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Digital games cannot only be used for fun and entertainment. The term 'serious games' (SG) denotes digital games serving serious purposes like education, training, advertising, research and health. Recently, a new generation of games has emerged involving whole-body movements. Compared to traditional interventions, these games may help elderly people to improve their health by enhancing physical fitness and coordinative abilities by combining increased motivation, game experience like fun and game flow and training. Serious games, particularly adventure and shooter games, already play an important role in health education, prevention and rehabilitation, e.g. to enhance health-related physical activity, improve sensory-motor coordination, prevent asthma, change nutrition behaviour and alleviate diabetes and prevent smoking or HIV. In this paper, the impact of SG on prevention and rehabilitation is discussed. Three criteria are applied. Beyond effectivity and efficiency, the additional benefits of serious games can be described and explained by different models including social, psychological, physiological and sensory-motor factors. The quality of study serves as a third criterion. Despite first promising results, there are only few high-quality studies. Adequate content, game interfaces, sustainability and appropriate settings are critical factors for the success of SG. In this regard, (sport) science can help to develop and evaluate SG and test appropriate settings that ensure sustainable use of serious games. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this prospective study were to identify, in vitamin K antagonist (VKA)-treated patients, factors associated with INR values: (i) greater than 6.0. and (ii) ranging from 4.0 to 6.0 complicated with bleeding. We also assessed VKA-related morbidity in these patients.Methods: During a 6-month period, 3090 consecutive patients were referred to our Department of Internal Medicine, including 412 VKA-treated patients. At admission, the medical records of VKA-treated patients were reviewed for type, duration and indication of VKA therapy, previous medical history of VKA-related hemorrhage, comorbidities and concomitant medications.Results: Forty of the 412 VKA-treated patients (9.7%) exhibited oral anticoagulant related overcoagulation. VKA overcoagulation was associated with high morbidity, leading to major bleeding in 27.5% of cases; moreover, 12.5% of these patients died, death being mainly due to major bleeding. Under multivariate analysis, significant factors for VKA-related overcoagulation were as follows: previous medical history of VKA therapy-related hemorrhage (P = 0.00001) and INR levels over therapeutic range (P = 0.0006), chronic liver disease (P = 0.03), therapy with amiodarone (P = 0.009); in contrast, statin therapy was found to be a protective factor of VKA overcoagulation (P = 0.008).Conclusion: The knowledge of predictive factors of VKA-related overcoagulation seems of utmost importance to improve patients’ management. Our study underlines the fact that the potential of drug interaction should be taken into account when choosing amiodarone for patients receiving VKAs. Interestingly, long-term (>6 month) statin therapy may be a protective factor of VKA overcoagulation. Our findings, therefore, suggest that there may be no need to switch long-term users of VKA and statin to a safer alternative therapy. [ABSTRACT FROM PUBLISHER]

Objective: The aim of this study was to evaluate the efficiency of a short-term Intermittent Work Exercise Program (IWEP) among healthy elderly subjects. Study design and setting: This longitudinal prospective study took place at the Strasbourg University Hospital geriatric department. Study participants: One hundred and fifty older volunteers, previously determined as being free from cardiac and pulmonary disease, were separated into two age groups: the 'young senior' (60.2 ± 3.1 yr) and the 'older senior' groups (70.8 ± 5.2 yr).These groups were then subdivided by gender into the 'young female senior', 'young male senior' 'older female senior' and 'older male senior' groups. Intervention: Before and after the IWEP, all subjects were asked to perform an incremental cycle exercise to obtain their first ventilatory threshold (VT), maximal tolerated power (MTP), peak oxygen uptake (VO) and maximal minute ventilation (MMV). The IWEP consisted of a 30-min cycling exercise which took place twice a week, and was divided into six 5-min stages consisting of 4 min at VT intensity and 1 min at 90% MTP. Measurements: An assessment was made of the effects of the IWEP on maximal cardio-respiratory function (MTP, VO, MMV) and endurance parameters (VT, heart rate [HR] measured at pretraining VT and lactate concentrations at pre-training MTP). Results: This short-term training program resulted in a significant increase of MTP (from 13.2% to 20.6%), VO (from 8.9% to 16.6%) and MMV (from 11.1% to 21.8%) in all groups (p<0.05). VT1 improved from 21% at pretraining to 27%, while HR at pre-training VT1 as well as lactate concentrations at pre-training MTP decreased significantly in all groups (p<0.05). The post-training values for VO and MMV of the 'older seniors' were not significantly different (p>0.05) from the 'young seniors' pre-training values for the same parameters. Conclusion: The most striking finding in this study is that after only 9 weeks, our short-term 'individually-tailored' IWEP significantly improved both maximal cardio-respiratory function and endurance parameters in healthy, previously untrained seniors. [ABSTRACT FROM AUTHOR]

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Alzheimer’s disease is a global, epidemic problem affecting mainly older adults with tremendous social and financial burdens. Older adults with Alzheimer’s disease showed reduced physical activity and cognitive changes that are probably amenable to aerobic exercise training. The purpose of this paper is to develop a conceptual model to guide future aerobic exercise research and practice by synthesizing the current state of the science on aerobic exercise training in older adults with AD. The literature review found 12 qualified studies that met the eligibility criteria for inclusion in this review and revealed six constructs (aerobic exercise training, physical fitness, physical performance, activities of daily living limitations, cognition, and psychological and behavioral symptoms), which composed the Functional Impact of aerobic exercise Training in Alzheimer’s disease (FIT-AD) model. The state of science on each construct in older adults with Alzheimer’s disease is reviewed and summarized. The emerging evidence suggests that aerobic exercise training might positively impacts all five other constructs. The implications of the FIT-AD model for future research and practice are discussed highlighted [ABSTRACT FROM PUBLISHER]

