Gold Standard Measure Research Articles

Semiautomated MRI-Based Method for Orbital Volume and Contour Analysis.

The architecture of the orbital cavity is intricate, and precise measurement of its growth is essential for managing ocular and orbital pathologies. Most methods for those measurements are by CT imaging, although MRI for soft tissue assessment is indicated in many cases, specifically pediatric patients. This study introduces a novel semiautomated MRI-based approach for depicting orbital shape and dimensions. A retrospective cohort study. Patients with at least 1 normal orbit who underwent both CT and MRI imaging at a single center from 2015 to 2023. Orbital dimensions included volume, horizontal and vertical lengths, and depth. These were determined by manual segmentation followed by 3-dimensional image processing software. Differences in orbital measurements between MRI and CT scans. Thirty-one patients (mean age 47.7 ± 23.8 years, 21 [67.7%]) females, were included. The mean differences in delta values between orbital measurements on CT versus MRI were: volume 0.03 ± 2.01 ml, horizontal length 0.53 ± 2.12 mm, vertical length, 0.36 ± 2.53 mm, and depth 0.97 ± 3.90 mm. The CT and. MRI orbital measurements were strongly correlated: volume (r = 0.92, p < 0.001), horizontal length (r = 0.65, p < 0.001), vertical length (r = 0.57, p = 0.001), and depth (r = 0.46, p = 0.009). The mean values of all measurements were similar on the paired-samples t test: p = 0.9 for volume (30.86 ± 5.04 ml on CT and 30.88 ± 4.92 ml on MRI), p = 0.2 for horizontal length, p = 0.4 for vertical length, and p = 0.2 for depth. We present an innovative semiautomated method capable of calculating orbital volume and demonstrating orbital contour by MRI validated against the gold standard CT-based measurements. This method can serve as a valuable tool for evaluating diverse orbital processes.

O100: A novel bedside assessment of skeletal muscle wasting predicts treatment-related toxicity prior to major surgery – The Muscle Ultrasound in Esophagogastric Cancer (MUSEC) study

Abstract Sarcopenia is an important prognosticator during treatment for Oesophagogastric (OG) cancer. Despite this, sarcopenia is not routinely measured in clinical practice due to resource availability. Ultrasound is emerging as a potential tool to quantify muscle mass and quality and might predict treatment-related complications. Skeletal muscle ultrasound has not been investigated in patients undergoing cancer treatment. Patients receiving treatment for OG cancer (chemotherapy plus surgery) were prospectively recruited. Ultrasound was performed at 4 time points during treatment. Primary outcome was a measurable change in skeletal muscle. Secondary outcome measures included correlation with gold-standard measures of muscle mass (CT skeletal muscle index (SMI)), and the association between sarcopenia on ultrasound and treatment-related complications. Fifty patients were recruited. Significant deterioration in quadriceps muscle thickness, cross sectional area, rectus femoris echointensity, and ultrasound sarcopenia index (USI) was observed during chemotherapy. USI showed moderate correlation with CT SMI (r = -.511, p=0.001) with ultrasound classifying more patients as sarcopenic (37% vs 18%, p=0.001), plus detecting a greater magnitude of muscle loss during chemotherapy (-20.2 ±18% vs -6.5 ±7.4%, p=&amp;lt;0.001). USI correlated better with physical function (1-minute sit to stand) compared to CT SMI (r .589, p=&amp;lt;0.001 versus r .149, p=0.169). Ultrasound-defined sarcopenia at baseline was associated with a higher incidence of dose limiting chemotoxicity and severe chemotoxicity but did not post-operative complications. Further validation studies are required, but bedside muscle ultrasound could provide an effective bedside assessment of muscle health and identifies a higher proportion of patients at risk of chemotoxicity prior to major surgery.

