Nevin Manimala

Exp Brain Res. 2022 Jan 16. doi: 10.1007/s00221-021-06299-y. Online ahead of print.

ABSTRACT

The dual task experimental paradigm is used to probe the attentional requirements of postural control. However, findings of dual task postural studies have been inconsistent with many studies even reporting improvement in postural stability during dual tasking and thus raising questions about cognitive involvement in postural control. A U-shaped non-linear relationship has been hypothesized between cognitive task complexity and dual task postural stability suggesting that the inconsistent results might have arisen from the use of cognitive tasks of varying complexities. To systematically review experimental studies that compared the effect of simple and complex cognitive tasks on postural stability during dual tasking, we searched seven electronic databases for relevant studies published between 1980 to September 2020. 33 studies involving a total of 1068 participants met the review’s inclusion criteria, 17 of which were included in meta-analysis (healthy young adults: 15 studies, 281 participants; Stroke patients: 2 studies, 52 participants). Narrative synthesis of the findings in studies involving healthy old adults was carried out. Our result suggests that in healthy population, cognitive task complexity may not determine whether postural stability increases or decreases during dual tasking (effect of cognitive task complexity was not statistically significant; P > 0.1), and thus the U-shaped non-linear hypothesis is not supported. Rather, differential effect of dual tasking on postural stability was observed mainly based on the age of the participants and postural task challenge, implying that the involvement of cognitive resources or higher cortical functions in the control of postural stability may largely depends on these two factors.

PMID:35034175 | DOI:10.1007/s00221-021-06299-y

World J Urol. 2022 Jan 15. doi: 10.1007/s00345-021-03922-z. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to conduct a comparative study of different etiologies of neurogenic bladder disorders (NBDs) in patients with bladder cancer (BC) regarding patient- and tumor-related parameters and their oncological outcome.

METHODS: Out of 98 patients with bladder tumors and neurogenic disease, 23 patients with BC and NBDs from Jan 1, 2010, to Dec 31, 2020, were included. The different etiologies of NBDs were merged in three groups based on the level of the nervous system (NS)-lesion: (i) central (n = 6), (ii) spinal cord (n = 10), and (iii) peripheral lesions (n = 7).

RESULTS: Patients with lesions at the spinal cord level were younger at the time of BC diagnosis compared to patients with central or peripheral NS lesions (54 vs. 68 vs. 78 years, p = 0.0219). However, the latency to malignant transformation was more than twice as long (33 vs. 15 years, p = 0.0108). Most tumors were muscle-invasive or locally advanced BCs (62%) and presented lymph node metastases (55%), resulting in a poor mean overall survival of 30.9 ± 3.6 months. No significant differences regarding histopathology, tumor stage, and oncological outcome could be observed between the groups.

CONCLUSION: Patients with NBDs have a poor prognosis regardless of their etiology or the level of NS lesion. Patients with spinal cord lesions, including congenital NBDs, appear to develop BC at a young age, but compared to other etiologies latency from NBD to BC is longer.

PMID:35034168 | DOI:10.1007/s00345-021-03922-z

Midwifery. 2022 Jan 7;106:103250. doi: 10.1016/j.midw.2022.103250. Online ahead of print.

ABSTRACT

BACKGROUND: This study investigated the prevalence and factors associated with poor maternal health care services utilization (MHCSU) i.e., having < 4 antenatal care (ANC) visits, not delivering at a health facility, and not receiving institutional postnatal care (PNC).

METHODS: We conducted a secondary analysis of data from the 2014 Eswatini Multiple Cluster Indicator Survey, a cross-sectional, nationally representative household survey. Participants were childbearing women (15-49 years) who had a live birth in the past two years preceding the survey. Multivariable logistic regression analyses were performed for each outcome variable.

RESULTS: The prevalence of poor MHCSU was 22.1% (202/903) for ANC, 10.4% (102/899) for institutional delivery or intrapartum care (IPC), and 26.9% (123/598) for PNC. Being younger, having a low education level, being never married, having no access to mass media, being a household head of low education, coming from a household of poor/middle wealth index, being a primipara, having an unintended pregnancy, and having a longer length of stay in the postpartum ward were significantly associated with poor MHCSU.

CONCLUSION: Midwives should pay special attention to women who present with the factors associated with poor MHCSU identified in this study, as early as the first booking for ANC to intervene early.

PMID:35032933 | DOI:10.1016/j.midw.2022.103250

J Fluency Disord. 2022 Jan 7;71:105896. doi: 10.1016/j.jfludis.2022.105896. Online ahead of print.