Background and Aims The amount of DNA in an unreplicated gametic chromosome complement is known as the C-value and is a key biodiversity character of fundamental significance with many practical and predictive uses. Since 1976, Bennett and colleagues have assembled eight compilations of angiosperm C-values for reference purposes and subsequently these have been pooled into the Angiosperm DNA C-values Database (http://data.kew.org/cvalues/). Since the last compilation was published in 2005, a large amount of data on angiosperm genome size has been published. It is therefore timely to bring these data together into a ninth compilation of DNA amounts. Scope The present work lists DNA C-values for 2221 species from 151 original sources (including first values for 1860 species not listed in previous compilations). Combining these data with those published previously shows that C-values are now available for 6287 angiosperm species. Key Findings Analysis of the dataset, which is by far the largest of the nine compilations published since 1976, shows that angiosperm C-values are now being generated at the highest rate since the first genome sizes were estimated in the 1950s. The compilation includes new record holders for the smallest (1C = 0·0648 pg in Genlisea margaretae) and largest (1C = 152·23 pg in Paris japonica) genome sizes so far reported, extending the range encountered in angiosperms to nearly 2400-fold. A review of progress in meeting targets set at the Plant Genome Size meetings shows that although representation for genera, geographical regions and some plant life forms (e.g. island floras and parasitic plants) has improved, progress to increase familial representation is still slow. In terms of technique it is now clear that flow cytometry is soon likely to become the only method available for plant genome size estimations. Fortunately, this has been accompanied by numerous careful studies to improve the quality of data generated using this technique (e.g. design of new buffers, increased awareness and understanding of problems caused by cytosolic inhibitors). It is also clear that although the speed of DNA sequencing continues to rise dramatically with the advent of next-generation and third-generation sequencing technologies, ‘complete genome sequencing’ projects are still unable to generate accurate plant genome size estimates. [ABSTRACT FROM AUTHOR]

Background: Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emis­sions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. Objective: We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks. data sources and extraction: We have summarized the literature for air pollution, traffic acci­dents, and physical activity using systematic reviews supplemented with recent key studies. data synthesis: We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3-14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8-40 days lost) and the increase in traffic accidents (5-9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents. conclusions: On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity can improve people's overall health and contribute to both primary and secondary prevention of many chronic diseases and conditions including diabetes. The aim of this study was to examine the association between levels of physical activity and optimal self-rated health (SRH) of U.S. adults with and without diabetes in all 50 states and territories of the Unites States.Methods: We estimated the prevalence of optimal SRH by diabetes status of 430,912 adults aged 18 years and older who participated in the 2007 state-based survey of the Behavioral Risk Factor Surveillance System (BRFSS). Prevalence ratios were produced with multivariate Cox regression models using levels of physical activity as a predictor and status of optimal SRH as an outcome variable while controlling for sociodemographic and behavioral health risk factors.Results: The prevalence of reporting optimal SRH was 53.3%, 52.2%, and 86.2% for adults with type 1 diabetes, type 2 diabetes, and without diabetes, respectively. Also in the aforementioned order, adults who reported being active had an increased likelihood of 81%, 32%, and 18% for reporting optimal SRH, when compared with adults who reported being inactive.Conclusions: Regular physical activity of adults, particularly adults with diabetes, is associated with optimal SRH. The findings of this study underscore the importance of advising and motivating adults with diabetes so that physical activity can be integrated into their lifestyle for diabetes care. Additionally, a population-based effort to promote physical activity in communities may benefit adults in general by improving their overall health and well-being. [ABSTRACT FROM AUTHOR]

1. This study investigates the mechanistic and ecological basis of phenotypic sorting in the sociable weaver Philetairus socius (Latham). In this colonially and communally breeding African bird, morphology, condition, age-specific survival rates and reproductive investment vary with colony size. 2. This variation might arise from non-adaptive constraints imposed by density dependence, or from adaptive life-history responses to colony size-dependent selection pressures. To attempt to distinguish these, the environments in which adults made reproductive decisions and in which offspring developed were manipulated. 3. When food supplementation improved the pre-breeding environment of adults, they bred earlier but did not change investment in eggs or incubation. 4. Nestling and subsequent adult phenotypes were unaffected by supplementary feeding, although post-fledging survival improved. Nestling origin and not rearing environment predicted phenotype in a cross-fostering experiment between colonies. 5. Phenotypic differences among colonies hence seemed not to be plastic responses to resource availability. Life-history differentiation, mediated either genetically or maternally, might have taken place over relatively narrow temporal and spatial scales. 6. Adaptive variation in reproductive investment could thus mitigate costs of large colony size, by reducing costs of reproduction and hence improving adult survival. If so, then fine-scale life-history adjustment could help to maintain stable variation in colony size. [ABSTRACT FROM AUTHOR]

