The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events

BackgroundWhen older adults turn to sit, about 80% of the subjects complete the turn before starting to sit i.e., a distinct-strategy, while in about 20%, part of the turning and sitting take place concurrently, i.e., an overlapping-strategy. A prolonged duration of the separation between tasks in the distinct-strategy (D-interval) and a prolonged duration of the overlap interval in overlapping-strategy (O-interval) are related to worse motor symptoms and poorer cognition. In the present study, we evaluated what strategy is employed by patients with Parkinson’s disease (PD) when they transition from turning to sitting.Methods96 participants with PD performed turn to sit as part of the Timed Up and Go test, both with and without medications, while wearing a body-fixed sensor. We quantified the turn-to-sit transition and determined which strategy (distinct or overlapping) was employed. We then stratified the cases and used regression models adjusted for age, gender, height, and weight to examine the associations of the D-interval or O-interval with parkinsonian features and cognition.ResultsMost patients (66%) employed the overlapping-strategy, both off and on anti-parkinsonian medications. Longer O-intervals were associated with longer duration of PD, more severe PD motor symptoms, a higher postural-instability-gait-disturbance (PIGD) score, and worse freezing of gait. Longer D-intervals were not associated with disease duration or PD motor symptoms. Neither the D- nor O-intervals were related to cognitive function. Individuals who employed the overlapping-strategy had more severe postural instability (i.e., higher PIGD scores), as compared to those who used the distinct-strategy.SignificanceIn contrast to older adults without PD, most patients with PD utilize the overlapping strategy. Poorer postural and gait control are associated with the strategy choice and with the duration of concurrent performance of turning and sitting. Additional work is needed to further explicate the mechanisms underlying these strategies and their clinical implications.     

高压氧治疗对慢性脑缺血大鼠认知功能的影响及其作用机制

目的 探讨高压氧（hyperbaric oxygen，HBO）治疗对慢性脑缺血（chronic cerebral ischemia，CCI）大鼠 学习记忆能力的影响及其作用机制。 方法 选取240只雄性SD大鼠随机分为假手术组、CCI组和HBO组，每组80只。采用双侧颈总动脉阻 断法建立CCI模型，HBO组建模12 h后开始进行HBO治疗28 d，压力0.2 MPa，每日1次，每次60 mi n。采用 Morri s水迷宫实验评估7、14、21、28 d大鼠的学习记忆能力，每个时间点20只，检测前均进行3 d训练， 记录各组大鼠的逃避潜伏时间、穿越平台次数。28 d后处死大鼠取海马组织进行HE染色评估神经元 损伤病理变化，RT-PCR法检测Nogo-A mRNA，Western blot法检测Nogo-A蛋白的表达水平。 结果 ①与假手术组比较，CCI 组7、14、21、28 d逃避潜伏时间均延长（均P＜0.05），28 d跨越平台次 数减少（P＜0.05）；与CCI 组比较，HBO组7、14、21、28 d逃避潜伏时间均缩短（均P＜0.05），28 d跨越 平台次数增加（P＜0.05）。②HE染色显示HBO组神经元损伤程度较CCI组减轻；③CCI组Nogo-A mRNA 和Nogo-A蛋白表达水平均较假手术组升高（均P＜0.05），HBO组表达水平均较CCI组下降（P＜0.05）。 结论 HBO治疗可改善慢性脑缺血大鼠认知功能，其机制可能与下调海马组织中Nogo-A的表达水平 有关。     

Cognition in breast cancer survivors: A pilot study of interval and continuous exercise

Objectives

The current study investigated the effects of two exercise interventions on cognitive function amongst breast cancer survivors.

Terapia de luz pulsada intensa regulada: un tratamiento complementario prometedor para la enfermedad de ojo seco

ObjectiveTo propose the Intense Pulsed Light (IPL) therapy as a helpful supplementary treatment in patients with dry eye disease.Material and methodsRetrospective cross sectional design. Medical records of patients in whom dry eye disease symptoms were not satisfactorily controlled with medical therapy alone and who underwent additional IPL with at least three sessions completed. Data were analyzed before therapy and 3 weeks after its completion to asses improvement. Determination of symptoms, through a visual analog scale; tear film stability, through tear Break Up Time (tBUT); measurement of tear secretion, through Schirmer Test; and ocular surface staining with Van Bijsterveld score were evaluated. SPSS software and nonparametric analysis of repeated measures were used. The study was approved by the ethics committee.Results50 eyes from 25 subjects were reviewed. There were 9 males (36%) and 16 females (64%), with a median age of 59 years (IQR 52-64). The median of the symptoms scale was 8 (IQR 8-9) and 3 (IQR 2-4) before and after the therapy respectively (P < .05). The median of BUT was 4 (IQR 3-5) and 10 (IQR 8-11), Schirmer test was 13 (IQR 12-15) and 15 (IQR 13-20), and Van Bijsterveld score was 3 (RIC 3-4) and 2 (IQR 2-3) before and after the therapy respectively (P < .05, for all measurements).ConclusionIPL treatment has excellent results regarding both: dry eye disease symptoms improvement and in office objective tests such as tBUT, Schirmer test and Van Bijsterveld score; IPL could be considered as an effective adjunct for dry eye disease.