BackgroundParkinson’s disease (PD) is the most prevalent movement disorder of the central nervous system, and affects more than 6.3 million people in the world. The characteristic motor features include tremor, bradykinesia, rigidity, and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients’ motor performance but often leads to levodopa-induced adverse effects, such as dyskinesia and motor fluctuation. Clinicians must regularly monitor patients in order to identify these effects and other declines in motor function as soon as possible. Current clinical assessment for Parkinson’s is subjective and mostly conducted by brief observations made during patient visits. Changes in patients’ motor function between visits are hard to track and clinicians are not able to make the most informed decisions about the course of therapy without frequent visits. Frequent clinic visits increase the physical and economic burden on patients and their families.ObjectiveIn this project, we sought to design, develop, and evaluate a prototype mobile cloud-based mHealth app, “PD Dr”, which collects quantitative and objective information about PD and would enable home-based assessment and monitoring of major PD symptoms.MethodsWe designed and developed a mobile app on the Android platform to collect PD-related motion data using the smartphone 3D accelerometer and to send the data to a cloud service for storage, data processing, and PD symptoms severity estimation. To evaluate this system, data from the system were collected from 40 patients with PD and compared with experts’ rating on standardized rating scales.ResultsThe evaluation showed that PD Dr could effectively capture important motion features that differentiate PD severity and identify critical symptoms. For hand resting tremor detection, the sensitivity was .77 and accuracy was .82. For gait difficulty detection, the sensitivity was .89 and accuracy was .81. In PD severity estimation, the captured motion features also demonstrated strong correlation with PD severity stage, hand resting tremor severity, and gait difficulty. The system is simple to use, user friendly, and economically affordable.ConclusionsThe key contribution of this study was building a mobile PD assessment and monitoring system to extend current PD assessment based in the clinic setting to the home-based environment. The results of this study proved feasibility and a promising future for utilizing mobile technology in PD management.
BackgroundEndometrial cancer (EC) is one of the most common gynecological malignancies globally. Although progress has been made in surgical and other adjuvant therapies, there is still a great need to develop new approaches to further reduce the incidence and mortality of EC. Oncolytic virotherapy offers a novel promising option of cancer treatment and has demonstrated good efficacy in preclinical models and clinical trials. However, only few oncolytic viruses have been tested for EC treatment. In this study, the potential of an oncolytic coxsackievirus B3 (CV-B3) strain 2035A (CV-B3/2035A) was investigated as a novel biotherapeutic agent against EC.MethodsHuman EC cell lines (Ishikawa, HEC-1-A and HEC-1-B) were infected with CV-B3/2035A, and viral replication and cytotoxic effects were evaluated in vitro. CV-B3/2035A-induced oncolysis was also investigated in nude mice bearing EC xenografts in vivo and in patient-derived EC samples ex vivo.ResultsHuman EC cell lines expressing different levels of CAR and DAF were all susceptible to infection by CV-B3/2035A and supported efficient viral replication in vitro. In the EC xenograft/nude mouse model, both intratumoral and intravenous administrations of CV-B3-2035A exerted significant therapeutic effects against pre-established EC tumors without causing significant treatment-related toxicity and mortality in nude mice. Moreover, CV-B3/2035A treatment resulted in decreased viability of patient-derived EC samples ex vivo.ConclusionsCV-B3/2035A showed oncolytic activity in human EC cell lines both in vitro and in vivo as well as in patient-derived EC samples ex vivo and thus could be used as an alternative virotherapy agent for the treatment of EC.Electronic supplementary materialThe online version of this article (10.1186/s12985-018-0975-x) contains supplementary material, which is available to authorized users.
A fundamental objective of the National Strategy for Suicide Prevention is the prevention of suicide in older adults, especially elderly males, because these individuals are at higher risk for suicide than any other age group. Furthermore, they are the fastest growing segment of the population. The suicide rates for older Caucasian men are particularly high. Because nurses play an important role in the identification of persons at risk for suicide, it is important that they be cognizant of the complex risk factors involved in late life suicide. Toward that end, we review the prevalence of suicidal behaviors in older adults and discuss risk factors that contribute to completed suicide in these individuals. Lastly, we discuss the role of nurses in the identification of older adults at risk for suicidal behavior so that life-saving treatment measures can be implemented.Older American's currently comprise about 13% of the population in the U.S., yet they account for 18% of all suicide deaths (Arias, Anderson, Kung, Murphy, & Kochanek, 2003). Suicide is the thirteenth leading cause of death in persons age 65 years or older (National Institute of Mental Health, 2004) and these individuals are at the highest risk for completed suicide. Furthermore, Caucasian men over the age of 85 have an especially high rate (59 per 100,000 persons) of completed suicide. Recognized as a major public health concern, the Office of the Surgeon General of the U.S. released the National Strategy for Suicide Prevention: Goals and Objectives for Action (Office of the Surgeon General, 1999). A central mandate of that strategy is the prevention of suicide in older adults because these individuals are at higher risk for suicide than any other age group and they are the fastest growing segment of the population (Arias et al., 2003 Older adults, however, present special challenges to suicide prevention efforts. For example, suicide and attempted suicide are often associated with depression, psychosis, and substance abuse among younger individuals, yet among older adults, depression and comorbid medical conditions play important contributory roles. (Alexopoulos, Bruce, Hull, Sirey, & Kakuma, 1999;Caine & Conwell, 2001;Conwell, Duberstein, & Caine, 2002;Miles, 1977;Pearson & Brown, 2000; Tuvey et al., 2002). Because nurses play a vital role in the identification of persons at risk for suicide, and the current "baby boom" cohort have substantially higher suicide rates than preceding generations (McIntosh, 1992), it is important to be cognizant of the complexity of risk factors associated with late life suicide. The purpose of this paper is to focus attention on the prevalence of suicidal behaviors in older adults and lay a foundation for understanding the role of risk factors in the prevention of suicide. We identify risk factors that contribute to completed suicide in these individuals and review the role of nurses in identifying older persons at risk for suicidal behavior so that life-saving treatment measures can be implemented.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.