Changes In Test Scores Research Articles

DOES DEPRESSION EXPLAIN COGNITIVE CHANGES IN PSYCHOTHERAPY? A MEDIATION ANALYSIS

Abstract Depression commonly affects older adults and is associated with detrimental outcomes, including cognitive impairment such as executive dysfunction. Psychotherapy effectively improves depression outcomes and may improve some aspects of cognition, but this relationship is not widely understood. This study examined the potential mediating role that depression severity might have between psychotherapy treatment and a change in cognitive test scores. Data for this secondary analysis were drawn from older adult participants (N=249, mean age = 70.2 [7.4] years) with major depressive disorder who participated in a RCT comparing two 9-week structured psychotherapies for depression. Our prior work found improvement in depression (noninferiority between treatment groups) and some improvement on measures of cognition during the RCT. Measures included pre- and post-treatment cognitive tests: Iowa Gambling Money Task, Digit Span Backwards, and Stroop test. The Hamilton Depression Rating Scale (HAM-D) assessed change in depression symptoms. Hayes PROCESS macro for SPSS analyzed separate mediation models testing depression as a mediator of treatment and each cognitive outcome. Change in depression did not mediate relationships between treatment and change in cognitive outcomes across the nine weeks of psychotherapy. While our investigation did not establish depression as a mediator of change in cognitive test performance in patients receiving psychotherapy, these findings may indicate that improvement in depression is somewhat independent of any observed changes in cognitive test performance. Future research involving a more cognitively impaired sample could strengthen these findings.

Efficacy of Sophora japonica L. Pill in Subjective Memory Complaints in Healthy Adults: a protocol of randomized, double-blind, placebo-controlled, parallel-group, clinical trial.

Subjective memory complaints, increasingly common among older adults, may indicate early cognitive decline or dementia. Sophora japonica L., a herbal medicine in Korean medicine, has shown potential cognitive benefits in preclinical studies through neuroprotective and anti-inflammatory properties. Given limited efficacy of current pharmacological treatments for cognitive impairment and growing interest in natural products, investigating S. japonica extract in humans is warranted. This randomized, double-blind, placebo-controlled trial will involve 100 participants aged 40-70 years with subjective memory complaints but without diagnosed cognitive impairment. Participants will receive either S. japonica extract (1,250 mg) or placebo daily for 8 weeks. The primary outcome is change in digit span test score, assessing short-term memory and attention. Secondary outcomes include changes in other cognitive function tests (visual short-term memory, visual learning, and verbal learning), as well as measures of depression (Beck Depression Inventory-II), anxiety (State-Trait Anxiety Inventory-Y), stress (Stress Response Inventory), heart rate variability, and quality of life (EuroQol 5-Dimension-3L). Assessments will be conducted at baseline and after 8 weeks, with safety monitoring throughout the study period. This study will provide evidence on the efficacy and safety of S. japonica extract for improving cognitive function in adults with subjective memory complaints. If proven effective, this supplement could offer a new approach for supporting cognitive health in aging populations. The comprehensive assessment of cognitive, mood, and quality of life outcomes will allow thorough evaluation of its potential benefits.

A randomised controlled pilot trial protocol for patient led cognitive gamified training during haemodialysis

Disruptions in cognitive function have been reported in individuals undergoing haemodialysis and those with chronic kidney disease. This pilot study protocol primarily assesses the feasibility and acceptability of using mobile cognitive gaming apps for patient-led cognitive training during haemodialysis sessions. The protocol consists of three phases: (1) reviewing and evaluating available cognitive gaming apps, (2) conducting focus groups/interviews with people with kidney disease to determine app preferences, and (3) undertaking a quasi-experimental randomised controlled trial to compare cognitive outcomes between a patient-led app intervention group and a standard care control group over four months. Primary outcomes will include changes in cognitive test scores [Montreal Cognitive Assessment (MoCA), Modified Mini-Mental State Exam (3MSE), Rapid Objective Working Memory Assessment (ROWMA)], while secondary outcomes will encompass quality of life measures [Patient-Reported Outcomes Measurement (PROM) Kidney Disease Quality of Life Short Form (KDQoL-SF™) v 1.3, Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Instrument, European Quality of Life Five Dimension (EQ-5D)]. If demonstrated to be effective, this novel method of utilising gamified cognitive training applications could potentially mitigate cognitive decline and improve the well-being of people receiving haemodialysis without necessitating significant clinical resources. The findings from this research will guide the development of a larger definitive randomised trial in the future.

