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Does inspiratory muscle training improve lung function and quality of life in people with inclusion body myositis? A pilot study
No full textInclusion Body Myositis is the most common acquired myositis in adults, predominantly weakening forearm flexor and knee extensor muscles. Subclinical respiratory muscle weakness has recently been recognised in people with Inclusion Body Myositis, increasing their risk of respiratory complications. Inspiratory muscle training, a technique which demonstrates efficacy and safety in improving respiratory function in people with neuromuscular disorders, has never been explored in those with Inclusion Body Myositis. In this pilot study, six adults with Inclusion Body Myositis (age range 53 to 81 years) completed eight weeks of inspiratory muscle training. Measures of respiratory function, quality of life, sleep quality and a two-minute walk test were performed pre and post-intervention. All participants improved their respiratory function, with maximal inspiratory pressure, sniff nasal inspiratory pressure and forced vital capacity increasing by an average of 50% (p = .002), 43% (p = .018) and 13% (p = .003) respectively. No significant change was observed in quality of life, sleep quality or two-minute walk test performance. No complications occurred due to inspiratory muscle training This pilot study provides the first evidence that inspiratory muscle training may be safe and effective in people with Inclusion Body Myositis, potentially mitigating the complications of poor respiratory function
Value creation through artificial intelligence and cardiovascular imaging: A scientific statement from the American Heart Association
No full textMultiple applications for machine learning and artificial intelligence (AI) in cardiovascular imaging are being proposed and developed. However, the processes involved in implementing AI in cardiovascular imaging are highly diverse, varying by imaging modality, patient subtype, features to be extracted and analyzed, and clinical application. This article establishes a framework that defines value from an organizational perspective, followed by value chain analysis to identify the activities in which AI might produce the greatest incremental value creation. The various perspectives that should be considered are highlighted, including clinicians, imagers, hospitals, patients, and payers. Integrating the perspectives of all health care stakeholders is critical for creating value and ensuring the successful deployment of AI tools in a real-world setting. Different AI tools are summarized, along with the unique aspects of AI applications to various cardiac imaging modalities, including cardiac computed tomography, magnetic resonance imaging, and positron emission tomography. AI is applicable and has the potential to add value to cardiovascular imaging at every step along the patient journey, from selecting the more appropriate test to optimizing image acquisition and analysis, interpreting the results for classification and diagnosis, and predicting the risk for major adverse cardiac events
Temporal samples of visual information guides skilled interception
No full textThis study investigated whether performance of an interceptive skill requires an intact visual-perception-action cycle. Eleven skilled male Australian rules football athletes (Mage = 17.54, SD = 0.15) were recruited from an elite developmental pathway squad for a within-subject study. Participants were required to kick a ball directly at a goal from a 20-meter distance while wearing a pair of stroboscopic glasses. The glasses were used to create four vision conditions. Condition one kept intact the visual-perception-action cycle with uninterrupted vision of the motor skill. Three other conditions included stroboscopic vision that presented temporal samples of vision, which interrupted the perception-action cycle through progressive increases to intermittent vision occlusion of the motor skill. Goal kick error of ball position relative to a central target line within the goal and number of successful goals kicked were measured. Written report of internal and external focus of attention was also measured after each vision condition. Generalized estimating equation analysis did not reveal a significant decrement in kick target error, nor accuracy of goals scored, across normal to stroboscopic vision conditions. Performance was maintained despite a shift in attention focus from external to internal across normal to stroboscopic vision conditions. These findings have theoretical and practical implications for the visual regulation of skilled interceptive actions
Timing of surgery in acute deep partial-thickness burns: A study protocol
No full textFor deep partial-thickness burns no consensus on the optimal treatment has been reached due to conflicting study outcomes with low quality evidence. Treatment options in high- and middle-income countries include conservative treatment with delayed excision and grafting if needed; and early excision and grafting. The majority of timing of surgery studies focus on survival rather than on quality of life. This study protocol describes a study that aims to compare long-term scar quality, clinical outcomes, and patient-reported outcomes between the treatment options. A multicentre prospective study will be conducted in the three Dutch burn centres (Rotterdam, Beverwijk, and Groningen). All adult patients with acute deep-partial thickness burns, based on healing potential with Laser Doppler Imaging, are eligible for inclusion. During a nine-month baseline period, standard practice will be monitored. This includes conservative treatment with dressings and topical agents, and excision and grafting of residual defects if needed 14–21 days post-burn. The subsequent nine months, early surgery is advocated, involving excision and grafting in the first week to ten days post-burn. The primary outcome compared between the two groups is long-term scar quality assessed by the Patient and Observer Scar Assessment Scale 3.0 twelve months after discharge. Secondary outcomes include clinical outcomes and patient-reported outcomes like quality of life and return to work. The aim of the study is to assess long-term scar quality in deep partial-thickness burns after conservative treatment with delayed excision and grafting if needed, compared to early excision and grafting. Adding to the ongoing debate on the optimal treatment of these burns. The broad range of studied outcomes will be used for the development of a decision aid for deep partial-thickness burns, to fully inform patients at the point of consent to surgery and support optimal person-centred care
