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INTRODUCTION: Mild cognitive impairment (MCI) is a prodromal stage of dementia. Understanding the mechanistic changes from healthy aging to MCI is critical for comprehending disease progression and enabling preventative intervention. METHODS: Patients with MCI and age‐matched controls (CN) were administered cognitive tasks during functional near‐infrared spectroscopy (fNIRS) recording, and changes in plasma levels of extracellular vesicles (EVs) were assessed using small‐particle flow cytometry. RESULTS: Neurovascular coupling (NVC) and functional connectivity (FC) were decreased in MCI compared to CN, prominently in the left‐dorsolateral prefrontal cortex (LDLPFC). We observed an increased ratio of cerebrovascular endothelial EVs (CEEVs) to total endothelial EVs in patients with MCI compared to CN, correlating with structural MRI small vessel ischemic damage in MCI. LDLPFC NVC, CEEV ratio, and LDLPFC FC had the highest feature importance in the random Forest group classification. DISCUSSION: NVC, CEEVs, and FC predict MCI diagnosis, indicating their potential as markers for MCI cerebrovascular pathology. Highlights: Neurovascular coupling (NVC) is impaired in mild cognitive impairment (MCI).Functional connectivity (FC) compensation mechanism is lost in MCI.Cerebrovascular endothelial extracellular vesicles (CEEVs) are increased in MCI.CEEV load strongly associates with cerebral small vessel ischemic lesions in MCI.NVC, CEEVs, and FC predict MCI diagnosis over demographic and comorbidity factors. [ABSTRACT FROM AUTHOR]

Introduction: Dancing is one way of maintaining an active lifestyle, and online dance interventions in group settings can be a solution when in-person classes are impossible. This study investigated the feasibility and potential clinical effects of an online dance program for older adults with and without Parkinson disease (PD). Methods: Participants attended 2 weekly dance classes in the same videoconference room for 2 months. The dance activities were mainly performed while seated (around 75%). Researchers monitored feasibility (ie, adherence, attendance, and technological barriers) and safety. Pre- and post-intervention assessments investigated self-perceptions, effects on emotional domains, quality of life, activity-specific balance confidence, lowerlimb functional mobility, and PD non-motor symptoms. Individuals also reported their self-perceptions regarding technology usability, enjoyment, and social interaction. Results: Most of the participants with PD (n = 12) had moderate PD (Hoehn & Yahr score) and presented a greater risk of falls when compared to participants without PD (n = 14). Overall, we found a high rate of adherence (100%), attendance (87.5%-91.7%), and safety (100%) for both groups. No falls or near-falls occurred during the sessions. Only the PD group ameliorated emotional domains (anxiety and depression) and improved lower-limb functional mobility. All participants reported feeling safe and perceived benefits, although over a third of older adults with PD reported moderate difficulties in using technology and in socializing with the group. Conclusion: This online dance protocol is feasible, safe, and a potential strategy to improve clinical parameters in older adults and people with moderate PD. [ABSTRACT FROM AUTHOR]

Surgical resection of both benign and malignant neoplasms can lead to significant tissue loss, which can have adverse effects on the stomatognathic tract. One example of this is the development of oroantral communication, often due to the extensive removal of palatal tissue. This condition can result in challenges related to swallowing, breathing, and speech. To help patients with oroantral communication regain these essential functions, dentists can provide palate obturator prostheses. This case study aims to report on three cases of prosthetic rehabilitation in patients who developed oroantral communication due to antineoplastic treatment. After the resection of squamous cell carcinoma (SCC) or pleomorphic adenoma (PA), these patients sought assistance from public health services because they experienced difficulties with speech and swallowing. All three individuals were successfully rehabilitated with palate obturator prostheses. Consequently, they experienced an improved quality of life, including enhanced comfort during breathing and eating, improved phonation leading to better communication, and increased self-esteem due to greater independence and a positive body self-image. [ABSTRACT FROM AUTHOR]

