Virtual reality exercise intradialysis to improve physical function: A feasibility randomized trial

[EN] Objective The main objective of this investigation was to assess feasibility of conducting a future RCT with an intradialysis non-immersive virtual reality exercise intervention. The secondary aim was to explore the impact of either conventional or VR exercise on physical function. Design Feasibility randomized trial. Participants Eighteen subjects who participated in a 16-week intradialysis combined exercise program. Interventions The program lasted four additional weeks of either combined exercise or virtual reality exercise. Main outcome measures Physical function was measured through several reliable tests (sit-to-stand-to-sit tests 10 and 60, gait speed, one-leg heel-rise tests, and 6-minute walk test) at baseline, after 16 weeks of intradialysis combined exercise and by the end of four additional weeks of exercise. Adherence to the exercise programs was registered. Results There was a significant time effect, so that physical function improved in both groups. By the end of the 20 weeks, function improved as measured through the sit-to-stand-to-sit tests 10 and 60, gait speed, one-leg heel-rise left leg, and the 6-minute walk test. Changes that did not occur due to error in the test were seen after 20 weeks were achieved in the sit-to-stand-to-sit test 60, gait speed, one-leg heel-rise test for the left leg, and 6-minute walking test. Conclusion Virtual reality was a feasible intervention. Both interventions improved physical function. Adherence was not significantly different between groups.Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain, Grant/Award Number: Consolidacion de Indicadores CEU-UCH 2016-2017/ISegura-Orti, E.; Perez-Dominguez, B.; Ortega-Pérez De Villar, L.; Melendez-Oliva, E.; Martínez-Gramaje, J.; García-Maset, R.; Gil-Gómez, J. (2019). Virtual reality exercise intradialysis to improve physical function: A feasibility randomized trial. Scandinavian Journal of Medicine and Science in Sports. 29(1):89-94. https://doi.org/10.1111/sms.13304S8994291Segura-Ortí, E., Gordon, P. L., Doyle, J. W., & Johansen, K. L. (2017). Correlates of Physical Functioning and Performance Across the Spectrum of Kidney Function. Clinical Nursing Research, 27(5), 579-596. doi:10.1177/1054773816689282Segura-Orti, E., & Johansen, K. L. (2010). Exercise in End-Stage Renal Disease. Seminars in Dialysis, 23(4), 422-430. doi:10.1111/j.1525-139x.2010.00766.xDelgado, C., & Johansen, K. L. (2011). Barriers to exercise participation among dialysis patients. Nephrology Dialysis Transplantation, 27(3), 1152-1157. doi:10.1093/ndt/gfr404Heiwe, S., & Tollin, H. (2012). Patients’ perspectives on the implementation of intra-dialytic cycling—a phenomenographic study. Implementation Science, 7(1). doi:10.1186/1748-5908-7-68Konstantinidou, E., Koukouvou, G., Kouidi, E., Deligiannis, A., & Tourkantonis, A. (2002). Exercise training in patients with end-stage renal disease on hemodialysis: Comparison of three rehabilitation programs. Journal of Rehabilitation Medicine, 34(1), 40-45. doi:10.1080/165019702317242695Corbetta, D., Imeri, F., & Gatti, R. (2015). Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review. Journal of Physiotherapy, 61(3), 117-124. doi:10.1016/j.jphys.2015.05.017Peruzzi, A., Cereatti, A., Della Croce, U., & Mirelman, A. (2016). Effects of a virtual reality and treadmill training on gait of subjects with multiple sclerosis: a pilot study. Multiple Sclerosis and Related Disorders, 5, 91-96. doi:10.1016/j.msard.2015.11.002Brien, M., & Sveistrup, H. (2011). An Intensive Virtual Reality Program Improves Functional Balance and Mobility of Adolescents With Cerebral Palsy. Pediatric Physical Therapy, 23(3), 258-266. doi:10.1097/pep.0b013e318227ca0fOrtega‐Pérez de VillarL Pérez‐ DomínguezB Segura‐OrtíE et al.Use of virtual reality game as part of exercise program for chronic kidney disease patients undergoing haemodialysis.2015.Cho, H., & Sohng, K.-Y. (2014). The Effect of a Virtual Reality Exercise Program on Physical Fitness, Body Composition, and Fatigue in Hemodialysis Patients. Journal of Physical Therapy Science, 26(10), 1661-1665. doi:10.1589/jpts.26.1661OrtegaL.Comparison of two exercise programs for hemodialysis patients intradialysis vs home based program. absolute and relative reliability of physical performance[tesis doctoral]. Universidad CEU Cardenal Herrera. Facultad de Ciencias de la Salud;2017.Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability. New England Journal of Medicine, 332(9), 556-562. doi:10.1056/nejm199503023320902Segura-Ortí, E., & Martínez-Olmos, F. J. (2011). Test-Retest Reliability and Minimal Detectable Change Scores for Sit-to-Stand-to-Sit Tests, the Six-Minute Walk Test, the One-Leg Heel-Rise Test, and Handgrip Strength in People Undergoing Hemodialysis. Physical Therapy, 91(8), 1244-1252. doi:10.2522/ptj.20100141Segura-Ortí, E. (2017). Fisioterapia sobre ejercicio en pacientes en hemodiálisis. Fisioterapia, 39(4), 137-139. doi:10.1016/j.ft.2017.05.003Bohm, C., Stewart, K., Onyskie-Marcus, J., Esliger, D., Kriellaars, D., & Rigatto, C. (2014). Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: a prospective randomized trial. Nephrology Dialysis Transplantation, 29(10), 1947-1955. doi:10.1093/ndt/gfu248KOUFAKI, P., NASH, P. F., & MERCER, T. H. (2002). Assessing the efficacy of exercise training in patients with chronic disease. Medicine & Science in Sports & Exercise, 34(8), 1234-1241. doi:10.1097/00005768-200208000-00002Cappy, C. S., Jablonka, J., & Schroeder, E. T. (1999). The effects of exercise during hemodialysis on physical performance and nutrition assessment. Journal of Renal Nutrition, 9(2), 63-70. doi:10.1016/s1051-2276(99)90002-xHeadley, S., Germain, M., Mailloux, P., Mulhern, J., Ashworth, B., Burris, J., … Jones, M. (2002). Resistance training improves strength and functional measures in patients with end-stage renal disease. American Journal of Kidney Diseases, 40(2), 355-364. doi:10.1053/ajkd.2002.34520Painter, P., Carlson, L., Carey, S., Paul, S. M., & Myll, J. (2000). Low-functioning hemodialysis patients improve with exercise training. American Journal of Kidney Diseases, 36(3), 600-608. doi:10.1053/ajkd.2000.16200Segura-Ortí, E., Kouidi, E., & Lisón, J. F. (2009). Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clinical Nephrology, 71(05), 527-537. doi:10.5414/cnp71527Esteve Simó, V., Junqué, A., Fulquet, M., Duarte, V., Saurina, A., Pou, M., … Ramírez de Arellano, M. (2014). Complete Low-Intensity Endurance Training Programme in Haemodialysis Patients: Improving the Care of Renal Patients. Nephron Clinical Practice, 128(3-4), 387-393. doi:10.1159/000369253Johansen, K. L., Painter, P. L., Sakkas, G. K., Gordon, P., Doyle, J., & Shubert, T. (2006). Effects of Resistance Exercise Training and Nandrolone Decanoate on Body Composition and Muscle Function among Patients Who Receive Hemodialysis: A Randomized, Controlled Trial. Journal of the American Society of Nephrology, 17(8), 2307-2314. doi:10.1681/asn.2006010034Tao, X., Chow, S. K. Y., & Wong, F. K. (2017). The effects of a nurse-supervised home exercise programme on improving patients’ perceptions of the benefits and barriers to exercise: A randomised controlled trial. Journal of Clinical Nursing, 26(17-18), 2765-2775. doi:10.1111/jocn.13798Rossi, A. P., Burris, D. D., Lucas, F. L., Crocker, G. A., & Wasserman, J. C. (2014). Effects of a Renal Rehabilitation Exercise Program in Patients with CKD: A Randomized, Controlled Trial. Clinical Journal of the American Society of Nephrology, 9(12), 2052-2058. doi:10.2215/cjn.11791113Boone, A. E., Foreman, M. H., & Engsberg, J. R. (2017). Development of a novel virtual reality gait intervention. Gait & Posture, 52, 202-204. doi:10.1016/j.gaitpost.2016.11.025Orcy, R. B., Dias, P. S., Seus, T. L., Barcellos, F. C., & Bohlke, M. (2012). Combined Resistance and Aerobic Exercise is Better than Resistance Training Alone to Improve Functional Performance of Haemodialysis Patients - Results of a Randomized Controlled Trial. Physiotherapy Research International, 17(4), 235-243. doi:10.1002/pri.1526Oliveros R, M. S., Avendaño, M., Bunout, D., Hirsch, S., De La Maza, M. P., Pedreros, C., & Müller, H. (2011). Estudio piloto sobre entrenamiento físico durante hemodiálisis. Revista médica de Chile, 139(8), 1046-1053. doi:10.4067/s0034-98872011000800010Silva, S. F. da, Pereira, A. A., Silva, W. A. H. da, Simôes, R., & Barros Neto, J. de R. (2013). Physical therapy during hemodialyse in patients with chronic kidney disease. Jornal Brasileiro de Nefrologia, 35(3), 170-176. doi:10.5935/0101-2800.20130028Bulckaen, M., Capitanini, A., Lange, S., Caciula, A., Giuntoli, F., & Cupisti, A. (2011). Implementation of exercise training programs in a hemodialysis unit: effects on physical performance. Journal of Nephrology, 24(6), 790-797. doi:10.5301/jn.2011.6386Cook, S. A., MacLaughlin, H., & Macdougall, I. C. (2007). A structured weight management programme can achieve improved functional ability and significant weight loss in obese patients with chronic kidney disease. Nephrology Dialysis Transplantation, 23(1), 263-268. doi:10.1093/ndt/gfm511PérezDF.Comparación de los efectos de un programa de ejercicio intradiálisis frente a un programa de ejercicio domiciliario[tesis doctoral]. Universidad CEU Cardenal Herrera Facultad de Ciencias de la Salud;2017.Wilkinson, T. J., Shur, N. F., & Smith, A. C. (2016). «Exercise as medicine» in chronic kidney disease. Scandinavian Journal of Medicine & Science in Sports, 26(8), 985-988. doi:10.1111/sms.1271