Efficacy Outcomes in Clinical Trials of Atopic Dermatitis Treatments: A Systematic Literature Review

Introduction: Complete skin clearance is a key atopic dermatitis (AD) treatment goal. Treatment efficacy in AD trials is evaluated using a range of clinical measures with the Investigator’s Global Assessment (IGA) as a key endpoint. Multiple and varied forms of the IGA scale are utilized across trials, including the Investigator’s Static Global Assessment and the Validated Investigator Global Assessment for ADTM. IGA scores usually range from 0 (clear) to 1 (almost clear), 2 (mild), 3 (moderate), and 4 (severe), but contain differences in detail assessed. Efficacy endpoints using IGA scales include achieving IGA=0 or 1 with ≥2-point improvement from baseline, or IGA=0. The Eczema Area and Severity Index (EASI) and achievement of ≥75% or ≥90% improvement from baseline (EASI75 and EASI90) are additional gold-standard measurements.&#x0D; Objective: To compare differences in efficacy outcomes in recent clinical trials of FDA-approved AD treatments for adults and children.&#x0D; Methods: A systematic literature search was conducted using MEDLINE, Embase, Cochrane Library, and hand search to identify AD trials published in English language between January 1, 2016 and August 16, 2023. Trials could include patients with any severity of AD who were treated with topical therapies (crisaborole, ruxolitinib), injectable systemics (dupilumab, tralokinumab), or oral systemics (upadacitinib, abrocitinib) according to approved indications. Efficacy outcomes of IGA=0 or 1 with ≥2-point improvement, IGA=0, EASI75, and EASI90 were categorized and summarized by AD severity, treatment type, and age groups in the trials.&#x0D; Results: Of 50 publications identified, 40 (80%) reported randomized controlled trials, 2 (4%) single-arm trials, and 8 (16%) open-label extension trials. By patient age groups, 11 publications were on children (&lt;12 years), 8 on adolescents (12–17 years),15 on patients ≥12 years, and 17 on adults (≥18 years). Moderate to severe AD was the most frequently studied severity (38/50 publications), of which all trials were either as systemic monotherapy or systemic therapy combined with a topical. Topical monotherapy for mild to moderate AD only was reported in 8/50 publications. For topicals, achievement of IGA=0 (clear) was not reported for any age group, and no trials reported EASI90 for children &lt;12 years. For injectable systemics, no outcome was reported for IGA=0 (clear) in children &lt;12 years. For oral systemics, no outcomes were reported for children &lt;12 years.&#x0D; Conclusions: This literature search of AD trial publications on FDA-approved treatments from 2016 onwards revealed several gaps in available outcomes data. There were no trials that assessed a topical therapy for moderate to severe AD, and complete disease clearance (IGA=0) was not demonstrated for any topicals. The findings reinforce the unmet need for a topical AD treatment that can provide high efficacy including complete clearance without restriction based on age or disease severity.&#x0D; Funding Support: Dermavant Sciences, Inc.

Sex Differences in Autistic Youth Born Extremely Preterm.

To evaluate sex differences in autistic traits in youth born extremely preterm (EP; 23-27 weeks) who were later diagnosed with autism spectrum disorder (ASD) at 10-years. A longitudinal cohort design from the Extremely Low Gestational Age Newborn Study (ELGAN) followed N = 857 EP infants from birth through 10-years. EP infants later diagnosed with ASD (N = 61, 20 females) participated in the study. Group differences were evaluated via inferential and Bayesian statistics (values > 1 suggest evidence for alternate hypothesis) on ASD screeners (M-CHAT at 2-years, SCQ and SRS-2 at 10-years), and gold-standard diagnostic measures (ADOS-2, ADI-R) at 10-years. Males scored significantly higher than females on measures of Social Affect from the ADOS-2, t(34.27)=-2.20, BF10 = 2.33, and measures of Repetitive and Restricted Behaviors from the ADI-R, t(40.52)=-2.85, BF10 = 5.26. Bayesian estimates suggested marginal evidence for sex differences in Nonverbal Communication, t(30.66)=-1.81, BF10 = 1.25, and Verbal Communication, t(24.64)=-1.89, BF10 = 1.39, from the ADI-R, wherein males scored higher than females. No statistically significant sex differences were identified on any of the ASD screeners at 2 (M-CHAT) or 10 years (SCQ). No significant sex differences were observed on any subscales of the SRS at 10 years. EP autistic males present with more autistic traits than EP autistic females on gold-standard diagnostic measures of autism at 10-years of age, despite not presenting with higher autistic traits on screeners at either age. These results align with sex differences observed in full-term, autistic youth. These results suggest ASD screeners may under identify autism in EP youth, particularly females.

