The Effect of Preoperative Oral Carbohydrate or Oral Rehydration Solution on Postoperative Quality of Recovery: A Randomized,Controlled Clinical Trial

Background

Numerous studies have demonstrated the beneficial effects of preoperative administration of oral carbohydrate (CHO) or oral rehydration solution (ORS). However, the effects of preoperative CHO or ORS on postoperative quality of recovery after anesthesia remain unclear. Consequently, the purpose of the current study was to evaluate the effect of preoperative CHO or ORS on patient recovery, using the Quality of Recovery 40 questionnaire (QoR-40).

Methods

This prospective, randomized, controlled clinical trial included American Society of Anesthesiologists (ASA) physical status 1 and 2 adult patients, who were scheduled to undergo a surgical procedure of body surface. Subjects were randomized to one of the three groups: 1) preoperative CHO group, 2) preoperative ORS group, and 3) control group. The primary outcome was the global QoR-40 administered 24 h after surgery. Intraoperative use of vasopressor, intraoperative body temperature changes, and postoperative nausea and vomiting (PONV) were also evaluated.

Results

We studied 134 subjects. The median [interquartile range (IQR)] global QoR-40 scores 24 h after the surgery were 187 [177–197], 186 [171–200], and 184 [171–198] for the CHO, ORS, and control groups, respectively (p = 0.916). No significant differences existed between the groups regarding intraoperative vasopressor use during the surgery (p = 0.475).

Conclusions

Results of the current study indicated that the preoperative administration of either CHO or ORS did not improve the quality of recovery in patients undergoing minimally invasive body surface surgery.

Trial Registration

www.umin.ac.jp UMIN000009388 https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000011029&language=E     

Phylogenetic revision of Minyomerus Horn, 1876 sec. Jansen & Franz, 2015 (Coleoptera,Curculionidae) using taxonomic concept annotations and alignments

This contribution adopts the taxonomic concept annotation and alignment approach. Accordingly, and where indicated, previous and newly inferred meanings of taxonomic names are individuated according to one specific source. Articulations among these concepts and pairwise, logically consistent alignments of original and revisionary classifications are also provided, in addition to conventional nomenclatural provenance information. A phylogenetic revision of the broad-nosed weevil genera Minyomerus Horn, 1876 sec. O’Brien & Wibmer (1982), and Piscatopus Sleeper, 1960 sec. O’Brien & Wibmer (1982) (Curculionidae [non-focal]: Entiminae [non-focal]: Tanymecini [non-focal]) is presented. Prior to this study, Minyomerus sec. O’Brien & Wibmer (1982) contained seven species, whereas the monotypic Piscatopus sec. O’Brien & Wibmer (1982) was comprised solely of Piscatopus griseus Sleeper, 1960 sec. O’Brien & Wibmer (1982). We thoroughly redescribe these recognized species-level entities and furthermore describe ten species as new to science: Minyomerus bulbifrons sec. Jansen & Franz (2015) (henceforth: [JF2015]), sp. n., Minyomerus aeriballux [JF2015], sp. n., Minyomerus cracens [JF2015], sp. n., Minyomerus gravivultus [JF2015], sp. n., Minyomerus imberbus [JF2015], sp. n., Minyomerus reburrus [JF2015], sp. n., Minyomerus politus [JF2015], sp. n., Minyomerus puticulatus [JF2015], sp. n., Minyomerus rutellirostris [JF2015], sp. n., and Minyomerus trisetosus [JF2015], sp. n. A cladistic analysis using 46 morphological characters of 22 terminal taxa (5/17 outgroup/ingroup) yielded a single most-parsimonious cladogram (L = 82, CI = 65, RI = 82). The analysis strongly supports the monophyly of Minyomerus [JF2015] with eight unreversed synapomorphies, and places Piscatopus griseus sec. O’Brien & Wibmer (1982) within the genus as sister to Minyomerus rutellirostris [JF2015]. Accordingly, Piscatopus sec. Sleeper (1960), syn. n. is changed to junior synonymy of Minyomerus [JF2015], and its sole member Piscatopus griseus sec. Sleeper (1960) is moved to Minyomerus [JF2015] as Minyomerus griseus [JF2015], comb. n. In addition, the formerly designated type Minyomerus innocuus Horn, 1876 sec. Pierce (1913), syn. n. is changed to junior synonymy of Minyomerus microps (Say, 1831) [JF2015] which has priority. The genus is widespread throughout western North America, ranging from Canada to Mexico and Baja California. Apparent patterns of interspecific diversity of exterior and genitalic morphology, varying host plant ranges, overlapping and widely extending species distributions, suggest an early origin for Minyomerus [JF2015], with a diversification that likely followed the development of North American desert biomes. Three species in the genus – i.e., Minyomerus languidus Horn, 1876 [JF2015], Minyomerus microps [JF2015], and Minyomerus trisetosus [JF2015] – are putatively considered parthenogenetic.     

