What to use to express the variability of data: Standard deviation or standard error of mean?

Mutations in LIFR rewire the JAK/STAT signaling pathway: A study unveiling mechanistic details of Stüve-Wiedemann syndrome

Stüve-Wiedemann syndrome (SWS), a rare autosomal recessive disorder, characterized by diminutive size, curvature of the elongated bones, bent fingers, episodes of heightened body temperature, respiratory distress or periods of breath-holding, and challenges with feeding, especially causes fatality in infants. SWS is an outcome of potential missense mutations in the leukemia inhibitory factor receptor gene reflected as numerous amino acid mutations at protein level. Employing in silico tools and techniques like mutational screening with Pred_MutHTP, I-Mutant2.0, PANTHER.db, PolyPhen, to classify mutations as deleterious/destabilizing, in conjunction with experimental data analysis, P136A and S279P emerged as 'effect'-causing mutations. Pre-existing knowledge suggests, SWS progression is effectuated conformationally altered and dysfunctional LIFR, unable to bind to LIF and further form the LIF/LIFR/gp130 signalling complex. To gain functional insights into the effect of the said mutations on the wild type protein, an all-atom, explicit, solvent molecular dynamics simulation was performed following docking approaches. Consequently, referring to the RMSD, RMSF, protein dynamic network analysis, energy landscape plots and domain motion analysis, it was revealed that unbound LIFR_WT was more prone to LIF binding as usual whereas the mutants exhibited considerable domain closure to inhibit LIF binding. We conducted binding affinity analysis via MM/GBSA and dissociation constant estimation after LIFR-LIF docking and found the WT_complex to be more stable and compact as a whole when compared to the flexible mutant complexes thus being associated with SWS. Our study offers a route for understanding molecular level implications upon LIFR mutations which opens an avenue for therapeutic interventions.

The role of the NLRP3 inflammasome in atherosclerotic disease: Systematic review and meta-analysis

Atherosclerosis is a chronic, progressive cardiovascular disease characterized by cholesterol deposition within blood vessel walls. Recent literature has suggested that the NLRP3 [NOD (nucleotide oligomerization domain)-, LRR (leucine-rich repeat)-, and PYD (pyrin domain)-containing protein 3] inflammasome is a key mediator in the development, progression, and destabilization of atherosclerotic plaques. This review aims to evaluate the current literature on the role of NLRP3 in human atherosclerosis. This systematic review was registered on the PROSPERO database (ID = CRD42022340039) and involved the search of a total of 8 databases. Records were screened in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 20 studies were included and quality assessed using the NIH: NHLBI tool. Six were eligible for meta-analysis using RevMan 5.4.1. We identified 20 relevant articles representing 3388 participants. NLRP3 mRNA levels and downstream cytokines, interleukin (IL)-1β and IL-18 were found to be associated with atherosclerotic disease. Fold changes in NLRP3 mRNA levels were most strongly associated with high risk atherosclerotic disease, compared to controls [0.84 (95 % CI: 0.41-1.28)]. IL-1β mRNA fold change was more robustly associated with high-risk atherosclerotic disease [0.61 (95 % CI: 0.10-1.13)] than IL-18 [0.47 (95 % CI: 0.02-0.91)]. NLRP3, IL-1β, and IL-18 are associated with high-risk atherosclerotic disease. However, given the scope of this review, the role of this inflammasome and its cytokine counterparts in acting as prognosticators of coronary artery disease severity is unclear. Several upstream activators such as cholesterol crystals are involved in the canonical or non-canonical activation of the NLRP3 inflammasome and its downstream cytokines. These findings highlight the necessity for further research to delineate the exact mechanisms of NLRP3 inflammasome activation and potential drug targets.

Integration of Proteomic and Metabolomic Data Reveals the Lipid Metabolism Disorder in the Liver of Rats Exposed to Simulated Microgravity

Long-term exposure to microgravity is considered to cause liver lipid accumulation, thereby increasing the risk of non-alcoholic fatty liver disease (NAFLD) among astronauts. However, the reasons for this persistence of symptoms remain insufficiently investigated. In this study, we used tandem mass tag (TMT)-based quantitative proteomics techniques, as well as non-targeted metabolomics techniques based on liquid chromatography-tandem mass spectrometry (LC-MS/MS), to comprehensively analyse the relative expression levels of proteins and the abundance of metabolites associated with lipid accumulation in rat liver tissues under simulated microgravity conditions. The differential analysis revealed 63 proteins and 150 metabolites between the simulated microgravity group and the control group. By integrating differentially expressed proteins and metabolites and performing pathway enrichment analysis, we revealed the dysregulation of major metabolic pathways under simulated microgravity conditions, including the biosynthesis of unsaturated fatty acids, linoleic acid metabolism, steroid hormone biosynthesis and butanoate metabolism, indicating disrupted liver metabolism in rats due to weightlessness. Finally, we examined differentially expressed proteins associated with lipid metabolism in the liver of rats exposed to stimulated microgravity. These findings contribute to identifying the key molecules affected by microgravity and could guide the design of rational nutritional or pharmacological countermeasures for astronauts.

Systematic review for optimizing sample size in dairy cow methane emission studies in temperate regions: a comprehensive methodological approach

This research introduces a systematic framework for calculating sample size in studies focusing on enteric methane (CH4, g/kg of DMI) yield reduction in dairy cows. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search across the Web of Science, Scopus, and PubMed Central databases for studies published from 2012 to 2023. The inclusion criteria were: studies reporting CH4 yield and its variability in dairy cows, employing specific experimental designs (Latin Square Design (LSD), Crossover Design, Randomized Complete Block Design (RCBD), and Repeated Measures Design) and measurement methods (Open-circuit respirometry chambers (RC), the GreenFeed system, and the sulfur hexafluoride tracer technique), conducted in Canada, the United States and Europe. A total of 150 studies, which included 177 reports, met our criteria and were included in the database. Our methodology for using the database for sample size calculations began by defining 6 CH4 yield reduction levels (5, 10, 15, 20, 30, and 50%). Utilizing an adjusted Cohen's f formula and a power analysis we calculated the sample sizes required for these reductions in balanced LSD and RCBD reports from studies involving 3 or 4 treatments. The results indicate that within-subject studies (i.e., LSD) require smaller sample sizes to detect CH4 yield reductions compared with between-subject studies (i.e., RCBD). Although experiments using RC typically require fewer individuals due to their higher accuracy, our results demonstrate that this expected advantage is not evident in reports from RCBD studies with 4 treatments. A key innovation of this research is the development of a web-based tool that simplifies the process of sample size calculation (samplesizecalculator.ucdavis.edu). Developed using Python, this tool leverages the extensive database to provide tailored sample size recommendations for specific experimental scenarios. It ensures that experiments are adequately powered to detect meaningful differences in CH4 emissions, thereby contributing to the scientific rigor of studies in this critical area of environmental and agricultural research. With its user-friendly interface and robust backend calculations, this tool represents a significant advancement in the methodology for planning and executing CH4 emission studies in dairy cows, aligning with global efforts toward sustainable agricultural practices and environmental conservation.

The Standard Error/Standard Deviation Mix-Up: Potential Impacts on Meta-Analyses in Sports Medicine

BACKGROUND

A recent review found that 45% of meta-analyses included statistical errors, of which, the most common was the calculation of effect sizes based on standard error (SE) rather than standard deviation (SD) [the SE/SD mix-up].

OBJECTIVES

The first aim of this study was to assess the impact of the SE/SD mix-up on the results of one highly cited meta-analysis. Our second aim was to identify one potential source of the SE/SD mix-up, by assessing how often SE is reported as a measure of sample variability in randomised controlled trials in sports medicine.

METHODS

We checked for potential SE/SD mix-ups in a 2015 meta-analysis of randomised controlled trials reporting the effects of recreational football interventions on aerobic fitness in adults. We corrected effect sizes affected by SE/SD mix-ups and re-analysed the data according to the original methodology. We compared pooled estimates of effect sizes from our re-analysis of corrected values with those of the original study. To assess how often SE was reported instead of SD as a measure of sample variance, we text mined results of randomised controlled trials from seven sports medicine journals and reported the proportion reporting of SE versus SD.

