bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Mate Retention Inventory-Short Form Using Item Response Theory
Authors: Nebl Patrick J. , McCoy Mark G. , Foster Garett C. , Zickar Michael J.
Published: October 2021

The mate retention inventory (MRI) has been a valuable tool in the field of evolutionary psychology for the past 30 years. The goal of the current research is to subject the MRI to rigorous psychometric analysis using item response theory to answer three broad questions. Do the individual items of the MRI fit the scale well? Does the overall function of the MRI match what is predicted? Finally, do men and women respond similarly to the MRI? Using a graded response model, it was found that all but two of the items fit acceptable model patterns. Test information function analysis found that the scale acceptably captures individual differences for participants with a high degree of mate retention but the scale is lacking in capturing information from participants with a low degree of mate retention. Finally, discriminate item function analysis reveals that the MRI is better at assessing male than female participants, indicating that the scale may not be the best indicator of female behavior in a relationship. Overall, we conclude that the MRI is a good scale, especially for assessing male behavior, but it could be improved for assessing female behavior and individuals lower on overall mate retention behavior. It is suggested that this paper be used as a framework for how the newest psychometrics techniques can be applied in order to create more robust and valid measures in the field of evolutionary psychology.
Examining Resident Power Building in a Place-Based Initiative
Authors: Sabado Parichart , D’Anna Laura , Fong Gisele , Petit Christine , Wood Jefferson
Published: October 2021

Rates of diseases and disabilities that are otherwise preventable are higher in low-income communities and communities of color. These disparities are attributed, in large part, to a power imbalance between residents and decision makers, and restoring resident power is necessary to improve health outcomes. A key strategy in many health promotion programs, resident power building is a process by which residents gain necessary skills to improve social conditions through their involvement in community change work. This study is part of a larger evaluation of Building Healthy Communities, a ground-breaking 10-year, $1 billion place-based initiative funded by The California Endowment designed to reverse the historical impact of racial and economic discrimination by advancing statewide policy, changing the narrative around health, and transforming underserved communities to achieve health equity. This article presents the resident power framework and identifies five domains that contributed to resident power building: continuity, culture, context, concrete action, and capacity. Continuity and culture mattered most to residents’ ability to organize and to their ability to exercise their voice, respectively. While this study examined resident power building within the context of a large-scale place-based initiative, the domains that the authors identified are salient across health promotion programs that use power building as a key strategy to achieve program outcomes. The domains serve as opportunities to modify power-building strategies and allow program staff to allocate resources to specific activities to achieve program outcomes.
Eptinezumab: A calcitonin gene-related peptide monoclonal antibody infusion for migraine prevention
Authors: Morgan Kelsey Woods , Joyner Kayla Rena
Published: October 2021

This article seeks to analyze the clinical trials concerning the newly approved eptinezumab to assess its efficacy, safety, and application to current clinical practice. The Institute of Health US National Library of Medicine Clinical Trials, PubMed, and Cochrane Library databases were searched for relevant abstracts, journal articles, and other published sources. Search terms included eptinezumab, Vyepti®, and ALD403. Relevant English-language articles were evaluated and included in the narrative. Two randomized controlled trials compared quarterly infusions of eptinezumab 100 mg, eptinezumab 300 mg, and placebo in chronic and episodic migraine sufferers. In episodic migraine, eptinezumab resulted in a reduction of approximately 4 monthly migraine days, which was significant compared to placebo. In chronic migraine, eptinezumab reduced monthly migraine days by approximately 8 days, also significant compared to placebo. More patients who received eptinezumab experienced at least 75% reduction in monthly migraine days compared to placebo, resulting in a number needed to treat as low as 6, depending on the study population and the dose. The preventive impact was noticed day one post-infusion. The most common treatment-emergent adverse events were nausea and fatigue, and there was a low incidence of hypersensitivity or study withdrawal. Eptinezumab is the fourth Calcitonin Gene-related Peptide monoclonal antibody to receive Federal Drug Administration approval. Its delivery as a quarterly infusion sets it apart from the other agents in this class. As an infusion, eptinezumab has a quick onset of action that may prove especially beneficial to those with severe or refractory episodic or chronic migraines, despite the perceived increased direct and indirect cost of an infusion.
Attitudes of the Turkish University Students and Staff Toward Sexual Harassment and Assault: Preliminary Psychometric Evaluation
Authors: Siyez Diğdem Müge , Ercan Gülsüm Songül , Esen Erol , Soylu Yağmur , Baran Bahar , Firuzan Esin , Belkis Özlem , Dündar Sezer Tijen , Efe Güney Mercan , Ergönen Akça Toprak , Günay Türkan , Tezcan Senem , Öztürk Barışcan
Published: October 2021