Design and validation of a new questionnaire with a gender perspective to measure medication adherence for secondary prevention of ischaemic heart disease: study protocol

Introduction and objectivesOnly about 50% of chronic patients in high-income countries adhere to their treatment. There are methods to measure medication adherence but none of them can be considered optimal....

Standardization and validation of neoLVOT assessment using three-dimensional trans-esophageal echocardiography before trans-catheter mitral valve replacement.

Trans-catheter mitral valve replacement (TMVR) procedures had emerged as an alternative solution for patients who are at high risk for mitral valve surgery. Although cardiac computed tomography (CT) remains the standard method for procedural planning, there is no full agreement on the best systolic phase for quantitation of the neoLVOT. Furthermore, a new three-dimensional trans-esophageal echocardiography (3DTEE) based software was developed to serve as filter and or an alternative for patients who cannot have CT due to any contraindication. To determine the systolic phase of the cardiac cycle that shows the narrowest NeoLVOT area in order to standardize the way of using these software and then to validate the 3DTEE-based software against the CT-based one as a gold standard, in mitral valve annulus (MA) and NeoLVOT assessment. A single center, observational, retrospective study. Initially, a sample of 20 patients (age 62±4 years, 70% men) had CT-based analysis at mid-diastole (80%), early-systole (10%), mid-systole (20%), late-systole (30%-40%), in order to detect the best systolic phase at which the neoLVOT area is the narrowest after TMVR. Then, the end systolic phase was standardized for the analysis of 49 patients (age 57±6 years, 60% men), using both the commercially available CT-based software and the newly available 3DTEE-based software (3mensio Structural Heart, Pie Medical Imaging, The Netherlands). The 3DTEE derived parameters were compared with the gold standard CT-based measurements. The neoLVOT area was significantly narrower at end-systole (224±62 mm2), compared to early-systole (299±70 mm2) and mid-systole (261±75 mm2), (p=.005). Excellent correlation was found between 3DTEE and CT measurements for MA AP diameter (r=.96), IC diameter (r=.92), MA area (r=.96), MA perimeter (r=.94) and NeoLVOT area (r=.96), (all p-values<.0001). Virtual valve sizing was based on annulus measurement and was identical between CT and 3DTEE. Interobserver and intraobserver agreements were excellent for all the measurements with ICCs>.80. End-systole is the phase that shows the narrowest neoLVOT and hence should be the standard phase used during the analysis. The 3DTEE based analysis using this new software is reliable compared to the CT-based analysis and can be serve as an alternative analysis tool in patients who cannot have CT for any clinical contraindication or as a screening test and/or filter for all patients before proceeding to a detailed CT scan.

Short-term vascular responses to spring and fall daylight savings time shifts.

