Purpose: To investigate associations between functional limitations experienced by rehabilitants and multidisciplinary team’s recommendations during vocational rehabilitation evaluation. Methods: The descriptions of ...Purpose: To investigate associations between functional limitations experienced by rehabilitants and multidisciplinary team’s recommendations during vocational rehabilitation evaluation. Methods: The descriptions of functional limitations were retrospectively identified for 32 patients with chronic musculoskeletal disorders. Vocational rehabilitation evaluation was conducted by a multidisciplinary team in an outpatient clinic of a university hospital. The descriptions were converted to ICF second-level categories. Square contingency coefficient Phi (φ) was calculated to describe the associations between ICF-categories appearing ≥10 times in the study sample and the recommendations given by a professional team. Results: In the study sample, 84 different ICF second-level categories were identified (average 18 codes/subject, range 9 - 25). Of them, 18 categories were observed for at least in 10 rehabilitants. Three statistically significant correlations were observed between these 18 categories and recommendations given by a rehabilitation team. Of them, positive association of moderate strength was found between joint mobility and muscle power functions and recommendation for retirement. Difficulties in walking showed weak negative correlation with recommendation for vocational rehabilitation. Conclusions: During vocational rehabilitation evaluation, the final recommendations given by rehabilitation professionals were only weakly correlated with functional limitations experienced by rehabilitants.展开更多
Background:Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability.Handgrip strength(HGS)using isometric dynamometry is a convenient,feasible,and wide...Background:Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability.Handgrip strength(HGS)using isometric dynamometry is a convenient,feasible,and widely used method of assessing muscular strength among people of all ages.While adult HGS norms have been published for many countries,no study has yet synthesized available data to produce international norms.The objective of this study was to generate international sex-and age-specific norms for absolute and body size-normalized HGS across the adult lifespan.Methods:Systematic searches were conducted in 6 databases/web search engines(MEDLINE,SPORTDiscus,Embase,Web of Science,CINAHL,and Google Scholar)up to December 1,2023.We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age.Pseudo data were generated using Monte Carlo simulation following harmonization for methodo-logical variation.Population-weighted Generalized Additive Models for Location,Scale,and Shape were used to develop sex-and age-specific norms for absolute HGS(kg)and HGS normalized by height(Ht,m)squared(i.e.,HGS/Ht^(2)in kg/m^(2)).Norms were tabulated as percentile values(5th to 95th)and visualized as smoothed percentile curves.Results:We included data from 100 unique observational studies representing 2,405,863 adults(51.9%female)aged 20 to 100+years from 69 countries and regions tested from the year 2000 onward.On average,absolute and normalized HGS values negligibly improved throughout early adulthood,peaked from age 3039 years(at 49.7 kg(males)and 29.7 kg(females)for absolute HGS or 16.3 kg/m^(2)(males)and 11.3 kg/m^(2)(females)for HGS/Ht^(2)),and declined afterwards.The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood.Conclusion:This study provides the world’s largest and most geographically comprehensive international norms for adult HGS by sex and age.These norms have utility for global peer-comparisons,health screening,and surveillance.展开更多
AIM： To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these. METHODS： Forty seven children with confirmed birch pollen allergy were...AIM： To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these. METHODS： Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus （L. acidophilus） NCFM^TM （ATCC 700396） and Bifidobacterium lactis （B. lactis） BI-04 （ATCC SD5219） or placebo in a double-blind manner for 4 mo, starting prior to onset of the birch pollen season. Symptoms were recorded in a diary. Blood samples were taken for analysis of cytokines and eosinophils. Fecal samples were analysed for microbiota components, calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils.RESULTS： The pollen season induced a reduction in Bifldobacterium , Clostridium and Bacteroides which could not be prevented by the probiotic intervention. During the intervention, significantly higher numbers ofB. lactis 11.2 × 10^7 ± 4.2 ×10^7 vs 0.1 × 10^7 ± 0.1 × 10^7 bacteria/g feces （P 〈 0.0001） and L. acidophilus NCFMTM 3.5 × 10^6 ± 1.3 × 10^6 vs 0.2 × 10^6 ±0.1 × 10^6 bacteria/g feces （P 〈 0.0001） were observed in the probiotic group compared to the placebo group.During May, there was a tendency for fewer subjects, （76.2% vs 95.2%, P = 0.078） to report runny nose, while during June, fewer subjects, 11.1% vs 33.3%, reported nasal blocking in the probiotics group （P = 0.101）. Concomitantly, fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group, 57.1% vs 95% （P = 0.013）. Eye symptoms tended to be slightly more frequent in the probiotic group, 12.5 d [interquartile range （IQR） 6-18] vs 7.5 d （IQR 0-11.5） （P = 0.066） during May. Fecal IgA was increased in the placebo group during the pollen season; this increase was prevented by the probiotics （P = 0.028）. CONCLUSION： Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.展开更多
AIM: To assess the expression of Ki67 as prognosticator in rectal/recto sigmoid cancer.METHODS: Samples from 146 patients with rectal and recto sigmoid cancer were studied for expression of Ki67 and its prognostic sig...AIM: To assess the expression of Ki67 as prognosticator in rectal/recto sigmoid cancer.METHODS: Samples from 146 patients with rectal and recto sigmoid cancer were studied for expression of Ki67 and its prognostic significance in comparison with clinicopathological predictors of survival. Formalin-fixed, paraffin-embedded tissues from 6 (4.1%) patients with T1, 26 (17.8%) with T2, 94 (64.4%) with T3, and 20 (13.7%) with T4 tumors were studied. Ki67 expression was determined immunohistochemically. Samples were divided according to mean value into high (＞40%) and low (≤40%) expression. Areas of extensive proliferation (＞50%) were defined as 'hot spot' areas. RESULTS: Hot spot areas were present in samples regardless of histopathological grade. Lower TNM and Dukes stage and higher expression of Ki67 and presence of Ki67 hot spot areas in histopathological samples were associated with better survival, whereas no association was observed with histopathological grade (P = 0.78). In Cox multivariate regression analysis, significant prognostic factors were Dukes stage (P＜0.001), presence of lymph node metastases (P = 0.015), age (P = 0.035) andpresence of Ki67 hot spot areas (P = 0.044). CONCLUSION: Proliferative activity as measured by Ki67 in rectal cancer is associated with survival improvement compared with patients with low Ki67. Areas of prognostically significant increased proliferation were found independently of histopathological tumor grade.展开更多
