Body mass index and quality of life in people living with HIV.

With advances in the treatment of HIV, people living with HIV (PLWH) are now expected to have a near-normal life expectancy, but challenges remain in the form of substantially poorer health-related quality of life (HRQoL) than the general population. Being overweight or obese may pose an additional burden in PLWH, but few studies have evaluated the relationship between body mass index (BMI) and HRQoL in PLWH. This study aimed to evaluate and describe the association between HRQoL and BMI among PLWH in the US. Data were obtained from the 2018 and 2019 US National Health and Wellness Survey, an online, self-reported, general population survey. Analyses included 575 PLWH who self-reported a physician diagnosis and prescription use for the treatment of HIV, as well as 1725 propensity score matched non-HIV controls. After adjusting for age, sex, race, and comorbidities, higher BMI was associated with poorer physical (ß = -0.18, p = 0.005) and general (ß = -0.42, p = 0.014) HRQoL among PLWH. Additionally, PLWH reported poorer mental, physical, and general HRQoL than non-HIV controls; these relationships were not moderated by BMI. The potential negative impact of higher BMI on patients' humanistic outcomes should be considered in HIV management, including selection of treatment.

The burden of illness in patients with paroxysmal nocturnal hemoglobinuria receiving treatment with the C5-inhibitors eculizumab or ravulizumab: results from a US patient survey.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and life-threatening disease with symptoms of hemolysis and thrombosis. Current therapies for this complement-mediated disease rely predominantly on inhibition of the C5 complement protein. However, data on treatment responses and quality of life in C5-inhibitor (C5i)-treated PNH patients are scarce. The objective of this study was to determine C5i treatment effects on clinical parameters, PNH symptoms, quality of life, and resource use for PNH patients. This cross-sectional study surveyed 122 individuals in the USA receiving treatment for PNH with C5-targeted monoclonal antibodies, eculizumab (ECU) or ravulizumab (RAV). Despite most patients receiving C5i therapy for ≥ 3 months (ECU 100%, n = 35; RAV 95.4%, n = 83), many patients remained anemic with hemoglobin levels ≤ 12 g/dL in 87.5% (n = 28/32) and 82.9% (n = 68/82) of ECU and RAV recipients, respectively. A majority of patients on ECU (88.6%; n = 31/35) and RAV (74.7%; n = 65/87) reported fatigue symptoms. Among PNH patients receiving C5i therapy for ≥ 12 months, some still reported thrombotic events (ECU, 10.0%, n = 1/10; RAV, 23.5%, n = 4/17) and required transfusions within the past year (ECU, 52.2%, n = 12/23; RAV, 22.6%, n = 7/31). Other patient-reported PNH symptoms included breakthrough hemolysis, shortness of breath, and headaches. Patients reported scores below the average population norms on the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scales. Overall, this study found that PNH patients receiving ECU or RAV therapy demonstrated a significant burden of illness, highlighting the need for improved PNH therapies.

The burden of illness of patients with paroxysmal nocturnal haemoglobinuria receiving C5 inhibitors in France, Germany and the United Kingdom: Patient-reported insights on symptoms and quality of life.

OBJECTIVES: To assess the clinical, humanistic and economic burden of paroxysmal nocturnal haemoglobinuria (PNH) among C5 inhibitor (C5i)-treated patients with PNH. METHODS: This was a web-based, cross-sectional survey (01FEB2021-31MAR2021) of adults with PNH treated with eculizumab (France, Germany, United Kingdom) or ravulizumab (Germany). Self-reported outcomes included: patient characteristics; patient-reported symptoms; and standardised patient-reported outcomes (e.g. Functional Assessment of Chronic Illness Therapy [FACIT]-Fatigue, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30]). RESULTS: Among 71 included patients, 98.6% were C5i-treated for ≥3 months (88.7% ≥12 months); among those with self-reported haemoglobin (Hb) levels (n = 63), most (85.7%) were anaemic (defined as ≤12.0 g/dL). Fatigue was the most common symptom at both diagnosis (73.2%) and survey time (63.4%); there were no statistically significant differences in symptom prevalence between treatment subgroups (eculizumab vs. ravulizumab). Total FACIT-Fatigue and EORTC QLQ-C30 scores were substantially lower than European general population references, but there were no statistically significant differences between treatment subgroups. Hb-level subgroups (<10.5 g/dL vs. ≥10.5 d/dL) followed similar trends for all measures, with few significant subgroup differences. CONCLUSIONS: Results suggest that there remains a considerable burden and unmet need among C5i-treated patients with PNH that requires improved therapies.

Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: A systematic literature review and meta-analysis.

Myelodysplastic syndromes (MDS) are a group of malignant hematologic diseases characterized by ineffective hematopoiesis, which may lead to chronic anemia and transfusion dependency, with up to 30% of patients progressing to acute myeloid leukemia (AML). Studies suggest transfusion dependency may impact overall survival (OS); however, there is a lack of evidence concerning the association between transfusion status (TS) and OS in patients with MDS who become transfusion independent (TI) after treatment. In addition, the holistic impact of TS on other clinical, economic, and humanistic outcomes has not been well understood. We conducted a systematic literature review (SLR) to understand this impact. Ten studies were included and showed consistent decrease in OS in transfusion dependent (TD) compared with TI patients. These findings were confirmed by a meta-analysis (MA) reporting better OS prognosis for TI patients. A second SLR was conducted to understand the association between TS and other clinical, economic, and humanistic outcomes. Twenty-eight studies were included and showed better prognosis for other outcomes, including AML progression and leukemia-free survival for TI patients. Risk of AML progression and cumulative non-leukemic death assessed by the MA showed a trend toward worse prognosis and higher risk of AML progression for TD patients. Lower healthcare resource utilization, better quality of life, and reduced non-leukemic death for TI patients were observed. Studies not eligible for MA also showed better clinical, economic, and humanistic outcomes for TI patients. These findings contribute to understanding the association between transfusion dependence and OS among other outcomes in patients with MDS.

Association of lifestyle factors with semen quality: A pilot study conducted in men from the Portuguese Trás-os-Montes and Alto Douro region followed in fertility support consultations.

A cross-sectional pilot study was conducted in men followed in fertility consultations, from the portuguese Trás-os-Montes and Alto Douro region, in order to associate several lifestyle factors with the spermatic parameters. Of a total of 522 men, 373 were compared based on the occupational exposure to harmful factors, smoking habits and practice of physical exercise per week, and the other 149 men according to their body mass index (normal weight vs. overweight vs. obesity). In the absence of harmful occupational factors, physical exercise seems to be associated with sperm quality improvement, whether individuals smoke or not. When exposed to harmful environments, non-smokers that practice physical exercise more than two times per week tended to present the best vitality, normal morphology and sperm concentration (p > .05). However, if they smoke, physical exercise seems not enough to enhance the spermatic parameters. The BMI correlated negatively with the spermatic quality, especially with sperm concentration (p < .05). Concerning men that did not present lifestyle risks associated, the motility, midpiece and tail abnormalities, and teratozoospermia index were significantly worse on obese individuals comparing to overweight men (p < .05). Thus, patients should also be recommended to control their weight and to have a BMI under 30 kg/m2 .

Prematurity-related knowledge among mothers and fathers of very preterm infants.