Increasing IQ Test Scores and Decreasing g: The Flynn Effect and Decreasing Positive Manifold Strengths in Austria (2005-2018).

After almost a century of global generational IQ test score gains, the Flynn effect has, in the past decades, been observed to show stagnation and reversals in several countries. Tentative evidence from academic achievement data has suggested that these trajectory changes may be rooted in a decreasing strength of the positive manifold of intelligence due to increasing ability differentiation and specialization in the general population. Here, we provide direct evidence for generational IQ test score and positive manifold strength changes based on IQ test standardization data from 1392 Austrian residents between 2005 and 2018. Our analyses revealed positive Flynn effects across all domains of the IQ test (Cohen's d from 0.21 to 0.91) but a trend toward decreasing strength in the positive manifold of intelligence (R2 from .908 to .892), though these changes were not statistically significant. Our results are consistent with the idea that increasingly inconsistent Flynn effect trajectories may be attributed to increasing ability differentiation and specialization in the general population over time.

Acquisition of musical skills and abilities in older adults—results of 12 months of music training

BackgroundOlder adults can acquire new skills across different domains. Practicing a musical instrument has been identified as a promising activity for improving cognition, promoting well-being, and inducing brain plasticity in older individuals. However, the mechanisms of these changes are still poorly understood. This study aims to assess musical skill acquisition in musically naïve older adults over one year of practice, focusing on individual factors influencing this process and the relations between musical skills.MethodsOne hundred fifty-six healthy older adults (age = 69.5 years ± 3.2) from Hannover and Geneva with no prior musical training participated in weekly piano practice (PP) or ‘music culture’ (MC) sessions over a one-year period. Baseline assessments included the Cognitive Reserve Index questionnaire (CRIq) and Cognitive Telephone Screening Instrument (CogTel). Musical abilities were measured using piano performance ratings (PP group), music quizzes (MC group), and aptitude tests such as the Beat Alignment Test (BAT), Melodic Discrimination Test (MDT) and Midi Scale Analysis (MSA) at baseline and six-, twelve and 18-month timepoints. The interrelationship between musical abilities was investigated through correlational analyses, and changes impacted through individual characteristics were modeled using Bayesian statistics.ResultsThe PP group demonstrated moderate improvements in piano articulation and dynamics, while the MC group achieved higher scores in the music quiz. Modest improvements in MDT and MSA were observed in both groups, with the PP group showing greater progress is MSA. Higher global cognitive functioning and musical sophistication was associated with greater performance in MDT for both groups. We did not identify any links between individual characteristics, like age, CogTel, CRIq, and musical sophistication, and improvement in musical aptitude tests. Changes in different musical aptitude test scores were not correlated, and neither the development of piano skills nor the music quiz correlated with initial performances on the musical aptitude tests.ConclusionMusically naïve older adults can acquire diverse musical abilities, which progress independently, suggesting a broad spectrum of musical abilities rather than a single general musical aptitude. Future research should also explore genetic and psychosocial factors influencing musical development.Trial RegistrationThe Ethikkomission of the Leibniz Universität Hannover approved the protocol on 14.08.17 (no. 3604–2017), the neuroimaging part and blood sampling was approved by the Hannover Medical School on 07.03.18. The full protocol was approved by the Commission cantonale d’éthique de la recherche de Genève (no. 2016–02224) on 27.02.18 and registered at clinicaltrials.gov on 17.09.18 (NCT03674931, no. 81185).

Improvement of tinnitus, anxiety, and depression following cochlear implant surgery: a prospective cohort study

