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Tremor in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is common, often unresponsive to treatment, and may contribute to disability. We aim to investigate whether tremor is associated with disability as measured in daily practice and clinical trials, independent of other impairments. We included 76 CIDP patients in this cross‐sectional study. We assessed tremor with the Tremor Research Group essential tremor rating assessment scale (TETRAS) and the Fahn–Tolosa–Marin clinical rating scale (FTM). Disability was measured with the inflammatory Rasch‐built overall disability scale (I‐RODS) and the adjusted Inflammatory Neuropathy Cause and Treatment disability scale (INCAT‐DS, categorized separately in arm score, or total score). Impairments including strength, sensory impairment, and fatigue were measured using specific impairment scales. We tested whether "the presence of a clinically relevant tremor" (based on TETRAS and FTM) or "tremor severity" (FTM part B sum score) was associated with disability scores (I‐RODS, INCAT‐DS total score, and INCAT‐DS arm score), independent of the impairment scores, using multivariate regression. Both "the presence of a clinically relevant tremor" and "tremor severity" were significantly associated with disability measured by the INCAT‐DS (arm score and total score), but not the I‐RODS, independent of strength, sensory impairment, and fatigue. The explained variances were low. Clinically relevant tremor can (partly) explain disability in CIDP, as measured with the INCAT‐DS, independent of muscle strength, sensory deficits, and fatigue. To assess disease activity in CIDP patients with tremor, both impairment and disability outcomes should be assessed, as disability is caused partly by tremor while the effect of immunotherapy on tremor seems limited. [ABSTRACT FROM AUTHOR]

Background: Limited research has been published regarding movement behaviour of adult persons with haemophilia (PWH). It is hypothesized that avoidance of activities and more sedentary behaviour cause poorer physical functioning. Aim: To determine differences in movement behaviour between PWH and healthy adults. Methods: Movement behaviour was measured with an accelerometer distinguishing between; lying/non‐wear, sitting, standing, walking, running and cycling. Time spent on activities was compared between PWH and healthy adults, using absolute time spent on activities and activities as percentage of wear time. Results: One hundred and five PWH (32 mild/moderate with a mean age of 42.8 ± 15.1, severe 42.1 ± 13.6) and 98 healthy adults (mean age 41.9 ± 15.5) showed that adults with severe haemophilia sit and stand more than healthy adults (4.5 [CI 0.6‐8.4] and 4.2 [CI 1.8‐6.6] h/wk, respectively) and walk and run less (3.4 [CI 1.4‐5.3] hours and 33.6 [CI 19.0‐41.7] min/wk, respectively). Patients with mild/moderate haemophilia stand more than healthy adults (3.3 [CI 0.1‐6.4] h/wk). Differences in sitting between severe haemophilia and healthy adults and differences in standing between mild/moderate haemophilia and healthy adults disappeared when using activities as percentage of wear time. Conclusion: Movement behaviour of adults with severe haemophilia differs from healthy adults, mainly due to less walking and less running. No differences were found in other activities and postures or the distribution of movement behaviour over the day. No significant differences were found between adults with mild/moderate haemophilia and healthy adults. [ABSTRACT FROM AUTHOR]

Age is a primary risk factor for Parkinson's disease (PD); however, the effects of aging on the Parkinsonian brain remain poorly understood, particularly for deep brain structures. We investigated intraoperative micro-electrode recordings from the subthalamic nucleus (STN) of PD patients aged between 42 and 76 years. Age was associated with decreased oscillatory beta power and non-oscillatory high-frequency power, independent of PD-related variables. Single unit firing and burst rates were also reduced, whereas the coefficient of variation and the structure of burst activity were unchanged. Phase synchronization (debiased weighed phase lag index [dWPLI]) between sites was pronounced in the beta band between electrodes in the superficial STN but was unaffected by age. Our results show that aging is associated with reduced neuronal activity without changes to its temporal structure. We speculate that the loss of activity in the STN may mediate the relationship between PD and age., (© 2024 The Author(s). European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Cognitive decline represents a severe non-motor symptom of Parkinson's disease (PD) that can significantly reduce the benefits of subthalamic deep brain stimulation (STN DBS). Here, we aimed to describe post-surgery cognitive decline and identify pre-surgery cognitive profile associated with faster decline in STN DBS-treated PD patients. A retrospective observational study of 126 PD patients treated by STN DBS combined with oral dopaminergic therapy followed for 3.54 years on average (SD = 2.32) with repeated assessments of cognition was conducted. Pre-surgery cognitive profile was obtained via a comprehensive neuropsychological examination and data analysed using exploratory factor analysis and Bayesian generalized linear mixed models. On the whole, we observed a mild annual cognitive decline of 0.90 points from a total of 144 points in the Mattis Dementia Rating Scale (95% posterior probability interval [-1.19, -0.62]) with high inter-individual variability. However, true score changes did not reach previously reported reliable change cut-offs. Executive deficit was the only pre-surgery cognitive variable to reliably predict the rate of post-surgery cognitive decline. On the other hand, exploratory analysis of electrode localization did not yield any statistically clear results. Overall, our data and models imply mild gradual average annual post-surgery cognitive decline with high inter-individual variability in STN DBS-treated PD patients. Nonetheless, patients with worse long-term cognitive prognosis can be reliably identified via pre-surgery examination of executive functions. To further increase the utility of our results, we demonstrate how our models can help with disentangling true score changes from measurement error in future studies of post-surgery cognitive changes., (© 2024 The Author(s). European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Background: Deciding whether or not to perform a health behaviour is an active decision-making process which has an impact on current and future behaviour and can be influenced by the beliefs both of patients and their healthcare professionals. The aim of this study was to explore rheumatoid arthritis (RA) patients' and occupational therapists' (OTs) perceptions of the benefits of and barriers to performing joint protection (JP). Methods: A mixed methods design was used. Questionnaires applied a theoretical framework of key themes to assess the relevance of JP benefits and barriers both to people with RA and OTs. Focused interviews with people with RA then enabled data triangulation. Investigator triangulation was used to check the validity of data interpretation. Findings: Ten people with RA and nine OTs participated. From the questionnaires, both groups agreed that highly relevant key themes for JP benefits were physical well-being, potential benefit and personal control. By contrast, the three key themes for JP barriers – negative attitude of others, negative impact on others and taking time from other things – were relevant for the majority of the OTs but not patients. The interviews enabled an understanding of the meaning behind RA patients' ratings, particularly their differences from OTs. People with RA explained JP benefits, and disease acceptance had altered some initial barriers into perceived benefits over time. Conclusions: Emphasizing benefits and identifying individually relevant barriers could be an important communication strategy for OTs in understanding patients' rationale for whether or not to adopt JP methods. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine prognostic validity, concurrent validity and responsiveness of ankle function score (AFS) for patients with acute ankle injury. In a prospective cohort study, AFS was compared with Olerud and Molander ankle score (OMAS), patient-specific complaints (PSC), and global perceived effect. Sensitivity and specificity were calculated to estimate prognostic validity; correlation was calculated for concurrent validity. Effect Size, Standardized Response Mean, and Responsiveness Ratio were calculated to estimate responsiveness. The sensitivity of AFS was 76% and the specificity was 57%. Correlation between AFS and OMAS at baseline, end of treatment and difference was 0.82, 0.70 and 0.79, respectively. Outcomes for responsiveness of AFS were comparable to outcomes for OMAS and PSC. This study found limited evidence for the AFS as a prognostic and evaluative instrument. The AFS is a simple instrument based on basic functional outcomes (pain, stability, weight bearing, swelling and gait) and may be used in addition to subjective clinical judgment as a prognostic and evaluative tool for recovery after acute ankle injury. [ABSTRACT FROM AUTHOR]

