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Old-age-associated pathologies usually coincide with altered sphingolipid metabolism. Changes in the level of sphingomyelin (SM) and ceramide are largely determined by the activation of neutral sphingomyelinase (nSMase) during aging. nSMase is a key enzyme in sphingolipid turnover; it generates ceramide through the hydrolysis of SM. While N—acetylcysteine (NAC) is a powerful antioxidant which has anti-inflammatory properties and it is the precursor of glutathione (GSH). The aim of this study is to determine the impact of NAC on nSMase activity in the age-dependent changes of sphingolipid (SM and ceramide) levels and GSH content in blood serum, gastrocnemius muscle and kidney tissue of 24-month-old rats. It was found that the effect of NAC on the tissue of 24-month-old rats increased SM content; GSH content and decreased the ceramide content. The gastrocnemius muscle and kidney were the most sensitive to the effects of NAC. The results show that GSH inhibit the activity of nSMase. These results emphasize that nSMase. plays a key role in age-associated ceramide accumulation in rat tissues during aging. Furthermore, it was indicated that NAC is an effective modulator of nSMase and has pleiotropic effects that may alter sphingolipid metabolism. The nSMase inhibition enhances the benefits of NAC treatment.

Evidence-based physiotherapy practice (EBPTP) is becoming increasingly important to improve patient outcomes and clinical decision-making in the physiotherapy profession.To evaluate the EBPTP in Jordan and identify the barriers to its implementation in clinical practice.The study used a cross-sectional survey of licensed physiotherapists working in Jordan using EBPTP self-reported questionnaire. Frequencies, percentages, and one sample Wilcoxon rank test were used to evaluate the EBPTP level. The EBPTP implementation was evaluated by demographic variations of participants, Spearman's correlation, and stepwise multiple linear regression analyses at 95% confidence interval.A total of 210 participants completed the survey. All EBPTP questionnaire elements showed significant positive levels (p = .00) except facility support reflecting non-significant negative level (p = .08). The EBPTP implementation was at a significantly lower level of uptake (p = .00). Clinical decision-making was based mainly on personal experience. The EBPTP implementation was significantly correlated with elements of the EBPTP questionnaire and differed by personal/organizational characteristics. There were four significant predictors of EBPTP implementation: understanding of EBPTP terminologies, facility support, formal training in EBPTP, and being a clinical instructor.The findings confirm a clear gap in EBPTP implementation among physiotherapists in Jordan. The EBPTP implementation factors were mainly based on education sectors and work facilities. Engagement of stakeholders and education sectors in EBPTP implementation is required to strengthen the standing of the physiotherapy profession in Jordan.

Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains unclear. This systematic review was conducted to study the impacts of various rehabilitation interventions on the limb apraxia post-stroke. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched for the experimental studies that investigated the effects of the rehabilitation interventions on apraxia in patients with stroke. The methodological quality was rated using the Physiotherapy Evidence Database scale (PEDro). Six studies met our inclusion criteria in this systematic review. Four were randomized controlled trials, pilot (

BACKGROUND: A coma is a prolonged unconscious state in which there is no response to various stimuli. In response, sensory stimulation was designed to stimulate brain plasticity and to promote brain regeneration. The effects of sensory stimulation intervention on comatose patients following traumatic brain injury (TBI) remain unclear. OBJECTIVES: This study aimed to examine the effects of sensory stimulation on the level of consciousness (LOC) after TBI and to identify the effective treatment dosage. METHODS: We searched PubMed, REHABDATA, EMBASE, CINAHL, MEDLINE, PEDro, SCOPUS, and Web of Science from inception to February 2020. Experimental studies investigating the influence of sensory stimulation on the LOC in the comatose patients (Glasgow coma scale

Objective: Parkinson’s disease (PD) is associated with non-motor complications such as sleep disturbance and depression. Transcranial direct current stimulation (tDCS) showed therapeutic effects on the motor dysfunctions. However, the potential effects of tDCS therapy on melatonin hormone, sleep dysfunctions, and depression in patients with PD still unclear. This feasibility study aimed to identify any potential changes in melatonin serum level, sleep functions and depression after the bilateral anodal tDCS in patients with PD. Material and Methods: Tensessions of bilateral anodal tDCS stimulation applied over left and right prefrontal and motor areas were given to twenty-five patients with PD. Melatonin serum level, Pittsburgh sleep quality index, and geriatric depression scale examined before and after tDCS stimulation. Results: After bilateral anodal tDCS, there was a significant reduction in melatonin serum level, improvement in depression, improvements in overall sleep quality, and sleep latency. Correlations test showed significant associations between melatonin serum level reduction and changes in subjective sleep quality, and sleep duration, as well as between improvements in depression and overall sleep quality, sleep latency, and sleep disturbance.Conclusion: Bilateral anodal tDCS therapy was a feasible and safe tool that showed potential therapeutic effects on melatonin serum level, sleep quality, and depression level in patients with PD. Although the further large scale and randomized-control trial studies are crucially needed, there is still a need for such a feasibility study to be established before such trials can be implemented as is recommended in the new medical research council guidelines.