AIM： To investigate the changing pattern of β-catenin expression and its prognostic value in advanced colorectal cancer （CRC）. METHODS： Archival tumor samples were analyzed for β-catenin using immunohistochemist...AIM： To investigate the changing pattern of β-catenin expression and its prognostic value in advanced colorectal cancer （CRC）. METHODS： Archival tumor samples were analyzed for β-catenin using immunohistochemistry （IHC） in 95 patients with advanced CRC. RESULTS： Membranous β-catenin expression was found in the normal colorectal epithelium. Almost 100% of CRC cases showed membranous and cytoplasmic expression, and 55 （58%） cases showed nuclear expression. In univariate （Kaplan-Meier） survival analysis, only the nuclear index （NI） was a significant predictor of disease free survival （DFS） （P = 0.023; n = 35）, with a NI above the median associated with longer DFS （34.2 too） than those with a NI below the median （15.5 too） （P = 0.045, ANOVA）. The other indices were not significant predictors of DFS, and none of the three tested indices （for membranous, cytoplasmic, or nuclear expression） predicted diseasespecific survival （DSS）. However, when dichotomized as positive or negative nuclear expression, the former was a significant predictor of more favorable DFS （P = 0.041） and DSS （P = 0.046）. CONCLUSION： Nuclear β-catenin expression provides additional information in predicting patient outcome in advanced CRC.展开更多
AIM： To investigate the changes that occur in E-cadherin expression during the process of metastasis in colorectal cancer.METHODS： E-cadherin expression was detected by immunohistochemistry and two indices of expres...AIM： To investigate the changes that occur in E-cadherin expression during the process of metastasis in colorectal cancer.METHODS： E-cadherin expression was detected by immunohistochemistry and two indices of expression were calculated which reflected the level of expression and the locations （membrane and cytoplasm）. Univariate and multivariate survival analyses were used to assess the value of these two E-cadherin indices as predictors of both disease-free （DFS） and disease-specific （DSS） survival. RESULTS： E-cadherin membrane index （MI）, but not cytoplasmic index （CI）, was significantly higher in primary tumors than their metastases （P = 0.0001）. Furthermore, both primary tumor MI and CI were higher among the patients who developed subsequent metastasis （P = 0.022 and P = 0.007, respectively）. Interestingly, both indices were higher in liver metastase compared to other anatomic sites （MI, P = 0.034 and CI, P = 0.022）. The CI of the primary tumors was a significant predictor of DFS （P = 0.042, univariate analysis）, with a strong inverse correlation between CI and DFS （P = 0.006, multivariate analysis）. Finally, the MI of primary tumor proved to be a significant independent predictor of DSS, with higher indices being associated with a more favorable outcome （P = 0.016）. CONCLUSION： Examination of E-cadherin expression and distribution in colorectal tumors can be extremely valuable in predicting disease recurrence. The observation that aberrant cytoplasmic expression of E-cadherin can predict disease recurrence is obviously of great importance for both patients and clinicians, and significantly affects decisions concerning the therapy and management of the patients.展开更多
AIM： To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer, inflammatory bowel disease or diverticulitis. METHODS： A sample of the distal colonic mucosa was taken during ...AIM： To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer, inflammatory bowel disease or diverticulitis. METHODS： A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients, twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-associated microbiota was qualitatively and quantitatively determined by means of qualitative and quantitative PCR. RESULTS： Bifidobacteria were found in 100% of the samples from patients with diverticulitis or IBD and a 76% of those suffering colon cancer. The species B. Iongum and B. bifidum were the most widely found, followed by B. animalis, B. catenulatum and B. adolescentis. B. breve, B. dentium and B. angulatum were not detected in any sample. A significantly higher occurrence of B. Iongum was observed in patients with diverticulitis than in those with colon cancer or IBD （100%, 62% and 75%, respectively, P 〈 0.05）. Similar results were obtained for B, animalis （56%, 0% and 25%, P 〈 0.05）, while B. adolescentis was only found in the mucosa from patients with colon cancer （5 out of 21, 24%）. At the quantitative level, patients with colon cancer or IBD showed lower counts of total Bifidobacterium （4.94 and 5.91 vs 6.96 log Cells/sample, respectively, P 〈 0.05） and of the species B. longum （4.05 and 4.79 vs 6.76, P 〈 0.05） than those with diverticulitis.CONCLUSION： Aberrancies in mucosa associated microbiota are present in different intestinal diseases. This may indicate a role of the microbiota in the pathogenesis of these diseases.展开更多
AIM: To investigate the quality of life following lapa-roscopic Nissen fundoplication by assessing short-term and long-term outcomes. METHODS: From 1992 to 2005, 249 patients under-went laparoscopic Nissen fundoplicat...AIM: To investigate the quality of life following lapa-roscopic Nissen fundoplication by assessing short-term and long-term outcomes. METHODS: From 1992 to 2005, 249 patients under-went laparoscopic Nissen fundoplication. Short-term outcome data including symptom response, side effects of surgery, endoscopy, and patient's perception of over-all success were collected prospectively. Long-term out-comes were investigated retrospectively in patients witha median follow-up of 10 years by assessment of reflux symptoms, side effects of surgery, durability of antire-flux surgery, need for additional treatment, patient's perception of success, and quality of life. Antireflux sur-gery was considered a failure based on the following criteria: moderate to severe heartburn or regurgitation; moderate to severe dysphagia reported in combination with heartburn or regurgitation; regular proton pump inhibitor medication use; endoscopic evidence of erosive esophagitis Savary-Miller grade 1-4; pathological 24-h pH monitoring; or necessity to undergo an additional surgery. The main outcome measures were short-and long-term cure rates and quality of life, with patient sat-isfaction as a secondary outcome measure. RESULTS: Conversion from laparoscopy to open sur-gery was necessary in 2.4% of patients. Mortality was zero and the 30-d morbidity was 7.6% (95%CI: 