Daylight saving time (DST) is a Western biannual time transition, setting the clock back 1 h in the fall and forward 1 h in the spring. There is an epidemiological link between DST and acute myocardial infarction risk in the first week following the spring shift; however, the mechanisms underlying the effect of DST on cardiovascular function remain unclear. The purpose of this study was to explore the short-term cardiovascular changes induced by fall and spring shifts in DST in a convenience sample of healthy adults. We hypothesized that spring, but not fall, DST shifts would acutely increase central pulse wave velocity, the gold standard measurement of central arterial stiffness. Twenty-one individuals (fall: n = 10; spring: n = 11) participated in four visits, occurring 1 wk before and at +1, +3, and +5 days after spring and fall time transitions. Central, brachial, and radial pulse wave velocity as well as carotid augmentation index were assessed with applanation tonometry. Sleep quality and memory function were assessed via questionnaire and the Mnemonic Similarities Task, respectively. Neither fall or spring transition resulted in changes to cardiovascular variables (carotid-femoral pulse wave velocity, carotid-brachial pulse wave velocity, carotid-radial pulse wave velocity, heart rate, mean arterial pressure, or augmentation index), sleep quality, or cognitive function (all P > 0.05). Our findings do not provide evidence that DST shifts influence cardiovascular outcomes in healthy adults. This study emphasizes the need for further research to determine the mechanisms of increased cardiovascular disease risk with DST that help explain epidemiological trends.NEW & NOTEWORTHY The debate of whether to abolish daylight savings time (DST) is, in part, motivated by the population-level increase in all-cause mortality and incidence of cardiovascular events following DST; however, there is an absence of data to support a physiological basis for risk. We found no changes in pulse wave velocity or augmentation index during the subacute window of DST. Large multisite trials are necessary to address the small, but meaningful, effects brought on by a societal event.

Beyond abuse and neglect: validation of the childhood interpersonal trauma inventory in a community sample of adults.

Childhood trauma is not restricted to abuse or neglect and other potentially traumatic experiences need to be pondered in practice and research. The study aimed to collect validity evidence of a new measure of exposure to a broad range of potentially traumatic experiences, the Childhood Interpersonal Trauma Inventory (CITI), by evaluating whether the CITI provides important additional information compared to a gold standard measure of childhood trauma. The sample consisted of 2,518 adults who completed the CITI and self-reported measures of trauma (Childhood Trauma Questionnaire; CTQ) and psychiatric symptoms (PTSD Checklist for DSM-5; Kessler Psychological Distress Scale; Dissociative Experiences Scale). First, the sensitivity to properly detect participants having been exposed to childhood maltreatment, as measured by the CTQ (here used as the gold standard), ranged between 64.81% and 88.71%, and the specificity ranged between 68.55% and 89.54%. Second, hierarchical regressions showed that the CITI predicted between 5.6 and 14.0% of the variance in psychiatric symptoms while the CTQ only captured a very small additional part of variance (0.3 to 0.7%). Finally, 25% (n = 407) of CTQ-negative participants screened positive at the CITI. The latter reported higher severity of psychiatric symptoms than participants without trauma, suggesting that the CITI permits the identification of adults exposed to significant traumas that remain undetected using other well-validated measures. The findings underscore the utility of the CITI for research purposes and the latter's equivalence to a gold standard self-reported questionnaire to predict negative outcomes.

Design optimization and validation of UV-C illumination chamber for filtering facepiece respirators

In this study, we constructed an UV-C illumination chamber using commercially available germicidal lamps and other locally available low-cost components for general-purpose biological decontamination purposes. The illumination chamber provides uniform illumination of around 1 J/cm2 in under 5 min across the chamber. The control mechanism was developed to automate the on/off process and make it more secure minimizing health and other electrical safety. To validate the decontamination efficacy of the UV-C Illumination Chamber we performed the Geobacillus spore strip culture assay. Additionally, we performed the viral load measurement by identifying the COVID-19-specific N-gene and ORF1 gene on surgical masks. The gold standard RT-qPCR measurement was performed to detect and quantify the COVID-19-specific gene on the mask sample. The biochemical assay was conducted on the control and test group to identify the presence of different types of bacteria, and fungi before and after exposure under the illumination chamber. The findings of our study revealed satisfactory decontamination efficacy test results. Therefore, it could be an excellent device in healthcare settings as a disinfection tool for biological decontamination such as SAR-CoV-2 virus, personal protection equipment (PPE), (including n95, k95 respirators, and surgical masks), and other common pathogens.