RESULTS

We identified potential SE/SD mix-ups in 9/16 effect sizes included in the meta-analysis describing the effects of football-based interventions versus non-exercise control. The published effect size was standardised mean difference (SMD) = 1.46 (95% confidence interval [CI] 0.91, 2.01). After correcting for SE/SD mix-ups, our re-analysis produced a smaller pooled estimate (SMD = 0.54 [95% CI 0.37, 0.71]). The original pooled estimate for trials comparing football versus running interventions was SMD = 0.68 (95% CI 0.06, 1.4). After correcting for SE/SD mix-ups and re-analysis, the effect was no longer statistically significant (SMD = 0.20 [95% CI - 0.10, 0.49)]). We found that 19.3% of randomised controlled trials reported SE rather than SD to describe sample variability. The relative frequency of the practice ranged from 0 to 25% across the seven journals sampled.

CONCLUSIONS

We found the SE/SD mix-up had inflated estimates for the effects of football on aerobic fitness. Meta-analysts should be vigilant to avoid miscalculating effect sizes. Authors, reviewers and editors should avoid and discourage (respectively) the practice of reporting SE as a measure of sample variability in sports medicine research.

The Efficacy of the Addition of tDCS and TENS to an Education and Exercise Program in Subjects with Knee Osteoarthritis: A Randomized Controlled Trial

Knee osteoarthritis (KOA) has a significant impact on patients' quality of life. This study aimed to assess the effectiveness of integrating transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) into an education and exercise program with the aim of decreasing pain and improving physical function in KOA. A randomized controlled trial with 65 KOA patients was conducted. The subjects were assigned to one of the following three groups: education and active exercise plus (1) double active tDCS and TENS, (2) active tDCS and sham TENS, and (3) double sham tDCS and TENS. Sessions were conducted over a 20 min period, whilst data on pain, chronic pain clinical variables, and physical function were collected. Although all groups showed improvement in pain-related symptoms in the short and medium term, the addition of tDCS and/or TENS did not significantly enhance the benefits of the exercise and education program. These findings suggest that an education and active exercise program in the treatment of KOA has a positive effect on pain, with or without the addition of tDCS and/or TENS.

Citizenship status and career self-efficacy: An intersectional study of biomedical trainees in the United States

This study examines the intersectional role of citizenship and gender with career self-efficacy amongst 10,803 doctoral and postdoctoral trainees in US universities. These biomedical trainees completed surveys administered by 17 US institutions that participated in the National Institutes of Health Broadening Experiences in Scientific Training (NIH BEST) Programs. Findings indicate that career self-efficacy of non-citizen trainees is significantly lower than that of US citizen trainees. While lower career efficacy was observed in women compared with men, it was even lower for non-citizen female trainees. Results suggest that specific career interests may be related to career self-efficacy. Relative to US citizen trainees, both male and female non-citizen trainees showed higher interest in pursuing a career as an academic research investigator. In comparison with non-citizen female trainees and citizen trainees of all genders, non-citizen male trainees expressed the highest interest in research-intensive (and especially principal investigator) careers. The authors discuss potential causes for these results and offer recommendations for increasing trainee career self-efficacy which can be incorporated into graduate and postdoctoral training.

Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies

Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.

From a glimpse into the key aspects of calibration and correlation to their practical considerations in chemical analysis

In this tutorial review, we provide a guiding reference on the good practice in building calibration and correlation experiments, and we explain how the results should be evaluated and interpreted. The review centers on calibration experiments where the relationship between response and concentration is expected to be linear, although certain of the described principles of good practice can be applied to non-linear systems, as well. Furthermore, it gives prominence to the meaning and correct interpretation of some of the statistical terms commonly associated with calibration and regression. To reach a mutual understanding in this significant field, we present, through a practical example, a step-by-step procedure, which deals with typical challenges related to linearity and outlier assessment, calculation of the associated error of the predicted concentration, and limits of detection. The utilization of regression lines to compare analytical methods is also elaborated. The results of regression and correlation data are acquired by implementing the Excel spreadsheet of Microsoft, being perhaps one of the most widely used user-friendly software in education and research.

Unveiling the structural and functional consequences of the p.D109G pathogenic mutation in human αB-Crystallin responsible for restrictive cardiomyopathy and skeletal myopathy

αB-Crystallin (αB-Cry) is expressed in many tissues, and mutations in this protein are linked to various diseases, including cataracts, Alzheimer's disease, Parkinson's disease, and several types of myopathies and cardiomyopathies. The p.D109G mutation, which substitutes a conserved aspartate residue involved in the interchain salt bridges, with glycine leads to the development of both restrictive cardiomyopathy (RCM) and skeletal myopathy. In this study, we generated this mutation in the α-Cry domain (ACD) which is crucial for forming the active chaperone dimeric state, using site-directed mutagenesis. After inducing expression in the bacterial host, we purified the mutant and wild-type recombinant proteins using anion exchange chromatography. Various spectroscopic evaluations revealed significant changes in the secondary, tertiary, and quaternary structures of human αB-Cry caused by this mutation. Furthermore, this pathogenic mutation led to the formation of protein oligomers with larger sizes than those of the wild-type protein counterpart. The mutant protein also exhibited increased chaperone activity and decreased chemical, thermal, and proteolytic stability. Atomic force microscopy (AFM), transmission electron microscopy (TEM), and fluorescence microscopy (FM) demonstrated that p.D109G mutant protein is more prone to forming amyloid aggregates. The misfolding associated with the p.D109G mutation may result in abnormal interactions of human αB-Cry with its natural partners (e.g., desmin), leading to the formation of protein aggregates. These aggregates can interfere with normal cellular processes and may contribute to muscle cell dysfunction and damage, resulting in the pathogenic involvement of the p.D109G mutant protein in restrictive cardiomyopathy and skeletal myopathy.

Efficacy and Safety of Alirocumab and Evolocumab as Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors in Familial Hypercholesterolemia: A Systematic Review and Meta-Analysis

BACKGROUND

Familial hypercholesterolemia (FH) is a prevalent and potentially fatal illness that causes a substantial elevation in low-density lipoprotein cholesterol (LDL-C).

OBJECTIVE

The aim of this study was to investigate the effects of monoclonal antibodies alirocumab and evolocumab on LDL-C and other lipid parameters, as well as their safety in familial hypercholesterolemia patients.

METHODS

A comprehensive search was done on PubMed/MEDLINE, EMBASE, Web of Science (WOS/ ISI), Scopus, ClinicalTrials (www.

CLINICALTRIALS

gov), and conferences/ congress research papers. Random effect models were used to calculate mean differences (%) and risk ratios (RRs), and confidence intervals (95%).

RESULTS

Ten studies (n=1489 patients) were included in this study. PCSK9 inhibitors decreased the levels of LDL-C by -49.59% (95%CI -55.5%, -43.67%) as compared to placebo. They also didn't alter the Treatment-Emergent Adverse Event (TEAE) and neuronal events by RR 0.92 (0.75, 1.13) and 1.31 (0.66, 2.59), respectively. PCSK9 inhibitors were effective and safe in treating patients with FH.

CONCLUSION

There was high-quality evidence showing that monoclonal antibodies (alirocumab & evolocumab) lower LDL-C (GRADE: high), lipoprotein (a) (GRADE: High), triglycerides (TG) (GRADE: High), total cholesterol (GRADE: High), non-high-density lipoprotein cholesterol (non- HDL-C) (GRADE: Moderate), and apolipoprotein B (GRADE: High), and increase the HDL-C (GRADE: High) as well as apolipoprotein A1 (GRADE: High). Comparing PCSK9 inhibitors against placebo, neither TEAE (GRADE: high) nor neuronal events (GRADE: moderate) were changed.

Differences in circadian variation in QT interval of the ECG in women compared to men

BACKGROUND

Measurement of the QT interval in the ECG (QT interval) is important in evaluating risk for cardiac death and for assessing the impact of drugs on the heart. The objective of this study is to determine whether the time of day affects the QT interval, QT interval variability and whether these relationships are influenced by an individual's sex.

METHODS

Twenty-four hour ECGs were analyzed in detail on 50 individuals, 49 years of age, without evidence of coronary artery disease, structural heart disease, or significant arrhythmias. Four different QT-heart rate adjustment formulae were calculated and compared.

