The Coefficient of Variation as an Index of Measurement Reliability

The regulation of NFKB1 on CD200R1 expression and their potential roles in Parkinson's disease

BACKGROUND

Overactivated microglia are a key contributor to Parkinson's disease (PD) by inducing neuroinflammation. CD200R1, a membrane glycoprotein mainly found on microglia, is crucial for maintaining quiescence with its dysregulation linked to microglia's abnormal activation. We and other groups have reported a decline in CD200R1 levels in several neurological disorders including PD. However, the mechanism regulating CD200R1 expression and the specific reasons for its reduction in PD remain largely unexplored. Given the pivotal role of transcription factors in gene expression, this study aimed to elucidate the transcriptional regulation of CD200R1 and its implications in PD.

METHODS

The CD200R1 promoter core region was identified via luciferase assays. Potential transcription factors were predicted using the UCSC ChIP-seq database and JASPAR. NFKB1 binding to the CD200R1 core promoter was substantiated through electrophoretic mobility shift and chromatin immunoprecipitation assays. Knocking-down or overexpressing NFKB1 validated its regulatory effect on CD200R1. Correlation between decreased CD200R1 and deficient NFKB1 was studied using Genotype-Tissue Expression database. The clinical samples of the peripheral blood mononuclear cells were acquired from 44 PD patients (mean age 64.13 ± 9.78, 43.2% male, median Hoehn-Yahr stage 1.77) and 45 controls (mean age 64.70 ± 9.41, 52.1% male). NFKB1 knockout mice were utilized to study the impact of NFKB1 on CD200R1 expression and to assess their roles in PD pathophysiology.

RESULTS

The study identified the CD200R1 core promoter region, located 482 to 146 bp upstream of its translation initiation site, was directly regulated by NFKB1. Significant correlation between NFKB1 and CD200R1 expression was observed in human PMBCs. Both NFKB1 and CD200R1 were significantly decreased in PD patient samples. Furthermore, NFKB1-/- mice exhibited exacerbated microglia activation and dopaminergic neuron loss after 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) treatment.

CONCLUSION

Our study identified that NFKB1 served as a direct regulator of CD200R1. Reduced NFKB1 played a critical role in CD200R1 dysregulation and subsequent microglia overactivation in PD. These findings provide evidence that targeting the NFKB1-CD200R1 axis would be a novel therapeutic strategy for PD.

Between-Session Reliability of Athletic Performance and Injury Mitigation Measures in Female Adolescent Athletes in the United States

Adolescence is a fundamental period for female athletes to develop athletic performance, mitigate injury risk, and gain collegiate sport scholarships, but there is also a high incidence of sport-related injuries. Physical profiling and athlete screening can support the individualisation of training programmes; however, there is a lack of data pertaining to the reliability of athletic performance and injury surrogate measures in adolescent female athletes. The aim of this study was to quantify the between-session reliability of an athletic performance and injury mitigation testing battery in female adolescent athletes. A total of 31 post-peak height velocity (PHV) (3.00 ± 0.82 years) female athletes (age: 16.20 ± 1.20 years; standing height: 166.00 ± 6.00 cm; mass: 65.5 ± 10.70 kg) from various sports (track and field = 1; lacrosse = 2; basketball = 2; soccer = 3; softball = 11; volleyball = 12) completed two sessions of a multicomponent testing battery 48 h to 1 week apart including the assessment of 33 measures addressing lower-limb isometric strength, eccentric strength, reactive strength, linear sprint and change of direction speed, and lower limb control. Of the 33 measures, between sessions, 29 had a high to nearly perfect intraclass correlation coefficient (ICC) (0.508-0.979), and 26 measures were not statistically significantly different between sessions (p ≤ 0.05). All measures demonstrated low to acceptable coefficient variation (CV%) (0.61-14.70%). The testing battery used can be utilised for recruitment and longitudinal monitoring within sports organisations for female adolescent athletes.

Depression of dynamic cerebral autoregulation during neural activation: The role of responders and non-responders

Neurovascular coupling (NVC) interaction with dynamic cerebral autoregulation (dCA) remains unclear. We investigated the effect of task complexity and duration on the interaction with dCA. Sixteen healthy participants (31.6 ± 11.6 years) performed verbal fluency (naming-words (NW)) and serial subtraction (SS) paradigms, of varying complexity, at durations of 05, 30 and 60 s. The autoregulation index (ARI), was estimated from the bilateral middle cerebral artery blood velocity (MCAv) step response, calculated by transfer function analysis (TFA), for each paradigm during unstimulated (2 min) and neuroactivated (1 min) segments. Intraclass correlation (ICC) and coefficient of variation (CV) determined reproducibility for two visits and objective criteria were applied to classify responders (R) and non-responders (NoR) to task-induced MCAv increase. ICC values demonstrated fair reproducibility in all tasks. ARI decreased in right (RH) and left (LH) hemispheres, irrespective of paradigm complexity and duration (p < 0.0001). Bilateral ARI estimates were significantly decreased during NW for the R group only (p < 0.0001) but were reduced in both R (p < 0.0001) and NoR (p = 0.03) groups for SS tasks compared with baseline. The reproducible attenuation of dCA efficiency due to paradigm-induced NVC response, its interaction, and different behaviour in R and NoR, warrant further research in different physiological and clinical conditions.

Altered pupil light and darkness reflex and eye-blink responses in late-life depression

BACKGROUND

Late-life depression (LLD) is a prevalent neuropsychiatric disorder in the older population. While LLD exhibits high mortality rates, depressive symptoms in older adults are often masked by physical health conditions. In younger adults, depression is associated with deficits in pupil light reflex and eye blink rate, suggesting the potential use of these responses as biomarkers for LLD.

METHODS

We conducted a study using video-based eye-tracking to investigate pupil and blink responses in LLD patients (n = 25), older (OLD) healthy controls (n = 29), and younger (YOUNG) healthy controls (n = 25). The aim was to determine whether there were alterations in pupil and blink responses in LLD compared to both OLD and YOUNG groups.

RESULTS

LLD patients displayed significantly higher blink rates and dampened pupil constriction responses compared to OLD and YOUNG controls. While tonic pupil size in YOUNG differed from that of OLD, LLD patients did not exhibit a significant difference compared to OLD and YOUNG controls. GDS-15 scores in older adults correlated with light and darkness reflex response variability and blink rates. PHQ-15 scores showed a correlation with blink rates, while MoCA scores correlated with tonic pupil sizes.

CONCLUSIONS

The findings demonstrate that LLD patients display altered pupil and blink behavior compared to OLD and YOUNG controls. These altered responses correlated differently with the severity of depressive, somatic, and cognitive symptoms, indicating their potential as objective biomarkers for LLD.

Numerical Optimization of Variable Blank Holder Force Trajectories in Stamping Process for Multi-Defect Reduction

An intelligent optimization technology was proposed to mitigate prevalent multi-defects, particularly failure, wrinkling, and springback in sheet metal forming. This method combined deep neural networks (DNNs), genetic algorithms (GAs), and Monte Carlo simulation (MCS), collectively as DNN-GA-MCS. Our primary aim was to determine intricate process parameters while elucidating the intricate relationship between processing methodologies and material properties. To achieve this goal, variable blank holder force (VBHF) trajectories were implemented into five sub-stroke steps, facilitating adjustments to the blank holder force via numerical simulations with an oil pan model. The Forming Limit Diagram (FLD) predicted by machine learning algorithms based on the Generalized Incremental Stress State Dependent Damage (GISSMO) model provided a robust framework for evaluating sheet failure dynamics during the stamping process. Numerical results confirmed significant improvements in formed quality: compared with the average value of training sets, the improvements of 18.89%, 13.59%, and 14.26% are achieved in failure, wrinkling, and springback; in the purposed two-segmented mode VBHF case application, the average value of three defects is improved by 12.62%, and the total summation of VBHF is reduced by 14.07%. Statistical methodologies grounded in material flow analysis were applied, accompanied by the proposal of distinctive optimization strategies for the die structure aimed at enhancing material flow efficiency. In conclusion, our advanced methodology exhibits considerable potential to improve sheet metal forming processes, highlighting its significant effect on defect reduction.

