Huntermerritt3471

Palliative care is advocated for older people with frailty and multimorbidity in the community. However, how to best deliver it is unclear.

To develop and model an intervention of short-term specialized palliative care that is initiated timely based on complex care needs and integrated with primary care for older people with frailty and their family, detailing the intervention components, outcomes and preconditions needed for implementation, using a novel theoretical approach.

Observational study informed by the UK MRC guidance for complex interventions integrated with a Theory of Change (i.e. hypothetical causal pathway to impact) approach. We synthesized evidence from a systematic review, semi-structured interviews, group discussions and Theory of Change workshops.

Primary care in Flanders, Belgium.

We identified patient and family carer-related long-term outcomes and preconditions to achieve them for example, service providers are willing and able to deliver the intervention. The intervention comive comparisons with other interventions.Immune-related myasthenia gravis is a rare, disabling, and potentially fatal adverse event of immune checkpoint inhibitor treatment. It is important to identify and manage it promptly. We present two cases of immune-related de novo myasthenia gravis observed at the Modena Cancer Center in two elderly patients treated with two anti-PD-1 monoclonal antibodies cemiplimab and nivolumab.

This study aimed to evaluate anthropometric, biochemical and clinical parameters in climacteric yoga practitioners.

This study investigated 108 climacteric women. We recruited 28 women between 40 and 65 years old who started yoga practices in premenopause and had already practiced for at least 5 years. As controls, we selected 30 physical activity (PA) practitioners who had practiced for at least 5 years and 50 sedentary women in the same age range. We conduced anthropometric, biochemical and blood pressure measurements.

The yoga group had significantly lower fasting blood glucose than the PA practitioners and sedentary women. Yoga practitioners also had lower weight, body mass index, waist circumference, body fat percentage and waist-to-height ratio; higher levels of high-density lipoprotein cholesterol; lower levels of triglycerides, insulin, Homeostasis Model Assessment of Insulin Resistance, uric acid, apolipoprotein B and high-sensitivity C-reactive protein; and lower frequency of metabolic syndrome, lipid accumulation product, visceral adiposity index and systolic blood pressure than the sedentary women.

Yoga practitioners had lower glucose serum concentrations than the PA practitioners and sedentary women. Overall, the yoga group also had better anthropometric, biochemical and clinical variables than the other groups. Although further investigation is required, yoga practice in premenopause seems to be beneficial for women when they reach menopause.

Yoga practitioners had lower glucose serum concentrations than the PA practitioners and sedentary women. Overall, the yoga group also had better anthropometric, biochemical and clinical variables than the other groups. Although further investigation is required, yoga practice in premenopause seems to be beneficial for women when they reach menopause.

Rheumatoid arthritis (RA) is an autoimmune disease, which compromises the synovial membrane resulting in chronic inflammation. Increasing evidence has demonstrated that long non-coding RNAs (lncRNAs) are implicated in the pathogenesis of RA. This study investigated the role of lncRNA ZNF667-AS1 in RA progression.

Synovial tissues and fibroblast-like synoviocytes (FLSs) were obtained from patients with RA. Gene expression was measured using RT-qPCR. Chondrocytes were treated with lipopolysaccharide (LPS) to establish

models of OA. Cell counting kit-8 (CCK-8), western blot, and enzyme-linked immunosorbent assay (ELISA) were used to examine the proliferation and inflammatory cytokine production in chondrocytes. Animal models of OA were established in SD rats. Peripheral blood mononuclear cells (PBMCs) were isolated from the OA rats. Flow cytometry was used to measure the changes of the inflammatory T-helper cell 17 (Th17) cells. The relationship between ZNF667-AS1 and miR-523-3p was verified by luciferase reporter assay.

ZNF667-AS1 was downregulated in RA-FLSs and LPS-stimulated chondrocytes. ZNF667-AS1 overexpression significantly promoted cell proliferation and inhibited the production of IL-6, IL-17 and TNF-α in LPS-stimulated chondrocytes. Additionally, ZNF667-AS1 overexpression reduced the generation of CD4 + IL-17+ cells. In mechanism, ZNF667-AS1 acted a sponge for miR-523-3p. MiR-523-3p overexpression reversed the ZNF667-AS1-mediated regulation of cell proliferation and inflammation. Furthermore, miR-523-3p overexpression abolished the inhibitory effects of ZNF667-AS1 on the JAK/STAT signalling activation.

ZNF667-AS1 exerts protective effects during RA development by sponging miR-523-3p and inactivating the JAK/STAT signalling.

