 6 months following predictor assessment. RESULTS: The tool accurately discriminated future fallers from non-fallers (area under the curve AUC = 0.83; 95% CI 0.76–0.89), comparable to the developmental study. CONCLUSION: The results validated the utility of the tool for allowing clinicians to quickly and accurately identify an individual's risk of an impending fall.
Chronic disease is prevalent in rural communities, but access to health care is limited. Allied health intervention, incorporating behaviour change and exercise, may improve health outcomes. PHYZ X ...2U is a new service delivery model incorporating face-to-face consultations via a mobile clinic and remote health coaching, delivered by physiotherapy and exercise physiology clinicians and university students on clinical placement, to provide exercise programs to people living with chronic disease in rural New South Wales, Australia. This pilot study evaluated the feasibility and acceptability of PHYZ X 2U by evaluating participants’ goal attainment, exercise, quality of life and behaviour change following participation in the 12-week program, and amount of health coaching received. Sixty-two participants with one or more chronic diseases set a total of 123 goals. Thirty-nine (63%) participants completed the program, with 59% of these achieving their goals and 43% progressing in their attitudes and behaviour towards exercise. Weekly exercise increased by 1h following program participation (P=0.02), but quality of life remained unchanged (P=0.24). Participants who completed the program received more health coaching than those lost to follow up. PHYZ X 2U can increase access to allied health for people with chronic disease living in rural and remote areas. Refining the service to maximise program adherence and optimally manage a broad range of chronic diseases is required.
The ocean sampling day consortium Kopf, Anna; Bicak, Mesude; Kottmann, Renzo ...
Gigascience,
06/2015, Letnik:
4, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Ocean Sampling Day was initiated by the EU-funded Micro B3 (Marine Microbial Biodiversity, Bioinformatics, Biotechnology) project to obtain a snapshot of the marine microbial biodiversity and ...function of the world's oceans. It is a simultaneous global mega-sequencing campaign aiming to generate the largest standardized microbial data set in a single day. This will be achievable only through the coordinated efforts of an Ocean Sampling Day Consortium, supportive partnerships and networks between sites. This commentary outlines the establishment, function and aims of the Consortium and describes our vision for a sustainable study of marine microbial communities and their embedded functional traits.
The Canterbury Region of New Zealand has undergone rapid and significant land use intensification over the last three decades resulting in a substantial increase of nitrate-nitrogen leached to the ...environment. In this article, we determined the nitrate grey water footprint of milk, which is the amount of water needed to dilute nitrogen leached past the root zone to meet different receiving water nitrate standards per milk production unit. Our analysis revealed the nitrate grey water footprint for Canterbury ranged from 433 to 11,110 litres of water per litre of milk, depending on the water standards applied. This footprint is higher than many estimates for global milk production, and reveals that footprints are very dependent on inputs included in the analyses and on the water quality standards applied to the receiving water. The extensive dairy farming in Canterbury is leading to significant pollution of the region's groundwater, much of which is used for drinking water. Dairy farming at this intensity is unsustainable and if not reduced could pose a significant risk to human health and the market perception of the sustainability of the New Zealand dairy industry and its products.
Background
A 3‐step clinical prediction tool including falling in the previous year, freezing of gait in the past month and self‐selected gait speed <1.1 m/s has shown high accuracy in predicting ...falls in people with Parkinson's disease (PD). The accuracy of this tool when including only self‐report measures is yet to be determined.
Objectives
To validate the 3‐step prediction tool using only self‐report measures (3‐step self‐reported prediction tool), and to externally validate the 3‐step clinical prediction tool.
Methods
The clinical tool was used with 137 individuals with PD. Participants also answered a question about self‐reported gait speed, enabling scoring of the self‐reported tool, and were followed‐up for 6 months. An intraclass correlation coefficient (ICC2,1) was calculated to evaluate test–retest reliability of the 3‐step self‐reported prediction tool. Multivariate logistic regression models were used to evaluate the performance of both tools and their discriminative ability was determined using the area under the curve (AUC).
