Peripheral magnetic theta burst stimulation to muscles can effectively reduce spasticity: a randomized controlled trial

Background Spasticity is a common complication of many neurological diseases and despite contributing much disability; the available therapeutic options are limited. Peripheral magnetic stimulation is one promising option. In this study, we investigated whether peripheral intermittent theta burst stimulation (piTBS) will reduce spasticity when applied directly on spastic muscles. Methods In this sham-controlled study, eight successive sessions of piTBS were applied directly to spastic muscles with supra threshold intensity. Assessment was done by modified Ashworth scale (mAS) and estimated Botulinum toxin dose (eBTD) at baseline and after the 8th session in both active and sham groups. Results A total of 120 spastic muscles of 36 patients were included in the analysis. Significant reduction of mAS and eBTD was found in the active compared to sham group (p < 0.001). The difference in mAS was also significant when tested in upper limb and lower limb subgroups. The degree of reduction in mAS was positively correlated with the baseline scores in the active group. Conclusion piTBS could be a promising method to reduce spasticity and eBTD. It consumes less time than standard high frequency protocols without compromising treatment efficacy. Trial registration: Clinical trial registry number: PACTR202009622405087. Retrospectively Registered 14th September, 2020.

Dysregulation of Receptor for Advanced Glycation End Products (RAGE) Expression as a Biomarker of Keratoconus

Background. Because of the implications of Receptor for Advanced Glycation End Products (RAGE) in keratoconus (KC), we describe a differential expression of RAGE transcripts and proteins in corneal tissues and tears of KC and healthy patients. Methods. Using a case-controlled study, corneal epitheliums and tears of KC and healthy subjects were obtained during corneal collagen cross-linking and photorefractive keratectomy (PKR) and during usual consultations. Quantitative reverse transcription (RT-qPCR) and Western-Blot were performed to analyze RAGE transcripts and proteins’ expression in corneal tissues and tears. Results. One hundred and six patients were included in this study. The characteristics of the patients were as follows: 56 KC (25 corneal epithelium and 31 tears) and 50 control subjects (25 corneal epithelium and 25 tears). Transcripts of RAGE, HMGB1, and S100 family ligands were quantified by RT-qPCR, identifying a significantly higher expression of RAGE and HMGB1 in the healthy group than in the KC group ( p = 0.03 and 0.04, respectively). Western Blot showed a significantly higher fl-RAGE expression in KC corneal epithelium than control ( p < 0.001 ) and lower s-RAGE expression in KC tears than control ( p = 0.04 ). Conclusions. Linked with the inflammatory process occurring in KC pathophysiology, we propose for the first time that the RAGE expression (total and truncated forms of receptor and ligands) in KC corneal tissues and tear samples provides viable biomarkers.

Randomized controlled study of proximal fibular osteotomy (PFO) with or without trabeculotomy in early osteoarthritis (OA) knee

This study was conducted to evaluate and compare the clinical and functional outcome of OA knee patients treated with proximal fibular osteotomy with or without trabeculotomy.This was a randomized controlled study amongst patients of osteoarthritis knee for a period of 1 year on patients with early osteoarthritis of knee. All patients were randomly allocated into two groups; group 1 patients were managed using PFO with trabeculotomy whereas group 2 patients were managed with proximal fibular osteotomy alone. All the patients were followed up post operatively at 15 days and at 2, 6 and 12 months post operatively. At each follow up patients were assessed for presence of Pain using Visual analogue scale. Also functional outcome was assessed using WOMAC.In present study, patients of two groups were comparable in their base line characters (p&#62;0.05). Post operatively, mean VAS score and WOMAC score improved significantly in both the groups, the improvement was significantly higher in group 1 as compared to group 2 at all the follow up (p&#60;0.05).Proximal fibular osteotomy with or without trabeculotomy can be used effectively as a promising tool for management of cases with early osteoarthritis of knee. It is safe, effective, and cost effective surgical technique for pain relief and improving functional outcome. PFO with trabeculotomy yields better results in terms of clinical as well as functional outcome as compared to PFO without trabeculotomy.

Mindful Kangaroo Care: mindfulness intervention for mothers during skin-to-skin care: a randomized control pilot study

Background Parents of babies admitted to the Newborn Intensive Care Unit (NICU) undergo considerable stress. There is evidence that mindfulness reduces stress in these parents. Kangaroo Care (KC) is practiced in NICUs across the world and is stress-relieving. Whether mindfulness practiced during KC in the NICU reduces parental distress has not yet been studied. The objective was to explore the feasibility and acceptability of teaching and practicing mindfulness during KC for mothers of premature babies. The objective was also to document preliminary outcomes of Mindful Kangaroo Care (MKC) on maternal stress, anxiety, depression, and mindful awareness. Methods In this pilot randomized controlled study, mothers of premature babies who were expected to stay in the NICU for at least four weeks were taught two mindfulness exercises to practice during KC and compared to mothers who received standard care with no mindfulness teaching. Mothers filled out stress, anxiety, depression and mindful awareness scales at recruitment and after four weeks. Acceptability and feasibility questionnaires were also completed. Results Fifteen mothers per group completed the study. The MKC group demonstrated a significant within-group reduction in anxiety (p = 0.003), depression (p = 0.02) and stress (p = 0.002), and a significant increase in both the curiosity (p = 0.008) and decentering (p = 0.01) scores of the Toronto Mindfulness Scale, all of which had medium to large effect sizes. Only the increases in curiosity and decentering were significant between groups. Fourteen mothers found the intervention acceptable, one neutral. Conclusion MKC was acceptable, feasible and led to a reduction in stress, anxiety and depression in mothers who practiced mindfulness exercises during KC.