Properties of polyplexes formed between a cationic polymer derived from l-arabinitol and nucleic acids

In this work a sugar-based cationic polymer derived from l-arabinitol, PUArab, was prepared and its interactions with the linear calf thymus DNA and with the circular plasmid pEGFP-C1 were investigated at different N/P ratios. The polyplexes were characterized by using several techniques. For both nucleic acids, a charge inversion was observed, together with a conformational change from a coiled structure to a more compacted one. However, the N/P ratio required to observe the DNA condensation depended on the nucleic acid architecture. PUArab presents low toxicity in several cell lines. The transfection efficiency, TE, of the PUArab/pEGFP-C1 polyplexes was investigated at several N/P ratios in order to study their potential as vectors in gene transfection

Recurrent NOMO1 gene deletion is a potential clinical marker in early-onset colorectal cancer and is involved in the regulation of cell migration

The incidence of early-onset colorectal cancer (EOCRC; age younger than 50 years) has been progressively increasing over the last decades globally, with causes unexplained. A distinct molecular feature of EOCRC is that compared with cases of late-onset colorectal cancer, in EOCRC cases, there is a higher incidence of Nodal Modulator 1 (NOMO1) somatic deletions. However, the mechanisms of NOMO1 in early-onset colorectal carcinogenesis are currently unknown. In this study, we show that in 30% of EOCRCs with heterozygous deletion of NOMO1, there were pathogenic mutations in this gene, suggesting that NOMO1 can be inactivated by deletion or mutation in EOCRC. To study the role of NOMO1 in EOCRC, CRISPR/cas9 technology was employed to generate NOMO1 knockout HCT-116 (EOCRC) and HS-5 (bone marrow) cell lines. NOMO1 loss in these cell lines did not perturb Nodal pathway signaling nor cell proliferation. Expression microarrays, RNA sequencing, and protein expression analysis by LC–IMS/MS showed that NOMO1 inactivation deregulates other signaling pathways independent of the Nodal pathway, such as epithelial–mesenchymal transition and cell migration. Significantly, NOMO1 loss increased the migration capacity of CRC cells. Additionally, a gut-specific conditional NOMO1 KO mouse model revealed no subsequent tumor development in mice. Overall, these findings suggest that NOMO1 could play a secondary role in early-onset colorectal carcinogenesis because its loss increases the migration capacity of CRC cells. Therefore, further study is warranted to explore other signalling pathways deregulated by NOMO1 loss that may play a significant role in the pathogenesis of the disease.This study was supported by the health research program of the Instituto de Salud Carlos III (Spanish Ministry of Economy and Competitiveness, PI20/01569 and PI20/0974), co-funded by FEDER funds, and Mutua Madrileña Foundation (FMM20/001). A.M.-M was supported by a predoctoral research grant from the Dr. Moraza Fundation (FMoraza18/001). P.G.V and N.G.-U were supported by a predoctoral research grant from the Consejería de Educación—Junta de Castilla y León. A.N.H. was supported by the National Institutes of Health K12 HD043483 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development

Agentes y lazos sociales: la experiencia de volverse comunidad

En la colonia Lomas de Polanco, al sur de la ciudad de Guadalajara, México, entre 1970 y 1990 se generó un movimiento ciudadano, enraizado en las Comunidades Eclesiales de Base y la educación popular, que emprendió una lucha exitosa para conseguir los servicios de infraestructura urbana ante las promesas incumplidas de autoridades y fraccionadores. La confluencia de actores, individuales y colectivos, de distintos contextos, contribuyeron a la reconstitución del tejido social y la creación de los lazos que dieron sentido de comunidad a los colonos y al desarrollo de su capacidad de agencia para la trasformación positiva de su entorno y de su vida. Esta experiencia se recupera en esta obra, a partir de una serie de entrevistas con los actores del movimiento, mediante un análisis retrospectivo y desde varias perspectivas teóricas. Su estudio permite comprender mejor las dinámicas sociales acontecidas y posibilita su reproducción para enfrentar de manera organizada y con éxito problemas en contextos urbanos y sociales particulares.Consejo Nacional de Ciencia y TecnologíaGobierno del Estado de Jalisc

Endodontic regenerative treatment for internal radicular resorption using bio-ceramic material, case report

The internal resorption of the internal radicular conduct is a process than can be both physiological or pathological, being the osteoclasts, odontoclasts and dentinoclast responsible for said process. 49-year-old female patient, refers orthodontic treatment at age 20, attends a dental check-up due to pain when chewing. Dental organ (DO) #11 was diagnosed with internal root resorption and symptomatic, suppurative apical periodontitis. Treatment started performing an endodontic access and taking a conductometry reading with an apical foramen locator, using a precision hybrid instrumentation technique and applying hypochlorite irrigation, the intra-canal was medicated with chemically pure calcium hydroxide for 7 days. The canal obturation was repaired infiltrating a bio-ceramic material (BIO-C Sealer) followed by the placement of the single cone using a vertical condensation technique

Distinct Campylobacter fetus lineages adapted as livestock pathogens and human pathobionts in the intestinal microbiota

Campylobacter fetus is a venereal pathogen of cattle and sheep, and an opportunistic human pathogen. It is often assumed that C. fetus infection occurs in humans as a zoonosis through food chain transmission. Here we show that mammalian C. fetus consists of distinct evolutionary lineages, primarily associated with either human or bovine hosts. We use whole-genome phylogenetics on 182 strains from 17 countries to provide evidence that C. fetus may have originated in humans around 10,500 years ago and may have "jumped" into cattle during the livestock domestication period. We detect C. fetus genomes in 8% of healthy human fecal metagenomes, where the human-associated lineages are the dominant type (78%). Thus, our work suggests that C. fetus is an unappreciated human intestinal pathobiont likely spread by human to human transmission. This genome-based evolutionary framework will facilitate C. fetus epidemiology research and the development of improved molecular diagnostics and prevention schemes for this neglected pathoge

Age and date for early arrival of the Acheulian in Europe (Barranc de la Boella, la Canonja, Spain)

The first arrivals of hominin populations into Eurasia during the Early Pleistocene are currently considered to have occurred as short and poorly dated biological dispersions. Questions as to the tempo and mode of these early prehistoric settlements have given rise to debates concerning the taxonomic significance of the lithic assemblages, as trace fossils, and the geographical distribution of the technological traditions found in the Lower Palaeolithic record. Here, we report on the Barranc de la Boella site which has yielded a lithic assemblage dating to ,1 million years ago that includes large cutting tools (LCT). We argue that distinct technological traditions coexisted in the Iberian archaeological repertoires of the late Early Pleistocene age in a similar way to the earliest sub-Saharan African artefact assemblages. These differences between stone tool assemblages may be attributed to the different chronologies of hominin dispersal events. The archaeological record of Barranc de la Boella completes the geographical distribution of LCT assemblages across southern Eurasia during the EMPT (Early-Middle Pleistocene Transition, circa 942 to 641 kyr). Up to now, chronology of the earliest European LCT assemblages is based on the abundant Palaeolithic record found in terrace river sequences which have been dated to the end of the EMPT and later. However, the findings at Barranc de la Boella suggest that early LCT lithic assemblages appeared in the SW of Europe during earlier hominin dispersal episodes before the definitive colonization of temperate Eurasia took place.The research at Barranc de la Boella has been carried out with the financial support of the Spanish Ministerio de Economı´a y Competitividad (CGL2012- 36682; CGL2012-38358, CGL2012-38434-C03-03 and CGL2010-15326; MICINN project HAR2009-7223/HIST), Generalitat de Catalunya, AGAUR agence (projects 2014SGR-901; 2014SGR-899; 2009SGR-324, 2009PBR-0033 and 2009SGR-188) and Junta de Castilla y Leo´n BU1004A09. Financial support for Barranc de la Boella field work and archaeological excavations is provided by the Ajuntament de la Canonja and Departament de Cultura (Servei d’Arqueologia i Paleontologia) de la Generalitat de Catalunya. A. Carrancho’s research was funded by the International Excellence Programme, Reinforcement subprogramme of the Spanish Ministry of Education. I. Lozano-Ferna´ndez acknowledges the pre-doctoral grant from the Fundacio´n Atapuerca. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics