Four-week Interval Research Articles

Adjuvant effect of saponin in an oil-based monovalent (serotype O) foot-and-mouth disease virus vaccine on the antibody response in guinea pigs and cattle.

To enhance the potency of a foot-and-mouth disease (FMD) vaccine, saponin was included in the vaccine formula. In this study, the combined effect of Montanide ISA 50 and saponin was evaluated. Two experiments were performed in guinea pigs and one in cattle to determine the optimal antigen and saponin doses. Only serotype O of foot-and-mouth disease virus (O/PanAsia-2 of ME-SA topotype) was employed in preparation of the monovalent vaccine. All animals were immunized twice with a four-week interval, except for the negative controls. Blood was collected 10 days after the second booster, and the immune response was evaluated using a serum neutralization test. Oil-based FMD vaccines containing saponin induced higher neutralizing antibody levels than formulations lacking saponin. The addition of saponin to formulations with low antigen payload (2.5 µg of inactivated whole virus particles [146S particles] per dose) gave significantly higher neutralizing antibody levels (p < 0.005) than 5 µg of 146S without saponin, suggesting that it can be used to improve FMD vaccine potency in susceptible animals. No adverse effects were observed in vaccinated cattle or guinea pigs.

Клинико-эндоскопические характеристики ГЭРБ у пациентов с ожирением

Relevance. Obesity and gastroesophageal reflux disease (GERD) – diseases of the XXI century. Obesity is a risk factor for GERD, and has significant negative impact on its course, and causes the ineffectiveness of standard therapeutic approaches. Material and methods. The study involved 1,433 patients treated with proton pump inhibitors (PPIs) for non-erosive reflux disease (NERD) or erosive esophagitis (EE). The observation period was two months and included three visits with a four-week interval. Special attention was paid to the influence of overweight (body mass index (BMI) &gt; 25 kg/m2) and abdominal obesity (waist circumference (WC) in men more than 94 cm, in women − more than 80 cm) on the course of GERD and the effectiveness of acid-suppressive therapy. Results. NERD was diagnosed in 618 (48.1%) patients, EE – in 614 (47.8%) patients. Overweight (BMI &gt; 25 kg/m2) was detected in 901 (62.7%) patients, obesity (BMI &gt; 30 kg/m2) – in 284 (19.9%) patients. Abdominal obesity was detected in 380 (56%) women and 193 (39%) men. Patients with BMI of 25 kg/m2 and abdominal obesity had more pronounced symptoms according to the results of the GERD Q questionnaire. Patients with NERD and EE did not differ in BMI and WC. The effectiveness of PPI therapy by the fourth week did not depend on BMI and WС, but patients without overweight and abdominal obesity were more likely to achieve clinical and endoscopic remission of the disease by the eighth week of therapy. The research participants received rabeprazole therapy in 96% of cases

An independent inter- and intraobserver agreement assessment of the AOSpine sacral fracture classification system

BACKGROUND CONTEXTThe AOSpine sacral classification scheme was recently described. It demonstrated substantial interobserver and excellent intraobserver agreement in the study describing it; however, an independent assessment has not been performed. PURPOSETo perform an independent inter- and intraobserver agreement evaluation of the AOSpine sacral fracture classification system. STUDY DESIGNAgreement study. METHODSComplete computerized tomography (CT) scans, including axial images, with coronal and sagittal reconstructions of 80 patients with sacral fractures were selected and classified using the morphologic grading of the AOSpine sacral classification system by six evaluators (from three different countries). Neurological modifiers and case-specific modifiers were not assessed. After a four-week interval, the 80 cases were presented to the same raters in a random sequence for repeat assessment. We used the Kappa coefficient (κ) to establish the inter- and intraobserver agreement. RESULTSThe interobserver agreement was substantial when considering the fracture severity types (A, B, or C), with κ=0.68 (0.63–0.72), but moderate when considering the subtypes: κ=0.52 (0.49–0.54). The intraobserver agreement was substantial considering the fracture types, with κ=0.69 (0.63–0.75), and considering subtypes, κ=0.61 (0.56–0.67). CONCLUSIONThe sacral classification system allows adequate interobserver agreement at the type level, but only moderate at the subtypes level. Future prospective studies should evaluate whether this classification system allows surgeons to decide the best treatment and to establish prognosis in patients with sacral fractures.

A Monovalent and Trivalent MVA-Based Vaccine Completely Protects Mice Against Lethal Venezuelan, Western, and Eastern Equine Encephalitis Virus Aerosol Challenge.

Venezuelan, eastern and western equine encephalitis viruses (EEV) can cause severe disease of the central nervous system in humans, potentially leading to permanent damage or death. Yet, no licensed vaccine for human use is available to protect against these mosquito-borne pathogens, which can be aerosolized and therefore pose a bioterror threat in addition to the risk of natural outbreaks. Using the mouse aerosol challenge model, we evaluated the immunogenicity and efficacy of EEV vaccines that are based on the modified vaccinia Ankara-Bavarian Nordic (MVA-BN®) vaccine platform: three monovalent vaccines expressing the envelope polyproteins E3-E2-6K-E1 of the respective EEV virus, a mixture of these three monovalent EEV vaccines (Triple-Mix) as a first approach to generate a multivalent vaccine, and a true multivalent alphavirus vaccine (MVA-WEV, Trivalent) encoding the polyproteins of all three EEVs in a single non-replicating MVA viral vector. BALB/c mice were vaccinated twice in a four-week interval and samples were assessed for humoral and cellular immunogenicity. Two weeks after the second immunization, animals were exposed to aerosolized EEV. The majority of vaccinated animals exhibited VEEV, WEEV, and EEEV neutralizing antibodies two weeks post-second administration, whereby the average VEEV neutralizing antibodies induced by the monovalent and Trivalent vaccine were significantly higher compared to the Triple-Mix vaccine. The same statistical difference was observed for VEEV E1 specific T cell responses. However, all vaccinated mice developed comparable interferon gamma T cell responses to the VEEV E2 peptide pools. Complete protective efficacy as evaluated by the prevention of mortality and morbidity, lack of clinical signs and viremia, was demonstrated for the respective monovalent MVA-EEV vaccines, the Triple-Mix and the Trivalent single vector vaccine not only in the homologous VEEV Trinidad Donkey challenge model, but also against heterologous VEEV INH-9813, WEEV Fleming, and EEEV V105-00210 inhalational exposures. These EEV vaccines, based on the safe MVA vector platform, therefore represent promising human vaccine candidates. The trivalent MVA-WEV construct, which encodes antigens of all three EEVs in a single vector and can potentially protect against all three encephalitic viruses, is currently being evaluated in a human Phase 1 trial.

A Pragmatic Application of Ultrasonography for the Assessment of Disease Activity in Patients with Early Inflammatory Arthritis.

The aim of the study was to examine the usefulness of targeted musculoskeletal ultrasonography (MSUS) in assessing the disease activity of patients with early inflammatory arthritis (EIA). Twenty-eight patients with EIA were enrolled. The MSUS examination of joints with arthritic signs (tenderness or swelling), measurement of 28-joint Disease Activity Score (DAS28), and its components were performed at four-week interval visits until power doppler (PD) US remission was achieved. Various MSUS parameters of grey scale (GS) and PD synovitis were measured. Pearson or Spearman correlation coefficients were determined for the purpose of the study. Data were gathered from a total of 85 visits. The Sum of GS grade correlated better with physical examination findings, while the Sum of PD grade correlated better with serum inflammatory markers and patient global health. However, Global OMERACT-EULAR Synovitis Score (GLOESS), which reflected both PD and GS grades, correlated evenly well with each clinical parameter. In addition, GLOESS correlated best with DAS28 in the overall study population (p < 0.01). Conclusively, our targeted MSUS parameters of arthritic joints, especially sums of semi-quantitative grades of synovitis, could be useful in monitoring patients with EIA.

Differential effects of high-intensity interval training (HIIT) on choriocapillaris perfusion in healthy adults and patients with type 1 diabetes mellitus (T1DM)

PurposeTo investigate the effects of a four-week high-intensity interval training (HIIT) on choriocapillaris (CC) perfusion in young healthy adults and type 1 diabetes mellitus (T1DM) patients. MethodsData of two HIIT studies with baseline to follow-up comparison were retrospectively analysed. Twenty healthy participants and twenty T1DM patients without clinical signs of diabetic retinopathy were included. All participants had performed a four-week all-out HIIT protocol with a total of 8 training sessions. Changes in physical fitness were assessed using power output at the individual aerobic lactate threshold (IANT). Optical coherence tomography angiography (OCTA) imaging was performed at baseline and follow-up. CC images were analysed for number, size and total area of flow deficits (FD), mean signal intensity, signal intensity standard deviation and kurtosis of signal intensity distribution. ResultsAt baseline, CC OCTA revealed a lower and more heterogeneous intensity signal in T1DM eyes (mean intensity signal and standard deviation of signal intensity, p < 0.001). Percent of CC FD area was greater in T1DM eyes (p < 0.001). While T1DM patients showed greater improvement of exercise capacity at IANT than healthy controls (group×time p = 0.0403), CC FD area and standard deviation of intensity increased in healthy controls but not in T1DM patients (group×time p ≤ 0.029). Moreover, linear regression slopes of FD region distribution differed significantly at baseline and follow-up (p = 0.0002) in healthy individuals but not in T1DM patients. ConclusionsEffects of regular physical exercise performed as HIIT on CC perfusion were only seen in healthy participants, not in T1DM patients suggesting impaired CC adaptation in T1DM.

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

BackgroundAn intractable plantar keratoma (IPK) is a conical thickening of the epidermis’ stratum corneum and a common cause of foot pain which can have a significant, detrimental impact on the mobility, quality of life and independence of individuals. Conservative treatments are currently offered to patients with IPK, but they are unsatisfactory since they do not offer a sufficient or permanent reduction of symptoms. The purpose of this study was the evaluation of the feasibility, safety and effectiveness of innovative treatments for intractable plantar keratoma (IPK).MethodsA randomized single blind trial with 40 patients divided with block randomization in four parallel groups was conducted to compare treatment combinations: conservative sharp debridement only or sharp debridement with needle insertion, physiological water injection or lidocaine injection. All patients obtained the same treatment four times at a four-week interval. At each visit, visual analog scale (VAS), Foot Function Index (FFI) and IPK size were evaluated. VAS and FFI were also completed at a six and twelve-month follow-up.ResultsOur findings in regards to feasibility demonstrated recruitment challenges because of the anticipated pain that would be provoked by needle insertion may not be worth the potential pain relief compared to debridement alone from the patient’s perspective. This was also the principal cause of drop out. Our preliminary results show no main effect of group for any of the clinical outcomes: pain felt on VAS, FFI score, IPK’s size (p > 0.05). However, the analysis revealed a statistically significant effect of time on VAS (p < 0.001), FFI score (p < 0.001) and IPK’s size (width and depth (p < 0.001); length (p = 0.001)), but no group x time interaction was found (p > 0.05).ConclusionsThis study demonstrates that IPK treatment consisting of sharp debridement with needle insertion, physiological saline water injection or lidocaine injection is feasible and safe. There was a non-statistically significant trend toward diminishing pain intensity compared to scalpel debridement alone. The pain provoked by needle insertion and injection treatments must be addressed with a scientifically proven protocol to make it more comfortable for patients before these treatments could be considered in further studies.Trial registrationClinicalTrials.gov, NCT04777227. 2 March, 2021 - Retrospectively registered (All participants were recruited prior to registration).

Projeto S: A Stepped-Wedge Randomized Trial to Assess CoronaVac Effectiveness in Serrana, Brazil

Background: A stepped-wedge trial is an approach for assessing vaccine effectiveness in the real world. By the end of the study, all participants could receive the intervention, eliminating the ethical dilemma of placebo, especially during a pandemic. Methods: We evaluated the effectiveness of CoronaVac in Serrana, Brazil, amid an uncontrolled community Covid-19 epidemic using a stepped-wedge randomized trial. The city was separated into 25 subareas, divided into four groups, and randomized to receive CoronaVac in a two-dose scheme with a four-week interval. Intervention was initiated in each group with a one-week interval. The primary endpoint was the incidence of symptomatic cases in fully immunized individuals. The secondary endpoints were Covid-19-related hospitalizations and deaths and incidence according to immunization coverage. Findings: The study occurred during epidemiological weeks 6 to 19 in 2021. Up to 27,406 participants received the first dose of the study vaccine, corresponding to 81·3% of the adults and 60·9% of the urban population. Among fully immunized individuals, the vaccine effectiveness was 80·5 (95% CI, 75·1 to 84·7) for preventing symptomatic Covid-19 cases, 95% (95% CI, 86·9 to 98·1) and 94·9% (95% CI, 76·4 to 98·9) for preventing Covid-19-related hospitalizations and deaths, respectively. There was a significant indirect protective effect in unvaccinated people when 52% of the adult population was fully vaccinated. The Gamma variant was dominant during the study. Interpretation: CoronaVac effectively prevented symptomatic Covid-19 cases and protected against severe disease and death during Gamma variant circulation. Unvaccinated individuals benefited from high vaccine coverage levels. Trial Registration: This study was registered with (ClinicalTrials.gov Identifier, NCT04747821) Funding: Fundacao Butantan and Sao Paulo Research Foundation (FAPESP). Declaration of Interest: MCB, BMC, GJV, NNF, PMMG, RH, BALF, and RTC received research funding from Butantan Institute during the conduct of this study. RP, MTRPC, APB, JPS, and ROP were employees of Butantan Institute during the conduct of this study. HAB, EGP, GGP, SCSV and DC are employees of Butantan Institute. All other authors declare no competing interests Ethical Approval: The study was reviewed and approved by the Ethics Committee of the Clinical Hospital, Ribeirao Preto Medical School, University of Sao Paulo (CAAE 42390621.1.0000.5440).

Factor Structure and Measurement Invariance of the Chinese version of the Snaith-Hamilton Pleasure Scale (SHAPS) in Non-clinical and Clinical populations

BackgroundAnhedonia, a key symptom of depression and schizophrenia, has emerged as a potential endophenotype. The aim of this study was to evaluate the psychometric properties of a Chinese version of the Snaith-Hamilton Pleasure Scale(SHAPS), a self-report anhedonia scale, in a non-clinical sample and clinical sample inclusive of major depressive disorder (MDD), schizophrenia, or a personality disorder. MethodsA total of 4,722 undergraduate students and 352 clinical patients participated in this study. Internal consistency was assessed by calculating Cronbach's α and mean inter-item correlation (MIC) values. Test-retest reliability and convergent validity were assessed with Pearson r coefficients. The best fitting of six potential factor-structure models was determined by confirmatory factor analysis (CFA). Measurement invariance across genders and samples was determined by multi-group CFA. ResultsInternal consistency of the Chinese version of the SHAPS was acceptable in non-clinical (Cronbach's α = 0.90) and clinical (Cronbach's α = 0.91) samples. Four-week interval test-retest reliability was 0.60. Moreover, the Spanish four-factor structure had the best fit indexes in both samples. Scalar invariance was established across genders as well as across non-clinical sample and clinical sample. SHAPS was significantly related with the Temporal Experience of Pleasure Scale (TEPS) and Beck Depression Inventory (BDI). LimitationsThere was a restricted scope of convergent validity and the size of clinical sample is relatively small, psychometric properties in elderly sample is also required. ConclusionThe Chinese version of the SHAPS is a reliable, effective, simple and convenient tool for assessing and screening for anhedonia.

Response of Bt cotton (Gossypium hirsutum L.) to irrigation and potassium fertilization under two tillage systems in a silty clay soil

ABSTRACT Cotton yield and quality are constantly deteriorating in water limited and poorly drained silty clay soils. Farmers practice deep plowing and irrigate at 2-week interval, which is costly, degrading soil, and reduce cotton yield. A field study was conducted to evaluate the impact of tillage, irrigation intervals, and K (potassium) levels on cotton yield and quality. The experiment comprised main plot [reduced tillage (RT) and conventional tillage (CT)], subplot [irrigation intervals (2, 3, and 4-week)], and sub-sub plot treatments [K levels (0, 50, 100, and 150 kg K ha−1)]. Experimental design was split-split-plot replicated thrice. RT with 4-week irrigation interval and K level can replace CT. RT with 4-week interval plus 150 kg K ha−1 produced 25.6% more returns than CT. Four-week interval with 150 kg K saved 50% water and showed higher lint yield than 2-week interval. Four-week interval increased lint yield by 41% and 15.7% over 2- and 3-week intervals, respectively. The highest K level improved lint quality and produced 50.9% higher lint yield than zero K level. Lint quality increased with deficit irrigation and higher K levels. Thus RT, infrequent irrigation, and appropriate K level is a sustainable approach for economic production of cotton.

Test-Retest Reliability of a Questionnaire on Motives for Physical Activity among Adolescents.