Cognitive intra-individual variability as an outcome or moderator of speed of processing training in aging adults with HIV-associated neurocognitive disorder: A secondary data analysis of a 2-year longitudinal randomized clinical trial

ObjectiveCognitive intra-individual variability (IIV), dispersion of cognitive performance across cognitive domains, indicates diminished cognitive control resulting from brain pathology or aging. For people with HIV-Associated Neurocognitive Disorder (HAND), cognitive IIV may interfere with and/or be improved by cognitive training. In this current secondary data analysis, we explored whether cognitive IIV functions as an outcome or moderator variable in speed of processing (SOP) training in middle-aged and older people living with HIV (PLWH). MethodIn this randomized clinical trial, 216 PLWH with HAND or borderline HAND were randomized to either: 1) 10 h of SOP training; 2) 20 h of SOP training, or 3) 10 h of Internet Navigation Control Training. Participants completed a seven-domain cognitive battery at baseline, posttest after training, and years 1 and 2 follow up; from this, the coefficient of variation (CoV) served as the cognitive IIV dispersion score. Participants also completed a gold-standard measure of SOP (i.e., Useful Field of View Test (UFOV®), a targeted cognitive outcomes of the SOP training paradigm) at each time point. ResultsUsing linear mixed-effect models, no strong pattern of SOP training effects were detected on cognitive IIV. However, a three-way interaction tests between time, group, and baseline cognitive IIV CoV suggested potential moderation effects. Stratified analyses showed differential treatment effects between the lower cognitive IIV and higher cognitive IIV group. ConclusionsAlthough SOP training did not improve cognitive IIV, cognitive IIV may be a modifier of SOP training. Implications for future research and other types of training are provided.

Estimating Glycemia From HbA1c and CGM: Analysis of Accuracy and Sources of Discrepancy.

To examine the accuracy of different periods of continuous glucose monitoring (CGM), hemoglobin A1c (HbA1c), and their combination for estimating mean glycemia over 90 days (AG90). We retrospectively studied 985 CGM periods of 90 days with <10% missing data from 315 adults (86% of whom had type 1 diabetes) with paired HbA1c measurements. The impact of mean red blood cell age as a proxy for nonglycemic effects on HbA1c was estimated using published theoretical models and in comparison with empirical data. Given the lack of a gold standard measurement for AG90, we applied correction methods to generate a reference (eAG90) that we used to assess accuracy for HbA1c and CGM. Using 14 days of CGM at the end of the 90-day period resulted in a mean absolute error (95th percentile) of 14 (34) mg/dL when compared with eAG90. Nonglycemic effects on HbA1c led to a mean absolute error for average glucose calculated from HbA1c of 12 (29) mg/dL. Combining 14 days of CGM with HbA1c reduced the error to 10 (26) mg/dL. Mismatches between CGM and HbA1c >40 mg/dL occurred more than 5% of the time. The accuracy of estimates of eAG90 from limited periods of CGM can be improved by averaging with an HbA1c-based estimate or extending the monitoring period beyond ∼26 days. Large mismatches between eAG90 estimated from CGM and HbA1c are not unusual and may persist due to stable nonglycemic factors.

Wireless and battery-free wearable biosensing of riboflavin in sweat for precision nutrition

Nutrition assessment is crucial for dietary guidance and prevention of malnutrition. Recent endeavors in wearable biochemical sensors have enabled real-time, in situ analysis of nutrients in sweat. However, the monitoring of riboflavin, an indispensable vitamin B involved in energy metabolism, remains challenging due to its trace level and variations in the sweat matrix. Herein, we report a wireless, battery-free, and flexible wearable biosensing system for the in situ monitoring of sweat riboflavin. Highly sensitive and selective electrochemical voltammetric detection is realized based on the synergistic effect of electrodeposited reduced graphene oxide (rGO) and platinum nanoparticles (PtNPs) with a low detection limit of 1.2 nM. The fully integrated system is capable of sweat sampling with the microfluidic patch, real-time riboflavin analysis and pH calibration with the flexible electrode array, as well as wirelessly simultaneous near field communication (NFC) energy harvesting and data transmission with the flexible circuit and a smartphone. On-body human sweat analysis demonstrates high accuracy cross-validated with gold-standard measurements, and reveals a strong correlation between sweat and urine riboflavin levels. The proposed wearable platform opens up attractive possibilities for noninvasive nutrient tracking, providing strong potential for personalized dietary guidance towards precision nutrition.