The aim of this study was to develop a scale to measure the attitudes of the university academic and administrative staff and students toward sexual harassment and assault, and examine its psychometric properties. After the development of the item pool and examination of the content validity of the intended items, Exploratory Factor Analysis (EFA) and parallel analysis was conducted and Cronbach’s alpha reliability coefficient was calculated collecting data from 150 participants (54.7% of female and 45.3% of male) for the initial version (comprised of 12 items) of the Attitudes Toward Sexual Harassment and Assault Scale (ATSHAS). In the second phase, Confirmatory Factor Analysis (CFA) was conducted with 354 participants (54% of female and 46% of male) for the revised version (10 items) of the ATSHAS. Additionally, Cronbach’s alpha reliability coefficient was calculated with second sample. After developing the item pool, the completion of the first phase of the study took 5 months, and the second phase took 4 months. The final version of the ATSHAS consisting of nine items demonstrated sufficient psychometric properties for measuring attitudes toward sexual harassment and assault in the university environment.
Utilization of Silicone Sheet as a Protective Guide During Transoral Robotic Tongue Base Surgery
Authors: Volner Keith , Mostales Joshua C. , Schoppy David , Lim Jae H.
Published: October 2021

This article presents a simple technique where a silicone sheet is used during transoral robotic surgery (TORS) to protect the upper airway structures from thermal damage during a base of tongue procedure. We review 10 cases of TORS tongue base reduction with the use of this technique, with no complications and with reduction of thermal damage to the lingual epiglottis and surrounding pharyngeal wall. Furthermore, it served as a guide during tongue base dissection to provide visual and tactile feedback to the inferior limit of resection, as well as to protect the endotracheal tube. The silicone sheet is an ideal material for use as a thermal barrier due to its widespread availability, intrinsic thermal properties, and translucency. The technique of using the silicone sheet is easy to implement and may prove useful to many transoral robotic surgeons, especially for newly trained TORS users and trainees.
Improving self-reported empathy and communication skills through harm in healthcare response training
Authors: Samuels Aimee , Broome Marion E. , McDonald Timothy B. , Peterson Chii-Hui , Thompson Julie A.
Published: October 2021

Objective

Communication and Resolution Programs (CRP) were developed to equip healthcare organizations with tools to respond when physical and psychological harm occurs. Our objective was to assess development of empathic behaviors and communication skills through CRP training based upon the Agency for Healthcare Research and Quality (AHRQ) CANDOR toolkit to assess the ability to develop and improve empathic behaviors and communication skills.

Methods

The Jefferson Scale of Empathy, the CANDOR Communication Assessment Questionnaire and a self-assessment were used pre- and post-intervention to analyze development of empathy, growth of communication, and improvement in confidence and knowledge through 6 h of virtual education over a six-week course.

Results

Self-reported communication, confidence and knowledge improved with statistical significance and small to moderate effect size in both men and women. A statistically significant improvement of self-reported empathy scores t (22)  =  2.23, p  =  .037; (95% CI  =  0.41 to 11.5) for women only represented a small to moderate effect size (Cohen’s d  =  0.46). While there was no improvement in Cognitive Complexity, (Cohen’s d  =  0.065) mean pre-post .42 (SD  =  6.52); Message Design Logic improved with statistical significance in paired pre-and post-assessment (Z  =  -3.28, p  =  .001). Notably, previous attendance at CANDOR classes demonstrated no impact on improvement of scores.

Conclusions

Our findings demonstrate improvement in self-reported empathy and communication skills through harm in healthcare response training. Healthcare organizations should carefully consider investing in CANDOR training for the benefit of patients, their families, and healthcare workforce members.
Pulmonary Large Cell Neuroendocrine Carcinoma Associated With Lambert-Eaton Syndrome
Authors: Hernandez-Arriaga Pamela , Gonzalez-Urquijo Mauricio , López Altamirano Daniel Fernando , Vaca-Cartagena Bryan , Vergil-Vargas Andres , Rios-Pascual Silviano , Perez-Saucedo Jose Eduardo , Sepúlveda-Malec Ricardo
Published: October 2021

Lambert-Eaton syndrome is a rare paraneoplastic disorder of the neuromuscular junction, characterized by impaired release of acetylcholine, which causes proximal muscle weakness, depressed tendon reflexes, and autonomic changes. Most cases of Lambert-Eaton syndrome present in small-cell lung carcinoma, and only a few cases have been reported in other lung subtypes. Herein, we report a case of 69 years old male patient with Lambert-Eaton syndrome as a rare association with a pulmonary large-cell neuroendocrine carcinoma, which presented 5 months before neoplasm diagnosis. A lobectomy was auspiciously performed. A review of the literature is also presented.
Choice of Material for Nasofrontal Duct Obliteration in Frontal Sinus Fracture
Authors: Rutland John W. , Bellaire Christopher P. , Katz Abigail , Liu Helen , Arrighi-Allisan Annie , Sanati-Mehrizy Paymon , Taub Peter J.
Published: October 2021