Achilles tendon assessment on quantitative MRI: Sources of variability and relationships to tendinopathy

Quantitative MRI (qMRI) measures are useful in assessing musculoskeletal tissues, but application to tendon has been limited. The purposes of this study were to optimize, identify sources of variability, and establish reproducibility of qMRI to assess Achilles tendon. Additionally, preliminarily estimates of effect of tendon pathology on qMRI metrics and structure-function relationships between qMRI measures and ankle performance were examined. T1, T1ρ, T2, and T2* maps of the Achilles tendon were obtained using a 3T MRI scanner. In participants with asymptomatic tendons (n = 21), MRI procedures were repeated twice, and region of interest selection was performed by three raters. Variance decomposition and reproducibility statistics were completed. To estimate the effect of pathology, qMRI measures from individuals with asymptomatic tendons were compared to qMRI measures from a pilot group of individuals with Achilles tendinopathy (n = 7). Relationships between qMRI and ankle performance measures were assessed. Between-participant variation accounted for the majority of variability (46.7%-64.0%) in all qMRI measures except T2*. ICCs met or exceeded 0.7 for all qMRI measures when averaged across raters or scans. Relaxation times were significantly longer in tendinopathic tendons (mean (SD) T1: 977.8 (208.6) ms, T1ρ: 35.4 (7.1) ms, T2: 42.8 (7.9) ms, T2*: 14.1 (7.6) ms, n = 7) compared to asymptomatic control tendons (T1: 691.7 (32.4) ms, T1ρ: 24.0 (3.6) ms, T2: 24.4 (7.5) ms, T2*: 9.5 (3.4) ms, n = 21) (p < 0.011 for all comparisons). T1 related to functional performance measures in symptomatic and asymptomatic groups. Study findings suggest that qMRI is reliable to assess the Achilles tendon. qMRI quantitatively assesses the presence of tendon pathology and relates to functional performance outcomes, supporting the utility of incorporating qMRI in research and clinic.

A novel approach to evaluation of tumor response for advanced pulmonary adenocarcinoma using the intertumoral heterogeneity response score

Treatment response and prognosis estimation in advanced pulmonary adenocarcinoma are challenged by the significant heterogeneity of the disease. The current Response Evaluation Criteria in Solid Tumors (RECIST) criteria, despite providing a basis for solid tumor response evaluation, do not fully encompass this heterogeneity. To better represent these nuances, we introduce the intertumoral heterogeneity response score (THRscore), a measure built upon and expanding the RECIST criteria. This retrospective study included patients with 3-10 measurable advanced lung adenocarcinoma lesions who underwent first-line chemotherapy or targeted therapy. The THRscore, derived from the coefficient of variation in size for each measurable tumor before and 4-6 weeks posttreatment, unveiled a correlation with patient outcomes. Specifically, a high THRscore was associated with shorter progression-free survival, lower tumor response rate, and a higher tumor mutation burden. These associations were further validated in an external cohort, confirming THRscore's effectiveness in stratifying patients based on progression risk and treatment response, and enhancing the utility of RECIST in capturing complex tumor behaviors in lung adenocarcinoma. These findings affirm the promise of THRscore as an enhanced tool for tumor response assessment in advanced lung adenocarcinoma, extending the RECIST criteria's utility.

Evaluating Operator Training Performance Using Recurrence Quantification Analysis of Autocorrelation Transformed Eye Gaze Data

OBJECTIVE

This research aimed to investigate the relationship between gaze behaviour dynamics and operator performance.

BACKGROUND

Individuals differ in their approach when learning a new task often resulting in performance disparity. During training some individuals learn the structure and dynamics of the task and develop a systematic approach, whereas others may achieve the same result albeit with increased perceived workload, or indeed some may fail to achieve superior performance levels. Previous research has shown that comparing gaze of experts with novices can provide unique insights into cognitive functioning of superior performers.

METHODS

Twenty-five individuals participated in a computer-based simulation task. The concept of coefficient of variation (CoV) of task scores was used to compute the participants' consistency of performance. Based on CoV, the cohort was split into two performance categories. The temporal patterns in participants gaze data were transformed using autocorrelation, and recurrence quantification analysis (RQA) was employed to analyse and quantify the patterns.

RESULTS

A Mann-Whitney U analysis demonstrated significantly (p < .01) higher determinism, entropy and laminarity in the superior group compared to the moderate group. Pearson's correlation revealed a significant (p < .01) negative correlation between the consistency of task performance (CoV) and the RQA measures.

CONCLUSION

The results demonstrated that eye gaze dynamics can be used as an objective measure of performance. Participants classified as superior performers consistently demonstrated a systematic gaze activity which were in line with the task structure.

APPLICATION

The methods presented here are applicable to observe and evaluate operators' strategic distribution of gaze. Specifically, for tactical monitoring and decision making in task environments where spatial locations of elements-of-interest vary continuously.

Swimming behavior affects ingestion of microplastics by fish

Microplastics (< 5 mm) are widely found in organisms and have the potential harm to ecosystems. Despite their widespread prevalence in environments, there is high individual varation in the abundance of microplastics found in individuals of the same species. In the present study, juvenile cichlid fish (Chindongo demasoni) were chosen to determine the ingestion personality for microplastics in the laboratory. The visible implant fluorescent tags were used for individual recognition. The fish were fed with microplastic fiber, pellet, and food for comparison. Our results showed that the observation of the behaviors of fish could be successfully matched with subsequent measurements for each individual through the tag method in microplastic research. The difference in the abundance of fiber (0-27 items/ind.) among fish individuals was also observed in our study. Meanwhile, the abundance of fiber showed a positive correlation with the average speed and covered area of fish, which indicates the degree of activity of fish. Moreover, fish with higher speed or a front position had higher capturing times for pellet. Our results suggest that the swimming behaviors of fish affect their ingestion of microplastics, and active fish had a higher likelihood of ingesting microplastics, which might be one of the reasons for the common phenomena, i.e., great individual differences observed in microplastic studies.

Test-retest reliability of ski-specific aerobic, sprint, and neuromuscular performance tests in highly trained cross-country skiers

PURPOSE

Laboratory tests are commonly performed by cross-country (XC) skiers due to the challenges of obtaining reliable performance indicators on snow. However, only a few studies have reported reliability data for ski-specific test protocols. Therefore, this study examined the test-retest reliability of ski-specific aerobic, sprint, and neuromuscular performance tests.

METHODS

Thirty-nine highly trained XC skiers (26 men and 13 women, age: 22 ± 4 years, V̇O2max : 70.1 ± 4.5 and 58.8 ± 4.4 mL·kg-1 ·min-1 , respectively) performed two test trials within 6 days of a diagonal V̇O2max test, n = 27; skating graded exercise test to assess the second lactate threshold (LT2 ), n = 27; 24-min double poling time trial (24-min DP, n = 25), double poling sprint test (SprintDP1 , n = 27), and 1-min self-paced skating sprint test (Sprint1-min , n = 26) using roller skis on a treadmill, and an upper-body strength test (UB-ST, n = 27) to assess peak power (Ppeak ) with light, medium, and heavy loads. For each test, the coefficient of variation (CV), intraclass correlation coefficient (ICC), and minimal detectable change (MDC) were calculated.

RESULTS

V̇O2max demonstrated good-to-excellent reliability (CV = 1.4%; ICC = 0.99; MDC = 112 mL·min-1 ), whereas moderate-to-excellent reliability was found for LT2 (CV = 3.1%; ICC = 0.95). Performance during 24-min DP, SprintDP1 , and Sprint1-min showed good-to-excellent reliability (CV = 1.0%-2.3%; ICC = 0.96-0.99). Absolute reliability for UB-ST Ppeak was poor (CV = 4.9%-7.8%), while relative reliability was excellent (ICC = 0.93-0.97) across the loads.

CONCLUSION

In highly trained XC skiers, sport-specific aerobic and sprint performance tests demonstrated high test-retest reliability, while neuromuscular performance for the upper body was less reliable. Using the presented protocols, practitioners can assess within- and between-season changes in relevant performance indicators.

The reliability and validity of lung cancer and melanoma clinical quality survival measures

OBJECTIVE

To develop a risk adjustment approach and test reliability and validity for oncology survival measures.

DATA SOURCES AND STUDY SETTING

We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2010 to 2013, with mortality data through 2015.

STUDY DESIGN

We developed 2-year risk-standardized survival rates (RSSR) for melanoma, non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC). Patients were attributed to group practices based on the plurality of visits. We identified the risk-adjustment variables via bootstrap and calculated the RSSRs. Reliability was tested via three approaches: (1) signal-to-noise ratio (SNR) reliability, (2) split-half, and (3) test-retest using bootstrap. We tested known group validity by stage at diagnosis using Cohen's d.

DATA COLLECTION/EXTRACTION METHODS

We selected all patients enrolled in Medicare and linked to SEER during the measurement period with an incident first primary diagnosis of stage I-IV melanoma, NSCLC, or SCLC. We excluded patients with missing data on month and/or stage of diagnosis.

PRINCIPAL FINDINGS

Results are based on patients with melanoma (n = 4344); NSCLC (n = 16,080); and SCLC (n = 2807) diagnosed between 2012 and 2013. The median (interquartile range) for the RSSRs at the group practice-level were 0.89 (0.83-0.87) for melanoma, 0.37 (0.30-0.43) for NSCLC, and 0.19 (0.11-0.25) for SCLC. C-statistics for the models ranged from 0.725 to 0.825. The reliability varied by approach with median SNR 0.20, 0.25, and 0.13; median test-retest 0.59, 0.57, and 0.56; median split-half reliability 0.21, 0.29, and 0.29 for melanoma, NSCLC, and SCLC, respectively. Cohen's d for stage I-IIIa and IIIb+ was 1.27, 0.86, 0.60 for melanoma, NSCLC, and SCLC, respectively.