Damage evolution inside compression-loaded laminates is a crucial aspect when designing crash structures. In this study, ex situ CT scanning is used to identify damage evolution in multidirectional composite laminates. Multiple CT scans throughout the stress–strain envelope are used to quantify the internal damage and failure propagation of a [45, −45, 90]s carbon fiber laminate. Initially, observed damage occurs in form of delamination between the −45° and 90° layers. Afterward, shear failure propagates from the central layers throughout the entire laminate. Shear failure in the middle two layers expands after continued loading up to double shear failure. The same distinct failure sequence is observed in multiple specimens, and the small deviation supports consistency. Furthermore, the stress–strain envelope of the successive load cycles matches closely with reference measurements. [ABSTRACT FROM AUTHOR]

Freeze foaming is a method to manufacture cellular ceramic scaffolds with a hierarchical porous structure. These so-called freeze foams are predestined for the use as bone replacement material because of their internal bone-like structure and biocompatibility. On the one hand, they consist of macrostructural foam cells which are formed by the expansion of gas inside the starting suspension. On the other hand, a porous microstructure inside the foam struts is formed during freezing and subsequent freeze drying of the foamed suspension. The aim of this work is to investigate for the first time the formation of macrostructure and microstructure separately depending on the composition of the suspension and the pressure reduction rate, by means of appropriate characterization methods for the different pore size ranges. Moreover, the foaming behavior itself was characterized by in-situ radiographical and computed tomography (CT) evaluation. As a result, it could be shown that it is possible to tune the macro- and microstructure separately with porosities of 49–74% related to the foam cells and 10–37% inside the struts. [ABSTRACT FROM AUTHOR]

The European Dementia Consensus Network (EDCON) is a special project of the Madariaga Foundation located in Brussels. The Madariaga Foundation seeks to facilitate collaboration between European countries and between the public and private sector. This paper will review the differences in the definitions of Severe Dementia and summarise the EDCON consensus on their implications for management. EDCON recommends that: - The attributes of the person suffering from dementia should be given as much attention (and are as important for care) as the severity of cognitive decline in dementia; - The dementia syndrome (particularly in it's severe form) is inadequately defined by criteria which only includes the domain of cognition; - Physical, legal, social and cultural factors defining the environment of patients and their families should be carefully examined and that the results of this examination should be used in conjunction with the results of the somatic and psychiatric assessment in planning care and placement of the patient; - patients with severe dementia should have access to palliative care; - family members should be included in the care plans for those with severe dementia who are in institutional care. [ABSTRACT FROM AUTHOR]

Colony sizes in birds can vary by orders of magnitude within species, and many studies have shown that selection pressures differ dramatically among small and large colonies. Does such selection result in phenotypic sorting at the level of individuals? This study describes inter-colony differences in morphology and reproductive investment in a population of a highly colonial, communal and sedentary African passerine bird, the sociable weaver Philetairus socius. Relative colony sizes were fairly stable over a 10-year period. Adults differed among colonies in terms of bill morphology, condition, body size and degree of ectoparasite infestation, and the last two declined consistently with colony size. In larger colonies, smaller eggs were laid, and nestlings were more parasite-infested, showed weaker cell-mediated immune responses, and experienced higher levels of brood reduction and snake predation. Taken together with another study showing that adult survival is higher in larger colonies, these results suggest that patterns of age-specific mortality are consistently related to colony size in the sociable weaver. Based on these observations I suggest two hypotheses that might account for the observed phenotypic sorting, involving colony size-dependent patterns in (1) density-dependent competition for food and (2) adaptive life-history adjustment. [ABSTRACT FROM AUTHOR]

VITAMIN B12 OR COBALAMIN DEFICIENCY occurs frequently (> 20%) among elderly people, but it is often unrecognized because the clinical manifestations are subtle; they are also potentially serious, particularly from a neuropsychiatric and hematological perspec-tive. Causes of the deficiency include, most frequently, food-cobalamin malabsorption syndrome (> 60% of all cases), perni-cious anemia (15%--20% of all cases), insufficent dietary intake and malabsorption. Food-cobalamin malabsorption, which has only recently been identified as a significant cause of cobalamin deficiency among elderly people, is characterized by the inability to release cobalamin from food or a deficiency of intestinal cobal-amin transport proteins or both. We review the epidemiology and causes of cobalamin deficiency in elderly people, with an empha-sis on food-cobalamin malabsorption syndrome. We also review diagnostic and management strategies for cobalamin deficiency. [ABSTRACT FROM AUTHOR]

