Benefits of Qigong as an integrative and complementary practice for health: a systematic review

Objetivo: analisar na literatura as evidências sobre os benefícios da prática integrativa e complementar de Qigong à saúde de pessoas adultas e idosas. Método: revisão sistemática mediante a busca de estudos nas bases de dados PubMed, CINAHL, LILACS, EMBASE e Cochrane Library. Foram incluídos ensaios clínicos randomizados e não randomizados; em português, inglês e espanhol; de 2008 a 2018. Adotou-se a estratégia Preferred Reporting Items for Systematic Reviews and Meta-Analyses, bem como a recomendação da Colaboração Cochrane para a avaliação do risco de viés dos ensaios clínicos analisados. Resultados: foram selecionados 28 estudos que indicaram o benefício da prática para o público-alvo, podendo ser utilizada para inúmeras condições de saúde, como: câncer; fibromialgia; Doença de Parkinson; Doença Pulmonar Obstrutiva Crônica; Burnout; estresse; isolamento social; lombalgia crônica; dor cervical; zumbido; osteoartrite; fadiga; depressão; e doenças cardiovasculares. Notou-se, contudo, grande risco de viés no que tange ao cegamento das pesquisas. Conclusão: a prática de Qigong produz resultados positivos sobre a saúde, principalmente, a médio e longo prazo. Este estudo contribui para o avanço no uso de práticas integrativas e complementares na enfermagem uma vez que reúne a produção científica na área a partir dos melhores resultados de pesquisas disponíveis.Objetivo: analizar las evidencias presentes en la literatura acerca de los beneficios del Qigong como práctica integradora y complementaria en relación a la salud de adultos y ancianos. Método: revisión sistemática mediante la búsqueda de estudios en las siguientes bases de datos: PubMed, CINAHL, LILACS, EMBASE y Cochrane Library. Se incluyeron ensayos clínicos aleatorizados y no aleatorizados en portugués, inglés y español, de 2008 a 2018. Se adoptó la estrategia Preferred Reporting Items for Systematic Reviews and Meta-Analyses, así como la recomendación de la Colaboración Cochrane empleada para evaluar el riesgo de sesgo de los ensayos clínicos analizados. Resultados: se seleccionaron 28 estudios que indicaron los beneficios de la práctica para el público objetivo, empleada en la afección de numerosos problemas de salud como cáncer, fibromialgia, Mal de Parkinson, Enfermedad Pulmonar Obstructiva Crónica, Burnout, estrés, aislamiento social, lumbalgia crónica, dolor cervical, tinnitus, osteoartritis, fatiga, depresión y enfermedades cardiovasculares. No obstante, se registró un gran riesgo de sesgo en lo que se refiere al procedimiento de enmascaramiento de las investigaciones. Conclusión: practicar Qigong produce resultados positivos en la salud, principalmente, a mediano y largo plazo. Este estudio contribuye al avance en el uso de prácticas integradoras y complementarias en enfermería, ya que reúne la producción científica en el área, seleccionada a partir de los mejores resultados de las investigaciones disponibles.Objective: to analyze, in the literature, evidence about the benefits of the integrative and complementary practice of Qigong with regard to the health of adults and the elderly. Method: a systematic review by searching for studies in the PubMed, CINAHL, LILACS, EMBASE and Cochrane Library databases. Randomized and non-randomized clinical trials were included; in Portuguese, English and Spanish; from 2008 to 2018. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy was adopted, as well as the recommendation of the Cochrane Collaboration for assessing the risk of bias in the clinical trials analyzed. Results: 28 studies were selected that indicated the benefit of the practice to the target audience, which can be used for numerous health conditions, such as: cancer; fibromyalgia; Parkinson’s disease; Chronic Obstructive Pulmonary Disease; Burnout; stress; social isolation; chronic low back pain; cervical pain; buzz; osteoarthritis; fatigue; depression; and cardiovascular diseases. However, there was a great risk of bias in terms of the blinding of the research studies. Conclusion: the practice of Qigong produces positive results on health, mainly in the medium and long term. This study contributes to the advancement in the use of integrative and complementary practices in nursing, since it brings together the scientific production in the area from the best research results available