Effects of Bushen-Jiangya granules on blood pressure and pharmacogenomic evaluation in low-to-medium-risk hypertensive patients: study protocol for a randomized double-blind controlled trial

Introduction Hypertension is one of the most important risk factors for cardiovascular disease, and its control rates remain low worldwide. The most effective strategy is that patients with hypertension should be diagnosed and treated early. Preliminary studies showed that the Bushen Jiangya granule (BSJY) could suppress ventricular hypertrophy and inflammatory responses, lower blood pressure, and protect the target organs of hypertension. We designed a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of BSJY in patients with low-to-medium risk hypertension. Methods and analysis This trial is a one-center, randomized, double-blind, placebo-controlled study. A total of 260 participants will be randomized in a 1:1 ratio to an experimental group (BSJY plus amlodipine) and a control group (placebo plus amlodipine). The trial cycle will last 8 weeks. The primary outcome is the change in 24-h average systolic and diastolic blood pressure. The secondary outcomes include heart rate variability, pharmacogenomic evaluation, improvement in TCM syndrome, and serum pro-inflammatory/anti-inflammatory cytokines between the two groups. The safety of medication will also be evaluated. All the data will be recorded in electronic case report forms and analyzed by SPSS V.22.0. Ethics and dissemination This study has been approved by the Research Ethics Committee of Guang’anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (No. 2019-186-KY-01). The participants are volunteers, understand the process of this trial, and sign an informed consent. The results of this study will be disseminated to the public through peer-reviewed journals and academic conferences. Discussion We hypothesize that patients with low-to-medium-risk hypertension will benefit from BSJY. If successful, this study will provide evidence-based recommendations for clinicians. Trial registration Chinese Clinical Trial Registry ChiMCTR1900002876. Registered in November 2019

Effect of six-week traditional resistance and functional training on functional performance in female netball players

Background Improving the quality of functional movements in athletes generally requires additional training targeting specific functional deficiencies. However, well-rounded, traditional strength and conditioning program should also improve player’s movement quality. Therefore, the primary aim of this study was to compare the effect of two different six-week interventions on the functional score of female netball players. Methods In a randomized controlled study, players were divided into control and intervention group. Both groups completed identical six-week strength and conditioning program, with the intervention group also completing additional corrective exercises three sessions per week during the same period. Results The FMS® score was significantly higher in the intervention group after 6-week program (f = 9.85, p = 0.004). However, the differences in total score may be attributed mainly to differences between groups in active straight leg raise (p = 0.004) and trunk stability push-up test (p = 0.02), as other individual tests demonstrated similar time and group effect. Conclusion These results indicate that although FMS® based intervention may improve overall functional movement score, the athletes in both groups have demonstrated similar improvements in most of the individual tests. Hence, a well-rounded strength and conditioning program incorporating athlete-specific exercises based on limitations identified in the functional movement screen, may result in a balanced training strategy and reduce the need for supplementary functional training sessions.

Impact of Mindfulness Training on Spanish Police Officers’ Mental and Emotional Health: a Non-Randomized Pilot Study

Objectives The purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer. Methods A pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data. Results High acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η2 = 0.43), self-compassion (η2 = 0.43), depression (η2 = 0.54), anxiety (η2 = 0.46), stress (η2 = 0.51), difficulties in emotion regulation, sleep quality (η2 = 0.57), and burnout (η2 = 0.31–0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; ηp2 = 0.21), depression symptoms (ηp2 = 0.23), general distress (ηp2 = 0.24), and the degree of physical and psychological exhaustion (personal burnout; ηp2 = 0.20). Conclusions The preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

Understanding the Effects of Structured Note-taking Systems for Video-based Learners in Individual and Social Learning Contexts

Video-based learning is widely adopted by online learners, yet, learning experience and quality may be negatively affected by asynchronous and remote natures of video-based learning. As note-taking is a common practice employed by video-based learners and is known to be an effective way to trigger active construction and processing of knowledge, yet as a meta-skill, it is challenging to most learners. In this study, we aim to approach the goal of providing cognitive and social scaffolds to video-based learners by structuring their note-taking process. We presented and evaluated structured note-taking systems designed for learners in two contexts, namely, individual learning context and social learning context. With an online controlled study involving 43 participants, we compared the structured note-taking systems with two baseline systems (for individual learning and social learning contexts respectively) and found that structured note-taking significantly improved certain aspects of video-based learning such as and higher cognitive engagement and lower distraction. We discussed our results to inform the design, iteration, and adoption of note-taking tools in video-based learning.