Notes

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consider the associated factors and to design effective interventions to combat frailty in our ageing society.

Frailty is a transient state that can be reversed. Professional nurses working in both community and residential care settings should be able to identify older adults at risk and improve their health conditions appropriately.
Frailty is a transient state that can be reversed. Professional nurses working in both community and residential care settings should be able to identify older adults at risk and improve their health conditions appropriately.Hypertensives present cardiac autonomic dysfunction. Reduction in sleep quality increases blood pressure (BP) and favors hypertension development. Previous studies suggested a relationship between cardiovascular autonomic dysfunction and sleep quality, but it is unclear whether this association is present in hypertensives. Thus, this study evaluated the relationship between sleep quality and cardiac autonomic modulation in hypertensives. Forty-seven middle-aged hypertensive men under consistent anti-hypertensive treatment were assessed for sleep quality by the Pittsburgh Sleep Quality Index (PSQI-higher score means worse sleep quality). Additionally, their beat-by-beat BP and heart rate (HR) were recorded, and cardiac autonomic modulation was assessed by their variabilities. Mann-Whitney and t tests were used to compare different sleep quality groups poor (PSQI > 5, n = 24) vs good (PSQI ≤ 5, n = 23), and Spearman's correlations to investigate associations between sleep quality and autonomic markers. Patients with poor sleep quality presented lower cardiac parasympathetic modulation (HR high-frequency band = 26 ± 13 vs 36 ± 15 nu, P = .03; HR total variance = 951 ± 1373 vs 1608 ± 2272 ms2 , P = .05) and cardiac baroreflex sensitivity (4.5 ± 2.3 vs 7.1 ± 3.7 ms/mm Hg, P = .01). click here Additionally, sleep quality score presented significant positive correlation with HR (r = +0.34, P = .02) and negative correlations with HR high-frequency band (r = -0.34, P = .03), HR total variance (r = -0.35, P = .02), and cardiac baroreflex sensitivity (r = -0.42, P = .01), showing that poor sleep quality is associated with higher HR and lower cardiac parasympathetic modulation and baroreflex sensitivity. In conclusion, in treated hypertensive men, poor sleep quality is associated with cardiac autonomic dysfunction.
The purpose of this study was twofold (a) report the long-term monthly quality assurance (QA) dosimetry results of the uniform scanning beam delivery system, and (b) derive the machine-specific tolerances based on the statistic process control (SPC) methodology and compare them against the AAPM TG224 recommended tolerances.

The Oklahoma Proton Center has four treatment rooms (TR1, TR2, TR3, and TR4) with a cyclotron and a universal nozzle. Monthly QA dosimetry results of four treatment rooms over a period of 6yr (Feb 2014-Jan 2020) were retrieved from the QA database. The dosimetry parameters included dose output, range, flatness, and symmetry. The monthly QA results were analyzed using the SPC method, which included individuals and moving range (I-MR) chart. The upper control limit (UCL) and lower control limit (LCL) were set at 3σ above and below the mean value, respectively.

The mean difference in dose output was -0.3% (2σ=±0.9% and 3σ=±1.3%) in TR1, 0% (2σ=±1.4% and 3σ=±2.1%) in TR2, -0.2% (2σ=±1.0% it may not always be possible to achieve the range difference within ±1 mm (TG224) for all the ranges.
Botulinum toxin (BoNT) injections were shown to improve muscle tone of limbs in patients with spasticity. However, limited data are available regarding the effects of repeated BoNT injections on walking ability.

To assess changes in walking velocity (WV), step length, and cadence under different test conditions after repeated treatment with abobotulinumtoxinA (aboBoNT-A; Dysport) in spastic lower limb muscles.

Secondary analysis of an open-label, multiple-cycle extension (National Clinical Trials number NCT01251367) to a phase III, double-blind, randomized, placebo-controlled, single-treatment cycle study, in adults with chronic hemiparesis (NCT01249404).

Fifty-two centers across Australia, Belgium, the Czech Republic, France, Hungary, Italy, Poland, Portugal, Russia, Slovakia, and the United States.

352 Ambulatory adults (18-80 years) with spastic hemiparesis and gait dysfunction caused by stroke or traumatic brain injury, with a comfortable barefoot WV of 0.1 to 0.8 m/s.

Up to four aboBoNT-A treobserved in patients with spastic hemiparesis after each aboBoNT-A treatment cycle.
To determine whether a diagnosis of polymyalgia rheumatica (PMR) is associated with premature mortality.

We extracted anonymised electronic medical records of patients over the age of 40 years, who were eligible for linkage with the Office for National Statistics (ONS) Death Registration dataset, from the Clinical Practice Research Datalink from 1990-2016. Patients with PMR were individually matched by age, sex and registered General Practice with up to 5 controls without PMR. The total number and proportion of deaths and mortality rates were calculated. The mortality rate ratio (MRR), with 95% confidence interval (CI), adjusted for age, sex, region, smoking status, body mass index (BMI), and alcohol consumption, was calculated using Poisson regression. The twenty most common causes of death were tabulated.

18,943 patients with PMR were matched to 87,801 controls. Mean (standard deviation) follow-up after date of diagnosis was 8.0 (4.4) years in patients with PMR, and 7.9 (4.6) in controls. PMR was not associated with an increase in the risk of death (adjusted MRR 1.00 [95% CI 0.97, 1.03]) compared to matched controls. Causes of death were broadly similar between patients with PMR and controls, although patients with PMR were slightly more likely to have a vascular cause of death recorded (24% vs 23%).

A diagnosis with PMR does not appear to increase the risk of premature death. Minor variations in cause of death were observed, but overall this study is reassuring for patients with PMR and clinicians.
A diagnosis with PMR does not appear to increase the risk of premature death. Minor variations in cause of death were observed, but overall this study is reassuring for patients with PMR and clinicians.
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