In a literature survey, 341 patients with primary and 109 with secondary dystonias treated with deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) were identified. In general, the outcomes for primary dystonias were more favourable compared to the secondary forms. For some secondary dystonias – like tardive dystonia, myoclonus-dystonia (M-D), NBIA (PANK2), the outcome was very good. Only for the primary generalized dystonias, the efficacy of GPi-DBS has been confirmed in randomised controlled trials. Predictors of outcome are the experience and dedication of the stereotactic team, the selection of patients – the diagnosis and pre-operative screening – and the quality of the post-operative care. Predictors of negative outcome are long duration of the disease – with contractures or scoliosis – and concomitant symptoms like spasticity and cerebellar dysfunction. More studies are required to establish the role of GPi-DBS in the treatment of secondary dystonias. [ABSTRACT FROM AUTHOR]

Aim To identify clinical factors associated with gait alterations in patients with Type 2 diabetes. Methods A sample of 76 diabetic patients underwent clinical examination and an outdoor gait assessment on tarred and cobblestoned terrains. We calculated respective differences in gait speed (performance measure) and gait variability (fall risk index) on changing terrains. Associations with clinical factors were investigated using correlation coefficients and linear regression analysis. Results The mean walking speed on the tarred pathway was 4.5 ± 0.6 km/h and 3.9 ± 0.8 km/h on the cobblestone pathway ( P < 0.001). The CVGCT increased from 2.6 ± 0.9% on the tarred pathway to 5.1 ± 2.8% on the cobblestone pathway ( P < 0.001). Regression analysis showed that 36% of the decrease in gait speed was explained proportionally by the mean of maximal isometric lower limb strength (22.2%; P ≤ 0.01), fear of falls (7.4%; P ≤ 0.01) and participants’ perceived vibration threshold (6.4%; P ≤ 0.01). Moreover, mean maximal isometric strength explained 11.8% ( P ≤ 0.01) of the increase of the coefficient of variation of the gait cycle time when participants changed from tarred terrain to cobblestones. Conclusion This study indicated that both physiological (strength and proprioception) and cognitive–behavioural factors (fear of falls) should be considered when treating diabetic patients with gait alterations. Therapists should apply these findings when developing specific fall prevention and treatment programmes. [ABSTRACT FROM AUTHOR]

