Role of virtual reality in examining the effect of fear of falling (FOF) on postural stability in individuals without and with Parkinson's disease in Egypt: a mixed-methods feasibility study protocol.

BACKGROUND: Falls are common in older people and individuals with neurological conditions. Parkinson's disease (PD) is known for postural instability causing mobility disabilities, falls and reduced quality of life. The fear of falling (FOF), a natural response to unstable balance, can worsen postural control problems. Evaluating FOF relies largely on affected persons' subjective accounts due to limited objective assessment methods available. The aim of this mixed-methods feasibility study is to develop an assessment method for FOF while in motion and walking within virtual environments. This study will assess a range of FOF-related responses, including cognitive factors, neuromuscular response and postural stability. METHODS AND ANALYSIS: This feasibility study will consist of four phases: the first two phases will include people without PD, while the other two will include people diagnosed with PD. Participants will be assessed for direct and indirect responses to real life, as well as virtual environment walking scenarios that may induce FOF. Data from questionnaires, different neurophysiological assessments, movement and gait parameters, alongside evaluations of usability and acceptability, will be collected. Semistructured interviews involving both participants and research assistants shall take place to elicit their experiences throughout different phases of the assessments undertaken. Demographic data, the scores of assessment scales, as well as feasibility, usability and acceptability of the measurement methods, will be illustrated via descriptive statistics. Movement and gait outcomes, together with neurophysiological data, will be extracted and calculated. Exploring relationships between different factors in the study will be achieved using a regression model. Thematic analysis will be the approach used to manage qualitative data. ETHICS AND DISSEMINATION: This feasibility study was approved by the Ethics Committee of the Faculty of Physical Therapy, Kafr El Sheikh University, Egypt (number: P.T/NEUR/3/2023/46). The results of this study will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT05931692).

Vocal fold cryptococcal granuloma: A rare occurrence in immunocompetent patient.

INTRODUCTION AND IMPORTANCE: Cryptoccous infection or cryptococcosis is a severe opportunistic infection occurring mainly in immunocompromised patients. Laryngeal cryptococcus infection is rare. In an immunocompetent patient, inhaled corticosteroid was reported to be a possible risk factor. CASE PRESENTATION: We discuss a case of right vocal fold cryptococcus infection in a healthy, immunocompetent 71-year-old man with no history of inhaled corticosteroid, presented with hoarseness and intermittent aspiration symptom for 1 year duration. Further examination showed right anterior vocal fold mass with presence of right vallecular cyst. CLINICAL DISCUSSION: Patient underwent direct laryngoscopy, excision of right vocal fold mass and marsupialization of vallecular cyst. Histopathological examination revealed cryptococcal infection. Patient subsequently treated with oral fluconazole 400 mg daily for 6 months. To date, hoarseness and aspiration symptoms have resolved. CONCLUSION: We are sharing our experience in managing laryngeal cryptococcus infection in an immunocompetent patient where the associated risk factors discussed in previous literatures are absent.

Post-transcriptional regulation of BIRC5/survivin expression and induction of apoptosis in breast cancer cells by tristetraprolin.

Inhibition of apoptosis is one of the hallmarks of cancer and is a target of various therapeutic interventions. BIRC5 is an inhibitor of apoptosis that is aberrantly expressed in cancer leading to sustained growth of tumours. Post-transcriptional control mechanisms involving RNA-binding proteins and AU-rich elements (AREs) are fundamental to many cellular processes and changes in the expression or function of these proteins can promote an aberrant and pathological phenotype. BIRC5 mRNA has an ARE in its 3' UTR making it a candidate for regulation by the RNA binding proteins tristetraprolin (TTP) and HuR (ELAVL1). In this study, we investigated the binding of TTP and HuR by RNA-immunoprecipitation assays and found that these proteins were associated with BIRC5 mRNA to varying extents. Consequently, BIRC5 expression decreased when TTP was overexpressed and apoptosis was induced. In the absence of TTP, BIRC5 mRNA was stabilized, protein expression increased and the number of apoptotic cells declined. As an ARE-mRNA stabilizing protein, recombinant HuR led to upregulation of BIRC5 expression, whereas HuR silencing was concomitant with downregulation of BIRC5 mRNA and protein and increased cell death. Survival analyses demonstrated that increased TTP and low BIRC5 expression predicted an overall better prognosis compared to dysregulated TTP and high BIRC5. Thus, the results present a novel target of ARE-mediated post-transcriptional regulation.

