1,334 research outputs found
Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study
Background
Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality
rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional
training.
Aims
The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM)
exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the
effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative
information regarding patient satisfaction with this new combined training program.
Methods
Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated
two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the
participants' rate of participation in and completion of both the PFM/VRR training program and the home
exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and
participant's satisfaction through a questionnaire.
Results
Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms
of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the
three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported
symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%).
Conclusion
A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women
with MUI and should be explore through further RCTs
Tunable Superconducting Properties of a-NbSi Thin Films and Application to Detection in Astrophysics
We report on the superconducting properties of amorphous NbxSi1-x thin films.
The normal-state resistance and critical temperatures can be separately
adjusted to suit the desired application. Notably, the relatively low
electron-phonon coupling of these films makes them good candidates for an "all
electron bolometer" for Cosmological Microwave Background radiation detection.
Moreover, this device can be made to suit both high and low impedance readouts
Incontinence : stress urinary incontinence treatment—surgery first?
A randomized trial involving 460 women with stress urinary incontinence compared physiotherapy with midurethral-sling surgery. We question whether the results, showing higher rates of improvement and cure for surgery than for physiotherapy, should change best practice and clinical practice guideline recommendations
Rejection of randomly coinciding events in LiMoO scintillating bolometers using light detectors based on the Neganov-Luke effect
Random coincidences of nuclear events can be one of the main background
sources in low-temperature calorimetric experiments looking for neutrinoless
double-beta decay, especially in those searches based on scintillating
bolometers embedding the promising double-beta candidate Mo, because of
the relatively short half-life of the two-neutrino double-beta decay of this
nucleus. We show in this work that randomly coinciding events of the
two-neutrino double decay of Mo in enriched LiMoO
detectors can be effectively discriminated by pulse-shape analysis in the light
channel if the scintillating bolometer is provided with a Neganov-Luke light
detector, which can improve the signal-to-noise ratio by a large factor,
assumed here at the level of on the basis of preliminary
experimental results obtained with these devices. The achieved pile-up
rejection efficiency results in a very low contribution, of the order of counts/(keVkgy), to the background counting rate
in the region of interest for a large volume ( cm)
LiMoO detector. This background level is very encouraging in
view of a possible use of the LiMoO solution for a bolometric
tonne-scale next-generation experiment as that proposed in the CUPID project
Background suppression in massive TeO bolometers with Neganov-Luke amplified light detectors
Bolometric detectors are excellent devices for the investigation of
neutrinoless double-beta decay (0). The observation of such
decay would demonstrate the violation of lepton number, and at the same time it
would necessarily imply that neutrinos have a Majorana character. The
sensitivity of cryogenic detectors based on TeO is strongly limited by the
alpha background in the region of interest for the 0 of
Te. It has been demonstrated that particle discrimination in TeO
bolometers is possible measuring the Cherenkov light produced by particle
interactions. However an event-by-event discrimination with NTD-based light
detectors has to be demonstrated. We will discuss the performance of a
highly-sensitive light detector exploiting the Neganov-Luke effect for signal
amplification. The detector, being operated with NTD-thermistor and coupled to
a 750 g TeO crystal, shows the ability for an event-by-event identification
of electron/gamma and alpha particles. The extremely low detector baseline
noise, RMS 19 eV, demonstrates the possibility to enhance the sensitivity of
TeO-based 0 experiment to an unprecedented level
Atypical B cells (CD21-CD27-IgD-) correlate with lack of response to checkpoint inhibitor therapy in NSCLC
Introduction: Checkpoint inhibitor (CI) therapy has revolutionized treatment for non-small cell lung cancer (NSCLC). However, a proportion of patients do not respond to CI therapy for unknown reasons. Although the current paradigm in anti-tumor immunity evolves around T cells, the presence of tertiary lymphoid structures and memory B cells has been positively correlated with response to CI therapy in NSCLC. In addition, double negative (DN) (CD27- IgD-) B cells have been shown to be abundant in NSCLC compared to healthy lung tissue and inversely correlate with the intratumoral presence of memory B cells. Nonetheless, no study has correlated DN B cells to survival in NSCLC. Methods: In this study, we evaluated the presence and phenotype of B cells in peripheral blood with flow cytometry of patients with NSCLC and mesothelioma before receiving CI therapy and correlated these with clinical outcome. Results: Non-responding patients showed decreased frequencies of B cells, yet increased frequencies of antigen-experienced CD21- DN (Atypical) B cells compared to responding patients and HC, which was confirmed in patients with mesothelioma treated with CI therapy. Conclusions: These data show that the frequency of CD21- DN B cells correlates with lack of response to CI therapy in thoracic malignancies. The mechanism by which CD21- DN B cells hamper CI therapy remains unknown. Our findings support the hypothesis that CD21- DN B cells resemble phenotypically identical exhausted B cells that are seen in chronic infection or function as antigen presenting cells that induce regulatory T cells.</p
Therapeutic Hypothermia for Neonatal Encephalopathy Results in Improved Microstructure and Metabolism in the Deep Gray Nuclei
BACKGROUND AND PURPOSE: Therapeutic hypothermia has reduced morbidity and mortality and is associated with a lower burden of lesions on conventional imaging in NE. However, its effects on brain microstructure and metabolism have not been fully characterized. We hypothesized that therapeutic hypothermia improves measures of brain microstructure and metabolism. MATERIALS AND METHODS: Forty-one neonates with moderate/severe NE (29 treated with hypothermia, 12 nontreated) and 12 healthy neonates underwent MR imaging, DTI, and (1)H-MR spectroscopy. MR imaging scans were scored by the predominant pattern of brain injury: normal, watershed, and BG/thalamus. ADC, FA, Lac:NAA, and NAA:Cho values from bilateral BG and thalamus ROIs were averaged. T test and linear regression analysis were used to determine the association between hypothermia and MR imaging quantitative measures. RESULTS: Conventional MR imaging findings were normal in 41% of treated neonates; all nontreated neonates had brain injury. Values of MR imaging metrics were closer to normal in treated neonates compared with nontreated neonates: ADC was 63% higher in the BG and 116% higher in the thalamus (both P < .05), and Lac:NAA was 76% lower (P = .04) in the BG. Treated neonates with normal MR imaging findings had normal (1)H-MR spectroscopy metabolites, and ADC was higher by 35% in the thalamus (P = .03) compared with healthy neonates. CONCLUSIONS: Therapeutic hypothermia may reduce disturbances of brain metabolism and preserve its microstructure in the setting of NE, possibly by minimizing cytotoxic edema and cell death. Long-term follow-up studies are required to determine whether early post-treatment DTI and (1)H-MR spectroscopy will be useful biomarkers of treatment response
Renal toxicity from platinum/pemetrexed and pembrolizumab in the era of combination therapy
Background: Recently, the phase 3 keynote-189 trial showed that in previously untreated
patients with advanced non-squamous NSCLC without targetable mutations, the
progression-free and overall survival were significantly longer with addition of pembrolizumab to chemotherapy than with chemotherapy alone. Both chemotherapy and pembrolizumab can give renal toxicity, which can be a major challenge in the clinical setting.
Methods: In a prospective multicenter observational real-life cohort study [Visser Eur
Respir J 2018], we evaluated the incidence of acute/chronic kidney disease (AKD/
CKD), its related treatment discontinuation frequency and associated clinical variables
with AKD in patients with stage IIIB/IV NSCLC treated with platinum/pemetrexed. In
addition, the Keynote 189 toxicity data was used for the combination treatment. We
thereafter reviewed literature to generate an algorithm for diagnosis and treatment in
increased creatinine levels.
Results: 149 patients received pemetrexed platinum, of whom 44 patients (30%) continued
maintenance. During induction therapy 48 patients (50%) treated with cisplatinum/pemetrexed developed AKD and 15 patients (29%) treated with carboplatin/pemetrexed. During
maintenance 13 patients (30%) developed AKD, leading to CKD and treatment discontinuation in eight patients (62%). In the Keynote 189 trial combining pembrolizumab with chemotherapy, nephritis has been reported in 1,7% of patients in any grade (1,5% grade 3-4).
However, when looking at an increased blood creatinine in the group that was treated with
carboplatin, a total of 12,2% of patients showed any increase (0,7% grade 3-4).
Conclusions: Increased blood creatinine levels from pemetrexed and pembrolizumab
is a common entity, probably more common in a real-life setting. This elevation is clinically challenging in a population that receives three agents that can cause a creatinine
increase. Currently, there are no markers to distinguish between renal failure due to
chemotherapy of immunothera
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