The aim of this study was to investigate the test–retest reliability of the motives for undertaking physical activity (PA) items from the Health Behavior in School-Aged Children (HBSC) study questionnaire among Slovak and Czech adolescents and to determine whether this reliability differs by gender, age group and country. We obtained data from 580 students aged 11 and 15 years old (51.2% boys) who participated in a test and retest study with a four-week interval in 2013 via the Health Behavior in School-Aged Children cross-sectional study in the Czech Republic and Slovakia. We estimated the test–retest reliability of all 13 dichotomized motives by using Intraclass Correlation Coefficients (ICC) and Cohen’s Kappa statistics, for continuous and dichotomized motives, respectively. Test–retest reliability showed moderate agreement for nine motives (ICC from 0.41 to 0.60) and fair agreement for four motives (ICC from 0.33 to 0.40). Kappa statistics were similarly moderate to large (0.33 to 0.61), except for three motives with small or trivial correlations. The motives “To improve my health” and “To enjoy the feeling of using my body” had consistently low Kappas and correlations. Overall, the results of this study suggest that most questions on motives for PA on the HBSC questionnaire have acceptable test–retest characteristics for use among adolescents.

How and when does perceived supervisor support for strengths use influence employee strengths use? The roles of positive affect and self-efficacy

The present study sought to investigate how positive affect would mediate the relationship between employee perceived supervisor support for strengths use (PSSSU) and actual employee strengths use as well as the moderating effect of self-efficacy on the relationship. We gathered data from 218 employees (53.7% = male; mean age = 34.51 years, SD = 7.45 years) working in various organisations and at three points in time, separated by a four-week interval. Results of a moderated-mediation path analysis indicated positive affect to partially mediate the positive association between PSSSU and employee strengths use. In addition, self-efficacy positively moderated the direct effect of PSSSU on positive affect. Self-efficacy also positively moderated the indirect effect of PSSSU on strengths use via positive affect. Self-efficacy influences employee perceptions of perceived supervisor support for strength use and their actual use of work strengths.

Development and Validation of a Short Version of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ-S)

We conducted three studies (total n = 998) aimed at developing and validating a shortened version of the Reinforcement Sensitivity Theory of Personality Questionnaire (i.e., the RST-PQ-S). In Study 1 (n = 341), twenty-two items were selected from the original RST-PQ, based on both theoretical and empirical criteria. Confirmatory factor analysis (CFA) on this short-form supported the six-factor structure comprising: FFFS, BIS, and four BAS components (Reward Interest, Goal Drive-Persistence, Reward Reactivity, and Impulsivity). The six scale scores showed adequate levels of internal consistency. Construct validity was supported by correlations with established personality measures. In Study 2 (n = 340), CFA results were cross-validated in an independent sample and construct validity was supported by correlations with BIS/BAS scales. In Study 3 (n = 317) test-retest correlations showed acceptable-to-good levels of temporal stability over a four-week interval. Results revealed a substantial overlap with original, full-length RST-PQ, providing evidence for the comparability of the two versions. Latent State-Trait analyses showed that the items of the RST-PQ-S mostly capture interindividual differences that are stable across situations. Taken together, findings indicate that the RST-PQ-S provides an efficient, valid and reliable alterative to the longer RST-PQ.

Reliability and validity of the Wrightington classification of elbow fracture-dislocation

The Wrightington classification system of fracture-dislocations of the elbow divides these injuries into six subtypes depending on the involvement of the coronoid and the radial head. The aim of this study was to assess the reliability and reproducibility of this classification system. This was a blinded study using radiographs and CT scans of 48 consecutive patients managed according to the Wrightington classification system between 2010 and 2018. Four trauma and orthopaedic consultants, two post CCT fellows, and one speciality registrar based in the UK classified the injuries. The seven observers reviewed preoperative radiographs and CT scans twice, with a minimum four-week interval. Radiographs and CT scans were reviewed separately. Inter- and intraobserver reliability were calculated using Fleiss and Cohen kappa coefficients. The Landis and Koch criteria were used to interpret the strength of the kappa values. Validity was assessed by calculating the percentage agreement against intraoperative findings. Of the 48 patients, three (6%) had type A injury, 11 (23%) type B, 16 (33%) type B+, 16 (33%) Type C, two (4%) type D+, and none had a type D injury. All 48 patients had anteroposterior (AP) and lateral radiographs, 44 had 2D CT scans, and 39 had 3D reconstructions. The interobserver reliability kappa value was 0.52 for radiographs, 0.71 for 2D CT scans, and 0.73 for a combination of 2D and 3D reconstruction CT scans. The median intraobserver reliability was 0.75 (interquartile range (IQR) 0.62 to 0.79) for radiographs, 0.77 (IQR 0.73 to 0.94) for 2D CT scans, and 0.89 (IQR 0.77 to 0.93) for the combination of 2D and 3D reconstruction. Validity analysis showed that accuracy significantly improved when using CT scans (p = 0.018 and p = 0.028 respectively). The Wrightington classification system is a reliable and valid method of classifying fracture-dislocations of the elbow. CT scans are significantly more accurate than radiographs when identifying the pattern of injury, with good intra- and interobserver reproducibility. Cite this article: Bone Joint J 2020;102-B(8):1041-1047.

