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Conclusion:
DISORDER
Delivering MS-BPD in conjunction with an online psychoeducational intervention was not found to provide additional benefit over and above access to an online intervention alone. In accordance with national guidelines, carer interventions should be routinely offered by youth mental health services as part of early inter...
PMC10619189
Background
overload and distress, guilt, MS-BPD, Borderline personality disorder, personality disorders, adversity, pain, mental disorder, BPD
Borderline personality disorder (BPD) is a severe mental disorder that usually has its onset during adolescence and early adulthood (The families and friends (henceforth ‘carers’) of people with BPD features also report adversity in terms of elevated burden (or negative appraisal of the experiences of caregiving), dist...
PMC10619189
Methods
PMC10619189
Study design
BPD
The study was a single-centre, parallel group, single-blinded, clustered, partially-nested RCT. Randomisation was by ‘unit’, that is, by the individual carer or group of carers per young person with BPD features. It was approved by the Melbourne Health Human Research Ethics Committee (HREC2014.105) and prospectively re...
PMC10619189
Study setting
The study was conducted at Orygen’s Helping Young People Early (HYPE) programme (
PMC10619189
Key inclusion and exclusion criteria
BPD
The young people with BPD features (‘clients’) were aged 15–25 years (inclusive) and the carers were their relatives, partners or friends. A carer’s participation was not dependent on their young person also consenting to participate.
PMC10619189
Discontinuation and withdrawal
EVENT
Carers were discontinued or withdrawn if their participation interfered with appropriate clinical management of the client’s risk to self or others, consent was revoked, or an event (e.g. disruptive behaviour in the group setting) led to discontinuation from the intervention at the discretion of the investigators.
PMC10619189
Treatment conditions
BPD, early-stage BPD, mental illness
SESSION
The two treatment arms were Online and MS-BPD + Online and the treatment period was 15 days. Rather than utilise TAU or a waiting list as comparators, which may not be operationalised consistently or have the same effect within and between trials, this trial aimed for a more rigorous design by comparing two manualised,...
PMC10619189
Measures
The primary outcome was the combined negative appraisal subscales (sometimes referred to as ‘negative experience of caregiving’ or ‘burden’) of the Experience of Caregiving Inventory (ECI) (
PMC10619189
Procedure
BPD
Consecutive referrals to HYPE were considered for an invitation to participate in the RCT. Written informed consent was obtained from all participants (and from a parent/legal guardian for individuals under 18 years of age). Upon completion of baseline questionnaires, carers were randomly and consecutively assigned as ...
PMC10619189
Statistical analysis
BLIND
An intent-to-treat (ITT) analysis with all carers who provided follow-up data was conducted by a statistician who was blind to group allocation, followed by a per-protocol (PP) analysis with carers who completed treatment. A hierarchical linear modelling approach was used in order to account for the nested structure of...
PMC10619189
Results
PMC10619189
Participant flow
DISORDER
Two hundred and eighty-one carers were considered for inclusion in the study and 103 were excluded. The most common reasons for exclusion were that consent was not completed before the client was discharged from HYPE (The 73 carers were family or friends of 53 clients. Data were not collected on seven clients because c...
PMC10619189
Treatment engagement
SD
Of the carers in the ITT analysis randomised to MS-BPD + Online, 20 (57.1%) completed treatment, while 12 (34.3%) did not attend any MS-BPD sessions. The carers spent a mean of 48.9 minutes (SD = 146.9) logged into the online intervention, visiting a mean of 0.7 (SD = 1.7) times. Carers were not logged out after period...
PMC10619189
ITT analysis
SE, BPD, Life–8, borderline personality disorder
DISORDER, SECONDARY
Absolute repeated-measures effect sizes for pre-post differences by group ranged from very small (Cohen’s Pre-post differences on outcome variables by group.MS-BPD: Making Sense of BPD; BPD: borderline personality disorder; ECI: Experience of Caregiving Inventory; CISS: Coping Inventory for Stressful Situations; PDKASQ...
PMC10619189
PP analysis
SECONDARY
No significant differences between the MS-BPD + Online and Online groups were detected for the primary and secondary outcome measures, when only treatment completers were analysed (all
PMC10619189
References
PMC10619189
1. Introduction
toxicity, dyslipidemia
HYPERTENSION, DYSLIPIDEMIA
This study evaluated the efficacy and safety of 20 mg of Cuban policosanol in blood pressure (BP) and lipid/lipoprotein parameters of healthy Japanese subjects via a placebo-controlled, randomized, and double-blinded human trial. After 12 weeks of consumption, the policosanol group showed significantly lower BP, glycat...
PMC10048825
2. Results
PMC10048825
2.1. Anthropometric and Blood Profiles
As shown in
PMC10048825
2.2. Liver, Kidney, and Inflammatory Parameters
At week 12, the policosanol group showed 8.7% lower (At week 12, the placebo group had even higher γ-GTP and BUN levels than at week 0, even though no significance was detected. The placebo group showed a 16% higher BUN level than the policosanol group at week 12 (As listed in
PMC10048825
2.3. Lipid and Lipoprotein Profiles
TG
After excluding the participants showing low compliance, who consumed a significantly more fat diet, heavy drinking, and smoking, during the 12-week consumption, the policosanol group (n = 15) showed 6.3% higher HDL-C (On the other hand, the TC and TG levels in the policosanol group were relatively unaffected at weeks ...
PMC10048825
2.4. VLDL Particle Observation and Composition Analysis
As shown in As shown in As shown in As shown in
PMC10048825
2.5. LDL Particle Observation and Composition Analysis
TEM
TEM showed a 5% increase in LDL particle size (531 ± 8 nmAs shown in
PMC10048825
2.6. Electromobility of LDL and Oxidation Extent
A comparison of the LDL electromobility under the nondenatured state (
PMC10048825
2.7. Change in apoA-I Contents in HDL
SDS-PAGE analysis of HDL
PMC10048825
2.8. Paraoxonase Activities in HDL
As shown in
PMC10048825
2.9. Ferric Ion Reduction Ability of HDL
At the same protein concentration (2 mg/mL), there was no difference in the ferric ion reduction ability (FRA) for HDL
PMC10048825
2.10. Embryo Survivability
As shown in As shown in
PMC10048825
3. Discussion
neurotoxicity, CML
CML
Cuban policosanol supplementation in Korean participants increased the serum HDL-C level and enhanced the HDL functionality to inhibit the oxidation and glycation of LDL and HDL [Many studies were carried out with different policosanol doses in different countries and ethnic populations, such as Caucasian [On the other...
PMC10048825
4. Materials and Methods
PMC10048825
4.1. Policosanol
Raydel
PMC10048825
4.2. Participants
allergies, diabetes
METABOLIC DISORDER, MAY, DYSLIPIDEMIA, ALLERGIES, HYPERTENSION, DIABETES
Healthy male and female volunteers with normal lipid levels and normal blood pressure were recruited nationwide in Japan via newspaper and internet advertisements between September 2021 and May 2022. The inclusion criteria were LDL-C levels in the normal range (120–160 mg/dL) and age between 20 and 65 years old. The ex...
PMC10048825
4.3. Study Design
120 mg/dL ≤ LDL
This study was a double-blinded, randomized, and placebo-controlled trial with a 12-week treatment period. After an initial screening, 72 subjects (Male 36, Female 36) with 120 mg/dL ≤ LDL <160 mg/dL were selected as shown in After allocating the participants into two groups, they were directed to take two tablets per ...
PMC10048825
4.4. Anthropometric Analysis
KDS
The blood pressure was measured using an Omron HEM-907 (Kyoto, Japan) with a total of three times of measurements, and the average was recorded. The height, body weight, and body mass index (BMI) were measured individually using a DST-210N (Muratec KDS Co., Ltd., Kyoto, Japan).
PMC10048825
4.5. Blood Analysis
After fasting overnight, blood samples were collected in ethylenediaminetetraacetic acid (EDTA)-coated tubes and centrifuged at 3000×
PMC10048825
4.6. Isolation of Lipoproteins and Quantification
TG
Very low-density lipoproteins (VLDL, d < 1.019 g/mL), LDL (1.019 < d < 1.063), HDLFor each lipoprotein purified individually, the total cholesterol (TC) and TG levels were measured using commercially available kits (cholesterol, T-CHO, and TG, Cleantech TS-S; Wako Pure Chemical, Osaka, Japan). The protein concentration...
PMC10048825
4.7. Quantification of Oxidation Extent in VLDL and LDL
The degree of oxidation of the individual VLDL (0.5 mg/mL of protein) and LDL (1.0 mg/mL of protein) was assessed by measuring the concentration of oxidized species in the lipoproteins using the thiobarbituric acid reactive substances (TBARS) method with malondialdehyde (MDA) as a standard [
PMC10048825
4.8. Oxidation of VLDL and LDL
Oxidized VLDL (oxVLDL) and LDL (oxLDL) were produced by incubating the native VLDL (0.5 mg/mL of protein) or LDL fraction (1.0 mg/mL of protein), which was purified from young and healthy males, with CuSO
PMC10048825
4.9. Agarose Electrophoresis
The relative electromobility of the VLDL and LDL (5 μg of protein) was compared under a non-natured state on 0.5% agarose gel (120 mm length × 60 mm width × 5 mm thickness). The electrophoresis was carried out with 50 V for 1 h in Tris-acetate-EDTA buffer (pH 8.0), as described previously [
PMC10048825
4.10. Electron Microscopy
TRANSMISSION, TEM
Transmission electron microscopy (TEM, Hitachi H-7800; Ibaraki, Japan) at the Raydel Research Institute (Daegu, Korea) was performed at an acceleration voltage of 80 kV. VLDL and LDL were stained negatively with 1% sodium phosphotungstate (PTA; pH 7.4) with a final apolipoprotein concentration of 0.3 mg/mL in TBS. Five...
PMC10048825
4.11. Paraoxonase Assay
The paraoxonase-1 (PON-1) activity in HDL
PMC10048825
4.12. Ferric Ion Reduction Ability Assay
The ferric ion reduction ability (FRA) was determined using the method reported by Benzie and Strain [
PMC10048825
4.13. Electrophoretic Patterns of HDL
The relative compositions of the apolipoproteins and band intensity of apoA-I in HDL
PMC10048825
Author Contributions
Conceptualization, K.-H.C.; methodology, S.-H.B., D.-J.K., H.-S.N. and H.N.; writing—original draft preparation, K.-H.C.; supervision, K.-H.C.; data curation and investigation, T.K. and Y.U. All authors have read and agreed to the published version of the manuscript.
PMC10048825
Institutional Review Board Statement
The protocol of human blood donation was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Koseikai Fukuda Internal Medicine Clinic (Osaka, Japan), with the IRB approval number 15000074, approval date on 18 September 2021. The animal study protocol was approved by the Committe...
PMC10048825
Informed Consent Statement
Not applicable.
PMC10048825
Data Availability Statement
The data used to support the findings of this study are available from the corresponding author upon reasonable request.
PMC10048825
Conflicts of Interest
The authors declare no conflict of interest.
PMC10048825
References
high-density lipoproteins-cholesterol, low-density lipoproteins, dyslipidemia
CML, TEM, DYSLIPIDEMIA
TEM image of VLDL (Comparison of the electromobility (TEM image of LDL (Comparison of the electromobility (Changes in the apoA-I contents in HDL, HDL-C, and %HDL-C in TC during 12 weeks of consumption of policosanol and placebo. HDL-C, high-density lipoproteins-cholesterol; TC, total cholesterol. (Comparison of the par...
PMC10048825
Background
Asymmetric walking gait impairs activities of daily living in neurological patient populations, increases their fall risk, and leads to comorbidities. Accessible, long-term rehabilitation methods are needed to help neurological patients restore symmetrical walking patterns. This study aimed to determine if a passive un...
PMC10339586
Methods
We divided 15 healthy young adults evenly between three experimental groups that each completed a baseline trial, an adaptation period with different interventions for each group, and a post-adaptation trial. To isolate the contribution of the exosuit we compared a group adapting to the exosuit and split-belt treadmill...
PMC10339586
Results
We found significant interaction and time effects on step length, stance time and swing time symmetry. Sb-only produced increased step length asymmetry at early adaptation compared to baseline (p < 0.0001) and an after-effect with increased asymmetry at early post-adaptation compared to baseline (p < 0.0001). Exo-only ...
PMC10339586
Conclusion
The passive exosuit successfully diminished asymmetrical step length after-effects induced by the split-belt treadmill in Exo-Sb. These results support the passive exosuit’s ability to alter walking gait patterns.
PMC10339586
Supplementary Information
The online version contains supplementary material available at 10.1186/s12984-023-01212-w.
PMC10339586
Keywords
PMC10339586
Background
stroke
STROKE
Over 8 million people in the United States live with lingering symptoms following stroke [The utilization of novel perturbations to alter walking gait symmetry has produced short-term ambulation improvements. By utilizing these perturbations, the CNS can be trained to adapt to complex, unexplored environments through t...
PMC10339586
Methods
PMC10339586
Participants
Fifteen healthy young adults (6 females, 9 males; 13 right-footed, 2 left-footed; age = 24.13 ± 2.47 years; mass = 72.2 ± 11.9 kg; height = 172.5 ± 9.8 cm; mean ± sd.) (Additional File
PMC10339586
Experimental protocol
Data collection took place in the virtual reality lab in the Biomechanics Research building at the University of Nebraska. We allocated participants evenly into three parallel groups with five participants each: Exosuit-only (Exo-only), Split-belt only (Sb-only), and Simultaneous (Exo-Sb). All participants in each grou...
PMC10339586
Exosuit design
We assembled the passive unilateral exosuit based on previous designs [ Passive Hip Exosuit Design. (
PMC10339586
Data analysis and processing
SECONDARY
We completed initial kinematic and kinetic data processing in Visual 3D (C-Motion Inc., Germantown, MD). Data was filtered in Visual 3D using a fourth-order low-pass Butterworth filter with a 6 Hz cutoff frequency. We exported ground reaction forces (GRF) and heel marker locations to MATLAB. Using a custom script, we u...
PMC10339586
Statistical analysis
For our statistical analysis, we compared the average step length, stance, and swing time SI values at five different time points: baseline (BL), early adaptation (EA), late adaptation (LA), early post-adaptation (EP), and late post-adaptation (LP). BL, LA, and LP correspond to the average SI values during the last ten...
PMC10339586
Results
PMC10339586
Demographics and outlier verification
We found no differences in height (F = 0.026, p = 0.974) and weight (F = 0.290, p = 0.753) among the three experimental groups. One participant from Exo-Sb had a step length symmetry index at EP over two standard deviations from the group mean. We considered this participant an outlier and removed him from the step-len...
PMC10339586
Temporal gait asymmetry is unaffected by the unilateral hip exosuit
For stance time SI, we found a significant interaction between group and time with a large effect size (F = 9.47, p-corrected = 0.00014, ηSimilar findings were seen for the swing time SI (Fig.  The Passive Exosuit Does Not Alter Induced Temporal Asymmetry. Panel A displays Exo-only (red), Exo-Sb (green), and Sb-only (b...
PMC10339586
Between group step length asymmetry differences persist at early adaptation and early post-adaptation
We found an interaction between group and time with a large effect size for step length SI (F = 29.55, p-corrected < 0.0001, η Between-Group Step Length SI Differences Persist. Step length SI values for Exo-only (red), Exo-Sb (green), and Sb-only (blue) at baseline (BL), early adaptation (EA), late adaptation (LA), ear...
PMC10339586
A unilateral hip exosuit diminished within-group step length asymmetry post-effects
We ran one-way repeated measure ANOVAs on each group to assess the effect of individual perturbations on step length asymmetry (Table  Step Length SI Group Means and SD Across Time PointsPPPP-values from mixed-model ANOVA; BL: Baseline, EA: Early-adaptation, LA: Late-adaptation, EP: Early Post-adaptation, LP: Late Post...
PMC10339586
Discussion
stroke
STROKE, RECRUITMENT
This study investigated how a passive unilateral hip exosuit modified the temporal and spatial gait characteristics of healthy individuals with induced walking asymmetry (i.e., split-belt treadmill walking). We hypothesized that wearing the passive unilateral hip exosuit while walking on a split-belt treadmill would di...
PMC10339586
Conclusions
Our study found that wearing a unilateral passive hip exosuit while walking on a split-belt treadmill led to diminished step length asymmetry once the belts return to a tied configuration. The simple design suggests that practical, inexpensive devices can alter walking patterns in healthy individuals. The results from ...
PMC10339586
Acknowledgements
The authors would like to thank Alex Dzewaltowski for his help on the MATLAB code.
PMC10339586
Authors’ contributions
MM
KK: conception, design, acquisition, analysis, interpretation, drafting, revision; MM: design, analysis, revision; PM: conception, design, analysis, interpretation, revision.
PMC10339586
Funding
This research was supported by funding from the Graduate Research and Creative Activity Grant (GRACA) from the University of Nebraska at Omaha, NIH P20GM109090, an AHA AIREA award (#959486) and a NU Collaboration Initiative grant. P.M. also received partial support from the NSF (2203143). The content is solely the resp...
PMC10339586
Data Availability
All data generated or analyzed during this study are included in this published article [and its supplementary information files].
PMC10339586
Declarations
PMC10339586
Ethics approval and consent to participate
The Institutional Review Board at the University of Nebraska Medical Center approved this study. Participants read and signed informed consent forms before filling out the health-history questionnaire.
PMC10339586
Consent for publication
A consent form for a cover photo was signed by the individual in the photo.
PMC10339586
Competing interests
An application for a provisional patent describing “Asymmetric Hip Brace” has been submitted by KK and PM (serial number 63/325,922; docket number 22025P, filed on March 31, 2022).
PMC10339586
Authors’ information
KK currently holds a doctoral research assistantship position in the Mary Frances Early College of Education’s Department of Kinesiology’s Concussion Research Laboratory at the University of Georgia.
PMC10339586
Abbreviations
Central nervous SystemConstraint-Induced Movement TherapyGround Reaction ForceExosuit Only GroupSplit-belt Only GroupSimultaneous GroupAnalysis of VarianceBaselineEarly AdaptationLate AdaptationEarly Post-adaptationLate Post-adaptationSymmetry Index
PMC10339586
References
PMC10339586
Purpose
obesity, satiety
OBESITY
Early satiety has been identified as one of the mechanisms that may explain the beneficial effects of nuts for reducing obesity. This study compared postprandial changes in appetite-regulating hormones and self-reported appetite ratings after consuming almonds (AL, 15% of energy requirement) or an isocaloric carbohydra...
PMC9614749
Methods
overweight
OBESE
This is a sub-analysis of baseline assessments of a larger parallel-arm randomised controlled trial in overweight and obese (Body Mass Index 27.5–34.9 kg/m
PMC9614749
Results
Postprandial C-peptide area under the curve (AUC) response was 47% smaller with AL compared to SB (
PMC9614749
Conclusion
More favourable appetite-regulating hormone responses to AL did not translate into better self-reported appetite or reduced short-term energy consumption. Future studies should investigate implications for longer term appetite regulation.
PMC9614749
ANZCTR Reference Number
ACTRN12618001861246
ACTRN12618001861246 2018.
PMC9614749
Supplementary Information
The online version contains supplementary material available at 10.1007/s00394-022-03027-2.
PMC9614749
Keywords
Open Access funding enabled and organized by CAUL and its Member Institutions
PMC9614749
Introduction
obesity
OBESITY
The high prevalence of overweight and obesity is a major public health concern [Epidemiological studies have provided evidence that regular consumption of nuts may reduce the risk of obesity [It has been suggested that humans compensate for the energy from nuts by reducing intake of other foods at subsequent eating occ...
PMC9614749
Materials and methods
PMC9614749
Ethics approvals and trial registration
Ethics approval was obtained from the University of South Australia Human Research Ethics Committee (201,436) and the trial was registered with the Australian and New Zealand Clinical Trials Registry (ATCRN12618001861246).
PMC9614749
Study setting, design and participants
weight loss
Data reported here were obtained from a parallel-arm randomised controlled trial that was conducted between January 15, 2019 and March 10, 2021 in the research facilities of the Alliance for Research in Exercise, Nutrition and Activity Centre (ARENA) at the University of South Australia, Adelaide. Written informed cons...
PMC9614749
Eligibility, randomisation and allocation
Participants were males and females, aged 25–65 years, weight stable, non-smokers, with a BMI of 27.5–34.9 kg/m
PMC9614749
Appetite assessments
appetite sensations
Participants attended the clinic following an overnight fast (> 10 h). Baseline blood samples were taken using an antecubital vein catheter, after which participants consumed their randomly allocated snack (almonds or a carbohydrate-based snack) with 200 mls of water within a 10-min period. Repeat blood sampling (via c...
PMC9614749
Meal challenge buffet
In a sub-set of participants, a buffet meal was provided 2 h after test food consumption. The number of participants who consumed the buffet was limited due to the impact of COVID-19 lockdowns. Participants were given 30 min to eat as much or as little as they liked. The buffet was nut-free and provided a selection of ...
PMC9614749
Statistics
All statistical analyses were performed using the SPSS for Windows V.24.0. (SPSS, Inc., Chicago, IL, USA). Sample size calculations were based on the primary outcome (change in weight) from the larger study and are detailed in the protocol paper [
PMC9614749
Results
PMC9614749
Participant flow and baseline characteristics
A total of 140 participants completed the assessments (Male = 42, Female = 98, Age 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/mConsort flow diagramParticipant baseline characteristicsAll
PMC9614749
Appetite-regulating hormones
SE
C-peptide AUC response was significantly smaller in AL compared to SB (46.9%, Mean AUC for appetite hormonesCholecystokinin C-peptide, Glucagon, Glucose-dependent Insulinotropic Polypeptide (GIP) and Pancreatic Polypeptide (PP) Concentrations. Mean ± SE timepoint comparison * The AL GIP AUC response was significantly l...
PMC9614749
Subjective appetite ratings
SE, fullness, appetite sensations
There was no evidence of a difference in self-reported appetite sensations (feelings of hunger, fullness, satisfaction and prospective food consumption [prospective eating]), obtained via VAS, to the different test snacks. In both groups, hunger and prospective eating decreased post snack and steadily increased over th...
PMC9614749