Characterizing Measurement-Based Care in the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

AbstractIntegration of measurement-based care (MBC) into clinical practice has shown promise in improving treatment outcomes for depression. Yet, without a gold standard measure of MBC, assessing fidelity to the MBC model across various clinical settings is difficult. A central goal of the Texas Youth Depression and Suicide Research Network (TX-YDSRN) was to characterize MBC across the state of Texas through the development of a standardized tool to assess the use of MBC strategies when assessing depression, anxiety, side effects, and treatment adherence. A chart review of clinical visits indicated standardized depression measures (71.2%) and anxiety measures (64%) were being utilized across sites. The use of standardized measures to assess medication adherence and side effects was limited to less than six percent for both, with the majority utilizing clinical interviews to assess adherence and side effects; yet medication was changed in nearly half. Rates of utilization of standardized measures for participants with multiple MBC forms were similar to those who only provided one form.

Impact of PCA Pre-Normalization Methods on Ground Reaction Force Estimation Accuracy.

Ground reaction force (GRF) components can be estimated using insole pressure sensors. Principal component analysis in conjunction with machine learning (PCA-ML) methods are widely used for this task. PCA reduces dimensionality and requires pre-normalization. In this paper, we evaluated the impact of twelve pre-normalization methods using three PCA-ML methods on the accuracy of GRF component estimation. Accuracy was assessed using laboratory data from gold-standard force plate measurements. Data were collected from nine subjects during slow- and normal-speed walking activities. We tested the ANN (artificial neural network) and LS (least square) methods while also exploring support vector regression (SVR), a method not previously examined in the literature, to the best of our knowledge. In the context of our work, our results suggest that the same normalization method can produce the worst or the best accuracy results, depending on the ML method. For example, the body weight normalization method yields good results for PCA-ANN but the worst performance for PCA-SVR. For PCA-ANN and PCA-LS, the vector standardization normalization method is recommended. For PCA-SVR, the mean method is recommended. The final message is not to define a normalization method a priori independently of the ML method.

Continuous Ketone Monitoring via Wearable Microneedle Patch Platform.

Ketone bodies (KBs), especially β-hydroxybutyrate (BHB), have gained tremendous attention as potential biomarkers as their presence in bodily fluids is closely associated with health and wellness. While a variety of blood fingerstick test strips are available for self-testing of BHB, there are major needs for wearable devices capable of continuously tracking changing BHB concentrations. To address these needs, we present here the first demonstration of a wearable microneedle-based continuous ketone monitoring (CKM) in human interstitial fluid (ISF) and illustrate its ability to closely follow the intake of ketone drinks. To ensure highly stable and selective continuous detection of ISF BHB, the new enzymatic microneedle BHB sensor relies on a gold-coated platinum working electrode modified with a reagent layer containing toluidine blue O (TBO) redox mediator, β-hydroxybutyrate dehydrogenase (HBD) enzyme, a nicotinamide adenine dinucleotide (NAD+) cofactor, along with carbon nanotubes (CNTs), chitosan (Chit), and a poly(vinyl chloride) (PVC) outer protective layer. The skin-worn microneedle sensing device operates with a miniaturized electrochemical analyzer connected wirelessly to a mobile electronic device for capturing, processing, and displaying the data. Cytotoxicity and skin penetration studies indicate the absence of potential harmful effects. A pilot study involving multiple human subjects evaluated continuous BHB monitoring in human ISF, against gold standard BHB meter measurements, revealing the close correlation between the two methods. Such microneedle-based CKM offers considerable promise for dynamic BHB tracking toward the management of diabetic ketoacidosis and personal nutrition and wellness.