OBJECTIVE: Empowering parents as health promoters may contribute to decrease the costs associated with prematurity. In Portugal, 8% and 1% of the births occurring in 2018 were preterm and very preterm, respectively. This study aimed to assess prematurity-related knowledge with regard to its prevalence, causes and consequences, according to sociodemographic, obstetric and offspring's characteristics, among mothers and fathers of very preterm infants. METHODS: Between May and July 2017, mothers and fathers of very preterm infants were invited to participate through the Portuguese association of parents for support to the premature baby, with 196 parents being included. Knowledge on prematurity (prevalence, causes and consequences) was collected through a structured online questionnaire. Reporting of this research follows STROBE guidelines for cross-sectional studies. RESULTS: Parents estimated a median prevalence of preterm and of very preterm delivery in Portugal of 15% and 8%, respectively. However, approximately 20% did not provide an estimate. More than 90% of the participants acknowledged placental complications, hypertensive disorders of pregnancy, multiple pregnancy and intrauterine growth restriction as causes of preterm delivery, whereas only 24.2% identified low socioeconomic status. Cardiac complications and respiratory morbidity were recognised as the main consequences of prematurity by more than 80% of the parents. Overall, parents with a higher socioeconomic status tended to provide correct responses more frequently than those with a low socioeconomic status. CONCLUSIONS: The results revealed the existence of knowledge gaps regarding the prevalence, causes and consequences of premature delivery. Understanding the main facilitators and barriers to the achievement of prematurity-related knowledge may contribute for the global improvement of preventing this condition. RELEVANCE TO CLINICAL PRACTICE: It is crucial to include the improvement of parents' knowledge about prematurity as a complementary dimension during the provision of medical care, with nurses playing a key role as main sources of information.

Resveratrol-Loaded Lipid Nanocarriers Are Internalized By Endocytosis in Yeast.

Different positive pharmacological effects have been attributed to the natural product resveratrol (RSV), including antioxidant, antiaging, and cancer chemopreventive properties. However, its low bioavailability and rapid metabolic degradation has led to the suspicion that many of the biological activities of this compound observed in vitro may not be attainable in humans. To improve its bioavailability and pharmacokinetic profile, attempts have been made to encapsulate RSV into lipid-based nanocarrier systems. Here, the dioctadecyldimethylammonium bromide (DODAB):monoolein (MO) liposomal system (1:2) loaded with RSV revealed appropriate characteristics for drug release purposes: reduced size for cellular uptake (157 ± 23 nm), stability up to 80 days, positive surface charge (ζ ≈ +40 mV), and a controlled biphasic release of RSV from the lipid nanocarriers over a period of almost 50 h at pH 5.0 and 7.4. Moreover, the encapsulation efficiency of the nanocarrier ranged from 70% to 92% and its RSV loading capacity from 9% to 14%, when [RSV] was between 100 and 200 µM. The partition coefficient ( Kp) of RSV between lipid and aqueous phase was log Kp = 3.37 ± 0.10, suggesting moderate to high lipophilicity of this natural compound and reinforcing the lipid nanocarriers' suitability for RSV incorporation. The thermodynamic parameters of RSV partitioning in the lipid nanocarriers at 37 °C (Δ H = 43.76 ± 5.68 kJ mol-1; Δ S = 0.20 ± 0.005 kJ mol-1; and Δ G = -18.46 ± 3.48 kJ mol-1) reflected the spontaneity of the process and the establishment of hydrophobic interactions. The cellular uptake mechanism of the RSV-loaded nanocarriers labeled with the lipophilic fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH) was studied in the eukaryotic model system Saccharomyces cerevisiae. Thirty minutes after incubation, yeast cells readily internalized nanocarriers and the spots of blue fluorescence of DPH clustered around the central vacuole in lipid droplets colocalized with the green fluorescence of the lipophilic endocytosis probe FM1-43. Subsequent studies with the endocytosis defective yeast deletion mutant ( end3Δ) and with the endocytosis inhibitor methyl-ß-cyclodextrin supported the involvement of an endocytic pathway. This novel nanotechnology approach opens good perspectives for medical applications.

Daylight Bactericidal Titania Textiles: A Contribution to Nosocomial Infections Control.

