Daily Activities Of Patients Research Articles

Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial.

Recently, there has been a renewed interest in traditional medicine for carpal tunnel syndrome (CTS). Curcumin has been reported as an agent with antioxidant, anti-inflammatory, analgesic, and neuroprotective attributes. This study is one of the first investigations to assess the effect of curcumin gel on CTS. This study is a prospective, 8-week, randomized, placebo-controlled, parallel-group clinical trial. A total of 70 patients with CTS were analyzed. The intervention group (n = 35) received a topical curcumin gel and a night wrist splint and the control group (n = 35) received a placebo gel and a night wrist splint for 8 weeks. The primary outcome was the assessment of the symptom severity scale (SSS) and functional status scale (FSS) of the participants using the Boston Carpal Tunnel Questionnaire (BCTQ) after 8 weeks. In addition, all participants were evaluated by electrodiagnostic (EDX) test at baseline and after 8 weeks. The mean scores of SSS demonstrated a significant decrease in the curcumin group compared to the placebo group; P-value= 0.021. The mean change score of SSS after the intervention was 12.45 ± 8.18 in curcumin and 3.28 ± 7.06 in the placebo group; P-value = 0.0001 and the mean change score of FSS were 6.24 ± 4.91 and 2.31 ± 4.95 in curcumin and placebo groups, respectively; P-value = 0.002. However, the EDX study showed no significant changes in both groups. It seems that curcumin gel could be effective in the improvement of the symptom severity and daily activity of patients with CTS.

Percutaneous pulsed radiofrequency ablation of articular nerves of the hip joint in patients with chronic hip pain refractory to conventional analgesics.

Total Hip Arthroplasty (THA) may be a risky proposition in patients with comorbidities, and they may require systemic analgesics for chronic hip pain (CHP). Since traditional pain medications may not provide complete pain relief or carry prohibitive adverse effects, pulsed radiofrequency (PRF) treatment of the hip articular nerves (HAN) has been proposed for effective clinical outcomes. We determined the efficacy of PRF-HAN in improvement in CHP compared to baseline pain on conventional systemic analgesics. Between August 2015 and December 2021, 31 adult patients with severe comorbid conditions and excruciating chronic hip pain were subjected to a PRF-HAN procedure following a diagnostic block. All 31 patients received PRF of the articular branches of the femoral and obturator nerves. Demographic parameters, numerical rating scale (NRS), Harris Hip Score (HHS), WOMAC scores, the change of these scores from baseline, and any adverse effects were recorded before treatment and on day 1, 1st week, 6 weeks, and 6 months after treatment. All the patients who underwent the PRF-HAN reported a significant improvement in NRS, HHS, and WOMAC scores compared to the baseline values on day 1, at the end of the 1st week, and the 6th week (p<0.001). No adverse events were documented in the study post-procedure until the end of 6 months. PRF-HAN is a strong alternative for chronic pain management and augments physical functioning and a return to daily activity in patients who would be deprived of arthroplasty considering associated comorbid conditions.

Влияние глаукомы и катаракты на повседневную деятельность пациентов с саркопеническим ожирением

Aim: to evaluate the effect of glaucoma and cataract on activities of daily living in elderly patients with sarcopenic obesity (SO). Patients and Methods: the study included 128 patients with cataract and SO and 125 age-matched patients with glaucoma and SO. All patients underwent a comprehensive clinical and instrumental ophthalmic examination. To assess activities of daily living, we used our own 8-question test. Results: the effect of cataract and SO causing total dependence on others was more significant (12.18 points) than that of glaucoma and SO causing moderate dependence (10.18 points, p&lt;0.01). The groups were also characterized by significant differences in all activities of daily living, including needle threading and nail clipping. In particular, limitations in needle threading were estimated at 1.84±0.03 points in patients with cataract and SO, which was significantly higher than in patients with glaucoma and SO (1.52±0.02 points, p&lt;0.01). A similar pattern was found for nail clipping (1.75±0.03 points and 1.43±0.04 points, respectively, p&lt;0.01). Factor analysis of the effect of cataract and SO and glaucoma and SO showed the highest factor loading on the development of dependency on others for needle threading (0.829 and 0.572 respectively) and nail clipping (0.807 and 0.469 respectively) in both groups. However, the effect of cataract and SO on the development of limitations in these activities of daily living is more significant than the effect of glaucoma and SO. Conclusions: among age-related eye diseases in elderly patients, cataract and SO significantly limit daily activities. KEYWORDS: glaucoma, cataract, sarcopenic obesity, activities of daily living, basic functional activity, elderly. FOR CITATION: Kopylov A.E., Agarkov N.M., Alymova M.V. Effect of glaucoma and cataract on daily activities in patients with sarcopenic obesity. Russian Journal of Clinical Ophthalmology. 2024;24(1):14–18 (in Russ.). DOI: 10.32364/2311-7729-2024-24-1-3.