ABSTRACT

PURPOSE: Gap duration contributes to the perception of utterances as fluent or disfluent, but few studies have systematically investigated the impact of gap duration on fluency judgments. The purposes of this study were to determine how gaps impact disfluency perception, and how listener background and experience impact these judgments.

METHODS: Sixty participants (20 adults who stutter [AWS], 20 speech-language pathologists [SLPs], and 20 naïve listeners) listened to four tokens of the utterance, “Buy Bobby a puppy,” produced at typical speech rates. The gap duration between “Buy” and “Bobby” was systematically manipulated with gaps ranging from 23.59 ms to 325.44 ms. Participants identified stimuli as fluent or disfluent.

RESULTS: The disfluency threshold – the point at which 50 % of trials were categorized as disfluent – occurred at a gap duration of 126.46 ms, across all participants and tokens. The SLPs exhibited higher disfluency thresholds than the AWS and the naïve listeners.

CONCLUSION: This study determined, based on the specific set of stimuli used, when the perception of utterances tends to shift from fluent to disfluent. Group differences indicated that SLPs are less inclined to identify disfluencies in speech potentially because they aim to be less critical of speech that deviates from “typical”.

PMID:35032922 | DOI:10.1016/j.jfludis.2022.105896

Public Health. 2022 Jan 12;203:58-64. doi: 10.1016/j.puhe.2021.11.017. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to translate and investigate the validity and reliability of the modified Baecke Physical Activity Questionnaire (mBQ) in the Greek adult population.

STUDY DESIGN: This is a cross-cultural study.

METHODS: The cross-cultural adaptation of the mBQ was performed according to official guidelines. The prefinal Greek translation was tested in 30 healthy participants. The reliability was determined (n = 100) by filling out the mBQ, two times, 1 week apart. For validation (n = 45), the scores between the mBQ and the International Physical Activity Questionnaire (IPAQ) were compared, and the correlation between mBQ and VO₂max and between mBQ and interview (METS) were assessed.

RESULTS: High statistical significant of test-retest reliability was found (intraclass correlation coefficient = 0.84; standard error of measurement = 0.48; smallest detectable difference = 16.7%; Cronbach’s alpha = 0.92). Statistical significant correlation between the mBQ and the IPAQ (r = 0.425, P = 0.005), high correlation between the mBQ and METS (r = 0.691, P = 0.000), and moderate correlation between mBQ and VO₂max (r = 0.388, P = 0.08) were found.

CONCLUSION: The Greek mBQ was found to be reliable and valid for assessing the level of physical activity in the Greek population. CLINICALTRIALS.

GOV IDENTIFIER: NCT04890756.

PMID:35032916 | DOI:10.1016/j.puhe.2021.11.017

J Clin Neurosci. 2022 Jan 12;96:101-106. doi: 10.1016/j.jocn.2021.12.022. Online ahead of print.

ABSTRACT

Renal dysfunction has been reported to be associated with larger hematoma volume in intracerebral hemorrhage (ICH) due to concomitant nutritional imbalances and platelet dysfunction; however, this association remains controversial. This study analyzed the association between potential risk factors and hematoma volume in patients with ICH. This retrospective cohort study used data from 456 patients with ICH at a single comprehensive stroke center. We assessed the association of estimated glomerular filtration rate (eGFR) and Controlling Nutritional Status score with hematoma volume using multivariable non-linear regression models. The effect of the use of antithrombotic agents on hematoma volume was analyzed using outcome-adaptive double/debiased machine learning approach, considering many covariates. The median and interquartile range of age and eGFR were 64 (54-75) years and 56.1 (39.3-66.7) mL/min/1.73 m², respectively. The multivariable non-linear regression model showed that (1) eGFR and hematoma volume had a positive linear association, which was not statistically significant, and (2) nutritional status was positively associated with hematoma volume, although not significantly. Outcome-adaptive double/debiased machine learning revealed that patients receiving antithrombotic agents did not present with significantly larger hematoma volume than those who were not receiving antithrombotic agents (estimated mean difference of hematoma volume [95% confidence interval] = 15.32 [-6.02 to 36.65]). Our analysis shows no statistically or clinically significant relationship between renal function and hematoma volume; however, nutritional status and the use of antithrombotic agents showed an increasing tendency of the degree of hematoma in patients with ICH.

PMID:35032897 | DOI:10.1016/j.jocn.2021.12.022

Mult Scler Relat Disord. 2022 Jan 4;58:103496. doi: 10.1016/j.msard.2022.103496. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive impairment is a symptom present in part of patients with neuromyelitis optica spectrum disorder (NMOSD) and its pathophysiology is unknown. Dysfunction of the GABAergic/glutamatergic pathways involving inhibitory and excitatory neurotransmitters have been implicated in several neurological disorders. This study aimed to investigate the changes in inhibitory gamma-aminobutyric acid (GABA) and excitatory glutamate and glutamine (Glx) neurotransmitter levels and their correlations with cognitive functions in patients with NMOSD.