Impact of food supplements on early child development in children with moderate acute malnutrition: A randomised 2 x 2 x 3 factorial trial in Burkina Faso

BackgroundLipid-based nutrient supplements (LNS) and corn–soy blends (CSBs) with varying soy and milk content are used in treatment of moderate acute malnutrition (MAM). We assessed the impact of these supplements on child development.Methods and findingsWe conducted a randomised 2 × 2 × 3 factorial trial to assess the effectiveness of 12 weeks’ supplementation with LNS or CSB, with either soy isolate or dehulled soy, and either 0%, 20%, or 50% of protein from milk, on child development among 6–23-month-old children with MAM. Recruitment took place at 5 health centres in Province du Passoré, Burkina Faso between September 2013 and August 2014. The study was fully blinded with respect to soy quality and milk content, while study participants were not blinded with respect to matrix. This analysis presents secondary trial outcomes: Gross motor, fine motor, and language development were assessed using the Malawi Development Assessment Tool (MDAT). Of 1,609 children enrolled, 54.7% were girls, and median age was 11.3 months (interquartile range [IQR] 8.2–16.0). Twelve weeks follow-up was completed by 1,548 (96.2%), and 24 weeks follow-up was completed by 1,503 (93.4%); follow-up was similar between randomised groups. During the study, 4 children died, and 102 children developed severe acute malnutrition (SAM). There was no difference in adverse events between randomised groups. At 12 weeks, the mean MDAT z-scores in the whole cohort had increased by 0.33 (95% CI: 0.28, 0.37), p < 0.001 for gross motor; 0.26 (0.20, 0.31), p < 0.001 for fine motor; and 0.14 (0.09, 0.20), p < 0.001 for language development. Children had larger improvement in language z-scores if receiving supplements with milk (20%: 0.09 [−0.01, 0.19], p = 0.08 and 50%: 0.11 [0.01, 0.21], p = 0.02), although the difference only reached statistical significance for 50% milk. Post hoc analyses suggested that this effect was specific to boys (interaction p = 0.02). The fine motor z-scores were also improved in children receiving milk, but only when 20% milk was added to CSB (0.18 [0.03, 0.33], p = 0.02). Soy isolate over dehulled soy increased language z-scores by 0.07 (−0.01, 0.15), p = 0.10, although not statistically significant. Post hoc analyses suggested that LNS benefited gross motor development among boys more than did CSB (interaction p = 0.04). Differences between supplement groups did not persist at 24 weeks, but MDAT z-scores continued to increase post-supplementation. The lack of an unsupplemented control group limits us from determining the overall effects of nutritional supplementation for children with MAM.ConclusionsIn this study, we found that child development improved during and after supplementation for treatment of MAM. Milk protein was beneficial for language and fine motor development, while suggested benefits related to soy quality and supplement matrix merit further investigation. Supplement-specific effects were not found post-intervention, but z-scores continued to improve, suggesting a sustained overall effect of supplementation.Trial registrationISRCTN42569496

In this analysis of secondary trial outcomes, Mette F. Olsen and colleagues show the effects of different supplements on child language and motor skill development.     

Performance indicators and functional adaptive windows in competitive cyclists: effect of one-year strength and conditioning training programme

Changes and relationships between cycling performance indicators following a one-year strength and conditioning training have not been totally clarified. The aims of this study are to investigate (i) the effect of a combined one-year strength and conditioning training programme on performance indicators and the possible relationships between these indicators, and (ii) the existence of possible endurance-functional-adaptive windows (EFAWs) linked to changes in muscular strength and body composition markers. Functional and lactate threshold power (FTP and LTP), maximal strength (1RM) and body composition (body mass index [BMI], body cell mass [BCM] and phase angle [PA]) were measured at the beginning and the end of a one-year strength and conditioning training programme of thirty cyclists. Correlations, differences, and predictive analysis were performed among parameters. Significant differences were found between pre- and post-conditioning programme results for FTP, LTP, 1RM (p < 0.0001) and BCM (p = 0.038). When expressed as power output (W), FTP and LTP were significantly correlated with 1RM (r = 0.36, p = 0.005 and r = 0.37, p = 0.004, respectively), body mass (r = 0.30 and p = 0.02), BCM (r = 0.68, p < 0.001) and PA (r = 0.42 and 0.39, respectively and p < 0.001). When expressed as W·kg-¹, these power thresholds were strongly correlated with body mass (r = -0.56 and -0.61, respectively) and BMI (r = -0.57 and -0.61 respectively) with p < 0.001. Predictive polynomial regressions revealed possible endurance and strength adaptation zones. The present findings indicated beneficial impacts of one-year strength and conditioning training on cycling performance indicators, confirmed the correlation between performance indicators, and suggested the existence of different EFAWs. Strategies aiming to improve performance should consider cyclist characteristics and performance goals to achieve EFAWs and thereby enhance cycling performance.     

Physical Fitness Percentiles of German Children Aged 9–12 Years: Findings from a Longitudinal Study

Background

Generating percentile values is helpful for the identification of children with specific fitness characteristics (i.e., low or high fitness level) to set appropriate fitness goals (i.e., fitness/health promotion and/or long-term youth athlete development). Thus, the aim of this longitudinal study was to assess physical fitness development in healthy children aged 9–12 years and to compute sex- and age-specific percentile values.

Methods

Two-hundred and forty children (88 girls, 152 boys) participated in this study and were tested for their physical fitness. Physical fitness was assessed using the 50-m sprint test (i.e., speed), the 1-kg ball push test, the triple hop test (i.e., upper- and lower- extremity muscular power), the stand-and-reach test (i.e., flexibility), the star run test (i.e., agility), and the 9-min run test (i.e., endurance). Age- and sex-specific percentile values (i.e., P₁₀ to P₉₀) were generated using the Lambda, Mu, and Sigma method. Adjusted (for change in body weight, height, and baseline performance) age- and sex-differences as well as the interactions thereof were expressed by calculating effect sizes (Cohen’s d).

Results

Significant main effects of Age were detected for all physical fitness tests (d = 0.40–1.34), whereas significant main effects of Sex were found for upper-extremity muscular power (d = 0.55), flexibility (d = 0.81), agility (d = 0.44), and endurance (d = 0.32) only. Further, significant Sex by Age interactions were observed for upper-extremity muscular power (d = 0.36), flexibility (d = 0.61), and agility (d = 0.27) in favor of girls. Both, linear and curvilinear shaped curves were found for percentile values across the fitness tests. Accelerated (curvilinear) improvements were observed for upper-extremity muscular power (boys: 10–11 yrs; girls: 9–11 yrs), agility (boys: 9–10 yrs; girls: 9–11 yrs), and endurance (boys: 9–10 yrs; girls: 9–10 yrs). Tabulated percentiles for the 9-min run test indicated that running distances between 1,407–1,507 m, 1,479–1,597 m, 1,423–1,654 m, and 1,433–1,666 m in 9- to 12-year-old boys and 1,262–1,362 m, 1,329–1,434 m, 1,392–1,501 m, and 1,415–1,526 m in 9- to 12-year-old girls correspond to a “medium” fitness level (i.e., P₄₀ to P₆₀) in this population.

Conclusions

The observed differences in physical fitness development between boys and girls illustrate that age- and sex-specific maturational processes might have an impact on the fitness status of healthy children. Our statistical analyses revealed linear (e.g., lower-extremity muscular power) and curvilinear (e.g., agility) models of fitness improvement with age which is indicative of timed and capacity-specific fitness development pattern during childhood. Lastly, the provided age- and sex-specific percentile values can be used by coaches for talent identification and by teachers for rating/grading of children’s motor performance.     

Soccer Player Characteristics in English Lower-League Development Programmes: The Relationships between Relative Age,Maturation, Anthropometry and Physical Fitness