¿LAS IMÁGENES GUIADAS MEJORAN LA CALIDAD DE VIDA RELACIONADA CON LA SALUD DE PACIENTES COM CÁNCER? UNA REVISIÓN INTEGRADORA

Objective: to analyze research studies that use Guided Imagery as a strategy to improve healthrelated quality of life in cancer patients.Method: an integrative review with assessment of the level of evidence, conducted in February 2020 with publications from January 2009 to February 2020 in Biblioteca Virtual em Saúde, National Library of Medicine, Scopus and Web of Science, with the following descriptors: Imagery, Psychotherapy; Neoplasms and Quality of Life, in English, Spanish and Portuguese.Results: a total of 16 articles were published between 2013 and 2019; 14 in English and 11 randomized clinical trials, including different types of cancer. Guided Imagery was associated with techniques such as breathing exercises and/or progressive muscle relaxation. Positive results for health-related quality of life were observed in 75% of the studies.Conclusion: Guided Imagery presents benefits when used to improve health-related quality of life in cancer patients. This study contributes to the promotion and dissemination of this practice.Objetivo: analisar pesquisas que utilizam Imagem Guiada como estratégia para melhoria da qualidade de vida relacionada à saúde de pacientes com câncer.Método: revisão integrativa com avaliação do nível de evidência, realizada em fevereiro/2020, com publicações de janeiro/2009 a fevereiro/2020, da Biblioteca Virtual em Saúde, National Library of Medicine, Scopus e Web of Science, com os descritores: Imagens, Psicoterapia; Neoplasias e Qualidade de vida, em inglês, espanhol e português.Resultados: 16 artigos foram publicados entre 2013 e 2019, 14 em inglês, 11 ensaios clínicos randomizados, incluindo diferentes tipos de câncer. A Imagem Guiada foi associada a técnicas como exercícios respiratórios e/ou relaxamento muscular progressivo. Resultados positivos para qualidade de vida relacionada à saúde foram observados em 75% dos estudos.Conclusão: a imagem guiada apresenta benefícios quando utilizada para melhoria da qualidade de vida relacionada à saúde de pacientes com câncer. O presente estudo contribui para promoção e divulgação dessa prática.Objetivo: analizar investigaciones que emplean Imágenes Guiadas como estrategia para mejorar la calidad de vida relacionada con la salud de pacientes con cáncer. Método: revisión integradora con evaluación del nivel de evidencia, realizada en febrero de 2020, con publicaciones de enero de 2009 a febrero de 2020, de la Biblioteca Virtual en Salud, la National Library of Medicine, Scopus y Web of Science, y con los siguientes descriptores: Imágenes, Psicoterapia; Neoplasias y Calidad de vida, en inglés, español y portugués. Resultados: se publicaron 16 artículos entre 2013 y 2019; 14 en inglés, y 11 fueron ensayos clínicos aleatorizados, incluyendo diferentes tipos de cáncer. Las Imágenes Guiadas se asociaron a técnicas como ser ejercicios respiratorios y/o relajación muscular progresiva. Se observaron resultados positivos para la calidad de vida relacionada con la salud en el 75% de los estudios. Conclusión: las imágenes guiadas presentan beneficios cuando se las emplea para mejorar la calidad de vida relacionada con la salud de pacientes con cáncer. Este estudio contribuye a la promoción y divulgación de esa práctica

Imagen guiada para la calidad de vida de mujeres con cáncer de cuello uterino: estudio cuasi-experimental