4.7%-11.7%). The median postoperative hospital stay was 2 d [interquartile range (IQR) 2-3 d]. Two hundred and forty-seven patients were interviewed for short-term analysis following endoscopy. Gastro-esophageal reflux disease was cured in 98.4% (95%CI: 95.9%-99.6%) of patients three months after surgery. New-onset dysphagia was encountered postoperatively in 13 patients (6.7%); 95% reported that the outcome was better after antireflux surgery than with preopera-tive medical treatment. One hundred and thirty-nine patients with a median follow-up of 10.2 years (IQR 7.2-11.6 years) were available for a long-term evalu-ation. Cumulative long-term cure rates were 87.7% (81.0%-92.2%) at 5 years and 72.9% (64.0%-79.9%) at 10 years. Gastrointestinal symptom rating scores and RAND-36 quality of life scores of patients with treatment success were similar to those of the general population but significantly lower in those with failed antireflux surgery. Of the patients available for long-term follow-up, 83% rated their operation a success. CONCLUSION: For the long-term, our results indicate decreasing effectiveness of laparoscopic antirefluxsurgery, although most of the patients seem to have an overall quality of life similar to that of the general population.展开更多
The electronic structure of the strontium aluminate （SrAl2O4：Eu^2＋） materials was studied with a combined experimental and theo- retical approach. The UV-VUV synchrotron radiation was applied in the experimental s...The electronic structure of the strontium aluminate （SrAl2O4：Eu^2＋） materials was studied with a combined experimental and theo- retical approach. The UV-VUV synchrotron radiation was applied in the experimental study while the electronic structure of the non-optimized and optimized crystal structure were investigated theoretically by using the density functional theory. The structure of the valence and conduction bands as well as the band gap energy of the material together with the position of the Eu2＋ 4f7 85712 ground state were calculated. The calculated band gap energy （6.4 eV） agreed well with the experimental value of 6.6 eV. The valence band consisted mainly of oxygen states whereas the bottom of the conduction band of strontium states. In agreement with the experimental results, the calculated 4f7 8S7r2 ground state of Eu2＋ lies in the energy gap of the host. The position of the 4f7 ground state depended on the Coulomb repulsion strength. The position of the 4f7 ground state with respect to the valence and conduction bands was discussed using theoretical and experimental evidence available.展开更多
The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous ...The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous cell carcinoma(cSCC).Important risk factors for the development and progression of cSCC include ultraviolet radiation,chronic skin ulcers and immunosuppression.Due to the role of cumulative long-term sun exposure,cSCC is usually a disease of the elderly,but the incidence is also growing in younger individuals due to increased recreational exposure to sunlight.Although clinical diagnosis of cSCC is usually easy and treatment with surgical excision curable,it is responsible for the majority of NMSC related deaths.Clinicians treating skin cancer patients are aware that certain cSCCs grow rapidly and metastasize,but the underlying molecular mechanisms responsible for the aggressive progression of a subpopulation of cSCCs remain incompletely understood.Recently,new molecular markers for progresprogression of cSCC have been identified.展开更多
Man made electromagnetic irradiation and fields cover now the globe due to the recent extensive propagation of mobile telephony.The increased load affects animals and also plants.Especially birds have been studied.Hum...Man made electromagnetic irradiation and fields cover now the globe due to the recent extensive propagation of mobile telephony.The increased load affects animals and also plants.Especially birds have been studied.Humans are also sensitive.They are good bioindicators as epidemiological methods are available.Humans can also report symptoms which cannot be directly measured with presently available technologies.The nonionizing irradiation can as the ionizing one break the DNA,damage proteins,even increase the blood brain barrier permeability,disturb the night rest,cause fatigue and hormonal disturbances.An increase of the tumours of human head has been described in correlation with the long term mobile phone use and on that side more exposed.The regulations covering mobile telephony are already about two decades old and need re-evaluation.The multitude of irradiation and the interaction of the different wavelength exposures,i.e.,frequency sensitivity is poorly known at present.We should not forget the comparative studies of different species especially those which rely in their lives on electromagnetic orientation physiology.Some countries have issued warnings on the exposures of children.The producers of mobile technology have recently warned the users not to keep those devices in active stage in skin contact.展开更多
AIM: To examine the expression of thymidylate synthase (TS) and oncoprotein Bcl-2 in advanced colorectal cancer (CRC) patients,and to determine their mutual relationship,association to therapeutic response and impact ...AIM: To examine the expression of thymidylate synthase (TS) and oncoprotein Bcl-2 in advanced colorectal cancer (CRC) patients,and to determine their mutual relationship,association to therapeutic response and impact on disease outcome.METHODS: Tumor samples from 67 patients with CRC,who were treated at advanced stage with either irinotecan alone or in combination with 5-fluorouracil/ leucovorin,were analyzed for expression of TS and Bcl-2 using immunohistochemistry.RESULTS: A significant linear correlation between lower expression levels of Bcl-2 and lower levels of TS expression was found (P = 0.033).Patients with high levels of both TS and Bcl-2 expression had a significantly longer disease-free survival (DFS) (42.6 mo vs 5.4 mo,n = 25) than those with low TS/Bcl-2 index (P = 0.001).Tumors with low levels of both TS and Bcl-2 were associated with a longer survival with metastasis (WMS) interval in the whole patients group (n = 67,P = 0.035).TS/Bcl-2 index was not significantly related to disease-specific survival.CONCLUSION: The present data suggest that CRC patients with low TS/Bcl-2 demonstrate a significantly shorter DFS and longer WMS.展开更多