IntroductionHearing loss affects ~1. 5 billion people worldwide and is the greatest risk factor for tinnitus, a condition that can further worsen people's quality of life, lead to high anxiety and depression, and affect general health and wellbeing.ObjectivesThis study aimed to assess the impact of cochlear implants (CIs) on tinnitus perception and quality of life and their relationship with psychological disorders, such as depression and anxiety.MethodsThirty adults with profound bilateral hearing loss who were candidates for CI surgery and experienced tinnitus were assessed using the Tinnitus Handicap Inventory (THI), the Visual Analog Scale (VAS), the World Health Organization Quality of Life Instruments–Bref (WHOQOL-BREF), and the Hospital Anxiety and Depression Scale questionnaires at four different time points: preoperatively, 7 days after cochlear implant activation, and 3 and 6 months after cochlear implant surgery. The International Outcome Inventory CI was applied at 3 and 6 months, and the Glasgow Benefit Inventory (GBI) questionnaire was applied at 6 months.ResultsThe VAS and THI scores improved; however, significant improvements were only observed in the THI scores 6 months post-surgery. Time spent using hearing aids did not correlate significantly with speech recognition test scores, nor were the changes in the preoperative THI score and VAS scores or the changes in the speech recognition test scores 6 months post-surgery significantly correlated. We observed a decrease in anxiety and depression scores at the 6-month follow-up compared to the preoperative period.ConclusionThe THI scores significantly increased after CI surgery, suggesting that the tinnitus had improved. Improved anxiety and depression scores after CI surgery were also observed. The WHOQOL-BREF quality-of-life self-evaluation scores, as well as the environment and general domains, significantly improved as well.

Impact of SARS-CoV-2 Infection on Physical Fitness in Air Force Basic Trainees.

The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on physical fitness in previously healthy adults is not well understood. In this study, we assess the impact of SARS-CoV-2 infection on the physical fitness test (PT) scores of Air Force basic trainees. SARS-CoV-2 testing data and trainee fitness test scores for the calendar year 2021 were obtained from U.S. Air Force basic military trainees. Trainees perform a standardized fitness test including push-ups, sit-ups, and a 2.4 kilometer run at the beginning and end of their training. For this study, basic trainees who performed 2 fitness tests in 2021 and also tested positive for SARS-CoV-2 were defined as the infected cohort. These were 1:1 matched by sex to an uninfected control group of basic trainees. Changes in fitness test scores and pass-fail rates were then compared across the infected and control groups. A total of 23,450 basic trainees performed a PT in calendar year 2021, 975 (4%) of whom tested positive for SARS-CoV-2. A total of 621 (64%) had completed 2 fitness tests during the defined study period and were included in the infected cohort. There were 96 females (15.5%) in each group and 525 males (84.5%) in each group. There was no difference in body mass index between the infected and the control groups (24.0 [Interquartile range (IQR) 21.8 to 36.0] vs. 24.3 [IQR 21.7-36.9], P = .253). The infected group had a higher rate of failing their PT at the end of training when compared to control (15.7% vs. 4.3%, P < .001). When comparing those who passed their first fitness test and went on to fail their second fitness test, this occurred more frequently in the infected group (2.3% vs. 0.81%, P = .037). When comparing trainees who failed their first fitness test and went on to pass their second fitness test, this occurred more frequently in the control group (46.3% vs. 39.6%, P = .016). Among the infected group, there were no differences in second test failure rates when comparing symptomatic to asymptomatic trainees (16.9% vs. 11.8%, P = .143). SARS-CoV-2 infection was associated with an increased risk of PT failure as well as conversion from a passing to failing test score. There were no differences in second test failure rates in symptomatic compared to asymptomatic trainees. A key confounder to the data was the effect deconditioning had on fitness during isolation.

Changes in Response Inhibition, Visual Anticipation and Verbal Fluency During Vagus Nerve Stimulation Therapy in Patients With Drug-Resistant Epilepsy.

The effect of vagus nerve stimulation (VNS) on cognitive domain of attention and executive functions (AEFs) has not been extensively researched. This study was set up to investigate performance variability on cognitive tests assessing AEFs in drug-resistant epilepsy (DRE) patients receiving VNS therapy during a follow-up of up to 5 years. Thirty-three DRE patients were assessed with the interference, maze, and written verbal fluency tests as a part of EpiTrack screening before and after VNS implantation through repeated follow-ups according to the clinical VNS protocol. A linear mixed-effects model was used to analyse changes in test scores. Maze performance improved significantly by an average of 0.20 s per month (95% confidence interval (CI): -0.365 to -0.041; p = 0.014). Interference performance improved by an average of 0.05 s per month (p = 0.207) and number of words increased by an average of 0.03 words per month (p = 0.079) on the verbal fluency test. On the maze test, patients with psychiatric comorbidities improved the most (0.52 s/month, p = 0.001), while on the interference test, patients with frontal lobe epilepsy (FLE), those taking 1-2 antiseizure medications (ASMs) and patients with focal to bilateral tonic-clonic seizures improved the most (0.14 s/month, p = 0.005; 0.14 s/month, p = 0.033 and 0.16 s/month, p = 0.087, respectively). For verbal fluency, no clinically meaningful improvement was noted in any of the groups. During the follow-up, maze performance markedly improved, while performance on the interference and verbal fluency tasks remained relatively stable at the group level. Accordingly, visual anticipation and planning improved during VNS therapy whereas response inhibition was unchanged at the group level despite significant enhancements in patients with FLE and those taking 1-2 ASM. Furthermore, the presence of psychiatric comorbidities correlated with even greater improvement on maze performance.