Mental disorders, social and demographic characteristics of patients with chronic and episodic migraine

To compare socio-demographic, clinical and psychological characteristics and comorbid mental disorders in patients with chronic migraine (CM) and episodic migraine (EM). Eighty patients with migraine (40 with CM (16 men and 24 women, mean age 33.5±6.1 years) and 40 with EM (9 men and 31 women, mean age 31.4±5.7 years) were examined. All patients were interviewed and tested with psychometric methods. Socio-demographic and clinical-psychological characteristics were determined in all patients. The psychiatrist assessed the mental status of patients and diagnosed comorbid mental disorders according to the ICD-10 criteria. Symptoms of depression, high levels of trait and state anxiety, and a tendency to emotional inadequacy of response were more common in CM patients than in EM patients (p<0.05). Mental disorders, predominantly of the anxiety-depressive spectrum, were more common in CM patients than EM patients (OR (95% CI)=2.54 (2.03 to 2.98, p<0.001). Seventy-five percent of CM patients had more than one psychiatric diagnosis, almost a quarter of CM patients had schizotypal disorder, which is significantly higher than in EM patients (OR (95% CI)=1.99; 1.03 to 2.42, p<0.001). There were more unmarried, single (without constant partner), unemployed, high-education patients in the CM group than in the EM group. The negative impact of headache on the daily activity of patients was significantly higher in the CM group than in the EM group (p<0.05). Mental disorders and psychological features (anxiety, depression symptoms, a tendency to emotional inadequacy of response) are more common in CM patients than in EM patients. The presence of these factors may contribute to the chronification of migraine.

Developmental Prediction of Poststroke Patients in Activities of Daily Living by Using Tree-Structured Parzen Estimator-Optimized Stacking Ensemble Approaches.

Poststroke injuries limit the daily activities of patients and cause considerable inconvenience. Therefore, predicting the activities of daily living (ADL) results of patients with stroke before hospital discharge can assist clinical workers in formulating more personalized and effective strategies for therapeutic intervention, and prepare hospital discharge plans that suit the patients needs. This study used the leave-one-out cross-validation procedure to evaluate the performance of the machine learning models. In addition, testing methods were used to identify the optimal weak learners, which were then combined to form a stacking model. Subsequently, a hyperparameter optimization algorithm was used to optimize the model hyperparameters. Finally, optimization algorithms were used to analyze each feature, and features of high importance were identified by limiting the number of features to be included in the machine learning models. After various features were fed into the learning models to predict the Barthel index (BI) at discharge, the results indicated that random forest (RF), adaptive boosting (AdaBoost), and multilayer perceptron (MLP) produced suitable results. The most critical prediction factor of this study was the BI at admission. Machine learning models can be used to assist clinical workers in predicting the ADL of patients with stroke at hospital discharge.

Design of 3D-printed prostheses for reconstruction of periacetabular bone tumors using topology optimization.