RESULTS

There were significant (P=0.0014) differences between the QT-heart rate relationship during three different time-periods (night 00:00 to 08:00 h, day 08:00 to 14:00 h and evening 14:00 to 24:00 h). Women, compared to men, had a steeper relation of QT to RR interval indicating that when heart rate slows at night, the QT interval is more prolonged which is consistent with a greater susceptibility to fatal arrhythmias. The variability of the QT interval (the SD) was significantly (P<0.01) greater in men than women at night and in the evening but not during the day. There were differences in the ability of different QT heart rate adjustment formulae to blunt the effect of heart rate changes on the QT interval during the day.

CONCLUSION

The time of the day that the QT interval is assessed should be considered. The QT heart rate relationship is different in women than in men especially at night. QT interval variability is greater at night especially in men. There are differences in the ability of QT heart rate adjustment formulae to blunt the effect of heart rate on the QT interval. Differences in the QTc at night might be the basis for the higher prevalence of sudden death in women at night.

Acute enhancement of Romanian deadlift performance after consumption of caffeinated chewing gum

This study investigates the effect of the consumption of caffeinated chewing gum on the performance of Romanian deadlift on the flywheel training device. A total of 19 participants completed a randomized, cross-over, single-blind experiment with food-grade caffeinated chewing gum trial (CAF) or placebo trail (PL). Gum were chewed for 10 min and rest for 15 min prior to the Romanian deadlift test using the inertial resistance training machine. 5 sets of 6 Romanian deadlifts were performed, with a 3-min rest between sets, followed by a 7-day washout period before the next set of trials. The average power, average force, total peak power, peak concentric power, peak eccentric power, heart rate, and rating of perceived exertion (RPE) for each trials were analyzed using paired-T test. Compared to placebo, caffeinated chewing gum trial enhanced peak concentric power (P = 0.016, Cohen's d = 0.44), peak eccentric power (P = 0.005, Cohen's d = 0.55), average power (P = 0.013, Cohen's d = 0.43), and total work (P = 0.026, Cohen's d = 0.28). However, in average force (P = 0.063, Cohen's d = 0.50), RPE (P = 0.266), and heart rate (P = 0.143), were no significant differences between trials. Caffeinated chewing gum with a dose of caffeine of 200 mg for 10 min may acutely enhance Romanian deadlift performance on the flywheel machine.

Effects of citrulline on endurance performance in young healthy adults: a systematic review and meta-analysis

BACKGROUND

Citrulline is a popular dietary supplement, primarily thought to exert ergogenic effects on exercise performance through the enhancement of nitric oxide (NO) synthesis and ammonia buffering. However, recent findings surrounding citrulline's effect on endurance performance have been inconsistent. A systematic review and meta-analysis of the relevant literature have yet to be undertaken.

AIM

To determine if acute ingestion of citrulline has an ergogenic effect on endurance performance in young healthy adults.

METHODS

A systematic search of three databases was undertaken to find peer-reviewed randomized controlled trials (RCTs) published in English investigating the effects of citrulline supplementation on endurance performance in young healthy adults. Two independent investigators completed a three-phased screening procedure against pre-determined eligibility criteria. Included studies evaluated loading or bolus dosage regimes of citrulline in participants aged 18 or over that were at least recreationally active. Outcome measures focused on time-to-completion (TTC) or time-to-exhaustion (TTE) in continuous submaximal intensity exercise. Cochrane's Risk of Bias 2 (RoB 2) tool was used to assess the risk of bias in individual studies. Meta-analysis was conducted using a fixed-effects model to pool the weighted estimate of standardized mean differences (SMD) across studies. A chi-squared test assessed heterogeneity between studies. This review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Nine studies (n = 158 participants) met the eligibility criteria; five reported TTE outcomes (I² = 0%, χ² = 0.37, df = 4, P = 0.99) and four reported TTC outcomes (I² = 0%, χ² = 0.46, df = 3, P = 0.93), both with a low between-study heterogeneity. The results of the meta-analyses showed no significant difference in the endurance performance measures, TTE (pooled SMD = 0.03 [-0.27, 0.33]) and TTC (pooled SMD = -0.07 [-0.50, 0.15]), after acute ingestion of citrulline supplementation or a control in young healthy adults.

DISCUSSION

The current evidence suggests no significant benefit of citrulline supplementation for endurance performance. However, the small evidence base requires further research to fully evaluate this topic. Recommendations include a focus on female populations; higher continuous doses of citrulline over seven days; and TTC outcome measures over longer distances to simulate competition.

Characteristics Related to Visual Acuity Loss After Successful Photodynamic Therapy for Eyes With Central Serous Chorioretinopathy

PURPOSE

This study aimed to examine baseline characteristics for identifying factors associated with vision loss (VL) in patients with central serous chorioretinopathy (CSC) who successfully responded to photodynamic therapy (PDT).

DESIGN

A retrospective, clinical case-control study.

METHODS

This study included 85 eyes with CSC, which underwent PDT, and resolved serous retinal detachment. These eyes were classified into 2 groups: the VL group (best-corrected visual acuity 6 months after PDT was worse than that at baseline) and the vision maintenance or improved group (the others). Baseline factors were analyzed to determine the characteristics of the VL group and assess the diagnostic potential of these factors.

RESULT

Seventeen eyes were included in the VL group. The mean values of the neurosensory retinal (NSR) thickness, the internal limiting membrane-external limiting membrane thickness (IET), and the external limiting membrane-photoreceptor outer segment thickness (EOT) in the VL group were significantly thinner than those in the vision maintenance or improved group (NSR thickness, 123.2 ± 39.7 µm vs 166.3 ± 49.6 µm, P < .001; IET, 63.1 ± 17.0 µm vs 88.0 ± 25.4 µm, P < .001; EOT, 60.1 ± 28.6 µm vs 78.3 ± 33.1, P = .041). The sensitivity, specificity, and positive and negative predictive values for predicting VL were 94.1%, 50.0%, 32.0%, and 97.1% for NSR thickness; 94.1%, 51.5%, 32.7%, and 97.2% for IET; and 94.1%, 30.9%, 25.4%, and 95.5% for EOT, respectively.

CONCLUSIONS

Pretreatment sensory retinal layer thickness could predict VL after PDT for CSC and may be a helpful reference for PDT.

BHLHE40 Maintains the Stemness of PαS Cells In Vitro by Targeting Zbp1 through the Wnt/β-Catenin Signaling Pathway

Primary bone mesenchymal stem cells (BMSCs) gradually lose stemness during in vitro expansion, which significantly affects the cell therapeutic effects. Here, we chose murine PαS (SCA-1+PDGFRα+CD45-TER119-) cells as representative of BMSCs and aimed to explore the premium culture conditions for PαS cells. Freshly isolated (fresh) PαS cells were obtained from the limbs of C57/6N mice by fluorescence-activated cell sorting (FACS). We investigated the differences in the stemness of PαS cells by proliferation, differentiation, and stemness markers in vitro and by ectopic osteogenesis and chondrogenesis ability in vivo, as well as the changes in the stemness of PαS cells during expansion in vitro. Gain- and loss-of-function experiments were applied to investigate the critical role and underlying mechanism of the basic helix-loop-helix family member E40 (BHLHE40) in maintaining the stemness of PαS cells. The stemness of fresh PαS cells representative in vivo was superior to that of passage 0 (P0) PαS cells in vitro. The stemness of PαS cells in vitro decreased gradually from P0 to passage 4 (P4). Moreover, BHLHE40 plays a critical role in regulating the stemness of PαS cells during in vitro expansion. Mechanically, BHLHE40 regulates the stemness of PαS cells by targeting Zbp1 through the Wnt/β-catenin signaling pathway. This work confirms that BHLHE40 is a critical factor for regulating the stemness of PαS cells during expansion in vitro and may provide significant indications in the exploration of premium culture conditions for PαS cells.