CONCLUSIONS

Our results suggest that these cancer survival measures demonstrated adequate test-retest reliability and expected findings for the known-group validity analysis. If data limitations and feasibility challenges can be addressed, implementation of these quality measures may provide a survival metric used for oncology quality improvement efforts.

Personalized pain management: The relationship between clinical relevance and reliability of measurements

Reliability is a topic in health science in which a critical appraisal of the magnitudes of the measurements is often left aside to favour a formulaic analysis. Furthermore, the relationship between clinical relevance and reliability of measurements is often overlooked. In this context, the aim of the present article is to provide an overview of the design and analysis of reliability studies, the interpretation of the reliability of measurements and its relationship to clinical significance in the context of pain research and management. The article is divided in two sections: the first section contains a step-by-step guide with simple and straightforward recommendations for the design and analysis of a reliability study, with a relevant example involving a commonly used assessment measure in pain research. The second section provides deeper insight about the interpretation of the results of a reliability study and the association between the reliability of measurements and their experimental and clinical relevance. SIGNIFICANCE: Reliability studies quantify the measurement error in experimental or clinical setups and should be interpreted as a continuous outcome. The assessment of measurement error is useful to design and interpret future experimental studies and clinical interventions. Reliability and clinical relevance are inextricably linked, as measurement error should be considered in the interpretation of minimal detectable change and minimal clinically important differences.

A three-dimensional method to calculate mechanical advantage in mandibular function : Intra- and interexaminer reliability study

PURPOSE

Masticatory muscles are physically affected by several skeletal features. The muscle performance depends on muscle size, intrinsic strength, fiber direction, moment arm, and neuromuscular control. To date, for the masticatory apparatus, only a two-dimensional cephalometric method for assessing the mechanical advantage, which is a measure for the ratio of the output force to the input force in a system, is available. This study determined the reliability and errors of a three-dimensional (3D) mechanical advantage calculation for the masticatory system.

METHODS

Using cone-beam computed tomography images from teenage patients undergoing orthodontic treatments, 36 craniofacial landmarks were identified, and the moment arms for seven muscles and their load moment arms (biomechanical variables) were determined. The 3D mechanical advantage for each muscle was calculated. This procedure was repeated by three examiners. Reliability was verified using the intraclass correlation coefficient (ICC) and the errors by calculating the absolute differences, variance estimator and coefficient of variation (CV).

RESULTS

Landmark coordinates demonstrated excellent intra- and interexaminer reliability (ICC 0.998-1.000; p < 0.0001). Intraexaminer data showed errors < 1.5 mm. Unsatisfactory interexaminer errors ranged from 1.51-5.83 mm. All biomechanical variables presented excellent intraexaminer reliability (ICC 0.919-1.000, p < 0.0001; CV < 7%). Interexaminer results were almost excellent, but with lower values (ICC 0.750-1.000, p < 0.0001; CV < 10%). However, the muscle moment arm and 3D mechanical advantage of the lateral pterygoid muscles had ICCs < 0.500 (p < 0.05) and CV < 30%. Intra- and interexaminer errors were ≤ 0.01 and ≤ 0.05, respectively.

CONCLUSIONS

Both landmarks and biomechanical variables showed high reliability and acceptable errors. The proposed method is viable for the 3D mechanical advantage measure.

Repeatability of neurite orientation dispersion and density imaging in patients with traumatic brain injury

BACKGROUND AND PURPOSE

The aim of this study was to assess the repeatability of neurite orientation dispersion and density imaging in healthy controls (HCs) and traumatic brain injury (TBI).

METHODS

Seventeen HCs and 48 TBI patients were scanned twice over 18 weeks with diffusion imaging. Orientation dispersion (ODI), neurite density (NDI), and the fraction of isotropic diffusion (F-ISO) were quantified in regions of interest (ROIs) from a gray matter, subcortical, and white matter atlas and compared using the coefficient of variation for repeated measures (CVrep ), which quantifies the expected percent change on repeated measurement. We used a modified signed likelihood ratio test (M-SLRT) to compare the CVrep between groups in each ROI while correcting for multiple comparisons.

RESULTS

NDI exhibited excellent repeatability in both groups; the only group difference was found in the fusiform gyrus, where HCs exhibited better repeatability (M-SLRT = 9.463, p = .0021). ODI also had excellent repeatability in both groups, although repeatability was significantly better in HCs in 16 cortical ROIs (p < .0022) and in the bilateral white matter and bilateral cortex (p < .0027). F-ISO exhibited relatively poor repeatability in both groups, with few group differences.

CONCLUSION

Overall, the repeatability of the NDI, ODI, and F-ISO metrics over an 18-week period is acceptable for assessing the effects of behavioral or pharmacological interventions, though caution is advised when assessing F-ISO changes over time.

Rapid and sensitive detection of E. coli O157:H7 by lateral flow immunoassay and silver enhancement

The aim of this study was to develop a sensitive lateral flow immunoassay (LFIA) for the rapid detection of Escherichia coli (E. coli) O157:H7, a pathogen contributor to diseases and fatalities worldwide. Au nanoparticles with high stability, uniform size, and shape were synthesized and coated with heterobifunctional PEG polymer with carboxyl groups, and they were bioconjugated to be used as label in sandwich-LFIA. Then, a silver enhancement strategy was developed as an accessible, rapid, and cost-effective approach for signal amplification to reduce the limit of detection (LOD). The optimal results were achieved when a solution of silver nitrate and hydroquinone/citrate buffer was added to the strips for 4 min. This led to a decrease in the visual LOD from 2 × 10⁶ (CFU mL^-1) to 2 × 10³ (CFU mL^-1), resulting in a threefold improvement in sensitivity compared to the conventional LFIA system. The specificity of the system was evaluated by using non-target bacteria (E. coli BL21 and E. coli T515) and its reliability was determined by testing commercial food samples (milk, tap water, and orange juice), demonstrating its effectiveness for quickly detecting pathogenic bacteria in food products.

Including visual orienting functions into cerebral visual impairment screening: Reliability, variability, and ecological validity

BACKGROUND

Cerebral visual impairment (CVI) is a heterogeneous brain-based visual processing disorder in which basic visual orienting functions (VOF) and higher-order perception can be impaired.

AIMS

To evaluate (1) the test-retest reliability and variability of an eye tracking-based VOF paradigm, and related clinical characteristics, and (2) the relations between VOF (variability) and daily visual functioning and visuoperceptual dimensions.

METHODS AND PROCEDURES

Thirty-three children with CVI (Males=14; mean age=9 years 10 months) underwent eye tracking thrice, completed a visuoperceptual battery, and parents completed the Flemish CVI questionnaire. VOF reliability and variability of reaction time (RTF), fixation duration and accuracy were assessed with intraclass correlation coefficient (ICC), Bland-Altman plots, and coefficient of variation. Relations were analysed with linear mixed models.

OUTCOMES AND RESULTS

Highly salient visual stimuli had good RTF reliability (ICCs=0.75) and triggered less variable VOF. Intermediate and low salience stimuli had poor-to-moderate reliability and triggered more variable VOF. Younger performance age related to more VOF variability. Greater visual (dis)interest, clutter and distance viewing impairments, and a weaker visuoperceptual profile related to slower RTF.

CONCLUSIONS AND IMPLICATIONS

Highly salient stimuli reveal a child's 'optimal' visual performance, whereas intermediate and low salience stimuli uncover VOF variability, which is a key CVI hallmark to detect.

Reliability of high-density surface electromyography for assessing characteristics of the thoracic erector spinae during static and dynamic tasks

PURPOSE

To establish intra- and inter-session reliability of high-density surface electromyography (HDEMG)-derived parameters from the thoracic erector spinae (ES) during static and dynamic goal-directed voluntary movements of the trunk, and during functional reaching tasks.

METHODS

Twenty participants performed: 1) static trunk extension, 2) dynamic trunk forward and lateral flexion, and 3) multidirectional functional reaching tasks on two occasions separated by 7.5 ± 1.2 days. Muscle activity was recorded bilaterally from the thoracic ES. Root mean square (RMS), coordinates of the barycentre, mean frequency (MNF), and entropy were derived from the HDEMG signals. Reliability was determined with intraclass correlation coefficient (ICC), coefficient of variation, and standard error of measurement.

RESULTS

Good-to-excellent intra-session reliability was found for all parameters and tasks (ICC: 0.79-0.99), whereas inter-session reliability varied across tasks. Static tasks demonstrated higher reliability in most parameters compared to functional and dynamic tasks. Absolute RMS and MNF showed the highest overall reliability across tasks (ICC: 0.66-0.98), while reliability of the barycentre was influenced by the direction of the movements.

CONCLUSION

RMS and MNF derived from HDEMG show consistent inter-session reliability in goal-directed voluntary movements of the trunk and reaching tasks, whereas the measures of the barycentre and entropy demonstrate task-dependent reliability.

