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BACKGROUND: The cardinal motor symptoms of Parkinson's disease (PD) include rigidity, bradykinesia, and rest tremor. Rigidity and bradykinesia correlate with contralateral nigrostriatal degeneration and striatal dopamine deficit, but association between striatal dopamine function and rest tremor has remained unclear. OBJECTIVE: The aim of this study was to investigate the possible link between dopamine function and rest tremor using Parkinson's Progression Markers Initiative dataset, the largest prospective neuroimaging cohort of patients with PD. METHODS: Clinical, [123I]N-ω-fluoropropyl-2ß-carbomethoxy-3ß-(4-iodophenyl)nortropane ([123I]FP-CIT) single photon emission computed tomography (SPECT), and structural magnetic resonance imaging data from 354 early PD patients and 166 healthy controls were included in this study. We employed a novel approach allowing nonlinear registration of individual scans accurately to a standard space and voxelwise analyses of the association between motor symptoms and striatal dopamine transporter (DAT) binding. RESULTS: Severity of both rigidity and bradykinesia was negatively associated with contralateral striatal DAT binding (PFWE < 0.05 [FWE, family-wise error corrected]). However, rest tremor amplitude was positively associated with increased ipsilateral DAT binding (PFWE < 0.05). The association between rest tremor and binding remained the same controlling for Hoehn & Yahr stage, Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score, bradykinesia-rigidity score, or motor phenotype. The association between rest tremor and binding was independent of bradykinesia-rigidity and replicated using 2-year follow-up data (PFWE < 0.05). CONCLUSION: In agreement with the existing literature, we did not find a consistent association between rest tremor and contralateral dopamine defect. However, our results demonstrate a link between rest tremor and increased or less decreased ipsilateral DAT binding. Our findings provide novel information about the association between dopaminergic function and parkinsonian rest tremor. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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The paper presents an analysis of the proteomic composition in relation to both the risk of thrombosis and changes in the state of cardiomyocytes associated with the risk of cardiac fibrosis and heart failure. We examined 12 practically healthy male volunteers exposed to head-down -6° tilt bed rest (HDBR) for 21 days. The revealed decrease in the level of stimulating growth factor 2 (ST2) on days 10 and 21 relative to the initial values (background; 5 days before HDBR) indicated a decrease in the myocardial load and cardiomyocyte extensibility. The level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) increased on day 2, decreased on days 10 and 21 of HDBR relative to the background levels, and returned to baseline values after the recovery period (5 days after HDBR). The revealed changes in the level of NT-proBNP reflected the increase in circulating blood volume corresponding to HDBR duration and the role of the gravity component in increasing the functional load on the myocardium. Unchanged blood level of D-dimer at all points of the study indicates that there is no risk of thrombosis under the conditions of this study.

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Sleep and circadian timing systems are constantly regulated by both photic and non-photic signals. Connections between the vestibular nuclei and the biological clock raise the question of the effect of peripheral vestibular loss on daily rhythms, such as the sleep-wake cycle and circadian rhythm. To answer this question, we compared the sleep and rest-activity rhythm parameters of 15 patients with bilateral vestibulopathy (BVP) to those of 15 healthy controls. Sleep and rest-activity cycle were recorded by a device coupling actimetry with the heart rate and actigraphy at home over 7 days. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Sleep efficiency and subjective sleep quality were significantly reduced, and sleep fragmentation was increased in BVP patients compared to controls. BVP patients displayed a damped amplitude of the rest-activity rhythm and higher sleep fragmentation, reflected by a higher nocturnal activity compared to controls. These results suggest that both rest-activity and sleep cycles are impaired in BVP patients compared to healthy controls. BVP patients seem to have greater difficulty maintaining good sleep at night compared to controls. BVP pathology appears to affect the sleep-wake cycle and disturb the circadian rhythm synchronization. Nevertheless, these results need further investigation to be confirmed, particularly with larger sample sizes.

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OBJECTIVE: The diversity of electrode placement systems brought the problem of channel location harmonization in large-scale electroencephalography (EEG) applications to the forefront. Therefore, our goal was to resolve this problem by introducing and assessing the reference electrode standardization technique (REST) to transform EEGs into a common electrode distribution with computational zero reference at infinity offline. METHODS: Simulation and eye-closed resting-state EEG datasets were used to investigate the performance of REST for EEG signals and power configurations. RESULTS: REST produced small errors (the root mean square error (RMSE): 0.2936-0.4583; absolute errors: 0.2343-0.3657) and high correlations (>0.9) between the estimated signals and true ones. The comparison of configuration similarities in power among various electrode distributions revealed that REST induced infinity reference could maintain a perfect performance similar (>0.9) to that of true one. CONCLUSION: These results demonstrated that REST transformation could be adopted to resolve the channel location harmonization problem in large-scale EEG applications.