The relative age effect (RAE) and its relationships with maturation, anthropometry, and physical performance characteristics were examined across a representative sample of English youth soccer development programmes. Birth dates of 1,212 players, chronologically age-grouped (i.e., U9’s-U18’s), representing 17 professional clubs (i.e., playing in Leagues 1 & 2) were obtained and categorised into relative age quartiles from the start of the selection year (Q1 = Sep-Nov; Q2 = Dec-Feb; Q3 = Mar-May; Q4 = Jun-Aug). Players were measured for somatic maturation and performed a battery of physical tests to determine aerobic fitness (Multi-Stage Fitness Test [MSFT]), Maximal Vertical Jump (MVJ), sprint (10 & 20m), and agility (T-Test) performance capabilities. Odds ratio’s (OR) revealed Q1 players were 5.3 times (95% confidence intervals [CI]: 4.08–6.83) more likely to be selected than Q4’s, with a particularly strong RAE bias observed in U9 (OR: 5.56) and U13-U16 squads (OR: 5.45–6.13). Multivariate statistical models identified few between quartile differences in anthropometric and fitness characteristics, and confirmed chronological age-group and estimated age at peak height velocity (APHV) as covariates. Assessment of practical significance using magnitude-based inferences demonstrated body size advantages in relatively older players (Q1 vs. Q4) that were very-likely small (Effect Size [ES]: 0.53–0.57), and likely to very-likely moderate (ES: 0.62–0.72) in U12 and U14 squads, respectively. Relatively older U12-U14 players also demonstrated small advantages in 10m (ES: 0.31–0.45) and 20m sprint performance (ES: 0.36–0.46). The data identify a strong RAE bias at the entry-point to English soccer developmental programmes. RAE was also stronger circa-PHV, and relatively older players demonstrated anaerobic performance advantages during the pubescent period. Talent selectors should consider motor function and maturation status assessments to avoid premature and unwarranted drop-out of soccer players within youth development programmes.     

Effects of 7-day intake of hydrogen-rich water on physical performance of trained and untrained subjects

Hydrogen-rich water (HRW) is used as a supplement to improve performance and reduce fatigue in athletes. However, the potentially beneficial effects of HRW intake could be mediated by the training status of athletes. The purpose of the study was to analyse the ergogenic effect of intake of HRW for one week on aerobic and anaerobic performance, both in trained and untrained individuals. Thirty-seven volunteers participated in the study and were divided into two experimental groups: trained cyclists and untrained subjects. A double-blind crossover design was performed in which all subjects took a placebo (PW) and nano-bubble HRW (pH: 7.5; hydrogen concentration: 1.9 ppm; oxidation-reduction potential (ORP): -600 mV). At the end of 7-day intake, performance was assessed by an incremental VO₂max test and by a maximum anaerobic test. After HRW intake, only trained cyclists improved their performance in the anaerobic test with an increase in peak power (from 766.2 ± 125.6 to 826.5 ± 143.4 W; d = .51) and mean power (from 350.0 ± 53.5 to 380.2 ± 71.3 W; d = .51), and a decrease in the fatigue index (from 77.6 ± 5.8 to 75.1 ± 5.9%; d = .45). The findings demonstrate that the ergogenic effect of HRW is mediated by the training status, and that 7-day intake of HRW would be an effective strategy for improving anaerobic performance in trained cyclists.     

The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch–Sch?nlein Purpura

BackgroundThe development of gastrointestinal (GI) bleeding and end-stage renal disease (ESRD) can be a concern in the management of Henoch–Schönlein purpura (HSP). We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of adult patients with HSP.MethodsClinical data including the NLR of adult patients with HSP were retrospectively analyzed. Patients were classified into three groups as follows: (a) simple recovery, (b) wax & wane without GI bleeding, and (c) development of GI bleeding. The optimal cut-off value was determined using a receiver operating characteristics curve and the Youden index.ResultsA total of 66 adult patients were enrolled. The NLR was higher in the GI bleeding group than in the simple recovery or wax & wane group (simple recovery vs. wax & wane vs. GI bleeding; median [IQR], 2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23], P<0.001). For the purpose of predicting simple recovery, the optimal cut-off value of NLR was 3.18, and the sensitivity and specificity were 74.1% and 75.0%, respectively. For predicting development of GI bleeding, the optimal cut-off value was 3.90 and the sensitivity and specificity were 87.5% and 88.6%, respectively.ConclusionsThe NLR is useful for predicting development of GI bleeding as well as simple recovery without symptom relapse. Two different cut-off values of NLR, 3.18 for predicting an easy recovery without symptom relapse and 3.90 for predicting GI bleeding can be used in adult patients with HSP.     

Human Performance in a Realistic Instrument-Control Task during Short-Term Microgravity

Previous studies have documented the detrimental effects of microgravity on human sensorimotor skills. While that work dealt with simple, laboratory-type skills, we now evaluate the effects of microgravity on a complex, realistic instrument-control skill. Twelve participants controlled a simulated power plant during the short-term microgravity intervals of parabolic flight as well as during level flight. To this end they watched multiple displays, made strategic decisions and used multiple actuators to maximize their virtual earnings from the power plant. We quantified control efficiency as the participants’ net earnings (revenue minus expenses), motor performance as hand kinematics and dynamics, and stress as cortisol level, self-assessed mood and self-assessed workload. We found that compared to normal gravity, control efficiency substantially decreased in microgravity, hand velocity slowed down, and cortisol level and perceived physical strain increased, but other stress and motor scores didn’t change. Furthermore, control efficiency was not correlated with motor and stress scores. From this we conclude that realistic instrument control was degraded in short-term microgravity. This degradation can’t be explained by the motor and/or stress indicators under study, and microgravity affected motor performance differently in our complex, realistic skill than in the simple, laboratory-type skills of earlier studies.     