Impacts of university lockdown during the coronavirus pandemic on college students' academic achievement and critical thinking: A longitudinal study

The outbreak of the coronavirus disease 2019 (COVID-19) has resulted in widespread university lockdown. However, impacts of the university lockdown on the learning and academic development of university students have not been thoroughly investigated. The current study examined college students' changes of learning outcomes during the COVID-19 lockdown period and clarified what might explain individual differences in students' learning outcomes after they had learned from home for a whole semester when universities were physically closed due to the COVID-19 pandemic. Data were derived from a longitudinal study examining the development of college students including students' academic achievement and critical thinking (including both skills and dispositions) before and after the university lockdown. We observed significant decreases in critical thinking skills and dispositions from pre- to post-lockdown. Both perceived academic achievement and critical thinking exhibited greater variability after the lockdown. In addition, students' readiness for online learning, especially their self-management skills, consistently predicted post-lockdown learning outcomes after controlling for pre-lockdown outcomes and family socioeconomic status (SES). Those who have assumed more responsibilities at home, or who were more vulnerable to emotional distress during the pandemic, performed less well in post-lockdown learning outcomes. These findings call for better management of student learning and development when major changes are required in higher education practices for responding to the ongoing COVID-19 crisis as well as other potential situations.

Self-assembly and label-free fluorescent aptasensor based on deoxyribonucleic acid intercalated dyes for detecting lactoferrin in milk powder

Lactoferrin (Lf), an iron-binding glycoprotein, regulates the immune system. It has broad-spectrum antimicrobial activity and is critical for child physical growth and development. As a common additive in the dairy industry, it is crucial to quantify LF content. This study established a self-assembly and universal fluorescence aptasensor for detecting LF in milk powder based on structure-selective dyes of PicoGreen intercalated in the label-free aptamer. Herein, the aptamer functions as both a specific recognition element against targets and a fluorescent signal reporter integrated with structure-selective dyes. First, the aptamer folds into a three-dimensional spatial structure based on complementary base pairings and intermolecular weak non-covalent interactions. Then, the dye is intercalated into the minor groove structures of the aptamer and triggers its potential fluorescent property. When the target exists, the aptamer binds to it preferentially, and its space structure unfolds. This causes the freeing of the subsequent dye and decreases the corresponding fluorescence. Hence, the reflected fluorescence signals could directly determine the target concentrations. Under the optimum conditions, a good linear relationship (R2, 0.980) was obtained in the Lf range from 20 to 500 nM with a detection limit of 3 nM (2.4 mg/kg) and good specificity, as well as a reliable recovery of 95.8–105.1% in milk powder. In addition, the universality was also confirmed with a good performance by quickly changing the aptamers against other targets (chlorpyrifos, acetamiprid, bovine thyroglobulin, and human transferrin) or utilizing another fluorescence dye. Therefore, this self-assembly aptasensor provides a universal and concise strategy for effective detection.

Fourier analysis of collagen bundle orientation in myocardial infarction scars

Collagen bundle orientation (CBO) in myocardial infarct scars plays a major role in scar mechanics and complications after infarction. We aim to compare four histopathological methods for CBO measurement in myocardial scarring. Myocardial infarction was induced in 21 pigs by balloon coronary occlusion. Scar samples were obtained at 4 weeks, stained with Masson’s trichrome, Picrosirius red, and Hematoxylin–Eosin (H&E), and photographed using light, polarized light microscopy, and confocal microscopy, respectively. Masson’s trichrome images were also optimized to remove non-collagenous structures. Two observers measured CBO by means of a semi-automated, Fourier analysis protocol. Interrater reliability and comparability between techniques were studied by the intraclass correlation coefficient (ICC) and Bland–Altman (B&A) plots and limits of agreement. Fourier analysis showed an almost perfect interrater reliability for each technique (ICC ≥ 0.95, p < 0.001 in all cases). CBO showed more randomly oriented values in Masson’s trichrome and worse comparability with other techniques (ICC vs. Picrosirius red: 0.79 [0.47–0.91], p = 0.001; vs. H&E-confocal: 0.70 [0.26–0.88], p = 0.005). However, optimized Masson’s trichrome showed almost perfect agreement with Picrosirius red (ICC 0.84 [0.6–0.94], p < 0.001) and H&E-confocal (ICC 0.81 [0.54–0.92], p < 0.001), as well as these latter techniques between each other (ICC 0.84 [0.60–0.93], p < 0.001). In summary, a semi-automated, Fourier-based method can provide highly reproducible CBO measurements in four different histopathological techniques. Masson’s trichrome tends to provide more randomly oriented CBO index values, probably due to non-specific visualization of non-collagenous structures. However, optimization of Masson’s trichrome microphotographs to remove non-collagenous components provides an almost perfect comparability between this technique, Picrosirius red and H&E-confocal.

Generation gap, learning from the experience of compulsory remote architectural design studio

Physical design studio has been the mainstream method of architectural pedagogy for more than a century. Although the past two decades have brought forth emerging possibilities via advancements in digital communication, Virtual Design Studio (VDS) remained an experimental novelty until 2020. The interruption of face-to-face educational activities saw architecture schools facing a rapid paradigm shift because their studio-centred pedagogy retains intrinsic spatial qualities that are often attributed as critical dimensions of the learning process. This article explores the transition to the virtual design studio in a department of architecture after distance education became mainstream due to the global pandemic. The paper provides a comparison between students' and lecturers' points of view regarding different aspects of the virtual design studio. This addresses a potential generational gap concerning digital communication in a case study. A survey was administered to a group of architecture students who travelled back home and continued their education online and to the teachers of design studios who instructed VDS after the pandemic outbreak. The findings show the significant influence of effective communication, access to proper resources, maintenance of peer connections, and group works on the positive outcomes of the architectural design studio.

Defining minimal detectable difference in echocardiographic measures of right ventricular function in systemic sclerosis

BACKGROUND

Echocardiography (2DE) is integral for screening and longitudinal evaluation of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc). In the present study, we sought to establish the reliability, repeatability, and reproducibility of 2DE parameters in SSc patients with and without PAH and to define the minimal detectable difference (MDD), the smallest change detected beyond measurement error.

METHODS

SSc patients without known PAH and with invasively confirmed PAH on stable therapies underwent 2DE with strain at two time points. Analysis of variance (ANOVA) and coefficients of variation (CV) were calculated to assess for repeatability, reliability, and reproducibility. Intra- and inter-observer agreement were assessed using intraclass correlation. Bland-Altman analysis explored the level of agreement between evaluations. MDD was calculated using the standard error of measurement for each parameter by cohort.

RESULTS

ANOVA demonstrated few significant differences between evaluations across groups. Global right ventricular longitudinal systolic strain (GRVLSS, 9.7%) and fractional area change (FAC, 21.3%) had the largest CV, while tricuspid annular plane excursion (TAPSE), S' wave, and right ventricular outflow track velocity time integral (RVOT VTI) were 0.87%, 3.2%, and 6.0%, respectively. Intra- and inter-observer agreement was excellent. MDD for TAPSE, FAC, S' wave, RVOT VTI, GRVLSS, and RVSP were 0.11 cm, 0.03%, 1.27 cm/s, 0.81 cm, 1.14%, and 6.5 mmHg, respectively.

CONCLUSIONS

We demonstrate minimal measurement error in clinically important 2DE-based measures in SSc patients with and without PAH. Defining the MDD in this population has important implications for PAH screening, assessment of therapeutic response, and sample size calculations for future clinical trials.

Bilateral Deficit in Countermovement Jump and Its Influence on Linear Sprinting, Jumping, and Change of Direction Ability in Volleyball Players

We investigated the association between bilateral deficit (BLD) in the countermovement jump (CMJ) and change of direction (CoD) performance, CoD deficit, linear sprint, and approach jumping task. The participants (47 young volleyball players; age: 20.8 ± 3.8 years) performed bilateral and single-leg CMJs, modified T-test, 505 CoD test, 25-m sprints (with 5, 10, and 15 splits), and vertical approach jumps. The CoD deficit was also calculated from the 505 test and 10 m split time. BLD was calculated from CMJ jump height, peak power, and phase-specific force impulses (FIs). Several small to moderate statistically significant correlations (r = 0.42–0.49) were found between BLD and 505 times (7 correlations), sprint times (4 correlations), CoD deficit (1 correlation), and approach jump (1 correlation). T-test performance was not correlated with BLD variables (r = −0.15–0.22). The direction of the correlations indicated that the larger BLD is associated with superior performance, with the exception of 1 correlation for 505 times for the left leg and 1 for CoD deficit for the left leg. However, these two variables showed unacceptable reliability. Our results suggest that BLD could be useful in making decisions about the amount inclusion of unilateral training for volleyball players.

