Living in a rural area: a potential risk factor for falls in people with Parkinson disease.

INTRODUCTION: Falls are prevalent in patients with Parkinson disease (PD). Previous work focused on the impact of motor and non-motor symptoms on falls and ignored the impact of environmental factors, such as residence, economic level, and nursing status. The aim of this study was to investigate the prevalence and risk factors of falls in patients with PD and explore the impact of residence on falls. METHODS: A cross-sectional study of 100 patients with PD was carried out. Patients were recruited from Anhui Provincial Hospital (Hefei, Anhui province, China) between July 2017 and December 2020. Participants were grouped based on whether they had fallen in the previous 3 months, and demographic information was collected through detailed interviews. In addition, severity of motor symptoms, cognitive function, and self-care abilities were assessed with the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), the Hoehn-Yahr (H&Y) scale, the Mini-Mental State Examination (MMSE), and the Barthel Index. The results were analyzed using student t-test, Mann-Whitney U-test, χ2 test and multivariate binary logistic regression analyses. RESULTS: A total of 42% of the patients had fallen in the previous 3 months. The patients who had fallen were older and with a longer disease period, a higher UPDRS-III score, a higher H&Y stage, a lower MMSE score, and a lower Barthel Index score (all p<0.05). According to the logistic regression analysis, living in a rural area (odds ratio (OR)=3.34, 95% confidence interval (CI) 1.15-9.65), MMSE<24 (OR=4.79, 95%CI 1.17-19.65), having sleep disorders (OR=4.97, 95%CI 1.74-14.2), and having a high UPDRS-III score (OR=1.07, 95%CI 1.02-1.11) were independent risk factors for falls. The incidence of falls was higher in rural areas. Urban and rural patients showed different levels of disease severity; rural patients had higher H&Y stages, higher UPDRS-III scores and lower Barthel Index scores. CONCLUSION: Falls are caused by a variety of factors in people with PD. Multidimensional factors should be considered comprehensively to develop a personalized plan to prevent falls in PD patients.

ADAR1 Prevents R-loop Accumulation-Driven ATR Pathway Activation in Ovarian Cancer.

Adenosine (A)-to-inosine (I) RNA editing is the most prevalent RNA editing mechanism, in which adenosine deaminase acting on RNA 1 (ADAR1) is a major adenosine deaminase. Increasing evidence suggests that editing dysregulation of ADAR1 plays an important role in human tumorigenesis, while the underlying mechanism remains elusive. Here, we demonstrated that ADAR1 was highly expressed in ovarian cancer tissues and negatively correlated with progression free survival of ovarian cancer patients. Importantly, silence of ADAR1 repressed ovarian cancer cell growth and colony formation in vitro and inhibited ovarian cancer cell tumorigenesis in vivo. Further cell cycle and transcriptome profile analysis revealed that silence of ADAR1 in ovarian cancer cells induced cell cycle arrest at G1/G0 stage. Mechanistically, loss of ADAR1 caused R-loop abnormal accumulation, thereby contributing to single stand DNA break and ATR pathway activation. Additionally, ADAR1 interacted with DHX9 to regulate R-loop complex formation, and A-to-I editing of nascent RNA repressed R-loop formation during co-transcriptional process. Together, our results identify a novel ADAR1/R-loop/ATR axis critical for ovarian cancer progression and a potential target for ovarian cancer therapy.

A Comparison of Pain between Parkinson's Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey.

Background: Pain is frequent in Parkinson's disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods: Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson's Disease Questionnaire (PDQ-39). Results: Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P < 0.01, P < 0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson's Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion: PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient's life.