Results
Forty‐two participants (31%) reported ≥1 fall during follow‐up. The 3‐step self‐reported tool had an ICC2,1 of 0.991 (95% CI 0.971–0.997; P < 0.001) and AUC = 0.68; 95% CI 0.59–0.77, while the 3‐step clinical tool had an AUC = 0.69; 95% CI 0.60–0.78.
Conclusions
The 3‐step self‐reported prediction tool showed excellent test–retest reliability and was validated with acceptable accuracy in predicting falls in the next 6 months. The 3‐step clinical prediction tool was externally validated with similar accuracy. The 3‐step self‐reported prediction tool may be useful to identify people with PD at risk of falls in e/tele‐health settings.
This is an update of the section on complications that are associated with coughing in the 2006 CHEST cough guidelines that addresses two aims: (1) to systematically identify and thematically ...categorize the diverse complications of cough by providing a guide for future studies and (2) to identify gaps in the literature for future research.
What are the potential complications that are associated with the act of coughing that have been reported in infants, children, adolescents, and adults?
A scoping review was performed with the use of PubMed and SCOPUS databases that were searched from their beginning until September 6, 2019.
Two hundred forty-seven publications met our inclusion criteria. To these, we added 38 articles from the 2006 complications paper that were not identified in the literature search plus the paper itself for a final total of 286 publications that formed the basis of this review. Since 2006, three new categories of complications have been reported: ear, nose and throat; disease transmission; and laboratory testing. Multiple additional complications that fall outside of these three categories have also been identified and included in the following categories: cardiovascular, constitutional symptoms, dermatologic, GI, genitourinary, musculoskeletal, neurologic, ophthalmologic, psychosocial/quality of life, and respiratory. Not previously highlighted is that some of the complications led to serious morbidity that included death, especially in patients with comorbid conditions, and potentially resulted in harm to others when cough resulted in a motor vehicle accident.
Our work identified a large number of cough complications that we thematically categorized primarily by organ system so that future studies of each system or each complication can be conducted. The gap in the literature that future studies should address is to identify the frequency of the complications and the strength of their association with cough. Only then will one be able to describe the findings in a manner that allows specific recommendations for avoiding these complications. In the meantime, patients with cough should be evaluated and treated according to evidence-based guidelines to mitigate or prevent the myriad of potential complications that are associated with coughing.
Loss of retinal blood flow autoregulation is an early feature of diabetes that precedes the development of clinically recognizable diabetic retinopathy (DR). Retinal blood flow autoregulation is ...mediated by the myogenic response of the retinal arterial vessels, a process that is initiated by the stretch‑dependent activation of TRPV2 channels on the retinal vascular smooth muscle cells (VSMCs). Here, we show that the impaired myogenic reaction of retinal arterioles from diabetic animals is associated with a complete loss of stretch‑dependent TRPV2 current activity on the retinal VSMCs. This effect could be attributed, in part, to TRPV2 channel downregulation, a phenomenon that was also evident in human retinal VSMCs from diabetic donors. We also demonstrate that TRPV2 heterozygous rats, a nondiabetic model of impaired myogenic reactivity and blood flow autoregulation in the retina, develop a range of microvascular, glial, and neuronal lesions resembling those observed in DR, including neovascular complexes. No overt kidney pathology was observed in these animals. Our data suggest that TRPV2 dysfunction underlies the loss of retinal blood flow autoregulation in diabetes and provide strong support for the hypothesis that autoregulatory deficits are involved in the pathogenesis of DR.
There is growing evidence that placental growth factor (PlGF) is an important player in multiple pathologies, including tumorigenesis, inflammatory disorders and degenerative retinopathies. PlGF is a ...member of the vascular endothelial growth factor (VEGF) family and in the retina, binding of this growth factor to specific receptors is associated with pathological angiogenesis, vascular leakage, neurodegeneration and inflammation. Although they share some receptor signalling pathways, many of the actions of PlGF are distinct from VEGF and this has revealed the enticing prospect that it could be a useful therapeutic target for treating early and late stages of diabetic retinopathy (DR) and neovascular age-related macular degeneration (AMD). Recent research suggests that modulation of PlGF could also be important in the geographic atrophy (GA) form of late AMD by protecting the outer retina and the retinal pigment epithelium (RPE). This review discusses PlGF and its signalling pathways and highlights the potential of blocking the bioactivity of this growth factor to treat irreversible visual loss due to the two main forms of AMD.
Retinal ischemia remains a common sight threatening end-point in blinding diseases such as diabetic retinopathy and retinopathy of prematurity. Endothelial colony forming cells (ECFCs) represent a ...subpopulation of endothelial progenitors with therapeutic utility for promoting reparative angiogenesis in the ischaemic retina. The current study has investigated the potential of enhancing this cell therapy approach by the dampening of the pro-inflammatory milieu typical of ischemic retina. Based on recent findings that ARA290 (cibinetide), a peptide based on the Helix-B domain of erythropoietin (EPO), is anti-inflammatory and tissue-protective, the effect of this peptide on ECFC-mediated vascular regeneration was studied in the ischemic retina.
The effects of ARA290 on pro-survival signaling and function were assessed in ECFC cultures in vitro. Efficacy of ECFC transplantation therapy to promote retinal vascular repair in the presence and absence of ARA290 was studied in the oxygen induced retinopathy (OIR) model of retinal ischemia. The inflammatory cytokine profile and microglial activation were studied as readouts of inflammation.
ARA290 activated pro-survival signaling and enhanced cell viability in response to H2O2-mediated oxidative stress in ECFCs in vitro. Preconditioning of ECFCs with EPO or ARA290 prior to delivery to the ischemic retina did not enhance vasoreparative function. ARA290 delivered systemically to OIR mice reduced pro-inflammatory expression of IL-1β and TNF-α in the mouse retina. Following intravitreal transplantation, ECFCs incorporated into the damaged retinal vasculature and significantly reduced avascular area. The vasoreparative function of ECFCs was enhanced in the presence of ARA290 but not EPO.
Regulation of the pro-inflammatory milieu of the ischemic retina can be enhanced by ARA290 and may be a useful adjunct to ECFC-based cell therapy for ischemic retinopathies.
•Endothelial colony-forming cells (ECFCs) express innate repair receptor (IRR) subunits.•ARA290 activates pro-survival pathways in ECFCs and is not angiogenic in vitro.•Pre-priming ECFCs with ARA290 does not improve their reparative capacity in ischemic retina.•Systemic ARA290 treatment improves vasoreparative potential of ECFCs and dampens inflammation in ischemic retina.•ARA290 may be a useful pharmacological adjunct to improve ECFC cell therapy.
When analyzing the origins of the Anglo-Irish “economic war” of 1932-1938, historians have focused primarily on two precipitant causes: the destablizing effect on Anglo-Irish relations of Eamon de ...Valera's return to power in Ireland in 1932, and the reaction to the resulting situation by the British Government. Underlying both were unresolved constitutional and financial questions. Chief of these were the oath of allegiance to the king, which de Valera had pledged, if elected, to remove from the Free State Constitution, and the land annuities, which were annual instalments paid by Irish tenant farmers purchasing their land through loans advanced by the British Government under the Land Purchase Acts of 1870-1909. These payments de Valera had promised to withhold from the British Government.
Although the dispute between de Valera and the British Government has been studied extensively, the political context in which it was carried on has not. This is especially true on the British side. The British Government and its Dominions Secretary, J.H. Thomas, are often criticized for their handling of the affair. F.S.L. Lyons, for example, writes that Thomas “sniffed the approach of treason in every tainted breeze and saw in the return to power in 1932 of the intransigent republican of 1922 a direct threat to the whole basis of the settlement so painfully reached in the Treaty.” A.J.P. Taylor, though no less critical of Thomas, sees the whole affair more broadly as “a last kick of the old rule that English statesmen took leave of their senses when dealing with Ireland.”
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