Validation of an alternative technique for RQ estimation in anesthetized pigs

BackgroundRespiratory quotient (RQ) is an important variable when assessing metabolic status in intensive care patients. However, analysis of RQ requires cumbersome technical equipment. The aim of the current study was to examine a simplified blood gas-based method of RQ assessment, using Douglas bag measurement of RQ (Douglas-RQ) as reference in a laboratory porcine model under metabolic steady state. In addition, we aimed at establishing reference values for RQ in the same population, thereby generating data to facilitate further research.MethodsRQ was measured in 11 mechanically ventilated pigs under metabolic steady state using Douglas-RQ and CO-oximetry blood gas analysis of pulmonary artery and systemic carbon dioxide and oxygen content. The CO-oximetry data were used to calculate RQ (blood gas RQ). Paired recordings with both methods were made once in the morning and once in the afternoon and values obtained were analyzed for potential significant differences.ResultsThe average Douglas-RQ, for all data points over the whole day, was 0.97 (95%CI 0.95–0.99). The corresponding blood gas RQ was 0.95 (95%CI 0.87–1.02). There was no statistically significant difference in RQ values obtained using Douglas-RQ or blood gas RQ for all data over the whole day (P = 0.43). Bias was − 0.02 (95% limits of agreement ± 0.3). Douglas-RQ decreased during the day 1.00 (95%CI 0.97–1.03) vs 0.95 (95%CI 0.92–0.98) P < 0.001, whereas the decrease was not significant for blood gas RQ 1.02 (95%CI 0.89–1.16 vs 0.87 (0.80–0.94) P = 0.11.ConclusionRQ values obtained with blood gas analysis did not differ statistically, compared to gold standard Douglas bag RQ measurement, showing low bias but relatively large limits of agreement, when analyzed for the whole day. This indicates that a simplified blood gas-based method for RQ estimations may be used as an alternative to gold standard expired gas analysis on a group level, even if individual values may differ. In addition, RQ estimated with Douglas bag analysis of exhaled air, was 0.97 in anesthetized non-fasted pigs and decreased during prolonged anesthesia.

Oral carcinogenesis and non-invasive biomarkers for the diagnosis of oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most prevalent cancer in Pakistani population because of consumption of different tobacco-containing products whether smoked or chewed. These patients commonly report at a late stage of the disease. The patient's survival only depends upon early-stage diagnosis. Literature has reported that there is an increased tendency of transformation of oral potentially malignant disorder (OPMD) into OSCC. Biopsy is the gold standard measure for diagnosis but for OPMD cases biopsy was not recommended and most of the times the patients were also not willing to have a biopsy done. So, along with the biopsy there is a need for non-invasive protein biomarker that might aid in the early detection of oral cancer as well as highlight the high-risk individuals. This short communication focuses on the role of early diagnostic biomarkers present in literature, such as synuclein-γ (SNCG), Squamous cell carcinoma antigen (SCCAg), p53, MMPs-12, and IL-6. Furthermore, application of these biomarkers in multi-centre longitudinal studies is needed to establish their role as a non-invasive diagnostic biomarker for OSCC.

A systematic review of the relationship between muscle oxygen dynamics and energy rich phosphates. Can NIRS help?

