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BACKGROUND: Patient and public involvement and engagement (PPIE) in healthcare research is crucial for effectively addressing patients' needs and setting appropriate research priorities. However, there is a lack of awareness and adequate methods for practicing PPIE, especially for vulnerable groups like childhood cancer survivors. AIMS: This project aimed to develop and evaluate engagement methods to actively involve pediatric oncological patients, survivors, and their caregivers in developing relevant research questions and practical study designs. METHODS AND RESULTS: An interdisciplinary working group recruited n = 16 childhood cancer survivors and their caregivers to work through the entire process of developing a research question and a practicable study design. A systematic literature review was conducted to gather adequate PPIE methods which were then applied and evaluated in a series of three workshop modules, each lasting 1.5 days. The applied methods were continuously evaluated, while a monitoring group oversaw the project and continuously developed and adapted additional methods. The participants rated the different methods with varying scores. Over the workshop series, the participants successfully developed a research question, devised an intervention, and designed a study to evaluate their project. They also reported increased expertise in PPIE and research knowledge compared to the baseline. The project resulted in a practical toolbox for future research, encompassing the final workshop structure, evaluated methods and materials, guiding principles, and general recommendations. CONCLUSION: These findings demonstrate that with a diverse set of effective methods and flexible support, actively involving patients, survivors, and caregivers can uncover patients' unmet disease-related needs and generate practical solutions apt for scientific evaluation. The resulting toolbox, filled with evaluated and adaptable methods (workbook, Supplement 1 and 2), equips future scientists with the necessary resources to successfully perform PPIE in the development of health care research projects that effectively integrate patients' perspectives and address actual cancer-related needs. This integration of PPIE practices has the potential to enhance the quality and relevance of health research and care, as well as to increase patient empowerment leading to sustainable improvements in patients' quality of life.
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Supervivientes de Cáncer , Neoplasias , Padres , Participación del Paciente , Humanos , Supervivientes de Cáncer/psicología , Padres/psicología , Participación del Paciente/psicología , Neoplasias/psicología , Neoplasias/terapia , Niño , Femenino , Masculino , Cuidadores/psicología , Adulto , Adolescente , Proyectos de InvestigaciónRESUMEN
BACKGROUND: Transcranial Pulse Stimulation (TPS) has been recently introduced as a novel ultrasound neuromodulation therapy with the potential to stimulate the human brain in a focal and targeted manner. Here, we present a first retrospective analysis of TPS as an add-on therapy for Parkinson's disease (PD), focusing on feasibility, safety, and clinical effects. We also discuss the placebo response in non-invasive brain stimulation studies as an important context. METHODS: This retrospective clinical data analysis included 20 PD patients who received ten sessions of TPS intervention focused on the individual motor network. Safety evaluations were conducted throughout the intervention period. We analyzed changes in motor symptoms before and after TPS treatment using Unified Parkinson's Disease Rating Scale part III (UPDRS-III). RESULTS: We found significant improvement in UPDRS-III scores after treatment compared to baseline (pre-TPS: 16.70 ± 8.85, post-TPS: 12.95 ± 8.55; p < 0.001; Cohen's d = 1.38). Adverse events monitoring revealed no major side effects. CONCLUSION: These preliminary findings suggest that TPS can further improve motor symptoms in PD patients already on optimized standard therapy. Findings have to be evaluated in context with the current literature on placebo effects.
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Enfermedad de Parkinson , Terapia por Ultrasonido , Humanos , Enfermedad de Parkinson/terapia , Estudios Retrospectivos , Terapia por Ultrasonido/efectos adversos , Ultrasonografía , EncéfaloRESUMEN
Humans typically have bilateral symmetry, however, deviations from perfect symmetry can be observed. In the case of the upper extremities, mostly a right-biased asymmetry in the length or strength of the bones, but also lean body mass was reported. Regarding the lower extremities, the asymmetry patterns are weaker. The aim of this study is to analyze directional and cross-asymmetry in body composition parameters among healthy non-athletic women. In particular, it is hypothesized that body composition asymmetry patterns of the limbs change with increasing age. 584 Austrian women aged between 16 and 83 years were enrolled in the study. Data collection took place between 1995 and 2000 at the Menox outpatient department for the treatment of climacteric symptoms in Vienna. Bone mineral density (BMD), bone mineral content (BMC), lean mass, and fat mass was determined using dual-energy-x-ray absorptiometry (DEXA). Signed asymmetry was calculated for each body composition parameter of the upper and lower limbs. Right-sided symmetry dominated for lean mass, BMC, and BMD in the upper extremity. Asymmetry in the lower limbs was not as strong as in the arms, but a right-sided asymmetry was still observable. Fat mass showed the strong right-sided asymmetry of all measurements for the lower extremities in the whole sample. Contra lateral asymmetry of the extremities could be found in 37-45% of the sample for lean mass, BMD, and BMC. For fat mass, almost half of the sample displayed cross asymmetry. Significant associations between asymmetry patterns and age were observable for the fat mass of the upper extremities only. Participants younger than 30 years showed a significant left-sided asymmetry for fat mass in the upper extremities. However, this pattern changed around the age of 30 and shifted to a slight right-sided asymmetry. In general, the body composition of the upper and lower limbs showed distinct asymmetry patterns.
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Density separation is a process routinely used to segregate minerals, organic matter, and even microplastics, from soils and sediments. Here we apply density separation to archaeological bone powders before DNA extraction to increase endogenous DNA recovery relative to a standard control extraction of the same powders. Using nontoxic heavy liquid solutions, we separated powders from the petrous bones of 10 individuals of similar archaeological preservation into eight density intervals (2.15 to 2.45 g/cm3, in 0.05 increments). We found that the 2.30 to 2.35 g/cm3 and 2.35 to 2.40 g/cm3 intervals yielded up to 5.28-fold more endogenous unique DNA than the corresponding standard extraction (and up to 8.53-fold before duplicate read removal), while maintaining signals of ancient DNA authenticity and not reducing library complexity. Although small 0.05 g/cm3 intervals may maximally optimize yields, a single separation to remove materials with a density above 2.40 g/cm3 yielded up to 2.57-fold more endogenous DNA on average, which enables the simultaneous separation of samples that vary in preservation or in the type of material analyzed. While requiring no new ancient DNA laboratory equipment and fewer than 30 min of extra laboratory work, the implementation of density separation before DNA extraction can substantially boost endogenous DNA yields without decreasing library complexity. Although subsequent studies are required, we present theoretical and practical foundations that may prove useful when applied to other ancient DNA substrates such as teeth, other bones, and sediments.