Differential Effects Of Cardiovascular And Resistance Exercise On Functional Mobility In Individuals With Advanced Cancer: A Randomized Trial

Objective: To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer. Design: Prospective, 2-group pretest-posttest pilot study with randomization to either resistance or cardiovascular exercise mode. Setting: Comprehensive community cancer center and a hospital-based fitness facility. Demographics: Volunteer sample of individuals with advanced cancer recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice. Outcome Measures: Functional mobility was assessed using the Short Physical Performance Battery (SPPB); self-reported pain and fatigue were assessed secondarily using visual analog scales. Data were analyzed using a split plot 2x2 analysis of variance (=.05). Interventions: Ten weeks of individualized resistance or cardiovascular exercise, prescribed and monitored by oncology-trained physical therapists and exercise personnel. Results: Fifty-two patients (78.8%) completed the study: 23 (67.7%) of 34 patients in the resistance arm and 29 (90.6%) of 32 patients in the cardiovascular arm. No participant withdrew because of study adverse events. Ten-week outcomes (n=52) included a significant increase in SPPB total score (P\u3c.001), increase in gait speed (P=.001), and reduction in fatigue (P=.05). Although cardiovascular exercise participants had a modestly greater improvement in SPPB total score than resistance training participants (F1,49=4.21, P=.045), the difference was not confirmed in a subsequent intention-to-treat analysis (N=66). Conclusions: Individuals with advanced cancer appear to benefit from exercise for improving functional mobility. Neither resistance nor cardiovascular exercise appeared to have a strong differential effect on outcome.https://dune.une.edu/pt_facpost/1003/thumbnail.jp

Supporting Dining Occupations for Dementia Residents in Skilled Nursing Facilities

Dementia Friendly Dining provides skilled nursing facilities (SNFs) with a practice guideline and training resources for caregivers. The program is informed by existing research on environmental modifications, both physical and social, to enhance the occupations of feeding, eating, and dining for individuals with dementia (IwD) in SNF settings. The physical and social environment has a significant effect in supporting the dining experience for IwD and their caregivers (Keller et al., 2015; Hung et al, 2016; Palese et al., 2018), but many facilities have not integrated physical and social modifications, creating a gap in practice. Therefore, an evidence-based dining program that addresses both the physical and social environments, and fits the cultural context of the SNF is needed in order to support dining occupations for individuals with early and middle stage dementia. The Dementia Friendly Dining program materials include: evidence tables that summarize evidence-based practices for caregiver staff and families, a toolkit of familiar and meaningful items to enhance social interactions, an interactive online training module for caregivers, and a user guide for all facility staff with recommendations on how to set-up the environment and facilitate tasks that will enrich the individual’s dining experience. A survey to assess the feasibility and usefulness of the materials was completed by the partnering facility’s rehab director, OT and SLP practitioners, and a content expert. Findings from the survey indicate the materials are feasible and would be an effective tool to implement in the New Braunfels SNF. Program modifications are suggested by the reviewers in order to promote generalization to other SNFs. In addition, programming to support individuals with middle and late stage dementia are suggested. The Dementia Friendly Dining program illustrates the valuable role OT practitioners have as direct providers and consultants in adapting the environment for an organization or population

Mesoarchaean collision of Kapisilik terrane 3070Ma juvenile arc rocks and \u3e3600Ma Isukasia terrane continental crust (Greenland)

The Mesoarchaean Kapisilik and Eoarchaean Isukasia terranes in the Nuuk region of southern West Greenland were tectonically juxtaposed in the Archaean. The north of the Isukasia terrane is distal from the Kapisilik terrane and has only rare growth of ~2690Ma metamorphic zircon and no 2980-2950Ma metamorphic zircon. The southern part of the Isukasia terrane lies between two ~2690Ma shear zones, and has locally preserved high pressure granulite facies assemblages and widespread growth of 2980-2950Ma metamorphic zircon and also sporadic growth of ~2690Ma metamorphic zircon. Within this southern part of the Isukasia terrane there is a folded klippe of mylonitised Mesoarchaean detrital meta-sedimentary rocks (carrying \u3e3600 and ~3070Ma detrital zircons), mafic and ultramafic rocks, with ~2970Ma metamorphic zircon overgrowths. South of the Isukasia terrane is the Kapisilik terrane, containing ~3070Ma arc-related volcanic rocks, gabbro-anorthosites and meta-tonalites, intruded by 2970-2960Ma granites. Zircons of an Ivisârtoq supracrustal belt ~3075Ma intermediate volcanic rock have initial e{open}Hf values of +2 to +5 thus are juvenile crustal additions. ~3070Ma tonalites along the northern edge of the Kapisilik terrane have whole rock positive initial e{open}Nd values and thus are also juvenile crustal additions. In contrast, igneous zircons in 2960Ma granites intruded into juvenile ~3075Ma supracrustal rocks of the Kapisilik terrane have initial e{open}Hf values of -5 to -10, and must have involved the partial melting of \u3e3600Ma Isukasia terrane rocks.The integrated structural and zircon U-Th-Pb-Hf isotopic data show that at 2980-2950. Ma the Kapisilik terrane juvenile arc components collided with, and over-rid, the Isukasia terrane. The southern edge of the Isukasia terrane came to lie in the deep crust under the Ivisârtoq supracrustal belt and melted at 2970-2960. Ma to produce granites. These granites derived from ancient crust rose into the upper crust, where they intruded the overlying allochthonous juvenile ~3075. Ma Ivisârtoq supracrustal belt arc assemblages. The southern edge of the Isukasia terrane is interpreted as an interior nappe of Eoarchaean basement rocks interfolded with a klippe of Mesoarchaean metasedimentary and mafic/ultramafic rocks, both of which are affected by 2980-2950. Ma metamorphism. The mixed Eoarchaean-Mesoarchaean detrital provenance suggests that the klippe could be dismembered components of an accretionary prism or forearc crust. The northern part of the Isukasia terrane is interpreted as foreland, free of 2980-2950. Ma high-grade metamorphic overprint. This shows that the Isukasia terrane is not a coherent block, but contains ancient rocks that are parautochthonous or allochthonous to each other, with contrasting later metamorphic history.At ~2690. Ma the crustal architecture arisen from Mesoarchaean collision between an older continental block and an island arc was reworked along intra-crustal shear zones, coeval with amphibolite facies metamorphism. This reworking followed on from major terrane assembly at 2710-2700. Ma in the southern part of the Nuuk region, when the Eoarchaean Færingehavn terrane was juxtaposed with 2840-2825. Ma arc rocks. Thus the 2980-2950. Ma assembly of the Isukasia and Kapisilik terranes is distinct from the later 2710-2700. Ma terrane assembly further south in the Nuuk region

