Responsiveness to sensory cues using the Timed Up and Go test in patients with Parkinson's disease: a prospective cohort study.

Objective: To test the effectiveness of the Timed Up and Go (TUG) test to define responsiveness to auditory and visual cues in patients with Parkinson's disease. Methods: Consecutive patients > 50 years old were enrolled if they were classified as stage 1–3 of the Hoehn and Yahr scale; scored ≤ 45 on part III of the Unified Parkinson's Disease Rating Scale; > 23 on the Mini-Mental State Examination; and were able to perform the TUG test without assistance. Within-subject analysis identified positive-responders, negative-responders and non-responders. TUG times with and without sensory cues were studied among all patients, and among responders only using the Friedman Test. Results: Twenty-two patients (16 men, 6 women), mean age 72.4 years (standard deviation (SD) 8.7 years) were included. Basal mean TUG time was 12.3 (SD 4.0). TUG times after visual cues (11.7 (SD 4.8)) were lower than in basal conditions (p = 0.006), whereas TUG times after auditory cues were not (p > 0.05). In the 16 patients who were positive-responders, mean TUG times after visual (11.0 (SD 3.1)) and auditory (11.3 (SD 3.6)) cues were lower than in basal conditions (12.5 (SD 3.8)) (p = 0.0002). Conclusion: The TUG test may be used to tailor the rehabilitation programme in patients with Parkinson's disease, identifying those who respond to visual and auditory cueing

Maximizing rehabilitation outcomes in geriatric hip fracture patients: the impact of surgical variables

Background and aim: Hip fracture is a major traumatic event with high mortality and disability rate. Its management in the acute setting and in the rehabilitation process is highly debated. This study evaluates the possible determinants of hip fracture rehabilitation outcome, among which surgical intervention type, weight-bearing status and hospitalization length Methods: The data of 738 hip fracture patients, who completed rehabilitation process in our centre, were collected and patients' functional abilities at the time of admission and discharge were analysed. Results: It has been observed that functional recovery depends on several factors: the type of surgery, the post-operative course and related complications, the hospitalisation time, the surgeon's techniques and expertise and the Orthopaedics centre where the operation is performed. Conclusions: In conclusion, data integration in perspective of an individualised rehabilitation program appears crucial for the functional recovery of the hip fracture patient

Medical workforce planning in a changing health context: Comparison between Italy and Europe

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre-and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of active physicians by specialization per 1,000 inhabitants. Open access data from official Italian and European institutional sources were used. The most of medical schools were distributed in the North, followed by South, islands and Central Italy, while the highest enrolment rate in the pre-lauream medical education was reported in Central Italy, followed by South & islands and North. The total number of active residency programs increased from 1092 to 1286 in the three considered academic years, while number of post-lauream training contracts decreased from 11.0 to 10.2 per 100,000 inhabitants. A misalignment between contracts assigned to residency programs and grants assigned to general practitioners specific courses was observed. Furthermore, when compared to the EU countries in study, Italy documented the lowest number of post-graduated training positions in 2015, with a rate of 12.1/100,000 inhabitants. Also, an excess of medical specialists (3.06 per 1,000 inhabitants) with a simultaneous shortage of general practitioners (0.89 per 1,000 inhabitants) was reported. On the contrary, Italy documented the highest number of paediatric practitioners. More efforts, including the implementation of adequate tools, are required both at national and regional level in order to provide a medical workforce planning in line with a continuously changing health context

Medical workforce planning in a changing health context: Comparison between Italy and Europe

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre-and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of active physicians by specialization per 1,000 inhabitants. Open access data from official Italian and European institutional sources were used. The most of medical schools were distributed in the North, followed by South, islands and Central Italy, while the highest enrolment rate in the pre-lauream medical education was reported in Central Italy, followed by South & islands and North. The total number of active residency programs increased from 1092 to 1286 in the three considered academic years, while number of post-lauream training contracts decreased from 11.0 to 10.2 per 100,000 inhabitants. A misalignment between contracts assigned to residency programs and grants assigned to general practitioners specific courses was observed. Furthermore, when compared to the EU countries in study, Italy documented the lowest number of post-graduated training positions in 2015, with a rate of 12.1/100,000 inhabitants. Also, an excess of medical specialists (3.06 per 1,000 inhabitants) with a simultaneous shortage of general practitioners (0.89 per 1,000 inhabitants) was reported. On the contrary, Italy documented the highest number of paediatric practitioners. More efforts, including the implementation of adequate tools, are required both at national and regional level in order to provide a medical workforce planning in line with a continuously changing health context

Biochemical characterization of solid-state fermented cassava roots (Manihot esculenta Crantz) and its application in broiler feed formulation

DATA AVAILABILTY : The availability of experimental data would be subject to reasonable request.The biochemical parameters of solid-state fermented peeled and unpeeled cassava roots (Manihot esculenta Crantz) and their application in broiler feed formulations were investigated. Fermentation occurred at room temperature for 72 h (pH 3—9). The samples utilized for five (5) broiler starter feeds were labeled: control, unfermented unpeeled cassava (UUC), unfermented peeled cassava (UPC), fermented unpeeled cassava (FUC), and fermented peeled cassava (FPC). Formulations were made by substituting fermented/non-fermented cassava roots at pH 7 for maize (w/w%). Fermentation-induced changes included increased soluble and total protein concentrations (69.3 and 334.5 mg/g) and (9.6 and 10.8%), respectively, in cultures prepared with peeled and unpeeled cassava at pH 7 compared to the control (p  0.05) for birds fed with fermented peeled and unpeeled cassava. Conversely, serum albumin and calcium levels were significantly lower (p < 0.05) for birds fed with the control feed compared to birds fed with fermented feeds. The results imply that fermented peeled and unpeeled cassava roots could be a safe and nutritionally beneficial replacement for maize in broiler diet.https://link.springer.com/journal/112742023-12-29hj2023Consumer ScienceFood Scienc

In Situ Observations of a Magnetosheath High-Speed Jet Triggering Magnetopause Reconnection

Magnetosheath high‐speed jets—localized dynamic pressure enhancements typically of ∼1 Earth radius in size—impact the dayside magnetopause several times per hour. Here we present the first in situ measurements suggesting that such an impact triggered magnetopause reconnection. We use observations from the five Time History of Events and Macroscale Interactions during Substorms spacecraft in a string‐of‐pearls configuration on 7 August 2007. The spacecraft recorded magnetopause in‐and‐out motion during an impact of a magnetosheath jet (VN∼−300 km/s along the magnetopause normal direction). There was no evidence for reconnection for the preimpact crossing, yet three probes observed reconnection after the impact. We infer that the jet impact compressed the originally thick (60–70 di), high magnetic shear (140–160° magnetopause until it was thin enough for reconnection to occur. Magnetosheath high‐speed jets could therefore act as a driver for bursty dayside reconnection

Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010

<p>Abstract</p> <p>Background</p> <p>Analysis of severe maternal morbidity (maternal near misses) provides information on the quality of care. We assessed the prevalence/incidence of maternal near miss, maternal mortality and case fatality ratio through systematic review of studies on severe maternal morbidity in sub-Saharan Africa.</p> <p>Methods</p> <p>We examined studies that reported prevalence/incidence of severe maternal morbidity (maternal near misses) during pregnancy, childbirth and postpartum period between 1996 and 2010. We evaluated the quality of studies (objectives, study design, population studied, setting and context, definition of severe acute obstetric morbidity and data collection instruments). We extracted data, using a pre-defined protocol and criteria, and estimated the prevalence or incidence of maternal near miss. The case-fatality ratios for reported maternal complications were estimated.</p> <p>Results</p> <p>We identified 12 studies: six were cross-sectional, five were prospective and one was a retrospective review of medical records. There was variation in the setting: while some studies were health facility-based (at the national referral hospital, regional hospital or various district hospitals), others were community-based studies. The sample size varied from 557 women to 23,026. Different definitions and terminologies for maternal near miss included acute obstetric complications, severe life threatening obstetric complications and severe obstetric complications. The incidence/prevalence ratio and case-fatality ratio for maternal near misses ranged from 1.1%-10.1% and 3.1%-37.4% respectively. Ruptured uterus, sepsis, obstructed labor and hemorrhage were the commonest morbidities that were analyzed. The incidence/prevalence ratio of hemorrhage ranged from 0.06% to 3.05%, while the case fatality ratio for hemorrhage ranged from 2.8% to 27.3%. The prevalence/incidence ratio for sepsis ranged from 0.03% to 0.7%, while the case fatality ratio ranged from 0.0% to 72.7%.</p> <p>Conclusion</p> <p>The incidence/prevalence ratio and case fatality ratio of maternal near misses are very high in studies from sub-Saharan Africa. Large differences exist between countries on the prevalence/incidence of maternal near misses. This could be due to different contexts/settings, variation in the criteria used to define the maternal near misses morbidity, or rigor used carrying out the study. Future research on maternal near misses should adopt the WHO recommendation on classification of maternal morbidity and mortality.</p

In Silico Prediction and Analysis of Caenorhabditis EF-hand Containing Proteins

Calcium (Ca+2) is a ubiquitous messenger in eukaryotes including Caenorhabditis. Ca+2-mediated signalling processes are usually carried out through well characterized proteins like calmodulin (CaM) and other Ca+2 binding proteins (CaBP). These proteins interact with different targets and activate it by bringing conformational changes. Majority of the EF-hand proteins in Caenorhabditis contain Ca+2 binding motifs. Here, we have performed homology modelling of CaM-like proteins using the crystal structure of Drosophila melanogaster CaM as a template. Molecular docking was applied to explore the binding mechanism of CaM-like proteins and IQ1 motif which is a ∼25 residues and conform to the consensus sequence (I, L, V)QXXXRXXXX(R,K) to serve as a binding site for different EF hand proteins. We made an attempt to identify all the EF-hand (a helix-loop-helix structure characterized by a 12 residues loop sequence involved in metal coordination) containing proteins and their Ca+2 binding affinity in Caenorhabditis by analysing the complete genome sequence. Docking studies revealed that F165, F169, L29, E33, F44, L57, M61, M96, M97, M108, G65, V115, F93, N104, E144 of CaM-like protein is involved in the interaction with IQ1 motif. A maximum of 170 EF-hand proteins and 39 non-EF-hand proteins with Ca+2/metal binding motif were identified. Diverse proteins including enzyme, transcription, translation and large number of unknown proteins have one or more putative EF-hands. Phylogenetic analysis revealed seven major classes/groups that contain some families of proteins. Various domains that we identified in the EF-hand proteins (uncharacterized) would help in elucidating their functions. It is the first report of its kind where calcium binding loop sequences of EF-hand proteins were analyzed to decipher their calcium affinities. Variation in Ca+2-binding affinity of EF-hand CaBP could be further used to study the behaviour of these proteins. Our analyses postulated that Ca+2 is likely to be key player in Caenorhabditis cell signalling

Bronchopulmonary dysplasia: clinical aspects and preventive and therapeutic strategies

Abstract Background Bronchopulmonary dysplasia (BPD) is the result of a complex process in which several prenatal and/or postnatal factors interfere with lower respiratory tract development, leading to a severe, lifelong disease. In this review, what is presently known regarding BPD pathogenesis, its impact on long-term pulmonary morbidity and mortality and the available preventive and therapeutic strategies are discussed. Main body Bronchopulmonary dysplasia is associated with persistent lung impairment later in life, significantly impacting health services because subjects with BPD have, in most cases, frequent respiratory diseases and reductions in quality of life and life expectancy. Prematurity per se is associated with an increased risk of long-term lung problems. However, in children with BPD, impairment of pulmonary structures and function is even greater, although the characterization of long-term outcomes of BPD is difficult because the adults presently available to study have received outdated treatment. Prenatal and postnatal preventive measures are extremely important to reduce the risk of BPD. Conclusion Bronchopulmonary dysplasia is a respiratory condition that presently occurs in preterm neonates and can lead to chronic respiratory problems. Although knowledge about BPD pathogenesis has significantly increased in recent years, not all of the mechanisms that lead to lung damage are completely understood, which explains why therapeutic approaches that are theoretically effective have been only partly satisfactory or useless and, in some cases, potentially negative. However, prevention of prematurity, systematic use of nonaggressive ventilator measures, avoiding supraphysiologic oxygen exposure and administration of surfactant, caffeine and vitamin A can significantly reduce the risk of BPD development. Cell therapy is the most fascinating new measure to address the lung damage due to BPD. It is desirable that ongoing studies yield positive results to definitively solve a major clinical, social and economic problem

Progress towards a public chemogenomic set for protein kinases and a call for contributions

Protein kinases are highly tractable targets for drug discovery. However, the biological function and therapeutic potential of the majority of the 500+ human protein kinases remains unknown. We have developed physical and virtual collections of small molecule inhibitors, which we call chemogenomic sets, that are designed to inhibit the catalytic function of almost half the human protein kinases. In this manuscript we share our progress towards generation of a comprehensive kinase chemogenomic set (KCGS), release kinome profiling data of a large inhibitor set (Published Kinase Inhibitor Set 2 (PKIS2)), and outline a process through which the community can openly collaborate to create a KCGS that probes the full complement of human protein kinases