Simple Summary: Glioblastoma multiforme (GBM) and metastatic triple-negative breast cancer (TNBC) with PTEN mutations are associated with brain tumor spreading and poor patient outcomes. GBM, and possibly TNBC, migrate on axons and blood vessels to disseminate in the brain; however, the mechanism is unresolved. There is a need for new therapeutic targets to blunt brain tumor spreading. Using 3D aligned printed microfibers mimicking brain structures proved that RHOB, in addition to ROCK and PTEN signaling, were essential for GBM and TNBC 3D cell migration. GBM and TNBC cell lines with PTEN loss of function and high RHOB expression exhibited amoeboid morphology with increased durotaxis, binding and migration speed on 3D microfibers, in contrast to the PTEN wildtype. Depending on the PTEN genotype, RHO-ROCK-PTEN inhibitors or PTEN rescue significantly regulated these properties. Regarding GBM and brain metastasizing TNBC, we conclude that RHOB inhibitors could play a novel role for improved therapy response and patient outcome. Background: Glioblastoma multiforme (GBM) and metastatic triple-negative breast cancer (TNBC) with PTEN mutations often lead to brain dissemination with poor patient outcome, thus new therapeutic targets are needed. To understand signaling, controlling the dynamics and mechanics of brain tumor cell migration, we implemented GBM and TNBC cell lines and designed 3D aligned microfibers and scaffolds mimicking brain structures. Methods: 3D microfibers and scaffolds were printed using melt electrowriting. GBM and TNBC cell lines with opposing PTEN genotypes were analyzed with RHO-ROCK-PTEN inhibitors and PTEN rescue using live-cell imaging. RNA-sequencing and qPCR of tumor cells in 3D with microfibers were performed, while scanning electron microscopy and confocal microscopy addressed cell morphology. Results: In contrast to the PTEN wildtype, GBM and TNBC cells with PTEN loss of function yielded enhanced durotaxis, topotaxis, adhesion, amoeboid migration on 3D microfibers and significant high RHOB expression. Functional studies concerning RHOB-ROCK-PTEN signaling confirmed the essential role for the above cellular processes. Conclusions: This study demonstrates a significant role of the PTEN genotype and RHOB expression for durotaxis, adhesion and migration dependent on 3D. GBM and TNBC cells with PTEN loss of function have an affinity for stiff brain structures promoting metastasis. 3D microfibers represent an important tool to model brain metastasizing tumor cells, where RHO-inhibitors could play an essential role for improved therapy. [ABSTRACT FROM AUTHOR]

Various types of internal defects occur during manufacturing and handling of composite materials. It is practically impossible to manufacture composite structures without defects, making it crucial to understand the effect of defects on their failure behavior to maintain structural safety. In this work, the effect of pre-defects on the failure behavior of plain weave textile composites was studied. Unit cell configurations with symmetric, in-phase, and shifted fiber tow arrangements were considered. Inter-laced warp and fill tows and matrix pockets of plain weave unit cells were modeled in three-dimensional finite elements, and cohesive elements were inserted between all bulk elements to account for the fracture modes of the fiber and matrix direction failure of warp and fill tows, matrix pocket failure, and interface failure. Unit cell models containing pre-defects of voids, tow-matrix pocket separation, warp-fill tow separation, and cracks in the warp and fill tows were analyzed, and their effects on progressive failure behavior were investigated in terms of the interaction between fiber tow arrangements and defects. Results indicated that initial failure occurred in matrix-direction failure mode in fill tows, whereas fiber tow-matrix pocket separation was the major failure mode under uniaxial tensile load. Furthermore, failure behavior was found to be highly dependent on the fiber tow arrangement pattern and the location of pre-defects. [ABSTRACT FROM AUTHOR]

Bone marrow malignancies are clonal disorders resulting from neoplastic transformation of hematopoietic stem or progenitor cells. Similar to their normal counterparts, transformed blood-forming cells remain dependent on signals from the hematopoiesis-regulating stromal environment for survival and proliferation. There is increasing evidence that the microenvironment may also take a more active part in the disease process. A review of the literature on stromal abnormalities in the leukemias, the myelodysplastic syndromes, and multiple myeloma reveals three principal mechanisms by which stromal derangements can contribute to the evolution of a neoplastic disease. In the simplest case, neoplastic blood-forming cells induce reversible changes in stroma function or composition which result in improved growth conditions for the malignant cells ('malignancy-induced microenvironment'). In the second setting, functionally abnormal end cells derived from the malignant clone become an integral part of the stroma system, selectively stimulating the neoplastic cells and inhibiting normal blood cell formation ('malignant microenvironment'). In the third condition, the emergence of a neoplastic cell population is the consequence of a primary stroma lesion characterized by inability to control regular blood cell formation ('malignancy-inducing microenvironment'). The perception of different stroma-related disease mechanisms may eventually lead to the development of alternative therapeutic approaches. [ABSTRACT FROM AUTHOR]

Focuses on plasma amino acid concentrations in healthy and malnourished patients. Indepth look at how plasma amino acid concentrations were examined; Determination of plasma samples; Details on results; Conclusions.

The phenomenon of coupling between light and surface plasmon polaritons requires specific momentum matching conditions. In the case of a single scattering object on a metallic surface, such as a nanoparticle or a nanohole, the coupling between a broadband effect, i.e., scattering, and a discrete one, such as surface plasmon excitation, leads to Fano-like resonance lineshapes. The necessary phase matching requirements can be used to engineer the light–plasmon coupling and to achieve a directional plasmonic excitation. Here, we investigate this effect by using a chiral nanotip to excite surface plasmons with a strong spin-dependent azimuthal variation. This effect can be described by a Fano-like interference with a complex coupling factor that can be modified thanks to a symmetry breaking of the nanostructure. [ABSTRACT FROM AUTHOR]

Vitamin B12 is often used to improve cognitive function, depressive symptoms, and fatigue. In most cases, such complaints are not associated with overt vitamin B12 deficiency or advanced neurological disorders and the effectiveness of vitamin B12 supplementation in such cases is uncertain. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to assess the effects of vitamin B12 alone (B12 alone), in addition to vitamin B12 and folic acid with or without vitamin B6 (B complex) on cognitive function, depressive symptoms, and idiopathic fatigue in patients without advanced neurological disorders or overt vitamin B12 deficiency. Medline, Embase, PsycInfo, Cochrane Library, and Scopus were searched. A total of 16 RCTs with 6276 participants were included. Regarding cognitive function outcomes, we found no evidence for an effect of B12 alone or B complex supplementation on any subdomain of cognitive function outcomes. Further, meta-regression showed no significant associations of treatment effects with any of the potential predictors. We also found no overall effect of vitamin supplementation on measures of depression. Further, only one study reported effects on idiopathic fatigue, and therefore, no analysis was possible. Vitamin B12 supplementation is likely ineffective for improving cognitive function and depressive symptoms in patients without advanced neurological disorders. [ABSTRACT FROM AUTHOR]