Introduction: Mind-body therapies, such as guided imagery relaxation, which are among the main integrative practices used by cancer patients, are essential for maintaining a healthy balance between sympathetic and parasympathetic arousal in the brain. Objective: To evaluate the effect of guided image relaxation, with the use of virtual reality, on the health-related quality of life of women with cervical cancer undergoing concomitant treatment with chemoradiotherapy. Materials and Method: A quasi-experimental study, carried out in an oncology referral hospital in southern Brazil, from October 2019 to January 2021. 52 women participated, divided into two groups, experimental (relaxation intervention guided by imagery with virtual reality), and control (default routine). The Functional instrument was used to assess health-related quality of life scores. Assessment of Cancer therapy cervix cancer, applied before, 14 days after and at the end of treatment, in approximately 35 days. The analyzes were performed using the mixed generalized linear model, with an autoregressive covariance matrix of order 1, and the significance was confirmed by the Sidak test. Results: There was a statistically significant difference for the experimental group in the physical (p =0.02), functional (p =0.00), specific symptoms of cervical cancer and treatment effects (p =0.03) and overall quality of life (p =0.02). Conclusion: Guided Image Relaxation contributed to an improvement in the Health-Related Quality of Life of patients with cervical cancer during treatment with chemoradiation. How to cite this article: Santana, Edenice de Oliveira; Marcondes, Larissa; Silva, Luana Aparecida Alves da; Sawada, Namie Okino; Rosa, Luciana Martins da; Kalinke, Luciana Puchalski.  Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental. Revista Cuidarte. 2023;14(1):e2358. http://dx.doi.org/10.15649/cuidarte.2358Highlights: A utilização do Relaxamento com Imagem Guiada melhora a qualidade de vida relacionada à saúde de mulheres com câncer de colo de útero. A terapia de Relaxamento por Imagem Guiada demonstrou forte potencial para cuidado sintomático. As práticas integrativas complementares em saúde proporcionam melhores experiências no curso do tratamento do câncer de colo de útero. Relaxamento com Imagem Guiada é uma prática fácil, de baixo custo e importante adjuvante na melhora da qualidade de vida das mulheres com câncer de colo de útero. Introdução: As terapias mente-corpo, como o relaxamento com imagem guiada, que estão entre as principais práticas integrativas utilizadas por pacientes oncológicos, são essenciais para manter equilíbrio saudável entre a excitação simpática e parassimpática no cérebro. Objetivo: Avaliar o efeito do relaxamento por imagem guiada, com o uso da realidade virtual, na qualidade de vida relacionada à saúde de mulheres com câncer de colo uterino em tratamento concomitante com quimiorradioterapia. Materiais e Método: Estudo quase experimental, realizado em um hospital de referência em oncologia no Sul do Brasil, de outubro de 2019 a janeiro de 2021. Participaram 52 mulheres, divididas em dois grupos, experimental (intervenção relaxamento por imagem guiada com realidade virtual), e controle (rotina padrão). Utilizou-se para avaliação dos escores da qualidade de vida relacionada à saúde o instrumento Functional Assessmentof Cancer Therapy Cervix Cancer,aplicado antes, 14 dias após e, ao término do tratamento, em aproximadamente 35 dias. As análises foram realizadas pelo modelo linear generalizado misto, com a matriz de covariância autorregressiva de ordem 1, e a significância foi confirmada pelo teste de Sidak. Resultados: Houve diferença estatisticamente significativa para o grupo experimental nos domínios físico (p=0,02), funcional (p=0,00), sintomas específicos do câncer de colo de útero e efeitos do tratamento (p=0,03) e qualidade de vida global (p=0,02). Conclusão: O relaxamento por Imagem Guiada contribuiu na melhora na Qualidade de Vida Relacionada à Saúde das pacientes com câncer de colo do útero, durante o tratamento com quimiorradiação. Como citar este artigo: Santana, Edenice de Oliveira; Marcondes, Larissa; Silva, Luana Aparecida Alves da; Sawada, Namie Okino; Rosa, Luciana Martins da; Kalinke, Luciana Puchalski.  Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental. Revista Cuidarte. 2023;14(1):e2358. http://dx.doi.org/10.15649/cuidarte.2358Introducción: Las terapias de mente y cuerpo, como la relajación de imágenes guiadas, que se encuentran entre las principales prácticas integradoras utilizadas por los pacientes con cáncer, son esenciales para mantener un equilibrio saludable entre la activación simpática y parasimpática en el cerebro. Objetivo: Evaluar el efecto de la relajación de imagen guiada, con el uso de realidad virtual, sobre la calidad de vida relacionada con la salud de mujeres con cáncer de cuello uterino en tratamiento concomitante con quimiorradioterapia. Materiales y Método: Estudio cuasi-experimental, realizado en un hospital de referencia de oncología en el sur de Brasil, de octubre de 2019 a enero de 2021. Participaron 52 mujeres, divididas en dos grupos, experimental (intervención de relajación guiada por imaginería con realidad virtual), y control (rutina por defecto). El instrumento funcional se utilizó para evaluar las puntuaciones de calidad de vida relacionada con la salud. Evaluación de Cáncer terapia cuello uterino cáncer, aplicado antes, 14 días después y al final del tratamiento, en aproximadamente 35 días. Los análisis se realizaron utilizando el modelo lineal generalizado mixto, con una matriz de covarianza autorregresiva de orden 1, y la significación fue confirmada por la prueba de Sidak. Resultados: hubo una diferencia estadísticamente significativa para el grupo experimental en la calidad de vida física (p = 0,02), funcional (p = 0,00), síntomas específicos del cáncer de cuello uterino y efectos del tratamiento (p = 0,03) y en general (p = 0,02).). Conclusión: La Relajación por Imagen Guiada contribuyó a mejorar la Calidad de Vida Relacionada con la Salud de las pacientes con cáncer de cuello uterino durante el tratamiento con quimiorradioterapia. Como citar este artículo: Santana, Edenice de Oliveira; Marcondes, Larissa; Silva, Luana Aparecida Alves da; Sawada, Namie Okino; Rosa, Luciana Martins da; Kalinke, Luciana Puchalski.  Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental. Revista Cuidarte. 2023;14(1):e2358. http://dx.doi.org/10.15649/cuidarte.235

Recursive Feature Elimination with Cross Validation for Alzheimer's Disease Classification using Cognitive Exam Scores

Prodromal detection of Alzheimer's Disease(AD) is a substantial challenge in the research community. Among the tools used in AD diagnosis, cognitive exams are standard in most procedures. However, the barrage of cognitive examinations is both time and resource consuming. With the use of Machine Learning, Feature Elimination (FE) can be combined with classification algorithms to determine which cognitive exams are best suited for diagnosis. Using the results of FE, it can be determined if subsections of different composite scores can be combined to create a new enhanced and exhaustive exam. This paper implements a Recursive Feature Elimination with Cross Validation (RFECV) machine learning algorithm to determine which cognitive exams perform best for AD classification tasks. Out of 119 features, an average of 16 features were selected as optimal. These optimal features average 75% Accuracy, 70% Precision, and 75% Recall and an F1 Weighted score of 71% in classification

Comparison of Dimensionality Reduction Methods for Multimodal Classification of Early Stages of Alzheimer's Disease

Early diagnosis of Alzheimer's Disease (AD) is challenging due to its progressive nature. This study proposes a comprehensive comparison of four classifiers combined with different dimensionality reduction methods to discriminate normal controls (CN) from pre-mild cognitive impairment (pMCI) and early MCI (EMCI) using multimodal datasets including MRIs, PETs, SUVr, clinician amyloid visual reads, and subjects demographics. The most robust classifier for CN vs. MCI is the Mutual Information Best Percentile - Bagging Classifier combination, with 73.91% accuracy and a 4.82% standard deviation (SD). The best performance of 65.23% (11.84% SD) accuracy for CN vs. EMCI was DTC with ANOVA. In comparing CN with pMCI the best classification accuracy was ANOVA-DTC 51.06% (14.19% SD). An accuracy of 56.34% (10.67% SD) was achieved by bagging with ANOVA for multiclass classification of CN vs. pMCI vs. EMCI

Plasma Alzheimer’s Disease Biomarkers and Brain Amyloid in a Multi‐Ethnic Aging Cohort

