Sensorimotor adaptation to auditory perturbation of speech is facilitated by noninvasive brain stimulation

Repeated exposure to disparity between the motor plan and auditory feedback during speech production results in a proportionate change in the motor system’s response called auditory-motor adaptation. Artificially raising F1 in auditory feedback results in a concomitant decrease in F1 during speech production. Transcranial direct current stimulation (tDCS) can be used to alter neuronal excitability in focal areas of the brain. The present experiment explored the effect of noninvasive brain stimulation applied to the speech premotor cortex on the timing and magnitude of adaptation responses to artificially raised F1 in auditory feedback. Participants (N = 18) completed a speaking task in which they read target words aloud. Participants' speech was processed to raise F1 by 30% and played back to them over headphones in real time. A within-subjects design compared acoustics of participants’ speech while receiving anodal (active) tDCS stimulation versus sham (control) stimulation. Participants' speech showed an increasing magnitude of adaptation of F1 over time during anodal stimulation compared to sham. These results indicate that tDCS can affect behavioral response during auditory-motor adaptation, which may have translational implications for sensorimotor training in speech disorders

The nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial

Background: after hospitalisation for cardiac disease, older patients are at high risk of readmission and death. Objective: the cardiac care bridge (CCB) transitional care programme evaluated the impact of combining case management, disease management and home-based cardiac rehabilitation (CR) on hospital readmission and mortality. Design: single-blind, randomised clinical trial. Setting: the trial was conducted in six hospitals in the Netherlands between June 2017 and March 2020. Community-based nurses and physical therapists continued care post-discharge. Subjects: cardiac patients ≥ 70 years were eligible if they were at high risk of functional loss or if they had had an unplanned hospital admission in the previous 6 months. Methods: the intervention group received a comprehensive geriatric assessment-based integrated care plan, a face-to-face handover with the community nurse before discharge and follow-up home visits. The community nurse collaborated with a pharmacist and participants received home-based CR from a physical therapist. The primary composite outcome was first all-cause unplanned readmission or mortality at 6 months. Results: in total, 306 participants were included. Mean age was 82.4 (standard deviation 6.3), 58% had heart failure and 92% were acutely hospitalised. 67% of the intervention key-elements were delivered. The composite outcome incidence was 54.2% (83/153) in the intervention group and 47.7% (73/153) in the control group (risk differences 6.5% [95% confidence intervals, CI -4.7 to 18%], risk ratios 1.14 [95% CI 0.91-1.42], P = 0.253). The study was discontinued prematurely due to implementation activities in usual care. Conclusion: in high-risk older cardiac patients, the CCB programme did not reduce hospital readmission or mortality within 6 months. Trial registration: Netherlands Trial Register 6,316, https://www.trialregister.nl/trial/6169. Keywords: cardiac rehabilitation; cardiology; case management; disease management; transitional care

The association between the outcomes of trauma, education and some socio-economic indicators

Background: There are many debates on socioeconomic indicators influencing trauma outcomes.Objectives: This study aimed to determine the association between education as a socioeconomic indicator and trauma outcomes.Methods: This descriptive-analytical study was conducted on 30,448 trauma patients during 2016-2021. The data were based on the minimum dataset of the National Trauma Registry of Iran (NTRI) from six different trauma centers in various cities of the country. The variables used in this study included age, education level, marital status, cause of injury, Glasgow Coma Scale (GCS), intensive care unit (ICU) admission, Injury Severity Score (ISS), and in-hospital mortality. Logistic regression was used to investigate the association between independent variables and trauma outcomes.Results: The study included 30,448 trauma patients with male predominance (75.8%). The mean age was 36.9 years. The most frequent education level was secondary education, with 14,228 (46.6%). Education levels had significant relationships with ISS, death, and ICU admission (P<0.001). Moreover, after applying the multiple logistic regression, the odds of deaths for trauma patients with no formal, primary, and secondary education levels were 3.36, 5.03, and 3.65 times, respectively, more than the odds of deaths at the higher education level after controlling for other factors (all Ps<0.05). However, there were no such relationships between education levels and the odds of ICU admission.Conclusion: Findings of the present study showed a significant association between the education levels and trauma outcomes. Adjusted for other covariates, the chance of death for trauma patients with no formal, primary, or secondary education levels was higher than that at the higher education level

Purslane Effect on GLP-1 and GLP-1 receptor in type 2 diabetes

Background: The aim of this study was to examine the effect of purslane seeds in glucagon-like peptide-1 concentration and glucagon-like peptide-1 receptor in women with diabetes. Methods: This was a quasi-experimental study. The population was consisted of the city of Sari where diabetic women with diabetes II who had no history of using purslane seeds. All individuals used the same dose of metformin under the specialist supervision. Among these individuals, 16 were assigned at random to Purslane group and control group. The purslane group consumed 2.5 grams Purslane with lunch and along with 5 grams of purslane (Portulaca oleracea seeds 7.5 g daily) with dinner meals twice daily for 8 weeks. Blood sample was taken before and after 8 weeks, after 12 hours of fasting to 5 ml of the left brachial vein. Results: After 8 weeks using purslane seeds in the experimental group, a significant increase was seen in glucagonlike peptide-1 concentrations (p<0.007), but there was no significant difference in the concentration of glucagon-like peptide-1 receptor (p <0.455). No significant relationship was found between changes in glucagon-like peptide-1 and its receptor. Conclusion: The use of purslane seeds improved Type II diabetes; therefore it can be effective in improving the health of women with diabete

WNT-5A regulates TGFβ-related activities in liver fibrosis

WNT-5A is a secreted growth factor that belongs to the non-canonical members of the Wingless-related MMTV-integration family. Previous studies pointed to a connection between WNT-5A and the fibrogenic factor TGF-β warranting further studies into the functional role of WNT-5A in liver fibrosis. Therefore, we studied WNT-5A expressions in mouse and human fibrotic livers and examined the relation between WNT-5A and various fibrosis-associated growth factors, cytokines and extracellular matrix proteins. WNT-5A gene and protein expressions were significantly increased in fibrotic mouse and human livers compared to healthy. Regression or therapeutic intervention in mice resulted in decreased hepatic WNT-5A levels paralleled by lower collagen levels. Immunohistochemical analysis showed WNT-5A staining in fibrotic septa co-localizing with desmin staining indicating WNT-5A expression in myofibroblasts. In vitro studies confirmed WNT-5A expression in this cell-type and showed that TGF-β significantly enhanced WNT-5A expression in contrast to PDGF-BB and pro-inflammatory cytokines IL1β and TNFα. After silencing of WNT-5A, reduced levels of collagen type I, vimentin, and fibronectin in TGF-β-stimulated myofibroblasts were measured as compared to non-silencing siRNA-treated controls. Interestingly, the antifibrotic cytokine IFNγ suppressed WNT-5A in vitro and in vivo. IFNγ-treated fibrotic mice showed significantly less WNT-5A expression as compared to untreated fibrotic mice. In conclusion, WNT-5A paralleled collagen I levels in fibrotic mouse and human livers. WNT-5A expression in myofibroblasts is induced by the profibrotic factor TGF-β and plays an important role TGF-β induced regulation of fibrotic matrix proteins, whereas its expression can be reversed upon treatment, both in vitro and in vivo