Motor learning in developmental coordination disorder: behavioral and neuroimaging study.

Developmental coordination disorder (DCD) is characterized by motor learning deficits that are poorly understood within whole-body activities context. Here we present results of one of the largest non-randomized interventional trials combining brain imaging and motion capture techniques to examine motor skill acquisition and its underpinning mechanisms in adolescents with and without DCD. A total of 86 adolescents with low fitness levels (including 48 with DCD) were trained on a novel stepping task for a duration of 7 weeks. Motor performance during the stepping task was assessed under single and dual-task conditions. Concurrent cortical activation in the prefrontal cortex (PFC) was measured using functional near-infrared spectroscopy (fNIRS). Additionally, structural and functional magnetic resonance imaging (MRI) was conducted during a similar stepping task at the beginning of the trial. The results indicate that adolescents with DCD performed similarly to their peers with lower levels of fitness in the novel stepping task and demonstrated the ability to learn and improve motor performance. Both groups showed significant improvements in both tasks and under single- and dual-task conditions at post-intervention and follow-up compared to baseline. While both groups initially made more errors in the Stroop task under dual-task conditions, at follow-up, a significant difference between single- and dual-task conditions was observed only in the DCD group. Notably, differences in prefrontal activation patterns between the groups emerged at different time points and task conditions. Adolescents with DCD exhibited distinct prefrontal activation responses during the learning and performance of a motor task, particularly when complexity was increased by concurrent cognitive tasks. Furthermore, a relationship was observed between MRI brain structure and function measures and initial performance in the novel stepping task. Overall, these findings suggest that strategies that address task and environmental complexities, while simultaneously enhancing brain activity through a range of tasks, offer opportunities to increase the participation of adolescents with low fitness in physical activity and sports.

ß-catenin attenuation leads to up-regulation of activating NKG2D ligands and tumor regression in BrafV600E-driven thyroid cancer cells.

Introduction: BRAFV600E mutations frequently occur in papillary thyroid cancer (PTC). ß-catenin, encoded by CTNNB1, is a key downstream component of the canonical Wnt signaling pathway and is often overexpressed in PTC. BRAFV600E-driven PTC tumors rely on Wnt/ß-catenin signaling to sustain growth and progression. Methods: In the present study, we investigated the tumorigenicity of thyroid cancer cells derived from BRAFV600E PTC mice following Ctnnb1 ablation (BVE-Ctnnb1null). Results: Remarkably, the tumorigenic potential of BVE-Ctnnb1null tumor cells was lost in nude mice. Global gene expression analysis of BVE-Ctnnb1null tumor cells showed up-regulation of NKG2D receptor activating ligands (H60a, H60b, H60c, Raet1a, Raet1b, Raet1c, Raet1d, Raet1e, and Ulbp1) and down-regulation of inhibitory MHC class I molecules H-2L and H-2K2 in BVE-Ctnnb1null tumor cells. In vitro cytotoxicity assay demonstrated that BVE-Ctnnb1wt tumor cells were resistant to NK cell-mediated cytotoxicity, whereas BVE-Ctnnb1null tumor cells were sensitive to NK cell-mediated killing. Furthermore, the overexpression of any one of these NKG2D ligands in the BVE-Ctnnb1wt cell line resulted in a significant reduction of tumor growth in nude mice. Conclusions: Our results indicate that active ß-catenin signaling inhibits NK cell-mediated immune responses against thyroid cancer cells. Targeting the ß-catenin signaling pathway may have significant therapeutic benefits for BRAF-mutant thyroid cancer by not only inhibiting tumor growth but also enhancing host immune surveillance.

Peri-Implant Inflammation in Waterpipe Users and Cigarette Smokers: An Observational Study.