Immunomodulatory Effects of Vitamin D in Respiratory Tract Infections and COVID-19 in Children

Acute respiratory tract infections (ARTIs) are one of the main reasons that the pediatric population goes to the doctor. The connection between ARTI and vitamin D (VD) is currently debated by the medical community, and so far, there has been little agreement with regard to the ideal level of 25(OH)D concentration that would provide protection for the respiratory tract, or the effectiveness of its administration in the treatment of respiratory infections. The purpose of this literature review was to bring attention to the immunomodulatory and antiviral function of vitamin D and its relation to the respiratory system by examining the main ARTIs, including SARS-CoV-2. The latter has affected the pediatric population in different ways, from asymptomatic patients to severe forms with multisystem inflammatory syndrome in children (MIS-C). Although there are not much clinical data on the SARS-CoV-2 disease in the pediatric population worldwide, we tried to find out whether there is a connection between the severity of this disease, other ARTIs, and vitamin D supplementation. We also aimed to find out if 25OHD deficiency had an adverse effect on the evolution of the disease and the recovery period in the case of younger patients affected by COVID-19. For this literature review, the PICO framework was selected as the methodological approach. Our results demonstrated many methods by which this vitamin may lower the risk of ARTI with regard to the COVID-19 infection. Despite these significant advancements, more research is needed to support the idea that 25(OH)D concentration can influence the evolution of respiratory tract infections in children.

Comparing Ultralong Carbon Nanotube Growth from Methane over Mono- and Bi-Metallic Iron Chloride Catalysts

This research endeavours to study the growth of ultralong carbon nanotubes (UL-CNTs) from methane using diverse catalysts, namely FeCl3, bi-metallic Fe-Cu, Fe-Ni, and Fe-Co chlorides. Aqueous catalyst solutions were evenly dispersed on silica substrates and grown at 950 °C in the presence of hydrogen via a horizontal chemical vapour deposition (CVD) furnace. The samples underwent characterisation by Raman spectroscopy, scanning electron microscopy (SEM), and optical microscopy to identify the quality of CNTs and enumerate individual UL-CNTs. Our findings revealed that FeCl3, as a mono-metallic catalyst, generated the longest UL-CNTs, which measured 1.32 cm, followed by Fe-Cu (0.85 cm), Fe-Co (0.7 cm), and Fe-Ni (0.6 cm), respectively. The G/D ratio (graphene to defects) from the Raman spectroscopy was the highest with the FeCl3 catalyst (3.09), followed by Fe-Cu (2.79), Fe-Co catalyst (2.13), and Fe-Ni (2.52). It indicates that the mono-iron-based catalyst also produces the highest purity CNTs. Moreover, this study scrutinises the vapour-liquid-solid (VLS) model for CNT growth and the impact of carbide formation as a precursor to CNT growth. Our research findings indicate that forming iron carbide (Fe3C) is a crucial transition phase for amorphous carbon transformation to CNTs. Notably, the iron catalyst generated the longest and densest CNTs relative to other iron-based bi-metallic catalysts, which is consistent with the temperature of carbide formation in the mono-metallic system. From correlations made using the phase diagram with carbon, we conclude that CNT growth is favoured because of increased carbon solubility within the mono-metallic catalyst compared to the bi-metallic catalysts.

Behaviour and welfare of African lion (Panthera leo) cubs used in contact wildlife tourism

Lion (Panthera leo) cubs are used in wildlife interaction tourism but the effects on cub welfare are unknown. We assessed the behaviour of three cohorts of lion cubs, twelve animals in total, at three different interaction facilities, using continuous and scan-sampling methodologies for the entire duration of cub utilisation for human interactions. Cubs spent most time inactive (62%), particularly sleeping (38%), but also spent a substantial amount of time playing (13%) and being alert (12%). A generalised linear mixed model revealed that cub behaviour was similar in two facilities but different from cubs in the third. In these two similar facilities, as human interactions increased, the time spent resting, sleeping and playing with other cubs decreased, and alert behaviour, grooming of humans and flight responses increased. In the third facility, cubs had an abnormal activity budget, with high levels of inactivity (80%) accompanied by a lack of response to human interactions. We conclude that in some facilities normal cub behaviour cannot be achieved and may be compromised by a high frequency of human interactions, which therefore needs to be controlled to limit adverse effects on cub behaviour.

Repeatability and reproducibility of Cobra HD fundus camera meibography in young adults with and without symptoms of dry eye

PURPOSE

The inter-session repeatability (ISR), inter-examiner reproducibility (IER) and within-subject variability (WSV) of the Cobra HD fundus camera meibographer were examined in participants with and without dry eye symptoms.

METHODS

Symptoms were determined based on Ocular Surface Disease Index scores (≥13 being considered symptomatic), and subgroups were compared using the Mann-Whitney U-test. Images of meibomian glands (MGs) from the upper and lower right eyelids were captured by two examiners on the same day (S1) to determine IER. One examiner repeated the measurements on a second day (S2) to obtain the ISR. ISR, IER and WSV were calculated using Friedman, correlation tests and Bland and Altman analyses with mean differences (md) and 95% confidence intervals (CIs), within-subject standard deviations (Sw) and intra-class correlation coefficients (ICC).

RESULTS

The ISR experiment included 72 participants (mean age: 23 ± 5 years, range: 19-43, 36 symptomatic). Mean MG loss of the upper (S1: 13.5 ± 9.5%, S2: 12.8 ± 8.5%) and lower eyelids (S1: 7.5 ± 6.9%, S2: 7.3 ± 6.3%) was not significantly different between sessions for all participants, symptomatic and asymptomatic subgroups for both eyelids. The ISR Sw for the upper and lower eyelids was 1.3% and 1.0%; md was 0.7 ± 3.5% (CI:-6.25% to 7.62%) and 0.1 ± 2.1% (CI: -3.94% to 4.17%), respectively. The IER experiment included 74 participants (mean age: 23 ± 5 years, range: 19-43, 37 symptomatic). Mean MG loss of the upper (Examiner 1: 12.7 ± 8.2%, Examiner 2: 13.1 ± 8.0%) and lower eyelids (Examiner 1: 7.0 ± 6.2%, Examiner 2: 7.4 ± 6.2%) was not significantly different between examiners for all participants, symptomatic and asymptomatic subgroups for both eyelids. The IER ICC values were >0.86 for all conditions, Sw was 1.3% and 1.2%, with a md of -0.4 ± 3.2% (CI: -6.65% to 5.90%) and -0.4 ± 2.9% (CI: -6.15% to 5.31%), respectively. The WSV Sw values were <1.4%, and ICC values were >0.89 for both eyelids, examiners and experimental sessions.

CONCLUSIONS

The Cobra HD fundus camera demonstrates good repeatability, reproducibility and low WSV, and is a reliable clinical instrument for meibography.

The use of synchrotron X-ray fluorescent imaging to study distribution and content of elements in chemically fixed single cells: a case study using mouse pancreatic beta-cells

Synchrotron X-ray fluorescence microscopy (SXRF) presents a valuable opportunity to study the metallome of single cells because it simultaneously provides high-resolution subcellular distribution and quantitative cellular content of multiple elements. Different sample preparation techniques have been used to preserve cells for observations with SXRF, with a goal to maintain fidelity of the cellular metallome. In this case study, mouse pancreatic beta-cells have been preserved with optimized chemical fixation. We show that cell-to-cell variability is normal in the metallome of beta-cells due to heterogeneity and should be considered when interpreting SXRF data. In addition, we determined the impact of several immunofluorescence (IF) protocols on metal distribution and quantification in chemically fixed beta-cells and found that the metallome of beta-cells was not well preserved for quantitative analysis. However, zinc and iron qualitative analysis could be performed after IF with certain limitations. To help minimize metal loss using samples that require IF, we describe a novel IF protocol that can be used with chemically fixed cells after the completion of SXRF.

Mesoscopic Monitoring of Human Skin Explants Viscoelastic Properties

The investigation of the mechanical properties of skin is of great interest for monitoring physiological and pathological changes in the cutaneous barrier function for dermatological and cosmetic issues. Skin constitutes a complex tissue because of its multi-layered organisation. From a rheological point of view, it can be considered to be a soft tissue with viscoelastic properties. In order to characterise ex vivo mechanical properties of skin on the mesoscopic scale, a biosensor including a thickness shear mode transducer (TSM) in contact with a skin explant was used. A specific experimental set-up was developed to monitor continuously and in real-time human skin explants, including the dermis and the epidermis. These were kept alive for up to 8 days. Skin viscoelastic evolutions can be quantified with a multi-frequency impedance measurement (from 5 MHz to 45 MHz) combined with a dedicated fractional calculus model. Two relevant parameters for the non-destructive mesoscopic characterisation of skin explants were extracted: the structural parameter αapp and the apparent viscosity ηapp. In this study, the validity of the biosensor, including repeatability and viability, was controlled. A typical signature of the viscoelastic evolutions of the different cutaneous layers was identified. Finally, monitoring was carried out on stripped explants mimicking a weakened barrier function.

