Standard Measures Research Articles

Quantitative brain [18F]FDG PET beyond normal blood glucose levels

Introduction SUV measurements from static brain [18F]FDG PET acquisitions are a commonly used tool in preclinical research, providing a simple alternative for kinetic modelling, which requires complex and time-consuming dynamic acquisitions. However, SUV can be severely affected by the animal handling and preconditioning protocols, primarily by those that may induce changes in blood glucose levels (BGL). Here, we aimed at developing and investigating the feasibility of SUV-based approaches for a wide range of BGL far beyond normal values, and consequently, to develop and validate a new model to generate standardized and reproducible SUV measurements for any BGL.Material and methods We performed dynamic and static brain [18F]FDG PET acquisitions in 52 male Sprague-Dawley rats sorted into control (n = 10), non-fasting (n = 14), insulin-induced hypoglycemia (n = 12) and glucagon-induced hyperglycemia (n = 16) groups. Brain [18F]FDG PET images were cropped, aligned and co-registered to a standard template to calculate whole-brain and regional SUV. Cerebral Metabolic Rate of Glucose (CMRglc) was also estimated from 2-Tissue Compartment Model (2TCM) and Patlak plot for validation purposes.Results Our results showed that BGL=100±6 mg/dL can be considered a reproducible reference value for normoglycemia. Furthermore, we successfully established a 2nd-degree polynomial model (C1=0.66E-4, C2=-0.0408 and C3=7.298) relying exclusively on BGL measures at pre-[18F]FDG injection time, that characterizes more precisely the relationship between SUV and BGL for a wide range of BGL values (from 10 to 338 mg/dL). We confirmed the ability of this model to generate corrected SUV estimations that are highly correlated to CMRglc estimations (R2= 0.54 2TCM CMRgluc and R2= 0.49 Patlak CMRgluc). Besides, slight regional differences in SUV were found in animals from extreme BGL groups, showing that [18F]FDG uptake is mostly directed toward central regions of the brain when BGLs are significantly decreased.Conclusion Our study successfully established a non-linear model that relies exclusively on pre-scan BGL measurements to characterize the relationship between [18F]FDG SUV and BGL. The extensive validation confirmed its ability to generate SUV-based surrogates of CMRglu along a wide range of BGL and it holds the potential to be adopted as a standard protocol by the preclinical neuroimaging community using brain [18F]FDG PET imaging.

Peripheral Perfusion Index in Ugandan Children With Plasmodium falciparum Severe Malaria: Secondary Analysis of Outcomes in a 2014-2017 Cohort Study.

Continuous, noninvasive tools to monitor peripheral perfusion, such as perfusion index (PI), can detect hemodynamic abnormalities and assist in the management of critically ill children hospitalized with severe malaria. In this study of hospitalized children with severe malaria, we aimed to assess whether PI correlates with clinical markers of perfusion and to determine whether combining PI with these clinical measures improves identification of children with greater odds of mortality. Post hoc analysis of a prospective, multicenter, cohort study conducted between 2014 and 2017. Two referral hospitals in Central and Eastern Uganda. Six hundred children younger than 5 years old with severe malaria and 120 asymptomatic community children. None. PI was measured at 6-hour intervals for the first 24 hours of hospitalization. We compared PI to standard clinical perfusion measures such as capillary refill time, presence of cold peripheral limbs, or temperature gradient. Admission PI was highly correlated with clinical measures of perfusion. Admission PI was lower in children with severe malaria compared with asymptomatic community children; and, among the children with severe malaria, PI was lower in those with clinical features of poor perfusion or complications of severe malaria, such as shock and hyperlactatemia (all p < 0.02). Among children with severe malaria, lower admission PI was associated with greater odds of mortality after adjustment for age, sex, and severe malaria criteria (adjusted odds ratio, 2.4 for each log decrease in PI [95% CI, 1.0-5.9]; p = 0.045). Diagnostically, the presence of two consecutive low PI measures (< 1%) predicted mortality, with a sensitivity of 50% and a specificity of 76%. In severe malaria, PI correlates with clinical complications (including shock and elevated serum lactate) and may be useful as an objective, continuous explanatory variable associated with greater odds of later in-hospital mortality.

Establishment of a Sensitive and Reliable Droplet Digital PCR Assay for the Detection of Bursaphelenchus xylophilus.

Pine wilt disease (PWD), which poses a significant risk to pine plantations across the globe, is caused by the pathogenic agent Bursaphelenchus xylophilus, also referred to as the pine wood nematode (PWN). A droplet digital PCR (ddPCR) assay was developed for the quick identification of the PWN in order to improve detection sensitivity. The research findings indicate that the ddPCR assay demonstrated significantly higher analysis sensitivity and detection sensitivity in comparison to traditional quantitative PCR (qPCR). However, it had a more limited dynamic range. High specificity was shown by both the ddPCR and qPCR techniques in the diagnosis of the PWN. Assessments of reproducibility revealed that ddPCR had lower coefficients of variation at every template concentration. Inhibition tests showed that ddPCR was less susceptible to inhibitors. There was a strong linear association between standard template measurements obtained using ddPCR and qPCR (Pearson correlation = 0.9317; p < 0.001). Likewise, there was strong agreement (Pearson correlation = 0.9348; p < 0.001) between ddPCR and qPCR measurements in the evaluation of pine wood samples. Additionally, wood samples from symptomatic (100% versus 86.67%) and asymptomatic (31.43% versus 2.9%) pine trees were diagnosed with greater detection rates using ddPCR. This study's conclusions highlight the advantages of the ddPCR assay over qPCR for the quantitative detection of the PWN. This method has a lot of potential for ecological research on PWD and use in quarantines.

Initial development of a sleep health literacy scale

ObjectivesHealth literacy includes the skills necessary for effective communication with health professionals, understanding health instructions, and recognizing health needs. Our study aimed to create a novel measure of sleep health literacy—an individual's capacity to comprehend sleep-related information and navigate sleep-related healthcare services. MethodsThe Sleep Health Literacy scale consists of two subscales: “Sleep Health Communication” (11 Likert-scale items assessing access to resources and communication with healthcare providers) and “Sleep Health Knowledge” (46 true/false items assessing specific knowledge of sleep health). The Sleep Health Literacy scale was completed by 154 undergraduate students (mean age=20.96years; 79.87% female) in study 1. In study 2, an additional sample of 251 participants (mean age=20.23years; 79.87% female) completed the Sleep Health Literacy scale, along with measures of convergent and discriminant validity. ResultsExploratory factor analysis results in study 1 revealed a two-factor structure for the “Sleep Health Communication” subscale (“comprehension” and “critical application”). The subscale demonstrated good internal consistency (α = 0.81) and inter-item and item-total correlations. On the “Sleep Health Knowledge” subscale, participants answered 76.36% of items correctly. In study 2, the Sleep Health Literacy had good convergent validity with Sleep Beliefs Scale and the All Aspect of Health Literacy Scale. ConclusionsThe Sleep Health Literacy scale offers a standardized measure to assess sleep health literacy, an understudied domain that has important links to health. This measure may allow researchers and clinicians to better understand how to improve sleep health. Further validation of the Sleep Health Literacy scale is warranted in more diverse samples.

Association between dopamine genes, adiposity, food addiction, and eating behavior in Chilean adult.

A frequent consumption of high sugar/fat foods can affect dopamine signaling in the brain and cause sustained stimulation of the reward system. It has been hypothesized that a hypodopaminergic trait results in an individual overeating in order to increase brain DA. Genetic variants in this route have been connected with addiction and eating behaviors. Most studies focus on a specific SNP, and few studies have used multilocus genetic scores, which quantify genetic risk on a continuum. To assess the relationship between multilocus genetic scores based on multiple gene variants in the dopaminergic pathway and measurements of anthropometry, eating behavior, food reinforcement, and food addiction (FA) in Chilean adults. We recruited 221 Chilean adults for a cross-sectional study. A standard anthropometric measurement procedure was followed and eating behavior was examined using the Three Factor Eating questionnaire (TFEQ), Food Reinforcement Value Questionnaire (FRVQ), Yale Food Addiction Scale (YFAS) and 24-h diet recall. Multilocus genetic scores were calculated using TaqMan assays (rs1800497-rs1799732-rs6277-rs4680). No differences were found in the entire sample for anthropometric measurements, by MLGS. We found that participants with a score ≥ 2.0 in the MLGS showed higher food choices on the RVFQ and lower energy intake in protein, lipids, SAFA, MUFA, PUFA, dietary cholesterol, omega-3 and Omega-6 fatty acids in the 24-h recall (p < 0.05). Stratified by nutritional condition, the group with obesity had inferior scores on cognitive restriction, greater scores on uncontrolled eating, emotional eating, and responding to palatable food in the RVFQ. Also, in subjects with obesity, there was more food addiction in the group scoring "MLGS ≥2.0 or low dopamine signaling" (53%), compared to the group scored "MLGS <2.0 or high dopamine signaling" (23%) (p-value; 0.05). Emotional Eating scores correlated positively with MLGS in subjects with obesity. In adults with obesity, the MLGS of the dopamine pathway, reflecting hypodopaminergic signaling, was associated with greater scores on food addiction and altered eating behavior traits.

Development and validation of a multiple-choice test for sustainability competence in primary school using the GreenComp framework

There is no standardized definition or measurement tool for sustainability competence, which hinders comparative research. This study addresses this gap by developing a new test based on the European reference framework GreenComp. The proposed instrument, consisting of eleven multiple-choice items, was validated through expert review and exploratory and confirmatory factor analysis, showing strong construct validity and high internal consistency reliability. Applied to students aged 8 to 12, it revealed a prevalence of basic and anthropocentric perspectives on sustainability. This promising tool can assess sustainability competence in primary education and has the potential for use across European countries.

Testing the volume integrals of travel-time sensitivity kernels for flows

Context. Helioseismic inversions largely rely on sensitivity kernels, in which 3D spatial functions describe how the changes in the solar interior translate into the change in helioseismic observables. These sensitivity kernels in most cases come from the forward modelling that is used in the most advanced solar models. Aims. We aim to test the sensitivity kernels by comparing their volume integrals with measured values from helioseismic travel times. Methods. By manipulating the tracking rate, we mimicked the additional zonal velocity in the Dopplergram datacubes. These datacubes were then processed by a standard travel-time measurements pipeline. We investigated the dependence of the east-west travel time averaged over a box around the disc centre on the implanted tracking velocity. The slope of this dependence is directly proportional to the total volume integral of the sensitivity kernel that corresponds to the travel-time geometry that is used. Results. The agreement between measurements and models for travel times that are computed with a ridge filtering is very good to acceptable. The dependence we sought to determine indeed resembles a linear function, and its slope agrees with the expected volume integral from the forward-modelled sensitivity kernel. The agreement is poorer for the phase-speed filtered datacubes. The disagreement is particularly strong for the slowest phase speeds (filters td1–td4). For the higher phase speeds, our result indicates that the measured kernel integrals are systematically larger than expected from the forward modelling. We admit our testing procedure may not be appropriate for high phase speeds and higher radial modes.

Volumetric muscle composition analysis in sporadic inclusion body myositis using fat-referenced magnetic resonance imaging: Disease pattern, repeatability, and natural progression.

Fat-referenced magnetic resonance imaging (MRI) has emerged as a promising volumetric technique for measuring muscular volume and fat in neuromuscular disorders, but the experience in inflammatory myopathies remains limited. Therefore, this work aimed at describing how sporadic inclusion body myositis (sIBM) manifests on standardized volumetric fat-referenced MRI muscle measurements, including within-scanner repeatability, natural progression rate, and relationship to clinical parameters. Ten sIBM patients underwent whole-leg Dixon MRI at baseline (test-retest) and after 12 months. The lean muscle volume (LMV), muscle fat fraction (MFF), and muscle fat infiltration (MFI) of the quadriceps, hamstrings, adductors, medial gastrocnemius, and tibialis anterior were computed. Clinical assessments of IBM Functional Rating Scale (IBMFRS) and knee extension strength were also performed. The baseline test-retest MRI measurements were used to estimate the within-subject standard deviation (sw). 12-month changes were derived for all parameters. The MRI measurements showed high repeatability in all muscles; sw ranged from 2.7 to 18.0 mL for LMV, 0.7-1.3 percentage points (pp) for MFF, and 0.2-0.7 pp for MFI. Over 12 months, average LMV decreased by 7.4% while MFF and MFI increased by 3.8 pp and 1.8 pp, respectively. Mean IBMFRS decreased by 2.4 and mean knee extension strength decreased by 32.8 N. The MRI measurements showed high repeatability and 12-month changes consistent with muscle atrophy and fat replacement as well as a decrease in both muscle strength and IBMFRS. Our findings suggest that fat-referenced MRI measurements are suitable for assessing disease progression and treatment response in inflammatory myopathies.

Different observers introduce not negligible biases in comparative karyomorphological studies.

Within a practical course of cytotaxonomy organized in Pisa (Italy) on February 2024 by the Group for Floristics, Systematics and Evolution of the Italian Botanical Society, we tested whether using image analysis softwares possible biases are still introduced by different observers. We conclude that observer bias selectively applies in possibly overestimating the length of short arms in a karyotype. As a consequence, the parameters most sensitive to these possible errors are CVCI and CVCL, and to a less degree MCA and THL. To achieve more stable results among observers, a still lacking standardized measurement protocol could be helpful.

Comparison of orientation encoding across layers within single columns of primate V1 revealed by high-density recordings.

Primary visual cortex (V1) has been the focus of extensive neurophysiological investigations, with its laminar organization serving as a crucial model for understanding the functional logic of neocortical microcircuits. Utilizing newly developed high-density, Neuropixels probes, we measured visual responses from large populations of simultaneously recorded neurons distributed across layers of macaque V1. Within single recordings, myriad differences in the functional properties of neuronal subpopulations could be observed. Notably, while standard measurements of orientation selectivity showed only minor differences between laminar compartments, decoding stimulus orientation from layer 4C responses outperformed both superficial and deep layers within the same cortical column. The superior orientation discrimination within layer 4C was associated with greater response reliability of individual neurons rather than lower correlated activity within neuronal populations. Our results underscore the efficacy of high-density electrophysiology in revealing the functional organization and network properties of neocortical microcircuits within single experiments.

Psychometric Validation of the Slovenian Version of the Revised Child Anxiety and Depression Scale - Child and Parent Versions (RCADS and RCADS-P)

Abstract Objective Anxiety and depression are common disorders in children and adolescents and can have a negative impact on their lives. The Revised Child Anxiety and Depression Scale – Child and Parent versions (RCADS and RCADS-P) are widely used standardized measurement tools, but the Slovenian versions have not yet been validated. The aim of the present study was to examine the psychometric properties of the Slovenian version of RCADS and RCADS-P in a representative Slovenian school sample. Methods We examined the psychometric properties (factor structure, internal reliability, short-term stability, inter-rater agreement and convergent validity) of the Slovenian version of the RCADS and the RCADS-P in 754 primary and secondary school students and parents of 485 students. The short-term stability of anxiety and depressive symptoms in youth was assessed in a subsample of 117 children and adolescents. Results Confirmatory factor analysis showed an acceptable fit of the 6-factor model with CFI=0.92, TLI=0.92 and RMSEA=0.056 for RCADS and with CFI=0.93, TLI=0.92 and RMSEA=0.047 for RCADS-P. Cronbach's α and McDonald's ω ranged from 0.70 to 0.95 for the total scale and the six subscales. The subscales correlated significantly positively with the total Child Anxiety Life Interference Scale score. Conclusion The results affirm the good psychometric properties of the Slovenian versions of RCADS and RCADS-P within a school-based sample. There is a need in the future to examine psychometric properties in clinical samples and to provide normative data.

Three-Dimensional Bone Alignment from Cone-Beam Computed-Tomography Scans in Weight-Bearing and Clinical Outcomes Following the Modified Grice–Green Surgical Procedure for Adult Acquired Flatfoot

Severe adult-acquired flatfoot deformity is widely addressed surgically via the Grice–Green subtalar arthrodesis. Standard radiographic measurements have been reported, but these are limited to planar views. These complex deformities and the relevant corrections after surgery should be assessed in weight-bearing using 3D analyses now enabled by modern cone-beam CT scans. The present study is aimed at reporting these 3D radiographical foot bone alignments and the clinical results for this surgery. Ten patients were treated with the Grice–Green procedure. This implies inserting an autologous bone graft from the proximal tibial into the extra-articular sinus-tarsi to perform a subtalar arthrodesis. Before and after surgery, the patients were assessed based on the clinical range-of-motion and Foot-Function and Posture Indexes. Three-dimensional models of the tibia, calcaneus, talus, navicular, and 1st metatarsus were reconstructed from cone-beam CT scans in a single-leg up-right posture. Relevant longitudinal axes were defined to calculate ten spatial angles. Post-operatively, a significant realignment was observed for seven angles, including corrections lift-up of the talus (on average by 15°) and subtalar joint (13° in 3D), as well as the Meary’s angle (21°). Only few correlations were found between traditional clinical and novel 3D radiographical measurements, suggesting the former only limitedly represent the corresponding real skeletal status, and the latter thus offer the physician a more comprehensive evaluation. The present original analysis from modern cone-beam CT scans shows precisely the correction of foot and ankle bone alignments achieved using the Grice–Green surgical procedure, finally in 3D and in weight-bearing. For the first time, traditional clinical and score system evaluations are reported together with bone orientation and joint angles in the three anatomical planes.

Abstract C009: An exploratory ecologic analysis of the association of neighborhood obesogenic factors with prostate cancer mortality in Chicago, Illinois: Challenges and opportunities

Abstract Introduction: Obesity has been associated with aggressive prostate cancer (PCa). Environments that promote obesity, known as obesogenic environments, may also contribute to PCa progression at the population level. However, studies exploring these factors are limited. The purpose of this study was to examine the association between neighborhood obesogenic factors with PCa mortality rates in Chicago. Methods: We used an ecological study design with Chicago Community Areas (n=77) serving as the geographical area unit of analysis. All community area-level data were obtained from the Chicago Health Atlas public data portal. For each area, two obesogenic factors were examined: food environment and park access. The number of healthy and unhealthy grocery stores was used to characterize the food environment. The retail food establishments data was retrieved for the year 2013. The stores were classified into chain grocery stores, non-chain grocery stores, liquor stores, and convenience stores which included dollar tsores, corner stores and gas stations. Chain and non-chain grocery stores were grouped as healthy food access, and other (convenience store, dollar store and liquor store) as unhealthy food access. The area of public parks per 100,000 community area population was used as a measure of park access. An exclusive park area for each community was calculated by intersecting the community area and park area shape files from the year 2016. The outcome variable was community area-level PCa mortality rate age-adjusted to the community area male population. To normalize the data, all included variables were standardized to zero mean and unit standard deviation. Linear regression models analyzed the association of the standardized measures of obesogenic environment (individually and simultaneously) with age-adjusted rates using the Statistical Analysis Software 9.4. Results: The mean number of healthy (0 - 11) and unhealthy (0 - 10) food stores in each community area were 3.1 and 2.6 respectively and mean park area (14.0 - 4096.5 acres) available in each community area was 453.5 acres per 100,000 population. The mean (0 – 29.6) PCa mortality was 9.8 per 100,000 population. Healthy food access was inversely associated with PCa mortality rates, where for every for one 1-standard deviation increase in healthy food access standard deviation, there is a 0.40 unit decrease in community area PCa mortality rate standard deviation (p=0.002) while accounting for the other obesogenic factors (unhealthy food access and park access). Conclusion: The findings of this study suggest that the neighborhood access to healthy food may be a determinant of neighborhood PCa mortality rates. Ecological studies are helpful to understand the impact at the geographical level. Methodological challenges and opportunity in ecological analyses, such as addressing bias and multivariable control of confounding, will be discussed. Citation Format: Ravneet Kaur, Jiehuan Sun, Nebiyou Y. Tilahun, Vincent L. Freeman. An exploratory ecologic analysis of the association of neighborhood obesogenic factors with prostate cancer mortality in Chicago, Illinois: Challenges and opportunities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C009.

Understanding Depression in Autism: The Role of Subjective Perception and Anterior Cingulate Cortex Volume.

The prevalence of depression is elevated in individuals with autism spectrum disorder (ASD) compared to the general population, yet the reasons for this disparity remain unclear. While social deficits central to ASD may contribute to depression, it is uncertain whether social interaction behavior themselves or individuals' introspection about their social behaviors are more impactful. Although the anterior cingulate cortex (ACC) and amygdala are frequently implicated in ASD, depression, and social functioning, it is unknown if these regions explain differences between ASD adults with and without co-occurring depression. The present study contrasted observed vs. subjective perception of autism symptoms and social performances assessed with both standardized measures and a lab task, in 65 sex-balanced (52.24% male) autistic young adults. We also quantified ACC and amygdala volume with 7-Tesla structural neuroimaging to examine correlations with depression and social functioning. We found that ASD individuals with depression exhibited differences in subjective evaluations including heightened self-awareness of ASD symptoms, lower subjective satisfaction with social relations, and less perceived affiliation during the social interaction task, yet no differences in corresponding observed measures, compared to those without depression. Larger ACC volume was related to depression, greater self-awareness of ASD symptoms, and worse subjective satisfaction with social interactions. In contrast, amygdala volume, despite its association with clinician-rated ASD symptoms, was not related to depression. Due to the cross-sectional nature of our study, we cannot determine the directionality of the observed relationships. Additionally, we included only individuals with an IQ over 60 to ensure participants could complete the social task, which excluded many on the autism spectrum. We also utilized self-reported depression indices instead of clinically diagnosed depression, which may limit the comprehensiveness of the findings. Our approach highlights the unique role of subjective perception of autism symptoms and social interactions, beyond the observable manifestation of social interaction in ASD, in contributing to depression, with the ACC playing a crucial role. These findings imply possible heterogeneity of ASD concerning co-occurring depression. Using neuroimaging, we were able to demarcate depressive phenotypes co-occurring alongside autistic phenotypes.

Reliability testing of an IMU-based 2-segment foot model for clinical gait analysis

BackgroundThe one of the most commonly used reference system for clinical gait analysis is an optical motion capture system (OMC) using a multi-segment foot model. A time- and cost-efficient alternative could be an inertial measurement unit (IMU)-based systems. However, these are limited to a single segment approach for the foot and ankle. Therefore, the current setup was modified to be based on a 2-segment foot model, allowing for a separate analysis of the hind- and midfoot. The study aimed to evaluate the reliability (inter-rater, intra-rater, and test-retest reliability) of an IMU-based 2-segment foot model. Material and methodsTwelve healthy subjects were recruited to test the inter-rater, intra-rater, and test-retest reliability of the new IMU based 2-segment foot model. Gait analysis was performed on a treadmill at a constant speed of 4 km/h. Kinematic data of the tibia/hindfoot, tibia/forefoot and hindfoot/forefoot over 100 % gait cycle were analyzed. The reliability was tested by using statistical parametric mapping (SPM) and the intraclass correlation coefficient (ICC). ResultsThe SPM showed no significant difference for inter-, intra-rater, and test-retest reliability, but for a small segment of tibia/forefoot dorsiflexion test-retest reliability (2.1° difference). The single standard deviation measurement error for the sagittal and transverse plane was <5° and worse for the frontal plane. ConclusionThe new 2-segment foot model revealed a high inter-rater, intra-rater, and test-retest reliability. It is suitable for use in adult clinical practice. Still, comparative data to the OMC system using a multi-segment foot model are missing.

Toward a Standard Measure of Gun Ownership: A Methodological and Theoretical Quandary in Firearm Research

One limitation of the literature on gun ownership is a lack of consensus regarding how to operationalize the dependent variable. Consequently, gun measures vary widely across studies, and findings about the prevalence and predictors of gun ownership are inconsistent. In the current study, we endeavor to develop an empirically supported, standard measure of gun ownership. First, utilizing data from a national sample of the U.S. population, we analyze the relative validity of household versus personal measures of gun ownership and critically appraise the value of accounting for gun quantity and the purpose of ownership. Second, per our findings, we recommend a short set of survey questions as the standard measure of gun ownership. These questions (1) differentiate non-owners, personal gun owners, and household gun owners; (2) account for the number of firearms owned; and (3) categorize owners by motivation (protective vs. non-protective).

Soil management practice and smallholder agricultural productivity in Nigeria

This study investigates how various soil management practices can enhance soil fertility and pest control, ultimately increasing crop yields among farming households in Nigeria. Utilizing descriptive statistics, logit regression and propensity score matching on data from the 2019 Living Standard Measurement Study, the findings reveal that households using herbicides experience higher agricultural productivity. The use of pesticides and certified crops also positively influences productivity. Key determinants of soil technology access include cooperative membership and the age of household heads, both of which significantly affect access to herbicides, pesticides, organic fertilizers, and certified crops. Education plays a vital role, positively impacting the use of organic and inorganic fertilizers as well as certified crops. Additionally, larger farm sizes correlate with better access to these resources. Conversely, the gender of the household head negatively affects access to certified crops. The study emphasizes the importance of capacity building and knowledge transfer to encourage the adoption of effective soil technology practices among farmers, thereby enhancing agricultural productivity and addressing food security issues.

Investigating current clinical practice in assessment and diagnosis of voice disorders: A cross-sectional multidisciplinary global web survey.

Published best-practice guidelines and standardized protocols for voice assessment recommend multidisciplinary evaluation utilizing a comprehensive range of clinical measures. Previous studies report variations in assessment practices when compared with these guidelines. To provide an up-to-date evaluation of current global multidisciplinary practice patterns and the opinions of otolaryngologist, ear, nose and throat (ENT) and speech-language pathology (SLP) clinicians on initial assessment and differential diagnosis of adults with voice disorders (VDs). ENTs and SLPs worldwide who had worked with VDs within the last 10 years completed an anonymous online survey. Themes explored demographic information about the clinical practice, information about diagnostic assessment pathways, clinical assessments routinely used for initial voice evaluation and clinician perceived value of clinical assessments important for diagnosis. Patterns in the clinical practice of 88 SLPs and 21 ENTs from 18 countries with 1 to more than 25 years' experience were analysed. Clinicians provided services across a range of locations, and a range of assessment pathways was available for initial evaluation. Case history, laryngoscopy and auditory-perceptual measures were the most frequently selected assessments. Most clinicians favoured formal assessment measures for auditory-perceptual evaluation. Clinicians placed equal weighting on ENT and SLP assessment to aid diagnosis for muscle tension VDs and functional neurological voice disorders (FVDs). Practice patterns for initial diagnostic voice assessment are largely consistent with the currently published guidelines. Decisions for the selection of assessment tools vary according to VD classification, and assessment decisions appear to be guided by case history. Clinicians are not always following established protocols for obtaining reliable standardized measures. Further research is needed to understand the barriers to adhering to standardized protocols and to develop evidence for the use of case history in the process of VD diagnosis. What is already known on the subject Best-practice guidelines recommend a multidisciplinary and multidimensional assessment of adults with vocal symptoms. Prior uni-disciplinary survey studies have reported a divergence in clinical practice with the recommended guidelines. No previous studies have examined otolaryngologists and SLPs concurrently to investigate the multidisciplinary approach clinicians' use in a diagnostic voice assessment. What this paper adds to the existing knowledge This study highlights new insights into multidisciplinary voice evaluation practice patterns with an emphasis on diagnostic assessment from a global perspective. The findings build on prior research exploring clinical assessment pathways, service utilization and clinicians' preferences when selecting clinical tools to inform a differential diagnosis. What are the potential or actual clinical implications of this work? This paper provides insights to inform future service and resource planning to ensure the delivery of evidenced-based diagnostic assessment pathways. This study also makes recommendations for areas of future research to understand barriers to clinicians following recommended best-practice guidelines.