Background: Prostheses for the reconstruction of periacetabular bone tumors are prone to instigate stress shielding. The purpose of this study is to design 3D-printed prostheses with topology optimization (TO) for the reconstruction of periacetabular bone tumors and to add porous structures to reduce stress shielding and facilitate integration between prostheses and host bone. Methods: Utilizing patient CT data, we constructed a finite element analysis (FEA) model. Subsequent phases encompassed carrying out TO on the designated area, utilizing the solid isotropic material penalization model (SIMP), and this optimized removal area was replaced with a porous structure. Further analyses included preoperative FEA simulations to comparatively evaluate parameters, including maximum stress, stress distribution, strain energy density (SED), and the relative micromotion of prostheses before and after TO. Furthermore, FEA based on patients' postoperative CT data was conducted again to assess the potential risk of stress shielding subsequent to implantation. Ultimately, preliminary follow-up findings from two patients were documented. Results: In both prostheses, the SED before and after TO increased by 143.61% (from 0.10322 to 0.25145mJ/mm3) and 35.050% (from 0.30964 to 0.41817mJ/mm3) respectively, showing significant differences (p < 0.001). The peak stress in the Type II prosthesis decreased by 10.494% (from 77.227 to 69.123MPa), while there was no significant change in peak stress for the Type I prosthesis. There were no significant changes in stress distribution or the proportion of regions with micromotion less than 28μm before and after TO for either prosthesis. Postoperative FEA verified results showed that the stress in the pelvis and prostheses remained at relatively low levels. The results of follow-up showed that the patients had successful osseointegration and their MSTS scores at the 12thmonth after surgery were both 100%. Conclusion: These two types of 3D-printed porous prostheses using TO for periacetabular bone tumor reconstruction offer advantages over traditional prostheses by reducing stress shielding and promoting osseointegration, while maintaining the original stiffness of the prosthesis. Furthermore, in vivo experiments show that these prostheses meet the requirements for daily activities of patients. This study provides a valuable reference for the design of future periacetabular bone tumor reconstruction prostheses.

The influence of walking in an exoskeleton on rehabilitation of patients with spinal cord injury consequences

Objective: to substantiate the expediency of including training walking in an exoskeleton in the complex rehabilitation of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).Methods: 120 patients (84 men and 36 women, age 37.1 ± 8.40 years) with the consequences of SCI at the level of thoracic and lumbar spine who were in the hospital at the second stage of medical rehabilitation were examined. The duration of injury ranged from 1 year to 19 years (77.8 ± 4.05 months). All patients were divided into two groups (80 and 40 patients), comparable by sex, age, duration and severity of injury. Training walking in exoskeleton have been added in the group I rehabilitation program. ASIA, SCIM III scales and SF-36 quality of life questionnaire were used to evaluate the effectiveness of the rehabilitation measures.Results: there was an increase in the total score on SCIM III by 3.20 ± 0.50 (p = 0.05) in group I, which indicates an increase in the level of functioning and daily activity of patients. Positive dynamics was revealed when assessing the quality of life using SF-36 questionnaire: sum index reflecting the psychological component of health increased from 56,0 to 59,5 points (p = 0,05). Group II also showed positive dynamics of the analyzed indicators, but the changes by the end of the rehabilitation course were not statistically significant.Conclusion: the use of exoskeleton training walking at the second stage of medical rehabilitation increases the effectiveness of rehabilitation measures and improves the quality of life of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).

The net contribution of rehabilitation to improvement in performance in patients with spinal cord lesions in five countries

Context Change in ability realization reflects the main contribution of rehabilitation to improvement in the performance of daily activities in patients with spinal cord lesions (SCL). Objective To assess the net effect of rehabilitation of patients with SCL and compare it between countries. Methods We calculated the Spinal Cord Ability Realization Measurement Index (SCI-ARMI) and its change from admission to rehabilitation to discharge, for inpatients admitted to SCL units in five countries, between 2016 and 2019. We used chi-square tests, analysis of variance (ANOVA), McNemar's test, Pearson’s correlations, and analysis of covariance (ANCOVA) to compare countries and patient groups and assess the relationships of various factors with SCI-ARMI gain during rehabilitation. Results The study included 218 inpatients (67% males, age 52 ± 17). In Brazil, Israel, Italy, Portugal, and Turkiye, respectively, SCI-ARMI gain was 2 (SD = 15), 19 (SD = 17), 31 (SD = 23), 13 (SD = 15), and 16 (SD = 12). Yet, after controlling for admission SCI-ARMI and the time from SCL onset to the examination, the effect of the country on ability realization gain was found non-significant (P = 0.086). Conclusion The study confirmed that rehabilitation makes a net contribution to improvement in performance in patients with SCL, beyond the contribution of neurological recovery. After controlling for affecting factors, this contribution was quite similar in the participating units from different countries.