Alterations in levels of cytokine following treatment to predict outcome of sepsis: A meta-analysis

BACKGROUND

The mortality rate of patients with sepsis has been increasing in recent years. Alterations of biomarkers levels during treatment are important in evaluating treatment efficacy and predicting outcomes in sepsis. This meta-analysis investigated the relationship between changes in cytokine levels after treatment compared with those on hospital admission, and their relationship with the prognosis of patients with sepsis.

METHODS

From conception until August 4, 2021, a complete literature search of the PubMed, Web of Science, and Cochrane Library electronic databases was done. Observational studies where the outcomes of sepsis patients were divided into non-survivors and survivors and which reported cytokine levels at least before treatment in ICU were included in the current study. Standardized mean difference (SMD) with 95% confidence intervals (CI) values from individual studies were pooled using a random-effects model. Quality assessment, subgroup analysis, publication bias, and sensitivity analyses were all carried out.

RESULTS

A total of 2570 patients with sepsis from 25 eligible studies were included, and 14 of them measured the cytokine levels before and after treatment in ICU. Among IL-6, TNF-α, IL-1β and IL-10 levels, those of IL-6 were significantly lower after treatment in ICU than at baseline in patients with sepsis in the survival group (SMD = -0.69, P < 0.0001), but were comparable in the non-survival group (SMD = -0.99, P = 0.0575). Similarly, post-treatment TNF-α levels were significantly lower than those at baseline only in patients with sepsis in the survival group (SMD = -0.44, P < 0.0001), but not in the non-survival group (SMD =-0.17, P = 0.0842).

CONCLUSION

This meta-analysis shows that reduced IL-6 and TNF-α levels after sepsis treatment in ICU may be indicators of better prognosis and survival of patients with sepsis.

Effect of different irrigation activation techniques on irrigation penetration into the simulated lateral canals

This study, in which a hundred human teeth with single straight canal were used, focused on the evaluation of contrast solution penetration ability into the simulated lateral canals activated by XP-endo Finisher (XPF), EDDY, Nd:YAG, and Er:YAG laser systems with three different observation methods. The root canals were prepared up to X4 at working length using the ProTaper Next system. The teeth were decalcified and simulated lateral canals were created with #8 K-file at 2, 4, and 6 mm levels. Then the teeth were cleared using methyl salicylate and divided into 5 equal groups according to irrigation activation techniques (CSI, XPF, EDDY, Nd:YAG, and Er:YAG laser). After the contrast solution was activated, images of the simulated lateral canals were obtained by a dental microscope, digital radiography, and CBCT. The contrast solution penetration scores at the 2, 4, and 6 mm levels according to irrigation activation techniques and observation methods were analyzed statistically using Kruskal-Wallis non-parametric analysis of variance Bonferroni test post hoc comparisons. With the other 2 parameters are ignored, the highest and lowest contrast solution penetration were observed at 6 and 2 mm simulated lateral canal levels (p < 0.05), in Er:YAG irrigation activation and CSI technique (p < 0.05), and in direct visual and digital radiographic observation method (p < 0.05), respectively. Within the limits of this study, it was determined that the contrast solution penetration into the simulated lateral canals decreased from the coronal to the apical and achieved with the most effective Er:YAG laser activation technique. In addition, direct visual observation was found to be the best method for the assessment of contrast solution penetration.

Reliability and Practical Use of a Commercial Device for Measuring Punch and Kick Impact Kinetics

Martial arts, boxing and combat sports such as mixed martial arts participation have gained popularity in recent years internationally. One common aspect to these sports is the training and skill in maximizing strike impact of punches and kicks, referred to as impact kinetics, with commercial devices now available to assess punching and kicking power in athletes training facilities and gyms. We, therefore, assessed the reliability of a commercial device, the PowerKubeTM (Strike Research Ltd., Norwich, England) via the technical error of measurement (TEM) in both linear and non-linear simulated strikes to the center of target, off-center, level and inclined in a laboratory setting. The highest mean impact power resulted from level, center strikes (5782 ± 230 W) followed by level, off-center strikes (4864 ± 119 W, p < 0.05), inclined center strikes (4500 ± 220 W, p < 0.05), and inclined, off-center strikes (3390 ± 151). Peak power reductions ranged from 15.9% (level, off-center) to a maximum of 41.4% (incline, off-center) compared to the level, center strikes. Coaches are advised to take steps such as videoing strikes with high sampling rates to better ensure consistency in impact orientation, being perpendicular and centered on the strike pad, to best capture the peak power of kicks or punches.

DSPECT-specific normative limits for left ventricular size and function

BACKGROUND

Differences in spatial resolution and image filtering between the solid-state DSPECT and traditional Anger SPECT (ASPECT) cameras are likely to result in differences in LV measurements. However, DSPECT-specific normal values are not available. The traditional approach of using patients deemed to have a low (< 5%) probability of coronary artery disease for the derivation of normative values has a number of limitations. We used healthy organ-donor subjects without known disease or medication use for derivation of normal values.

METHODS

Subjects were 92 consecutive kidney or liver donors who underwent single-day rest (5 mCi)-stress (15 mCi) Tc-99m sestamibi-gated SPECT myocardial perfusion imaging (MPI) on the DSPECT camera for pre-operative evaluation and had normal perfusion and LV function. Exclusion criteria included any known cardiac disease or medications. LV measurements were made on the post-stress supine stress images using QGS®.

RESULTS

Of 92 subjects (mean age 54.4 ± 15.0 and 39% men), mean EF ± 2SD for women and men was 77.2% ± 14.1% and 70.0 % ± 14.7%, respectively. Mean end-diastolic volume ± 2SD for women and men was 67.0 ± 32.2 mL and 99.6 ± 51.6 mL (indexed 38.3 ± 17.2 mL/m2 and 48.1 ± 25.9 mL/m2), respectively. Mean end-systolic volume ± 2SD for women and men was 16.1 ± 15.7 mL and 31.2 ± 29.2 mL (indexed 9.2 ± 8.8 mL/m2 and 15.0 ± 14.2 mL/m2), respectively. Mean LV wall volume ± 2SD for women and men was 95.9 ± 26.0 mL and 112.0 ± 48.8 mL (indexed 55.0 ± 13.8 mL/m2 and 54.1 ± 24.6 mL/m2), respectively.

CONCLUSION

We report DSPECT-specific LV measurements from normal subjects from which limits of normality can be derived for clinic use. Organ donors who undergo pre-operative MPI are a suitable cohort for the derivation of normal values.

Test-retest reliability of the L-Test in patients with advanced knee osteoarthritis

BACKGROUND

The reliability of tests to be used in research or clinical practice should be established for each population specific to their intended use. Reliability is important because it allows correct evaluations to be made about treatment effects or about the amount of changes.

OBJECTIVES

To evaluate the test-retest reliability and minimal detectable change of the L-test in patients with advanced knee osteoarthritis (OA).

METHODS

The intraclass correlation coefficient (ICC2,1) was used to assess the test-retest reliability of the L-test. The minimal detectable change with 95% confidence interval (MDC95) was calculated to determine the true change. The inclusion criteria were diagnosis of knee OA, had Kellgren Lawrence Grade IV and age of ≥40 years.

RESULTS

Twenty-five participants who met the inclusion criteria were included. Five were male and the mean age was 62.32±9.77 years. All of the participants had radiographic findings indicative of Kellgren-Lawrence Grade IV. The L-test showed excellent test-retest reliability. The ICC was 0.99, the SEM and the MDC95 was 1,90 and 5.28 seconds, respectively.

CONCLUSIONS

The L-test is a reliable outcome measurement for the assessment of walking ability in patients with advanced knee OA, and it showed very high test-retest reliability in these patients. This test may assist clinicians and researchers in assessing the functional mobility of patients and planning rehabilitation in patients with advanced knee OA.