Test–retest reliability of skeletal muscle oxygenation measurement using near‐infrared spectroscopy during exercise in patients with sport‐related iliac artery flow limitation

The ankle‐brachial index is an accurate tool for detecting claudication in atherosclerotic patients. However, this technique fails to identify subtle flow limitations of the iliac arteries (FLIA) in endurance athletes. Near‐infrared spectroscopy (NIRS) is a noninvasive technique that measures skeletal muscle tissue oxygenation status. The aim of the present study is to examine the absolute and relative test–retest reliability of NIRS and evaluate its potential as a diagnostic tool in FLIA. NIRS‐derived exercise variables were analyzed during exercise and recovery in FLIA 17 patients and 19 healthy controls. The relative reliability of absolute variables (such as the maximal value) were slight to yet predominantly substantial (intraclass correlation coefficient [ICC], ICC range: 0.06–0.76) with good to excellent absolute reliability (absolute limits of agreement [ALoA], ALoA range: 0.8 ± 10.2 to 0.7 ± 13.1; coefficient of variation [CV], CV range: 5%–11%). Absolute values encompassing signal amplitudes showed moderate to almost perfect relative reliability (ICC range: 0.51–0.89) and poor to good absolute reliability (ALoA range: −1.3 ± 7.0 to −2.5 ± 15.7; CV range: 15%–32%). Kinetic variables showed moderate to almost perfect relative reliability for most recovery kinetics variables (ICC range: 0.54–0.86) with fair to good absolute reliability (ALoA range: 0.4 ± 12.2 to 3.9 ± 37.9; CV range: 18%–27%). Particularly, kinetic variables showed significant differences between patients and healthy subjects. NIRS is found to be a reliable method for examining muscle tissue oxygenation variables. Given the significant differences in especially recovery kinetics between normal subjects and patients, NIRS may contribute to diagnosing FLIA in endurance athletes.

Hot spot identification method based on Andrews curves: an application on the COVID-19 crisis effects on caregiver distress in neurocognitive disorder

Identifying and locating areas - hot spots - that present high concentration of observations in a high-dimensional data set is crucial in many data processing and analysis methods and techniques, since observations that belong to the same hot spot share information and behave in a similar way. A useful tool towards that aim is the reduction of the data dimensionality and the graphical representation of them. In the present paper, a new method to identify and locate hot spots is proposed, based on the Andrews curves. Simulations results demonstrate the performance of the proposed method, which is also applied to a high-dimensional data set, regarding caregiver distress related to symptoms of people with neurocognitive disorder and to the mental effects of the recent outbreak of the COVID-19 pandemic.

Predictors of arterial stiffness in adolescents and adults with type 1 diabetes: a cross-sectional study

INTRODUCTION

Individuals with type 1 diabetes have increased arterial stiffness compared with age-matched healthy controls. Our aim was to determine which hemodynamic and demographic factors predict arterial stiffness in this population.

RESEARCH DESIGN AND METHODS

Carotid-femoral pulse wave velocity (cfPWV) was examined in 41 young adults and adolescents with type 1 diabetes without microvascular complications. Two ordinary least squares regression analyses were performed to determine multivariate relationships between cfPWV (loge) and (1) age, duration of diabetes, sex, and hemoglobin A1c and (2) augmentation index (AIx), mean arterial pressure, flow-mediated dilation (FMD), and heart rate. We also examined differences in macrovascular outcome measures between sexes.

RESULTS

Age, sex, and FMD provided unique predictive information about cfPWV in these participants with type 1 diabetes. Despite having similar cardiovascular risk factors, men had higher cfPWV compared with women but no differences were observed in other macrovascular outcomes (including FMD and AIx).

CONCLUSIONS

Only age, sex, and FMD were uniquely associated with arterial stiffness in adolescents and adults with uncomplicated type 1 diabetes. Women had less arterial stiffness and similar nitric oxide-dependent endothelial function compared with men. Larger, prospective investigation is warranted to determine the temporal order of and sex differences in arterial dysfunction in type 1 diabetes.

Investigating Optimal Echo Times for Quantitative Susceptibility Mapping of Basal Ganglia Nuclei in the Healthy Brain

BACKGROUND

Quantitative susceptibility mapping (QSM) technique had been used to measure the magnetic susceptibility of brain tissue in clinical practice. However, QSM presented echo-time (TE) dependence, and an appropriate number of echo-times (nTEs) for QSM became more important to obtain the reliable susceptibility value.

OBJECTIVE

The aim of the study was to explore the optimal nTEs for quantitative susceptibility mapping (QSM) measurements of basal ganglia nuclei in the healthy brain.

METHODS

3D multi-echo enhanced gradient recalled echo T2 star weighted angiography (ESWAN) sequence was acquired on a 3.0T MR scanner for QSM analysis. Regions of interests (ROIs) were drawn along the margin of the head of the caudate nucleus (HCN), putamen (Pu) and globus pallidus (GP). The mean susceptibility value and standard deviation of the ROIs were derived from the pixels within each region.

RESULTS

CV analysis demonstrated that TE6, TE8 and TE14 ESWAN sequences presented consistent lower CV value (< 1) for QSM measure of HCN, Pu and GP. ANOVA identified that susceptibility value showed no significant difference between TE6 and TE8 in HCN, Pu and GP (P > 0.05). ICC analysis demonstrated that the susceptibility value of TE6-TE8 had the highest ICC value as compared with TE6-TE14 and TE8-TE14 in HCN, Pu and GP. Combined with the timeefficiency of MRI scanning, TE6 sequence could not only provide the reliable QSM measurement but also short imaging time.

CONCLUSION

The current study identified that the optimal nTEs of ESWAN were 6 TEs (2.9ms ~ 80.9ms) for QSM measurement of basal ganglia nuclei in the healthy brain.

Exploring the effect of capsaicin-induced central sensitization on the upper limb nociceptive withdrawal reflex threshold

The nociceptive withdrawal reflex (NWR) threshold is commonly employed in the lower limb to assess clinical and experimentally induced pain. However, no studies to date have investigated changes in spinal nociception in the upper limb, via the NWR threshold, following experimentally induced central sensitization (CS). We tested the hypothesis that experimentally induced CS of the C5-C6 spinal segment significantly reduces NWR thresholds in muscles of the upper limb. Upper limb NWR thresholds from 20 young, healthy adults were assessed by applying noxious electrical stimuli to the right index finger and recording muscle activity from the biceps brachii (BI), triceps brachii (TRI), flexor carpi ulnaris (WF), and extensor carpi radialis longus (WE) muscles via surface electromyography. Topical cream (either 0.075% capsaicin, or control) was applied to the C5-C6 dermatome of the lateral forearm (50 cm²). NWR thresholds were compared at baseline, and four 10-min intervals after topical application. WF muscle NWR thresholds were significantly reduced in the capsaicin session compared to control, while TRI muscle NWR thresholds were significantly reduced 40 min after capsaicin application only (p < 0.05). There were no significant differences for BI or WE muscle NWR thresholds. We observed poor to moderate test-retest reliability for all upper limb NWR thresholds, a key contributor to the selective reduction in NWR thresholds among muscles. Accordingly, while our findings demonstrate some comparability to previously reported lower limb NWR studies, we concurrently report limitations of the upper limb NWR technique. Further exploration of optimal parameters for upper limb NWR acquisition is needed.

Comparison of body temperature in donkeys using rectal digital, infrared, and mercury-in-glass thermometers during the hot-dry season in a tropical savannah

The study aimed at comparing variations in body temperature values recorded using rectal digital, infrared, and mercury-in-glass thermometers in donkeys during the hot-dry season, prevailing under tropical savannah conditions. Thirty donkeys that served as subjects were divided into three groups of adults, yearlings, and foals. Values of the body temperature of each donkey were recorded bihourly, starting from 06:00 h till 18:00 h, by digital (5-cm depth of insertion), mercury-in-glass (3 cm depth), and infrared thermometers. The values obtained by each type of the thermometer were compared with those recorded using a 15-cm digital probe (Model HI935007, Hanna Instruments, range -50.0 to 150.0°C; accuracy ± 0.2°C) which served as the gold standard. Dry-bulb temperature (34.00 ± 0.50°C), temperature-humidity index (79.65 ± 0.15), and wet-bulb globe temperature (28.00 ± 0.50) index peaked at 14:00 h. The mean body temperatures for rectal probe, digital, mercury-in-glass, and infrared thermometers were 38.35 ± 0.11°C, 37.24 ± 0.04°C, 36.76 ± 0.06°C, and 36.92 ± 0.07°C, respectively. In comparison to the rectal probe, the mean bias for digital (-1.11 ± 0.05°C), mercury-in-glass (-1.59 ± 0.07°C), and infrared thermometers (-1.38 ± 0.07°C) was large. The Passing-Bablok regression plot demonstrated significant deviation from linearity (p < 0.01) when digital, infrared, and mercury-in-glass thermometers were compared to the rectal probe. The area under the curve (AUC) for digital (AUC: 0.7005 ± 0.01 [95%: 0.6853 - 0.7310], infrared (AUC: 0.6711 ± 0.01 [95%: 0.6322 - 0.7100], and mercury-in-glass (AUC: 0.6321 ± 0.01 [95%: 0.6001 - 0.7873] thermometers showed poor accuracy with low sensitivity. In conclusion, the use of digital, mercury-in-glass, and infrared thermometers in recording body temperature in donkeys during the hot-dry season underestimated the values. Their use in measuring body temperature may result in wrong diagnosis, and compromise the control of hyperthermia and diseases associated with thermoregulatory impairments in donkeys.