BackgroundPhosphocreatine dynamics provide the gold standard evaluation of in-vivo mitochondrial function and is tightly coupled with oxygen availability. Low mitochondrial oxidative capacity has been associated with health issues and low exercise performance.MethodsTo evaluate the relationship between near-infrared spectroscopy-based muscle oxygen dynamics and magnetic resonance spectroscopy-based energy-rich phosphates, a systematic review of the literature related to muscle oxygen dynamics and energy-rich phosphates was conducted. PRISMA guidelines were followed to perform a comprehensive and systematic search of four databases on 02-11-2021 (PubMed, MEDLINE, Scopus and Web of Science). Beforehand pre-registration with the Open Science Framework was performed. Studies had to include healthy humans aged 18–55, measures related to NIRS-based muscle oxygen measures in combination with energy-rich phosphates. Exclusion criteria were clinical populations, laboratory animals, acutely injured subjects, data that only assessed oxygen dynamics or energy-rich phosphates, or grey literature. The Effective Public Health Practice Project Quality Assessment Tool was used to assess methodological quality, and data extraction was presented in a table.ResultsOut of 1483 records, 28 were eligible. All included studies were rated moderate. The studies suggest muscle oxygen dynamics could indicate energy-rich phosphates under appropriate protocol settings.ConclusionArterial occlusion and exercise intensity might be important factors to control if NIRS application should be used to examine energetics. However, more research needs to be conducted without arterial occlusion and with high-intensity exercises to support the applicability of NIRS and provide an agreement level in the concurrent course of muscle oxygen kinetics and muscle energetics.Trial registrationhttps://osf.io/py32n/.Key points1. NIRS derived measures of muscle oxygenation agree with gold-standard measures of high energy phosphates when assessed in an appropriate protocol setting.2. At rest when applying the AO protocol, in the absence of muscle activity, an initial disjunction between the NIRS signal and high energy phosphates can been seen, suggesting a cascading relationship.3. During exercise and recovery a disruption of oxygen delivery is required to provide the appropriate setting for evaluation through either an AO protocol or high intensity contractions.

High-resolution snapshots of antibody repertoires as potential correlates of protection

High-resolution snapshots of antibody repertoires as potential correlates of protection Klaus Eyer from ETH Zurich describes high-resolution snapshots of antibody repertoires as potential correlates of protection. The induction and long-term presence of key adaptive immune cells are essential for vaccine-mediated protection. As a direct, causal measure of protection is often challenging; finding and defining correlates of protection are critical for vaccine development, approval, and efficacy testing. Correlates of protection are quantifiable signs of being protected from becoming infected and/or developing disease that may be causal to protection itself. Antibodies in serum are often assessed as potential correlates as immunisations often lead to generating a vaccine-specific, functionally active and diverse antibody repertoire. In its simplest form, a potential correlate could be their presence if binding by the antibody is sufficient. This is assessed in the so-called titer measurements. Here, a serum sample is sequentially diluted, and the binding of the antibodies towards the vaccine is evaluated and compared to an often empirically derived threshold. This gold-standard measure has many advantages: it is fast, reliable and easily compared.

Home-based video assessment of children's autism-related behaviours: Psychometric analysis and linkages with parental responsiveness and context.

Assessment of autism-related behaviours (ARBs) in children has generally been limited to direct observations in clinical settings or informant-based reports. The widespread availability of video-streaming devices has made home observations of children's ARBs feasible. This approach could enable assessment of the generalization and durability of interventions and may be able to overcome methodological limitations of predominant current assessment approaches (response biases, limited sensitivity to treatment). Forty-four autistic children and their families participated in a repeated-measures study with a correlational design. Approximately 10 hr of unprompted behaviour at home were videorecorded over the course of a week (2 hr per day) for each participant. Gold standard measures of ARBs were also administered (ADOS-2 and ADI-R). Two home-based observational measures of ARBs utilizing streaming video were developed and evaluated: the ARCHER and the CHEERS. Trained independent evaluators made ratings on the ARCHER, CHEERS and an observational measure of parental responsiveness. Correlations with the ADOS-2 and ADI-R were .47 and .34 for ARCHER scores and .51 and .48 for CHEERS scores, respectively. In linear mixed models, more responsive parenting was associated with fewer ARBs on a daily basis. Children spent their afternoons engaged in many typical activities including electronics, homework and games with family members, and ARBs were more prominent in some of these contexts (e.g., electronics) than others (e.g., family games). Home-based observational assessment of ARBs may be useful for clinical and descriptive research.