: Daylight bactericidal cotton (100% cotton) textiles are presented and proposed for future hospital use. Amorphous titania (a-TiO2) and amorphous titania/chitosan complexes (a-TiO2//CS) were the selected bactericidal agents. Nanoparticles (NPs) and films were the two paths designed. Cotton textiles were impregnated with a-TiO2-based NPs or coated with a-TiO2 films. Industrial impregnation/coating will be implemented during the textile finishing treatments. A novel (room temperature and base-catalyzed), green (hydrothermal water as a catalyst), time-saving, and easy scale-up sol-gel process was established to produce the a-TiO2-based NPs. Amorphous-TiO2 films were produced by a dip-in (acid catalyzed) sol-gel solution. The daylight bactericidal performance (without the need of an external ultraviolet light source) of a-TiO2 NPs, films, and impregnated/coated textiles was proven according to AATCC 100 and ASTM E2149, using Staphylococcus aureus (ATCC®6538TM) as the bacterial indicator strain. A bacterial reduction of 99.97% was achieved for the a-TiO2 films and of 99.97% for the a-TiO2/CS NPs. Regarding the impregnated textiles, a bacterial reduction of 91.66% was achieved with a-TiO2/CS NPs, and 99.97% for cotton textiles coated with an a-TiO2 film.

Amino Acids in the Development of Prodrugs.

Although drugs currently used for the various types of diseases (e.g., antiparasitic, antiviral, antibacterial, etc.) are effective, they present several undesirable pharmacological and pharmaceutical properties. Most of the drugs have low bioavailability, lack of sensitivity, and do not target only the damaged cells, thus also affecting normal cells. Moreover, there is the risk of developing resistance against drugs upon chronic treatment. Consequently, their potential clinical applications might be limited and therefore, it is mandatory to find strategies that improve those properties of therapeutic agents. The development of prodrugs using amino acids as moieties has resulted in improvements in several properties, namely increased bioavailability, decreased toxicity of the parent drug, accurate delivery to target tissues or organs, and prevention of fast metabolism. Herein, we provide an overview of models currently in use of prodrug design with amino acids. Furthermore, we review the challenges related to the permeability of poorly absorbed drugs and transport and deliver on target organs.

Photonic Band Gap and Bactericide Performance of Amorphous Sol-Gel Titania: An Alternative to Crystalline TiO2.

In addition to its traditional application in white pigments, nanocrystalline titania (TiO2) has optoelectronic and photocatalytic properties (strongly dependent on crystallinity, particle size, and surface structure) that grant this naturally occurring oxide new technological applications. Sol-gel is one of the most widely used methods to synthesize TiO2 films and NPs, but the products obtained (mostly oxy-hydrated amorphous phases) require severe heat-treatments to promote crystallization, in which control over size and shape is difficult to achieve. In this work, we obtained new photocatalytic materials based on amorphous titania and measured their electronic band gap. Two case studies are reported that show the enormous potential of amorphous titania as bactericide or photocatalyst. In the first, amorphous sol-gel TiO2 thin films doped with N (TiO2−xNx, x = 0.75) were designed to exhibit a photonic band gap in the visible region. The identification of Ti-O-N and N-Ti-O bindings was achieved by XPS. The photonic band gaps were found to be 3.18 eV for a-TiO2 and 2.99 eV for N-doped a-TiO2. In the second study, amorphous titania and amine-functionalized amorphous titania nanoparticles were synthetized using a novel base-catalysed sol-gel methodology. All the synthesized amorphous TiO2 nanoparticles exhibit bactericide performance (E. coli, ASTME 2149-13).

Conjugated linoleic acid improves oocyte cryosurvival through modulation of the cryoprotectants influx rate.

BACKGROUND: In cryopreservation, oocytes are subjected to extreme hyperosmotic conditions, inducing large volume changes that, along with an abrupt temperature drop, interfere with their developmental competence. Our objectives in this work were to find conditions enabling an increase in oocyte cryosurvival and subsequent development. METHODS: Abattoir-derived bovine oocytes were cultured without (Control group) or with trans-10,cis-12 conjugated linoleic acid isomer (CLA group). Comparative observations were made for 1) the oocyte developmental competence after exposure to cryoprotectants followed or not by vitrification/warming, 2) the oocyte membrane permeability to water (using the non-permeant cryoprotectant sucrose) and 3) the oocyte membrane permeability to two cryoprotectants (ethylene glycol, EG, and dimethyl sulfoxide, DMSO). Mature oocytes cultured with or without CLA and vitrified/warmed or only exposed to cryoprotectants without vitrification were subjected to in vitro fertilization; embryo culture proceeded until the blastocyst stage. The oocyte membrane permeabilities to water and cryoprotectants were estimated using mature oocytes subjected to hyperosmotic challenges. For water permeability, 200 mM sucrose was used, whereas for the cryoprotectant permeability, a 10 % solution of both EG and DMSO was used. The data were analyzed using the MIXED procedure and Student's T-test. RESULTS: CLA supplementation improves the developmental competence of vitrified/warmed and cryoprotectants exposed oocytes (p < 0.01) and reduces their membrane permeability to water (37 %, p < 0.001) and to cryoprotectants (42 %, p < 0.001). CONCLUSIONS: By slowing the fluxes of water and of permeant cryoprotectants, CLA contributed to improved oocyte cryosurvival and post-thawed viability. This isomer supplementation to the maturation media should be considered when designing new protocols for oocyte cryopreservation.

Zooming into protein oligomerization in neurodegeneration using BiFC.

Several neurodegenerative diseases are characterized by the accumulation of misfolded and aggregated proteins, which lead to neurotoxicity. However, the nature of those toxic species is controversial. Developments in optical microscopy and live-cell imaging are essential in providing crucial insight into the molecular mechanisms involved. In particular, the technique of bimolecular fluorescence complementation (BiFC) represents a remarkable improvement for observing protein-protein interactions within living cells. Unlike other techniques, BiFC provides spatial and temporal resolution and can be carried out in a physiological environment. Among other applications, BiFC has been used to study molecular determinants of oligomerization in neurodegenerative disorders, thereby promising to unveil novel targets for therapeutics. We review the applicability of BiFC for investigating the molecular basis of neurodegenerative diseases associated with protein misfolding and aggregation.

The role of botulinum toxin in the management of nonneurogenic overactive bladder in children: Highlights for clinical practice. A systematic review.

Overactive bladder (OAB) is the most common voiding dysfunction in children; however, nonneurogenic or idiopathic OAB remains poorly studied. First-line treatment includes conservative measures; however, as many patients are refractory, have adverse effects, or are contraindicated for anticholinergics, new options must be explored. This review covers the use of intravesical botulinum toxin (BoNT) for idiopathic OAB treatment in children, emphasizing its efficacy, safety, differences between toxins, doses, and injection techniques. Clinical results were promising, with all 8 studies reporting good results. All authors used BoNT type A (BoNT-A), either onabotulinum or abobotulinum toxin A. Response rates were variable, with full-response percentages of 32%-60%. As proven by the full-response rates of 50%, repeated injections are as safe and effective as first injections. Only a few cases of urinary tract infection, transient urinary retention, and hematuria have been reported, with no major local or systemic adverse effects. Despite these limitations, evidence encourages and supports BoNT-A use as a safe and effective treatment modality for refractory idiopathic OAB in pediatric settings, regardless of dosage and target toxin. To the best of our knowledge, this is the first systematic review of the use of intravesical BoNT-A for idiopathic OAB treatment in children.

Mackerel and Seaweed Burger as a Functional Product for Brain and Cognitive Aging Prevention.

Most world countries are experiencing a remarkable aging process. Meanwhile, 50 million people are affected by Alzheimer's disease (AD) and related dementia and there is an increasing trend in the incidence of these major health problems. In order to address these, the increasing evidence suggesting the protective effect of dietary interventions against cognitive decline during aging may suggest a response to this challenge. There are nutrients with a neuroprotective effect. However, Western diets are poor in healthy n-3 polyunsaturated fatty acids (n-3 PUFAs), such as docosahexaenoic acid (DHA), iodine (I), and other nutrients that may protect against cognitive aging. Given DHA richness in chub mackerel (Scomber colias), high vitamin B9 levels in quinoa (Chenopodium quinoa), and I abundance in the seaweed Saccorhiza polyschides, a functional hamburger rich in these nutrients by using these ingredients was developed and its formulation was optimized in preliminary testing. The effects of culinary treatment (steaming, roasting, and grilling vs. raw) and digestion on bioaccessibility were evaluated. The hamburgers had high levels of n-3 PUFAs in the range of 42.0-46.4% and low levels of n-6 PUFAs (6.6-6.9%), resulting in high n-3/n-6 ratios (>6). Bioaccessibility studies showed that the hamburgers could provide the daily requirements of eicosapentaenoic acid (EPA) + DHA with 19.6 g raw, 18.6 g steamed, 18.9 g roasted, or 15.1 g grilled hamburgers. Polyphenol enrichment by the seaweed and antioxidant activity were limited. The hamburgers contained high levels of Se and I at 48-61 µg/100 g ww and 221-255 µg/100 g ww, respectively. Selenium (Se) and I bioaccessibility levels were 70-85% and 57-70%, respectively, which can be considered high levels. Nonetheless, for reaching dietary requirements, considering the influence of culinary treatment and bioaccessibility, 152.2-184.2 g would be necessary to ensure daily Se requirements and 92.0-118.1 g for I needs.

Clinical course and disease burden of patients with generalized pustular psoriasis in Portugal: a multicenter retrospective cohort study.

OBJECTIVES: Generalized pustular psoriasis (GPP) is a rare, life-threatening skin inflammatory disorder. This study aimed to describe the disease course, treatment strategies, and healthcare utilization among patients with GPP in Portugal. METHODS: This multicentric, observational, retrospective study included consecutive adult patients with GPP undergoing a dermatology evaluation in different reporting institutions by experienced dermatologists between 2002 and 2023. RESULTS: A total of 59 patients were assessed. Most of the cohort had a previous history of plaque psoriasis (71%) and 83% presented at least one comorbidity. At the initial encounter, 64% of the cohort needed hospitalization. Systemic involvement was common, including fever (37%), and elevated white blood cell count and erythrocyte sedimentation rate/C-reactive protein (49%). Nearly, 73% of patients initiated systemic drugs, and 70% had to discontinue the first treatment. During the study, 98% of patients experienced at least one flare. At the last visit, 3.4% of patients had died, and 71.2% exhibited signs of active disease despite undergoing treatment. CONCLUSIONS: Our study demonstrates that GPP is a chronic, debilitating condition associated with systemic involvement, frequent flares, and hospitalizations, despite receiving multiple systemic treatments. Improved disease awareness and new treatments are needed to improve patient care and decrease the burden of the disease.

Professional reintegration among professionally active Portuguese stroke survivors: a multicentric study.

PURPOSE: To assess professional reintegration, the perceived impact of stroke on work, and the main determinants of return to work (RTW) among stroke survivors. MATERIALS AND METHODS: A cross-sectional study was performed, based on a cohort of stroke survivors. A structured questionnaire was administered to previously working stroke survivors, 18-24 months post-stroke. Data on sociodemographic characteristics, stroke features and their impact on work, access to rehabilitation services during hospital admission and after discharge, social support, and professional reintegration were reported by 553 stroke survivors. RESULTS: On average, 56.6% (95% CI 52.4-60.8) of stroke survivors resumed professional activity, 20 months after stroke. Approximately 90% of survivors who RTW, returned to the same job and same function they performed before stroke. The majority did not receive reintegration support. The main determinants of RTW were lower age, higher socioeconomic status, and better functional status. CONCLUSIONS: Professional reintegration and vocational support after stroke, remained below the international goals for community reintegration of stroke survivors. Future studies should explore the impact of professional and social reintegration on the psychological health and quality of life of stroke survivors and the barriers, challenges, and strategies used to overcome them, to allow for effective professional reintegration policies.

The amount of professionally active people affected by stroke events is rising worldwide, with increasing numbers of survivors with restricted occupational participation.Higher age and lower socioeconomic status appear to be main determinants for no return to work and so, a special attention should be given to this particular group of stroke survivors.Vocational and social support after stroke is highly needed to help in the reintegration of a professionally active life.Social and community support after stroke should be offered as soon as possible after stroke to promote a successful professional reintegration.

Non-pharmacological interventions in primary care to improve the quality of life of older patients with palliative care needs: a systematic review of randomised controlled trials.

OBJECTIVES: Our systematic review aimed to summarise non-pharmacological interventions applicable in primary care that improve the quality of life of older patients with palliative care needs. DESIGN: Systematic review. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was patients' quality of life. Secondary outcomes were symptoms relief and patients' well-being measures. METHODS AND ANALYSIS: We searched MEDLINE, EMBASE, PsycINFO, Cochrane and CINAHL up to October 2022 for randomised controlled trials (RCTs). We also handsearched abstract books of relevant congresses and scientific meetings in the last 5 years. Screening, data extraction and quality evaluation (Cochrane risk-of-bias (RoB) V.2.0 tool and Grading of Recommendations, Assessment, Development and Evaluations (GRADE)) were done independently by two reviewers, with disagreements solved by a third reviewer. Findings were narratively synthesised. RESULTS: We identified 4 RCTs, including 268 patients. One study used a broad criteria of palliative care needs ('progressive, life-threatening disease'), two studies focused on advanced cancer and one study on heart failure. The non-pharmacological interventions evaluated were advance care planning conducted by general practitioners (GPs); social worker-aided palliative care; online primary palliative care training for GPs and spiritual history taking by nurses and GPs. No intervention showed a statistically significant impact on quality of life and the evidence was low according to GRADE. CONCLUSION: The results highlight a dearth of evidence on what non-pharmacological interventions can be effectively done in primary care to improve the quality of life of older persons with palliative care needs. The results should be interpreted with caution, as the search more comprehensively covers interventions delivered by GPs. PROSPERO REGISTRATION NUMBER: CRD42020154216.

Spatial and Temporal Analysis of Normal and Shear Forces During Grasping, Manipulation and Social Activities.

Extensive research has established and widely acknowledged the important contribution of human hand sensory receptors in providing tactile feedback. The absence of these receptors results in a poor perception of the environment, impairing our efficient manipulation skills. Although the literature emphasizes the significance of normal forces in human grasping, further investigations should point toward the role of shear forces in this process. This paper presents an analysis of human everyday grasping activities through the use of 20 three-axis magnetic soft skin force sensors, in the form of rings and bands, that measure both normal and shear forces. Our study includes twelve tasks that cover various grasping requirements. Results highlight the importance of spatial information and the usefulness of shear forces in the prediction of unexpected changes that can not be always observed in normal forces. Tactile sensing can ultimately be integrated into prosthetic and rehabilitation devices for improved control and potentially provide sensory feedback to the user.

How Biological Activity in Sea Cucumbers Changes as a Function of Species and Tissue.

Biological activity and bioactive compound content in sea cucumbers was assessed, considering Parastichopus regalis, Holothuria mammata, Holothuria forskali, and Holothuria arguinensis as species and intestine, muscle band, respiratory tree, body wall, and gonads as tissues. P. regalis had the lowest content in phenolic compounds and antioxidant activity in contrast to Holothuria species. In the respiratory tree, the highest phenolic concentration was recorded in H. arguinensis, 76.4 ± 1.2 mg GAE/100 g dw vs. 21.0-49.0 mg GAE/100 g dw in the other species. H. arguinensis had the highest DPPH and FRAP results in the gonads, 13.6 ± 0.7 mg AAE/100 g dw vs. 2.6-3.5 mg AAE/100 g dw and 27.1 ± 0.3 µmol Fe2+/g dw vs. 8.0-15.9 µmol Fe2+/g dw, respectively. Overall, P. regalis biomass presented the highest anti-inflammatory activity levels and H. arguinensis the lowest anti-inflammatory levels. The respiratory tree was the most anti-inflammatory (measured by the inhibition of cyclooxygenase-2, COX-2) tissue in H. mammata and H. forskali (also the muscle band in this case), 76.3 ± 6.3% and 59.5 ± 3.6% COX-2 inhibition in 1 mg/mL aqueous extracts, respectively. The results demonstrated a variable bioactive potential and advantage in targeting antioxidant properties in the muscle band and anti-inflammatory activity in the respiratory tree, which may constitute a starting point for a biorefinery approach envisaging multiple applications.