Treatment of Alzheimer Disease.

Symptom-oriented treatment has been the mainstay of Alzheimer disease (AD) pharmacotherapy for decades. This article reviews the evidence basis for symptomatic treatments for AD and the emerging data on amyloid-lowering therapies with possible disease-slowing effects. Amyloid-lowering monoclonal antibody therapies entered clinical use in 2021. In July 2023, lecanemab became the first of these to gain full US Food and Drug Administration (FDA) approval and limited Medicare payment coverage. Donanemab gained similar approval status in July 2024. The approved agents remove amyloid plaque from the brain and appear to slow clinical disease progression but can produce significant adverse events known as amyloid-related imaging abnormalities with cerebral edema or effusion and with cerebral hemorrhages. Extensive safety monitoring is therefore required, including scheduled MRI scans. Also in 2023, brexpiprazole became the first agent specifically approved by the FDA for agitation associated with AD. Suvorexant, an orexin receptor antagonist, previously was approved for the treatment of insomnia in people with mild and moderate AD. There is robust evidence for the use of acetylcholinesterase inhibitors for patients with mild, moderate, and severe dementia due to AD, including outcomes beyond changes in cognitive screening test scores. More limited studies support the use of memantine in moderate and severe stages. These agents have a primary effect of delaying decline in cognition and function and postponing the emergence of adverse behaviors. Pharmacotherapy for behavioral and psychological symptoms is less predictable, and most clinical trials have had negative results. Anti-amyloid therapies provide the first FDA-approved option to alter AD pathology, but an understanding of overall utility and value to patients remains in its infancy.

“Rest of the folks are tired and weary”: The impact of historical lynchings on biological and cognitive health for older adults racialized as Black

Childhood structural racism may lead to poorer health and longevity for individuals racialized as Black. Racism-related stress cumulatively taxes the body resulting in worsening biological and cognitive health. This study examines the association between state-level exposure to historical lynchings (adverse childhood racism for modern older adults), with C-reactive protein (CRP, a marker of systemic inflammation), and global cognitive performance (modified TICS). We linked the percentage of lynchings of people racialized as Black at the state-level between 1882 and 1968 from the Archives at Tuskegee Institute with repeated CRP and cognitive test scores at baseline (2006/2008), year 4 (2010/2012), and year 8 (2014/2016) for a national sample of older adults in the Health and Retirement Study (N=10,500, aged >50). In multivariable generalized estimating equation models, we compared participants (by racialized group) living in states with high lynching proportions (>50th percentile) on changes in CRP and cognitive test scores adjusting for demographics, health conditions, and behaviors. Mean age was 69 (SD=9.9) and most participants were cisgender women (59%). On average participants racialized as non-LatinX Black living in states with high lynching proportions experienced 18.5% (95% CI 3%, 36%) higher CRP levels and -0.92 (95% CI -1.34, -0.50) lower cognitive test scores than participants racialized as non-LatinX Black that lived in states with lower lynching proportions. As artist Marvin Gaye sang in Flyin' High (in the Friendly Sky), "Rest of the folks are tired and weary," which describes how adverse childhood racism is associated with inflammation and dementia risk for people racialized as Black.

Benralizumab: Effectiveness in Patients with Uncontrolled Severe Eosinophilic Asthma at 6 and 12 Months at a Third-Level Care Hospital. Capacity for ICS-LABA Therapy Reduction.