The electronic and defect energy level structure of polyerystalline Sr2MgSi2OT：Eu^2＋,R^3＋ persistent luminescence materials were studied with thermoluminescence and different synchrotron radiation spectroscopies （...The electronic and defect energy level structure of polyerystalline Sr2MgSi2OT：Eu^2＋,R^3＋ persistent luminescence materials were studied with thermoluminescence and different synchrotron radiation spectroscopies （UV-VUV emission and excitation, X-ray absorption near-edge spectroscopy （XANES） and extended X-ray absorption f＇me structure （EXAFS））. Special attention was paid on the effect of the R3＋ co-dopants on the persistent luminescence properties of the materials. Theoretical calculations using the density functional theory （DFT） were carried out simultaneously with the experimental work. The experimental band gap energy （Eg） value of ca. 7.1 eV agreed very well with the DFT value of 6.7 eV. The variation of the Eg value was attempted to relate with the trap structure as well as with the different properties of the R3＋ co-dopants. The trap level energy distribution depended strongly on the R3＋ co-dopant except for the shallowest trap energy above the room temperature remaining practically the same, however. The different processes in the mechanism of persistent luminescence from Sr2MgSi2OT：Eu^2＋,R^3＋ were assembled and their contributions discussed.展开更多
Although more widespread screening and routine adjuvant therapy has improved the outcome for breast cancer patients in recent years, there remains considerable scope for improving the efficacy, safety and tolerability...Although more widespread screening and routine adjuvant therapy has improved the outcome for breast cancer patients in recent years, there remains considerable scope for improving the efficacy, safety and tolerability of adjuvant therapy in the early stage disease and the treatment of advanced disease. Toremifene is a selective estrogen receptor modifier(SERM) that has been widely used for decades in hormone receptor positive breast cancer both in early and late stage disease. Its efficacy has been well established in nine prospective randomized phase Ⅲ trials compared to tamoxifen involving more than 5500 patients, as well as in several large uncontrolled and non-randomized studies. Although most studies show therapeutic equivalence between the two SERMs, some show an advantage for toremifene. Several meta-analyses have also confirmed that the efficacy of toremifene is at least as good as that of tamoxifen. In terms of safety and tolerability toremifene is broadly similar to tamoxifen although there is some evidence that toremifene is less likely to cause uterine neoplasms, serious vascular events andit has a more positive effect on serum lipids than does tamoxifen. Toremifene is therefore effective and safe in the treatment of breast cancer. It provides not only a useful therapeutic alternative to tamoxifen, but may bring specific benefits.展开更多
The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymi...The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymia with different aberrations in brain function related to emotion regulation; however, the development of these deviations is poorly understood. A notable amount of research covers the relation of alexithymia to differentenvironmental factors. Many of these associations, for example, with low socio-economic status and general psychopathology in childhood, are well established. However, the retrospective and cross-sectional designs commonly used in these studies, as well as the use of self-report measures, hinder the ability to firmly establish causality. Certain individual developmental factors, such as lagging speech development and congenital cardiac malformations in childhood, have been associated with the development of alexithymia. Regarding the stability of alexithymia, a systematic review of the literature was conducted for this paper. In addition to being characterized as a personality feature in the general population, alexithymia also clearly has a state-like dimension that results in increases and decreases in alexithymic features in conjunction with mental disorder symptoms. An essential question is whether the alexithymic features in adulthood are, in fact, infantile features of a restricted ability to identify and describe emotions that simply persist in individuals through adolescence to adulthood. To firmly establish the roots of alexithymia development, longitudinal studies, particularly in younger populations, are needed. Furthermore, multifaceted study settings are encouraged.展开更多
The role of neurotrophins in neuronal plasticity has recently become a strong focus in neuroregeneration research field to elucidate the biological mechanisms by which these molecules modulate synapses,modify the resp...The role of neurotrophins in neuronal plasticity has recently become a strong focus in neuroregeneration research field to elucidate the biological mechanisms by which these molecules modulate synapses,modify the response to injury,and alter the adaptation response.Intriguingly,the prior studies highlight the role of p75 neurotrophin receptor(p75^(NTR))in various injuries and diseases such as central nervous system injuries,Alzheimer's disease and amyotrophic lateral sclerosis.More comprehensive elucidation of the mechanisms,and therapies targeting these molecular signaling networks may allow for neuronal tissue regeneration following an injury.Due to a diverse role of the p75^(NTR)in biology,the body of evidence comprising its biological role is diffusely spread out over numerous fields.This review condenses the main evidence of p75^(NTR)for clinical applications and presents new findings from published literature how data mining approach combined with bioinformatic analyses can be utilized to gain new hypotheses in a molecular and network level.展开更多
文摘Purpose: To investigate associations between functional limitations experienced by rehabilitants and multidisciplinary team’s recommendations during vocational rehabilitation evaluation. Methods: The descriptions of functional limitations were retrospectively identified for 32 patients with chronic musculoskeletal disorders. Vocational rehabilitation evaluation was conducted by a multidisciplinary team in an outpatient clinic of a university hospital. The descriptions were converted to ICF second-level categories. Square contingency coefficient Phi (φ) was calculated to describe the associations between ICF-categories appearing ≥10 times in the study sample and the recommendations given by a professional team. Results: In the study sample, 84 different ICF second-level categories were identified (average 18 codes/subject, range 9 - 25). Of them, 18 categories were observed for at least in 10 rehabilitants. Three statistically significant correlations were observed between these 18 categories and recommendations given by a rehabilitation team. Of them, positive association of moderate strength was found between joint mobility and muscle power functions and recommendation for retirement. Difficulties in walking showed weak negative correlation with recommendation for vocational rehabilitation. Conclusions: During vocational rehabilitation evaluation, the final recommendations given by rehabilitation professionals were only weakly correlated with functional limitations experienced by rehabilitants.