Patients with diabetes are at higher risk of experiencing fall-related injuries when walking than healthy controls. The underlying mechanism responsible for this is not yet clear. Thus we intend to summarize diabetic patients' gait characteristics and emphasize those which could be the possible underlying mechanisms for increased fall risk. This systematic review aims, in particular, to: (1) evaluate the quality of existing studies which investigate the gait characteristics of diabetic patients, (2) highlight areas of agreement and contradiction in study results, (3) discuss and emphasize parameters associated with fall risk, and (4) propose new orientations and further domains for research needed for their fall risk prevention. We conducted an electronic search of Pedro, PubMed, Ovid and Cochrane. Two authors independently assessed all abstracts. Quality of the selected articles was scored, and the study results summarized and discussed. We considered 236 abstracts of which 28 entered our full text review. Agreement on data quality between two reviewers was high (kappa: 0.90). Authors investigating gait parameters in a diabetic population evaluated in particular parameters either associated with fall risk (speed, step length or step-time variability) or with ulcers (pressure). There is agreement that diabetic patients walk slower, with greater step variability, and present higher plantar pressure than healthy controls. We concluded that diabetic patients present gait abnormalities, some of which can lead to heightened fall risk. To understand its' underlying mechanisms, and to promote efficient prevention, further studies should analyse gait under 'real-life' conditions. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES. In this experimental study, a 4-cm thermoactive viscoelastic foam overlay and a heating source on the operating room table was compared with the standard operating room table with a heating source for the effect on the postoperative pressure ulcer incidence in cardiac surgery patients. BACKGROUND. Pressure ulcer incidence in the cardiac surgery population is reported to be up to 29.5%. The prolonged compressive forces from lying on the operating room table are one source of pressure ulcer development in this population. Pressure-reducing devices on the operating room (OR)-table should reduce the patients' interface pressure and thus the hazard of skin breakdown. METHODS. A randomized controlled trial was performed to test the effect of a 4-cm thermoactive viscoelastic foam overlay with a water-filled warming mattress on the OR-table (test OR-table) compared with the standard OR-table (a water-filled warming mattress, no pressure-reducing device) on the postoperative pressure ulcer incidence in cardiac surgery patients. INSTRUMENTS. The pressure ulcer classification system of the European Pressure Ulcer Advisory Panel (EPUAP) was used for pressure ulcer grading. RESULTS. The results show that patients lying on the 4-cm thermoactive viscoelastic foam overlay suffer slightly more pressure ulcer (17.6%) than patients on the standard OR-table without the foam overlay (11.1%). Because of the clinical relevance of the results, the randomized controlled trial was terminated after 175 patients at the interim analysis although the power calculation stated 350 patients. CONCLUSIONS. The combination of a 4-cm viscoelastic foam overlay and a warming source cannot be recommended for pressure ulcer prevention on the operating room table. RELEVANCE TO CLINICAL PRACTICE. Foam overlays are used to prevent pressure ulcers in patients. It is necessary to use such devices according to patient safety and use of resources. [ABSTRACT FROM AUTHOR]

Measurement of the cervical range of motion (CROM) is significant for early diagnosis of cervical spondylosis and determination of the severity of the disease. Aiming at the problem of convenient and continuous measurement of CROM and the reduction of the impact of data fluctuations, this paper proposes a low‐cost method for testing and analyzing CROM. This paper analyzes the correspondence between smartphone orientation sensor angle and CROM, obtains smartphone orientation sensing data, and uses the extreme‐point symmetric mode decomposition method by calculating the energy of the difference value to extract the adaptive global mean curve of the CROM data, and calculates the cervical ROM. The statistical analysis of the CROM test results is carried out. Results show that the method proposed can obtain the CROM including flexion and extension, lateral flexion, and rotation in a single measurement, which has the advantages of continuous measurement and low cost. [ABSTRACT FROM AUTHOR]

Meta‐research, also known as "research on research" is a field of study that investigates the methods, reporting, reproducibility, evaluation, and incentives along the research continuum. Meta‐research literacy is imperative to ensure high quality, transparent and reproducible primary data or meta‐research products. In this commentary, we propose that early career researchers should be trained in meta‐research as a foundation to develop a deeper understanding of the research process and ability to appraise the research literature and design high‐quality original studies, irrespective of their chosen field of study. We discuss the importance of meta‐research and open science from the perspective of an early career trainee, highlighting essential areas for growth and obstacles one may encounter. [ABSTRACT FROM AUTHOR]

Exercise therapy is the most common approach for people with chronic neck pain (CNP). Although well-established, it remains unknown which type of exercise is the best for treating this condition. Moreover, pain processing can play a role in the persistence of pain and in the response to interventions. Thus, the aim of this randomized controlled trial is to compare the acute and long-term effects of two exercise protocols (specific and non-specific) on pain and pain processing in individuals with CNP. One hundred and ten participants aged between 18 and 65 years who have had non-specific neck pain for more than 3 months will be recruited. They will be randomized and allocated into two groups (specific exercises and non-specific exercises) and both groups will perform an exercise programme twice a week for 8 weeks. Both programmes are divided into two progressive and individualized phases. The primary outcomes are change in pain intensity after 8 weeks of exercise and exercise-induced hypoalgesia, and secondary outcomes are pressure pain threshold, temporal summation of pain, conditioned pain modulation, the Neck Disability Index, the Baecke Physical Activity Questionnaire, and the Global Perception of Change Scale. Outcomes will be assessed at baseline, after 8 weeks of intervention, and at 6-month follow-up., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Objectives: To examine the feasibility of individuals with spinal cord injury or disease (SCI/D) to perform combined oropharyngeal and respiratory muscle training (RMT) and determine its impact on their respiratory function. Methods: A prospective study at a single Veterans Affairs (VA) Medical Center. Inclusion criteria included: 1) Veterans with chronic SCI/D (>6 months postinjury and American Spinal Injury Association (ASIA) classification A–D) and 2) evidence of OSA by apnea‐hypopnea index (AHI ≥5 events/h). Eligible participants were randomly assigned to either an experimental (exercise) group that involved performing daily inspiratory, expiratory (using POWERbreathe and Expiratory Muscle Strength Trainer 150 devices, respectively), and tongue strengthening exercises or a control (sham) group that involved using a sham device, for a 3‐month period. Spirometry, maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), polysomnography, and sleep questionnaires were assessed at baseline and at 3 months. Results: Twenty‐four individuals were randomized (12 participants in each arm). A total of eight (67%) participants completed the exercise arm, and ten (83%) participants completed the sham arm. MIP was significantly increased (p < 0.05) in the exercise group compared with the baseline. Conclusions: Combined oropharyngeal and RMT are feasible for individuals with SCI/D. Future studies are needed to determine the clinical efficacy of these respiratory muscle exercises. [ABSTRACT FROM AUTHOR]

