Incompetent

Autonomic dysfunction is a prevalent feature of Parkinson's disease (PD), mediated by disease involvement of the autonomic nervous system. Chronotropic incompetence (CI) refers to inadequate increase of heart rate in response to elevated metabolic demand, partly dependent on postganglionic sympathetic tone. In a retrospective study, PD patients with/without CI were identified. We show that PD with CI was associated with a higher levodopa equivalent daily dose and Hoehn and Yahr stage, 5±2 years after motor onset...

BACKGROUND: The AO Foundation/Orthopaedic Trauma Association (AO/OTA) introduced a new trochanteric fracture classification in January 2018, concerning the lateral wall integrity. It suggested the intramedullary nail fixation in patients with an incompetent lateral wall fracture. OBJECTIVE: To determine the reliability of lateral wall-thickness measurement and the fracture parameters associated with lateral wall integrity. METHODS: This retrospective study evaluated patients with an intertrochanteric fracture who had had surgery in King Chulalongkorn Memorial Hospital between January 2014 and January 2019...

BACKGROUND: Teamwork in emergency medical services is a very important factor in efforts to improve patient safety. The potential differences of staff gender on communication, patient safety, and teamwork were omitted. The aim of this study is to evaluate these inadequately examined areas. METHODS: A descriptive and anonymous study was conducted with an online questionnaire targeting emergency physicians and paramedics. The participants were asked about teamwork, communication, patient safety and handling of errors...

BACKGROUND: Visual impairment (VI) with comorbid mental disorders (MDs) are expected to have a major impact on people's daily functioning, for which tailored support is needed. However, this has been barely investigated. Therefore, this study aimed to (1) determine the impact of VI and comorbid MDs on functioning in essential life domains, (2) gain insight into best-practices that are currently used to support this target group, and (3) determine strategies to optimize care in the future...

Parkinson's disease (PD) is closely linked to α-synuclein (α-syn) misfolding and accumulation in Lewy bodies. The PDZ serine protease HTRA1 degrades fibrillar tau, which is associated with Alzheimer's disease, and inactivating mutations to mitochondrial HTRA2 are implicated in PD. Here, we report that HTRA1 inhibits aggregation of α-syn as well as FUS and TDP-43, which are implicated in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. The protease domain of HTRA1 is necessary and sufficient for inhibiting aggregation, yet this activity is proteolytically-independent...

Patients with pseudobulbar palsy often present with velopharyngeal incompetence. Velopharyngeal incompetence is usually observed during expiratory activities such as speech and/or blowing during laryngoscopy. These patients typically exhibit good velopharyngeal closure during swallowing, which is dissociated from expiratory activities. We named this phenomenon "speech-swallow dissociation" (SSD). SSD on endoscopic findings can help in diagnosing the underlying disease causing dysphagia. This endoscopic finding is qualitative, and the quantitative characteristics of SSD are still unclear...

This cross-sectional study investigated the effect of caregivers' care ( n  = 100) burden and psychological resilience on the psychosocial adjustment of patients ( n  = 100) with open heart surgery. Patients had poor psychosocial adjustment. Caregivers who felt incompetent in providing care had a higher care burden and a lower psychological resilience than those who did not. In addition, patients whose caregivers had higher resilience and lower burden of care had better psychosocial adjustment...

INTRODUCTION: Varicose veins (VV) are one of the most common pathologies associated with the venous system of the lower limb. In the Indian population, its incidence is higher, and it is one of the most commonly encountered cases in the hospital. The study aimed to note the widely affected anatomical structure in male and female varicose patients using Doppler ultrasound (DU) examination findings. METHODS: A total of 200 Doppler ultrasound reports of varicose patients were retrospectively analyzed and categorized based on the affected structure...

Bcl-2-associated X protein (BAX) and Blc-2 homologous antagonist killer 1 (BAK) are two pro-apoptotic members of BCL2 family. Here, two BAX/BAK double knock-out human induced pluripotent stem cell lines (iPSC) we generated using CRISPR-Cas9 to generate apoptosis incompetent cell lines. The resulting cell lines were karyotypically normal, had typical morphology and expressed typical markers for the undifferentiated state.

Memes on social media can carry ageist messages and can elicit reactions that are both emotional and self-evaluative. The present study investigates age-related differences in nine discrete emotions and in the evaluation of when individuals have been or will be their best selves. Participants (n = 360) representing young (m = 26 years), middle-aged (m = 39 years) and older adults (m = 63 years) were randomly assigned to view either non-ageist (animals) or ageist (e...

BACKGROUND: Breastfeeding initiation and continuation rates are shaped by complex and interrelated determinants across individual, interpersonal, community, organisational, and policy spheres. Young mothers, however, face a double burden of stigma, being perceived as immature and incompetent in their mothering and breastfeeding abilities. In this study, we aimed to understand the experiences of young mothers who exclusively breastfed for six months and beyond and explore their experiences of stigma and active resistance through social media...

BACKGROUND: Regional anaesthesia plays an important role in perioperative care, but gaps in proficiency persist among consultants and specialists. This study aimed to assess confidence levels in performing Plan A blocks among this cohort and to examine the barriers and facilitators influencing regional anaesthesia education. METHODS: Utilising a mixed-methods design, we performed a quantitative survey to gauge self-reported confidence in performing Plan A blocks, coupled with qualitative interviews to explore the complexities of educational barriers and facilitators...

IMPORTANCE: Cardiopulmonary exercise testing (CPET) has an established role in the assessment of patients with heart failure. However, data are lacking in patients with transthyretin (ATTR) amyloidosis. OBJECTIVE: To use CPET to characterize the spectrum of functional phenotypes in patients with ATTR amyloidosis and assess their association with the cardiac amyloid burden as well as the association between CPET parameters and prognosis. DESIGN, SETTING AND PARTICIPANTS: This single-center study evaluated patients diagnosed with ATTR amyloidosis from May 2019 to September 2022 who underwent CPET at the National Amyloidosis Centre...

BACKGROUND: Tele-consultations are increasingly used for screening and diagnosis. Only a few studies have assessed dental students' visual attention to clinical images. AIM: To (i) determine dental students' gaze behavior, visual fixations, and diagnostic competence while viewing clinical images, and (ii) explore potential opportunities to strengthen the teaching-learning approaches. DESIGN: Tobii Pro Nano-device captured the eye-tracking data for 65 dental undergraduate students in this cross-sectional study...

In his case report, a 74-year-old physically fit man was evaluated repeatedly for several years in the cardiology department due to dyspnoea on exertion (DOE). Several standard cardiac and pulmonary tests were performed but did not provide sufficient cause for the DOE. Lastly, the patient was evaluated with a cardiopulmonary exercise test (CPET) with simultaneous in- and expiratory gas sampling. The test revealed a low aerobic capacity due to chronotropic incompetence (CI), thus explaining the DOE. Subsequently, the patient was treated with a rate-responsive pacemaker...

K-Ras is the most commonly mutated oncogene in human cancer. The recently approved non-small cell lung cancer drugs sotorasib and adagrasib covalently capture an acquired cysteine in K-Ras-G12C mutation and lock it in a signaling-incompetent state. However, covalent inhibition of G12D, the most frequent K-Ras mutation particularly prevalent in pancreatic ductal adenocarcinoma, has remained elusive due to the lack of aspartate-targeting chemistry. Here we present a set of malolactone-based electrophiles that exploit ring strain to crosslink K-Ras-G12D at the mutant aspartate to form stable covalent complexes...

The aim of this study was to evaluate the postoperative course and long-term functional and aesthetic outcomes in patients with Beckwith-Wiedemann syndrome (BWS) following surgical reduction of macroglossia, using multiple questionnaires. Patients with BWS who underwent keyhole reduction for macroglossia were included in this study. The postoperative course for each patient was recorded, and multiple questionnaires were administered to evaluate aesthetic concerns, oral incompetence or feeding difficulties, sleep-disordered breathing symptoms, and speech...

Recurrent pregnancy loss, premature birth, and associated complications exhibit a multifactorial etiology and persist as substantial challenges during pregnancy, despite the notable advancements in the medical field. Among several factors, cervical insufficiency or incompetence emerges as a prominent causal factor, characterized by painless softening and shortening of the cervix associated with absent contractions. The implementation of emergency cerclage represents a pivotal intervention in mitigating preterm birth among individuals with advanced cervical insufficiency...

Introduction: Oral incompetence (OI) following facial nerve injury or sacrifice remains a frustrating problem for patients and clinicians alike. Dynamic procedures for facial paralysis often do not fully address OI and static surgeries are frequently needed. Current static options frequently involved multiple facial incisions. Methods: We describe a novel technique to address OI due to lower division facial nerve paralysis and report outcomes in an initial series of patients. Results: OI symptoms improved in 94% of patients following a single-stage surgery...

OBJECTIVE: We aimed to determine the association between polycystic ovarian syndrome (PCOS) and cervical incompetence (CI). We hypothesise that insulin resistance induces a glucose metabolism disorder that could potentially cause cervical incompetence, resulting in an adverse outcome. DESIGN: We conducted a systematic review and meta-analysis of observational studies to summarise the evidence regarding the strength of the association of occurrence of CI in a PCOS pregnant woman compared to a non-PCOS pregnant woman...