Selective effects of serotonin on choices to gather more information

BACKGROUND

Gathering and evaluating information leads to better decisions, but often at cost. The balance between information seeking and exploitation features in neurodevelopmental, mood, psychotic and substance-related disorders. Serotonin's role has been highlighted by experimental reduction of its precursor, tryptophan.

AIMS

We tested the boundaries and applicability of this role by asking whether changes to information sampling would be observed following acute doses of serotonergic and catecholaminergic clinical treatments. We used a variant of the Information Sampling Task (IST) to measure how much information a person requires before they make a decision. This task allows participants to sample information until satisfied to make a choice.

METHODS

In separate double-blind placebo-controlled experiments, we tested 27 healthy participants on/off 20 mg of the serotonin reuptake inhibitor (SRI) citalopram, and 22 participants on/off 40 mg of the noradrenergic reuptake inhibitor atomoxetine. The IST variant minimised effects of temporal impulsivity and loss aversion. Analyses used a variety of participant prior expectations of sampling spaces in the IST, including a new prior that accounts for learning of likely states across trials. We analysed behaviour by a new method that also accounts for baseline individual differences of risk preference.

RESULTS

Baseline preferences demonstrated risk aversion. Citalopram decreased the expected utility of choices and probability of being correct based on informational content of samples collected, suggesting participants collected less useful information before making a choice. Atomoxetine did not influence information seeking.

CONCLUSION

Acute changes of serotonin activity by way of a single SRI dose alter information-seeking behaviour.

Measuring tibial hemodynamics and metabolism at rest and after exercise using near-infrared spectroscopy

The bone vascular system is important, yet evaluation of bone hemodynamics is difficult and expensive. This study evaluated the utility and reliability of near-infrared spectroscopy (NIRS), a portable and relatively inexpensive device, in measuring tibial hemodynamics and metabolic rate. Eleven participants were tested twice using post-occlusive reactive hyperemia technique with the NIRS probes placed on the tibia and the medial gastrocnemius (MG) muscle. Measurements were made at rest and after 2 levels of plantarflexion exercise. The difference between oxygenated and deoxygenated hemoglobin signal could be reliably measured with small coefficients of variation (CV; range 5.7-9.8%) and high intraclass correlation coefficients (ICC; range 0.73-0.91). Deoxygenated hemoglobin rate of change, a potential marker for bone metabolism, also showed good reliability (CV range 7.5-9.8%, ICC range 0.90-0.93). The tibia was characterized with a much slower metabolic rate compared with MG (p < 0.001). While exercise significantly increased MG metabolic rate in a dose-dependent manner (all p < 0.05), no changes were observed for the tibia after exercise compared with rest (all p > 0.05). NIRS is a suitable tool for monitoring hemodynamics and metabolism in the tibia. However, the local muscle exercise protocol utilized in the current study did not influence bone hemodynamics or metabolic rate. Novelty: NIRS can be used to monitor tibial hemodynamics and metabolism with good reliability. Short-duration local muscle exercise increased metabolic rate in muscle but not in bone. High level of loading and exercise volume may be needed to elicit measurable metabolic changes in bone.

Advancements in the Protocol for Rate of Force Development/Relaxation Scaling Factor Evaluation

Brief submaximal actions are important for wide range of functional movements. Until now, rate of force development and relaxation scaling factor (RFD-SF and RFR-SF) have been used for neuromuscular assessment using 100-120 isometric pulses which requires a high level of attention from the participant and may be influenced by physiological and/or psychological fatigue. All previous studies have been conducted on a smaller number of participants which calls into question the eligibility of some of the outcome measures reported to date. Our aims were: (1) to find the smallest number of rapid isometric force pulses at different force amplitudes is still valid and reliable for RFD-SF slope (k _{R F D -SF}) and RFR-SF slope (k _RFR-SF ) calculation, (2) to introduce a new outcome measure - theoretical peak of rate of force development/relaxation (TP _RFD and TP _RFR ) and (3) to investigate differences and associations between k _RFD-SF and k _RFR-SF . A cross-sectional study was conducted on a group of young healthy participants; 40 in the reliability study and 336 in the comparison/association study. We investigated the smallest number of rapid isometric pulses for knee extensors that still provides excellent reliability of the calculated k _RFD-SF and k _RFR-SF (ICC₂,₁ ≥ 0.95, CV < 5%). Our results showed excellent reliability of the reduced protocol when 36 pulses (nine for each of the four intensity ranges) were used for the calculations of k _RFD-SF and k _RFR-SF . We confirmed the negligibility of the y-intercepts and confirmed the reliability of the newly introduced TP _RFD and TP _RFR . Large negative associations were found between k _RFD-SF and k _RFR-SF (r = 0.502, p < 0.001), while comparison of the absolute values showed a significantly higher k _RFD-SF (8.86 ± 1.0/s) compared to k _RFR-SF (8.03 ± 1.3/s) (p < 0.001). The advantage of the reduced protocol (4 intensities × 9 pulses = 36 pulses) is the shorter assessment time and the reduction of possible influence of fatigue. In addition, the introduction of TP _RFD and TP _RFR as an outcome measure provides valuable information about the participant's maximal theoretical RFD/RFR capacity. This can be useful for the assessment of maximal capacity in people with various impairments or pain problems.

Insulin increases central aortic stiffness in response to hyperglycemia in healthy humans: A randomized four-arm study

INTRODUCTION

Increasing arterial stiffness is a feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Multiple studies demonstrate divergence of carotid-femoral pulse wave velocity and augmentation index in persons with diabetes mellitus, though mechanisms responsible for this are unclear.

MATERIALS AND METHODS

We tested the effect of acutely and independently increasing plasma glucose, plasma insulin, or both on hemodynamic function and markers of arterial stiffness (including carotid-femoral pulse wave velocity, augmentation index, forward and backward wave reflection amplitude, and wave reflection magnitude) in a four-arm, randomized study of healthy young adults.

RESULTS

Carotid-femoral pulse wave velocity increased only during hyperglycemic-hyperinsulinemia (+0.36 m/s; p = 0.032), while other markers of arterial stiffness did not change (all p > 0.05). Heart rate (+3.62 bpm; p = 0.009), mean arterial pressure (+4.14 mmHg; p = 0.033), central diastolic blood pressure (+4.16 mmHg; p = 0.038), and peripheral diastolic blood pressure (+4.09 mmHg; p = 0.044) also significantly increased during hyperglycemic-hyperinsulinemia.

CONCLUSIONS

Hyperglycemic-hyperinsulinemia acutely increased cfPWV, heart rate, mean arterial pressure, and diastolic blood pressure in healthy humans, perhaps reflecting enhanced sympathetic tone. Whether repeated bouts of hyperglycemia with hyperinsulinemia contribute to chronically-enhanced arterial stiffness remains unknown.

Improvement of caffeic acid biotransformation into para-hydroxybenzoic acid by Candida albicans CI-24 via gamma irradiation and model-based optimization

Para-hydroxybenzoic acid (PHBA) has great potential in biological applications due to its putative antiviral activity against SARS-CoV-2 and its antimicrobial activity in the face of the radically increasing number of multidrug-resistant pathogens. This is in addition to its antimutagenic, anti-inflammatory, antioxidant, hypoglycemic, antiestrogenic, and antiplatelet aggregating activities. In this study, an approximate sixfold increase in the production of PHBA was achieved via biotransformation of caffeic acid by Candida albicans. The improvement was performed in two steps: first, through mutation by gamma irradiation (5 KGy dose), resulting in the recovery of a mutant (CI-24), which produced approximately triple the amount of PHBA produced by the wild-type isolate. Then, biotransformation by this mutant was further optimized via response surface methodology model-based optimization. The maximum PHBA production (7.47 mg/mL) was obtained in a fermentation medium composed of 1% w/v yeast extract as a nitrogen source, with an initial pH of 6.6, incubated at 28 °C at an agitation rate of 250 rpm. To further enhance the performance and economics of the process, cells of the CI-24 mutant were immobilized in calcium alginate beads and could retain an equivalent biotransformation capacity after three successive biotransformation cycles.

Acute hyperglycaemia enhances both vascular endothelial function and cardiac and skeletal muscle microvascular function in healthy humans

KEY POINTS

Multiple clinical studies report that acute hyperglycaemia (induced by mixed meal or oral glucose) decreases arterial vascular function in healthy humans. Feeding, however, impacts autonomic output, blood pressure, and insulin and incretin secretion, which may themselves alter vascular function. No prior studies have examined the effect of acute hyperglycaemia on both macro- and microvascular function while controlling plasma insulin concentrations. Macrovascular and microvascular functional responses to euglycaemia and hyperglycaemia were compared. Octreotide was infused throughout both protocols to prevent endogenous insulin release. Acute hyperglycaemia (induced by intravenous glucose) enhanced brachial artery flow-mediated dilatation, increased skeletal muscle microvascular blood volume and flow, and expanded cardiac muscle microvascular blood volume. Compared to other published findings, the results suggest that vascular responses to acute hyperglycaemia differ based on the study population (i.e. normal weight vs. overweight/obese) and/or glucose delivery method (i.e. intravenous vs. oral glucose).