基金supported by European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska Curie grant agreement(No.101028929)BJFis supported by National Heart Foundation of Australia Postdoc-toral Fellowship(No.106588)+1 种基金BG is supported by Australian Government Research Training Program ScholarshipDPLis supported by Clive Kearon Award,McMaster University.Additional funding information can be found in Supplemen-tary Funding.
文摘Background:Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability.Handgrip strength(HGS)using isometric dynamometry is a convenient,feasible,and widely used method of assessing muscular strength among people of all ages.While adult HGS norms have been published for many countries,no study has yet synthesized available data to produce international norms.The objective of this study was to generate international sex-and age-specific norms for absolute and body size-normalized HGS across the adult lifespan.Methods:Systematic searches were conducted in 6 databases/web search engines(MEDLINE,SPORTDiscus,Embase,Web of Science,CINAHL,and Google Scholar)up to December 1,2023.We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age.Pseudo data were generated using Monte Carlo simulation following harmonization for methodo-logical variation.Population-weighted Generalized Additive Models for Location,Scale,and Shape were used to develop sex-and age-specific norms for absolute HGS(kg)and HGS normalized by height(Ht,m)squared(i.e.,HGS/Ht^(2)in kg/m^(2)).Norms were tabulated as percentile values(5th to 95th)and visualized as smoothed percentile curves.Results:We included data from 100 unique observational studies representing 2,405,863 adults(51.9%female)aged 20 to 100+years from 69 countries and regions tested from the year 2000 onward.On average,absolute and normalized HGS values negligibly improved throughout early adulthood,peaked from age 3039 years(at 49.7 kg(males)and 29.7 kg(females)for absolute HGS or 16.3 kg/m^(2)(males)and 11.3 kg/m^(2)(females)for HGS/Ht^(2)),and declined afterwards.The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood.Conclusion:This study provides the world’s largest and most geographically comprehensive international norms for adult HGS by sex and age.These norms have utility for global peer-comparisons,health screening,and surveillance.
文摘AIM： To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these. METHODS： Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus （L. acidophilus） NCFM^TM （ATCC 700396） and Bifidobacterium lactis （B. lactis） BI-04 （ATCC SD5219） or placebo in a double-blind manner for 4 mo, starting prior to onset of the birch pollen season. Symptoms were recorded in a diary. Blood samples were taken for analysis of cytokines and eosinophils. Fecal samples were analysed for microbiota components, calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils.RESULTS： The pollen season induced a reduction in Bifldobacterium , Clostridium and Bacteroides which could not be prevented by the probiotic intervention. During the intervention, significantly higher numbers ofB. lactis 11.2 × 10^7 ± 4.2 ×10^7 vs 0.1 × 10^7 ± 0.1 × 10^7 bacteria/g feces （P 〈 0.0001） and L. acidophilus NCFMTM 3.5 × 10^6 ± 1.3 × 10^6 vs 0.2 × 10^6 ±0.1 × 10^6 bacteria/g feces （P 〈 0.0001） were observed in the probiotic group compared to the placebo group.During May, there was a tendency for fewer subjects, （76.2% vs 95.2%, P = 0.078） to report runny nose, while during June, fewer subjects, 11.1% vs 33.3%, reported nasal blocking in the probiotics group （P = 0.101）. Concomitantly, fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group, 57.1% vs 95% （P = 0.013）. Eye symptoms tended to be slightly more frequent in the probiotic group, 12.5 d [interquartile range （IQR） 6-18] vs 7.5 d （IQR 0-11.5） （P = 0.066） during May. Fecal IgA was increased in the placebo group during the pollen season; this increase was prevented by the probiotics （P = 0.028）. CONCLUSION： Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.
基金Supported by the Emil Aaltonen Foundation and Turku University Research Foundation
文摘AIM: To assess the expression of Ki67 as prognosticator in rectal/recto sigmoid cancer.METHODS: Samples from 146 patients with rectal and recto sigmoid cancer were studied for expression of Ki67 and its prognostic significance in comparison with clinicopathological predictors of survival. Formalin-fixed, paraffin-embedded tissues from 6 (4.1%) patients with T1, 26 (17.8%) with T2, 94 (64.4%) with T3, and 20 (13.7%) with T4 tumors were studied. Ki67 expression was determined immunohistochemically. Samples were divided according to mean value into high (＞40%) and low (≤40%) expression. Areas of extensive proliferation (＞50%) were defined as 'hot spot' areas. RESULTS: Hot spot areas were present in samples regardless of histopathological grade. Lower TNM and Dukes stage and higher expression of Ki67 and presence of Ki67 hot spot areas in histopathological samples were associated with better survival, whereas no association was observed with histopathological grade (P = 0.78). In Cox multivariate regression analysis, significant prognostic factors were Dukes stage (P＜0.001), presence of lymph node metastases (P = 0.015), age (P = 0.035) andpresence of Ki67 hot spot areas (P = 0.044). CONCLUSION: Proliferative activity as measured by Ki67 in rectal cancer is associated with survival improvement compared with patients with low Ki67. Areas of prognostically significant increased proliferation were found independently of histopathological tumor grade.
基金Grants from the Special Government Funding (EVO) allocated to Turku University Central Hospital and Cancer Society of South-West Finland (Turku)
文摘AIM： To investigate the changing pattern of β-catenin expression and its prognostic value in advanced colorectal cancer （CRC）. METHODS： Archival tumor samples were analyzed for β-catenin using immunohistochemistry （IHC） in 95 patients with advanced CRC. RESULTS： Membranous β-catenin expression was found in the normal colorectal epithelium. Almost 100% of CRC cases showed membranous and cytoplasmic expression, and 55 （58%） cases showed nuclear expression. In univariate （Kaplan-Meier） survival analysis, only the nuclear index （NI） was a significant predictor of disease free survival （DFS） （P = 0.023; n = 35）, with a NI above the median associated with longer DFS （34.2 too） than those with a NI below the median （15.5 too） （P = 0.045, ANOVA）. The other indices were not significant predictors of DFS, and none of the three tested indices （for membranous, cytoplasmic, or nuclear expression） predicted diseasespecific survival （DSS）. However, when dichotomized as positive or negative nuclear expression, the former was a significant predictor of more favorable DFS （P = 0.041） and DSS （P = 0.046）. CONCLUSION： Nuclear β-catenin expression provides additional information in predicting patient outcome in advanced CRC.
基金Supported by grants from the Special Government Funding (EVO) allocated to Turku University Central Hospital
文摘AIM： To investigate the changes that occur in E-cadherin expression during the process of metastasis in colorectal cancer.METHODS： E-cadherin expression was detected by immunohistochemistry and two indices of expression were calculated which reflected the level of expression and the locations （membrane and cytoplasm）. Univariate and multivariate survival analyses were used to assess the value of these two E-cadherin indices as predictors of both disease-free （DFS） and disease-specific （DSS） survival. RESULTS： E-cadherin membrane index （MI）, but not cytoplasmic index （CI）, was significantly higher in primary tumors than their metastases （P = 0.0001）. Furthermore, both primary tumor MI and CI were higher among the patients who developed subsequent metastasis （P = 0.022 and P = 0.007, respectively）. Interestingly, both indices were higher in liver metastase compared to other anatomic sites （MI, P = 0.034 and CI, P = 0.022）. The CI of the primary tumors was a significant predictor of DFS （P = 0.042, univariate analysis）, with a strong inverse correlation between CI and DFS （P = 0.006, multivariate analysis）. Finally, the MI of primary tumor proved to be a significant independent predictor of DSS, with higher indices being associated with a more favorable outcome （P = 0.016）. CONCLUSION： Examination of E-cadherin expression and distribution in colorectal tumors can be extremely valuable in predicting disease recurrence. The observation that aberrant cytoplasmic expression of E-cadherin can predict disease recurrence is obviously of great importance for both patients and clinicians, and significantly affects decisions concerning the therapy and management of the patients.
文摘AIM： To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer, inflammatory bowel disease or diverticulitis. METHODS： A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients, twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-associated microbiota was qualitatively and quantitatively determined by means of qualitative and quantitative PCR. RESULTS： Bifidobacteria were found in 100% of the samples from patients with diverticulitis or IBD and a 76% of those suffering colon cancer. The species B. Iongum and B. bifidum were the most widely found, followed by B. animalis, B. catenulatum and B. adolescentis. B. breve, B. dentium and B. angulatum were not detected in any sample. A significantly higher occurrence of B. Iongum was observed in patients with diverticulitis than in those with colon cancer or IBD （100%, 62% and 75%, respectively, P 〈 0.05）. Similar results were obtained for B, animalis （56%, 0% and 25%, P 〈 0.05）, while B. adolescentis was only found in the mucosa from patients with colon cancer （5 out of 21, 24%）. At the quantitative level, patients with colon cancer or IBD showed lower counts of total Bifidobacterium （4.94 and 5.91 vs 6.96 log Cells/sample, respectively, P 〈 0.05） and of the species B. longum （4.05 and 4.79 vs 6.76, P 〈 0.05） than those with diverticulitis.CONCLUSION： Aberrancies in mucosa associated microbiota are present in different intestinal diseases. This may indicate a role of the microbiota in the pathogenesis of these diseases.
基金Supported by EVO-funding of the Central Hospital of Central Finland
文摘AIM: To investigate the quality of life following lapa-roscopic Nissen fundoplication by assessing short-term and long-term outcomes. METHODS: From 1992 to 2005, 249 patients under-went laparoscopic Nissen fundoplication. Short-term outcome data including symptom response, side effects of surgery, endoscopy, and patient's perception of over-all success were collected prospectively. Long-term out-comes were investigated retrospectively in patients witha median follow-up of 10 years by assessment of reflux symptoms, side effects of surgery, durability of antire-flux surgery, need for additional treatment, patient's perception of success, and quality of life. Antireflux sur-gery was considered a failure based on the following criteria: moderate to severe heartburn or regurgitation; moderate to severe dysphagia reported in combination with heartburn or regurgitation; regular proton pump inhibitor medication use; endoscopic evidence of erosive esophagitis Savary-Miller grade 1-4; pathological 24-h pH monitoring; or necessity to undergo an additional surgery. The main outcome measures were short-and long-term cure rates and quality of life, with patient sat-isfaction as a secondary outcome measure. RESULTS: Conversion from laparoscopy to open sur-gery was necessary in 2.4% of patients. Mortality was zero and the 30-d morbidity was 7.6% (95%CI: 4.7%-11.7%). The median postoperative hospital stay was 2 d [interquartile range (IQR) 2-3 d]. Two hundred and forty-seven patients were interviewed for short-term analysis following endoscopy. Gastro-esophageal reflux disease was cured in 98.4% (95%CI: 95.9%-99.6%) of patients three months after surgery. New-onset dysphagia was encountered postoperatively in 13 patients (6.7%); 95% reported that the outcome was better after antireflux surgery than with preopera-tive medical treatment. One hundred and thirty-nine patients with a median follow-up of 10.2 years (IQR 7.2-11.6 years) were available for a long-term evalu-ation. Cumulative long-term cure rates were 87.7% (81.0%-92.2%) at 5 years and 72.9% (64.0%-79.9%) at 10 years. Gastrointestinal symptom rating scores and RAND-36 quality of life scores of patients with treatment success were similar to those of the general population but significantly lower in those with failed antireflux surgery. Of the patients available for long-term follow-up, 83% rated their operation a success. CONCLUSION: For the long-term, our results indicate decreasing effectiveness of laparoscopic antirefluxsurgery, although most of the patients seem to have an overall quality of life similar to that of the general population.
基金supported by the Jenny and Antti Wihuri Foundation and the Academy of Finland Project (117057/2006)supported by the European Community-Research Infrastructure Action under the FP6 Structuring the European Research Area Programme (RII3-CT-2004-506008 (IA-SFS))supported by research mobility agreements (112816/2006/JH and 116142/2006/JH, 123976/2007/TL) between the Academy of Finland and the Academy of Sciences of the Czech Republic
文摘The electronic structure of the strontium aluminate （SrAl2O4：Eu^2＋） materials was studied with a combined experimental and theo- retical approach. The UV-VUV synchrotron radiation was applied in the experimental study while the electronic structure of the non-optimized and optimized crystal structure were investigated theoretically by using the density functional theory. The structure of the valence and conduction bands as well as the band gap energy of the material together with the position of the Eu2＋ 4f7 85712 ground state were calculated. The calculated band gap energy （6.4 eV） agreed well with the experimental value of 6.6 eV. The valence band consisted mainly of oxygen states whereas the bottom of the conduction band of strontium states. In agreement with the experimental results, the calculated 4f7 8S7r2 ground state of Eu2＋ lies in the energy gap of the host. The position of the 4f7 ground state depended on the Coulomb repulsion strength. The position of the 4f7 ground state with respect to the valence and conduction bands was discussed using theoretical and experimental evidence available.
基金Supported by The Academy of Finland,project 137687the Finnish Cancer Research Foundation,Sigrid Jusélius Foundation,Turku University Hospital EVO grant,project 13336personal grant to Kivisaari A from Finnish Medical Foundation
文摘The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous cell carcinoma(cSCC).Important risk factors for the development and progression of cSCC include ultraviolet radiation,chronic skin ulcers and immunosuppression.Due to the role of cumulative long-term sun exposure,cSCC is usually a disease of the elderly,but the incidence is also growing in younger individuals due to increased recreational exposure to sunlight.Although clinical diagnosis of cSCC is usually easy and treatment with surgical excision curable,it is responsible for the majority of NMSC related deaths.Clinicians treating skin cancer patients are aware that certain cSCCs grow rapidly and metastasize,but the underlying molecular mechanisms responsible for the aggressive progression of a subpopulation of cSCCs remain incompletely understood.Recently,new molecular markers for progresprogression of cSCC have been identified.
文摘Man made electromagnetic irradiation and fields cover now the globe due to the recent extensive propagation of mobile telephony.The increased load affects animals and also plants.Especially birds have been studied.Humans are also sensitive.They are good bioindicators as epidemiological methods are available.Humans can also report symptoms which cannot be directly measured with presently available technologies.The nonionizing irradiation can as the ionizing one break the DNA,damage proteins,even increase the blood brain barrier permeability,disturb the night rest,cause fatigue and hormonal disturbances.An increase of the tumours of human head has been described in correlation with the long term mobile phone use and on that side more exposed.The regulations covering mobile telephony are already about two decades old and need re-evaluation.The multitude of irradiation and the interaction of the different wavelength exposures,i.e.,frequency sensitivity is poorly known at present.We should not forget the comparative studies of different species especially those which rely in their lives on electromagnetic orientation physiology.Some countries have issued warnings on the exposures of children.The producers of mobile technology have recently warned the users not to keep those devices in active stage in skin contact.
文摘AIM: To examine the expression of thymidylate synthase (TS) and oncoprotein Bcl-2 in advanced colorectal cancer (CRC) patients,and to determine their mutual relationship,association to therapeutic response and impact on disease outcome.METHODS: Tumor samples from 67 patients with CRC,who were treated at advanced stage with either irinotecan alone or in combination with 5-fluorouracil/ leucovorin,were analyzed for expression of TS and Bcl-2 using immunohistochemistry.RESULTS: A significant linear correlation between lower expression levels of Bcl-2 and lower levels of TS expression was found (P = 0.033).Patients with high levels of both TS and Bcl-2 expression had a significantly longer disease-free survival (DFS) (42.6 mo vs 5.4 mo,n = 25) than those with low TS/Bcl-2 index (P = 0.001).Tumors with low levels of both TS and Bcl-2 were associated with a longer survival with metastasis (WMS) interval in the whole patients group (n = 67,P = 0.035).TS/Bcl-2 index was not significantly related to disease-specific survival.CONCLUSION: The present data suggest that CRC patients with low TS/Bcl-2 demonstrate a significantly shorter DFS and longer WMS.
基金Project supported by the Turku University Foundation, Jenny and Antti Wihuri Foundation (Finland) and the Academy of Finland (117057/2006)supported by the European Community-Research Infrastructure Action under the FP6 Structuring the European Re-search Area Programme, RII3-CT-2004-506008 (IA-SFS)+1 种基金supported by the Integrated Infrastructure Initiative "Integrating Activity on Synchrotron and Free Electron Laser Science"supported by Research Mobility Agreements (112816/2006/JH and 116142/2006/JH, 123976/2007/TL) between the Academy of Finland and the Academy of Sciences of the Czech Republic
文摘The electronic and defect energy level structure of polyerystalline Sr2MgSi2OT：Eu^2＋,R^3＋ persistent luminescence materials were studied with thermoluminescence and different synchrotron radiation spectroscopies （UV-VUV emission and excitation, X-ray absorption near-edge spectroscopy （XANES） and extended X-ray absorption f＇me structure （EXAFS））. Special attention was paid on the effect of the R3＋ co-dopants on the persistent luminescence properties of the materials. Theoretical calculations using the density functional theory （DFT） were carried out simultaneously with the experimental work. The experimental band gap energy （Eg） value of ca. 7.1 eV agreed very well with the DFT value of 6.7 eV. The variation of the Eg value was attempted to relate with the trap structure as well as with the different properties of the R3＋ co-dopants. The trap level energy distribution depended strongly on the R3＋ co-dopant except for the shallowest trap energy above the room temperature remaining practically the same, however. The different processes in the mechanism of persistent luminescence from Sr2MgSi2OT：Eu^2＋,R^3＋ were assembled and their contributions discussed.
文摘Although more widespread screening and routine adjuvant therapy has improved the outcome for breast cancer patients in recent years, there remains considerable scope for improving the efficacy, safety and tolerability of adjuvant therapy in the early stage disease and the treatment of advanced disease. Toremifene is a selective estrogen receptor modifier(SERM) that has been widely used for decades in hormone receptor positive breast cancer both in early and late stage disease. Its efficacy has been well established in nine prospective randomized phase Ⅲ trials compared to tamoxifen involving more than 5500 patients, as well as in several large uncontrolled and non-randomized studies. Although most studies show therapeutic equivalence between the two SERMs, some show an advantage for toremifene. Several meta-analyses have also confirmed that the efficacy of toremifene is at least as good as that of tamoxifen. In terms of safety and tolerability toremifene is broadly similar to tamoxifen although there is some evidence that toremifene is less likely to cause uterine neoplasms, serious vascular events andit has a more positive effect on serum lipids than does tamoxifen. Toremifene is therefore effective and safe in the treatment of breast cancer. It provides not only a useful therapeutic alternative to tamoxifen, but may bring specific benefits.
文摘The purpose of this paper is to review the current literature regarding the development of alexithymic personality features. Modern brain imaging technologies provide interesting data on the associations of alexithymia with different aberrations in brain function related to emotion regulation; however, the development of these deviations is poorly understood. A notable amount of research covers the relation of alexithymia to differentenvironmental factors. Many of these associations, for example, with low socio-economic status and general psychopathology in childhood, are well established. However, the retrospective and cross-sectional designs commonly used in these studies, as well as the use of self-report measures, hinder the ability to firmly establish causality. Certain individual developmental factors, such as lagging speech development and congenital cardiac malformations in childhood, have been associated with the development of alexithymia. Regarding the stability of alexithymia, a systematic review of the literature was conducted for this paper. In addition to being characterized as a personality feature in the general population, alexithymia also clearly has a state-like dimension that results in increases and decreases in alexithymic features in conjunction with mental disorder symptoms. An essential question is whether the alexithymic features in adulthood are, in fact, infantile features of a restricted ability to identify and describe emotions that simply persist in individuals through adolescence to adulthood. To firmly establish the roots of alexithymia development, longitudinal studies, particularly in younger populations, are needed. Furthermore, multifaceted study settings are encouraged.
文摘The role of neurotrophins in neuronal plasticity has recently become a strong focus in neuroregeneration research field to elucidate the biological mechanisms by which these molecules modulate synapses,modify the response to injury,and alter the adaptation response.Intriguingly,the prior studies highlight the role of p75 neurotrophin receptor(p75^(NTR))in various injuries and diseases such as central nervous system injuries,Alzheimer's disease and amyotrophic lateral sclerosis.More comprehensive elucidation of the mechanisms,and therapies targeting these molecular signaling networks may allow for neuronal tissue regeneration following an injury.Due to a diverse role of the p75^(NTR)in biology,the body of evidence comprising its biological role is diffusely spread out over numerous fields.This review condenses the main evidence of p75^(NTR)for clinical applications and presents new findings from published literature how data mining approach combined with bioinformatic analyses can be utilized to gain new hypotheses in a molecular and network level.