Introduction: Within the surgical management algorithm for frontal sinus fracture (FSF), the choice of material for nasofrontal duct (NFD) obliteration is controversial, and a multitude of materials have been described in the literature. The present study aims to perform a systematic review to determine postoperative outcomes associated with various NFD obliteration materials. Methods: Two independent reviewers identified studies to be included based on inclusion and exclusion criteria. Odds ratios and Fisher’s Exact Tests were then used to compare outcomes between cohorts based on the material used for NFD obliteration. Complications under review included donor site complications, reoperations, frontal sinus infections, cerebrospinal fluid leaks, cosmetic defects, persistent pain and/or headaches, and mucocele formation. Results: Twenty-nine studies met inclusion criteria. The use of a vascularized flap was associated with a reduced risk of reoperation and postoperative frontal sinus infection compared with non-flap materials (OR = 0.23 (CI: 0.05, 1.04), P = .05. The use of avascular bone graft was associated with an increased risk of reoperation (OR = 8.89 (CI: 2.24, 29.94), P < .001. Use of bone graft was associated with increased postoperative frontal sinus infection compared with non-bone materials (OR = 3.92 (CI: 1.28, 11.96)), P = .017 and postoperative mucocele formation, P = .0035. The use of bone graft was associated with increased risk of total postoperative complications (OR = 2.68 (CI: 1.41, 5.11), P < .01. Use of autologous materials was associated with decreased number of total complications when compared with non-autologous materials (OR = 0.13 (CI: 0.02, 0.99), P = .02. Conclusions: Avascular grafts, such as bone grafts, for NFD obliteration may be associated with an increased risk of reoperation. In particular, bone grafts are associated with higher rates of reoperation, postoperative infection and mucocele formation. Vascularized flaps appear to offer excellent postoperative outcomes with minimal operative morbidity. This systematic review may be useful in further refining the roles of certain materials in NFD obliteration for FSF surgery.
Calculating the serial interval of SARS-CoV-2 in Lebanon using 2020 contact-tracing data
Authors: Haddad Nadine , Clapham Hannah Eleanor , Abou Naja Hala , Saleh Majd , Farah Zeina , Ghosn Nada , Mrad Pamela , Howard Natasha
Published: October 2021

Introduction

The first detected case in Lebanon on 21 February 2020 engendered implementation of a nationwide lockdown alongside timely contact-tracing and testing.

Objectives

Our study aims to calculate the serial interval of SARS-CoV-2 using contact tracing data collected 21 February to 30 June 2020 in Lebanon to guide testing strategies.

Methods

rRT-PCR positive COVID-19 cases reported to the Ministry of Public Health Epidemiological Surveillance Program (ESU-MOH) are rapidly investigated and identified contacts tested. Positive cases and contacts assigned into chains of transmission during the study time-period were verified to identify those symptomatic, with non-missing date-of-onset and reported source of exposure. Selected cases were classified in infector–infectee pairs. We calculated mean and standard deviation for the serial interval and best distribution fit using AIC criterion.

Results

Of a total 1788 positive cases reported, we included 103 pairs belonging to 24 chains of transmissions. Most cases were Lebanese (98%) and male (63%). All infectees acquired infection locally. Mean serial interval was 5.24 days, with a standard deviation of 3.96 and a range of − 4 to 16 days. Normal distribution was an acceptable fit for our non-truncated data.

Conclusion

Timely investigation and social restriction measures limited recall and reporting biases. Pre-symptomatic transmission up to 4 days prior to symptoms onset was documented among close contacts. Our SI estimates, in line with international literature, provided crucial information that fed into national contact tracing measures. Our study, demonstrating the value of contact-tracing data for evidence-based response planning, can help inform national responses in other countries.
Impact of telemedicine adoption on accessibility and time to treatment in patients with thoracic malignancies during the COVID-19 pandemic
Authors: Nimgaonkar Vivek , Aggarwal Charu , Berman Abigail T. , Gabriel Peter , Shulman Lawrence N. , Kucharczuk John , Roy Megan , Bauml Joshua M. , Singh Aditi P. , Cohen Roger B. , Langer Corey J. , Marmarelis Melina E.
Published: October 2021

Background

To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility.

Methods

This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included.

Results

240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45).

Conclusions

Rapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.
Associations between body composition and fundamental motor skill competency in children
Authors: Webster E. Kipling , Sur Indica , Stevens Alicia , Robinson Leah E.
Published: October 2021

Background

Evidence supports an inverse relationship between weight status and motor competence, but most work utilizes body mass index as the proxy for weight status. Body mass index fails to account for essential components of body composition, which may be critical for motor performance. The purpose of this investigation was to examine the relationship between fundamental motor skills competency and body composition (i.e., fat mass, fat percentage, and fatfree mass) as measured by bio-electrical impedance analysis and body mass index in children.

Methods

Two hundred forty-four children from the Southeastern portion of the United States participated in this project (6.05 ± 2.01 years, 53.3% male). Fundamental motor skills were measured using the Test of Gross Motor Development – 2nd edition and body composition was assessed with the Tanita SC-331S Body Composition Analyzer (bio-electrical impedance analysis). Body mass index was calculated using CDC normative growth charts.

Results

Bio-electrical impedance analysis measures accounted for 23.1%, F(3, 241) = 24.10,p < .001 and 2.7%, F(3, 241) = 2.22,p = .086 variance in locomotor and object control subscales, respectively; body mass index accounted for 8.4% (locomotor) and 0.1% (object control) variance. For the Test of Gross Motor Development -2nd edition total score, bio-electrical impedance analysis measures accounted for 24.4% F(3, 241) = 25.90,p < .001 compared to body mass index which accounted for 7.9% F(1, 244) = 20.86,p < .001 of the variance. Only fat free mass (p < .001) was a significant predictor for locomotor skills and total models for the Test of Gross Motor Development – 2nd edition; BMI was also a significant predictor (p < .001) in both the locomotor and total models.

Conclusions

Different components of body composition (i.e., fat free mass) were associated with different aspects of fundamental motor skills competency. Excess body fat may be a morphological constraint to proficient locomotor performance when transporting the body through space. In contrast, body composition did not significantly predict object manipulation performance. More work is needed to understand the causality and directionality of this relationship; however, bio-electrical impedance analysis accounts for more variance in fundamental motor skills performance than body mass index in a field-based setting.
Conjunctival granulomatous capillary haemangioma in children: case report and review of the literature
Authors: Shi Caiping , Ren Yanhong , Feng Jia , Guo Weizhong , Zheng Xiaoyu
Published: October 2021

Background

Granulomatous capillary haemangioma refers to a benign vascular tumour that commonly affects the skin, with occasional involvement of the mucosa. Reports of conjunctival granulomatous capillary haemangioma in children are uncommon. In this article, we present a case of granulomatous capillary haemangioma and a brief review of the relevant literature.

Case presentation

An 11-year-old girl presented with a conjunctival mass. An excision of the entire lesion was performed. Histopathology showed a granulomatous capillary haemangioma.

Conclusions

The clinical manifestations of granulomatous capillary haemangioma lack specificity; pathological characteristics and immunohistochemistry are the main basis for diagnosis. We retrospectively analysed the diagnosis and treatment of a patient with conjunctival granulomatous capillary haemangioma to deepen the understanding and facilitate the diagnosis and treatment of this disease.
Validation of the Arabic Severe Respiratory Insufficiency Questionnaire
Authors: Alawieh Marwan F. , Bzeih Rania N. , El-Khatib Mohamad F. , Sibai Abla M. , Ghandour Lilian A. , Zeineldine Salah M.
Published: October 2021

Background/objectives

Assessment of Health-Related Quality of Life (HRQL) in patients with chronic respiratory insufficiency requiring Home Mechanical Ventilation (HMV) requires a valid measurement tool. The Severe Respiratory Insufficiency (SRI) questionnaire, originally developed in German, has been translated into different languages and tested in different contexts, but has so far not been in use in Arabic-speaking populations. The objective of this study is to validate the Arabic version of the SRI questionnaire in a sample of Arabic-speaking patients from Lebanon.

Methods

Following forward/backward translations, the finalized Arabic version was administered to 149 patients (53 males–96 females, age 69.80 ± 10 years) receiving HMV. Patients were recruited from outpatient clinics and visited at home. The Arabic SRI and the 36-Item Short-Form Health Survey (SF-36) were administered, in addition to questions on sociodemographics and medical history. Exploratory Factor Analysis (EFA) was used to explore dimensionality; internal consistency reliability of the unidimensional scale and its subscales was assessed using Cronbach’s alpha. External nomological validity was examined by assessing the correlation between the SRI and SF-36 scores.

Results

The 49-item Arabic SRI scale showed a high internal consistency reliability (Cronbach alpha for the total scale was 0.897 and ranged between 0.73 and 0.87 for all subscales). Correlations between the SF-36-Mental Health Component MHC and SF-36-Physical Health Component with SRI-Summary Scale were 0.57 and 0.66, respectively, with higher correlations observed between the SF-36 and specific sub-scales such as the Physical Functioning and the Social Functioning subscales [r = 0.81 and r = 0.74 (P < 0.01), respectively].

Conclusion and recommendations

The Arabic SRI is a reliable and valid tool for assessing HRQL in patients with chronic respiratory insufficiency receiving home mechanical ventilation.
Long-term outcomes of transvaginal mesh surgery for pelvic organ prolapse: a retrospective cohort study
Authors: Wang Xiaojuan , Chen Yisong , Hu Changdong , Hua Keqin
Published: October 2021

Background

The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up.

Methods

We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients’ medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: “What is your overall postoperative satisfaction, on a scale from 0 to 10?”. Relapse-free survival was analyzed using Kaplan–Meier curves.

Results

In total, 134 patients were included. With a median 12-year (range 10–15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh.

Conclusions

Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.
Investigating the potential of proton therapy for hypoxia-targeted dose escalation in non-small cell lung cancer
Authors: Köthe Andreas , Bizzocchi Nicola , Safai Sairos , Lomax Antony John , Weber Damien Charles , Fattori Giovanni
Published: October 2021

Background

Hypoxia is known to be prevalent in solid tumors such as non-small cell lung cancer (NSCLC) and reportedly correlates with poor prognostic clinical outcome. PET imaging can provide in-vivo hypoxia measurements to support targeted radiotherapy treatment planning. We explore the potential of proton therapy in performing patient-specific dose escalation and compare it with photon volumetric modulated arc therapy (VMAT).

Methods

Dose escalation has been calibrated to the patient specific tumor response of ten stage IIb-IIIb NSCLC patients by combining HX4-PET imaging and radiobiological modelling of oxygen enhancement ratio (OER) to target variable tumor hypoxia. In a dose-escalation-by-contour approach, escalated dose levels were simulated to the most hypoxic region of the primary target and its effectiveness in improving loco-regional tumor control was assessed. Furthermore, the impact on normal tissue of proton treatments including dose escalation was evaluated in comparison to the normal tissue complication probability (NTCP) of conventional VMAT plans.