OBJECTIVE: The aim of this study was to compare peri-implant clinical and radiographic status and levels of advanced glycation endproducts (AGEs) in peri-implant sulcular fluid (PISF) in waterpipe users and cigarette smokers. METHODS: Waterpipe users, cigarette smokers, and never smokers were included. Demographic details were collected using a questionnaire. Characteristics of implants (dimensions, jaw location, depth of placement, insertion torque, and duration in function) were recorded. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD), and crestal bone loss (CBL) were recorded in all groups. Volume of PISF and levels of AGEs were determined using standard techniques. Sample-size estimation was done on data from a pilot investigation, and correlation between clinicoradiographic and immunoinflammatory parameters was assessed using logistic regression models. Probability values <.05 were considered statistically significant. RESULTS: In all, 25, 25, and 24 cigarette smokers, never smokers, and waterpipe users, respectively, were examined. All participants were male and had comparable mean ages. Cigarette smokers and waterpipe users had a smoking history of 20.2 ± 3.5 years and 18.8 ± 0.6 years, respectively. The mPI (P < .01), CBL (P < .01), PD (P < 0.01), and mGI (P < .01) were significantly higher in cigarette smokers and waterpipe users than never smokers. There was no significant difference in clinicoradiographic status and AGE concentrations in waterpipe users and cigarette smokers. A statistically significant correlation was recorded between AGEs and PD in cigarette smokers (P < .01) and waterpipe users (P < .01). CONCLUSIONS: Waterpipe usage is not less hazardous to peri-implant tissue health than conventional cigarette smoking. It is imperative to caution patients with dental implants about the detrimental effects of tobacco products on oral health.

Maximum Phonation Time Normative Values Among Malaysians and Its Relation to Body Mass Index.

OBJECTIVE: Maximum phonation time (MPT) is a test to measure glottic efficiency for laryngeal pathology screening and treatment monitoring. The normative value of MPT for South East Asia population has yet to be reported. It is postulated that MPT may be affected by body mass index (BMI) despite the paucity of evidence. Therefore, this study was designed to establish the normative value of MPT for a South East Asia population and investigate its relation to BMI. DESIGN & SETTING: This cross-sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center between May and September 2017. PARTICIPANTS AND METHODS: Three hundred males and females with mean age of 30.23 (±11.04) years were recruited in equal number for each gender (n = 150) and divided into 3 groups of 50 according to their BMI (n = 50). The three groups are non-obese (BMI≤22.9kg/m2); obese (BMI between 23 and 34.9 kg/m2); and morbidly obese (BMI >35kg/m2). BMI and Voice Handicap Index-10 (VHI-10) were obtained. The average of three readings of MPT was measured using a stopwatch while the participants phonate /a/, /i/ and /u/. Unpaired t-test and ANOVA were used to compare means between and across groups. Spearman correlation assessed the correlation between MPT and BMI. MAIN OUTCOME MEASURES: The normative values of MPT of both genders and correlation with BMI were analyzed. RESULTS: The MPT normative values for males and females in the non-obese group were of 21.41 (±6.85) seconds and 18.05 (±5.06)seconds respectively for /a/. The MPT for all vowels were significantly higher in males across the BMI groups (P ≤ 0.05). There was low negative correlation between MPT and BMI in both genders. CONCLUSIONS: This pioneering study documented the normative values of MPT among Malaysians showed that males had longer MPT than females across the BMI groups. Obesity affects the MPT in that as BMI increases, the MPT decreases.

Dual-tasking in older women: physical activity or else?

The interplay between gender, Physical Activity (PA), and Dual Tasking (DT) in older adults is unclear. This study aimed to address DT based on gender and PA level. One-hundred and twenty older adults (81 women and 39 men) participated. Timed up and go test and spatiotemporal gait measures were collected in single and DT conditions. Participants were grouped according to gender and PA level. Physical activity did not explain gender differences, women were slower and had shorter stride lengths when DT regardless of PA level. Findings indicate the necessity for tailored PA and functional interventions to improve women's performance.

Perceptions and performance of exercise in people with knee osteoarthritis in the Middle East: are they different to countries in the developed world? A qualitative study in Jordan.