METHODS: A total of 29 patients with NMOSD and 28 sex-, age-, and education-matched healthy controls (HCs) were included in the study. All participants underwent clinical and cognitive assessments and proton magnetic resonance spectroscopy scanning. Meshcher-Garwood point-resolved spectroscopy was used to measure GABA and Glx levels in the medial prefrontal cortex (mPFC) and left thalamus. Total creatine (tCr) was applied as an internal reference. The GABA and Glx levels in the patient group were compared with those in HCs and correlated with cognitive scores and clinical variables.

RESULTS: Patients with NMOSD showed lower GABA+/tCr levels in the mPFC compared with HCs (P = 0.028). The GABA+/tCr levels in the mPFC were significantly associated with verbal memory performance (r = 0.462, P = 0.027) and overall cognition (r = 0.440, P = 0.035) in the NMOSD group. The GABA+/tCr levels in the left thalamus or Glx/tCr levels in both regions were not significantly different between groups, nor were they related to any cognitive domain in patients with NMOSD (all P values > 0.05).

CONCLUSION: The GABA+ levels in the mPFC decreased and correlated with cognitive dysfunction in patients with NMOSD, suggesting that the changes in regional GABA+ levels might be a potential metabolic feature of cognitive decline in patients with NMOSD.

PMID:35032882 | DOI:10.1016/j.msard.2022.103496

Mult Scler Relat Disord. 2022 Jan 10;58:103517. doi: 10.1016/j.msard.2022.103517. Online ahead of print.

ABSTRACT

BACKGROUND: Spasticity is a common and disabling problem in multiple sclerosis (MS), but its effect in other CNS inflammatory demyelinating diseases (CNSIDDs), such as neuromyelitis optica spectrum disorder (NMOSD) is not widely studied. This study aims to compare subjective and objective measurements of spasticity in NMOSD patients and determine associated factors.

METHODS: A prospective cross-sectional study was performed on CNSIDD patients attending the Multiple Sclerosis and Related Disorders Clinic at Siriraj Hospital, a tertiary hospital in Thailand, from June to November 2020 was performed. MS, NMOSD, and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) patients were included. Patients’ self-rated Numeric Rating Scale (NRS) for spasticity and clinician-evaluated Modified Ashworth Scale (MAS) scores on the same visit were compared and assessed for correlations. Data on characteristics of patients including demographics, number of transverse myelitis (TM) attacks, disease duration, and Expanded Disability Status Scale (EDSS) score were collected.

RESULTS: Seventy-nine CNSIDD patients were included with 25 MS, 53 NMOSD, and 1 MOGAD. There was a statistically significant correlation between NRS and MAS scores (r = 0.934, p < 0.001). Spasticity was more commonly observed in NMOSD patients compared to MS (34% vs 8%, p = 0.016). Clinical characteristics strongly associated with spasticity were higher number of TM attacks (p < 0.001), severe TM attacks (p < 0.001), longitudinally extensive transverse myelitis attacks (p < 0.001), longer disease duration (p = 0.025), higher EDSS (p < 0.001), and pyramidal Functional System Scale scores (p = 0.001).

CONCLUSIONS: Patients’ self-reported NRS score had a good correlation with clinician-evaluated MAS score for spasticity assessment in NMOSD and CNSIDD patients overall. Number and severity of TM attacks were associated with spasticity. Spastic patients had more disability measured by EDSS.

PMID:35032877 | DOI:10.1016/j.msard.2022.103517

Environ Int. 2022 Jan 12;160:107054. doi: 10.1016/j.envint.2021.107054. Online ahead of print.

ABSTRACT

BACKGROUND: Exposure to phthalates during pregnancy may alter DNA methylation in the placenta, a crucial organ for the growth and development of the fetus.

OBJECTIVES: We studied associations between urinary concentrations of phthalate biomarkers during pregnancy and placental DNA methylation.

METHODS: We measured concentrations of 11 phthalate metabolites in maternal spot urine samples collected between 22 and 29 gestational weeks in 202 pregnant women. We analyzed DNA methylation levels in placental tissue (fetal side) collected at delivery. We first investigated changes in global DNA methylation of repetitive elements Alu and LINE-1. We then performed an adjusted epigenome-wide association study using IlluminaHM450 BeadChips and identified differentially methylated regions (DMRs) associated with phthalate exposure.