We aimed to determine the short- and medium-term effects of a multimodal physical exercise program (MPEP) on bone health status, fall risk, balance, and gait in patients with Alzheimer's disease. A single-blinded, controlled clinical trial was performed where 72 subjects were allocated in a 3:1 ratio to an intervention group (IG; n = 53) and control group (CG; n = 19), where the IG's subjects were admitted to live in a State Reference Center of Alzheimer's disease, which offers the targeted exercise program, while the CG's subjects resided in independent living. A multidisciplinary health team assessed all patients before allocation, and dependent outcomes were again assessed at one, three, and six months. During the study, falls were recorded, and in all evaluations, bone mineral density was measured using a calcaneal quantitative ultrasound densitometer; balance and gait were measured using the performance-oriented mobility assessment (POMA), the timed up and go test (TUG), the one-leg balance test (OLB), and the functional reach test (FR). There were no differences between groups at baseline for all outcome measures. The prevalence of falls was significantly lower in the IG (15.09%) than in the CG (42.11%) (χ2 = 5.904; p = 0.015). We also found that there was a significant time*group interaction, with a post hoc Šidák test finding significant differences of improved physical function, especially in gait, for the IG, as assessed by POMA-Total, POMA-Gait, and TUG with a large effect size (ƞ2p = 0.185–0.201). In balance, we found significant differences between groups, regardless of time, and a medium effect size as assessed by POMA-Balance and the OLB (ƞ2p = 0.091–0.104). Clinically relevant effects were observed, although without significant differences in bone health, with a slowing of bone loss. These results show that a multimodal physical exercise program reduces fall risk and produces an improvement in gait, balance, and bone mineral density in the short and medium term in institutionalized patients with Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Physical activity measures derived from wearable accelerometers have been shown to be highly predictive of all-cause mortality. Prediction models based on traditional risk factors and accelerometry-derived physical activity measures are developed for five time horizons. The data set contains 2978 study participants between 50 and 85 years old with an average of 13.08 years of follow-up in the NHANES 2003–2004 and 2005–2006. Univariate and multivariate logistic regression models were fit separately for five datasets for one- to five-year all-cause mortality as outcome (number of events 46, 94, 155, 218, and 297, respectively). In univariate models the total activity count (TAC) was ranked first in all five horizons (AUC between 0.831 and 0.774) while the active to sedentary transition probability (ASTP) was ranked second for one- to four-year mortality models and fourth for the five-year all-cause mortality model (AUC between 0.825 and 0.735). In multivariate models age and ASTP were significant in all one- to five-year all-cause mortality prediction models. Physical activity measures are consistently among the top predictors, even after adjusting for demographic and lifestyle variables. Physical activity measures are strong stand-alone predictors and substantially improve the prediction performance of models based on traditional risk factors. [ABSTRACT FROM AUTHOR]

Epilepsies are common chronic neurological diseases characterized by recurrent unprovoked seizures of central origin. The mainstay of treatment involves symptomatic suppression of seizures with systemically applied antiseizure drugs (ASDs). Systemic pharmacotherapies for epilepsies are facing two main challenges. First, adverse effects from (often life-long) systemic drug treatment are common, and second, about one-third of patients with epilepsy have seizures refractory to systemic pharmacotherapy. Especially the drug resistance in epilepsies remains an unmet clinical need despite the recent introduction of new ASDs. Apart from other hypotheses, epilepsy-induced alterations of the blood–brain barrier (BBB) are thought to prevent ASDs from entering the brain parenchyma in necessary amounts, thereby being involved in causing drug-resistant epilepsy. Although an invasive procedure, bypassing the BBB by targeted intracranial drug delivery is an attractive approach to circumvent BBB-associated drug resistance mechanisms and to lower the risk of systemic and neurologic adverse effects. Additionally, it offers the possibility of reaching higher local drug concentrations in appropriate target regions while minimizing them in other brain or peripheral areas, as well as using otherwise toxic drugs not suitable for systemic administration. In our review, we give an overview of experimental and clinical studies conducted on direct intracranial drug delivery in epilepsies. We also discuss challenges associated with intracranial pharmacotherapy for epilepsies. [ABSTRACT FROM AUTHOR]

Situations involving competition for resources among entities can be modeled by the competitive multi-armed bandit (CMAB) problem, which relates to social issues such as maximizing the total outcome and achieving the fairest resource repartition among individuals. In these respects, the intrinsic randomness and global properties of quantum states provide ideal tools for obtaining optimal solutions to this problem. Based on the previous study of the CMAB problem in the two-arm, two-player case, this paper presents the theoretical principles necessary to find polarization-entangled N-photon states that can optimize the total resource output while ensuring equality among players. These principles were applied to two-, three-, four-, and five-player cases by using numerical simulations to reproduce realistic configurations and find the best strategies to overcome potential misalignment between the polarization measurement systems of the players. Although a general formula for the N-player case is not presented here, general derivation rules and a verification algorithm are proposed. This report demonstrates the potential usability of quantum states in collective decision making with limited, probabilistic resources, which could serve as a first step toward quantum-based resource allocation systems. [ABSTRACT FROM AUTHOR]