The rehabilitation with maxillofacial prostheses (MFP) is indispensable for the functional and aesthetic recovery of patients with congenital malformations and facial mutilations. The "Reabilitar" project, in collaboration with the School of Dentistry at the Federal University of Paraná, has the objective of promoting the Reconstructive Facial Prosthesis Service, offered through the Brazilian Unified Health System (SUS), as a referral center for maxillofacial rehabilitation in Paraná. Moreover, the project seeks to provide training to students at all levels in the techniques involved in fabricating MFP, as well as in patient management. The prostheses crafted by this service encompass both extraoral and intraoral prostheses. Students are granted the opportunity to observe various activities, including facial prosthetic planning, extra and intraoral impressions, iris painting, wax sculpture, and gypsum model construction. Consequently, this project offers students the chance to expand their knowledge by exposing them to the clinical and hospital environment in a field that is often overlooked in university curricula. [ABSTRACT FROM AUTHOR]

Cancer of the oral cavity and oropharynx is primarily represented by Squamous Cell Carcinoma (SCC). SCC is one of the most common neoplastic diseases in Brazil and is strongly associated with alcoholism and tobacco consumption. Treatment for SCC may involve surgical resection of the tumor, which can result in maxillary defects requiring rehabilitation through the use of a palatal obturator prosthesis. This case report focuses on a 58-year-old female patient who developed a 2 cm oroantral communication in the soft palate as a result of SSC resection. She was successfully rehabilitated using a palatal obturator prosthesis. Traditional dental impressions were unsuccessful due to the posterior location of the communication. Instead, digital scanning was employed, which allowed for better access to the affected area. The use of the prosthesis significantly improved the patient's quality of life by enhancing her ability to speak, breathe, swallow, and boosting her self-esteem. [ABSTRACT FROM AUTHOR]

Background: Missed or delayed diagnosis of acute stroke, or false-negative stroke (FNS), at initial emergency department (ED) presentation occurs in ≈9% of confirmed stroke patients. Failure to rapidly diagnose stroke can preclude time-sensitive treatments, resulting in higher risks of severe sequelae and disability. In this study, we developed and tested a modified version of a structured medical record review tool, the Safer Dx Instrument, to identify FNS in a subgroup of hospitalized patients with stroke to gain insight into sources of ED stroke misdiagnosis.Methods: We conducted a retrospective cohort study at 2 unaffiliated comprehensive stroke centers. In the development and confirmatory cohorts, we applied the Safer Stroke-Dx Instrument to report the prevalence and documented sources of ED diagnostic error in FNS cases among confirmed stroke patients upon whom an acute stroke was suspected by the inpatient team, as evidenced by stroke code activation or urgent neurological consultation, but not by the ED team. Inter-rater reliability and agreement were assessed using interclass coefficient and kappa values (κ).Results: Among 183 cases in the development cohort, the prevalence of FNS was 20.2% (95% CI, 15.0-26.7). Too narrow a differential diagnosis and limited neurological examination were common potential sources of error. The interclass coefficient for the Safer Stroke-Dx Instrument items ranged from 0.42 to 0.91, and items were highly correlated with each other. The κ for diagnostic error identification was 0.90 (95% CI, 0.821-0.978) using the Safer Stroke-Dx Instrument. In the confirmatory cohort of 99 cases, the prevalence of FNS was 21.2% (95% CI, 14.2-30.3) with similar sources of diagnostic error identified.Conclusions: Hospitalized patients identified by stroke codes and requests for urgent neurological consultation represent an enriched population for the study of diagnostic error in the ED. The Safer Stroke-Dx Instrument is a reliable tool for identifying FNS and sources of diagnostic error. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma (KS) is an angioproliferative neoplasm caused by human herpesvirus 8 that affects mucocutaneous tissues and aero-digestive tracts. KS typically exhibits an aggressive course and has a poor prognosis in individuals with AIDS. The aim of this study is to present a case of disseminated KS. An adult white male was hospitalized due to complications arising from AIDS. Clinical examination revealed the presence of multiple bluish-purple nodules on the hard palate and tongue. Additionally, purplish papular lesions were observed on the skin of the lower and upper limbs as well as on the face. Complementary tests indicated anemia, thrombocytopenia, an increase in erythrocyte sedimentation rate, elevated C-reactive proteins, and elevated gamma glutamyl transferase. The diagnosis of KS was confirmed through an incisional biopsy and subsequent histopathological examination. The patient was reinitiated on antiretroviral therapy, which led to a significant reduction in oral lesions. Subsequently, the patient was referred to another specialized cancer treatment hospital for chemotherapy.. [ABSTRACT FROM AUTHOR]