Quantitative Evaluation of Human Cerebellum-Dependent Motor Learning through Prism Adaptation of Hand-Reaching Movement

The cerebellum plays important roles in motor coordination and learning. However, motor learning has not been quantitatively evaluated clinically. It thus remains unclear how motor learning is influenced by cerebellar diseases or aging, and is related with incoordination. Here, we present a new application for testing human cerebellum-dependent motor learning using prism adaptation. In our paradigm, the participant wearing prism-equipped goggles touches their index finger to the target presented on a touchscreen in every trial. The whole test consisted of three consecutive sessions: (1) 50 trials with normal vision (BASELINE), (2) 100 trials wearing the prism that shifts the visual field 25° rightward (PRISM), and (3) 50 trials without the prism (REMOVAL). In healthy subjects, the prism-induced finger-touch error, i.e., the distance between touch and target positions, was decreased gradually by motor learning through repetition of trials. We found that such motor learning could be quantified using the “adaptability index (AI)”, which was calculated by multiplying each probability of [acquisition in the last 10 trials of PRISM], [retention in the initial five trials of REMOVAL], and [extinction in the last 10 trials of REMOVAL]. The AI of cerebellar patients less than 70 years old (mean, 0.227; n = 62) was lower than that of age-matched healthy subjects (0.867, n = 21; p < 0.0001). While AI did not correlate with the magnitude of dysmetria in ataxic patients, it declined in parallel with disease progression, suggesting a close correlation between the impaired cerebellar motor leaning and the dysmetria. Furthermore, AI decreased with aging in the healthy subjects over 70 years old compared with that in the healthy subjects less than 70 years old. We suggest that our paradigm of prism adaptation may allow us to quantitatively assess cerebellar motor learning in both normal and diseased conditions.     

The Effect of an Acute Bout of Moderate-Intensity Aerobic Exercise on Motor Learning of a Continuous Tracking Task

Introduction

There is evidence for beneficial effects of acute and long-term exercise interventions on several forms of memory, including procedural motor learning. In the present study we examined how performing a single bout of continuous moderate intensity aerobic exercise would impact motor skill acquisition and retention in young healthy adults, compared to a period of rest. We hypothesized that exercise would improve motor skill acquisition and retention, compared to motor practice alone.

Materials and Methods

Sixteen healthy adults completed sessions of aerobic exercise or seated rest that were immediately followed by practice of a novel motor task (practice). Exercise consisted of 30 minutes of continuous cycling at 60% peak O₂ uptake. Twenty-four hours after practice, we assessed motor learning with a no-exercise retention test (retention). We also quantified changes in offline motor memory consolidation, which occurred between practice and retention (offline). Tracking error was separated into indices of temporal precision and spatial accuracy.

Results

There were no differences between conditions in the timing of movements during practice (p = 0.066), at retention (p = 0.761), or offline (p = 0.966). However, the exercise condition enabled participants to maintain spatial accuracy during practice (p = 0.477); whereas, following rest performance diminished (p = 0.050). There were no significant differences between conditions at retention (p = 0.532) or offline (p = 0.246).

Discussion

An acute bout of moderate-intensity aerobic exercise facilitated the maintenance of motor performance during skill acquisition, but did not influence motor learning. Given past work showing that pairing high intensity exercise with skilled motor practice benefits learning, it seems plausible that intensity is a key modulator of the effects of acute aerobic exercise on changes in complex motor behavior. Further work is necessary to establish a dose-response relationship between aerobic exercise and motor learning.     