ABSTRACT

High glucose concentrations acutely provoke endothelial cell oxidative stress and are suggested to trigger diabetes-related macro- and microvascular injury in humans. Multiple clinical studies report that acute hyperglycaemia (induced by mixed meal or oral glucose) decreases arterial vascular function in healthy humans. Feeding, however, impacts autonomic output, blood pressure, and insulin and incretin secretion, which may each independently alter vascular function and obscure the effect of acute hyperglycaemia per se. Surprisingly, no studies have examined the acute effects of intravenous glucose-induced hyperglycaemia on both macro- and microvascular function while controlling plasma insulin concentrations. In this randomized study of healthy young adults, we compared macrovascular (i.e. brachial artery flow-mediated dilatation, carotid-femoral pulse wave velocity and post-ischaemic brachial artery flow velocity) and microvascular (heart and skeletal muscle perfusion by contrast-enhanced ultrasound) functional responses to euglycaemia and hyperglycaemia. Octreotide was infused throughout both protocols to prevent endogenous insulin release. Acute intravenous glucose-induced hyperglycaemia enhanced brachial artery flow-mediated dilatation (P = 0.004), increased skeletal muscle microvascular blood volume and flow (P = 0.001), and expanded cardiac muscle microvascular blood volume (P = 0.014). No measure of vascular function changed during octreotide-maintained euglycaemia. Our findings suggest that unlike meal-provoked acute hyperglycaemia, 4 h of intravenous glucose-induced hyperglycaemia enhances brachial artery flow-mediated dilatation, provokes cardiac and skeletal muscle microvascular function, and does not impair aortic stiffness. Previous findings of acute large artery vascular dysfunction during oral glucose or mixed meal ingestion may be due to differences in study populations and meal-induced humoral or neural factors beyond hyperglycaemia per se. (ClinicalTrials.gov number NCT03520569.).

Intra-rater reliability of transversus abdominis measurement by a novice examiner: Comparison of "freehand" to "probe force device" method of real-time ultrasound imaging

A "free hand" real-time-ultrasound method is commonly applied to measure transversus abdominis. Potentially, this increases transversus abdominis measurement error due to uncontrolled variability in probe to skin force, inclination, and roll, particularly for novice examiners. This single-group repeated-measures reliability study compared the intra-rater reliability of transversus abdominis thickness and activation measurement by a novice examiner between free hand and a standardized probe force device method. The examiner captured ultrasound videos of transversus abdominis in a single session in healthy participants (n =  33). Free hand ultrasound featured uncontrolled probe force, inclination, and roll, while probe force device method ultrasound standardized these parameters. Images of transversus abdominis at rest and contracted were measured and transversus abdominis activation calculated. Intraclass correlation coefficient, coefficient of variation, standard error of measurement, and worthwhile differences were calculated. The probe force device method resulted in greater reliability (intraclass correlation coefficient = 0.75-0.96) and lower measurement error (coefficient of variation = 8.89-28.7%) compared to free hand (intraclass correlation coefficient = 0.63-0.93; coefficient of variation = 6.52-29.4%). Reliability was good for all measurements except free hand TrA-C, which was moderate. TrA-C had the lowest reliability, followed by contracted thickness of the transverse abdominis, with resting thickness of the transverse abdominis being highest. Worthwhile differences were lower using a probe force device method versus free hand for resting thickness of the transverse abdominis and contracted thickness of the transverse abdominis and similar for TrA-C. Standardization using probe force device method ultrasound to measure transversus abdominis improved intra-rater reliability in a novice examiner. Use of a probe force device method is recommended to improve reliability through reduced sources of measurement error. Probe force device method intra- and inter-rater reliability in examiners of varying experience, in clinical populations, and to visualize other structures merits exploration.

Reliability and Feasibility of Extended Field of View Ultrasound Imaging Techniques for Measuring the Limb Muscle Cross-Sectional Area

Purpose: Panoramic ultrasound imaging (pUSI) is an extended field of view (FOV) imaging technique that enables visualization of larger muscles; however, it is not available in all ultrasound systems. Using an acoustic standoff pad that is compatible with any ultrasound system may be an alternative method to increase FOV, but it has not been used to evaluate limb muscles. The purpose of this study was to evaluate the reliability and feasibility of using pUSI and an acoustic standoff pad to measure the limb muscle cross-sectional area (mCSA). Method: A cross-sectional study was conducted. Using pUSI and an acoustic standoff pad, we obtained B-mode ultrasound images of the rectus femoris, biceps brachii, and lateral gastrocnemius muscles of 26 healthy participants on two occasions 7-10 days apart. The agreement between the two methods was determined using intra-class correlation coefficients (ICCs) and Bland-Altman plots. Test-retest reliability was assessed using ICCs and standard error of measurement (SEM). The feasibility of acquiring and analyzing the images was evaluated using a Likert scale. Results: The acoustic standoff pad and pUSI demonstrated strong agreement (ICC_[3,3] > 0.85); however, the mCSAs were different (p < 0.05). Test-retest reliability for each technique was high for all muscles (ICC_[3,3] > 0.85; SEM = 0.6-1.5 cm²). Image acquisition was highly feasible, but there were some limitations in analyzing the images. Conclusions: pUSI and an acoustic standoff pad are two reliable techniques for measuring mCSA, but the measurements are not directly comparable. Future studies should evaluate the accuracy of the acoustic standoff pad compared with gold-standard methods.

Production, characterization and bioinformatics analysis of L-asparaginase from a new Stenotrophomonas maltophilia EMCC2297 soil isolate

An exhaustive screening program was applied for scoring a promising l-asparaginase producing-isolate. The recovered isolate was identified biochemically and molecularly and its l-asparaginase productivity was optimized experimentally and by Response Surface Methodology. The produced enzyme was characterized experimentally for its catalytic properties and by bioinformatics analysis for its immunogenicity. The promising l-asparaginase producing-isolate was selected from 722 recovered isolates and identified as Stenotrophomonas maltophilia and deposited at Microbiological Resources Centre (Cairo Mircen) under the code EMCC2297. This isolate produces both intracellular (type I) and extracellular (type II) l-asparaginases with about 4.7 fold higher extracellular l-asparaginase productivity. Bioinformatics analysis revealed clustering of Stenotrophomonas maltophilial-asparaginase with those of Pseudomonas species and considerable closeness to the two commercially available l-asparaginases of E. coli and Erwinia chrysanthemi. Fourteen antigenic regions are predicted for Stenotrophomonas maltophilial-asparaginase versus 16 and 18 antigenic regions for the Erwinia chrysanthemi and E. colil-asparaginases. Type II l-asparaginase productivity of the test isolate reached 4.7 IU/ml/h and exhibited maximum activity with no metal ion requirement at 37 °C, pH 8.6, 40 mM asparagine concentration and could tolerate NaCl concentration up to 500 mM and retain residual activity of 55% at 70 °C after half an hour treatment period. Application both of random mutation by gamma irradiation and Response Surface Methodology that determined 38.11 °C, 6.89 pH, 19.85 h and 179.15 rpm as optimum process parameters could improve the isolate l-asparaginase productivity. Maximum production of about 8 IU/ml/h was obtained with 0.4% dextrose, 0.1% yeast extract and 10 mM magnesium sulphate. In conclusion l-asparaginase of the recovered Stenotrophomonas maltophilia EMCC2297 isolate has characters enabling it to be used for medical therapeutic application.

Hospital variation in cost of childbirth and contributing factors: a cross-sectional study

OBJECTIVE

To examine hospital variation in cost of childbirth hospitalisations and identify factors that contribute to the variation.

DESIGN

Cross-sectional analysis of linked birth certificate and hospital discharge data.

SETTING

Two hundred and twenty hospitals in California delivering ≥ 100 births per year.

POPULATION

A total of 405 908 nulliparous term singleton vertex births during 2010-2012.

METHODS

Cost of childbirth hospitalisations was compared across hospitals after accounting for differences in patient clinical risk factors. Relative contributions of patient sociodemographic, obstetric intervention, birth attendant and institutional characteristics to variation in cost were assessed by further adjusting for these factors in hierarchical generalised linear models.

MAIN OUTCOME MEASURES

Cost of childbirth hospitalisation.