Abstract Background Dementia diagnoses are more common among Hispanic (HW) than non‐Hispanic white (NHW) older adults. Alzheimer’s disease (AD) is the most common neuropathological finding in patients with dementia. Plasma AD biomarkers have accelerated efforts towards increasing access to timely diagnosis, but existing data often come from cohorts lacking ethnic diversity. Clinical translation of plasma AD biomarkers requires continued evaluation in study cohorts that reflect the growing ethnic diversity of the population. Method We studied 379 older adults (age 71.9±7.8 years old, 60.2% female) from the 1Florida Alzheimer’s Disease Research Center who underwent blood draw and analysis for P‐tau181 (Quanterix). Of these, 240 completed Aβ‐PET (converted to Centiloids). Over half (57%) self‐identified as HW (32% Cuba, 18% South American, 7% other). Analyses included 1) comparing plasma biomarker concentrations between clinically normal (CN), amnestic MCI (amnMCI), amnestic dementia (amnDEM), and nonamnestic MCI/dementia (ANCOVA controlling for age), 2) evaluating P‐tau181 correlations with Aβ burden (Spearman’s rho), and 3) determining discriminability (AUC) of Aβ‐PET[+] from Aβ‐PET[‐]. Interactions between independent variables and ethnicity were evaluated to inform whether observed relationships differed between HW and non‐Hispanic white (NHW). Lastly, using a cutoff derived from the PET sub‐cohort, we investigated rates of P‐tau181‐defined “AD positivity” (plasmaAD[+]) between HW and NHW diagnosed with amnMCI. Additional data for plasma GFAP and NfL will also be presented. Results Plasma P‐tau181 was higher in amnMCI (p = .004, d = 0.53) and amnDEM (p<.001, d = 0.97) than CN. Higher P‐tau181 related to greater Aβ burden (ρ = .59 [.50‐.67], p<.001) and had good discriminability between Aβ‐PET[+] and Aβ‐PET[‐] (AUC = 0.86 [0.81‐0.91], Youden’s Index = 2.39 pg/mL). There were no significant interactions with ethnicity. Applying the P‐tau181 cutoff (2.39 pg/mL) to all amnMCI participants, HW diagnosed with amnMCI had lower odds of being plasmaAD[+] than NHW (36.5% vs. 58.5%; OR = 0.41 [0.21‐0.78], p = .006). Conclusion Plasma P‐tau181 may aid etiological diagnosis of cognitively impaired older adults from Hispanic and non‐Hispanic ethnic origins. Hispanic ethnicity alone does not significantly influence the interpretation of how plasma P‐tau181 relates to Aβ‐PET, but may be linked to greater likelihood of non‐AD causes of memory loss. Blood‐based biomarkers could help reduce barriers to clinical diagnosis and research participation that disproportionately impact underrepresented groups

Plasma Alzheimer's biomarkers and brain amyloid in Hispanic and non-Hispanic older adults

INTRODUCTIONAlzheimer's disease studies often lack ethnic diversity. METHODSWe evaluated associations between plasma biomarkers commonly studied in Alzheimer's (p-tau181, GFAP, and NfL), clinical diagnosis (clinically normal, amnestic MCI, amnestic dementia, or non-amnestic MCI/dementia), and Aβ-PET in Hispanic and non-Hispanic older adults. Hispanics were predominantly of Cuban or South American ancestry. RESULTSThree-hundred seventy nine participants underwent blood draw (71.9 ± 7.8 years old, 60.2% female, 57% Hispanic of which 88% were Cuban or South American) and 240 completed Aβ-PET. P-tau181 was higher in amnestic MCI (p = 0.004, d = 0.53) and dementia (p < 0.001, d = 0.97) than in clinically normal participants and discriminated Aβ-PET[+] and Aβ-PET[-] (AUC = 0.86). P-tau181 outperformed GFAP and NfL. There were no significant interactions with ethnicity. Among amnestic MCI, Hispanics had lower odds of elevated p-tau181 than non-Hispanic (OR = 0.41, p = 0.006). DISCUSSIONPlasma p-tau181 informs etiological diagnosis of cognitively impaired Hispanic and non-Hispanic older adults. Hispanic ethnicity may relate to greater likelihood of non-Alzheimer's contributions to memory loss. HIGHLIGHTSAlzheimer's biomarkers were measured in Hispanic and non-Hispanic older adults. Plasma p-tau181 related to amnestic cognitive decline and brain amyloid burden. AD biomarker associations did not differ between Hispanic and non-Hispanic ethnicity. Hispanic individuals may be more likely to have non-Alzheimer causes of memory loss