A multicomponent exercise intervention to improve physical functioning, cognition and psychosocial well-being in elderly nursing home residents: a study protocol of a randomized controlled trial in the PROCARE (prevention and occupational health in long-term care) project

Background Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. Methods A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45–60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents’ capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). Discussion This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. Trial registration The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018

Efficacy and toxicity of bimodal radiotherapy in WHO grade 2 meningiomas following subtotal resection with carbon ion boost:Prospective phase 2 MARCIE trial

Background: Novel radiotherapeutic modalities using carbon ions provide an increased relative biological effectiveness (RBE) compared to photons, delivering a higher biological dose while reducing radiation exposure for adjacent organs. This prospective phase 2 trial investigated bimodal radiotherapy using photons with carbon-ion (C12)-boost in patients with WHO grade 2 meningiomas following subtotal resection (Simpson grade 4 or 5).Methods:A total of 33 patients were enrolled from July 2012 until July 2020. The study treatment comprised a C12-boost (18 Gy [RBE] in 6 fractions) applied to the macroscopic tumor in combination with photon radiotherapy (50 Gy in 25 fractions). The primary endpoint was the 3-year progression-free survival (PFS), and the secondary endpoints included overall survival, safety and treatment toxicities. Results:With a median follow-up of 42 months, the 3-year estimates of PFS, local PFS and overall survival were 80.3%, 86.7%, and 89.8%, respectively. Radiation-induced contrast enhancement (RICE) was encountered in 45%, particularly in patients with periventricularly located meningiomas. Patients exhibiting RICE were mostly either asymptomatic (40%) or presented immediate neurological and radiological improvement (47%) after the administration of corticosteroids or bevacizumab in case of radiation necrosis (3/33). Treatment-associated complications occurred in 1 patient with radiation necrosis who died due to postoperative complications after resection of radiation necrosis. The study was prematurely terminated after recruiting 33 of the planned 40 patients. Conclusions:Our study demonstrates a bimodal approach utilizing photons with C12-boost may achieve a superior local PFS to conventional photon RT, but must be balanced against the potential risks of toxicities.</p

PHB Producing Cyanobacteria Found in the Neighborhood&mdash;Their Isolation, Purification and Performance Testing

Cyanobacteria are a large group of prokaryotic microalgae that are able to grow photo-autotrophically by utilizing sunlight and by assimilating carbon dioxide to build new biomass. One of the most interesting among many cyanobacteria cell components is the storage biopolymer polyhydroxybutyrate (PHB), a member of the group of polyhydroxyalkanoates (PHA). Cyanobacteria occur in almost all habitats, ranging from freshwater to saltwater, freely drifting or adhered to solid surfaces or growing in the porewater of soil, they appear in meltwater of glaciers as well as in hot springs and can handle even high salinities and nutrient imbalances. The broad range of habitat conditions makes them interesting for biotechnological production in facilities located in such climate zones with the expectation of using the best adapted organisms in low-tech bioreactors instead of using &ldquo;universal&rdquo; strains, which require high technical effort to adapt the production conditions to the organism&lsquo;s need. These were the prerequisites for why and how we searched for locally adapted cyanobacteria in different habitats. Our manuscript provides insight to the sites we sampled, how we isolated and enriched, identified (morphology, 16S rDNA), tested (growth, PHB accumulation) and purified (physical and biochemical purification methods) promising PHB-producing cyanobacteria that can be used as robust production strains. Finally, we provide a guideline about how we managed to find potential production strains and prepared others for basic metabolism studies

Cyanobacterial PHA Production—Review of Recent Advances and a Summary of Three Years’ Working Experience Running a Pilot Plant

Cyanobacteria, as photoautotrophic organisms, provide the opportunity to convert CO2 to biomass with light as the sole energy source. Like many other prokaryotes, especially under nutrient deprivation, most cyanobacteria are able to produce polyhydroxyalkanoates (PHAs) as intracellular energy and carbon storage compounds. In contrast to heterotrophic PHA producers, photoautotrophic cyanobacteria do not consume sugars and, therefore, do not depend on agricultural crops, which makes them a green alternative production system. This review summarizes the recent advances in cyanobacterial PHA production. Furthermore, this study reports the working experience with different strains and cultivating conditions in a 200 L pilot plant. The tubular photobioreactor was built at the coal power plant in Dürnrohr, Austria in 2013 for direct utilization of flue gases. The main challenges were the selection of robust production strains, process optimization, and automation, as well as the CO2 availability