Patients undergoing tumor resection may encounter functional and aesthetic challenges, such as oroantral communication, an abnormal connection between the oral cavity and the maxillary sinus. This condition can lead to issues like speech difficulties, swallowing problems, and chewing limitations. Intraoral mutilations stemming from such conditions can profoundly affect a patient's psychological well-being, potentially causing depression and social isolation due to diminished self-esteem. This study aims to present a case of rehabilitation involving a palatal obturator prosthesis for an oncological patient with intraoral mutilation after maxillectomy. The palatal obturator prosthesis serves the dual purpose of closing the oroantral communication and preventing the reflux of liquids and solids into the nasal cavity. Moreover, it enhances aesthetics, speech, and the patient's ability to breathe comfortably. Rehabilitation through maxillofacial prosthesis offers significant benefits to individuals who have experienced such mutilation, as it can restore lost functions, address the defect, and subsequently improve appearance, quality of life, and social reintegration within the family and the community. [ABSTRACT FROM AUTHOR]

The surgical resection of benign and malignant neoplasms of the face and head can result in significant tissue loss, including ear amputation. This loss can have a profound impact on a patient's self-esteem, overall well-being, and quality of life. To help restore these qualities, the creation of extraoral maxillofacial prostheses can serve as a valuable rehabilitation option. This case study aims to report on three cases of rehabilitation with auricular prostheses for patients who underwent auricular amputation as part of their antineoplastic treatment. After the resection of conditions such as squamous cell carcinoma (SCC) or malignant neoplasms in the head, face, and neck, these patients were referred to maxillofacial prosthesis services due to their discomfort with the absence of their ears. Using an analog method, all prostheses were meticulously crafted, following the necessary steps of molding, waxing, and silicone application. In all cases, silicone auricular adhesive prostheses were created, significantly enhancing the patients' quality of life and their positive body self-image.. [ABSTRACT FROM AUTHOR]

Copyright of Biota Neotropica (Edicao em Iingles) is the property of Biota Neotropica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although evidence has indicated a positive effect of transcranial direct current stimulation (tDCS) on reducing pain, few studies have focused on the elderly population with knee osteoarthritis (KOA). To evaluate whether tDCS reduces KOA pain in elderly individuals with a dysfunctional descending pain inhibitory system (DPIS). In a double-blind trial, individuals ≥ 60 years with KOA pain and a dysfunctional DPIS, we randomly assigned patients to receive 15 daily sessions of 2 mA tDCS over the primary motor cortex (anode) and contralateral supraorbital area (cathode) (M1-SO) for 20 min or sham tDCS. Change in pain perception indexed by the Brief Pain Inventory (BPI) at the end of intervention was the primary outcome. Secondary outcomes included: disability, quantitative sensory testing, pain pressure threshold and conditioned pain modulation (CPM). Subjects were followed-up for 2 months. Of the 104 enrolled subjects, with mean (SD) age of 73.9 (8.01) years and 88 (84.6%) female, 102 finished the trial. In the intention-to-treat analysis, the active tDCS group had a significantly greater reduction in BPI compared to the sham group (difference, 1.59; 95% CI, 0.95 to 2.23; P < 0.001; Cohen's d, 0.58); and, also a significantly greater improvement in CPM-pressure in the knee (P = 0.01) and CPM-pain in the hand (P = 0.01). These effects were not sustained at follow-up. The intervention was well tolerated, with no severe adverse effects. M1-SO tDCS is associated with a moderate effect size in reducing pain in elderly patients with KOA after 15 daily sessions of stimulation. This intervention has also shown to modulate the DPIS. • Fifteen daily sessions of tDCS decreases knee osteoarthritis pain in the elderly. • Motor cortex tDCS modulates the descending inhibitory pain system in the elderly. • 2 mA for 20 min of anodal tDCS is safe and well tolerated in the elderly. • tDCS alone did not induce long-term effects in the elderly with knee chronic pain. [ABSTRACT FROM AUTHOR]