The absence of sufficient knowledge of the heterogeneous damage behaviour of textile reinforced composites, especially under combined in-plane and out-of-plane loadings, requires the development of multi-scale experimental and numerical methods. In the scope of this paper, three different types of plain weave fabrics with increasing areal weight were considered to characterise the influence of ondulation and nesting effects on the damage behaviour. Therefore an advanced new biaxial testing method has been elaborated to experimentally determine the fracture resistance at the combined biaxial loads. Methods in image processing of the acquired in-situ CT data and micrographs have been utilised to obtain profound knowledge of the textile geometry and the distribution of the fibre volume content of each type. Combining the derived data of the idealised geometry with a numerical multi-scale approach was sufficient to determine the fracture resistances of predefined uniaxial and biaxial load paths. Thereby, Cuntze's three-dimensional failure mode concept was incorporated to predict damage and failure. The embedded element method was used to obtain a structured mesh of the complex textile geometries. The usage of statistical and visualisation methods contributed to a profound comprehension of the ondulation and nesting effects. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a progressive neurodegenerative disorder brought about due to dopaminergic neuronal cell loss in the midbrain substantia nigra pars compacta region. PD presents most commonly in older adults and is a disorder of both motor and nonmotor dysfunction. The novel SARS-CoV-2 virus is responsible for the recent COVID-19 pandemic, and older individuals, those with preexisting medical conditions, or both have an increased risk of developing COVID-19 with more severe outcomes. People-with-Parkinson's (PwP) of advanced age can have both immune and autonomic nervous problems that potentially lead to pre-existing pulmonary dysfunction and higher infection risk, increasing the probability of contracting COVID-19. A lifestyle change involving moderate-intensity exercise has the potential to protect against SARS-CoV-2 through strengthening the immune system. In addition to a potential protective measure against SARS-CoV-2, exercise has been shown to improve quality-of-life (QoL) in PD patients. Recent studies provide evidence of exercise as both neuroprotective and neuroplastic. This article is a literature review investigating the role exercise plays in modifying the immune system, improving health outcomes in PwP, and potentially acting as a protective measure against SARS-Cov-2 infection. We conclude that exercise, when correctly performed, improves QoL and outcomes in PwP, and that the enhanced immune response from moderate-intensity exercise could potentially offer additional protection against COVID-19. [ABSTRACT FROM AUTHOR]

Walking is the most common, environment-friendly, and inexpensive type of physical activity. To perform in-depth walkability analysis, one option is to objectively evaluate different aspects of built environment related to walkability. In this study, we proposed a computational framework for walkability measurement using open data. Three major steps of this framework include the web scrapping of publicly available online data, determining varying weights of variables, and generating a synthetic walkability index. The results suggest three major conclusions. First, the proposed framework provides an explicit mechanism for walkability measurement. Second, the synthetic walkability index from this framework is comparable to Walk Score, and it tends to have a slightly higher sensitivity, especially in highly walkable areas in urban core. Third, this framework was effectively applied in a metropolitan area that contains three small cities that together represent a small, old shrinking region, which extends the topical area in the literature. This framework has the potential to quantify walkability in any city, especially cities with a small population where walkability has rarely been studied, or those having no quantification indicator. For such areas, researchers can calculate the synthetic walkability index based on this framework, to assist urban planners, community leaders, health officials, and policymakers in their practices to improve the walking environment of their communities. [ABSTRACT FROM AUTHOR]

Background: Neighbourhood environments influence older adults' health and health-enhancing behaviours, such as physical activity, eating a healthy diet and socialising. However, little is known about the effects of the neighbourhood environment on the health of older immigrants, the number of which is rapidly increasing in developed countries. Using Nominal Group Technique (NGT) sessions, this study of older Chinese immigrants to urban Melbourne, Australia, examined built and social environmental facilitators of and barriers to regular engagement in physical activity, eating a healthy diet and regular contact with other people. Methods: Participants were recruited from four types of neighbourhoods stratified by walkability and proportion of Chinese dwellers. Twelve NGTs, four specific to each of physical activity, healthy diet and social contacts were conducted in Mandarin or Cantonese (91 participants). NGT responses from groups addressing the same questions were aggregated, similar items were combined, and scores combined across groups. Inductive thematic analysis was used to categorise answers into higher-order themes of factors associated with each behaviour. Results: For physical activity, 29 facilitators and 28 barriers were generated with the highest ranked facilitator and barrier being "proximity to destinations" and "poor/inadequate public transport", respectively. For healthy diet, 25 facilitators and 25 barriers were generated, the highest ranked facilitator and barrier were "high food safety standards/regulations" and "lack of family/household members' social support for a healthy diet". The social contacts NGTs generated 23 facilitators and 22 barriers, with the highest ranked facilitator and barrier being "proximity to destinations and activities" and "poor public transport", respectively. Discussion: Independent living arrangements and the accessibility of destinations of daily living (e.g., bilingual health services, libraries, places of worship and grocery stores / supermarkets), recreational facilities, affordable public transport, and community centres and activities for Chinese people are key elements for promoting regular engagement in physical activity, healthy eating and socialising in older Chinese immigrants. Governments should plan for the provision of this basic infrastructure of community facilities for older immigrants. [ABSTRACT FROM AUTHOR]