Role of shockwave therapy in the treatment of pain syndrome in patients with knee ligamentitis

Relevance. Damage to the para-articular structures in the area of the joints can lead to chronic pain, which imposes mental and social restrictions on a person’s life, disrupts his/her mobility, and therefore, represents a global healthcare problem. Subject and methods. An open randomized controlled trial was conducted among patients with post-traumatic ligamentitis of the knee joint with pain in the subacute stage, aged 30.2 ± 10.4 years (n = 40). The patients were divided into two groups: group 1 (n = 10, control group) received standard drug therapy, while group 2 (n = 30, main group) additionally received SWT. To assess the intensity of the pain syndrome, we used the visual analog scale (VAS index) and the Lequesne index, which determines the daily activity of patients with injuries in the knee joint. Results and discussion. According to statistics, against the background of an increase in the number of injuries per 100,000 population in the Russian Federation, the absolute number of injuries of the knee joint and lower legs is also growing. At the same time, there was a high direct correlation between these indicators. In this observation, the patients in the 2nd (main) group who received complex treatment with the use of shockwave therapy showed positive dynamics of the VAS index score and the Lequesne index, and a strong direct correlation was noted between the indicators. Meanwhile, according to the data of correlation and regression analysis, it was possible to predict the stability of clinical improvement for two future periods. In the patients in the 1st (control) group, no pronounced clinical picture was observed. Conclusion. Thus, after complex treatment, including drug therapy and shockwave therapy, in the patients in the 2nd (main) group with knee ligamentitis with pain in the subacute period, a pronounced stable positive effect was noted, which was accompanied by a decrease in pain syndrome, an increase in motor activity, and an improvement in the quality of life of patients.

EFFECTS OF REHABILITATION PROGRAM FOCUSED ON IMPROVING REAL-LIFE DAILY ACTIVITIES OF PATIENTS WITH MILD COGNITIVE IMPAIRMENTS OR DEMENTIA AND THEIR CAREGIVERS.

To evaluate the effectiveness of a dyadic outpatient rehabilitation program focused on improving the real-life daily activities of patients with mild cognitive impairments or dementia and their caregivers. Retrospective study. Eight patients with mild cognitive impairments or dementia and their caregivers. The rehabilitation program comprised eight 1-hour sessions by occupational therapists with patients and his/her caregivers. Patients were assessed for motor function, cognitive function, and quality of life, and their caregivers were assessed for depression and caregiver burden. Participants were assessed at pre-program and post-program, and 3-month follow-up. The scores of caregiver-assessed Quality of life in Alzheimer's disease scale in patients significantly improved at post-program (median [interquartile range], 30.0 [7.0]) compared with pre-program (27.0 [2.8], effect size = 0.77, p = 0.029). In caregivers, the Zarit Caregiver Burden Interview scores decreased significantly at post-program (16.5 [13.0]) compared with pre-program (22.0 [17.5], effect size = 0.72, p = 0.042). There were no significant differences in other assessments. The rehabilitation program focused on real daily activities and demonstrated to improve patients' quality of life and caregivers' depression and caring burden through patient-caregiver interaction. Future enhanced follow-up systems are warranted.

Experiences of people with long COVID: Symptoms, support strategies and the Long COVID Optimal Health Programme (LC-OHP).

Long COVID (LC) is a multisystem illness, with fluctuating symptoms that affect the daily activities of patients. There are still no standardised diagnostic criteria or treatment approaches for managing LC. The LC-Optimal Health Programme (LC-OHP) was designed to support the mental wellbeing and physical health of people with LC. Gaining an in-depth understanding of patients' experiences and support strategies is imperative to identifying appropriate supports to guide them through their recovery. This study aimed to elicit the experiences and perceptions of adults with LC regarding symptoms, support strategies and the LC-OHP. As part of a wider randomised controlled trial of the LC-OHP, participants in the intervention group had their sessions audio-recorded. Transcripts were thematically analysed to identify common emergent themes. The LC-OHP was delivered to 26 participants. Data were collected between January 2022 and February 2023. Four main themes emerged: 'Symptoms and impact of LC';'Other sources of support and perceived challenges';'Strategies to support LC'and 'Perceptions of the LC-OHP'. LC experiences were mostly described as fluctuating and burdensome that significantly impacted daily activities, and physical and mental health. The LC-OHP was perceived as beneficial. Access and experiences of other sources of support were varied. Increasing LC awareness amongst health practitioners and the wider community has the potential to improve the experiences of those affected by LC. The LC-OHP was derived from the OHP. It was adapted to people with LCfollowing consultation with practitioners at an LC clinic. Additionally, the mode and timing of delivering the programme to this population were taken into account for its delivery at the convenience of participating patients. While considering that fatigue and brain fog are amongst the most reported complaints of people with LC, public members with LC were not involved directly in this study; however, feedback obtained from practitioners working with this population was implemented in amending the programme and its delivery. Additionally, feedback from patients with other chronic health conditions who used the OHP in previous studies has been implemented to make the programme more user-friendly. Moreover, feedback obtained from participants receiving this programme in this study was implanted immediately and shared with other participants. Finally, this study was overviewed by a data management committee that included two public members with LC, who contributed and provided guidance to support this study.

Exploring the Complex Phenotypes of Impaired Finger Dexterity in Mild-to-moderate Stage Parkinson's Disease: A Time-Series Analysis.

Impaired dexterity is an early motor symptom in Parkinson's disease (PD) that significantly impacts the daily activity of patients; however, what constitutes complex dexterous movements remains controversial. To explore the characteristics of finger dexterity in mild-to-moderate stage PD. We quantitatively assessed finger dexterity in 48 mild-to-moderate stage PD patients and 49 age-matched controls using a simple alternating two-finger typing test for 15 seconds. Time-series analyses of various kinematic parameters with machine learning were compared between sides and groups. Both the more and less affected hands of patients with PD had significantly lower typing frequency and slower typing velocity than the non-dominant and the dominant hands of controls (p = 0.019, p = 0.016, p < 0.001, p < 0.001). The slope of the typing velocity decreased with time, indicating a sequence effect in the PD group. A typing duration of 6 seconds was determined sufficient to discriminate PD patients from controls. Typing error, repetition, and repetition rate were significantly higher in the more affected hands of patients with PD than in the non-dominant hand of controls (p < 0.001, p = 0.03, p < 0.001). The error rate was constant, whereas the repetition rate was steep during the initiation of typing. A predictive model of the more affected hand demonstrated an accuracy of 70% in differentiating PD patients from controls. Our study demonstrated complex components of impaired finger dexterity in mild-to-moderate stage PD, namely bradykinesia with sequence effects, error, and repetition at the initiation of movement, suggesting that multiple neural networks may be involved in dexterity deficits in PD.

The Observable Movement Quality scale for patients with low back pain (OMQ-LBP): validity and reliability in a primary care setting of physical therapy

BackgroundThe Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP).ObjectiveThis study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list.MethodsConstruct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach’s alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14).ResultsAfter Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach’s alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming.ConclusionsThe OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.

Respiratory Rehabilitation Improves Quality of Life and Functionality of Covid 19 Patients

Abstract Respiratory rehabilitation leads to reduction of symptoms, strengthens extremity musculature and improves emotional state and management of daily activities in patients with respiratory diseases. Aim of our study was to determine quality of life and functionality of COVID 19 patients before and after respiratory rehabilitation program. The study was conducted at the Clinical Center, Kragujevac, from June to July 2020. The study was a prospective clinical trial and included 62 patients with the acutephase of COVID-19. Respiratory rehabilitation program started at hospital and continued at home for three months overall. Quality of life was measured by the EQ-5D-5L and patient’s functionality by The FIM score. All five dimension of EQ-5D-5L were higher after respiratory rehabilitation program as well as EQ-5D index score and VAS score (0.8516±0.202 and 53.31±17.129 before rehabilitation, 0.9147±0.074 and 64.53±8.368 after rehabilitation). Respiratory exercise showed significantly improvement in FIM total score from 104.48±12.880 to 106.21±9.791, as well as in FIM motor and cognitive subscores. Respiratory rehabilitation program improves quality of life and functionality of COVID 19 patients.

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol

IntroductionStroke is a common chronic disease with high rates of morbidity and disability and a great burden on patients. As a result, it affects daily activities of patients and causes...

Association of heart failure symptoms burden with physical well-being: exploring the roles of self-care and sleep quality using a moderated-mediation analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients with heart failure (HF) commonly experience symptom burden. Symptoms such as breathlessness, fatigue, and fluid retention can have an important impact on the patient's daily activities and overall health. Given the evidence of symptoms' negative impact on the quality of life in patients with HF, self-care maintenance is critical. However, there is a paucity of knowledge regards the role played by self-care and the quality of sleep in this population. Purpose To explore the association between HF symptoms burden and quality of life (i.e., physical well-being) and how the association was moderated by levels of self-care maintenance and mediated by sleep quality. Methods This was a secondary analysis of a single-center cross-sectional study conducted in Spain, between February and December 2017. Symptom burden was measured using the Heart Failure Somatic Perception Scale (HFSPS), and quality of life was assessed using the physical well-being subscale of the 12-Item Short Form Survey (SF-12). Self-care was assessed using the self-care maintenance subscale of the Self-Care Heart Failure Index (SCHFI) (version 6.2), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A moderated-mediation analysis was conducted to explore the role of self-care as a moderator and sleep quality as a mediator in the association using SPSS PROCESS macro with 5000 bootstrap samples, adjusted for age, sex, Body Mass Index (BMI) and NYHA covariates. Results A total of 178 patients completed the questionnaires. The patients were older (mean age 80, SD ±8,9) with a mean BMI of 29 (SD ± 5,5). About of patients were males (50.6%) and NYHA class 1 or 2 (58.4%). Symptom burden was negatively associated with sleep quality (B = -.104, t(1, 176) = -7.7675, p = &amp;lt;,001), which was positively associated with physical well-being (B = .5664, t(1, 176) = 2.9810, p = .003). The association between symptom burden and physical well-being was moderated by self-care maintenance (interaction value= -.0038, t(1, 176) = -2.0022, p = .047). In the moderated mediation analysis (Figure 1), we found that the direct effect strength of burden symptom on physical well-being was different by the level of self-care maintenance (Johnson-Neyman value= 32.3560, low = 15.1685 high = 84.8315). There was also a significant indirect effect of symptom burden on physical well-being through sleep quality adjusted (B = -.0589, 95% CI [ -.1001, -.0230]). Conclusion Self-care maintenance moderates the association symptom burden and physical well-being, while sleep quality acts as a mediator in the association. Improving quality of life, while empowering self-care, should also consider an evaluation and improving stretegies of sleep quality as it impacts physical quality of life.Moderated-mediation analysis

Advances in Electrode Materials for Scalp, Forehead, and Ear EEG: A Mini-Review.

Electroencephalogram (EEG) records the electrical activity of neurons in the cerebral cortex and is used extensively to diagnose, treat, and monitor psychiatric and neurological conditions. Reliable contact between the skin and the electrodes is essential for achieving consistency and for obtaining electroencephalographic information. There has been an increasing demand for effective equipment and electrodes to overcome the time-consuming and cumbersome application of traditional systems. Recently, ear-centered EEG has met with growing interest since it can provide good signal quality due to the proximity of the ear to the brain. In addition, it can facilitate mobile and unobtrusive usage due to its smaller size and ease of use, since it can be used without interfering with the patient's daily activities. The purpose of this mini-review is to first introduce the broad range of electrodes used in conventional (scalp) EEG and subsequently discuss the state-of-the-art literature about around- and in-the-ear EEG.

Does Therapeutic Exercise Support Improvement in Cognitive Function and Instrumental Activities of Daily Living in Patients with Mild Alzheimer's Disease? A Randomized Controlled Trial.

