In an asymptomatic population, we investigated the relationships between glycated haemoglobin (HbA1c) and cartilage T2 relaxation time at the knee joint level. Fourteen and 17 participants with high and normal levels of HbA1c were recruited, respectively. A blood sample was used to determine the HbA1c level. T2 relaxation time (T2) of the superficial and deep parts of the femoral cartilage in the anterior, central, and posterior topographical sites was calculated using magnetic resonance (1.5 T) images. Each participant completed a knee injury and osteoarthritis outcome score questionnaire (KOOS) and a series of biomechanical analyses while running at their self-selected speed. The group with a high level of HbA1c had a lower score of KOOS symptoms than the other group (P < 0.05). HbA1c was found to be negatively related to the KOOS symptoms score. The group with a high level of HbA1c had low T2 values in all of the investigated topographical sites of the knee femoral cartilage (P < 0.05 in all cases). T2 was negatively correlated with HbA1c levels in all investigated knee femoral cartilage regions. Our data suggest that the subjects with high levels of HbA1c were those with low knee joint symptoms and lower values of T2. These results indicate that HbA1c could be correlated with cartilage deterioration due to its ability to dehydrate collagen fibre, possibly acting as a risk factor for the development of osteoarthritis.

• MeSH
• Osteoarthritis, Knee blood   physiopathology   MeSH
• Adult MeSH
• Glycated Hemoglobin * metabolism   MeSH
• Cartilage, Articular * metabolism   MeSH
• Knee Joint * MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

AIM: To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers' speaking-up behaviour in a developing economy. DESIGN: The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana. METHODS: The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample. RESULTS: The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers. CONCLUSION: Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty. IMPACT: Healthcare workers' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual. REPORTING METHOD: Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Organizational Culture * MeSH
• Attitude of Health Personnel * MeSH
• Cross-Sectional Studies MeSH
• Health Personnel * psychology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Ghana MeSH

This systematic literature review (SLR) aimed to comprehensively synthesize existing studies that have reported on TMG-derived parameters of lower extremities in soccer players. The PubMed, Web of Science, and EBSCOHost (including MEDLINE, SPORTDiscuss, ERIC, DOAJ, and SCOPUS) databases were searched from inception to the 31st of August, 2023. Reports were eligible if they satisfied the following criteria: recruited active soccer players, with no restriction on race, sex, age, level of expertise, or health status; studies utilizing TMG for measuring muscle contractile properties. In total, 25 published journal articles from 22 original studies were included in the current review, encompassing a total of 1224 participants (4% females). The analysis considered various muscles, with the biceps femoris (BF), rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), semitendinosus (ST), gastrocnemius lateralis (GL), and gastrocnemius medialis (GM) being investigated. Significant variations were observed in TMG parameters across different muscles, age categories, and levels of play. The quality of evidence varied from low to moderate for all analyses. The meta-regression analysis indicated that age moderated several TMG-derived parameters in lower limb muscles including BF Vc, RF Td and Vc, ST Dm and sustain time, VL Dm, Tc, Td and relaxation time (Tr), and VM Tc, Td and Tr, respectively. In conclusion, the current review illuminated the multifaceted applications of TMG in assessing lower extremity muscles in soccer players. Beyond evaluating muscle contractile properties in various superficial muscles of the lower limbs in soccer players, TMG-derived parameters may serve as potentially valuable markers in identifying neuromuscular risk factors for anterior cruciate ligament injuries and predicting hamstring-related injuries.

• Publication type
• Journal Article MeSH
• Review MeSH

BackgroundDuring the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as social distancing, lockdowns and enhanced hygiene led to a decrease in respiratory pathogens. However, as NPIs were relaxed, a resurgence in several respiratory pathogens was observed including one local Chlamydia pneumoniae outbreak in Switzerland, prompting the need for a better understanding of C. pneumoniae epidemiology.AimTo assess temporal and geographical variations in C. pneumoniae detection before, during and after the COVID-19 pandemic.MethodsData on C. pneumoniae PCR detection ratios (number of positive tests/ total number of tests) across pre-pandemic (2018-2019), pandemic (2020-2022) and post-pandemic (2023) periods were collected via a global survey disseminated through various professional networks.ResultsC. pneumoniae detection ratios were analysed across 28 sites (27 in Europe, one in Taiwan) in 2023 (Dataset A, n = 172,223 tests) and 20 sites from 2018 to 2023 (Dataset B, n = 693,106 tests). Twenty-seven sites were laboratories (hospital or clinical) and one a surveillance system (Denmark). A significant decrease in detection ratios was observed during the pandemic period (from 1.05% to 0.23%, p < 0.001). In 2023, detection ratios increased to 0.28% (p < 0.002). Notable regional variations were found, with statistically significant increases in detection ratios at six sites located in Switzerland and Slovenia, where ratios ranged from 0.52% to 3.25%.DiscussionThe study highlights how NPIs influenced C. pneumoniae epidemiology, with reduced detection during the pandemic and partial resurgence afterwards. Regional variations suggest differing NPI impacts and underscore the need for continued surveillance.

• MeSH
• Chlamydophila pneumoniae * isolation & purification   genetics   MeSH
• COVID-19 * epidemiology   MeSH
• Chlamydophila Infections * epidemiology   diagnosis   MeSH
• Humans MeSH
• Pandemics MeSH
• Polymerase Chain Reaction MeSH
• SARS-CoV-2 MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH
• Taiwan MeSH

Neurodegenerative motor disorders affect the neuromuscular system challenging daily life and normal activity. Parkinson's Disease (PD) is among the most prevalent ones, with a large impact and rising prevalence rates. Speech is most affected by PD as far as phonatory and articulatory performance is concerned. Neuromotor activity (NMA) alterations have an impact on larynx muscles responsible for vocal fold adduction and abduction, hampering phonation stability and regularity. The main muscular articulators involved in phonation control are the cricothyroid (tensor) and thyroarytenoid (relaxer) systems, regulated by two distinct direct neuromotor pathways, activated by the precentral gyrus laryngeal control areas. These articulations control the musculus vocalis, directly responsible for regular vocal fold vibration. An indirect estimation of the muscular tension produced by inverse filtering may split into two independent channels, assumed to be the tensor and relaxer neuromotor pathways such as the differential neuromotor activity (DNMA). The amplitude distributions of both DNMA channels allow comparing phonations from PD-affected persons (PDPs) and age-matched healthy control participants (HCPs) with respect to a set of reference mid-age normative participants (RSPs). The comparisons are carried out by Jensen-Shannon distributions of PDP and HCP phonations with respect to those of RSPs. A dataset of 96 phonation samples from participants balanced by gender is used to train a set of decision tree classifiers (DTCs) to distinguish PDP from HCP phonation. The best results from 10-fold cross-validation offered accumulated mismatches of 0.09 and 0.1292 for male and female subsets. The sensitivity, specificity, and accuracy of the classification results when separating PDP from HCP phonatios were 93.33%, 88.23%, and 90.63% (male PDP versus HCP) and 92.86%, 83.33%, and 87.50% (female PDP versus HCP), providing a stratification of PDPs and HCPs by objective disease grading from explainable AI (XAI) methods.

• MeSH
• Adult MeSH
• Phonation * physiology   MeSH
• Laryngeal Muscles * physiopathology   MeSH
• Larynx * physiopathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Parkinson Disease * physiopathology   complications   MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

In this manuscript, we highlight the evolutionary origins of mitochondria from bacterial endosymbionts and explore their contributions to health, energy metabolism, and neural-immune communication. Mitochondrial adaptability and the roles played by these organelles in promoting oxygen-dependent ATP production provide critical regulation of cognition, motivation, and inflammation. Hypoxia has been identified as an important initiator of inflammation, neurodegeneration, and mitochondrial dysfunction, emphasizing the overall importance of oxygen homeostasis to health and well-being. The Behavior, Exercise, Relaxation, and Nutrition framework highlights these observations as tools that can be used to optimize mitochondrial efficiency. Interestingly, mitochondrial dysfunction may also be linked to psychiatric disorders (e.g., schizophrenia), a hypothesis that focuses on energy dynamics, a proposal that may extend our understanding of these disorders beyond traditional neurotransmitter-focused concepts. Collectively, these perspectives underscore the critical contributions of mitochondria to health and disease and offer a novel framework that may help to explain the connections featured in mind-body medicine.

• MeSH
• Biological Evolution MeSH
• Pain * metabolism   physiopathology   MeSH
• Exercise * physiology   MeSH
• Energy Metabolism * MeSH
• Cognition * physiology   MeSH
• Humans MeSH
• Mitochondria metabolism   MeSH
• Motivation * MeSH
• Pleasure * physiology   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

The aim of this study was to test the hypothesis that individuals with an increase in HbA1c (i.e. above the regular but below the diabetic threshold) exhibit an impairment in the Achilles tendon structure and walking capacity, due to the adverse effect of the advanced glycation end-product. One hundred fifty-eight participants matched for gender, age, physical activity and BMI, were divided in two cohorts based on the HbA1c level: normal HbA1c (NGH; <39 mmol/molHb; n = 79) and altered HbA1c (AGH; >=39 mmol/molHb; n = 79). Each participant performed several walking trials to evaluate the kinematic parameters during walling at the self-selected speed and a quantitative MRI scan of the Achilles tendon (AT) to obtain its intrinsic characteristics (i.e. T2* relaxation time short and long component). The AT T2* relaxation time short component (a parameter related to the tendon collagen quality) was reduced in AGH compared to NGH. Furthermore, AGH exhibited a slower self-selected walking speed (NGH: 1.59 ± 0.18 m/s; AGH:1.54 ± 0.16 m/s) and a shorter stride length (NGH: 1.59 ± 0.13 m; AGH:1.55 ± 0.11 m). Our data suggest that a non-pathological increase in HbA1c is able to negatively affect AT collagen quality and walking capacity in healthy people. These results highlight the importance of glycemic control, even below the pathological threshold. Since diabetes could alter several biological pathways, further studies are necessary to determine which mechanisms and their timing, regarding the HbA1c rise, affect tendon composition and, consequently, walking capacity.

• MeSH
• Achilles Tendon * diagnostic imaging   physiology   metabolism   MeSH
• Biomechanical Phenomena MeSH
• Walking * physiology   MeSH
• Diabetes Mellitus diagnosis   MeSH
• Adult MeSH
• Glycated Hemoglobin * metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Glycation End Products, Advanced metabolism   MeSH
• Healthy Volunteers MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVE: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. METHODS: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. RESULTS: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. CONCLUSIONS: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

• MeSH
• Medication Adherence * psychology   MeSH
• Adult MeSH
• HIV Infections * drug therapy   psychology   MeSH
• Cohort Studies MeSH
• Quality of Life * MeSH
• Anti-HIV Agents * therapeutic use   urine   MeSH
• Middle Aged MeSH
• Humans MeSH
• CD4 Lymphocyte Count MeSH
• Viral Load MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Východiska: Multimodální prehabilitace v onkogynekologii je založena na úzké spolupráci onkologů a onkogynekologů s prehabilitačním týmem. Součástí týmu jsou rehabilitační lékaři, fyzioterapeuti, ergoterapeuti, nutriční terapeut a klinický psycholog. Cílem je dosažení maximálně možného psychosenzomotorického potenciálu před plánovaným radikálním operačním výkonem. Případ: U 66leté pacientky s diagnostikovaným high-grade serózním ovariálním karcinomem IIIC dle FIGO byla po skončení neoadjuvantní chemoterapie indikována 21denní lůžková prehabilitace v režimu 4/7. Prehabilitaci dominovala individuální fyzioterapie a ergoterapie s frekvencí 2× denně po dobu 20–30 min. Byly aplikovány terapeutické programy obsahující prvky kardiorespiračního tréninku, relaxačních metod, svalového i kognitivního tréninku. Terapie byla doplněna i o prvky teleprehabilitace v domácím prostředí. Závěr: Vyhodnocením aplikovaných funkčních testů lze demonstrovat významné zlepšení celkové fyzické kondice, respiračních parametrů i kvality života popisované pacientky.

Background: Multimodal prehabilitation in oncogynecology is based on close collaboration between oncologists, oncogynecologists and the prehabilitation team. The team includes rehabilitation physicians, physiotherapists, occupational therapists, a nutritional therapist and a clinical psychologist. The aim is to achieve the maximum possible psychosensomotor potential before the planned radical surgery. Case: A 66-year-old female patient diagnosed with high-grade serous ovarial carcinoma, stage IIIC according to International Federation of Gynecology and Obstetrics (FIGO) classification, after completion of neoadjuvant chemotherapy, was indicated for 21 days of inpatient prehabilitation in a 4/7 regimen. Prehabilitation was dominated by individual physiotherapy and occupational therapy with a frequency of twice a day for 20–30 minutes. Therapeutic programs containing elements of cardiorespiratory training, relaxation methods, muscular and cognitive training were applied. The therapy was supplemented with elements of telerehabilitation in the home environment. Conclusion: The evaluation of the applied functional tests demonstrates a significant improvement in the overall physical condition, respiratory parameters and quality of life of the patient described.

• Keywords
• HGSC,
• MeSH
• Preoperative Exercise * MeSH
• Cardiorespiratory Fitness MeSH
• Quality of Life MeSH
• Humans MeSH
• Ovarian Neoplasms * surgery   diagnosis   rehabilitation   MeSH
• Aged MeSH
• Telerehabilitation MeSH
• Physical Fitness MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

Spasticity often results in significant disability, which complicates rehabilitation and daily activities. This review explores the role of botulinum toxin type A (BoNT-A) in the treatment of spasticity, focusing on its effects on muscle structure and activity, function, cortical reorganization, and pain. Our findings indicate that BoNT-A injections improve motor function and gait, particularly in stroke patients, by reducing abnormal muscle activity and enhancing postural control. However, BoNT-A may also induce unwanted biomechanical changes, such as muscle atrophy and alterations in contractile elements, which could impact long-term muscle function. Regarding pain management in spasticity, BoNT-A has shown promise by reducing both peripheral and central sensitization mechanisms. Additionally, BoNT-A influences the central nervous system (CNS) by inducing cortical reorganization, which may further contribute to clinical improvements. Lastly, BoNT-A treatment requires careful consideration of individual patient characteristics to optimize outcomes and minimize side effects. A multidisciplinary approach that combines BoNT-A with physical therapy is essential to maximize functional recovery and improve the quality of life in patients with spasticity.

• MeSH
• Pain * drug therapy   MeSH
• Botulinum Toxins, Type A * therapeutic use   pharmacology   MeSH
• Muscle, Skeletal * drug effects   MeSH
• Humans MeSH
• Pain Management MeSH
• Neuromuscular Agents * therapeutic use   pharmacology   MeSH
• Muscle Spasticity * drug therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH