A systematic review and meta-analysis of the effectiveness of virtual reality as an exercise intervention for individuals with a respiratory condition.

Background Respiratory diseases impose an immense health burden worldwide and affect millions of people on a global scale. Reduction of exercise tolerance poses a huge health issue affecting patients with a respiratory condition, which is caused by skeletal muscle dysfunction and weakness and by lung function impairment. Virtual reality systems are emerging technologies that have drawn scientists’ attention to its potential benefit for rehabilitation. Methods A systematic review and meta-analysis following the PRISMA guidelines was performed to explore the effectiveness of virtual reality gaming and exergaming-based interventions on individuals with respiratory conditions. Results Differences between the virtual reality intervention and traditional exercise rehabilitation revealed weak to insignificant effect size for mean heart rate (standardized mean difference, SMD = 0.17; p = 0.002), peak heart rate (SMD = 0.36; p = 0.27), dyspnea (SMD = 0.32; p = 0.13), and oxygen saturation SpO2 (SMD = 0.26; p = 0.096). In addition, other measures were collected, however, to the heterogeneity of reporting, could not be included in the meta-analysis. These included adherence, enjoyment, and drop-out rates. Conclusions The use of VRS as an intervention can provide options for rehabilitation, given their moderate effect for dyspnea and equivalent to weak effect for mean and maximum peak HR and SpO2. However, the use of virtual reality systems, as an intervention, needs further study since the literature lacks standardized methods to accurately analyze the effects of virtual reality for individuals with respiratory conditions, especially for duration, virtual reality system type, adherence, adverse effects, feasibility, enjoyment, and quality of life

Palliative care: End-of-life symptoms

Gregory B. Crawford, Katherine A. Hauser, and Wendy I. Janse

Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees1, 2, 3, 4, 5. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour1, 6, 7, homing ability8, 9 and reproductive success2, 5. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants10, 11, 12, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems

Stimulating the RIG-I pathway to kill cells in the latent HIV reservoir following viral reactivation

The persistence of latent HIV proviruses in long-lived CD4(+) T cells despite antiretroviral therapy (ART)(1–3) is a major obstacle to viral eradication(4–6). Because current candidate latency-reversing agents (LRAs) induce HIV transcription but fail to clear these cellular reservoirs,(7–8) new approaches for killing these reactivated latent HIV reservoir cells are urgently needed. HIV latency depends upon transcriptional quiescence of the integrated provirus and circumvention of immune defense mechanisms(4–6,9). These defenses include cell-intrinsic innate responses that use pattern-recognition receptors (PRR) to detect viral pathogens and subsequently induce apoptosis of the infected cell(10). Retinoic acid-inducible gene I (RIG-I) forms one class of pattern-recognition receptors that mediates apoptosis and elimination of infected cells after recognition of viral RNA(11–14). Here we show that acitretin, an FDA-approved retinoic-acid derivative, enhances RIG-I signaling ex vivo, increases HIV transcription, and induces preferential apoptosis of HIV-infected cells. These effects are abrogated by RIG-I knockdown. Acitretin also decreases proviral DNA levels in CD4+ T cells from HIV-infected subjects on suppressive ART, an effect amplified by combination with suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor. Pharmacologic enhancement of an innate cellular defense network could provide a means to eliminate reactivated cells in the latent HIV reservoir

Measurement of B0 ---> D(*)+ D*- branching fractions and B0 ---> D*+(s) D*- polarization with a partial reconstruction technique

We present a study of the decays B0->D_s(*)+D*-, using 20.8 fb-1 of e+e- annihilation data recorded with the BABAR detector. The analysis is conducted with a partial reconstruction technique, in which only the D_s(*)+ and the soft pion from the D*- decay are reconstructed. We measure the branching fractions BR(B0->D_s+D*-) = (1.03 +/- 0.14 +/- 0.13 +/- 0.26)% and BR(B0->D_s*+D*-) = (1.97 +/- 0.15 +/- 0.30 +/- 0.49)%, where the first error is statistical, the second is systematic, and the third is the error due to the D_s+->phi pi+ branching fraction uncertainty. From the B0->D_s*+D*- angular distributions, we measure the fraction of longitudinal polarization Gamma_L/Gamma = (51.9 +/- 5.0 +/- 2.8)%, which is consistent with theoretical predictions based on factorization.Comment: 9 pages, 4 postscript figues, submitted to Physical Review D (Rapid Communications

Measurement of the branching fraction and CP violating asymmetries in neutral B decays to D*+- D-+

We present measurements of the branching fraction and CP-violating asymmetries for neutral B decays to D*+-D-+. The measurement uses a data sample of approximately 88 million Y(4S) --> B Bbar decays collected with the BABAR detector at the SLAC PEP-II asymmetric-energy B factory. We measure the branching fraction to be (8.8 +- 1.0 +- 1.3) x 10^-4 and the time-integrated CP-violating asymmetry between the rates to D*+D- and D*-D+ to be A = -0.03 +- 0.11 +- 0.05. We also measure the time-dependent CP-violating asymmetry parameters to be S-+ = -0.24 +- 0.69 +- 0.12, C-+ = -0.22 +- 0.37 +- 0.10 for B --> D*-D+ and S+- = -0.82 +- 0.75 +- 0.14$, C+- = -0.47 +- 0.40 +- 0.12 for B --> D*+D-. In each case the first error is statistical and the second error is systematic.Comment: 7 pages, 3 figures, published as Phys. Rev. Lett 90 (2003) 22180

Measurement of the CKM matrix element |V(ub)| with B ---> rho e nu decays

We present a measurement of the branching fraction for the rare decays B->rho e nu and extract a value for the magnitude of Vub, one of the smallest elements of the Cabibbo-Kobayashi-Maskawa quark-mixing matrix. The results are given for five different calculations of form factors used to parametrize the hadronic current in semileptonic decays. Using a sample of 55 million BBbar meson pairs recorded with the BABAR detector at the PEP-II e+e- storage ring, we obtain Br(B0->rho- e+ nu)=(3.29 +-0.42 +-0.47 +-0.60) x 10^-4 and |Vub|=(3.64 +-0.22 +-0.25 +0.39-0.56)x10^-3, where the uncertainties are statistical, systematic, and theoretical, respectively.Comment: Submitted to Phys. Rev. Let