This randomized controlled trial aims to investigate the effect of 12 weeks of therapeutic exercise on cognitive function and daily activities in patients with mild Alzheimer's disease (AD). A total of 171 patients with mild AD from the Amarousion Day Care Center of the Alzheimer Society of Athens and the Athens General Hospital "G. Gennimatas" were randomly divided into three groups. Group A (aerobic and resistance exercise, n = 57), group B (resistance exercise, n = 57), and group C (control group, n = 57). Group A followed a weekly program consisting of 5 days with 30 min walking and 3 days with resistance exercises for about 45 min. Group B followed only a resistance exercise program, the same as group A. Group C did not participate in any exercise program. After the intervention, cognitive function was assessed with the Cognitive Examination-Revised (ACE-R), Trail Making Test A-B (TMT A-B), and Digit Span Test Forward and Backward (DST F-B) and daily activities with the instrumental activities of daily living scale (IADLs). A significant intervention effect was observed for all outcome measures (global cognitive function and instrumental activities of daily living). ANCOVA Bonferroni corrected post hoc tests revealed that the aerobic and resistance group improved compared to the control group on all measurement scales. The resistance group also showed an improvement compared to the control group. No significant effects were found between the aerobic and resistance group and the resistance group in any of the outcome measures.

Applicability of the OPTA Questionnaire for Patients with Stable Ischemic Heart Disease in Indian Clinical Practice: A Cross-sectional, Real-word Evidence Study.

Angina is the symptomatic form of stable ischemic heart disease (SIHD). The OPtimal Treatment of Angina (OPTA) questionnaire was developed and validated to overcome the lack of a standardized and accurate tool to assess patients' clinical conditions with SIHD. This study aimed to understand the applicability of OPTA in patients with SIHD in routine clinical practice in India. In this cross-sectional, single-visit study, 344 patients with SIHD were enrolled. Study endpoints were physicians' agreement on the applicability of OPTA, the usefulness of OPTA in assessing degree of impairment in daily activities of patients, and its positive predictive value (PPV). All enrolled patients completed the study. The mean [standard deviation (SD)] age was 56.6 (10.77) years, with a majority of patients being male (69.5%) and on antianginal treatment for &gt;1 year (80.4%). Physicians of all participating patients agreed that the OPTA questionnaire could accurately assess whether treatment received by patients was optimal (100% agreement rate). No or moderate degree of impairment of daily activities was reported by 93.9% and 73.0% of patients for one and two health-related questions, respectively. The PPV and sensitivity of the questionnaire were 88.97% [confidence interval (CI): 87.58%, 90.22%] and 39.33% (CI: 34.01%, 44.85%), respectively. The OPTA questionnaire showed good agreement regarding health status between physicians and patients and could be used to periodically assess and guide clinical judgment in the management of SIHD in India. Further assessment of the impact of various treatments temporally and in the long term may be warranted.

Lipoinjection with Adipose Stem Cells for Nasal Modeling: Rhino Cell, a Highly Versatile Alternative.

It is undeniable that a significant number of patients who want to improve their facial appearance is increasingly interested in nonsurgical procedures. Without a doubt, the use of autologous fat could not be left out as a magnificent alternative for nasal modeling simply because of four influential factors: ease of collection, compatibility, the temporality of the results, and safety. This work describes an innovative alternative technique for nasal modeling using micrografts enriched with adipose-derived mesenchymal stem cells (ASCs). With this technique, fat was collected and divided into two samples, nanofat and microfat. Nanofat was used to isolate the ASCs; microfat was enriched with ASCs and used for nasal modeling. Lipoinjection was performed in a supraperiosteal plane on the nasal dorsum. Through a retrolabial access, the nasal tip and base of the columella were lipoinjected. We consider that nonsurgical nasal modeling using micrografts enriched with ASCs can be an attractive and innovative alternative. This technique will never be a substitute for surgical rhinoplasty. It can be performed in a minor procedure area with rapid recovery and return to the patient's daily activities the next day. If necessary, the procedure can be repeated.