Ocaratuzumab,an Fc-engineered antibody demonstrates enhanced antibody-dependent cell-mediated cytotoxicity in chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is common in both developed and developing nations where the need for inexpensive and convenient administration of therapy is apparent. Ocaratuzumab is a novel Fc-engineered humanized IgG1 anti-CD20 monoclonal antibody (mAb) designed for effective antibody-dependent cell-mediated cytotoxicity (ADCC) at very low concentrations that may facilitate sub-cutaneous (vs. intravenous) dosing. Here, we report ocaratuzumab’s potency against CLL cells. In vitro assessment of ocaratuzumab’s direct cytotoxicity (DC), complement-dependent cytotoxicity (CDC), antibody-dependent cellular phagocytosis (ADCP), and ADCC was performed on CLL cells. Ocaratuzumab induced DC, CDC, and ADCP similarly to rituximab or ofatumumab (anti-CD20 mAbs). However, ocaratuzumab showed an advantage in NK cell-mediated ADCC over these antibodies. In allogeneic ADCC, [E:T (effector:target) ratios = 25:1, 12:1, 6:1], ocaratuzumab (10 µg/mL) improved ADCC by ~3-fold compared with rituximab or ofatumumab (P &lt; 0.001 all tested E:T ratios). Notably, the superiority of ocaratuzumab-induced ADCC was observed at low concentrations (0.1–10 ug/ml; P &lt; 0.03; allogeneic assays). In extended allogeneic ADCC E:T titration, ocaratuzumab (0.1 µg/mL) demonstrated 19.4% more cytotoxicity than rituximab (E:T = 0.38:1; P = 0.0066) and 21.5% more cytotoxicity than ofatumumab (E:T = 1.5:1; P = 0.0015). In autologous ADCC, ocaratuzumab (10 µg/mL) demonstrated ~1.5-fold increase in cytotoxicity compared with rituximab or ofatumumab at all E:T ratios tested (E:Ts = 25:1,12:1,6:1; all P &lt; 0.001). Obinutuzumab, a glyco-engineered anti-CD20 mAb, showed no improvement in ADCC activity compared with ocaratuzumab. The enhanced ADCC of ocaratuzumab suggests that it may be effective at low concentrations. If supported by clinical investigation, this feature could potentially allow for subcutaneous dosing at low doses that could expand the potential of administering chemoimmunotherapy in developing countries.     

Smartphone-Supported versus Full Behavioural Activation for Depression: A Randomised Controlled Trial

Background

There is need for more cost and time effective treatments for depression. This is the first randomised controlled trial in which a blended treatment - including four face-to-face sessions and a smartphone application - was compared against a full behavioural treatment. Hence, the aim of the current paper was to examine whether a blended smartphone treatment was non-inferior to a full behavioural activation treatment for depression.

Methods

This was a randomised controlled non-inferiority trial (NCT01819025) comparing a blended treatment (n=46) against a full ten-session treatment (n=47) for people suffering from major depression. Primary outcome measure was the BDI-II, that was administered at pre- and post-treatment, as well as six months after the treatment.

Results

Results showed significant improvements in both groups across time on the primary outcome measure (within-group Cohen’s d=1.35; CI [−0.82, 3.52] to d=1.47; CI [−0.41, 3.35]; between group d=−0.13 CI [−2.37, 2.09] and d=−0.10 CI [−2.53, 2.33]). At the same time, the blended treatment reduced the therapist time with an average of 47%.

Conclusions

We could not establish whether the blended treatment was non-inferior to a full BA treatment. Nevertheless, this study points to that the blended treatment approach could possibly treat nearly twice as many patients suffering from depression by using a smartphone applica¬tion as add-on. More studies are needed before we can suggest that the blended treatment method is a promising cost-effective alternative to regular face-to-face treatment for depression.

Trial Registration

Cognitive Behavioral Therapy Treatment of Depression With Smartphone Support NCT01819025     

THE BETA-BINOMIAL MODEL: VARIABILITY IN OVERDISPERSION ACROSS METHODS AND OVER TIME

The beta‐binomial model accounts for variability between samples as well as variability between judges (overdispersion), making it possible to combine responses across judges and replications. Overdispersion (measured by gamma) was examined in this 3‐part study. (1) Groups of judges (n = 53–59) performed two replications each of a paired comparison and paired preference. Results showed that extent of overdispersion could not be predicted from the method. (2) The stability of gamma across discrimination methods (2‐alternative forced choice [2‐AFC], 3‐alternative forced choice [3‐AFC], triangle and duo‐trio) was also examined (n = 103). Results indicated that gamma was largely consistent across 2‐AFC, 3‐AFC and triangle tasks, but it was higher in the duo‐trio task. (3) The stability of gamma over time was also investigated (n = 25). Results demonstrate that overdispersion varied over time with no clear pattern. In all cases, use of the beta‐binomial model allowed responses across judges and replications to be combined, increasing the power achieved for a given panel size.     