Background: Culture and lifestyle could justify the variability in clinical patterns of knee osteoarthritis (OA) and was reported to affect exercise adherence.Objective: To explore perceptions and aspects influencing exercise adherence in people with knee OA in Jordan (a developing country) as they might be different from those reported in the developed world.Methods: Fourteen participants were included in the study (13 females, one male). One focus group and seven in depth semi-structured interviews were conducted. The discussions were audio-taped and transcribed. Framework analysis was used and data were interpreted using the socio-ecological model.Results: At the individual level, knowledge of the role of exercise in knee OA and personal factors influenced exercise performance and adherence. At the sociocultural level, cultural attitudes and beliefs and social interaction affected exercises adherence. At the organizational/political level, suboptimal service delivery process, inappropriate delivery of home exercises, accessibility of services affected exercise adherence. Opportunities for improving service delivery were also reported. At the environmental level, geography and weather affected adherence.Conclusions: Understanding the interaction of health-related behavior with individual, social/cultural, organizational, and environmental aspects would improve exercise adherence and equip physiotherapists with knowledge and resources to facilitate the implementation of patient-centered services.

The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section.

BACKGROUND: The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). METHODS: The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. RESULTS: The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. CONCLUSION: The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available.

Supraglottic Schwannoma: Dilemma and Challenges in Management.

Laryngeal schwannomas are rare lesions that represent less than 1.5% of all benign laryngeal tumors. Its slow and submucosal growth may cause a delay in consultation and management. Herein, a case of right supraglottic schwannoma is diagnosed in a 34-year-old lady who was unconcerned about hoarseness for 10 years. She was referred to otorhinolaryngology clinic for assessment when hoarseness was detected during consultation for a gynecology surgery. Apart from hoarseness, there were no noisy breathing, shortness of breath or aspiration symptoms. Flexible nasopharyngolaryngoscopy showed a submucosal bulge at the right vestibular fold obscuring the vocal fold causing an airway concern. Computer tomography scan of the neck revealed a heterogenous enhancing mass centered at the right supraglottis measuring 2.6 × 2.7 × 2.7 cm. There were no erosions of the adjacent thyroid and arytenoid cartilages. Subsequently, complete excision of the lesion was done endoscopically. Definitive diagnosis of schwannoma was obtained via histopathology examination. This paper presents our approach and operative steps in the excision of this lesion using microlaryngoscopy with cold instruments.

Langerhans Cell Histiocytosis in Paediatric Zygoma Swelling.

Langerhans cell histiocytosis (LCH) is a rare neoplasm characterized by accumulation of histiocytes in various tissues. It has a wide clinical spectrum and its presentation may mimic clinical features of common diseases. High level of suspicion is required for early diagnosis. Here is a rare case of a rapidly aggressive LCH which first presented with right zygomatic swelling.

Extraluminal migration of ingested fish bone in the upper aerodigestive tract: A series of three cases with broad clinical spectrum of manifestations and outcomes.

INTRODUCTION: Incidental fish bone ingestion may penetrate the upper aerodigestive tract and cause extraluminal migration due to late presentation or missed diagnosis. The migrated fish bone exhibits a wide spectrum of clinical manifestations, ranging from mild symptoms to potentially fatal complications. PRESENTATION OF CASE: We report three cases of extraluminal fish bone migration with diverse clinical presentations and complications. The first patient had mild throat symptoms and a fish bone that travelled through the neck and migrated towards the subcutaneous tissue without causing complications. The second patient developed deep neck abscess and thoracic complications as a result of the migrated foreign body, but recovered after surgical exploration and foreign body removal. The third patient presented late in sepsis and upper airway obstruction, subsequently succumbed to multiorgan failure before any surgical intervention. DISCUSSION: Thorough physical and endoscopy examinations are essential in patients with fish bone ingestion. Normal endoscopic findings in a symptomatic patient should always raise the suspicion of a migrated fish bone. A radiographic imaging study is often helpful in locating the foreign body and potential complications. The migrated fish bone that acts as the source of infection in the neck should be traced and removed surgically. The resulting abscess, if present, must be drained. The management of a migrated fish bone can be challenging and often require multi-discipline collaboration. CONCLUSION: The migration of the ingested fish bone outside the upper aerodigestive tract can cause serious complications and death in some cases. Clinicians should always maintain a high level of suspicion towards extraluminal migration in a patient with a history of fish bone ingestions but normal endoscopic findings. We emphasize the importance of early recognition and prompt surgical intervention to remove the migrated fish bone to minimise the potential morbidity and mortality.