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Multimeric SWI/SNF chromatin remodelers assemble into discrete conformations with unique complex functionalities difficult to dissect. Distinct cancers harbor mutations in specific subunits, altering the chromatin landscape, such as the PBAF-specific component ARID2 in melanoma. Here, we performed comprehensive epigenomic profiling of SWI/SNF complexes and their associated chromatin states in melanoma and melanocytes and uncovered a subset of PBAF-exclusive regions that coexist with PRC2 and repressive chromatin. Time-resolved approaches revealed that PBAF regions are generally less sensitive to ATPase-mediated remodeling than BAF sites. Moreover, PBAF/PRC2-bound loci are enriched for REST, a transcription factor that represses neuronal genes. In turn, absence of ARID2 and consequent PBAF complex disruption hinders the ability of REST to bind and inactivate its targets, leading to upregulation of synaptic transcripts. Remarkably, this gene signature is conserved in melanoma patients with ARID2 mutations. In sum, we demonstrate a unique role for PBAF in generating accessibility for a silencing transcription factor at repressed chromatin, with important implications for disease.

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Women's football has grown in popularity, competitiveness and professionalism, increasing the demands placed on players and their injury risk. This study aimed to identify differences in the match workload and international travel between injured and non-injured professional women's footballers. The study was conducted as an observational, retrospective, case-control study over two football seasons (2021/2022 and 2022/2023) in four top-tier European women's football leagues. Fifty-eight professional women football players (81 injuries) formed the injury group and were matched with 81 elite women football players (162 non-injuries), from the same league, to form the control group. For each injury, cumulative match workload (minutes played, appearances, days between matches, rest) and international travel (distances, time, time zones crossed) were calculated over a 28-day period preceding the injury, for both the injured players and matched controls. The injured group had a higher number of instances of less than 5 days between matches compared to the controls (p = 0.03, effect size = 0.3, small). The anterior cruciate ligament injury group made more appearances (p = 0.09, effect size = 0.8, moderate), had more instances of less than 5 days between matches (p = 0.09, effect size = 0.8, moderate) and had less rest time (p = 0.12, effect size = 0.8, moderate) than the control group. No meaningful differences were observed between the hamstring injury group and the control group. These findings underscore the importance of careful consideration when developing match fixture schedules in elite women's football, particularly concerning the number of matches scheduled in a short period. Strategies to increase rest and recovery are recommended to safeguard players against injuries.

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Uterine cancer is the most common gynecologic malignancy in the United States, with endometrioid endometrial adenocarcinoma (EC) being the most common histologic sub-type. Considering the molecular classifications of EC, efforts have been made to identify additional biomarkers that can assist in diagnosis, prognosis, and individualized therapy. We sought to explore the relationship of Repressor Element 1 (RE1) silencing transcription factor (REST), which downregulates neuronal genes in non-neuronal tissue, along with matrix metalloproteinase-24 (MMP24) and EC. We analyzed the expression of REST and MMP24 in 31 cases of endometrial cancer and 16 controls. We then explored the baseline expression of REST and MMP24 in two EC cell lines (Ishikawa and HEC-1-A) compared to a benign cell line (t-HESC) and subsequently evaluated proliferation, migration, and invasion in the setting of loss of REST gene expression. REST and MMP24 expression were significantly lower in human EC samples compared to control samples. REST was highly expressed in EC cell lines, but decreasing REST gene expression increased proliferation (FC: 1.13X, p < 0.0001), migration (1.72X, p < 0.0001), and invasion (FC: 7.77X, p < 0.05) in Ishikawa cells, which are hallmarks of cancer progression and metastasis. These findings elicit a potential role for REST as a putative tumor suppressor in EC.

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Creating effective prosthetic fingers involves precise treatment planning and skilled fabrication to restore aesthetic appearance and passive function. Successful outcomes depend significantly on retention and how closely the prosthesis mimics natural finger contours. We analyzed techniques for fabricating finger prostheses with palms and fingers in clinical rest position (CRP) versus palms and fingers extended (PFE) straight out. The aesthetics and function (passive) were also examined when fabricated in these two physiological conditions. We reviewed 20 articles from national and international journals over 20 years. Most literature focuses on extended posture fabrication, with few addressing CRP. This review article compares the CRP and PFE prosthetic finger fabrication approaches and explains how a prosthetic finger fabricated in a CRP offers superior aesthetic and partial functional outcomes and emerges as a promising alternative to the PFE. The potential impact of these findings on prosthodontics is significant, emphasizing the need for further research to validate these results and the ongoing development in the field.