Aims: To determine the impact of a multi‐component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community. Method: A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science), grey literature and reference lists of relevant studies in December 2021– January 2022 and again between January 2023 and February 2023 when no additional new studies were identified. Key inclusion criteria were studies with female older adults above the age of 60, with any type of UI, residing in the community, addressing the effects of a multi‐component exercise intervention combining pelvic floor muscle training (PFMT), strength and balance exercises. The primary outcome of interest was the cure rate of UI in community‐dwelling older women (%). Studies underwent quality appraisal using the RevMan Risk of Bias tool and the Evidence‐based Librarianship tool, identifying significant biases. A narrative synthesis presents results for all outcomes; a meta‐analysis was also performed for secondary outcomes. Results: Following the PRISMA 2020 guidelines, a total of 596 records were identified from the systematic search. Five studies met the inclusion criteria. Participants receiving the intervention had a statistically significant mean cure rate of 44.0% (p < 0.05), which decreased at follow‐up, except for participants with stress UI. Participants receiving the intervention had significantly decreased frequency of UI episodes (p < 0.00001) and increased maximum walking speed (p < 0.0003) at a 3‐month follow‐up. Conclusion: A multi‐component exercise, combining PFMT, strength and balance exercises, is effective in improving and curing UI, especially stress UI, in community‐dwelling older women. [ABSTRACT FROM AUTHOR]

Please cite this paper as: de Bie R, Massuger L, Lenselink C, Derksen Y, Prins J, Bekkers R. The role of individually targeted information to reduce anxiety before colposcopy: a randomised controlled trial. BJOG 2011;118:945-950. We investigated whether providing targeted information on an individual level by mail and by phone reduces anxiety in women referred to the colposcopy clinic. Randomised controlled trial. Women referred to the colposcopy clinic. Between December 2007 and April 2010, 169 patients with abnormal smear results were randomised into two study arms. Group A received individually targeted information about the diagnosis and procedure by mail and phone. Group B received the standard folder about colposcopies alone. Patients were requested to fill out a questionnaire prior to their first colposcopy appointment. The questionnaire included the hospital anxiety and depression scale (HADS), and the Spielberger state-trait anxiety inventory (STAI), as well as a short self-administered questionnaire. Twenty women were excluded from further analyses after randomisation, leaving 149 women for evaluation. The median STAI state anxiety score was high (50.0), but there was no significant difference in median STAI state anxiety and HADS anxiety scores between both groups. However, knowledge about human papillomavirus and the colposcopy procedure did significantly increase in group A ( P = 0.004). Anxiety levels before primary colposcopy are surprisingly high, and are not reduced following individually targeted information given before colposcopy. [ABSTRACT FROM AUTHOR]

Background: Intensity is an important determinant of physiological adaptations and health benefits of exercise, but the role of exercise intensity on improving outcomes in people with chronic low back pain (CLBP) is unclear. This systematic review aimed to determine the effect of higher versus lower intensity exercise intensity on pain, disability, quality of life and adverse events in people with CLBP. Methods: Six databases and four clinical trial registries were searched from inception to 21 December 2022, for randomised controlled trials that compared two or more exercise intensities in adults with CLBP. Data were analysed using random‐effects meta‐analysis for disability and synthesised narratively for pain, quality of life and adverse events due to limited studies. Risk of bias was assessed using the Cochrane tool and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations framework. Results: Four trials (n = 214 participants, 84% male) reported across five studies were included. Higher intensity exercise reduced disability more than lower intensity exercise at end‐treatment (SMD [95% CI] = −0.39 [−0.56 to −0.22]; very low certainty) but not at 6‐month follow‐up (SMD [95% CI] = −0.20 [−0.53 to 0.13]; very low certainty). Higher intensity exercise did not reliably improve pain and quality of life more than lower intensity exercise. Adverse events did not differ between exercise intensities. All studies were at high risk of bias. Conclusion: Based on very low certainty evidence from a limited number of studies, exercise intensity does not appear to meaningfully influence clinical outcomes in people with CLBP. [ABSTRACT FROM AUTHOR]

Mental illnesses are one of the biggest contributors to the global disease burden. Despite the increased recognition, diagnosis and ongoing research of mental health disorders, the etiology and underlying molecular mechanisms of these disorders are yet to be fully elucidated. Moreover, despite many treatment options available, a large subset of the psychiatric patient population is nonresponsive to standard medications and therapies. There has not been a comprehensive study to date examining the burden and impact of treatable genetic disorders (TGDs) that can present with neuropsychiatric features in psychiatric patient populations. In this study, we test the hypothesis that TGDs that present with psychiatric symptoms are more prevalent within psychiatric patient populations compared to the general population by performing targeted next-generation sequencing of 129 genes associated with 108 TGDs in a cohort of 2301 psychiatric patients. In total, 48 putative affected and 180 putative carriers for TGDs were identified, with known or likely pathogenic variants in 79 genes. Despite screening for only 108 genetic disorders, this study showed a two-fold (2.09%) enrichment for genetic disorders within the psychiatric population relative to the estimated 1% cumulative prevalence of all single gene disorders globally. This strongly suggests that the prevalence of these, and most likely all, genetic diseases is greatly underestimated in psychiatric populations. Increasing awareness and ensuring accurate diagnosis of TGDs will open new avenues to targeted treatment for a subset of psychiatric patients., (© 2024 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)