Results

Ignoring regions of tumor hypoxia can cause overestimation of TCP values by up to 10%, which can effectively be recovered on average to within 0.9% of the nominal TCP, using patient-specific dose escalations of up to 22% of the prescribed dose to PET defined hypoxic regions. Despite such dose escalations, the use of protons could also simultaneously reduce mean doses to the heart (− 14.3 GyRBE), lung (− 8.3 GyRBE), esophagus (− 6.9 GyRBE) and spinal cord (− 3.8 Gy) compared to non-escalated VMAT plans. These reductions are predicted to lead to clinically relevant decreases in NTCP for radiation-induced pneumonitis (− 11.3%), high grade heart toxicity (− 7.4%) and esophagitis (− 7.5%).

Conclusions

This study suggests that the administration of proton therapy for dose escalation to patient specific regions of tumor hypoxia in the treatment of NSCLC can mitigate TCP reduction due to hypoxia-induced radio resistance, while simultaneously reducing NTCP levels even when compared to non-escalated treatments delivered with state-of-the-art photon techniques.
Ketogenic diet as elective treatment in patients with drug-unresponsive hyperinsulinemic hypoglycemia caused by glucokinase mutations
Authors: Maiorana Arianna , Caviglia Stefania , Greco Benedetta , Alfieri Paolo , Cumbo Francesca , Campana Carmen , Bernabei Silvia Maria , Cusmai Raffaella , Mosca Antonella , Dionisi-Vici Carlo
Published: October 2021

Background

Hyperinsulinemic hypoglycemia (HI) is the most frequent cause of recurrent hypoglycemia in children. Despite diagnostic and therapeutic advances, it remains an important cause of morbidity, leading to neurological complications, such as psychomotor retardation and epilepsy. Patients with diffuse drug-unresponsive HI manifest neurological impairment and neurobehavioral problems, even though surgically treated with a near-total pancreatectomy. Based on the analogies between HI and GLUT1 deficiency, both presenting with neuroglycopenia and lack of alternative cerebral energy sources, we administered a ketogenic diet (KD) in three drug-unresponsive GCK-HI patients with the aim of preserving neurodevelopment and avoiding the need of a near-total pancreatectomy. They presented recurrent symptomatic hypoglycemia, intellectual disability and refractory epilepsy. Patients were treated with classical KD for 79, 27 and 18 months, respectively.

Results

All patients became asymptomatic in a few days and showed an important improvement of the alert state. Epilepsy disappeared and no appearance of novel hypoglycemic lesions was detected with a brain MRI. Cognitive and adaptive abilities rapidly improved and normalized. IQ rose significantly from 81 to 111 (p = 0.04) in patient 1, from 82 vs 95 (p = 0.04) in patient 2, from 60 to 90 (p = 0.04) in patient 3.

Conclusions

We demonstrated the safety and efficacy of KD in the treatment of drug-unresponsive GCK-HI at a short and long-term. The neuroprotective effects of KD determined the recovery from epilepsy and intellectual disabilities and averted the need of a near-total pancreatectomy. All patients and their families reported an improvement of physical and psychosocial well-being, with a substantial improvement of their quality of life. These results might change the course and the quality of life of these patients and their families, having a relevant impact on human lives. Therefore, KD might be considered the elective treatment in unresponsive forms of GCK-HI.
Neuronal excitatory-to-inhibitory balance is altered in cerebral organoid models of genetic neurological diseases
Authors: Foliaki Simote T. , Schwarz Benjamin , Groveman Bradley R. , Walters Ryan O. , Ferreira Natalia C. , Orrù Christina D. , Smith Anna , Wood Aleksandar , Schmit Olivia M. , Freitag Phoebe , Yuan Jue , Zou Wenquan , Bosio Catharine M. , Carroll James A. , Haigh Cathryn L.
Published: October 2021

The neuro-physiological properties of individuals with genetic pre-disposition to neurological disorders are largely unknown. Here we aimed to explore these properties using cerebral organoids (COs) derived from fibroblasts of individuals with confirmed genetic mutations includingPRNPE200K, trisomy 21 (T21), andLRRK2G2019S, which are associated with Creutzfeldt Jakob disease, Down Syndrome, and Parkinson’s disease. We utilized no known disease/healthy COs (HC) as normal function controls. At 3–4 and 6–10 months post-differentiation, COs with mutations showed no evidence of disease-related pathology. Electrophysiology assessment showed that all COs exhibited mature neuronal firing at 6–10 months old. At this age, we observed significant changes in the electrophysiology of the COs with disease-associated mutations (dCOs) as compared with theHC, including reduced neuronal network communication, slowing neuronal oscillations, and increased coupling of delta and theta phases to the amplitudes of gamma oscillations. Such changes were linked with the detection of hypersynchronous events like spike-and-wave discharges. These dysfunctions were associated with altered production and release of neurotransmitters, compromised activity of excitatory ionotropic receptors including receptors of kainate, AMPA, and NMDA, and changed levels and function of excitatory glutamatergic synapses and inhibitory GABAergic synapses. Neuronal properties that modulate GABAergic inhibition including the activity of Na–K-Cl cotransport 1 (NKCC1) in Cl−homeostasis and the levels of synaptic and extra-synaptic localization of GABA receptors (GABARs) were altered in theT21COs only. The neurosteroid allopregnanolone, a positive modulator of GABARs, was downregulated in all the dCOs. Treatment with this neurosteroid significantly improved the neuronal communication in the dCOs, possibly through improving the GABAergic inhibition. Overall, without the manifestation of any disease-related pathology, the genetic mutationsPRNPE200K,T21, andLRRK2G2019Ssignificantly altered the neuronal network communication in dCOs by disrupting the excitatory-to-inhibitory balance.
Bisperoxovanadium promotes motor neuron survival and neuromuscular innervation in amyotrophic lateral sclerosis
Authors: Wang Junmei , Tierney Lydia , Mann Ranjeet , Lonsway Thomas , Walker Chandler L.
Published: October 2021