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BACKGROUND: Some chromatinopathies may present with common clinical findings (intellectual disability, brain and limb malformation, facial dysmorphism). Furthermore, one of their cardinal shared features is growth dysregulation.We aimed to assess and deepen this resemblance in three specific conditions, namely Wiedemann-Steiner (WDSTS), Kleefstra (KLEFS1) and Coffin-Siris syndrome (CSS1), with a particular focus on possible metabolic roots. METHODS: Eleven patients were enrolled, three with WDSTS, five with KLEFS1 and three with CSS1, referring to Fondazione IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy. We performed both a physical examination with detailed anthropometric measurements and an evaluation of the patients' REE (rest energy expenditure) by indirect calorimetry, comparing the results with age- and sex-matched healthy controls. RESULTS: We observed new clinical features and overlap between these conditions suggesting that different disturbances of epigenetic machinery genes can converge on a common effect, leading to overlapping clinical phenotypes.The REE was not distinguishable between the three conditions and healthy controls. CONCLUSIONS: Epigenetic machinery plays an essential role both in growth regulation and in neurodevelopment; we recommend evaluating skeletal [craniovertebral junction abnormalities (CVJ) polydactyly], otolaryngological [obstructive sleep apnea syndrome (OSAs), recurrent otitis media], dental [tooth agenesis, talon cusps], and central nervous system (CNS) [olfactory bulbs and cerebellum anomalies] features. These features could be included in monitoring guidelines. Further studies are needed to deepen the knowledge about energy metabolism.

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Introduction: Grazing management is essential to maintain the stability of grassland ecosystems. Methods: To determine the optimal rest-grazing period of alpine meadow, five rest-grazing periods were set based on soil thawing and plant re-greening in this study. The niche, interspecific relationships, and stability of plant communities at different rest-grazing periods were investigated. Results: Rest-grazing during soil thawing resulted in a small niche width and niche overlap of plants, overall positive interspecific associations, and a high stability of plant communities. Delayed rest-grazing time to plant re-greening resulted in a large niche width and niche overlap of plants, overall negative interspecific associations, and a low stability of plant communities. Discussion: Rest-grazing in alpine meadows should begin as soon as possible to promote healthy and sustainable utilization of grasslands.

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Our study, conducted between April 2022 and January 2024, was aimed at clarifying components of the rest-activity rhythm (RAR) involved in improvement of social frailty state before or after a 3-month multi-component exercise intervention in the elderly. Participants were recruited from the general population in Akita prefecture, Japan. We administered a four-item social frailty screening questionnaire to classify the severity of social frailty in each participant before and after the 3-month intervention. The RAR parameters were measured on an Actiwatch Spectrum Plus device worn by the subjects for 7 continuous days. As the final sample, 65 participants classified into the improved/maintained group (n = 36) or the deteriorated group (n = 29) according to the change in the social frailty classification after the intervention were included in the analysis. The results of a binomial logistic regression analysis showed significantly higher values of interdaily stability (IS) and usual walking speed at the post-test after the intervention. Based on our findings, we propose that stability of the rest-activity rhythm related to synchronization with external stimuli (such as social effect and physical activity) might have clinical impact on improvement of social frailty state in elderly community-dwellers.

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Salmon backbones make up about 10 % of the total fish weight and contain valuable proteins, collagen and lipids that can be used for marine ingredients production. Gelatine is derived from the collagen fraction and this study evaluated how different fractionation and extraction procedures can affect the yield and composition of extracted gelatine. Fractionation by mild thermal treatment of backbones (10 min in 40-42 °C) leads to structural changes of muscle, which improves separation of meat from bones and gives better yield of de-muscled backbone fractionation compared to mechanical meat removal. The highest yield of the gelatine (9.3 ± 0.3g dry gelatine from 100g de-muscled backbone dry material) was obtained from mechanically de-muscled backbones. De-muscled backbones were pre-treated with alkaline (0.04 N NaOH) followed by EDTA and 10 % ethanol for de-calcification and lipid extraction, respectively. Gelatine from pretreated backbones was extracted with 60 °C water. The amount of gelatine amino acids (sum of hydroxyproline, proline and glycine) was 43.4 ± 0.2 % of all amino acids in the gelatine. Extracted backbone gelatines showed film-forming ability. Gelatine films were obtained by casting procedure. Resulted salmon backbone 6 % gelatine and 30 % sorbitol films showed properties (e.g. water vapour permeability, colour difference, transparency value) similar to films obtained with commercial gelatine, indicating the capability of the extracted gelatines for its valorisation as edible coatings or bio-based film layers in packaging.

