Potential Values of Circulating microRNA-21 to Predict Early Recurrence in Patients with Colorectal Cancer after Treatments.

Insufficient prognosis of local recurrence contributes to the poor progression-free survival rate and death in colorectal cancer (CRC) patients. Various biomarkers have been explored in predicting CRC recurrence. This study investigated the expressions of plasma/exosomal microRNA-21 (miR-21) in 113 CRC patients by qPCR, their values of predicting CRC recurrence, and the possibility to improve the prognostic efficacy in early CRC recurrence in stratified patients by combined biomarkers including circulating miR-21s, circulating tumour cells/microemboli (CTCs/CTM), and serum carcinoembryonic antigen (CEA)/carbohydrate antigen 19-9 (CA19-9). Expressions of plasma and exosomal miR-21s were significantly correlated (p < 0.0001) in all and late-stage patients, presenting similar correlations with other biomarkers. However, stage IV patients stratified by a high level of exosomal miR-21 and stage I to III patients stratified by a high level of plasma miR-21 displayed significantly worse survival outcomes in predicting CRC recurrence, suggesting their different values to predict CRC recurrence in stratified patients. Comparable and even better performances in predicting CRC recurrence in late-stage patients were found by CTCs/CTM from our blood samples as sensitive biomarkers. Improved prognosing efficacy in CRC recurrence and better outcomes to significantly differentiate recurrence in stratified patients could be obtained by analysing combined biomarkers.

Community vs. institutional elders' evaluations of and preferences for yoga exercises.

AIMS: To evaluate and compare the appropriateness of the Silver Yoga exercise programme for community and institutional elders and to determine their preferences towards yoga exercises. BACKGROUND: Yoga has been used to promote the health of elders. The Silver Yoga was developed to accommodate the physical tolerance and body flexibility of elders and applied to community and institutional elders with positive health promotion benefits. DESIGN: Descriptive design with quantitative programme evaluation and semi-structured interviews. METHOD: A convenience sample of 97 participants (64 community elders; 33 institutional elders) was interviewed individually after six months of Silver Yoga exercises. Participants rated the level of difficulty, acceptability, feasibility and helpfulness of the Silver Yoga programme (four phases: warm-up, hatha yoga, relaxation and guided-imagery meditation) and the abdominal breathing technique, based on a 10-point Cantril ladder scale. Further, participants expressed their preferences of yoga exercises based on four open-ended questions. RESULTS: The programme was fairly acceptable, feasible and helpful for community and institutional elders (means ranged from 8·33-9·70). The warm-up, relaxation, guided-imagery meditation and abdominal breathing are fairly easy to follow and perform (means ranged from 0·20-0·94). However, the postures in hatha yoga phase were relatively challenging but still manageable for the institutional elders (mean = 1·97, SD 2·33). Further, community elders preferred to practise yoga 61-90 minutes everyday in a group of 11-20, while the institutional elders preferred to practise yoga 31-60 minutes three times per week, in a group of <10. CONCLUSIONS: The Silver Yoga exercise programme is acceptable, feasible, helpful and manageable for community and institutional elders. However, different exercise protocols, such as practice intensity and group size, could be applied to different older populations. RELEVANCE TO CLINICAL PRACTICE: The Silver Yoga exercise programme could be applied to both community and institutional elders to promote their health.

Induction of multiple criteria optimal classification rules for biological and medical data.

To induce critical classification rules from observed data is a major task in biological and medical research. A classification rule is considered to be useful if it is optimal and simultaneously satisfies three criteria: is highly accurate, has a high rate of support, and is highly compact. However, current classification methods, such as rough set theory, neural networks, ID3, etc., may only induce feasible rules instead of optimal rules. In addition, the rules found by current methods may only satisfy one of the three criteria. This study proposes a multi-criteria model to induce optimal classification rules with better rates of accuracy, support and compactness. A linear multi-objective programming model for inducing classification rules is formulated. Two practical data sets, one of HSV patients results and another of European barn swallows, are tested. The results illustrate that the proposed method can induce better rules than current methods.

Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises.

AIMS AND OBJECTIVES: Promoting physical fitness of young-older adults is essential in reducing healthcare expenditures which would occur in the future for those with chronic health problems. The silver yoga exercise programme was developed to accommodate the reduced body flexibility experienced by many older adults and was critically reviewed by experts and pilot-tested with community-dwelling older adults. This study aimed to test older adults' physical fitness after a 24-week silver yoga exercise programme and to examine whether the programme could be further shortened to fit senior activity centres' programme designs. DESIGN: A quasi-experimental, pre-post tests design was used: baseline, at 12-week and at 24-week periods. METHODS: Convenience samples of 204 subjects were recruited from eight senior activity centres and 176 subjects completed the study. Subjects were randomly assigned into three groups based on the centres: (1) Experiment I: complete silver yoga with stretching and meditation, (2) Experiment II: shortened silver yoga without the guided-imagery meditation and (3) Wait-list control. The interventions were conducted three times per week for 24 weeks. Physical fitness indicators included body compositions, cardiovascular-respiratory functions, physical functions and the range of motion. RESULTS: At the end of the 24-week period, the physical fitness of subjects in Experiments I and II had significantly improved whether or not guided-imagery meditation was used and all had better physical fitness than subjects in the control group (all p < 0.05). CONCLUSIONS: The physical fitness of older adults in both the 70-minute complete silver yoga group and the 55-minute shortened silver yoga group had significantly improved after the interventions. It was recommended that the silver yoga programme be shortened by eliminating the guided-imagery meditation. RELEVANCE TO CLINICAL PRACTICE: The shortened silver yoga exercise programme is recommended to be incorporated as an activity programme in community-settings to promote the physical fitness of older adults.

Effects of yoga on sleep quality and depression in elders in assisted living facilities.

BACKGROUND: Being relocated to an assisted living facility can result in sleep disturbances and depression in elders. This may be attributed to or worsened by lack of regular physical activity. Appropriate exercise programs may be an important component of quality of life in this group of transitional frail elders. PURPOSE: This study aimed to test the effects of a 6-month yoga exercise program in improving sleep quality and decreasing depression in transitional frail elders living in assisted living facilities. METHODS: A quasi-experimental pretest-and-posttest design was used. A convenience sample of 69 elderly residents of assisted living facilities was divided randomly into a yoga exercise (n = 38) and control group (n = 31) based on residence location. A total of 55 participants completed the study. The intervention was implemented in three small groups, and each practice group was led by two pretrained certified yoga instructors three times per week at 70 min per practice session for 24 weeks. The outcome measures of sleep quality (Pittsburgh Sleep Quality Index) and depression state (Taiwanese Depression Questionnaire) were examined at baseline, at the 12th week, and at the 24th week of the study. RESULTS: After 6 months of performing yoga exercises, participants' overall sleep quality had significantly improved, whereas depression, sleep disturbances, and daytime dysfunction had decreased significantly (p < .05). In addition, participants in the intervention group had better results on all outcome indicators than those of participants in the control group (p < .05). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is recommended that yoga exercise be incorporated as an activity program in assisted living facilities or in other long-term care facilities to improve sleep quality and decrease depression in institutionalized elders.

Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial.

BACKGROUND: Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults. OBJECTIVE: To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status. DESIGN: Cluster randomized trial. SETTINGS: Eight senior activity centers, southern Taiwan. PARTICIPANTS: A sample of 139 participants was recruited, and 128 of them completed the study. INCLUSION CRITERIA: (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 +/- 6.23 years, and the average number of chronic illness was 0.83 +/- 0.90. The average BI score of the participants was 99.92 +/- 0.62, and the mean SPMSQ score was 9.90 +/- 0.30. METHODS: Participants were randomly assigned into either the experimental (n=62) or the control (n=66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group. RESULTS: Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p<.05). CONCLUSIONS: After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.