Effectiveness of Positive and Negative Ions for Elite Japanese Swimmers’ Physical Training: Subjective and Biological Emotional Evaluations

The purpose of this study is to examine the subjective and objective arousal of elite swimmers during physical training under a positive and negative ion environment. The participants were 10 elite Japanese collegiate swimmers participating in the Fédération Internationale de Natation (FINA) Swimming World Cup (age: 20.80 ± 1.39, five males and five females). Each participant went through two experiments (they were subjected to both the positive and negative ion environment and the control environment) within a four-week interval. The training task was a High-Intensity Interval Training (HIIT) routine for the swimmers. The subjective arousal state was measured using a Two-Dimensional Mood Scale (TDMS). In addition, biological emotional evaluations in the form of an electroencephalogram (EEG) were conducted to assess the arousal state of the elite swimmers. The examination of the change in the arousal level at rest and during training demonstrated that both subjective and objective arousal levels were significantly higher in the positive and negative ion environment than in the control environment. In addition, the average training performance scores were also significantly higher in the positive and negative ion environment than in the control environment. This study posits that the positive and negative ion environment has a positive effect on sports training.

Extracellular vesicle species differentially affect endothelial cell functions and differentially respond to exercise training in patients with chronic coronary syndromes

Extracellular vesicles are released upon cellular activation and mediate inter-cellular communication. Individual species of extracellular vesicles might have divergent roles in vascular homeostasis and may show different responses to therapies such as exercise training. We examine endothelial effects of medium-size and small extracellular vesicles from the same individual with or without chronic coronary syndrome, and in chronic coronary syndrome patients participating in a four-week high-intensity interval training intervention. Human aortic endothelial cells were exposed to medium-size extracellular vesicles and small extracellular vesicles isolated from plasma samples of study participants. Endothelial cell survival, activation and re-endothelialisation capacity were assessed by respective staining protocols. Extracellular vesicles were quantified by nanoparticle tracking analysis and flow cytometry. Extracellular vesicle microRNA expression was quantified by realtime-quantitative polymerase chain reaction. In patients with chronic coronary syndrome (n = 25), plasma counts of leukocyte-derived medium-size extracellular vesicles were higher than in age-matched healthy controls (n = 25; p = 0.04) and were reduced by high-intensity interval training (n = 15; p = 0.01 vs baseline). Re-endothelialisation capacity was promoted by medium-size extracellular vesicles from controls, but not by medium-size extracellular vesicles from chronic coronary syndrome patients. High-intensity interval training for 4 weeks enhanced medium-size extracellular vesicle-mediated support of in vitro re-endothelialisation. Small extracellular vesicles from controls or chronic coronary syndrome patients increased endothelial cell death and reduced repair functions and were not affected by high-intensity interval training. The present study demonstrates that medium-size extracellular vesicles and small extracellular vesicles differentially affect endothelial cell survival and repair responses. This equilibrium is unbalanced in patients with chronic coronary syndrome where leukocyte-derived medium-size extracellular vesicles are increased leading to a loss of medium-size extracellular vesicle-mediated endothelial repair. High-intensity interval training partially restored medium-size extracellular vesicle-mediated endothelial repair, underlining its use in cardiovascular prevention and therapy to improve endothelial function.

Evaluation of equivocal small cystic pancreatic lesions with spectral-detector computed tomography.