Background: The palliative care unit is an emotionally challenging place where patients and their families may feel at loss. Art can allow the expression of complex feelings. We aimed to examine how cancer patients hospitalized in the palliative care unit experienced a musical intervention. Methods: We conducted a qualitative study based on semi-structured interviews. The study took place in a palliative care unit from 18 January 2017 to 17 May 2017. Two artists performed in the palliative care unit once a week from 9:30 am to 5:30 pm. The data from patient interviews were analysed based on an inductive approach to the verbatim accounts. Results: The accounts we gathered led us to weigh the positive emotions engendered by this musical intervention against the potential difficulties encountered. The artists opened a parenthesis in the care process and brought joy and well-being to the palliative care unit. Patients also encountered difficulties during the intervention: reference to an altered general state, to loss of autonomy; a sense of the effort required, of fatigue; an adaptation period; reference to the end of life, to death; a difficulty in choosing songs. Conclusions: Although music appeared to benefit the patients, it sometimes reminded them of their altered state. The difficulties experienced by patients during the experience were also related to physical exhaustion. Additional studies are needed to determine the benefits of music for patients and their families in the palliative care unit. [ABSTRACT FROM AUTHOR]

The mechanistic target of rapamycin (mTOR) is an evolutionarily conserved protein kinase that regulates growth and metabolism. mTOR is found in two protein complexes, mTORC1 and mTORC2, that have distinct components and substrates and are both inhibited by rapamycin, a macrolide drug that robustly extends lifespan in multiple species including worms and mice. Although the beneficial effect of rapamycin on longevity is generally attributed to reduced mTORC1 signaling, disruption of mTORC2 signaling can also influence the longevity of worms, either positively or negatively depending on the temperature and food source. Here, we show that loss of hypothalamic mTORC2 signaling in mice decreases activity level, increases the set point for adiposity, and renders the animals susceptible to diet‐induced obesity. Hypothalamic mTORC2 signaling normally increases with age, and mice lacking this pathway display higher fat mass and impaired glucose homeostasis throughout life, become more frail with age, and have decreased overall survival. We conclude that hypothalamic mTORC2 is essential for the normal metabolic health, fitness, and lifespan of mice. Our results have implications for the use of mTORC2‐inhibiting pharmaceuticals in the treatment of brain cancer and diseases of aging. [ABSTRACT FROM AUTHOR]

We assessed the effects of a 16-week primary-care-based exercise program on body composition in perimenopausal women. The women (n = 150) were randomized into control (n = 75) or exercise (n = 75) groups. Exercise was provided in a 16-week (60 min/session, 3 days/week) concurrent program. Body composition was measured using dual-energy X-ray absorptiometry. These are secondary analyses of the FLAMENCO Project (Clinical Trials Reference NCT02358109). In the intention-to-treat analyses, the control group showed no changes in body mass index (BMI) between post- and pre-test, whereas the exercise group showed a 0.75 kg/m2 decrease in BMI (95% CI: −1.29 to −0.22; p = 0.006). Gynoid and android fat mass in control group decreased by 98.3 g and 46.1 g after the 16 weeks, whereas they decreased by 213 g and 139 g in the exercise group, respectively (95% CI: −209 to −3.86; p = 0.042 and 95% CI: −164 to −26.9; p = 0.007, respectively). The control group decreased their pelvis bone mineral content by 2.85 g in the post-test compared with the pre-test, whereas the exercise group increased it by 1.13 g (95% CI: 0.93 to 7.81; p = 0.013). Per-protocol analyses showed similar results. These analyses suggest that the exercise intervention decreased fat depositions and BMI. Exercise might improve bone mineral content in specific areas such as the pelvis. [ABSTRACT FROM AUTHOR]

Nitrogen-vacancy (NV) centres in diamond hold promise in quantum sensing applications. A major interest in them is an enhancement of their sensitivity by the extension of the coherence time (T2). In this report, we experimentally generated more than four dressed states in a single NV centre in diamond based on Autler-Townes splitting (ATS). We also observed the extension of the coherence time to T2 ~ 1.5 ms which is more than two orders of magnitude longer than that of the undressed states. As an example of a quantum application using these results we propose a protocol of quantum sensing, which shows more than an order of magnitude enhancement in the sensitivity. [ABSTRACT FROM AUTHOR]

We present an experimental illustration on the quantum sensitivity of decision making machinery. In the decision making process, we consider the role of available information, say hint, whether it influences the optimal choices. To the end, we consider a machinery method of decision making in a probabilistic way. Our main result shows that in decision making process our quantum machine is more highly sensitive than its classical counterpart to the hints we categorize into "good" and "poor". This quantum feature originates from the quantum superposition involved in the decision making process. We also show that the quantum sensitivity persists before the quantum superposition is completely destroyed. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is pathologically characterized by the accumulation of amyloid-β (Aβ) plaques, neurofibrillary tangles and widespread neuronal loss in the brain. In recent years, blood biomarkers have emerged as a realistic prospect to highlight accumulating pathology for secondary prevention trials. Neurofilament light chain (NfL), a marker of axonal degeneration, is robustly elevated in the blood of many neurological and neurodegenerative conditions, including AD. A strong relationship with cerebrospinal fluid (CSF) NfL suggests that these biomarker modalities reflect the same pathological process. Yet, the connection between blood NfL and brain tissue pathology has not been directly compared. In this study, longitudinal plasma NfL from cognitively healthy controls (n = 12) and AD participants (n = 57) were quantified by the Simoa platform. On reaching post-mortem, neuropathological assessment was performed on all participants, with additional frozen and paraffin-embedded tissue acquired from 26 participants for further biochemical (Aβ1–42, Aβ1–40, tau) and histological (NfL) evaluation. Plasma NfL concentrations were significantly increased in AD and correlated with cognitive decline, independent of age. Retrospective stratification based on Braak staging revealed that baseline plasma NfL concentrations were associated with higher neurofibrillary tangle pathology at post-mortem. Longitudinal increases in plasma NfL were observed in all Braak groupings; a significant negative association, however, was found between plasma NfL at time point 1 and both its rate of change and annual percentage increase. Immunohistochemical evaluation of NfL in the medial temporal gyrus (MTG) demonstrated an inverse relationship between Braak stages and NfL staining. Importantly, a significant negative correlation was found between the plasma NfL measurement closest to death and the level of NfL staining in the MTG at post-mortem. For the first time, we demonstrate that plasma NfL associates with the severity of neurofibrillary tangle pathology and neurodegeneration in the post-mortem brain. [ABSTRACT FROM AUTHOR]