Patterns of allergic rhinitis among adults in Qassim region, Saudi Arabia: a cross sectional study.

INTRODUCTION: developing and developed countries have a high prevalence of allergic rhinitis (AR). Severe AR has negative impacts on sleep, quality of life, and work performance. The study aimed to identify the patterns of AR among patients attending the ears nose and throat Unit (ENT) clinic at King Saud Hospital, Qassim, Saudi Arabia. METHODS: this study was a cross-sectional study conducted at the ENT clinic of King Saudi Hospital, Unaizah City, Qassim region, Saudi Arabia. We examined outpatients diagnosed with AR using an interview questionnaire and clinical examination. RESULTS: the sample included 455 patients. Of these, 23.7% were 21-30 years old, 65.7% had a family history of AR, 57.8% had no general symptoms, 75.6% reported runny nose as the most common nasal symptom, and 35.4% reported no complications. Dust was the most common trigger of AR (82.4%), 49.2% reported allergic symptoms in all seasons, 96% of patients have inferior turbinate hypertrophy, and oral histamine was the most commonly used treatment (33.2%). CONCLUSION: perineal AR and inferior turbinate hypertrophy were very common findings comparing to previous studies, further studies to assess the risk factors are highly recommended.

ß-Catenin Attenuation Inhibits Tumor Growth and Promotes Differentiation in a BRAFV600E-Driven Thyroid Cancer Animal Model.

BRAFV600E mutation is the most frequent genetic alteration in papillary thyroid cancer (PTC). ß-Catenin (Ctnnb1) is a key downstream component of canonical Wnt signaling pathway and is frequently overexpressed in PTC. BRAF V600E-driven tumors have been speculated to rely on Wnt/ß-catenin signaling to sustain its growth, although many details remain to be elucidated. In this study, we investigated the role of ß-catenin in BrafV600E -driven thyroid cancer in a transgenic mouse model. In Braf V600E mice with wild-type (WT) Ctnnb1 (BVE-Ctnnb1WT or BVE), overexpression of ß-catenin was observed in thyroid tumors. In Braf V600E mice with Ctnnb1 knockout (BVE-Ctnnb1null), thyroid tumor growth was slowed with significant reduction in papillary architecture. This was associated with increased expression of genes involved in thyroid hormone synthesis, elevated 124iodine uptake, and serum T4. The survival of BVE-Ctnnb1null mice was increased by more than 50% during 14-month observation. Mechanistically, downregulation of MAPK, PI3K/Akt, and TGFß pathways and loss of epithelial-mesenchymal transition (EMT) were demonstrated in the BVE-Ctnnb1null tumors. Treatment with dual ß-catenin/KDM4A inhibitor PKF118-310 dramatically improved the sensitivity of BVE-Ctnnb1WT tumor cells to BRAFV600E inhibitor PLX4720, resulting in significant growth arrest and apoptosis in vitro, and tumor regression and differentiation in vivo These findings indicate that ß-catenin signaling plays an important role in thyroid cancer growth and resistance to BRAFV600E inhibitors. Simultaneously targeting both Wnt/ß-catenin and MAPK signaling pathways may achieve better therapeutic outcome in BRAFV600E inhibitor-resistant and/or radioiodine-refractory thyroid cancer.

First Report of Meloidogyne incognita on Mulberry in Saudi Arabia.

The genus Morus comprises many species (Suttie 2012). The species Morus alba is one of the most popular mulberry species worldwide. In October 2020, numerous mulberry trees presented chlorotic leaves and stunted growth with severe root galling in a private compound in Riyadh region, Saudi Arabia. The infected roots showed galls, which are typical symptoms of infection by root-knot nematodes (RKNs). Infected roots were dissected, and males and females were extracted from roots while second stage juveniles (J2s) were from both soil and eggmasses. Morphological and morphometrical features were documented. Perineal patterns of females, males, and J2s were studied using a compound microscope. The endoparasitic females had pearly shaped bodies with projecting neck. Stylet knobs were rounded and set off and the shape of the cone distinctly curved. The posterior perineal had a dorsally high square arch. Striae patterns were zig-zag or forked along the lateral lines. Males were vermiform and the head cap flat to concave. Mostly conus of stylet was longer than shaft. Stylet knobs were prominent, set off, flat and usually greater width than the length. Males had a bluntly rounded tail, spicules were slightly curved and gubernaculum was crescentic. The J2s were vermiform, and stylet knobs were prominent and rounded shape. The J2s tail had a transparent area with an obtuse tip. The morphological measurements (means and range) of the perineal patterns of females (n = 4) were: length of vulval slit (LVS) = 22.5 (21.5 to 23.4) µm, anus to vulval slit (AVS) = 22 (21.8 to 22.1) µm, and anus length (AL) = 7.7 (7.5 to 7.8) µm. The males (n = 16) measurements were: length (L) = 1136 (1116 to 1159) µm; a (total body length / greatest body width) = 34.8 (33 to 37.1); body width = 32.7 (31.2 to 33.8) µm; stylet length = 25.6 (24.7 to 27.3) µm; dorsal oesophageal gland orifice (DGO) = 2.9 (2.6 to 3) µm, tail length = 7.1 (6.5 to 7.8) µm, c (total body length / tail length) = 161 (143.1 to 175), spicules length = 30.8 (26 to 33.8) µm; gubernaculum = 9.7 (9.1 to 10.4) µm. The J2s (n = 11) measurements were: L = 395 (378 to 405) µm; a = 26.2 (24.3 to 28.4); c = 8.6 (8.2 to 9.2); head end to metacorpus valve = 53 (49.4 to 54.6) µm; excretory pore to head end = 78 (72.8 to 80) µm, stylet length = 10.7 (10.4 to 11.7) µm; body width = 15.1 (14.3 to 15.6) µm; tail length = 45.8 (44.2 to 49.4) µm; hyaline tail terminus length = 12.5 (10.4 to 13) µm. Both the morphological and morphometrical features of the perineal pattern of the females, males, and J2s match the original description of Meloidogyne incognita (Kofoid and White, 1919) Chitwood, 1949 (Eisenback and Hirschmann 1981; Taylor and Netscher 1974). To perform Koch's postulates, mulberry plants maintained in pots were inoculated with 2,500 J2s and eggs of the original population of M. incognita using five replicates. After two months, all inoculated plants had galled roots typical of RKNs. Reproduction factor value was 6.4. The noninoculated plants did not present galls in the roots. These results confirmed the nematode's pathogenicity on mulberry. To the best of our knowledge, this is the first report that M. incognita was identified as a parasite of mulberry (Morus alba) in Saudi Arabia and the world, while Meloidogyne hispanica was reported on mulberry trees in Iran (Shokoohi et al. 2016). The importance of this report shed some lights on this new problem to direct the attention of farmers and home gardeners to take actions for the management of this newly identified problem. The authors declare no conflict of interest. Acknowledgments Authors wish to thanks College of Food and Agricultural Sciences, Research Center and Deanship of Scientific Research, King Saud University, Saudi Arabia for supporting this work. References: Eisenback, J. D. and Hirschmann, H. 1981. J. Nematol. 13:513. Shokoohi, E. et al. 2016. Australasian Plant Dis. Notes 11:16. Suttie, J. M. 2012. Food and Agricultural Organization of the United Nations. Taylor D. P., Netscher, C. 1974. Nematologica 20:268.

Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial.

OBJECTIVE: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. DESIGN: A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s-1, n = 21) and limited (walking speed <0.79 m s-1, n = 24) capacity at baseline. SETTING: Community. SUBJECTS: Adults six-months post stroke with walking impairment. INTERVENTIONS: Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. MAIN MEASURES: A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. fNIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an fMRI sub-study used ankle-dorsiflexion to simulate walking. RESULTS: ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). fNIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). fMRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. CONCLUSION: In individual who walk slowly it may be difficult to improve dual-task walking ability.Registration: ISRCTN50586966.

Kinome inhibition reveals a role for polo-like kinase 1 in targeting post-transcriptional control in cancer.

