The Effect of Co-dependent (Thinking in Motion [tim]) Versus Single-modality (Cognifit) Interventions on Cognition and Gait Among Community Dwelling Older Adults With Cognitive Decline: a Randomized Controlled Study

Background. Cognition and motor skills are interrelated throughout the aging process and often show simultaneous deterioration among older adults with cognitive decline. Co-dependent training has the potential to ameliorate both domains; however, its effect on the gait and cognition of older adults with cognitive decline has yet to be explored. The aim of this study is to compare the effects of the well-established single-modality cognitive computerized training program, CogniFit, with “Thinking in motion (TIM),” a co-dependent group intervention, among community-dwelling older adults with cognitive decline. Methods. Employing a single-blind randomized control trial design, 47 community-dwelling older adults with cognitive decline were randomly assigned to eight-week thrice weekly trainings of TIM or CogniFit. Pre- and post-intervention assessments included cognitive performance, evaluated by a CogniFit battery, as a primary outcome, and gait, under single- and dual-task conditions, as a secondary outcome. Results. CogniFit total Z scores significantly improved from baseline to post-intervention for both groups. There was a significant main effect for time [F (1, 44) = 17.43, p<.001, ηp2=.283] but not for group [F (1, 44) = 0.001, p=.970]. No time X group interaction [F (1, 44) = 1.29, p=.261] was found. No changes in gait performance under single and dual-task performance were observed in both groups. Conclusions. The findings show that single-modality (CogniFit) and co-dependent (TIM) trainings improve cognition but not gait in older adults with cognitive decline. Such investigations should be extended to include various populations and a broader set of outcome measurements. Trial registration: anzctr Id: 371522. Date: 08/11/2016

Pattern of Nutritional status in Node Negative versus Node Positive Head and Neck Cancer patients undergoing treatment - a prospective cohort study

Purpose The aim of this study was to study the nutritional profile of node negative and node positive patients undergoing treatment for head and neck squamous cell cancer (HNSCC). Methods This prospective cohort study was conducted between 2018 and 2020. Patients diagnosed with HNSCC, planned for treatment were enrolled after written informed consent. In Node negative(N0) and Node positive(N+) cohorts of patients, nutritional status was determined using- anthropometric measures and Subjective Global Assessment (SGA) scale pre-treatment, during and after treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric tests, p value of 0.05 was considered significant. Results 161 patients were analyses, 73 N0 and 88 N+ cohorts. Pre-treatment, 9.6 to 20.4% patients in N0 and 23.9 to 32.8% patients in N+ cohorts were malnourished. Incidence of malnutrition at completion of treatment was 40.8–52.5% overall, 20.5–41.1% N0, 39.5–62.8% N+. Mean reduction in weight (11.1% ±7.82 v/s 6.26% ±8.3, p=0.000), mean reduction in BMI (2.57 ±1.87 v/s 1.29 ±1.62, p=0.000), median reduction in MUAC (2cm v/s 1cm, p=0.000) and median increase in SGA score were higher (13 v/s 6, p=0.000) in multi-modality as compared to single modality treatment. Similar findings were noted in N0 and N+ cohorts. Conclusion As compared to N0, N+ patients had higher burden of malnutrition at diagnosis, more worsening of nutritional parameters during treatment. More decline in Nutritional status was seen in patients receiving multi-modality as compared to single modality treatment.

An engineered nanocomplex with Photodynamic and Photothermal synergistic properties for cancer treatment

Photodynamic therapy (PDT) and photothermal therapy (PTT) are promising therapeutic methods for cancer treatment; however, as single modality therapies, either PDT or PTT are still limited in their success rate. A dual application of both PDT and PTT, in a combined protocol, has gained immense interest. In this study, gold nanoparticles (AuNPs) are conjugated with a PDT agent, meso-tetrahydroxyphenylchlorin (mTHPC) photosensitizer, designed as nanotherapeutic agents that can activate a dual photodynamic/photothermal therapy. The AuNP-mTHPC complex is biocompatible, soluable, and photostable. PDT efficiency is high because of immediate reactive oxygen species (ROS) production upon mTHPC activation by the 650 nm laser which decreased mitochondrial membrane potential (∆ψm). Likewise, the AuNP-mTHPC complex is used as a photoabsorbing (PTA) agent for PTT, due to efficient plasmon absorption and excellent photothermal conversion characteristics of AuNPs under laser irradiation at 532 nm. Under the laser irradiation of a PDT/PTT combination, a twofold phototoxicity outcome follows, compared to PDT-only or PTT-only treatment. This indicates that PDT and PTT have synergistic effects together as a combined therapeutic method. Hence, applying our AuNP-mTHPC may be a potential treatment of cancer in the biomedical field.

Peritonsillar Abscess Treatment under Local Anaesthesia: Incision and Drainage versus Needle Aspiration

Background: Peritonsillar abscess is usually complication of acute tonsillitis which itself is prevalent in society. As a general surgical principle, abscess any were, has to be drained so same applies for quinsy but methodology for this drainage is not being agreed. Aim: To find best modality for drainage of this abscess and see its incidence in which age group and sex. Study design: Prospective study Place and duration of the study: Department of ENT, Rai Medical College, Sargodha from 1st Feb. 2017 to 31st Jan. 2019. Methodology: One hundred and thirty five patients above 15 years of age and those in need of hospital admission due to severity of symptoms were included. Paediatric, immunocompromised, requiring general anesthesia and acute tonsillitis patients were excluded. Results: There were 65.2% males and 34.8% females. Commonly affected age group was 21-40 years. Needle aspiration was found more effective for management of peritonsillar abscess. Conclusion: No consensus for single modality and both needle aspiration and incision/drainage is advocated and needle aspiration proved fruitful in management. Keywords: Quinsy, Peritonsillar abscess, needle aspiration

Three-Dimensional Non-Destructive Inspection Using Novel Infrared-Terahertz Fusion Approaches

The imaging of structures with a complex material composition and geometry is still a challenge in the field of non-destructive testing (NDT). In this study, a non-invasive imaging technique is proposed for the non-destructive inspection of both cultural heritage and natural fiber composites. The proposed technique combines the surface information provided by infrared thermography (IRT) and the internal structure retrieved with terahertz (THz) time-domain spectroscopy using an unsupervised deep residual fusion network. Experiments show that the fusion results contain more material information than a single modality. In addition, 3D imaging has been achieved using the fusion results on natural fiber composites.

Multi-parametric characterization of brain-wide hemodynamic and calcium responses to sensory stimulation in mice

Modern optical neuroimaging approaches are expanding our ability to elucidate complex brain function. Diverse imaging contrasts enable direct observation of neural activity with functional sensors along with the induced hemodynamic responses. To date, decoupling the complex interplay of neurovascular coupling and dynamical physiological states has remained challenging when employing single-modality functional neuroimaging tools. We devised a hybrid fluorescence optoacoustic tomography (FLOT) platform combined with a custom data processing pipeline based on statistical parametric mapping, accomplishing the first simultaneous noninvasive observation of both direct and indirect brain-wide activation patterns with optical contrast. Correlated changes in the oxy- and deoxygenated hemoglobin, total hemoglobin, oxygen saturation and rapid GCaMP6f fluorescence signals were observed in response to peripheral sensory stimulation. While the concurrent epifluorescence served to corroborate and complement the functional optoacoustic observations, the latter further aided in decoupling the rapid calcium responses from the slowly varying background in the fluorescence recordings mediated by hemodynamic changes. The hybrid imaging platform expands the capabilities of conventional neuroimaging methods to provide more comprehensive functional readings for studying neurovascular and neurometabolic coupling mechanisms and related diseases.

Surgical Challenges of Chronic Empyema and Bronchopleural Fistula

Chronic empyema has always been a clinical challenge for physicians. There is no standard procedure or treatment to deal with the situation, and multi-modality approach is often necessary. Surgical intervention plays a very crucial role in the treatment of chronic empyema. Since bronchopleural fistula is often seen in chronic empyema patients, therefore it should also be mentioned. In this chapter, the focus will be on the different treatment options, various surgical approaches, and the rationale behind every single modality. Certain specific entity will be included as well, such as tuberculosis infection, post lung resection empyema, and intrathoracic vacuum assisted closure system application. Even with the advancement of technology and techniques, chronic empyema management is still evolving, and we look forward to less traumatic ways of approach with better outcome in the future.

Focal Cognitive Syndromes

The neurologic results of cortical lesions reflect the structural properties of the affected region. Lesions affecting primary sensorimotor cortices result in primary sensorimotor deficits that are qualitatively all-or-nothing, such as blindness (hemianopia) and paralysis (hemiparesis). Quantitatively, though, the severity of the deficit depends on the extent of the lesion (so that a hemiparetic patient may not be completely paralyzed but simply weak). Lesions affecting modality-specific association regions result in conceptually more complex disorders that are confined to a single modality, such as nonfluent aphasia (a form of motor speech disorder reflecting the language-dominant hemisphere) or prosopagnosia (a visual disorder impairing the ability to disambiguate visually similar entities, specifically faces, reflecting the “what” visual pathway in inferotemporal cortices).