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Pain is prevalent and functionally impactful in older adults. The prefrontal cortex is involved in pain perception, attentional control, and cortical control of locomotion. see more Although pain is a known moderator of attentional capacity, its moderating effect on cortical control of locomotion has not been assessed. This study aimed to examine the effects of subjective pain on changes in functional near-infrared spectroscopy-derived measurements of oxygenated hemoglobin (HbO2), gait velocity, and cognitive accuracy from single- to dual-task walking conditions among older adults.
The sample consisted of 383 healthy older adults (55% female).
Participants completed two single tasks (Single-Task-Walk [STW] and Cognitive Interference [Alpha]) and the Dual-Task-Walk (DTW), during which participants performed the two single tasks simultaneously. The Medical Outcomes Study Pain Severity Scale and Pain Effects Scale were used to assess pain severity and interference. ProtoKinetics Movement Analysis Software was used to assess gait velocity and rate of correct letter generation to assess cognitive accuracy. Functional Near-Infrared Spectroscopy (fNIRS) was used to assess HbO2 during active walking.
Linear mixed-effects models revealed that HbO2 increased from single- to dual-task conditions. Perceived pain presence was associated with an attenuated increase in HbO2 from Alpha to DTW. Among those with pain, worse pain severity was associated with an attenuated increase in HbO2 from STW to DTW. Pain interference did not moderate the increase in HbO2 from single to dual tasks. Pain did not have a moderating effect on behavioral outcomes.
Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
This study aimed to reveal the prognostic values of prior local therapy in first-line therapy using androgen receptor-axis targeting agents (abiraterone or enzalutamide) or docetaxel for castration-resistant prostate cancer (CRPC).
The study included 303 patients treated with first-line therapy for non-metastatic and metastatic CRPC. The association between prior local therapy and therapeutic outcome including progression-free survival and overall survival was investigated by univariate and multivariate analyses as well as propensity score-matched analysis.
In univariate analysis, local prior therapy was associated with a lower risk of all-cause mortality (hazard ratio, 0.56, 95% confidence interval, 0.40-0.79; P=0.0009). Overall survival, but not progression-free survival, was better among patients with prior local therapy compared with patients without prior local therapy even after multivariate analysis and propensity score-matched analysis.
This study robustly indicated that prior local treatment was prognostic for overall survival among patients with CRPC. This finding is useful to predict patient prognosis in CRPC.
This study robustly indicated that prior local treatment was prognostic for overall survival among patients with CRPC. This finding is useful to predict patient prognosis in CRPC.
Prompt identification of infections is critical for slowing the spread of infectious diseases. However, diagnostic testing shortages are common in emerging diseases, low resource settings, and during outbreaks. This forces difficult decisions regarding who receives a test, often without knowing the implications of those decisions on population-level transmission dynamics. Clinical prediction rules (CPRs) are commonly used tools to guide clinical decisions.
Using early severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) as an example, we used data from electronic health records to develop a parsimonious 5-variable CPR to identify those who are most likely to test positive. To consider the implications of gains in daily case detection at the population level, we incorporated testing using the CPR into a compartmentalized model of SARS-CoV-2.
We found that applying this CPR (area under the curve, 0.69; 95% confidence interval, .68-.70) to prioritize testing increased the proportion of thoseds capacity, the use of a clinical prediction rule to prioritize diagnostic testing can have meaningful impact on population-level outcomes, including delaying and lowering the infection peak, and reducing healthcare burden.A simple, accurate and precise RP-HPLC method was developed for the simultaneous determination of chloroquine, pyrimethamine and cetirizine hydrochloride concentrations in bulk drug and human serum. The assay was performed using a mobile phase of methanol water (7030) at pH of 2.8 ± 0.05 on the Purospher C-18 column with UV detection at 230 nm and rosuvastatin used as an internal standard. The retention times observed for chloroquine, pyrimethamine and cetirizine hydrochloride were 3.5, 2.5 and 5.5 minutes, respectively. The method was found to be specific for the assayed drugs showing a linear response in the concentration range of 1-100 μg mL-1 with coefficients of determination values of (r = 0.999). The method was developed and validated according to ICH guidelines. The method was used to monitor the serum samples and was found to be sensitive for therapeutic purposes, showing the potential to be a useful tool for routine analysis in laboratories.
Visual attention helps us to selectively process relevant information and is crucial in our everyday interactions with the environment. Not surprisingly, it is one of the cognitive domains that is most frequently affected by acquired brain injury. Reliable assessment of attention deficits is pivotal to neuropsychological examination and helps to optimize individual rehabilitation plans. Compared with conventional pen-and-paper tests, computerized tasks borrowed from the field of experimental psychology bring many benefits, but lab-based experimental setups cannot be easily incorporated in clinical practice. Light-weight and portable mobile tablet devices may facilitate the translation of computerized tasks to clinical settings. One such task is based on the Theory of Visual Attention (TVA), a mathematical model of visual attention. TVA-based paradigms have been widely used to investigate several aspects of visual attention in both fundamental and clinical research, and include measures for general processing capacity as well as stimulus-specific attentional parameters.