Limbal BCAM expression identifies a proliferative progenitor population capable of holoclone formation and corneal differentiation

The corneal epithelium is renowned for high regenerative potential, which is dependent on the coordinated function of its diverse progenitor subpopulations. However, the molecular pathways governing corneal epithelial progenitor differentiation are incompletely understood. Here, we identify a highly proliferative limbal epithelial progenitor subpopulation characterized by expression of basal cell adhesion molecule (BCAM) that is capable of holocone formation and corneal epithelial sheet generation. BCAM-positive cells can be found among ABCB5-positive limbal stem cells (LSCs) as well as among ABCB5-negative limbal epithelial cell populations. Mechanistically, we show that BCAM is functionally required for cellular migration and differentiation and that its expression is regulated by the transcription factor p63. In aggregate, our study identifies limbal BCAM expression as a marker of highly proliferative corneal epithelial progenitor cells and defines the role of BCAM as a critical molecular mediator of corneal epithelial differentiation

Expressions 1998-1999

https://openspace.dmacc.edu/expressions/1018/thumbnail.jp

The State of Research on Racial and Ethnic Discrimination in the Receipt of Health Care

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2012.30077

A survey of current practices by the British Oculoplastic Surgery Society (BOPSS) and recommendations for delivering a sustainable multidisciplinary approach to thyroid eye disease in the United Kingdom

The Royal College of Physicians (RCP) and Thyroid Eye Disease Amsterdam Declaration Implementation Group (TEAMeD-5) have the common goal of improving access to high quality care for thyroid eye disease (TED). The TEAMeD-5 programme recommends all patients with moderate-to-severe TED should have access to multidisciplinary clinics (MDT) with combined Ophthalmology and Endocrinology expertise

Interstitial Lung Abnormalities After Hospitalization for Covid-19 in Patients With Cancer: A Prospective Cohort Study

INTRODUCTION: Survivors of SARS-CoV-2 pneumonia often develop persistent respiratory symptom and interstitial lung abnormalities (ILAs) after infection. Risk factors for ILA development and duration of ILA persistence after SARS-CoV-2 infection are not well described in immunocompromised hosts, such as cancer patients. METHODS: We conducted a prospective cohort study of 95 patients at a major cancer center and 45 patients at a tertiary referral center. We collected clinical and radiographic data during the index hospitalization for COVID-19 pneumonia and measured pneumonia severity using a semi-quantitative radiographic score, the Radiologic Severity Index (RSI). Patients were evaluated in post-COVID-19 clinics at 3 and 6 months after discharge and underwent comprehensive pulmonary evaluations (symptom assessment, chest computed tomography, pulmonary function tests, 6-min walk test). The association of clinical and radiological factors with ILAs at 3 and 6 months post-discharge was measured using univariable and multivariable logistic regression. RESULTS: Sixty-six (70%) patients of cancer cohort had ILAs at 3 months, of whom 39 had persistent respiratory symptoms. Twenty-four (26%) patients had persistent ILA at 6 months after hospital discharge. In adjusted models, higher peak RSI at admission was associated with ILAs at 3 (OR 1.5 per 5-point increase, 95% CI 1.1-1.9) and 6 months (OR 1.3 per 5-point increase, 95% CI 1.1-1.6) post-discharge. Fibrotic ILAs (reticulation, traction bronchiectasis, and architectural distortion) were more common at 6 months post-discharge. CONCLUSIONS: Post-COVID-19 ILAs are common in cancer patients 3 months after hospital discharge, and peak RSI and older age are strong predictors of persistent ILAs