Evaluation of small cystic lesions of the pancreas remains a challenging task, as due to their size appearance can be rather hypodense than clearly fluid-filled. To evaluate whether additional information provided by novel dual-layer spectral-detector computed tomography (SDCT) imaging can improve assessment of these lesions. For this retrospective study, we reviewed reports of 1192 contrast-enhanced portal-venous phase SDCT scans of the abdomen conducted between May 2017 and January 2019. On basis of the radiological report 25 small (≤1.5 cm) cystic pancreatic lesions in 22 patients were identified, in which additional short-term follow-up imaging was recommended to confirm/clarify cystic nature. Conventional images (CI) and spectral images (SI) including virtual-monoenergetic images at 40 keV (VMI), iodine-density and iodine-overlay images were reconstructed. Two readers indicated lesion conspicuity and confidence for presence of cystic nature on three-point scales. First, solely CI were evaluated, while in a second reading after a four-week interval, the combination of CI and corresponding SI were reviewed. Quantitatively, ROI-based mean attenuation was measured in CI and VMI. In the subjective reading, SI significantly improved lesion conspicuity (CI 2 [1-2], SI 3 [2-3], P < 0.001) and confidence regarding presence of cystic nature (CI 2 [1-2], SI 3 [3-3], P < 0.001). Inter-observer agreement depicted by intraclass correlation coefficient improved considerably from 0.51 with only CI to 0.85 when the combination with SI was used. Further, VMI displayed significantly higher signal-to-noise (CI 1.2 ± 0.8, VMI 3.2 ± 1.8, P < 0.001) and contrast-to-noise ratios (CI 2.6 ± 0.8, VMI 4.7 ± 1.9). Compared to CI alone, combination with SI significantly improves visualization and confidence in evaluation of small equivocal cystic pancreatic lesions.

Inter-rater and test-retest reliability of the \u201cstandardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients\u201d

BackgroundRemoval of a tracheostomy tube in critically ill neurologic patients is a difficult issue, particularly due to the high incidence of oropharyngeal dysphagia. For an objective evaluation of decannulation readiness the “Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients” (SESETD) – a stepwise evaluation of ‘secretion management’, ‘spontaneous swallows’ and ‘laryngeal sensibility/cough’ – has been introduced. With the recent study detailed data on inter-rater and test-retest reliability are presented.MethodsTo obtain inter-rater reliability levels both in a group of raters with at least 5 years of experience (‘experts’) and in a group of raters with no or only minor experience using the SESETD (‘non-experts’), for each single item of the protocol and the sum score α-, respectively κ-levels were determined. The ‘experts’ assessed the same videos after a four-week interval to determine test-retest reliability. Ten videos from tracheostomized neurological patients completely weaned from mechanical ventilation were assessed independently by six ‘experts’. 27 ‘non-experts’ applied the SESETD on 5 videos from the same patient population after introduction to the protocol in a one-hour workshop.ResultsFor the items ‘secretion management’ and ‘spontaneous swallows’ α-levels were identified at > 0.800 both in the group of ‘experts’ and ‘non-experts’. With regard to the item ‘laryngeal sensibility/cough’ in both groups, the α-level was ≥0.667. With κ-levels of 1.0 for ‘secretion management’, 0.93 for ‘spontaneous swallows’ and 0.76 for ‘laryngeal sensibility/cough’ test-retest reliability showed at least substantial agreement for each item. Intraclass correlation coefficient for the sum score was excellent in both groups (α ≥ 0.90).ConclusionsThe SESETD demonstrates good to excellent agreement for each single item included as well as the sum score in experienced and unexperienced raters supporting its usefulness for implementation in daily clinical routine and as an outcome measure for clinical trials.