RESULTS

Median risk-standardised cost of childbirth was $7149 among the hospitals (10^th -90th percentile range: $4760-$10,644). Maternal sociodemographic characteristics and type of birth attendant did not explain hospital variation in cost. Adjustment for obstetric interventions overall reduced within-hospital variance by 15.8% (P < 0.001), while adjusting for caesarean delivery alone reduced within-hospital variance by 14.4% (P < 0.001). However, obstetric interventions did not explain between-hospital variation in cost. In contrast, adjustment for institutional characteristics reduced between-hospital variance by 30.3% (P = 0.002). Hospital type of ownership, teaching/urban-rural status, neonatal care capacity and geographic region were most impactful. Risk-standardised cost was positively correlated with risk-standardised rate of severe newborn morbidities (correlation coefficient 0.22, P = 0.001), but not associated with risk-standardised rate of severe maternal morbidities.

CONCLUSIONS

Cost of childbirth hospitalisations varied widely among hospitals in California. Institutional characteristics significantly contributed to this variation. Higher-cost hospitals did not have better outcomes, suggesting potential opportunities to enhance value in care.

TWEETABLE ABSTRACT

Hospitals vary in cost of childbirth. Institutional characteristics significantly contribute to the variation.

Neck Muscle EMG-Force Relationship and Its Reliability During Isometric Contractions

BACKGROUND

Susceptible to injury, the neck is subject to scientific investigations, frequently aiming to elucidate possible injury mechanisms via surface electromyography (EMG) by indirectly estimating cervical loads. Accurate estimation requires that the EMG-force relationship is known and that its measurement error is quantified. Hence, this study examined the relationship between EMG and isometric force amplitude of the anterior neck (AN), the upper posterior neck (UPN), and the lower posterior neck (LPN) and then assessed the relationships' test-retest reliability across force-percentiles within and between days.

METHODS

EMG and force data were sampled from 18 participants conducting randomly ordered muscle contractions at 5-90% of maximal voluntary force during three trials over 2 days. EMG-force relationships were modeled with general linear mixed-effects regression. Overall fitted lines' between-trial discrepancies were evaluated. Finally, the reliability of participants' fitted regression lines was quantified by an intraclass correlation coefficient (ICC) and the standard error of measurement (SEM).

RESULTS

A rectilinear model had the best fit for AN while positively oriented quadratic models had the best fit for UPN and LPN, with mean adjusted conditional coefficients of determination and root mean square errors of 0.97-0.98 and 4-5%, respectively. Overall EMG-force relationships displayed a maximum 6% between-trial discrepancy and over 20% of maximal force, and mean ICC was above 0.79 within day and 0.27-0.61 between days across areas. Corresponding SEM was below 12% both within and between days across areas, excluding UPN between days, for which SEM was higher.

CONCLUSIONS

EMG-force relationships were elucidated for three neck areas, and provided models allow inferences to be drawn from EMG to force on a group level. Reliability of EMG-force relationship models was higher within than between days, but typically acceptable for all but the lowest contraction intensities, and enables adjustment for measurement imprecision in future studies.

Variation among conventional cultivars could be used as a criterion for environmental safety assessment of Bt rice on nontarget arthropods

The current difficulty facing risk evaluations of Bacillus thuringiensis (Bt) crops on nontarget arthropods (NTAs) is the lack of criteria for determining what represents unacceptable risk. In this study, we investigated the biological parameters in the laboratory and field population abundance of Nilaparvata lugens (Hemiptera: Delphacidae) on two Bt rice lines and the non-Bt parent, together with 14 other conventional rice cultivars. Significant difference were found in nymphal duration and fecundity of N. lugens fed on Bt rice KMD2, as well as field population density on 12 October, compared with non-Bt parent. However, compared with the variation among conventional rice cultivars, the variation of each parameter between Bt rice and the non-Bt parent was much smaller, which can be easily seen from low-high bar graphs and also the coefficient of variation value (C.V). The variation among conventional cultivars is proposed to be used as a criterion for the safety assessment of Bt rice on NTAs, particularly when statistically significant differences in several parameters are found between Bt rice and its non-Bt parent. Coefficient of variation is suggested as a promising parameter for ecological risk judgement of IRGM rice on NTAs.

Bar velocities capable of optimising the muscle power in strength-power exercises

This study aimed at testing whether there are mean propulsive velocities (MPVs) capable of maximising the mean propulsive power (MPP) during the execution of bench press (BP), bench throw (BT), half squat (HS) and jump squat (JS). Additionally, we assessed the differences in MPP/MPV between ballistic and traditional exercises. Seventeen male rugby sevens players performed MPP tests in BP, BT, HS and JS and maximum isometric force (MIF) tests in HS and BP. The JS presented higher MPP (977.4 ± 156.2 W) than the HS (897.9 ± 157.7 W) (P < 0.05); the BP (743.4 ± 100.1 W) presented higher MPP than the BT (697.8 ± 70.4 W) (P < 0.05). Ballistic exercises presented higher optimum MPV (JS = 1.02 ± 0.07 m·s^-1; BT = 1.67 ± 0.15 m·s^-1) than traditional exercises (HS = 0.93 ± 0.08 m·s^-1; BP = 1.40 ± 0.13 m·s^-1) (P < 0.05). The optimum MPP in the JS, BT, HS and BP occurred at 28.2 ± 5.79, 23.3 ± 4.24, 32.4 ± 9.46 and 27.7 ± 5.33% of the MIF, respectively. The coefficient of variation (CV) of MPV at optimum MPP ranged from 7.4% to 9.7%, while the CV of %MIF ranged from 18.2% to 29.2%. The MPV is a more precise indicator of the optimum loads than the percentages of MIF due to its low inter-subject variability as expressed by CV. Therefore, MPV can be used to determine the optimum power load in the four investigated exercises.

Consistency of strength curves for determining maximal effort production during isokinetic knee testing of anterior cruciate ligament-deficient patients

The purpose of this investigation was to attempt to establish decision rules for determining maximal effort production during isokinetic strength testing of unilateral anterior cruciate ligament-deficient patients based on the degree of strength curve consistency within a set. Thirty-three participants performed six bilateral knee extension and flexion exertions at maximal effort and at 80% of perceived maximum at testing velocities of 60 and 180°s(-1). Within-set consistency was quantified by computation of the variance ratio across strength curves. Tolerance interval-based cutoff scores covering 99% of the population were calculated for declaring efforts as being maximal or not at confidence levels of 90%, 95%, and 99%. The sensitivity percentages attained for the injured knee for both testing velocities ranged between 9.1% and 27.2%, while specificity percentages ranged between 84.8% and 100%. For the non-injured knee, sensitivity values for both testing velocities ranged between 21.2% and 45.0%, while specificity percentages ranged between 97.0% and 100%. The developed decision rules do not effectively discriminate on an individual patient basis between maximal and non-maximal isokinetic knee musculature efforts. Further research is needed for development of methods that would enable to ascertain maximal effort production in this patient population during knee muscle strength testing.

An assessment of air pollutant exposure methods in Mexico City, Mexico

Geostatistical interpolation methods to estimate individual exposure to outdoor air pollutants can be used in pregnancy cohorts where personal exposure data are not collected. Our objectives were to a) develop four assessment methods (citywide average (CWA); nearest monitor (NM); inverse distance weighting (IDW); and ordinary Kriging (OK)), and b) compare daily metrics and cross-validations of interpolation models. We obtained 2008 hourly data from Mexico City's outdoor air monitoring network for PM10, PM2.5, O3, CO, NO2, and SO2 and constructed daily exposure metrics for 1,000 simulated individual locations across five populated geographic zones. Descriptive statistics from all methods were calculated for dry and wet seasons, and by zone. We also evaluated IDW and OK methods' ability to predict measured concentrations at monitors using cross validation and a coefficient of variation (COV). All methods were performed using SAS 9.3, except ordinary Kriging which was modeled using R's gstat package. Overall, mean concentrations and standard deviations were similar among the different methods for each pollutant. Correlations between methods were generally high (r=0.77 to 0.99). However, ranges of estimated concentrations determined by NM, IDW, and OK were wider than the ranges for CWA. Root mean square errors for OK were consistently equal to or lower than for the IDW method. OK standard errors varied considerably between pollutants and the computed COVs ranged from 0.46 (least error) for SO2 and PM10 to 3.91 (most error) for PM2.5. OK predicted concentrations measured at the monitors better than IDW and NM. Given the similarity in results for the exposure methods, OK is preferred because this method alone provides predicted standard errors which can be incorporated in statistical models. The daily estimated exposures calculated using these different exposure methods provide flexibility to evaluate multiple windows of exposure during pregnancy, not just trimester or pregnancy-long exposures.

IMPLICATIONS

Many studies evaluating associations between outdoor air pollution and adverse pregnancy outcomes rely on outdoor air pollution monitoring data linked to information gathered from large birth registries, and often lack residence location information needed to estimate individual exposure. This study simulated 1,000 residential locations to evaluate four air pollution exposure assessment methods, and describes possible exposure misclassification from using spatial averaging versus geostatistical interpolation models. An implication of this work is that policies to reduce air pollution and exposure among pregnant women based on epidemiologic literature should take into account possible error in estimates of effect when spatial averages alone are evaluated.