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron (MN) disease, with no present cure. The progressive loss of MNs is the hallmark of ALS. We have previously shown the therapeutic effects of the phosphatase and tensin homolog (PTEN) inhibitor, potassium bisperoxo (picolinato) vanadium (bpV[pic]), in models of neurological injury and demonstrated significant neuroprotective effects on MN survival. However, accumulating evidence suggests PTEN is detrimental for MN survival in ALS. Therefore, we hypothesized that treating the mutant superoxide dismutase 1 G93A (mSOD1G93A) mouse model of ALS during motor neuron degeneration and an in vitro model of mSOD1G93A motor neuron injury with bpV(pic) would prevent motor neuron loss. To test our hypothesis, we treated mSOD1G93A mice intraperitoneally daily with 400 μg/kg bpV(pic) from 70 to 90 days of age. Immunolabeled MNs and microglial reactivity were analyzed in lumbar spinal cord tissue, and bpV(pic) treatment significantly ameliorated ventral horn motor neuron loss in mSOD1G93A mice (p = 0.003) while not significantly altering microglial reactivity (p = 0.701). Treatment with bpV(pic) also significantly increased neuromuscular innervation (p = 0.018) but did not affect muscle atrophy. We also cultured motor neuron-like NSC-34 cells transfected with a plasmid to overexpress mutant SOD1G93A and starved them in serum-free medium for 24 h with and without bpV(pic) and downstream inhibitor of Akt signaling, LY294002. In vitro, bpV(pic) improved neuronal viability, and Akt inhibition reversed this protective effect (p < 0.05). In conclusion, our study indicates systemic bpV(pic) treatment could be a valuable neuroprotective therapy for ALS.
Huatan Dingji Decoction intervening in atrial fibrillation: protocol for a randomized double-blind single-simulated placebo-controlled clinical trial
Authors: Xiao Ying , Wang Xinyi , Yang Jin , Liu Keke , Li Mianmian , Ma Zilin , Deng Bing , Shen Lin , Wei Yihong , Zhang Shuai , Zhang Na , Zhao Ping , Zhu Chen , Mao Meijiao , Tang Nuo , Wu Qiong
Published: October 2021

Background

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and can lead to heart failure (HF), stroke, pulmonary embolism (PE), and other complications, seriously affecting people’s quality of life and health. Western medicine is limited in the treatment of AF, while Traditional Chinese Medicine (TCM) has unique advantages, such as less side effects, low toxicity, long effect duration, and high compliance. The prescription of HTDJ is a common prescription for the treatment of atrial fibrillation in Longhua Hospital, Shanghai University of Traditional Chinese Medicine. It has been used for many years and has a large number of clinically effective cases. It has a good clinical application prospect, but there is a lack of effective evaluation of its clinical efficacy.

Method

This study adopts a randomized double-blind, single-simulated, placebo-controlled research method. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. Participants would take the medicine for 1 month, and the curative effect would be evaluated. Subsequently, the participants would not take TCM and only receive western medicine treatment. They would be followed up for another 8 weeks, and a clinical evaluation would be conducted. The secondary outcomes include echocardiography, Hamilton Anxiety Scale, Hamilton Depression Scale, rate of increase and decrease of anti-arrhythmia western medicine, the MOS 36-item short-form health survey, N-terminal-pro hormone B-type natriuretic peptide level, and integral TCM syndrome score. Adverse events will be monitored throughout the trial. Cases are from outpatient and inpatient with atrial fibrillation in the Cardiology Department of Longhua Hospital. Evaluations will be conducted at baseline and at weeks 4 and 12 after randomization.

Discussion

In this study, the efficacy and safety of HTDJ plus western medicine in the treatment of atrial fibrillation (qi deficiency and phlegm opacities) will be evaluated, so as to provide medical evidence of short-term and medium-term clinical efficacy for the treatment of atrial fibrillation with integrated traditional and western medicine and lay a foundation for further clinical development and application.