THE SCALE OF PROPENSITY TO MORAL DISENGAGEMENT AS A PSYCHO-DIAGNOSTIC TOOL OF AN ORGANIZATION’S ETHICS DEVELOPMENT

To develop an organization’s ethics, a warning should be made when people disposed to moral disengagement join it; and it is necessary to create conditions that would not give employees any grounds for finding excuses for their unethical behavior. Propensity to moral disengagement (PMD) should be revealed during selection of new employees, at examination of an organization in order to develop programs aimed to improve its ethical culture. The research goal was to translate the Propensity to&nbsp;Morally&nbsp;Disengage&nbsp;Scale (Moore et al., 2012) into Ukrainian and to adapt it. The Scale has three forms: with 24, 16, and 8 statements. Translation of the original Scale into Ukrainian was made in several stages: direct translation, expert evaluation of the translation and creation of a preliminary version, reverse translation of the preliminary version, expert evaluation of the reverse translation, creation of the test version of the Scale, pilot survey (N = 32), creation of the final scale version in Ukrainian through specification of the test version (Novik, Ionova, 2007), literary editing. The translation is equivalent to the original; there is direct correlation (р ≤ 0,001) between the PMD figures obtained in one group (N = 58) by two measurements (in Ukrainian and English) with a four-week interval. The Ukrainian variant of the PMD Scale has shown good reproducibility of its results; the results of two surveys conducted in one group with a four-week interval correlate well (N = 122, age M=19.7; SD=1.4, students of Ivan Franko National University of Lviv): PMD-24 (r = 0.79), PMD-16 (r = 0.82), PMD-8 (r = 0.74), with р ≤ 0.001. In the Ukrainian version, the shorter is the form, the worse is its internal coordination –&nbsp; α-Cronbach factor determined for the first and the second measurements, respectively, 0.82 and 0.86 (PMD-24), 0.77 and 0.8 (PMD-16), 0.54 and 0.56 (PMD-8), N = 122. Thus, a higher number of statements ensures better reliability of the Scale. The confirmatory analysis has shown that result correspondence to the theoretical model depends on the size of the respondents’ group. With a smaller group (N = 190, 132 women and 58 men aged 18-57, M = 30; SD = 8.93), the shorter scale form gives the result that corresponds the best to the theoretical model: а) PMD-24 results and 8–factor model (interdependent factors): χ²/df = 2.06; RMSEA = 0.07; CFI = 0.79; GFI = 0.83; b) PMD-16 results and 8–factor model (independent factors): χ²/df = 2.05; RMSEA = 0.07; CFI = 0.87; GFI = 0.91; c) PMD-8 results and 1-factor model: χ²/df = 1.6; RMSEA = 0.05; CFI = 0.94; GFI = 0.96. Here is a contradiction: the best internal coordination was obtained for the PMD-24 scale, but the best factor validity was determined for the PMD-8 scale. The sample was enlarged (N = 477, with 277 women and 200 men aged 18-60 – M = 30; SD = 8.85), and the confirmatory analysis was made once again. With the larger group (N = 477) only PMD-24 results corresponded to the theoretical model (eight interrelated factors): χ²/df = 2.76; RMSEA = 0.06; CFI = 0.83; GFI = 0.9. The results for the PMD-16 and PMD-8 forms showed insufficient correspondence to the model – χ²/df &gt; 3. Thus, for the Ukrainian variants,&nbsp; the best reliability and factor validity goes to the PMD scale with 24 statements. To check construct validity, the following techniques were used: 1) The MACH IV Scale (Christie, Geis, 1970), Ukrainian variant (Grebin 2016), 2) Social Well-Being Scales (Keyes, 1998), Ukrainian adaptation (Chetverik-Burchak, 2014), 3) The Big Five Locator (Howard et al., 1996), Ukrainian adaptation (Burlachuk, Korolov, 2000). Significant correlation were obtained (p &lt; 0.001) between PMD-24 and agreeableness (r = -0.18), social actualization (r = -0.21), social contribution (r = -0.15), machiavellianism (r = 0.49); PMD shown by men is higher than that of women (М1 = 81.41, М2 = 71.42, р = 0.000, t = 7.18). This correlates well with the current scientific data and proves construct validity of the scale. Thus, it is suggested to use the PMD scale consisting of 24 statements in the Ukrainian variant as a reliable and valid psycho-diagnostic tool. &nbsp

Whole body vibration improves symptoms of diabetic peripheral neuropathy

Whole Body Vibration (WBV) is an innovative therapy that may be effective for reducing chronic pain associated with diabetic peripheral neuropathy (DPN), Current treatments for DPN pain have demonstrated questionable efficacy and significant risk of adverse events. Preliminary research has indicated that WBV may be effective for controlling chronic pain symptoms of DPN. METHODS: 20 participants (9 male, 11 female), 58.51 ± 10.69 years old, and BMI of 33.60 ± 8.20 kg/m2 were randomly assigned to a sham-treatment (n = 8) or WBV treatment (n = 12) group in a pre-post design. Pain was assessed with a 10-point verbal analog pain scale (VAS). Treatment consisted of three sessions/week with at least one day between sessions, 12 min/session (four bouts of 3 min), for four weeks. Control was established with a sham vibration protocol for two weeks in which the participants were blinded to the treatment. RESULTS: VAS scores of the treatment group decreased significantly at both 2 and 4 weeks (p = 0.019). The treatment group was found to have a significantly lower VAS score than the controls at two weeks (p = 0.033). After cessation of WBV vibration treatment, participants reported reduced DPN-related pain from 1 to 5 weeks later. ConclusionWBV is effective for reducing DPN-associated pain over a two- and four-week interval. This was the first study to demonstrate this using a sham vibration control. We further saw a persistence in pain reduction beyond the day of treatment, indicating a potential chronic effect of WBV treatment.