ZNF667-AS1 exerts protective effects during RA development by sponging miR-523-3p and inactivating the JAK/STAT signalling.Objective To estimate the prevalence of amyotrophic lateral sclerosis (ALS) in the United States for 2016 using data from the National ALS Registry (Registry). Established in 2009, the Registry collects data on ALS patients in the U.S. to better describe the epidemiology of ALS, examine risk factors such as environmental and occupational exposures, and characterize the demographics of those living with the disease. Methods To identify adult prevalent cases of ALS, the Registry compiles data from three national administrative databases (maintained by the Centers for Medicare and Medicaid Services, the Veterans Health Administration, and the Veterans Benefits Administration). To ascertain cases not necessarily included in these databases and to better understand risk-factors associated with ALS and disease progression, the Registry also includes data collected from patients who voluntarily enroll via a web portal to complete online surveys. Results In 2016, the Registry conservatively identified 16,424 adult persons who met the Registry definition of ALS for an age-adjusted prevalence rate of 5.2 per 100,000 U.S. population. The pattern of patient characteristics (e.g., age, sex, and race/ethnicity) has not changed from previous Registry reports. Overall, ALS was more common among whites, males, and persons aged 60-69 years. The age groups with the lowest number of ALS cases were persons aged 18-39 years. Males had a higher prevalence rate of ALS than females overall and across all data sources. Conclusions Data collected by the National ALS Registry are being used to better describe the epidemiology and demographics of ALS in the U.S.Epidemiological studies demonstrate the relevance of cardiovascular diseases for health policies and medical care, especially coronary heart diseases and myocardial infarction. Research has shown that a significant proportion of patients undergoing coronary angiography suffer from clinically relevant mental stress. The aim of this study is to investigate to what extent the psychological state of cardiology patients changes in short- and mid-term periods after coronary angiography has been performed. The study design is naturalistic, longitudinal and comparative about consecutively admitted patients undergoing coronary angiography (N = 419; consenting patients fulfilling inclusion criteria n = 68) at four measurement points before and after angiography and 6 weeks and 6 months after discharge. The statistical analysis includes paired t-tests, chi-square tests, effect sizes and random effects regression models. The sample was representative of the target population. The prevalence of risk factors were 84% heart attack, 31% diabetes and 84% hypertension. There were no angiographic pathological findings in 12% of the sample. The neuroticism levels of the sample was higher than in the general population. There were almost no pre-post differences for depression, anxiety, psychological well-being, self-efficacy, resilience or locus of control. At the mid-term, well-being and anxiety decreased and internal locus of control increased. Neuroticism was negatively and extraversion and openness were positively associated with mental state and resources. The sample showed persistent adverse subsyndromal depressivity. At the mid-term, patients realised that their prognosis also depends on their own behaviour (internal attribution). Special psychosomatic attention should be given to people with subsyndromal depression, higher emotional instability and those with angina pectoris symptoms displaying normal coronary angiography.

Online video learning has been gaining substantial attention in medical education. The purpose of the study was to evaluate medical students' online video-viewing patterns as well as to identify features associated with their class style preferences in precision medicine courses.

A mixed methods research design was used. Part of the cognitive load of the class content of "acute liver failure" was shifted to a 10-minute pre-class online video learning which was further reduced using threshold concept strategy. In the 2019 academic year, all fifth-year medical students who had viewed the pre-class video were invited to take a survey on their learning process and four class style expectations for the upcoming in-person class. selleck products For each round of medical students, teaching assistants helped collect anonymous survey data before the class. The teacher then adjusted the in-person class as part of precision medical education. Furthermore, the researchers coded the video-viewing patterns through an action log transfedical education.The association between medical students' preferred class styles and online video-viewing patterns was not clearly seen.

This study aimed to investigate the changes in high-sensitivity C-reactive protein (hs-CRP) level and metabolic indices such as blood pressure, serum lipid level and serum glucose level according to grip strength in postmenopausal women.

Data from participants (postmenopausal women) in the Seventh Korea National Health and Nutrition Examination Survey 2018 were analyzed. Absolute handgrip strength was the sum of the maximal grip strength of both hands, and relative handgrip was calculated as absolute handgrip divided by the body mass index. We performed linear regression analysis after adjusting for confounders to assess the influence of grip strength on hs-CRP level and metabolic indices.

Linear regression analysis showed that after adjusting for confounders, with an increased absolute grip strength, systolic blood pressure and hs-CRP levels were decreased; however, the changes were not significant for the remaining indices. Relative grip strength was associated with hs-CRP levels and metabolic indices. With a high relative grip strength, hs-CRP, blood pressure, fasting blood glucose, hemoglobin A1c and triglyceride levels were decreased, while the high-density lipoprotein cholesterol level was increased.

Our study evaluated the overall health status using grip strength in postmenopausal women. The grip strength adjusted by body size was suitable in evaluating the overall health status, including inflammatory and metabolic indices. Additionally, increased grip strength was associated with a better health status in postmenopausal women.

Our study evaluated the overall health status using grip strength in postmenopausal women. The grip strength adjusted by body size was suitable in evaluating the overall health status, including inflammatory and metabolic indices. Additionally, increased grip strength was associated with a better health status in postmenopausal women.