Dysfunctions in post-transcriptional control are observed in cancer and chronic inflammatory diseases. Here, we employed a kinome inhibitor library (n = 378) in a reporter system selective for 3'-untranslated region-AU-rich elements (ARE). Fifteen inhibitors reduced the ARE-reporter activity; among the targets is the polo-like kinase 1 (PLK1). RNA-seq experiments demonstrated that the PLK1 inhibitor, volasertib, reduces the expression of cytokine and cell growth ARE mRNAs. PLK1 inhibition caused accelerated mRNA decay in cancer cells and was associated with reduced phosphorylation and stability of the mRNA decay-promoting protein, tristetraprolin (ZFP36/TTP). Ectopic expression of PLK1 increased abundance and stability of high molecular weight of ZFP36/TTP likely of the phosphorylated form. PLK1 effect was associated with the MAPK-MK2 pathway, a major regulator of ARE-mRNA stability, as evident from MK2 inhibition, in vitro phosphorylation, and knockout experiments. Mutational analysis demonstrates that TTP serine 186 is a target for PLK1 effect. Treatment of mice with the PLK1 inhibitor reduced both ZFP36/TTP phosphorylation in xenograft tumor tissues, and the tumor size. In cancer patients' tissues, PLK1/ARE-regulated gene cluster was overexpressed in solid tumors and associated with poor survival. The data showed that PLK1-mediated post-transcriptional aberration could be a therapeutic target.

Exploring attitudes of physiotherapy students towards a community-based project used as a learning tool.

BACKGROUND: Community-based projects are an experiential learning tool that provides students with an opportunity to work within a team, to apply their skills and to learn in real workplace settings. Promoting physical activity is an important component of physiotherapy education, but the best method for training students to promote physical activity is open for discussion. PURPOSE: This study explored the attitudes and learning experiences of physiotherapy students who worked in groups to complete a community-based project involving the delivery of physical activity programs to a healthy population. METHODS: Data were collected from a focus group of eight physiotherapy students each of whom had participated in a community-based project early in their studies. RESULTS: Four themes emerged from the analysis of the data: 1) self-confidence and independence; 2) creativity and innovation; 3) effective communication; and 4) team dynamics. The students had positive attitudes toward community-based projects and reported that their experiences were a highly valued component of their early practice-based learning. The findings of this study are expected to encourage educators to use community-based projects early in undergraduate physiotherapy programs, as it helps students develop professional skills such as effective communication, creativity, and innovation. Students also learned to innovate to solve real-world problems in the workplace such as resource limitations. They also learned to appreciate the importance of team dynamics in a successful intervention. CONCLUSION: The findings suggest early participation in community-based projects is an excellent way for physiotherapy students to develop the competencies required for clinical practice and for their role in promoting physical activity.

Magnitude and Determinants of Computer Vision Syndrome among College Students at a Saudi University.

PURPOSE: To review students' perceived symptom-based computer vision syndrome (CVS) and its determinants and to suggest preventive measures. METHODS: This cross-sectional survey was conducted in 2021 at a university in Central Saudi Arabia. The presence and severity of symptoms related to CVS were investigated. The total CVS symptom score was the outcome variable. The CVS score was correlated to participants' demographics, visual habits when using digital devices, and knowledge about CVS. Due to skewed distribution, a nonparametric method was used for analysis. RESULTS: Overall, 521 students were surveyed. The prevalence of CVS based on at least one symptom was 96% (95% confidence interval 94.3-97.7). The median score was 8.0 (interquartile range 4.0-12.0). Of the 24 possible CVS scores, 42 students (8%) had scores of 18 or more (severe CVS). Being female (Mann-Whitney [MW] P < 0.001), being older (Spearman P < 0.001), refractive error (MW P < 0.001), the presence of dry eye (MW P < 0.001), using devices other than a desktop computer (KruskalWallis) P = 0.03), and more than 6 h constantly working with a device (MW P = 0.001) were correlated with a higher CVS score. Older age, female, refractive error, and using digital devices for more than 6 h were the independent and significant predictors of CVS in college students. CONCLUSION: Most of the students suffered from mild-to-moderate CVS symptoms. Health promotion for prevention and periodic ophthalmic consultations are recommended. Identified predictors should be the focus when implementing strategies to combat CVS in the adolescent Saudi population.