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Sensory reweighting for balance in people living with Parkinson’s Disease: postural adaptation, muscle co-contraction, and perceptual delays
No full textBackgroundPostural instability is common in people with Parkinson’s Disease (PwPD), increasing their risk of injurious falls. Evidence suggests a sensory reweighting deficit in PwPD, along with compensatory muscle co-contraction in response to postural challenges. During balance tasks requiring sensory reweighting, older adults exhibit elevated postural sway and muscle co-contraction, as well as longer perceptual delays, compared to young adults. Such responses may be exacerbated in PwPD, with implications for fall risk.Research questionThe aim of this study was to assess postural sway, muscle co-contraction, and perceptual delays in PwPD and healthy age-matched controls during a sensory reweighting balance task.MethodsEleven PwPD and 16 control participants completed a sensory reweighting protocol: standing without vision on a fixed platform (2-min), which then undergoes a period of body sway-referencing (3-min) before returning to its fixed position (2.5-min). Anteroposterior (AP) path length, co-contraction index (CCI), and perceptual delay were analysed across task phases.ResultsPwPD showed a longer delay in perceiving when the body sway-referenced platform returned to a fixed position. This perceptual delay in PwPD (43.40-s) was over double that observed in control participants (21.25-s). AP path length and co-contraction aftereffects were longer in control participants than PwPD.SignificanceWhere conditions require it, PwPD can effectively adjust their reliance on proprioceptive information for postural control. However, the significant delay shown by PwPD in perceiving changes to sensory conditions could be detrimental during everyday sensory transitions, potentially increasing fall risk.<br/
Magnetic resonance imaging in comatose adults resuscitated after out-of-hospital cardiac arrest: a posthoc study of the targeted therapeutic mild hypercapnia after resuscitated cardiac arrest trial
No full textBackgroundNeuroimaging with magnetic resonance imaging (MRI) may assist clinicians in evaluating brain injury and optimising care in comatose adults resuscitated after out-of-hospital cardiac arrest (OHCA). However, contemporary international data on its use are lacking.AimThe primary aim was to compare the patient characteristics, early postresuscitation care, and neurological outcomes of patients according to MRI use.MethodsWe performed a posthoc analysis of the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) trial, a multinational randomised trial comparing targeted mild hypercapnia or normocapnia in comatose adults after OHCA.ResultsAfter exclusions, 1639 patients enrolled in the TAME trial were analysed. Of these, 149 (9%) had an MRI. Compared to non-MRI patients, MRI patients were younger (58.9 versus 61.7 years, p: 0.02), had a longer median time from OHCA to return of spontaneous circulation (30 versus 25 min, p < 0.0001), and had a higher average arterial lactate level (8.78 versus 6.74 mmol/L, p < 0.0001) on admission to hospital. MRI patients were more likely to receive additional advanced diagnostic assessments during intensive care unit admission (p < 0.0001). At 6 months, 23 of 140 patients (16.4%) in the MRI group had a favourable neurological outcome, compared with 659 of 1399 patients (47.1%) in the no-MRI group (p < 0.001). On multivariable modelling, country of enrolment was the dominating predictor in the likelihood of an MRI being performed.ConclusionsIn the TAME trial, 9% of patients had an MRI during their intensive care unit admission. Among these patients, only 16% had a favourable neurological outcome at 6 months.<br/
Classifications of haemodialysis vascular access stenosis: a scoping review
No full textObjectives: Vascular access (VA) stenoses play a significant role in the morbidity of the haemodialysed population. Classifications for diagnosis, assessment and proposal of treatment strategies can be useful clinical and methodological tools. This review aims to present a comprehensive summary and propose further methodological approaches. Design: A systematic review of the literature, evaluating classifications for dialysis-related VA stenosis. Data sources: Web of Science, Scopus, PubMed, Google Scholar and the ClinicalTrials.gov registry were searched from inception to 7 December 2024. Eligibility criteria: All articles containing classifications regarding dialysis VA were eligible, with no restrictions on the study type or language of the full text. Data extraction and synthesis: Two independent researchers performed the search and initial screening. Four vascular surgeons assessed the included classifications using a modified Buchbinder’s critical appraisal tool to evaluate quality. Results: From 4771 screened papers, 59 full-text papers were retrieved and 24 articles contained classifications. Three classifications were dedicated to VA stenosis, all based on the anatomical location of lesions. According to the modified Buchbinder’s appraisal, the classifications were assessed as moderate-to-good quality. The literature disposes of immense inconsistency in terms of the definition of significant stenosis indicated for treatment. Conclusions: VA significant stenosis and its classification is a non-uniformly understood issue with many different criteria and categorisations. This basic methodological problem leads to inconsistent results. We recommend the unification of the criteria and their validation in prospective studies