Irisin Protects Musculoskeletal Homeostasis via a Mitochondrial Quality Control Mechanism.

Irisin, a myokine derived from fibronectin type III domain-containing 5 (FNDC5), is increasingly recognized for its protective role in musculoskeletal health through the modulation of mitochondrial quality control. This review synthesizes the current understanding of irisin's impact on mitochondrial biogenesis, dynamics, and autophagy in skeletal muscle, elucidating its capacity to bolster muscle strength, endurance, and resilience against oxidative-stress-induced muscle atrophy. The multifunctional nature of irisin extends to bone metabolism, where it promotes osteoblast proliferation and differentiation, offering a potential intervention for osteoporosis and other musculoskeletal disorders. Mitochondrial quality control is vital for cellular metabolism, particularly in energy-demanding tissues. Irisin's influence on this process is highlighted, suggesting its integral role in maintaining cellular homeostasis. The review also touches upon the regulatory mechanisms of irisin secretion, predominantly induced by exercise, and its systemic effects as an endocrine factor. While the therapeutic potential of irisin is promising, the need for standardized measurement techniques and further elucidation of its mechanisms in humans is acknowledged. The collective findings underscore the burgeoning interest in irisin as a keystone in musculoskeletal health and a candidate for future therapeutic strategies.

Bundling implementation strategies supports outcome measure adoption in stroke rehabilitation: preliminary findings

BackgroundOver 80% of people who experience a stroke present with residual impairment of the upper extremity, such as the shoulder, elbow, wrist, and hand. However, rarely do stroke rehabilitation practitioners (e.g., occupational therapists) use standardized outcome measures to objectively evaluate upper extremity function. Accordingly, the purpose of this project was to develop a bundle of implementation strategies that supports practitioners’ adoption of the Fugl-Meyer Assessment of the Upper Extremity in stroke rehabilitation practice.MethodsWe used tenets of Implementation Mapping to guide the development of our implementation strategy bundle. We partnered with one, large academic health system serving over 200 stroke patients annually through intensive rehabilitation care. Strategies were selected and developed through a multi-method process that included a review of the literature, qualitative input from our health system’s practitioners and managers, and expert consultation. We also specified the hypothesized implementation “mechanisms” our strategies intended to change. Practitioners’ adoption (yes/no) of the Fugl-Meyer Assessment was calculated by analyzing electronic health record documentation of the 6-month time frame before strategies were deployed compared to the 6-month time frame after deployment.ResultsPractitioners were exposed to the following implementation strategies to support Fugl-Meyer adoption: conduct educational meetings, prepare outcome measure champions, provide equipment, develop training materials, and adapt documentation systems. In the 6-months before deployment of our implementation strategies, practitioners implemented the Fugl-Meyer with 14.8% of stroke patients. In the six months after deployment, adoption of the Fugl-Meyer increased to 73.8% (p < .001).ConclusionsWhen systematically developed in collaboration with health system partners, a bundle of implementation strategies may support outcome measure adoption in stroke rehabilitation. Improving the use of standardized outcome measures is of paramount importance in stroke rehabilitation to objectively monitor patients’ progress or decline, to demonstrate the value of rehabilitation services for enhancing patients’ recovery, and to advocate for continued reimbursement for rehabilitation care. Future opportunities lie in further specifying the mechanisms through which implementation strategies are intended to work and how those mechanisms contribute to strategy effectiveness.Trial registrationNCT registration: NCT04888416; May 06, 2021.