A Standardized Method for the Construction of Tracer Specific PET and SPECT Rat Brain Templates: Validation and Implementation of a Toolbox

High-resolution anatomical image data in preclinical brain PET and SPECT studies is often not available, and inter-modality spatial normalization to an MRI brain template is frequently performed. However, this procedure can be challenging for tracers where substantial anatomical structures present limited tracer uptake. Therefore, we constructed and validated strain- and tracer-specific rat brain templates in Paxinos space to allow intra-modal registration. PET [¹⁸F]FDG, [¹¹C]flumazenil, [¹¹C]MeDAS, [¹¹C]PK11195 and [¹¹C]raclopride, and SPECT [^99mTc]HMPAO brain scans were acquired from healthy male rats. Tracer-specific templates were constructed by averaging the scans, and by spatial normalization to a widely used MRI-based template. The added value of tracer-specific templates was evaluated by quantification of the residual error between original and realigned voxels after random misalignments of the data set. Additionally, the impact of strain differences, disease uptake patterns (focal and diffuse lesion), and the effect of image and template size on the registration errors were explored. Mean registration errors were 0.70±0.32mm for [¹⁸F]FDG (n = 25), 0.23±0.10mm for [¹¹C]flumazenil (n = 13), 0.88±0.20 mm for [¹¹C]MeDAS (n = 15), 0.64±0.28mm for [¹¹C]PK11195 (n = 19), 0.34±0.15mm for [¹¹C]raclopride (n = 6), and 0.40±0.13mm for [^99mTc]HMPAO (n = 15). These values were smallest with tracer-specific templates, when compared to the use of [¹⁸F]FDG as reference template (p&0.001). Additionally, registration errors were smallest with strain-specific templates (p&0.05), and when images and templates had the same size (p≤0.001). Moreover, highest registration errors were found for the focal lesion group (p&0.005) and the diffuse lesion group (p = n.s.). In the voxel-based analysis, the reported coordinates of the focal lesion model are consistent with the stereotaxic injection procedure. The use of PET/SPECT strain- and tracer-specific templates allows accurate registration of functional rat brain data, independent of disease specific uptake patterns and with registration error below spatial resolution of the cameras. The templates and the SAMIT package will be freely available for the research community.     

A Randomized Controlled Trial of Multicomponent Exercise in Older Adults with Mild Cognitive Impairment

Background

To examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions.

Methodology/Principal Findings

Subjects were 100 older adults (mean age, 75 years) with MCI. The subjects were classified to an amnestic MCI group (n = 50) with neuroimaging measures, and other MCI group (n = 50) before the randomization. Subjects in each group were randomized to either a multicomponent exercise or an education control group using a ratio of 1∶1. The exercise group exercised for 90 min/d, 2 d/wk, 40 times for 6 months. The exercise program was conducted under multitask conditions to stimulate attention and memory. The control group attended two education classes. A repeated-measures ANOVA revealed that no group × time interactions on the cognitive tests and brain atrophy in MCI patients. A sub-analysis of amnestic MCI patients for group × time interactions revealed that the exercise group exhibited significantly better Mini-Mental State Examination (p = .04) and logical memory scores (p = .04), and reducing whole brain cortical atrophy (p<.05) compared to the control group. Low total cholesterol levels before the intervention were associated with an improvement of logical memory scores (p<.05), and a higher level of brain-derived neurotrophic factor was significantly related to improved ADAS-cog scores (p<.05).

Conclusions/Significance

The results suggested that an exercise intervention is beneficial for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amnestic MCI. Low total cholesterol and higher brain-derived neurotrophic factor may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of exercise on cognitive function in older adults with MCI.

Trial Registration

UMIN-CTR UMIN000003662 ctr.cgi&quest;function&hairsp;&equals;&hairsp;brows&amp;action&hairsp;&equals;&hairsp;brows&amp;type&hairsp;&equals;&hairsp;summary&amp;recptno&hairsp;&equals;&hairsp;R000004436&amp;language&hairsp;&equals;&hairsp;J.     

Clinicopathological and prognostic significance of osteopontin expression in patients with prostate cancer: a systematic review and meta-analysis