Practical notes on popular statistical tests in renal physiology

Competent statistical analysis is essential to maintain rigor and reproducibility in physiological research. Unfortunately, the benefits offered by statistics are often negated by misuse or inadequate reporting of statistical methods. To address the need for improved quality of statistical analysis in papers, the American Physiological Society released guidelines for reporting statistics in journals published by the society. The guidelines reinforce high standards for the presentation of statistical data in physiology but focus on the conceptual challenges and, thus, may be of limited use to an unprepared reader. Experimental scientists working in the renal field may benefit from putting the existing guidelines in a practical context. This paper discusses the application of widespread hypothesis tests in a confirmatory study. We simulated pharmacological experiments assessing intracellular calcium in cultured renal cells and kidney function at the systemic level to review best practices for data analysis, graphical presentation, and reporting. Such experiments are ubiquitously used in renal physiology and could be easily translated to other practical applications to fit the reader's specific needs. We provide step-by-step guidelines for using the most common types of t tests and ANOVA and discuss typical mistakes associated with them. We also briefly consider normality tests, exclusion criteria, and identification of technical and experimental replicates. This review is supposed to help the reader analyze, illustrate, and report the findings correctly and will hopefully serve as a gauge for a level of design complexity when it might be time to consult a biostatistician.

Employees Perception of Organizational Crises and Their Reactions to Them – A Norwegian Organizational Case Study

Organizational sensemaking is crucial for resource planning and crisis management since facing complex strategic problems that exceed their capacity and ability, such as crises, forces organizations to engage in inter-organizational collaboration, which leads to obtaining individual and diverse perspectives to comprehend the issues and find solutions. This online qualitative survey study examines how Norwegian Sea Rescue Society employees perceived the concept of an organizational crisis and how they sensed their co-workers react to it. The scope was the ongoing COVID-19 pandemic, a global event affecting all countries and organizations and responding similarly globally. Data were collected during the Fall of 2020. The instrument of choice was the Internal Crisis Management and Crisis Communication survey (ICMCC). The results showed that the overall sample strongly believed in their organization’s overall resilience level. However, a somewhat vague understanding of roles and responsibilities in a crisis where detected, together with some signs of informal communication, rumor spreading, misunderstanding, frustration, and insecurity. This study contributes to the academic field of organizational research, hence crisis management and sensemaking, and could be valuable to managers and decision-makers across sectors. Increased knowledge about how employees react to a crisis may help optimize internal crisis management planning and utilize robust mitigation and response strategies.

Increased Wnt/β-catenin signaling contributes to autophagy inhibition resulting from a dietary magnesium deficiency in injury-induced osteoarthritis

Background

Dietary magnesium deficiency, which is common in modern diet, has been associated with osteoarthritis (OA) susceptibility. Despite this clinical association, no study has addressed if dietary magnesium deficiency accelerates OA development, especially at molecular level. This study aimed to explore aggravating effects of dietary magnesium deficiency on cartilage damage in an injury-induced murine OA model and to determine the underlying mechanism.

Methods

Twelve-week-old C57BL/6J mice subject to injury-induced OA modeling were randomized into different diet groups in which the mice were fed a diet with daily recommended magnesium content (500 mg/kg) or diets with low magnesium content (100 or 300 mg/kg). Articular cartilage damage was evaluated using the OARSI score. To determine molecular mechanisms in vitro, mouse chondrocytes were treated with media of low magnesium conditions at 0.1 and 0.4 mM, compared with normal magnesium condition at 0.7 mM as control. Anabolic and catabolic factors, autophagy markers, β-catenin, Wnt ligands, and a magnesium channel transient receptor potential cation channel subfamily member 7 (TRPM7) were analyzed by quantitative real-time PCR and immunoblotting. Autolysosomes were detected by DALGreen staining via fluorescence microscopy and autophagosomes were evaluated by transmission electron microscopy. Autophagy markers, β-catenin, and TRPM7 were assessed in vivo in the mouse cartilage, comparing between dietary magnesium deficiency and normal diet, by immunohistochemistry.

Results

Dietary magnesium deficiency aggravated injury-induced cartilage damage, indicated by significant higher OARSI scores. Autophagy markers LC3-II and Beclin-1 were decreased both in low magnesium diet-fed mice and low magnesium-treated chondrocytes. The number of autolysosomes and autophagosomes was also reduced under low magnesium conditions. Moreover, magnesium deficiency induced decreased anabolic and increased catabolic effect of chondrocytes which could be restored by autophagy activator rapamycin. In addition, reduced autophagy under low magnesium conditions is mediated by activated Wnt/β-catenin signaling. The expression of TRPM7 also decreased in low magnesium diet-fed mice, indicating that downstream changes could be regulated through this channel.

Conclusions

Dietary magnesium deficiency contributes to OA development, which is mediated by reduced autophagy through Wnt/β-catenin signaling activation. These findings indicated potential benefits of adequate dietary magnesium for OA patients or those individuals at high risk of OA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13075-022-02848-0.

The Bar-On Model and Multifactor Measure of Human Performance: Validation and Application

In this article, we describe the ongoing validation and application of the Bar-On model of human performance that is assessed with the Multifactor Measure of Performance (MMP). (The Bar-On Multifactor Measure of Performance (MMP) is the intellectual property of Into Performance ULC.) The MMP is a psychometric instrument designed to study, evaluate and enhance performance. We discuss the meaning and importance of performance, and explain the need for creating and applying a comprehensive model and measure of this construct. To address this need, the MMP is structurally organized to assess and strengthen 18 Core Factors that contribute to performance. Five Ring Factors were added to facilitate a deeper understanding of leadership, industriousness, productiveness, risk for burnout, and coachability. Together, they represent a multifactor approach that focuses on current behavior of the “whole person” by evaluating physical, cognitive, personal, social, and inspirational factors combined. We discuss the properties of the MMP’s normative population, as the baseline for accurate reporting, tailored to different workplace activities and needs. Possible limitations of the research are indicated, together with the need for additional studies to address them. We reflect on the MMP within the Unified Validity Framework and conclude with recommendations for researchers and practitioners to apply this model and measure.

Basic Statistics for Surgeons

Interpreting research is an important skill to ensure one can maintain their practise with current evidence. The technicalities of statistics can be daunting and thus, this article aims to provide a clear overview of key statistical tests that a surgeon will encounter. It highlights the various study designs, summary statistics and comparative tests that are used in clinical research. Furthermore, it provides a guide to determine which statistical method is most appropriate for various study designs. Overall, it aims to act as an introductory text to supplement further reading into the more advanced statistical methodologies.

Level of Evidence: Level V

Finger millet-based muffin decreases insulin response in individuals with prediabetes in a randomised controlled trial

Millet is a grain high in polyphenols and antioxidants, which are bioactive compounds known to influence blood glucose response. The aim of this study was to compare the effect of finger millet muffin and wheat muffin on glycaemic response (GR), insulin response (IR), gastric emptying (GE) and satiety in healthy individuals and people with prediabetes. In a single-blind randomised controlled crossover trial at Oxford Brookes Centre for Nutrition and Health, fifteen healthy individuals and fourteen individuals with prediabetes were recruited between May and December 2017. The participants' GR (3 h), IR (3 h), GE (4 h) and satiety (4 h) were measured before and after the consumption of muffins. A mixed method ANOVA was used to compare GE and the incremental AUC (iAUC) for GR and IR between the participant groups and muffins. There was a significant interaction between participants and muffins on IR iAUC at 180 min (P = 0·042). A significant effect of muffins was found on the GR peak (P = 0·013). The millet muffin decreased the GR peak and IR iAUC compared with the wheat muffin in participants with prediabetes. A significant interaction between participants and muffins for GE ascension time Tasc (P = 0·017) was observed, with no effect of muffins on satiety AUC in the participant groups. This study suggested that polyphenol and fibre-rich finger millet may have the potential to influence the management of prediabetes.

Trajectories of Mini-Mental State Examination Scores over the Lifespan in General Populations: A Systematic Review and Meta-Regression Analysis

Objectives: Over the lifespan cumulative changes to the brain lead to cognitive decline and eventually to dementia in 20-25% of adults 85 years and older. A commonly used screening tool for cognitive function is the Standard 30 point Mini-Mental State Examination (MMSE). Though the MMSE is used to screen for dementia, little is known about the changes in scores over the lifespan in general populations.Method: A systematic search was conducted using Cochrane, EMBASE, MEDLINE and PsycINFO for articles published from January 1, 2007 to May 25, 2017. Articles were included if they had a longitudinal design reporting at least two MMSE scores. A mixed-effect meta-regression analysis was conducted to examine the influence of age on MMSE score followed by a change-point regression analysis determining the age at which MMSE declines.Results: 45 articles including 58,939 individuals (age range 18-108 years, 61.2% female) summarized 222 MMSE point estimates from 35 cohorts. The meta-regression demonstrated a significant decrease in MMSE scores with higher age (regression coefficient of age: -0.10 (Confidence Interval (CI) -0.15, -0.05)). The average annual decline in MMSE scores identified by the change-point analysis at the age of 41 years and 84 years were -0.04 (95% CI: -0.05, -0.03) and -0.53 (95% CI: -0.55, -0.50), respectively.Conclusions: Between the age of 29 and 105 years MMSE scores decline, with the highest decline between age 84 and 105 years.Clinical Implementations: The use of MMSE should be restricted to higher age categories in aging general populations.