Copyright of Tecnologia em Metalurgia, Materiais e Mineração is the property of Associacao Brasileira de Metalurgia e Materiais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Individuals with Parkinson disease (PD) present with balance and functional mobility disabilities that negatively affect the quality of life (QOL).Objective: To systematically review the effects of hydrotherapy on balance, functional mobility, QOL, and motor status in subjects with PD.Design: Systematic review and meta-analysis.Participants: A total of 484 participants were included. The mean age of participants ranged from 54 to 78 years. The average duration of PD ranged from 3 to 10 years.Methods: MEDLINE (Pubmed), Embase, Cochrane CENTRAL, SCOPUS, Scielo, Physiotherapy Evidence Database (PEDro), and Google Scholar were searched from inception to December 2017. Randomized controlled trials (RCT), non-RCT, and pre-post studies were included.Main Outcome Measurements: Berg Balance Scale; Timed Up and Go test; Parkinson's disease quality of life and Short Form-36 Health Survey (SF-36); Unified Parkinson Disease Rating Scale-Part III.Results: Nineteen studies were identified, including 8 RCTs, 3 non-RCTs, and 8 pre-post studies. Our meta-analysis showed a moderate-quality of evidence for positive effects of hydrotherapy combined or not with land-based therapy on balance (133 subjects; MD = 2.00 [95% CI, 0.56 to 3.43; I2 0%, p=.01]) and functional mobility (133 subjects; MD = -1.08 [95% CI, -1.99 to -0.18; I2 8%, p=.02]). We found a low quality of evidence for no effects of hydrotherapy combined or not with land-based therapy on QOL (76 subjects; MD = -6.35 [95% CI, -13.04 to 0.33; I2 7%, p=.06]) and on motor status (140 subjects; MD = -1.11 [95% CI, -3.27 to 1.04; I2 0%, p=.31). The risk of bias across the included RCTs was low.Conclusions: Hydrotherapy combined or not with other therapies may improve balance and functional mobility in subjects with PD when compared to land-based therapy alone or usual care.Level Of Evidence: Level I. [ABSTRACT FROM AUTHOR]

Montmorillonite clay (MMT) was modified with polyaniline (Pani) and used to produce nanocomposites in a polystyrene (PS) matrix. MMT/Pani particles were evaluated by Infrared Spectroscopy (FT‐IR), where groups of both MMT and Pani were found; and by XRD, where an increase in the interlamellar distance was detected, changes on the resistive electrical behavior of MMT to a diffusive one for MMT/Pani were identified by Electrochemical Impedance Spectroscopy (EIS). Nanocomposites of PS with MMT‐Pani were produced by melt intercalation in the proportions of 1%, 3%, 5%, and 10%. They were characterized by Transmission Electron Microscopy (TEM), Differential Scanning Calorimetry (DSC), Thermogravimetry (TG), and EIS. Main results showed a decrease in the glass transition temperature and in the onset temperature according to the amount of MMT‐Pani. Analyses by EIS demonstrated a capacitive behavior (polarization) for nanocomposites containing smaller amounts of MMT‐Pani and diffusive behavior for the largest proportions, which were explained by a model of electronic diffusion in the Pani polymeric chain due to the chain intercalation observed by TEM in samples with higher concentration of MMT‐Pani. Therefore, the results suggest that the addition of MMT‐Pani alters some properties of the polystyrene matrix, changing its degradation and transition temperature, and its electrical behavior. POLYM. COMPOS., 40:37–45, 2019. © 2017 Society of Plastics Engineers [ABSTRACT FROM AUTHOR]