Digestate as sustainable nutrient source for microalgae - challenges and prospects

The interest in microalgae products has been increasing, and therefore the cultivation industry is growing steadily. To reduce the environmental impact and production costs arising from nutrients, research needs to find alternatives to the currently used artificial nutrients. Microalgae cultivation in anaerobic effluents (more specifically, digestate) represents a promising strategy for increasing sustainability and obtaining valuable products. However, digestate must be processed prior to its use as nutrient source. Depending on its composition, different methods are suitable for removing solids (e.g., centrifugation) and adjusting nutrient concentrations and ratios (e.g., dilution, ammonia stripping). Moreover, the resulting cultivation medium must be light-permeable. Various studies show that growth rates comparable to those in artificial media can be achieved when proper digestate treatment is used. The necessary steps for obtaining a suitable cultivation medium also depend on the microalgae species to be cultivated. Concerning the application of the biomass, legal aspects and impurities originating from digestate must be considered. Furthermore, microalgae species and their application fields are essential criteria when selecting downstream processing methods (harvest, disintegration, dehydration, product purification). Microalgae grown on digestate can be used to produce various products (e.g., bioenergy, animal feed, bioplastics, and biofertilizers). This review gives insight into the origin and composition of digestate, processing options to meet requirements for microalgae cultivation and challenges regarding downstream processing and products

Digestate as Sustainable Nutrient Source for Microalgae—Challenges and Prospects

The interest in microalgae products has been increasing, and therefore the cultivation industry is growing steadily. To reduce the environmental impact and production costs arising from nutrients, research needs to find alternatives to the currently used artificial nutrients. Microalgae cultivation in anaerobic effluents (more specifically, digestate) represents a promising strategy for increasing sustainability and obtaining valuable products. However, digestate must be processed prior to its use as nutrient source. Depending on its composition, different methods are suitable for removing solids (e.g., centrifugation) and adjusting nutrient concentrations and ratios (e.g., dilution, ammonia stripping). Moreover, the resulting cultivation medium must be light-permeable. Various studies show that growth rates comparable to those in artificial media can be achieved when proper digestate treatment is used. The necessary steps for obtaining a suitable cultivation medium also depend on the microalgae species to be cultivated. Concerning the application of the biomass, legal aspects and impurities originating from digestate must be considered. Furthermore, microalgae species and their application fields are essential criteria when selecting downstream processing methods (harvest, disintegration, dehydration, product purification). Microalgae grown on digestate can be used to produce various products (e.g., bioenergy, animal feed, bioplastics, and biofertilizers). This review gives insight into the origin and composition of digestate, processing options to meet requirements for microalgae cultivation and challenges regarding downstream processing and products

Novel application of fluorescence lifetime and fluorescence microscopy enables quantitative access to subcellular dynamics in plant cells.

BACKGROUND: Optical and spectroscopic technologies working at subcellular resolution with quantitative output are required for a deeper understanding of molecular processes and mechanisms in living cells. Such technologies are prerequisite for the realisation of predictive biology at cellular and subcellular level. However, although established in the physical sciences, these techniques are rarely applied to cell biology in the plant sciences. PRINCIPAL FINDINGS: Here, we present a combined application of one-chromophore fluorescence lifetime microscopy and wavelength-selective fluorescence microscopy to analyse the function of a GFP fusion of the Brassinosteroid Insensitive 1 Receptor (BRI1-GFP) with high spatial and temporal resolution in living Arabidopsis cells in their tissue environment. We show a rapid, brassinolide-induced cell wall expansion and a fast BR-regulated change in the BRI1-GFP fluorescence lifetime in the plasmamembrane in vivo. Both cell wall expansion and changes in fluorescence lifetime reflect early BR-induced and BRI1-dependent physiological or signalling processes. Our experiments also show the potential of one-chromophore fluorescence lifetime microscopy for the in vivo monitoring of the biochemical and biophysical subcellular environment using GFP fusion proteins as probes. SIGNIFICANCE: One-chromophore fluorescence lifetime microscopy, combined with wavelength-specific fluorescence microscopy, opens up new frontiers for in vivo dynamic and quantitative analysis of cellular processes at high resolution which are not addressable by pure imaging technologies or transmission electron microscopy