Parkinson's disease (PD) is the second cause of the neurodegenerative disorder, affecting over 6 million people worldwide. The World Health Organization estimated that population aging will cause global PD prevalence to double in the coming 30 years. Optimal management of PD shall start at diagnosis and requires both a timely and accurate method. Conventional PD diagnosis needs observations and clinical signs assessment, which are time‐consuming and low‐throughput. A lack of body fluid diagnostic biomarkers for PD has been a significant challenge, although substantial progress has been made in genetic and imaging marker development. Herein, a platform that noninvasively collects saliva metabolic fingerprinting (SMF) by nanoparticle‐enhanced laser desorption–ionization mass spectrometry with high‐reproducibility and high‐throughput, using ultra‐small sample volume (down to 10 nL), is developed. Further, excellent diagnostic performance is achieved with an area‐under‐the‐curve of 0.8496 (95% CI: 0.7393–0.8625) by constructing deep learning model from 312 participants. In conclusion, an alternative solution is provided for the molecular diagnostics of PD with SMF and metabolic biomarker screening for therapeutic intervention. [ABSTRACT FROM AUTHOR]

Dopamine (DA) is involved in neurological and physiological functions such as motor control. L‐3,4‐dihydroxyphenylalanine (L‐DOPA), a precursor of DA, is conventionally believed to be an inert amino acid precursor of DA, and its major therapeutic effects in Parkinson's disease (PD) are mediated through its conversion to DA. On the contrary, accumulating evidence suggests that L‐DOPA itself is a neurotransmitter. We here show that L‐DOPA potentiates DA D2 receptor (DRD2) signaling through GPR143, the gene product of X‐linked ocular albinism 1, a G‐protein‐coupled receptor for L‐DOPA. In Gpr143‐gene‐deficient (Gpr143−/y) mice, quinpirole, a DRD2/DRD3 agonist, ‐induced hypolocomotion was attenuated compared to wild‐type (WT) mice. Administration of non‐effective dose of L‐DOPA methyl ester augmented the quinpirole‐induced hypolocomotion in WT mice but not in Gpr143−/y mice. In cells co‐expressing GPR143 and DRD2, L‐DOPA enhanced the interaction between GPR143 and DRD2 and augmented quinpirole‐induced decrease in cAMP levels. This augmentation by L‐DOPA was not observed in cells co‐expressing GPR143 and DRD1 or DRD3. Chimeric analysis in which the domain of GPR143 was replaced with GPR37 revealed that GPR143 interacted with DRD2 at the fifth transmembrane domain. Intracerebroventricular administration of a peptide that disrupted the interaction mitigated quinpirole‐induced behavioral changes in WT mice but not in Gpr143−/y mice. These findings provide evidence that coupling between GPR143 and DRD2 is required for selective DRD2 modulation by L‐DOPA in the dorsal striatum. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this case study was to demonstrate the clinical decision‐making process of healthcare professionals within a rehabilitation program during chemoradiotherapy (CHRT) for a high‐risk patient diagnosed with stage III non‐small cell lung cancer (NSCLC). The course of CHRT and patient's preferences, facilitators, and barriers were considered. Case‐description: The patient was a 69‐year‐old man with a history of rheumatoid arthritis diagnosed with stage III NSCLC. Intervention: A home‐based, personalized, and partly supervised rehabilitation program during CHRT, including aerobic, resistance, and breathing exercises, as well as nutritional counseling. Outcomes: The patient suffered from side effects of CHRT, which required adjustments in the context and intensity of the exercises. An important facilitator for the patient was encouraged by his wife in following the home‐based rehabilitation program. During home visits, the patient and physiotherapists performed the exercises together to help him to overcome the burden and motivate the patient to adhere to the rehabilitation program. Conclusion: This case study demonstrates that physical exercise training could be performed by adjusting training intensity and the way in which the physical exercise training was delivered, while the patient experienced side effects from CHRT. In addition, the involvement and support of (in)formal caregivers seems essential for adherence to rehabilitation. [ABSTRACT FROM AUTHOR]

Background and Objectives: Persistent nonspecific back pain is now established as a biopsychosocial phenomenon that can be meaningfully affected by individuals' cognitions, emotions, lifestyle factors and family and social relationships. Recent guidelines for the treatment of adolescents with persistent nonspecific back pain, as well as those for youth with mixed chronic pain, strongly recommend interdisciplinary care in which adolescents receive treatment for both mind and body. The objective of this scoping review was to examine the interventions evaluated in randomized trials for adolescents with persistent back pain to determine whether they correspond to these guidelines and to reveal future research priorities. Databases and data treatment: The review protocol was registered in March 2022. We followed the PRISMA guidelines for scoping reviews. Twelve electronic databases were searched for relevant study reports. Data were charted on study characteristics, participant characteristics and intervention details using the Template for Intervention Description and Replication (TIDieR) checklist. Results: The search yielded 1952 records, of which eight reports representing seven randomized trials were eligible. The most common interventions were exercise therapy (n = 6) and back education (n = 4). Five studies employed multiple intervention components, but none was multidisciplinary. Studies primarily targeted posture or biomechanical factors. One study included an intervention addressing participants' fears and beliefs about pain. Conclusions: Randomized trials for adolescents with persistent back pain have primarily relied upon an outdated, biomechanical explanation of persisting pain. Future randomized trials should align with current treatment recommendations and measure outcomes across multiple biopsychosocial domains. Significance: This scoping review describes in detail the interventions included in randomized trials for adolescents with persistent, nonspecific back pain. The review is important because it reveals discrepancies between those interventions and the interventions recommended for this population. [ABSTRACT FROM AUTHOR]

Aiming at understanding the role of CH4/CO2 ratio on gliding arc (GA)‐based dry reforming of methane (GA‐DRM), the GA‐DRM at CH4/CO2 ratio range of 0.11 to 1 was studied with kinetics simulation. The radicals of H, OH, and CH3 are identified as the main reactive species to induce the reactant conversion and product formation in GA‐DRM. The increase of CH4/CO2 raises the concentrations of H and CH3 and reduces the OH concentration. Subsequently, the CH4/CO2 ratio regulates the main reaction routes of GA‐DRM. The dehydrogenation coupling reaction enhances with CH4/CO2 and thus raises the selectivities of C2 hydrocarbons. The OH‐induced reactions for OH to H2O weaken with CH4/CO2, thereby increasing the H2 selectivity. [ABSTRACT FROM AUTHOR]

Cognitive performances of autistic people vary widely. Therefore, previous group‐based comparisons on cognitive aging in autistic adults might have overlooked those autistic adults that are particularly vulnerable for cognitive decline. Multivariate normative comparisons (MNC) statistically assess individual cognitive differences on the entire cognitive profile. Cognitive deviancy as indicated by MNC accurately predicts future cognitive decline, and is therefore sensitive in detecting meaningful cognitive differences. The current study aimed to (1) investigate the applicability of MNC to assess cognitive performance in autism individually, and (2) understand heterogeneous cognitive performance in autistic adults. As pre‐registered, we performed MNC in a sample of 254 non‐autistic adults, and two independent samples of respectively 118, and 86 autistic adults (20–85 years, mean: 50 years). Cognitive performance was measured on 11 outcomes in six domains (verbal/visual memory, working memory, verbal fluency, Theory of Mind, and psychomotor speed). Using MNC, about twice as many autistic individuals had a deviant cognitive profile (i.e., deviated statistically from the multivariate normspace) as compared to non‐autistic individuals. Importantly, most autistic individuals (>80%) did not have a deviant cognitive profile. Having a deviant profile was significantly associated with higher levels of psychological distress in autistic adults specifically, showing the clinical relevance of this method. Therefore, MNC seem a useful tool to individually detect meaningful cognitive differences in autism. These results are consistent with previous cognitive studies suggesting that most autistic adults show fairly similar cognitive profiles to non‐autistic adults, yet highlight the necessity for approaches reflecting the heterogeneity observed in autistic people. Lay Summary: Aiming to understand cognitive differences between autistic adults, we applied a new statistical method that assesses cognition in a sensitive, and individual manner. Cognitive profiles of autistic adults, and non‐autistic adults were, therefore, investigated statistically. About twice as many autistic individuals showed a different cognitive profile (20%) as compared to non‐autistic individuals, yet most autistic individuals (80%) did not. Differences were, in part, explained by differences in psychological distress. [ABSTRACT FROM AUTHOR]

Objective: Examine how rotator cuff (RC) tendinopathy differed from other shoulder problems (OSP) by measuring a variety of self‐reported bio‐psycho‐social factors, and establish which explain severity. Methods: A validated online survey battery was used to collect self‐reported biopsychosocial variables in an international population. Diagnostic group and severity were the dependent variables. Multiple logistic and linear regression analyses were utilised to generate explanatory models for group differences and severity after group comparison and univariate regression analysis. Results: 82 people with RC tendinopathy (50 female, 42.8 ± 13.9 years) and 54 with OSP (33 female, 40.2 ± 14.1 years) were recruited. Both groups had comparable severity results (Shoulder Pain and Disability Index = 37.3 ± 24.5 vs. 33.7 ± 22.5). Seven factors individually differentiated RC tendinopathy from OSP. The multivariable model included 4 factors: activity effect on pain (OR(95%CI) = 2.24(1.02–4.90)), previous injury in the shoulder (OR(95% CI) = 0.30(0.13–0.69)), activity level (moderate OR(95% CI) = 3.97(1.29–12.18), high OR(95% CI) = 3.66(1.41–9.48)) and self‐efficacy (OR(95%CI) = 1.12(1.02–1.22)) demonstrating acceptable accuracy. The second multivariable model for RC tendinopathy severity included one demographic, three psychological and two biomedical variables (β(range) = 0.19–0.38) and explained 68% of the variance. Conclusion: Self‐reported bio‐psycho‐social variables may be beneficial for further detailed clinical assessment as they partially distinguish RC tendinopathy from OSP, even when the groups have comparable overall pain and functional problems. Moreover, these variables were shown to be substantially associated with RC tendinopathy severity variance, implying that the clinical evaluation might be improved, perhaps by pre‐consultation online data collection. The models should be validated in the future and considered alongside data from physical and imaging examinations. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of Pilates exercise (PE) with other forms of exercise on pain and disability in individuals with chronic non‐specific low back pain (CNSLBP) and to inform clinical practice and future research. Study design: Systematic review with meta‐analysis conducted and reported in line the Preferred Reporting Items for Systematic review and Meta‐analysis. Literature search: Six electronic databases were searched from inception to April 2021. Study selection criteria: Randomised controlled trials (RCTs) comparing the effect of PE with other forms of exercise for adults with CNSLBP on pain and disability. Data synthesis: Two reviewers assessed the risk of bias of the trials, guided by the Cochrane RoB2 tool. Available data were extracted for meta‐analysis with subgroup analysis. Pilates exercise was compared to general exercise (GE), direction‐specific exercise (DSE) and spinal stabilisation exercise (SSE). Certainty of evidence was interpreted following the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven RCTs were included. A low certainty of evidence supported PE was more effective than GE in pain reduction [Effect size (ES) 0.44]. Moreover, very low levels of certainty were revealed for effectiveness of PE compared with DSE for pain reduction (ES 0.65) and equivalence of PE and SSE for pain and disability. Conclusions: This review found no strong evidence for using one type of exercise intervention over another when managing patients with CNSLBP. Existing evidence does not allow this review to draw definitive recommendations. In the absence of a superior exercise form clinicians should work collaboratively with the patient, using the individual's goals and preferences to guide exercise selection. Further appropriately designed research is warranted to explore this topic further. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine what factors make people with Parkinson's disease more susceptible to stereotype threat (i.e., the concern of being evaluated in line with negative group‐based stereotypes) and the clinical consequences of this. Method: Forty‐nine people with Parkinson's disease completed a measure of stereotype threat, as well as measures that indexed potential antecedents and clinical consequences of stereotype threat. Results: Younger age and greater communication difficulties emerged as significant predictors of stereotype threat. Higher stereotype threat was also associated with increased emotional distress. Conclusions: These findings are an important first step in understanding stereotype threat in Parkinson's disease and may help to guide the development of intervention and educational efforts aimed at countering its effects. [ABSTRACT FROM AUTHOR]

Background: For many people with Parkinson's disease (PWPD), the long‐term maintenance of speech following intensive treatment remains elusive. PD Check‐In, a model for supported self‐managed maintenance of speech following LSVT LOUD®, was developed and evaluated. Aims: To evaluate the impact of PD Check‐In on vocal intensity and level of satisfaction of PWPD and their communication partners (CPs) over 24 months following LSVT LOUD. Methods & Procedures: A repeated‐measures study design examined the impact of PD Check‐In on the speech of 16 PWPD. Participants received LSVT LOUD followed by PD Check‐In at 6 and 12 weeks, and 6, 12 and 24 months after treatment. Outcome measures included acoustic measures of vocal intensity (sound pressure level–SPL) during sustained phonation, functional phrases, reading, and monologue, and satisfaction questionnaires for PWPD and their CPs. Outcomes & Results: A significant treatment effect for time (p < 0.01) was identified for all SPL variables. Planned comparisons showed significant improvements for each variable pre‐ to post‐LSVT LOUD. There was a significant maintenance effect for SPL maximum sustained phonation only, post‐LSVT LOUD to 24 months. SPL remained significantly above baseline for functional phrases and maximum sustained phonation at 24 months. Participants' satisfaction with PD Check‐In was high, at 93.75% for PWPD and 79.99% for CPs, at 24 months post‐treatment. Long intervals between appointments led PWPD to feel less motivated about speech practice but more confident in self‐management. Conclusions & Implications: For PWPD and CPs, maintenance of speech following LSVT LOUD encompasses more than acoustic outcomes. WHAT THIS PAPER ADDS: What is already known on this subject?: Maintenance of speech following LSVT LOUD has been shown to be variable in individual and group models. For PWPD and their CPs, a model for speech maintenance supports their expectation of sustained treatment effect over time and meets their changing needs for speech and language therapy services. Supported self‐management is a model under investigation for long‐term maintenance of speech. What this paper adds to existing knowledge?: This study presents the impact of five individual PD Check‐In interventions on the maintenance of vocal intensity (SPL) of 16 PWPD over 24 months following LSVT LOUD. PWPD and CPs reported a high level of satisfaction with PD Check‐In independent of acoustic outcomes. What are the potential or actual clinical implications of this work?: Participant satisfaction with PD Check‐In is derived from multiple factors and not limited to acoustic outcomes post‐LSVT LOUD. Further investigation of the efficacy of PD Check‐In to support the perceived maintenance of speech of PWPD and CPs is warranted. [ABSTRACT FROM AUTHOR]