Effects of ocean acidification and warming on the development and biochemical responses of juvenile shrimp Palaemon elegans (Rathke, 1837)

Anthropogenic CO₂ emissions have led to the warming and acidification of the oceans. Although, there is a growing of evidence showing that simultaneous occurrence of ocean acidification and ocean warming are threats to marine organisms, information on their combined effect on coastal shrimp species remains scarce. The purpose of this study was to estimate the combined effects of seawater acidification and warming on growth-related traits and biochemical responses of P. elegans juveniles. In this work, shrimp were exposed for 65 days at 4 experimental conditions: pH 8.10 * 18 °C, pH 7.80 * 18 °C, pH 8.10 * 22 °C, pH 7.80 * 22 °C. The results showed that low pH decreases the lipid content by ∼13% (p < 0.05). Higher temperature reduced the condition factor by ∼11%, the protein content by ∼20%, the PUFA by ∼8,6% and shortened moulting events by 5 days (p > 0.05) while the SFA increased ∼9.4%. The decrease in condition factor and protein was however more prominent in organisms exposed to the combination of pH and temperature with a decrease of ∼13% and ∼21%, respectively. Furthermore, essential fatty acids as EPA and DHA also decreased by ∼20% and ∼6.6% in low pH and higher temperature condition. Despite this study suggest that warming may have a greater impact than acidification, it has been shown that their combined effect can exacerbate these impacts with consequences for the shrimp's body size and biochemical profile.

Transcriptional Regulation of the Synaptic Vesicle Protein Synaptogyrin-3 (SYNGR3) Gene: The Effects of NURR1 on Its Expression

Synaptogyrin-3 (SYNGR3) is a synaptic vesicular membrane protein. Amongst four homologues (SYNGR1 to 4), SYNGR1 and 3 are especially abundant in the brain. SYNGR3 interacts with the dopamine transporter (DAT) to facilitate dopamine (DA) uptake and synaptic DA turnover in dopaminergic transmission. Perturbed SYNGR3 expression is observed in Parkinson’s disease (PD). The regulatory elements which affect SYNGR3 expression are unknown. Nuclear-receptor-related-1 protein (NURR1) can regulate dopaminergic neuronal differentiation and maintenance via binding to NGFI-B response elements (NBRE). We explored whether NURR1 can regulate SYNGR3 expression using an in silico analysis of the 5′-flanking region of the human SYNGR3 gene, reporter gene activity and an electrophoretic mobility shift assay (EMSA) of potential cis-acting sites. In silico analysis of two genomic DNA segments (1870 bp 5′-flanking region and 1870 + 159 bp of first exon) revealed one X Core Promoter Element 1 (XCPE1), two SP1, and three potential non-canonical NBRE response elements (ncNBRE) but no CAAT or TATA box. The longer segment exhibited gene promoter activity in luciferase reporter assays. Site-directed mutagenesis of XCPE1 decreased promoter activity in human neuroblastoma SH-SY5Y (↓43.2%) and human embryonic kidney HEK293 cells (↓39.7%). EMSA demonstrated NURR1 binding to these three ncNBRE. Site-directed mutagenesis of these ncNBRE reduced promoter activity by 11–17% in SH-SY5Y (neuronal) but not in HEK293 (non-neuronal) cells. C-DIM12 (Nurr1 activator) increased SYNGR3 protein expression in SH-SY5Y cells and its promoter activity using a real-time luciferase assay. As perturbed vesicular function is a feature of major neurodegenerative diseases, inducing SYNGR3 expression by NURR1 activators may be a potential therapeutic target to attenuate synaptic dysfunction in PD.

Cross-Cultural Adaptation and Reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Assessing Fall-Risk Home Hazards for Stroke Using Technologies over a Conventional Home Visit

Objective

This study is aimed at translating the Home Falls and Accidents Screening Tool (HOME FAST) into the three main languages spoken in Malaysia and investigating its reliability through an alternative technology-based evaluation.

Methods

Translation into three languages and cross-cultural adaptation of the HOME FAST was conducted via the five steps adopted from the Mapi Institute. For interrater reliability, occupational therapists who attended a face-to-face home hazard workshop were recruited. Each therapist rated the HOME FAST by using the provided combination of videos and photographs of stroke survivors manoeuvring in their home. For test-retest reliability, the same occupational therapists were invited to rate the same combination of photographs and videos again. Reliability was analysed using Gwet's AC₁ and Bland and Altman's plot to describe agreement.

Results

The translation challenges were minimal and rectifiable. A Bahasa Melayu, Mandarin, and Tamil versions of the HOME FAST were developed. Overall interrater reliability for both video (AC₁ = 0.91) and photograph (AC₁ = 0.91) were good. The test-retest reliability yielded similar outcome (video: overall AC₁ = 0.92 and photograph: overall AC₁ = 0.93).

Conclusion

Using alternative technology (video and photograph) to do a home hazard assessment was feasible. However, the asynchronous nature of these methods has limitations in clarifying certain aspects in the home. Moving forward, potential investigation on other technologies such as telehealth for synchronous and real-time interaction is warranted.

What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of 'giving-way' of the ankle joint, and what shall we further investigate?

Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of 'giving-way' of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE®. Additional strategies included manual search of specific journals, as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative synthesis, 11 from individual case reports and 13 from four separate case series. Two authors independently reviewed all the articles and extracted ankle joint kinematic data. Excessive ankle inversion was the most pronounced kinematic pattern observed across all included cases, with a mean peak inversion angle of 67.5° (range 2.0 to 142) and a mean peak inversion velocity of 974°/s (range 468 to 1752). This was followed by internal rotation and plantar flexion, respectively. A homogeneous linear function revealed a mean inversion velocity across all cases of 337°/s (range 117 to 1400; R² = 0.78; p < 0.0001).

Introducing artificial intelligence to the radiation early warning system

Although radiation level is a serious concern which requires continuous monitoring, many existing systems are designed to perform this task. Radiation early warning system (REWS) is one of these systems which monitor the gamma radiation level in air. Such system requires high manual intervention, depends totally on experts' analysis, and has some shortcomings that can be risky sometimes. In this paper, the approach called RIMI (refining incoming monitored incidents) will be introduced which aims to improve this system while becoming more autonomous with keeping the final decision to the experts. A new method is presented which will help in changing this system to become more intelligent while learning from past incidents of each specific system.

Heart-Ankle Pulse Wave Velocity Is Superior to Brachial-Ankle Pulse Wave Velocity in Detecting Aldosterone-Induced Arterial Stiffness

Primary aldosteronism (PA) is associated with higher arterial stiffness compared to essential hypertension (EH). However, few studies have compared different pulse wave velocity (PWV) parameters to detect aldosterone-induced arterial stiffness. In this study, we aimed to compare the sensitivity in detecting aldosterone-induced arterial stiffness between brachial-ankle PWV (baPWV) and heart-ankle PWV (haPWV). We prospectively enrolled 1006 PA patients and 983 EH patients. Detailed medical history, basic biochemistry data and two PWV measurements (baPWV and haPWV) were collected in both groups. We performed analysis on the original cohort and two propensity score matching (PSM) models (model 1 adjusted for age and sex; model 2 adjusted for age, sex, systolic and diastolic blood pressure). The DeLong test was used to compare areas under receiver operating characteristic curves (AUCs) between baPWV and haPWV to predict PA. In all models, the PA patients had significantly higher baPWV compared to the EH patients. The AUC of haPWV was greater than that of baPWV. In conclusion, haPWV seems to be a better PWV parameter than baPWV in detecting aldosterone-induced arterial stiffness.