Novel serum protein biomarker panel for early diagnosis of pancreatic cancer
No full textPancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers. Late presentation of disease at the time of diagnosis is one of the major reasons for dismal prognostic outcomes for PDAC patients. Currently, there is a lack of clinical biomarkers, which can be used to diagnose PDAC patients at an early resectable stage. This study performed proteomic mass spectrometry to identify novel blood-based biomarkers for early diagnosis of PDAC. Serum specimens from 88 PDAC patients and 88 healthy controls (60 discovery cohort and 28 validation cohort) were analyzed using data independent acquisition high resolution mass spectrometry to identify candidate biomarker proteins. A total of 249 proteins were identified and quantified by the mass spectrometric analysis. Six proteins were markedly (\u3e1.5 fold) and significantly (p \u3c .05; q \u3c 0.1) increased in PDAC patients compared to healthy controls in discovery cohort. Notably, four of these six proteins were significantly upregulated in an independent validation cohort. The top three upregulated proteins (i.e., Polymeric Immunoglobulin Receptor [PIGR], von Willebrand Factor [vWF], and Fibrinogen) were validated using enzyme linked immunosorbent assay, which led to selection of PIGR and vWF as a diagnostic biomarker panel for PDAC. The panel showed high ability to diagnose early stage (stage I and II) PDAC patients (area under the curve [AUC]: 0.8926), which was further improved after the addition of clinically used prognostic biomarker (Ca 19-9) to the panel (AUC: 0.9798). In conclusion, a novel serum protein biomarker panel for early diagnosis of PDAC was identified
Deconstruction of Body Representation of the Back in Healthy Back Pain-free Individuals and People with Chronic Low Back Pain
Get PDFChanges in various body representations have been increasingly investigated and subsequently posited to be potentially important factors in the development and maintenance of chronic low back pain. Three main domains of body representation are considered here: body model, body schema (comprising superficial and postural schema), and body image. Most studies informing our contemporary understanding of these body representations have been undertaken in areas such as the hand and forearm, with a comparative dearth of studies performed on the low back. Consequently, this thesis consists of a comprehensive investigation of body representation initially in healthy back pain-free individuals and then in a comparative fashion between healthy back pain-free individuals and people living with chronic low back pain. Firstly, the development of, and then reliability data for, a novel testing device measuring body landmark and tactile localisation tasks in the back is presented (Chapter 2). Establishing this device as reliable allowed progression into formal testing for the body model of the back in healthy back pain-free individuals with midline and lateral body landmark localisation (Chapter 3). Chapter 4 investigated tactile localisation in healthy back pain-free individuals, providing information on the superficial schema at the low back. The investigation of width perception via calipers, and a back picture mapping task, supplied information on the body image of the back for healthy back pain-free individuals (Chapter 5). Having established normative values of these phenomena in healthy back pain-free individuals, comparative analysis was then made between this group and participants with mild and moderate chronic low back pain (CLBP) (Chapter 6). Results described within this thesis indicate minimal differences exist between groups. The body model for all groups presented as a squatter back, wider at the waist and hips (although not significant at the hips for the Mild CLBP group). With tactile localisation, lateral landmarks were perceived more lateral than they actually were, and vertically, landmarks were perceived with an increasing inferior mislocalisation when moving down the back. With body image, all groups overestimated width perception at the thorax and waist, while in the picture mapping task, accuracy did not differ between groups, and group was not related to whether a person was accurate, underestimated, or overestimated in terms of the accuracy of size depiction in the images. Further, those who were inaccurate in their selection were no more likely to over or underestimate in their image choice. The hope is this project may provide the foundation for future work in this area and enable researchers and clinicians to better understand body representation in patients with CLBP. Such understanding may inform management strategies that could be employed to address these differences
Cross-sectional, case-control and longitudinal associations between exposure to glucagon-like peptide-1 receptor agonists and the dispensing of antidepressants
No full textAim: To determine if the dispensing of glucagon-like peptide (GLP)-1 receptor agonists is associated with increased dispensing of antidepressants.