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Lymphoscintigraphy is a nuclear medicine procedure that uses a small quantity of radioactive particles for visualizing the lymphatic system. Traditionally, the radiotracer was injected subcutaneously, but the quality of lymphatic path imaging was scarce due to high background. Intradermal radiotracer injection is considered the modern-day intralymphatic injection. We propose rest/stress intradermal lymphoscintigraphy for the diagnosis, staging and surgical planning of lymphedema. Major and minor findings were described in primary and secondary lymphedema. Based on the in-depth information of the lymphatic pathways, physiotherapists and microsurgeons can obtain important functional information in patients' selection to treat with physical treatments and/or undergo microsurgery.

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PURPOSE: To assess myocardial injury using rest single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients with COVID-19 and to evaluate whether myocardial injury detected by rest MPI predict the prognosis of symptoms after 6 months follow-up. METHODS: Patients suspected of myocarditis between December 2022 and March 2023, after the lifting of COVID-19 pandemic restrictions, and between December 2018 and March 2019, prior to the pandemic, were referred to our study. All patients underwent rest MPI. One hundred and sixty four patients with COVID-19 infection after the lifting of pandemic restrictions and 101 patients before the pandemic were included as the study and control groups, respectively. One hundred and fifty three patients of the study group and 83 of the control group presented symptoms when they initially visit to our department. Compare the parameters of myocardial injury detected by rest SPECT MPI between the two groups and then investigate the association between myocardial injury and symptom prognosis in symptomatic patients of both groups. RESULTS: Total perfusion defect (TPD) (4.2% ± 3.3% vs. 2.3% ± 2.2%, P < 0.001), summed rest score (SRS) (5.3 ± 5.4 vs. 2.7 ± 2.0, P < 0.001), the proportion of patients with TPD > 4% (43.3% vs. 17.8%, P < 0.001), TPD > 10% (6.71% vs 0, P < 0.001), SRS > 4 (40.2% vs 15.8%, P < 0.001), SRS > 10 (12.8% vs 0, P < 0.001), the number of abnormal perfusion segments (3.9 ± 3.1 vs. 2.4 ± 1.7, P < 0.001) were all significantly higher in the study group. All the parameters of rest MPI were not associated with the prognosis of symptoms in symptomatic patients of both groups after 6 months follow-up. CONCLUSION: Myocardial injury in COVID-19 patients could be assessed by rest SPECT MPI. The COVID-19 patients could exhibited a higher frequency and greater severity of myocardial injury than uninfected control patients. Myocardial injury assessed by rest MPI did not predict for the prognosis of symptoms in symptomatic patients of both COVID-19 patients and uninfected patients.

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PURPOSE: To explore fatigue and physical activity behavior experiences and management, with an emphasis on activity pacing among adults with chronic conditions. MATERIALS AND METHODS: Semi-structured interviews were conducted with 15 adults with chronic conditions and the symptoms of chronic fatigue who had either received or not received fatigue management advice. Interviews were audio-recorded and transcribed verbatim, then analyzed using reflexive thematic analysis. RESULTS: Participants reported barriers to fatigue management such as overactivity, mental health issues, and workplace challenges. Additionally, they highlighted rest, restful activities, and supportive social environment as facilitators of effective fatigue management, along with the importance of nutrition and physical activity. In some cases, there were conflicting experiences with social environment and physical activity. Activity pacing was identified as a promising solution and participants recommended several strategies for future consideration. CONCLUSIONS: Participants identified fatigue as a significant denominator in daily living and recognized the importance of activity pacing in fatigue management. Through reflective processes, they uncovered crucial factors for effective fatigue management, highlighting a multidimensional, interdisciplinary, and tailored approach to activity pacing as a promising solution. Further research should explore clinicians' perspectives of a multidimensional fatigue management approach to further support optimal intervention design.

Fatigue was perceived commonly across various chronic conditions, extending beyond mere tiredness and diminishing individuals' capacity to perform daily activities.Rehabilitation professionals might incorporate activity pacing strategies tailored to each individual's needs to effectively manage fatigue across chronic conditions.A multidimensional approach, including physical, psychological, and social interventions, is suggested for comprehensive fatigue management in rehabilitation.Facilitating rest and fostering a supportive social environment might be integral components of rehabilitation process to enhance the effectiveness of fatigue management.

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Telemedicine is used to assist and support remote medical care for patients. Our objective was to build up a REST Webservices alert engine that receives clinical parameters from patients of vital signs and basic laboratories to monitor patients remotely. We built a REST API using FHIR, so it can interoperate with other applications, send data to be processed, and receive a response. If the API detects a health risk situation, it sends an alert about the medical parameters that are controlled. The results of the processed data, news and alert, can return synchronously or asynchronously, at the same time that the data to be processed is being sent. The alerts generated can be automatically sent to a web service, mail or WhatsApp of the physician. The alert message comes out as normal, low, medium and high risk. The presented approach establishes communication that enables timely health information exchange. We conducted an experiment (with fictitious data) where we sent several queries by Postman. Finally, we evaluated the communication to be successful by manual checking. The use of the API significantly improves the monitoring of chronic patients. Many works show the effectiveness of telemedicine to improve the control of certain chronic diseases. In addition, telemedicine interventions were also found to significantly improve other health outcomes. Our API enables us to transfer data and produce alerts successfully. This gives us hope that a future with ubiquitous healthcare information interoperability is possible using our system.

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Ectopic pancreas, also known as heterotopic pancreas, is a rare condition in which the pancreatic tissue is found outside its usual location in the gastrointestinal (GI) tract. It is commonly asymptomatic and benign, and is often discovered incidentally during routine imaging, endoscopy, surgery, or autopsy. However, complications can arise, such as inflammation, bleeding, obstruction, or even malignant transformation, necessitating surgical intervention in some cases. Ectopic pancreas at the ampulla of Vater (EPAV) is an extremely rare condition and a diagnostic and therapeutic nightmare. Most cases have been diagnosed through invasive surgery due to concerns for malignancy, which carries significant morbidity and mortality. In our case, endoscopic snare papillectomy (ESP) was employed to establish a diagnosis. Thus far, only one other case has been reported in which ESP was used to diagnose and resect a pancreatic heterotopia at the ampulla.

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Study Objectives: The purpose of the study was to compare the fatigue levels, work/rest patterns, health-related behaviors, and well-being of galley workers with other sailors on US Navy ships while underway. Methods: Analysis was based on a retrospective comparison of data from 3 fit-for-duty groups of sailors: 67 galley workers, 192 non-watchstanders, and 466 watchstanders. Participants completed questionnaires (Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI], Pittsburgh Sleep Quality Index [PSQI], and Profile of Mood States [POMS]) and activity logs, and wore actigraphs. Results: Galley workers slept MD = 6.57 (IQR = 1.42) h/d and worked MD = 12.8 (IQR = 2.42) h/d. Approximately 84% of the galley workers were classified as poor sleepers, ~57% reported having excessive daytime sleepiness (EDS), and ~38% reported elevated insomnia symptoms. Compared to non-watchstanders, galley workers had worse scores on POMS (total mood disturbance, tension-anxiety, depression, anger-hostility, fatigue, and confusion-bewilderment), ESS, ISI, and PSQI. Compared to non-watchstanders, galley workers had a higher risk for symptoms of EDS (75%), symptoms of clinically relevant insomnia (126%), and for being classified as poor sleepers (27%). Galley workers slept less and worked on average 2 h/d more than non-watchstanders. Compared to watchstanders, galley workers had worse ESS, ISI, and anger-hostility scores. More watchstanders napped compared to galley workers. Conclusions: Although they are considered day workers, the sleep patterns, fatigue levels, and mood of galley workers are comparable to, or worse than, watchstanders or other non-watchstanders. To ameliorate the effects of long work hours on sailor well-being, ship leadership should consider adopting strategies to improve galley workers' well-being.

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AIM: The aim of this study is to interpret plasma renin concentrations (PRCs) correctly in a clinical setting, it is essential to understand to what extent physical activity influences the concentration. Reference values for different postural positions exist for adults, but data for children are sparse. In this study, the effect of 30 min of rest on plasma renin concentrations in paediatric patients was examined. METHODS: In total, 41 paediatric patients, undergoing either arginine or clonidine provocation tests for growth hormone deficiency, were included. For each stimulation test, two blood samples were drawn. One at time 0 min and one after 30 min of rest. In total, renin concentrations were determined in 86 serum samples. RESULTS: Renin concentrations decreased from 0 to 30 min with a median value of -20.5% (inter-quartile range: -33.0% to -12.8%). This decrease was not dependent on sex, age, medication or comorbidity, and the variance of renin did not differ between 0 and 30 min. CONCLUSION: Renin concentrations in children differ according to postural position, which is comparable to adults. Thus, the clinical interpretation of renin results needs to consider the preanalytical conditions applied in the local reference population.