Waning immunity after receipt of Pertussis, Diphtheria, Tetanus and Polio-related vaccines: a systematic review and meta-analysis

DTP-containing (pertussis, diphtheria and tetanus) combined with polio vaccines are recommended by WHO as part of routine immunization programs. The decline of immunity after vaccination has been considered as a possible reason for the re-emergence of vaccine-preventable diseases worldwide. In this study, we evaluated the potential duration of protective immunity of pertussis, diphtheria, tetanus and polio through a systematic review and meta-analysis. We examined data on immunological and clinical outcomes. We observed evidence of waning post-vaccination immunity for pertussis and diphtheria, while tetanus and polio vaccines provided sustained protection. Further research on the risk factors of waning immunity after vaccination and the optimal timing of booster doses for pertussis and diphtheria are needed.

Efficacy and Safety of mesenchymal stem cell therapy in patients with acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND OBJECTIVES

The adjuvant treatment of stem cell therapy for acute myocardial infarction (AMI) has been studied in multiple clinical trials, but many questions remain to be addressed, such as efficacy, safety, identification of the optimal cell type, tractable route of delivery, transplant dosage, and transplant timing. The current meta-analysis aimed to explore the issues of mesenchymal stem cells (MSCs) transplantation in patients with AMI based on published randomized controlled trials (RCTs) and guide the design of subsequent clinical trials of MSCs therapy for AMI.

METHODS

The Cochrane Library, PubMed, EMBASE databases were searched for relevant clinical trials from January 1, 2000, to January 23, 2021. Results from RCTs involving MSCs transplantation for the treatment of AMI were identified. According to the Cochrane systematic review method, the literature quality, including studies, was evaluated and valid data was extracted. RevMan 5.3 and Stata 15.1 software were used for Meta-analysis.

RESULTS

After a literature search and detailed evaluation, 9 randomized controlled trials enrolling 460 patients were included in the quantitative analysis. Pooled analyses indicated that MSCs therapy was associated with a significantly greater improvement in overall left ventricular ejection fraction (LVEF), and the effect was maintained for up to 24 months. No significant difference in favor of MSCs treatment in left ventricular (LV) volume and in the risk of rehospitalization as a result of heart failure (HF) was noted, compared with the controls. For transplantation dose, the LVEF of patients accepting a MSCs dose of 107-108 cells was significantly increased by 2.62% (95% CI 1.54 to 3.70; P < 0.00001; I2 =0%), but this increase was insignificant in the subgroup that accepted an MSCs dose of < 107 cells (1.65% in LVEF, 95% CI, 0.03 to 3.27; P =0.05; I2 =75%) or >108 cells (4.65% in LVEF, 95% CI, -4.55 to 13.48; P =0.32; I2 =95%), compared with the controls. For transplantation timing, a significant improvement of LVEF of 3.18% was achieved in the group of patients accepting a MSCs infusion within 2 to 14 days Percutaneous coronary intervention (PCI) (95% CI, 2.89 to 3.47; P <0.00001; I2 = 0). There was no association between MSCs therapy and major adverse events.

CONCLUSION

Results from our systematic review suggest that MSCs therapy for patients with AMI appears to be safe and might induce a significant increase in LVEF with a limited impact on LV volume and rehospitalization caused by HF. The effect was maintained for up to 24 months. MSCs dose of 107-108 cells was more likely to achieve better clinical endpoints than <107 or >108 cells. The optimal time window for cell transplantation might be within 2-14 days after PCI. This meta-analysis was registered with PROSPERO, number CRD 42021241104.

Enhancing Student Learning by Integrating Anatomy in Pathology Teaching

BACKGROUND

Vertically integrating anatomy into pathology curricula is beneficial for student-centered learning. This study investigates the effectiveness of this approach on student learning outcomes.

ACTIVITY

Learners received a vertically integrated pathology curriculum; their pre- and post-course test data were collected.

RESULTS AND DISCUSSION

Two-hundred thirty-two learners participated in the activity. Upon completing the activity, their average post-course performance was significantly better than that of a control group (P < 0.05), with significantly higher scores on solving pathology case problems (P < 0.05), as well as on retaining anatomy concepts (P < 0.05). Vertically integrating anatomy in pathology instruction is an effective educational approach.

Readiness towards online learning among physiotherapy undergraduates

BACKGROUND

Online learning is an attractive option for educators, especially as means of overcoming the challenges posed by the global pandemic. Although it is best to evaluate student readiness prior to commencement of an online course, to ensure successful development and delivery of student-centric teaching and learning strategies, readiness towards online learning among physiotherapy undergraduates is unknown. The main aim of this study was to examine physiotherapy undergraduates' readiness towards online learning.

METHODS

In this cross-sectional study, participants were selected through a combination of total population and convenience sampling. The Student Online Learning Readiness questionnaire was distributed among physiotherapy undergraduates from two public and two private universities in Malaysia to investigate their technical, social and communication competencies. Information about device characteristics were obtained to evaluate their equipment readiness. Descriptive and group comparisons were conducted using independent t-test, and analysis of variance with p < 0.05 as level of significance.

RESULTS

A total of 352 physiotherapy undergraduates participated. The response rate was 81.6%. The results showed that physiotherapy undergraduates in these four institutions had moderate levels of readiness towards technical competencies (M = 3.7 ± 0.5), social competencies with instructor (M = 3.7 ± 0.6), social competencies with classmates (M = 3.8 ± 0.6) and communication competencies (M = 3.6 ± 0.5) related to online learning. The overall readiness for these four competencies was moderate (M = 3.7 ± 0.4), however the physiotherapy undergraduates had high (> 80% possessed smartphones and laptop) level of equipment readiness. Institution and gender had no significant effect on the level of readiness (p > 0.05). Year 1 and 2 had significantly higher levels of social competencies with instructor compared to final year physiotherapy undergraduates (p < 0.05).

CONCLUSION

Physiotherapy undergraduates in these four institutions had moderate to high levels of readiness towards online learning. Technical, social and communication competencies could be further enhanced with appropriate strategies.

SIGNIFICANCE

This study provides an insight into the level of readiness towards online learning among physiotherapy undergraduates. The findings of our study shed light on issues to consider when designing online courses. A pre-course training for undergraduates prior to the commencement of online courses may be useful.

TRIAL REGISTRATION

Not Applicable.

Finding "Bright Spots": Using Multiple Measures to Examine Local-Area Racial Equity in Cancer Mortality Outcomes

In this article, we present a variety of measures that quantify equity in cancer mortality outcomes, demonstrate how the measures perform with various cancer types, and identify counties, or "bright spots," that meet the criteria of those measures. Using county-level age-adjusted mortality rates for 2007-2016 from the National Center for Health Statistics, we identified counties that had both equitable and optimal outcomes for Black and White death rates across 5 types of cancer: cancers of the lung/bronchus, prostate, female breast, colorectum, and liver. The number of counties that met the criteria ranged from 0 to 442, depending on cancer type and measure used. Prostate cancer and male liver cancer consistently had the lowest number of "bright spots," with a maximum of 3 counties meeting the most lenient criteria. This paper presents several ways to examine equity, using rate ratios and standard error measures, in cancer mortality outcomes. It highlights areas with positive progress toward equity and areas with a potential need for equity-focused cancer-control planning. Examining local areas of positive deviance can inform cancer-control programming and planning around health equity.

An effector-reporter system to study cellular signal transduction in strawberry fruit (Fragaria ananassa)

An effector-reporter system is a powerful tool used to study cellular signal transduction, but this technique has been traditionally used in protoplasts. A similar system to study cellular signal transduction in fruits has not yet been established. In this study, we aimed to establish an effector-reporter system for strawberry fruit, a model nonclimacteric fruit. We first investigated the characteristics of transient gene expression in strawberry fruits and found marked variation in gene expression levels among individual fruits, and this variation has complicated the establishment of a technical system. To overcome this difficulty, we investigated a sampling strategy based on a statistical analysis of the activity pattern of four different reporters (GUS, GFP, FLuc, and RLuc) among individual fruits and combinations of pairs of reporters (GUS/GFP and RLuc/FLuc). Based on an optimized sampling strategy, we finally established a step-by step protocol for the effector/reporter assay. Using FaMYB10 and FaWRKY71 as the effectors and GUS driven by the FaCHS promoter as the reporter, we demonstrated that this effector/reporter system was practical and reliable. This effector/reporter technique will contribute to an in-depth exploration of the signaling mechanism for the regulation of strawberry fruit ripening.