Alkaline phosphatase decline and pain response as predictors of overall survival benefit in patients treated with radium-223: a post hoc analysis of the REASSURE study
No full textBackgroundAlkaline phosphatase (ALP) declines and pain responses can occur during radium-223 (223Ra) treatment, but their association with treatment outcomes is unclear.MethodsFor patients with metastatic castration-resistant prostate cancer treated with 223Ra in the REASSURE study, we investigated whether ALP decline (Week 12) and/or pain response (during treatment) are associated with improved overall survival (OS). The Brief Pain Inventory-Short Form (BPI-SF) was used to assess pain at baseline and pain response (in patients with baseline BPI-SF score ≥2).ResultsOf 785 patients with baseline and Week 12 ALP measurements, 779 were eligible for the OS analyses. Overall, 80% of patients had an ALP decline. Median OS was longer in patients with than without an ALP decline (18.1 versus 14.2 months; HR 0.74; 95% CI 0.60–0.92). In patients with an ALP decline, there was no clear OS difference between those with versus without a pain response. For patients without ALP decline, median OS was longer in those with versus without a pain response (16.2 versus 10.9 months; HR 0.50; 95% CI 0.32–0.77).ConclusionsDecreases in ALP and/or pain during 223Ra treatment are associated with improved OS. This may help support clinical decisions.<br/
Publisher Correction: Evolution of sexual size dimorphism in tetrapods is driven by varying patterns of sex-specific selection on size
No full textInulin dehydration to 5‐HMF in deep eutectic solvents catalyzed by acidic ionic liquids under mild conditions
No full textValorization of carbohydrate‐rich biomass by conversion into industrially relevant products is at the forefront of research in sustainable chemistry. In this work, we studied the inulin conversion into 5‐hydroxymethylfurfural, in deep eutectic solvents, in the presence of acidic task‐specific ionic liquids as catalysts. We employed aliphatic and aromatic ionic liquids as catalysts, and choline chloride‐based deep eutectic solvents bearing glycols or carboxylic acids, as solvents. The reactions were performed in a biphasic system, with acetone as a benign extracting solvent, enabling continuous extraction of 5‐HMF. We aimed to find the best experimental conditions for this transformation, in terms of catalyst loading, solvent, reaction time and temperature to achieve an economical and energy efficient process. We also analyzed the results in terms of solvent viscosity and structural organization as well as catalysts acidity, to elucidate which structural features mostly favour the reaction. Under optimized conditions, we obtained a yield in 5‐HMF of 71 %, at 80 °C in 3 h. Our system can be scaled up and recycled three times with no loss in yield. Finally, comparison with the literature shows that our system achieves a higher yield under milder conditions than most protocols so far reported for the same transformation
Remove saplings early: Cost‐effective strategies to contain tree invasions and prevent their impacts
No full textThere is an urgent need to design management strategies to reduce invasive species spread and impact, but the large spatial and temporal scales of most biological invasions make them challenging environments in which to conduct field studies. In this context, simulation models can play a key role in informing invasive species management. Woody plants are among the most harmful invaders, yet an evidence base to support different management objectives for these species remains poorly developed. Pines (Pinus) have been intensively studied, in terms of demography, dispersal, spread and impact, which makes them an ideal study system to model invasions. Using a multiyear database of observations of an invasive population, we employed an approximate Bayesian computation to fit an individual‐based spatially explicit model to compare management strategies to reduce the spread, population size and impact of a woody invader, Pinus contorta (pine hereafter), on grasslands in Patagonia. We simulated a pine population spreading from a plantation into a grassland over 50 years. Annual control actions in the grasslands started as soon as pines started spreading (when the pines from the plantation become reproductive) or were delayed at 10‐year intervals. For control actions, we targeted different pine life stages, prioritized different locations in the landscape and explored a wide range of available budgets. Removing saplings was the most cost‐effective way to reduce pine spread and population size, whereas reducing management delay had a stronger effect on minimizing pine invasion impact on native grassland productivity. Focusing only on invasive adults was ineffective because it was costly, and it allowed a build‐up in the population size of other stages which soon became adults (and started spreading seeds). Synthesis and applications: Our highest‐ranking strategies represent management actions to start implementing in the field as part of an adaptive management plan that iteratively evaluates the validity of our simulation model and updates the management recommendations. Our study can be applied to guide management of invasive pines and replicated with any invasive woody species with sufficient data