RESULTS: Monobenzyl phthalate concentration was inversely associated with placental methylation of Alu repeats. Moreover, all phthalate biomarkers except for monocarboxy-iso-octyl phthalate and mono(2-ethyl-5-hydroxyhexyl) phthalate were associated with at least one DMR. All but three DMRs showed increased DNA methylation with increased phthalate exposure. The largest identified DMR (22 CpGs) was positively associated with monocarboxy-iso-nonyl phthalate and encompassed heat shock proteins (HSPA1A, HSPA1L). The remaining DMRs encompassed transcription factors and nucleotide exchange factors, among other genes.

CONCLUSIONS: This is the first description of genome-wide modifications of placental DNA methylation in association with pregnancy exposure to phthalates. Our results suggest epigenetic mechanisms by which exposure to these compounds could affect fetal development. Of interest, four identified DMRs had been previously associated with maternal smoking, which may suggest particular sensitivity of these genomic regions to the effect of environmental contaminants.

PMID:35032864 | DOI:10.1016/j.envint.2021.107054

Pathol Res Pract. 2021 Dec 31;230:153756. doi: 10.1016/j.prp.2021.153756. Online ahead of print.

ABSTRACT

BACKGROUND: Mesenchymal stromal cells (MSC) have demonstrated ability to improve diabetic nephropathy (DN) in experimental models, as well as by improving kidney endogenous progenitor cells proliferation and differentiation. Many studies have demonstrated the effect of hypoxia on MSC improving their functionality but the potential enhancement of the nephroprotective properties of MSC cultured under low oxygen concentration has been explored in few studies, none of them in the context of DN. On the other hand, diabetes is associated with abnormalities in MSCs functionality. These findings related to the hypoxia preconditioning ability to enhance adipose-tissue derived-MSC (ASC) performance have led us to wonder if hypoxia could increase the known beneficial effect of normal ASC in DN and if it could correct the expected inability of diabetic rat-derived ASC to exert this effect in vivo. To answer these questions, in the present study we have used ASC from healthy and diabetic-induced rats, cultured under standard conditions or hypoxia preconditioned, in a DN rat model induced by streptozotocin (STZ).

METHODS: Diabetes was induced in Wistar-rats by 60 mg/kg streptozotocin (STZ) intraperitoneal injection. Fifteen days thereafter, five diabetic-induced rats and five healthy, previously injected with saline, were sacrificed and used as ASC donors . Both healthy and diabetic rat-derived ASC (cASC and dASC, respectively) were cultured under standard conditions (21%O2)(N) or were subjected to a 48 h conditioning period in hypoxia (3%O2)(H). Thus, four types of cells were generated depending on their origin (healthy or diabetic-induced rats) and the culture conditions(N or H):cASC-N, cASC-H, dASC-N and dASC-H. DN experimental study were carried out fifteen days after STZ induction of diabetes in fifty-two healthy rats. DN-induced-animals were randomly assigned to be injected with 200 µL saline as placebo or with 3 × 106 cASC-N, cASC-H, dASC-N or dASC-H, according to the study group. Serum glucose, urea and creatinine, and urine albumin levels were measured at 2-weeks intervals until day+ 45 after ND-induction.Animals were sacrificed and kidneys extracted for histopathological and transmission electron microcopy analysis RESULTS: None of the four study groups that received cell treatment showed significant changes in serum glucose, urea and creatinine levels, urine albumin concentration and body weight compared to placebo ND-induced group. Interestingly, only the group that received cASC-H showed a reduction in glucose and creatinine levels although it did not reach statistical significance.All DN-induced groups treated with ASC reduced significantly renal lesions such as mesangial expansion, mesangiolysis, microaneurysms and acute tubular necrosis compared to ND-induced placebo group (p ≤ 0.05). Renal injuries such as clear tubular cell changes, thickening of tubular basement membrane, tubular cysts and interstitial fibrosis significantly showed reduction in ND-induced rats treated with cASC-H regarding to their received cASCN (p ≤ 0.05). Non statistical differences were observed in the improvement capacity of cASC and dASC culture under standard condition.However, hypoxia preconditioning reduces the presence of tubular cysts (p ≤ 0.01).

CONCLUSIONS: Hypoxia preconditioning enhances the ability of healthy rat-derived ASC to improve kidney injury in a rat model of DN. Moreover, diabetic-derived ASC exhibits a similar ability to healthy ASC which is clearly more than expected, but it is not significantly modified by hypoxia preconditioning.

PMID:35032832 | DOI:10.1016/j.prp.2021.153756