Nelotanserin is a serotonin 2A and 2C (5-HT 2A/2C ) inverse agonist that was previously tested in the clinic for rapid-eye movement sleep behaviour disorder and psychosis in patients with Parkinson's disease (PD) dementia. Its effect on L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesia has however not been investigated. As 5-HT 2A antagonism/inverse agonism is a validated approach to alleviate dyskinesia, we undertook the current study to evaluate the anti-dyskinetic potential of nelotanserin in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmoset. Parkinsonism was induced in six common marmosets (Callithrix jacchus, three females and three males) that were then chronically treated with L-DOPA to induce dyskinesia. On experimental days, they were administered L-DOPA in combination with vehicle or nelotanserin (0.1, 0.3 and 1 mg/kg) subcutaneously, in a randomised fashion. Dyskinesia and parkinsonism were rated post hoc by a blinded observer. In comparison to vehicle, the addition of nelotanserin 0.3 and 1 mg/kg to L-DOPA diminished peak dose dyskinesia by 47% (P < 0.05) and 69% (P < 0.001). Nelotanserin 0.3 and 1 mg/kg also reduced the severity of global dyskinesia, by 40% (P < 0.01) and 55% (P < 0.001), when compared to vehicle. Nelotanserin 0.1 mg/kg did not alleviate peak dose or global dyskinesia severity. Nelotanserin had no impact on the anti-parkinsonian action of L-DOPA. Our results highlight that nelotanserin may represent an efficacious anti-dyskinetic drug and provide incremental evidence of the potential benefit of 5-HT 2A/2C antagonism/inverse agonism for drug-induced dyskinesia in PD., (© 2023 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Mild cognitive impairment (MCI) is common in Parkinson's disease (PD), affecting almost all patients with PD at some time. It has been shown that patients with PD, who express subjective cognitive complaints, are at a higher risk of eventually developing PD-MCI. This is corroborated by the Movement Disorders Society's (MDS) diagnostic criteria from 2012 for PD-MCI, from which it follows that a subjective cognitive complaint must be present in addition to objective cognitive impairment for a patient with PD to receive a diagnosis of PD-MCI. Nevertheless, there is currently no standardized measurement available for assessing subjective cognitive complaints. Therefore, this review aims to generate an overview of how subjective cognitive complaints are commonly operationalized in the empirical literature as well as whether they are found to be associated with the level of cognitive impairment. The findings revealed that a broad range of measures has been used to obtain subjective cognitive complaints and that there is little consistency between different studies with regard to how they have obtained these complaints, from whom they had obtained them, how many they have obtained, which types of complaints they have obtained and whether they were associated with cognitive impairment. Given the fact that the presence of subjective cognitive complaints is a requirement for setting a diagnosis, there is a need for more methodological consensus with regard to the measurement hereof., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Low back pain (LBP) is the leading cause of disability worldwide and has an excessive societal burden. Accumulating evidence has shown that some medical approaches such as imaging in absence of clear indications, medication and some invasive treatments may contribute to the problem rather than alleviating it. Objectives: To determine the extent of de‐implementation of non‐evidence‐based hospital treatments for LBP care in the Netherlands in the last three decades. Methods: Using a register‐based population‐level observational study with Dutch hospital data, providing a nearly complete coverage of hospital admissions in the Netherlands in 1991–2018, we assessed five frequently applied non‐evidence‐based hospital treatments for LBP. Time trends in treatment use (absolute and per 100,000 inhabitants) were plotted and analysed using Poisson regression. Results: The use of bed rest for non‐specific LBP and hernia nuclei pulposi, and discectomy for spinal stenosis decreased 91%, 81% and 86% since the availability of evidence/guidelines, respectively. De‐implementation, beyond 84%, was reached after 18 and 17 years for bed rest for non‐specific LBP and discectomy respectively, while it was not reached after 28 years for bed rest for hernia nuclei pulposi. For spinal fusion and invasive pain treatment, there was an initial increase followed by a reduction. Overall, these treatments reduced by 85% and 75%, respectively. Conclusions: In the Netherlands, de‐implementation of five non‐recommended hospital LBP treatments, if at all, took several decades. Although de‐implementation was substantial, slow de‐implementation has likely resulted in considerable waste of resources and avoidable harm to many patients in Dutch hospitals. Significance: Medically intensive approaches to low‐back pain care contribute to the high societal burden of this disease. There have been calls to avoid such care. Using Dutch hospital data, we showed that de‐implementation of five non‐recommended hospital low‐back pain treatments, if at all, took several decades (i.e. ≥17 years) after availability of evidence and guidelines. Slow de‐implementation has likely resulted in considerable waste of resources and avoidable harm to hospital patients; better ways for de‐implementation of non‐evidence‐based care are needed. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is one of the most important contributors to neonatal mortality and morbidity. Experiencing stress during pregnancy may increase the risk of adverse birth outcomes, including preterm birth. This association has been observed in previous studies, but differences in measures used limit comparability. Objective: The objective of the study was to investigate the association between two measures of maternal stress during pregnancy, life stress and emotional distress, and gestation duration. Methods: Women recruited in the Danish National Birth Cohort from 1996 to 2002, who provided information on their stress level during pregnancy and expecting a singleton baby, were included in the study. We assessed the associations between the level of life stress and emotional distress in quartiles, both collected at 31 weeks of pregnancy on average, and the rate of giving birth using Cox regression within intervals of the gestational period. Results: A total of 80,991 pregnancies were included. Women reporting moderate or high levels of life stress vs no stress had a higher rate of giving birth earlier within all intervals of gestational age (e.g. high level: 27–33 weeks: hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.04, 1.84; 34–36 weeks: 1.10, 95% CI 0.97, 1.25; 37–38 weeks: 1.21, 95% CI 1.15, 1.28). These associations between life stress and preterm birth were mainly driven by pregnancy worries. For emotional distress, a high level of distress was associated with shorter length of gestation in the preterm (27–33 weeks: 1.38, 95% CI 1.02, 1.86; 34–36 weeks: 1.05, 95% CI 0.91, 1.19) and early term (1.11, 95% CI 1.04, 1.17) intervals. Conclusions: Emotional distress and life stress were shown to be associated with gestational age at birth, with pregnancy‐related stress being the single stressor driving the association. This suggests that reverse causality may, at least in parts, explain the earlier findings of stress as a risk factor for preterm birth. [ABSTRACT FROM AUTHOR]

Objectives: This study was planned to evaluate the effectiveness of game‐based core exercises in children diagnosed with non‐neuropathic bladder dysfunction and compare this effectiveness to that of the biofeedback treatment method. Methods: The study included 48 children, aged 6–13 years, who were diagnosed with non‐neuropathic bladder dysfunction. The children satisfying the inclusion criteria were selected by drawing lots from the population with the method of nonprobability random sampling. The patients were divided into three groups: group I, "game‐based core stabilization exercise training"; group II, "biofeedback program"; and group III, "game‐based core stabilization exercise training in addition to the biofeedback program." The Dysfunctional Voiding and Incontinence Symptom Scale (DVISS) scores and uroflowmetry values of the patients were evaluated before and after the treatment. Results: The mean age of the participants was 8.81 ± 2.08 years. There was a statistically significant difference between the pretreatment and post‐treatment DVISS scores in all three groups (p <.05). However, no significant difference was found among the groups. There was no statistically significant difference in the uroflowmetry results of the patients in group I and II before and after the treatment. In group III, the time to maximum flow rate after treatment was significantly reduced, and the average flow rate was significantly increased. Conclusions: According to the results of this study, the use of game‐based exercises along with biofeedback treatment may reduce DVISS scores in children with non‐neuropathic bladder dysfunction. A combination of the two methods may have positively affected the uroflowmetry results of the patients. We think that game‐based exercises will contribute to the literature as a new treatment option in the treatment of non‐neuropathic bladder dysfunction. [ABSTRACT FROM AUTHOR]