Stable laser-acceleration of high-flux proton beams with plasma collimation
No full textLaser-plasma acceleration of protons offers a compact, ultra-fast alternative to conventional acceleration techniques, and is being widely pursued for potential applications in medicine, industry and fundamental science. Creating a stable, collimated beam of protons at high repetition rates presents a key challenge. Here, we demonstrate the generation of multi-MeV proton beams from a fast-replenishing ambient-temperature liquid sheet. The beam has an unprecedentedly low divergence of 1° (≤20 mrad), resulting from magnetic self-guiding of the proton beam during propagation through a low density vapour. The proton beams, generated at a repetition rate of 5 Hz using only 190 mJ of laser energy, exhibit a hundred-fold increase in flux compared to beams from a solid target. Coupled with the high shot-to-shot stability of this source, this represents a crucial step towards applications.<br/
Promoting self-efficacy of nursing students in academic integrity through a digital serious game: a pre/post-test study
No full textBackground: Academic integrity is an important component of nursing education, bridging academic ethics with professional practice. This study evaluated the effectiveness of a co-designed Academic Integrity digital serious game in improving nursing students’ self-efficacy related to academic integrity, academic offenses, professionalism, and artificial intelligence use. Methods: A pre-test/post-test design was employed, using a bespoke questionnaire to assess 303 first-year nursing students’ self-efficacy before and after playing the game. The questionnaire covered five subscales: academic integrity standards, academic offenses, professional values, feedback processes, and AI use in academic work. Results: Statistically significant improvements were observed across all subscales following the intervention, indicating enhanced self-efficacy in understanding and applying academic integrity principles, recognizing academic offenses, demonstrating professional behaviors, utilizing feedback, and appropriately using AI in academic contexts. Conclusions: The Academic Integrity digital serious game has the potential to be an effective tool for enhancing nursing students’ self-efficacy in the areas of academic and professional ethics. This approach shows promise for integrating academic integrity-based education in nursing curricula and preparing students for the ethical challenges of modern healthcare practice. This study was not registered.<br/
Assessing rice straw availability and associated carbon footprint for methanol production: a case study in India
No full textThe necessity of transitioning to clean energy sources is driving a transformative shift towards the utilisation of biofuels as a promising pathway to achieve a future with net-zero emissions and robust energy security. This global imperative has intensified research into biofuels, with bio-methanol emerging as a highly promising candidate.This study conclusively demonstrates the feasibility of producing bio-methanol from rice straw residues in rural India, focusing specifically on Assam. Utilising GIS technology, the research accurately mapped rice straw availability and designed an optimised supply network for efficient collection and transportation. The findings revealed substantial rice straw resources in the region, capable of yielding over 1200 tonnes of bio-methanol annually. Furthermore, the associated carbon footprint was significantly lower than that of conventional methanol production.By evaluating 5480 ha of potential cropland for rice, the study estimated an annual generation of 4411 tonnes of rice straw, translating to an impressive bio-methanol production potential of over 1215 tonnes, or approximately 3.3 tonnes per day. The study calculated the overall carbon footprint to be 421.84 tonnes CO2e per year, equating to just 0.096 kg CO2e per kilogram of rice straw and 0.347 kg CO2e per kilogram of biomethanol, remarkably lower than the footprint of traditional fossil methanol production. The results demonstrate the viability of bio-methanol from rice straw as a sustainable biofuel solution for rural India. Precise biomass assessment, optimised transport networks, and significantly reduced carbon footprint align perfectly with India's clean energy objectives. This robust framework provides policymakers with a powerful tool to harness rural bioenergy, revolutionising the energy landscape and driving sustainable development towards a cleaner future not only in India but in other developing countries as well.This study provides a compelling foundation for further exploration, asserting that biomethanol when blended with fossil fuels, can enhance energy security, foster a circular bioeconomy, and contribute significantly to net-zero emissions targets.<br/