Trial registration

ClinicalTrials.govChiCTR2000030517. Registered on March 5, 2020, with the Chinese Clinical Trial Registry
Electronic early notification of sepsis in hospitalized ward patients: a study protocol for a stepped-wedge cluster randomized controlled trial
Authors: Arabi Yaseen M. , Alsaawi Abdulmohsen , Al Zahrani Mohammed , Al Khathaami Ali M. , AlHazme Raed H. , Al Mutrafy Abdullah , Al Qarni Ali , Al Shouabi Ahmed , Al Qasim Eman , Abdukahil Sheryl Ann , Al-Rabeah Fawaz K. , Al Ghamdi Huda , Al Ghamdi Ebtisam , Alansari Mariam , Abuelgasim Khadega A. , Alatassi Abdulaleem , Alchin John , Al-Dorzi Hasan M. , Ghamdi Abdulaziz A. , Al-Hameed Fahad , Alharbi Ahmad , Hussein Mohamed , Jastaniah Wasil , AlKatheri Mufareh Edah , AlMarhabi Hassan , Mustafa Hani T. , Jones Joan , Al-Qahtani Saad , Qahtani Shaher , Qureshi Ahmad S. , Salih Salih Bin , Alselaim Nahar , Tashkandi Nabiha , Vishwakarma Ramesh Kumar , AlWafi Emad , Alyami Ali H. , Alyousef Zeyad ,   for the SCREEN Trial Group, Al Arfaj Ahmed , Al Moammary Mohamed S. , Rasheed Soud , Alwasaidi Turki , Matroud Amal , Al Anazi Rasha Ebeid , Alhasani Amar M. , Al Shammari Haifa , Alshamrani Majid M. , Qasim Saleh , Obbed Saeed , Munshi Adnan A. , Al Tabsh Hadia , Banat Basem R. , Abuskout Omar , Marcelo Anna Liza , Alhabshi Mayadah M. , Jaber Ibrahim J. , Shahin Mohammad , Yaakob Jamielah , Al Somali Hanan , Masala Clara , Al Qarni Mohammed , Chalabi Jamal , Greyvenstein Johanna E. , Jazieh Abdul Rahman , Omaish Noha , Abdrahim Azura , Abdrabo Mohammad , Al Hamdan Abdullah , Al Qasem Abdulaziz , Esilan Hattan
Published: October 2021

Background

To evaluate the effect of screening for sepsis using an electronic sepsis alert vs. no alert in hospitalized ward patients on 90-day in-hospital mortality.

Methods

The SCREEN trial is designed as a stepped-wedge cluster randomized controlled trial. Hospital wards (total of 45 wards, constituting clusters in this design) are randomized to have active alert vs. masked alert, 5 wards at a time, with each 5 wards constituting a sequence. The study consists of ten 2-month periods with a phased introduction of the intervention. In the first period, all wards have a masked alert for 2 months. Afterwards the intervention (alert system) is implemented in a new sequence every 2-month period until the intervention is implemented in all sequences. The intervention includes the implementation of an electronic alert system developed in the hospital electronic medical records based on the quick sequential organ failure assessment (qSOFA). The alert system sends notifications of “possible sepsis alert” to the bedside nurse, charge nurse, and primary medical team and requires an acknowledgment in the health information system from the bedside nurse and physician. The calculated sample size is 65,250. The primary endpoint is in-hospital mortality by 90 days.

Discussion

The trial started on October 1, 2019, and is expected to complete patient follow-up by the end of October 2021.

Trial registration

ClinicalTrials.gov NCT04078594. Registered on September 6, 2019
Open-label randomized controlled trial of ultra-low tidal ventilation without extracorporeal circulation in patients with COVID-19 pneumonia and moderate to severe ARDS: study protocol for the VT4COVID trial
Authors: Richard Jean-Christophe , Yonis Hodane , Bitker Laurent , Roche Sylvain , Wallet Florent , Dupuis Claire , Serrier Hassan , Argaud Laurent , Thiery Guillaume , Delannoy Bertrand , Pommier Christian , Abraham Paul , Muller Michel , Aubrun Frederic , Sigaud Florian , Rigault Guillaume , Joffredo Emilie , Mezidi Mehdi , Terzi Nicolas , Rabilloud Muriel
Published: October 2021

Background

Acute respiratory distress syndrome (ARDS) is a severe complication of COVID-19 pneumonia, with a mortality rate amounting to 34–50% in moderate and severe ARDS, and is associated with prolonged duration of invasive mechanical ventilation. Such as in non-COVID ARDS, harmful mechanical ventilation settings might be associated with worse outcomes. Reducing the tidal volume down to 4 mL kg−1 of predicted body weight (PBW) to provide ultra-low tidal volume ventilation (ULTV) is an appealing technique to minimize ventilator-inducted lung injury. Furthermore, in the context of a worldwide pandemic, it does not require any additional material and consumables and may be applied in low- to middle-income countries. We hypothesized that ULTV without extracorporeal circulation is a credible option to reduce COVID-19-related ARDS mortality and duration of mechanical ventilation.

