Physiotherapy for freezing of gait in Parkinson's disease: a systematic review and meta-analysis

Introduction. Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating FOG, but no systematic review has been carried out in this regard. Aim. To identify the characteristics, methodological quality, and main outcomes of the studies that have analyzed the effects of physiotherapy interventions in FOG up to date, by performing a systematic review and a meta-analysis. Patients and methods. Four electronic databases were searched in order to find randomized controlled trials that provided information regarding the effects of any kind of physiotherapy treatment on FOG. The methodological quality of the included investigations was assessed by means of the PEDro scale. Results. Twelve studies were identified for inclusion into the qualitative analysis, with four randomized controlled trials included in the final meta-analysis. The quality of the trials was generally good. Those physiotherapy modalities including cues were more effective for treating FOG than traditional physiotherapy approaches. The meta-analysis indicated that physiotherapy interventions had a significantly greater impact on FOG than control comparisons. Conclusions. Physiotherapy treatment, especially those modalities including visual and auditory cueing, should be prescribed to PD patients with FOG. Future studies including PD patients with cognitive impairment and FOG objective measurement tools are need to complete the existing scientific evidence

Modeling the role of reservoirs versus floodplains on large-scale river hydrodynamics

Large-scale hydrologic–hydrodynamic models are powerful tools for integrated water resources evaluation at the basin scale, especially in the context of flood hazard assessment. However, recent model developments have paid little attention to simulate reservoirs’ hydrodynamics within river networks. This study presents an adaptation of the MGB model to simulate reservoirs as an internal boundary condition, enabling the explicit simulation of hydrodynamic processes along reservoirs and their interaction with upstream and downstream floodplains in large basins. A case study is carried out in the Itajaí-Açu River Basin in Brazil, which has periodic flood-related disasters and three flood control dams. The model was calibrated for the 1950–2016 period forced with daily observed precipitation. The adjustment was satisfactory, with Nash–Sutcliffe metrics between 0.54 and 0.84 for the 11 gauges analyzed and with flood frequency curves also well represented. Simulation scenarios with and without floodplains and reservoirs were performed to evaluate the relative role of these factors on flood control basin-wide through evaluation of simulated discharges, water levels and flood extent. Itajaí do Oeste tributary and Itajaí-Açu mainstem present major floodplain attenuation, while in Itajaí do Sul and Itajaí do Norte tributaries the main flood control occurs due to reservoir attenuation. Downstream from the dams, results indicated that the reservoirs reach their maximum discharge reduction capacity for 5- to 10-year floods, decreasing it for larger floods. The developed model may be very useful for operational uses as flood forecasting and coordinated reservoir operation studies, as well as to enhance the comprehension of flood dynamics at basin scale

The most common handball injuries: A Systematic Review

Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice. It was carried out following the Preferred Informed Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The source of data collection was direct consultation of the PubMed and Medline databases. Several keywords were used for the documentary retrieval, and the quality of the studies that were selected was evaluated. Of the 707 studies retrieved, only 27 were considered appropriate for the review, and quality scores were obtained that ranged from 10 to 26 points, out of a maximum of 28. The most frequent injuries in handball players are located in the lower limbs (thigh, knee and ankle), and in the shoulder in the upper limbs. Regarding the playing position, the players who play over the 6-m line are the most affected by injuries, while the women players have a higher probability of injury. Most injuries occur during competition

Designing Equitable Transit Networks

Public transit is an essential infrastructure enabling access to employment, healthcare, education, and recreational facilities. While accessibility to transit is important in general, some sections of the population depend critically on transit. However, existing public transit is often not designed equitably, and often, equity is only considered as an additional objective post hoc, which hampers systemic changes. We present a formulation for transit network design that considers different notions of equity and welfare explicitly. We study the interaction between network design and various concepts of equity and present trade-offs and results based on real-world data from a large metropolitan area in the United States of America.Comment: Accepted in the non-archival track at the ACM Conference on Equity and Access in Algorithms, Mechanisms, and Optimization (EAAMO), 202

Quality of life and functional outcomes with tapentadol prolonged release in chronic musculoskeletal pain: post hoc analysis

Aims: To investigate quality of life (QOL) and functionality changes in chronic pain during tapentadol prolonged release (PR) treatment. Patients & methods: Post hoc analysis of data from three Phase III trials in patients with osteoarthritis knee pain or low back pain. QOL and functionality changes were assessed by SF-36 scores. Results: All SF-36 subdomain scores improved progressively to week 3 of tapentadol titration and were sustained during 12-week maintenance treatment. Improvements in SF-36 scores were similar between tapentadol dose groups (e.g., 200 to <300 mg vs >= 500 mg), with no greater effect from higher doses. QOL and functionality improvements were consistently greater with tapentadol PR than oxycodone controlled release. Conclusion: Tapentadol PR provides consistent, clinically relevant improvements in QOL and functionality in chronic pain

Lifestyle and Health among Spanish University Students: Differences by Gender and Academic Discipline

Today the need to analyze health behaviour from a gender perspective is as imminent as ever, particularly at university, where the number of women who register is on the rise and has exceeded the number of male students worldwide. We carried out a prevalence study aimed at analyzing Spanish university students’ lifestyles and identify differences according to gender and academic discipline. Of 3,646 eligible subjects doing university courses related to health (Group A), education (Group B) and other professions (Group C), 985 (27.0%) participated in the study. Information was elicited about their physical activity level, disturbed eating attitudes, consumption of alcohol, tobacco and illegal substances. Prevalence and Odds Ratios (OR) were calculated according to sex and kind of academic discipline. The obtained data confirmed that only 27.4% of the students were considered as sufficiently active, while 14.9% of them suffered from disturbed eating attitudes (DEA). Women were particularly less active (OR 0.46 (0.32–0.66); <em>p</em> < 0.0001), and more sedentary than men (OR 1.40 (1.00–1.97); <em>p</em> = 0.03). Binge drinking was more frequent in female than in male students (OR 1.79 (1.29–2.47); <em>p</em> = 0.0004). A third of the analyzed sample admitted that they had used illegal substances, while a lower consumption prevalence was found in women (OR 0.53 (0.40–0.71); <em>p</em> < 0.0001). The studied population was not very active (27.4%), especially women (OR = 0.45). Therefore, it seems that Spanish university students lead an unhealthy lifestyle, a situation which seems more conspicuous amongst females

PaLI: A Jointly-Scaled Multilingual Language-Image Model

Effective scaling and a flexible task interface enable large language models to excel at many tasks. PaLI (Pathways Language and Image model) extends this approach to the joint modeling of language and vision. PaLI generates text based on visual and textual inputs, and with this interface performs many vision, language, and multimodal tasks, in many languages. To train PaLI, we make use of large pretrained encoder-decoder language models and Vision Transformers (ViTs). This allows us to capitalize on their existing capabilities and leverage the substantial cost of training them. We find that joint scaling of the vision and language components is important. Since existing Transformers for language are much larger than their vision counterparts, we train the largest ViT to date (ViT-e) to quantify the benefits from even larger-capacity vision models. To train PaLI, we create a large multilingual mix of pretraining tasks, based on a new image-text training set containing 10B images and texts in over 100 languages. PaLI achieves state-of-the-art in multiple vision and language tasks (such as captioning, visual question-answering, scene-text understanding), while retaining a simple, modular, and scalable design

Improving hamstring flexibility through physical education based interventions : a systematic review and meta-analysis

Flexibility is recognized as a strong marker of physical health in children. Scientific research has indicated that there is a worldwide decline in children's physical fitness, including a reduction in flexibility levels. It has been suggested that a lack of flexibility in youth may be responsible for several health complications, including back pain, injury risk, and posture problems. Physical education (PE) classes are part of the school curriculum, which are an ideal setting to improve children physical fitness levels. The purpose of this systematic review and meta-analysis was to investigate whether incorporating a stretching component during regular PE classes can improve flexibility in school children. Three electronic databases were searched systematically until June 2019 for studies analysing the effects of interventions performed during PE classes aimed to improve the flexibility levels of school children (6-18 years). The critical appraisal was carried using PEDro and MINORS scales and a meta-analysis was performed. Seventeen studies of moderate-to-high methodological quality were included in the review and 14 in the meta-analysis, pooling 874 participants. The interventions showed significant improvements in the flexibility of the children, although the relative influence of genre could not be further analysed, due to the fact that insufficient data was reported. The meta-analysis for the hamstring flexibility resulted in a significant moderate effect. Flexibility levels can be improved through the incorporation of stretching interventions during PE classes, since flexibility is a key health-related physical fitness componentFurther research is needed on the effects of such interventions on trunk and upper body flexibility. © 2022 Authors. All rights reserved

Benefits of pilates in Parkinson's Disease : A systematic review and meta-analysis

Pilates may be a beneficial method of exercise for people with Parkinson's disease (PD). However, no studies have critically reviewed the scientific evidence in this regard. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of Pilates as a rehabilitation strategy for PD. A systematic search of the electronic databases PubMed, PEDro, Scopus, and SPORTDiscus was conducted to identify studies related to the effect of Pilates on PD. The search timeframe ranged from the inception of each database to March 2019. The search resulted in the identification of four randomized controlled trials (RCTs) and four non-RCT studies. The methodological quality of the investigations ranged from poor to fair. The descriptive analysis of the eight investigations showed that Pilates resulted in beneficial effects on fitness, balance and functional autonomy. A subsequent meta-analysis on the four RCTs indicated that Pilates was more effective than traditional training programmes in improving lower limb function. Pilates can be safely prescribed for people with mild-to-moderate PD. Preliminary evidence indicates that its practice could have a positive impact on fitness, balance and physical function. Its benefits on lower-body function appear to be superior to those of other conventional exercises. Future randomized studies with greater samples are needed to confirm these observations