Abstract Objective To assess the effects of automated peripheral stimulation (AMPS) in reducing gait variability of subjects with Parkinson disease (PD) and freezing of gait (FOG) treated with AMPS and to explore the effects of this treatment on gait during a single task (walking) and a dual task (walking while attending the word-color Stroop test). Design Interventional, double-blinded, placebo-controlled, randomized trial. Setting Clinical rehabilitation. Participants Thirty subjects were randomized into 2 groups: AMPS (n=15) and AMPS sham (n=15). Interventions Both groups received 2 treatment sessions a week for 4 consecutive weeks (totaling 8 treatment sessions). AMPS was applied by using a medical device (Gondola™) and consisted in mechanical pressure stimulations delivered by metallic actuators on 4 areas of the feet. Treatment parameters and device configuration were modified for AMPS sham group. Main Outcome Measures Gait analyses were measured at baseline and after the first, fourth, and eighth treatment sessions. Results Interactions among groups and sessions were found for both conditions while off anti-Parkinsonian medications. AMPS decreased gait variability in subjects with PD and FOG for both single and dual task conditions. Conclusions AMPS is an effective add-on therapy for treating gait variability in patients with PD and FOG. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Dance Medicine & Science is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aim: Ipsilateral nonstenotic carotid disease is increasingly recognized as an etiology of ischemic stroke, however tailored treatment strategies are lacking. We aimed to examine clinical characteristics and treatment effects in patients with minor ischemic stroke associated with ipsilateral nonstenotic carotid disease in the Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial.Methods: We performed an exploratory analysis of the interaction of the treatment effects of aspirin plus clopidogrel versus aspirin monotherapy, stratified by presence of ipsilateral nonstenotic carotid disease in patients with minor ischemic stroke in the POINT trial.Results: For this exploratory analysis, 167 patients presenting with ischemic stroke and ipsilateral nonstenotic carotid disease, defined as 1%-49% carotid stenosis ipsilateral to the corresponding territory of ischemic stroke, and 833 patients no carotid disease were included. Compared to patients with no carotid disease, patients with ipsilateral nonstenotic carotid disease were older (68.5 ± 11.3 years versus 61.3 ± 12.8 years; P < 0.001), and had a higher prevalence of hypertension (76.6% versus 59.2%, P < 0.001), ischemic heart disease (13.8% versus 5.4%, P < 0.001), and tobacco use (past: 34.1% versus 25.2%, P = 0.005; present: 27.5% versus 22.8%, P = 0.005). 5.4% of patients with ipsilateral nonstenotic carotid disease had recurrent ischemic stroke within 14 days. Patients receiving dual antiplatelet therapy had a numerical reduction in recurrent ischemic stroke compared to patients receiving aspirin monotherapy, however the exploratory analysis was underpowered to detect a statistically significant difference in treatment effect (HR 0.50, 95% CI 0.18-1.40, P = 0.19).Conclusion: Patients with minor ischemic stroke and ipsilateral nonstenotic carotid disease had a high risk of early stroke recurrence in the POINT trial. Dual antiplatelet therapy provided a non-statistically significant reduction in recurrent ischemic stroke with no difference in safety outcomes compared to aspirin monotherapy. Further study is needed to determine if early and short duration dual antiplatelet therapy is beneficial for all patients with ipsilateral nonstenotic carotid disease. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effectiveness of noninvasive brain stimulation (NIBS)—repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—on hemispatial neglect and performance in activities of daily living (ADL) after stroke. Data Sources MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Scopus, SciELO, and Physiotherapy Evidence Database were searched from database inception to December 2016. Data Selection Randomized controlled trials or crossover trials focused on determining the effects of tDCS or rTMS combined or not combined with other therapies for hemispatial neglect after stroke. Data Extraction Methodological characteristics of the studies, number of participants, comparison groups, interventions, and outcomes were extracted. Data Synthesis Ten trials comprising 226 participants had data that were suitable for the meta-analysis. Meta-analysis showed that NIBS combined with other therapies significantly improves hemispatial neglect (standardized mean difference [SMD]=–1.91; 95% confidence interval [CI], –2.57 to –1.25; I 2 =71%). A sensitivity analysis showed that rTMS (SMD=–2.16; 95% CI, –3.00 to –1.33; I 2 =76%) and tDCS (SMD=–1.07; 95% CI, –1.76 to –0.37; I 2 =0%) had positive effects on hemispatial neglect. Furthermore, both excitatory (SMD=–2.34; 95% CI, –3.56 to –1.12; I 2 =65%) and inhibitory (SMD=–1.69; 95% CI, –2.49 to –0.88; I 2 =75%) stimulations were effective. Conclusions This meta-analysis reveals moderate-quality evidence for the effectiveness of NIBS protocols combined with other therapies on hemispatial neglect and performance in ADL after stroke. [ABSTRACT FROM AUTHOR]