Methods

The VT4COVID study is a randomized, multi-centric prospective open-labeled, controlled superiority trial. Adult patients admitted in the intensive care unit with COVID-19-related mild to severe ARDS defined by a PaO2/FiO2 ratio ≤ 150 mmHg under invasive mechanical ventilation for less than 48 h, and consent to participate to the study will be eligible. Patients will be randomized into two balanced parallels groups, at a 1:1 ratio. The control group will be ventilated with protective ventilation settings (tidal volume 6 mL kg−1 PBW), and the intervention group will be ventilated with ULTV (tidal volume 4 mL kg−1 PBW). The primary outcome is a composite score based on 90-day all-cause mortality as a prioritized criterion and the number of ventilator-free days at day 60 after inclusion. The randomization list will be stratified by site of recruitment and generated using random blocks of sizes 4 and 6. Data will be analyzed using intention-to-treat principles.

Discussion

The purpose of this manuscript is to provide primary publication of study protocol to prevent selective reporting of outcomes, data-driven analysis, and to increase transparency. Enrollment of patients in the study is ongoing.

Trial registration

ClinicalTrials.govNCT04349618. Registered on April 16, 2020
An update on the mosquito fauna and mosquito-borne diseases distribution in Cameroon
Authors: Bamou Roland , Mayi Marie Paul Audrey , Djiappi-Tchamen Borel , Nana-Ndjangwo Stella Mariette , Nchoutpouen Elysée , Cornel Antony John , Awono-Ambene Parfait , Parola Phillipe , Tchuinkam Timoléon , Antonio-Nkondjio Christophe
Published: October 2021

The expansion of mosquito-borne diseases such as dengue, yellow fever, and chikungunya in the past 15 years has ignited the need for active surveillance of common and neglected mosquito-borne infectious diseases. The surveillance should be designed to detect diseases and to provide relevant field-based data for developing and implementing effective control measures to prevent outbreaks before significant public health consequences can occur. Mosquitoes are important vectors of human and animal pathogens, and knowledge on their biodiversity and distribution in the Afrotropical region is needed for the development of evidence-based vector control strategies. Following a comprehensive literature search, an inventory of the diversity and distribution of mosquitoes as well as the different mosquito-borne diseases found in Cameroon was made. A total of 290 publications/reports and the mosquito catalogue website were consulted for the review. To date, about 307 species, four subspecies and one putative new species of Culicidae, comprising 60 species and one putative new species of Anopheles, 67 species and two subspecies of Culex, 77 species and one subspecies of Aedes, 31 species and one subspecies of Eretmapodites, two Mansonia, eight Coquillettidia, and 62 species with unknown medical and veterinary importance (Toxorhynchites, Uranotaenia, Mimomyia, Malaya, Hodgesia, Ficalbia, Orthopodomyia, Aedeomyia, and Culiseta and Lutzia) have been collected in Cameroon. Multiple mosquito species implicated in the transmission of pathogens within Anopheles, Culex, Aedes, Eretmapodites, Mansonia, and Coquillettidia have been reported in Cameroon. Furthermore, the presence of 26 human and zoonotic arboviral diseases, one helminthic disease, and two protozoal diseases has been reported. Information on the bionomics, taxonomy, and distribution of mosquito species will be useful for the development of integrated vector management programmes for the surveillance and elimination of mosquito-borne diseases in Cameroon.
Influence of 2D:4D ratio on fitness parameters and accumulated training load in elite youth soccer players
Authors: Nobari Hadi , Alves Ana Ruivo , Clemente Filipe Manuel , Pérez-Gómez Jorge
Published: October 2021

Background

Digit ratio (2D:4D) characterized by the length of the second digit (2D) divided by the length of the fourth digit (4D), is a powerful marker of athletic performance. Some studies showed a negative correlation between 2D:4D ratio and sports performances.

Objectives

The purpose of the present study was three-fold: (1) to analyze the influence of anthropometric and 2D:4D ratio on variations of accumulated training load (ATL) and fitness parameters: maximal oxygen uptake (V̇O2max), countermovement jump (CMJ), isometric muscular strength of the knee extensor for hamstring (ISH) and flexor for quadriceps (ISQ) muscles; along three stages of evaluation of soccer players based on playing positions; (2) to analyze the correlations between 2D:4D ratio and aforementioned parameters; and (3) to investigate if variance in fitness levels and ATL can explain the 2D:4D ratio.

Methods

Twenty-four elite players under 17 years were daily monitored for their rating perceived exertion and ATL across 24 weeks over the season. Soccer players have also measured in three stages for anthropometric traits and fitness parameters.

Results

Significant differences were observed between playing positions for body mass, goalkeepers had higher body mass compared to centre-midfielder and winger players. Moreover, there were significant differences in ATL between early-season to mid-season in goalkeepers (P = 0.032). The 2D:4D ratio (left and right) shown largely and negatively association with muscular strength (ISQ: r =  − 0.80; r =  − 0.78,P ≤ 0.001, ISH: r =  − 0.63; r =  − 0.62,P = 0.001, respectively) and VO2maxchanges (r =  − 0.55,P = 0.005; r =  − 0.50,P = 0.013, respectively); lastly, both 2D:4D ratio significantly predicted changes in muscular strength and VO2maxin young soccer players.

Conclusions

Goalkeepers tended to have higher body mass compared to centre-midfielder and winger players; and 2D:4D ratio revealed a mighty predictor of physical fitness changes in soccer players. Evidence should be helpful to professionals to highlight the usefulness of the 2D:4D into the identification of talent, but also to optimize young players' performance.