With a novel Freeze Foaming method, it is possible to manufacture porous cellular components whose structure and composition also enables them for application as artificial bones, among others. To tune the foam properties to our needs, we have to understand the principles of the foaming process and how the relevant process parameters and the foam's structure are linked. Using in situ analysis methods, like X-ray microcomputed tomography (µCT), the foam structure and its development can be observed and correlated to its properties. For this purpose, a device was designed at the Institute of Lightweight Engineering and Polymer Technology (ILK). Due to varying suspension temperature and the rate of pressure decrease it was possible to analyze the foam's developmental stages for the first time. After successfully identifying the mechanism of foam creation and cell structure formation, process routes for tailored foams can be developed in future. [ABSTRACT FROM AUTHOR]

Background: National policy approaches to physical activity (PA) promotion and sedentary behaviour (SB) reduction are needed to address rising rates of non-communicable diseases. Understanding the policy process and impact through robust research and evaluation is crucial for facilitating successful reforms in national health policy. This scoping review, therefore, aimed to map the evidence on indicators, development, and content of national PA and/or SB policies globally. Methods: A systematic search of academic and grey literature was conducted through six bibliographic databases, Google, and websites of three large organisations for PA promotion. Results: Out of 24,872 screened documents, 203 publications from 163 studies were selected. The selected studies investigated PA/SB policies in 168 countries worldwide, and we provided summary results for each of the countries. Overall, 69, 29, and 2% of the analyses of national PA/SB policies were conducted for high-, middle-, and low-income countries, respectively. Twenty-two percent of the studies mentioned SB policies as part of their analysis, with only one study focusing solely on assessing SB policies. Operational definitions of policy were found in only 13% of publications. Only 15% of the studies used a conceptual or theoretical framework. A large variety of methods were used for data collection and analysis of PA/SB policy. Conclusions: We found that PA policy research is much more developed than it was considered several years ago. Research around SB policies is still in its infancy, but it seems to have experienced some positive progress in the last few years. Three key issues were identified that should be addressed in further research: [i] there is a lack of PA/SB policy research in low- and middle-income countries, which is an important limitation of the current body of evidence; [ii] the definition of policy varied significantly across studies, and most studies did not rely on any theoretical framework, which may impede cross-study comparisons; and [iii] studies have used a variety of methods to analyse policy, which may also cause problems with comparability. Future PA/SB policy research should aim towards a clearer conceptualisation of policy, greater reliance on existing theoretical frameworks, and the use and further development of standardised methods for PA/SB policy analysis. [ABSTRACT FROM AUTHOR]

The present increase in life span has been accompanied by an even higher increase in the burden of comorbidity. The challenges to healthcare systems are enormous and performance measures have been introduced to make the provision of healthcare more cost-efficient. Performance of hospitalisation is basically defined by the relationship between hospital stay, use of hospital resources, and main diagnosis/diagnoses and complication(s), adjusted for case mix. These factors, combined in different indexes, are compared with the performance of similar hospitals in the same and other countries. The reasons why an approach like this is being employed are clear.Cutting costs cannot be the only criteria, in particular in elderly, high-comorbidity patients: in this population, although social issues are important determinants of hospital stay, they are rarely taken into account or quantified in evaluations. Quantifying the impact of the "social barriers" to care can serve as a marker of the overall quality of treatment a network provides, and point to specific out-of-hospital needs, necessary to improve in-hospital performance. We therefore propose a simple, empiric medico-social checklist that can be used in nephrology wards to assess the presence of social barriers to hospital discharge and quantify their weight.Using the checklist should allow: identifying patients with social frailty that could complicate hospitalisation and/or discharge; evaluating the social needs of patient and entourage at the beginning of hospitalisation, adopting timely procedures, within the partnership with out-of-hospital teams; facilitating prioritization of interventions by social workers.The following ten items were empirically identified: reason for hospitalisation; hospitalisation in relation to the caregiver's problems; recurrent unplanned hospitalisations or early re-hospitalisation; social/family isolation; presence of a dependent relative in the patient's household; lack of housing or unsuitable housing/accommodation; loss of autonomy; lack of economic resources; lack of a safe environment; evidence of physical or psychological abuse.The simple tool here described needs validation; the present proposal is aimed at raising attention on the importance of non-medical issues in medical organisation in our specialty, and is open to discussion, to allow its refinement. [ABSTRACT FROM AUTHOR]