Background: Evaluation of the feasibility for osteopontin (OPN) to serve as a biomarker in the prognosis and clinical-pathological features of prostate cancer (PCA) patients.Methods: The original publications related to OPN and PCA were comprehensively searched in the online databases, including PubMed, Embase, Cochrane Library, Web of Science, Medline, Wanfang and China National Knowledge Infrastructure up to August 2019. Results were analyzed by Revman 5.3 and Stata 12.0.Results: A total of 21 studies were included in the analysis and the result showed that the positive OPN expression group had a lower overall survival than the negative expression group (univariate: hazards ratio (HR) = 2.32, 95% confidence interval (95% CI) [1.74, 3.10], multivariate: HR = 2.41, 95% CI [1.63, 3.57]) and a lower biochemical relapse-free survival than the negative group (univariate: HR = 1.42, 95% CI [0.92, 2.17], multivariate: HR = 1.61, 95% CI [1.39, 1.87]). In addition, there was a higher expression level of OPN in PCA tissues than in normal prostate tissues (OR = 46.55, 95% CI [12.85, 168.59], P<0.00001) and benign prostatic hyperplasia (BPH) tissues (OR = 11.07, 95% CI [3.43, 35.75], P<0.0001). Moreover, OPN positive expression was also related to high Gleason score (OR = 2.64, 95% CI [1.49, 4.70], P=0.0009), high TNM stage (OR = 3.15, 95% CI [1.60, 6.20, P=0.0009), high Whitmore–Jewett stage (OR = 2.53, 95% CI [1.06, 6.03], P=0.04), high lymph node (OR = 3.69, 95% CI [1.88, 7.23], P=0.0001), and distant metastasis (OR = 8.10, 95% CI [2.94, 22.35], P=0.01). There was no difference observed in the differentiation of PCA (OR = 1.79, 95% CI [0.39, 8.33], P=0.46).Conclusion: OPN could be recognized as a promising diagnostic and prognostic biomarker for PCA patients.     

Effect of acute mild dehydration on cognitive-motor performance in golf

ABSTRACT: Smith, MF, Newell, AJ, and Baker, MA. Effect of acute mild dehydration on cognitive-motor performance in golf. J Strength Cond Res 26(11): 3075-3080, 2012-Whether mild dehydration (-1 to 3% body mass change [ΔBM]) impairs neurophysiological function during sport-specific cognitive-motor performance has yet to be fully elucidated. To investigate this within a golfing context, 7 low-handicap players (age: 21 ± 1.1 years; mass: 76.1 ± 11.8 kg; stature: 1.77 ± 0.07 m; handicap: 3.0 ± 1.2) completed a golf-specific motor and cognitive performance task in a euhydrated condition (EC) and dehydrated condition (DC) (randomized counterbalanced design; 7-day interval). Dehydration was controlled using a previously effective 12-hour fluid restriction, monitored through ΔBM and urine color assessment (UCOL). Mild dehydration reduced the mean BM by 1.5 ± 0.5% (p = 0.01), with UCOL increasing from 2 (EC) to 4 (DC) (p = 0.02). Mild dehydration significantly impaired motor performance, expressed as shot distance (114.6 vs. 128.6 m; p < 0.001) and off-target accuracy (7.9 vs. 4.1 m; p = 0.001). Cognitive performance, expressed as the mean error in distance judgment to target increased from 4.1 ± 3.0 m (EC) to 8.8 ± 4.7 m (DC) (p < 0.001). The findings support those of previous research that indicates mild dehydration (-1 to 2% ΔBM) significantly impairs cognitive-motor task performance. This study is the first to show that mild dehydration can impair distance, accuracy, and distance judgment during golf performance.     

Revision of the Afrotropical Phaeogenini (Ichneumonidae,Ichneumoninae), with description of a new genus and?twelve new species

We revise the 10 genera and 23 species of the tribe Phaeogenini (Ichneumonidae: Ichneumoninae) known to occur in the Afrotropical region. We describe the following 13 new taxa: Kibalus Rousse, van Noort & Diller, gen. n.; K. toro Rousse, van Noort & Diller, sp. n.; K. mubfs Rousse & van Noort, sp. n.; Arearia oxymoron Rousse & van Noort, sp. n.; Chauvinia nyanga Rousse & van Noort, sp. n.; Dicaelotus asantesana Rousse & van Noort, sp. n.; D. hoerikwaggoensis Rousse & van Noort, sp. n.; D. tablemountainensis Rousse & van Noort, sp. n.; Heterischnus mfongosi Rousse & van Noort, sp. n.; H. mkomazi Rousse & van Noort, sp. n.; Lusius flummox Rousse & van Noort, sp. n.; Tycherus amatola Rousse & van Noort, sp. n.; and T. nardousberg Rousse & van Noort, sp. n. New distribution records: Heterischnus africanus (Heinrich, 1936) from South Africa, Tanzania and Uganda; H. krausi Schönitzer, 1999 from Rwanda; Lusius tenuissimus (Heinrich, 1938) from Democratic Republic of Congo, Malawi, Nigeria, South Africa, and Zimbabwe. A doubtful record of Aethecerus foveolatus Gregor, 1940 from Sao Tome is additionaly reported in the appendix. We provide illustrated diagnoses and identification notes. Online interactive dichotomous and matrix Lucid keys to genera and species are available at http://www.waspweb.org.