Materials and Methods: We used cross-sectional, case-control and retrospective cohort study designs to examine the association between dispensed GLP-1 receptor agonists and antidepressants between 2012 and 2022 in the 10% random sample of the Australian Pharmaceutical Benefits Scheme (PBS) data. PBS-listed GLP-1 receptor agonists, exenatide, dulaglutide and semaglutide were the exposures. Outcomes were the odds ratio [ORs; 99% confidence interval (CI)] and hazard ratio (99% CI) of being dispensed any antidepressant. Analyses were adjusted for demographic measures and the dispensing of medicines to manage cardiovascular diseases or anxiety/ insomnia. Statistical tests were two-sided at the 1% level of significance.
Results: In total, 358 075 of 1 746 391 individuals were dispensed antidepressants, and 8495 of the 24 783 dispensed a GLP-1 receptor agonist were also dispensed an antidepressant in 2022 (OR 1.44; 99% CI 1.38-1.50); 24 103 of the 1 746 391 participants had been dispensed a GLP-1 receptor agonist between 2012 and 2021, and of these 8083 were dispensed antidepressants in 2022 (OR 1.52; 99% CI 1.46-1.59). The 2012 cohort included 1 213 316 individuals who had not been dispensed antidepressants that year. The hazard ratio of being dispensed an antidepressant between 2013 and 2022 following the dispensing of a GLP-1 receptor agonist was 1.19 (99% CI 1.12-1.27). Additional analyses restricting the time of exposure confirmed these associations for all PBS-listed GLP-1 receptor agonists.
Conclusions: Individuals exposed to GLP-1 receptor agonists are at greater risk of being dispensed antidepressants. The possible impact of GLP-1 receptor agonists on the mood of consumers requires ongoing vigilance and further research
A common curriculum in obstetrics and gynecology for medical students globally
No full textObjective: Global variations in women\u27s health outcomes, increased international migration, and an increase in the number of medical schools underpin the need for global standardization in obstetrics and gynecology curricula for medical students. However, there are currently no recommendations regarding the content of a common curricu-lum. The aim of this project was to agree the objectives for a common curriculum in obstetrics and gynecology for medical students globally.
Methods: The curriculum was developed and agreed by an international taskforce of obstetricians and gynecologists. Published curricula for medical students in a variety of regions globally were reviewed and discussed, and the objectives for a com-mon curriculum in obstetrics and gynecology for medical students were agreed by consensus.
Results: The content of the proposed curriculum is classified into three domains: clinical skills, professional behaviors, and knowledge. The recommended curriculum covers health conditions that affect women globally in different social and cultural contexts, and addresses important global health issues of relevance to obstetrics and gynecology.
Conclusion: The methods and outcomes of a project by an international taskforce of obstetricians and gynecologists to develop a common curriculum in obstetrics and gynecology for medical students globally are presented. More work is required to identify ways in which the curriculum may be adapted to a minimum essential required curriculum in times of man- made or natural disasters. Achieving these will facilitate the intended long-term aims of this curriculum, to improve women\u27s health outcomes globall
The origins of the Christian idea of trinity: Answering Jewish charges of Heresy; exhorting Pagans against Polytheism; countering false gnostics
No full textIn this essay I explain that the Christian doctrine of the Trinity was first developed as a response to Jewish claims of Christian apostasy and polytheism. At the beginning of Christianity, most of its converts were observant Jews. The Jewish authorities took steps to reclaim their lost sheep and to stem the flow of departures. Their primary intellectual ammunition in that effort was the claim that the Christians were polytheists, because they claimed to believe in two Gods–the Father and His Son, Jesus Christ. The Christians’ apostasy was manifest by simple referring to the Mosaic commandment that righteous Israel should have only one God. This Jewish accusation of polytheism also neatly answered the inflammatory Christian charge that the Jews had crucified God and raised significant doubt about their claims of a special resurrection. The doctrine of the Trinity answered all those criticisms. God and Jesus Christ together were the one true God. But the nature of that oneness took some time to work out, and it is within a process of contending with pagan philosophical arguments and intra-Christian heretical positions, that a Christian doctrine of the Trinity begins to congeal. The work of Ante-Nicene Fathers—Justin Martyr, Theophilus of Antioch, Clement of Alexandria, Tertullian, Origen, Novatian, and others—whose voices we allow to be heard below—contain a trajectory of ideas that explain how the tri-unity is expressed in the momentous Creeds of Nicaea (AD 325) and Constantinople (381)
Successful strategies for academic and research impact
Get PDFAcademic impact and research impact are not the same thing. Join Elizabeth and Jackie to explore what the differences are, how they are measured, how to build both into your research projects – and how to make sure you don’t sacrifice one at the expense of the other