Asthma is a health condition with worldwide relevance, evaluated based on the necessary treatment to control symptoms and exacerbations. Severe asthma is uncontrolled despite high doses of ICS-LABA and treatment for triggering factors. Severe eosinophilic asthma is characterized by an increase in eosinophils in the peripheral circulation, walls, and passages of the respiratory tract. Biologic treatments such as benralizumab have demonstrated effectiveness as aids in decreasing respiratory tract inflammation and improving the management of symptoms in patients living with asthma. To assess the efficacy and safety of benralizumab as an add-on therapy for patients with severe, uncontrolled asthma and elevated blood eosinophil counts. Observational, analytic and ambispective study in 21 patients diagnosed with severe eosinophilic asthma treated with benralizumab, to determine the treatment's effectiveness through the change in estimated respiratory function by spirometry through the forced expiratory volume in one second (FEV1) value, reduction in second controlling treatment, serum eosinophil reduction, change in the Asthma Control Test score and the Asthma Control Questionnaire test at 6 and 16 months of treatment. An average difference of 241.43 mL (±461.43) in FEV1 at 6 months was found, as well as an average FeNO reduction of 49.8 ppm and eosinophil reduction of 612.78 cells at 12 months of treatment, additionally, CSI requirements were reduced in 95% of patients. Benralizumab improved respiratory function as well as key biomarkers such as eosinophil count, exhaled nitric oxide fraction (FeNO), which reflected in a decreased requirement of inhaled corticosteroids and improved symptom control.

Changes in Y-Balance Test Scores During Months 4, 5, and 6 of ACL Reconstruction Rehabilitation.

The anterior cruciate ligament (ACL) is well researched since injuries typically result in lengthy recoveries and rehabilitation periods until athletes can return to full activity. Although a large body of literature on the early and late stages of rehabilitation following ACL reconstructive (ACLR) surgery exists, less is known regarding the mid-phase of ACL rehabilitation and healthy versus injured limb differences in functional testing during this stage. The purpose of this study is to determine if Y-Balance Test (YBT) scores obtained during the mid-phase of ACLR rehabilitation change over months 4, 5, and 6. Case Series. Research laboratory. Patients or Other Participants: A total of 27 participants (17 females; 18.96±3.02 years (range 15-24); 173.63±10.29cm; 72.55±17.83kg) who sustained a unilateral ACL injury, experienced no episodes of instability or knee giving away, had not suffered a previous ACL injury, and expressed a desire to return to sport at the end of rehabilitation came in once a month following ACLR to participate in a battery of tests. YBT scores in the anterior, posterolateral (PL), and posteromedial (PM) directions in the healthy and reconstructed limbs. A main effect for limb was observed for the anterior (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4±5.8; Reconstructed: m4: 77.2±5.9, m5: 78.5±5.1, m6: 78.1±6.4, p=0.023) and PM (Healthy: m4: 80.0cm±8.7, m5: 81.0cm±9.1, m6: 82.9cm±8.9; Reconstructed: m4: 79.3cm±6.8, m5: 79.4cm±8.2, m6: 81.1cm±8.5, p=0.013). directions indicating that the reconstructed limb performed worse than the healthy limb. A main effect for time was observed for the PL direction (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4cm±5.8; Reconstructed: m4: 77.2cm±5.9, m5:78.5cm±5.1, m6: 78.1cm±6.4, p=0.023). The YBT measured improvement in the PL direction across time in the reconstructed limb. In the PM and anterior directions, the YBT did not measure these same improvements across this period.

A Farewell to the Narcissism Epidemic? A Cross-Temporal Meta-Analysis of Global NPI Scores (1982-2023).

Several recent accounts have failed to replicate the so-called Narcissism Epidemic, suggesting potential influences of the Global Financial Crisis (GFC) in 2008 as a reason for narcissism trend reversals. Here, we provide evidence for narcissism test score changes from 1982 to 2023. We investigated self-report data on the Narcissistic Personality Inventory (NPI) from 1105 studies (k = 1621, N = 546,225) using precision-weighted cross-temporal meta-analysis. Data collection years were meaningfully negatively associated with narcissism scores in virtually all analyses (bs: -0.409 to -0.008; partial eta square's: < 0.001 to 0.118; ps: < 0.001 to 0.174), thus indicating cross-temporally decreasing narcissism self-report scores. Examination of regression segments pre- and post-dating the GFC and segmented line regressions indicated mostly stable narcissism scores during the 1980s and 1990s that subsequently showed negative slopes with somewhat differing decreases onsets according to analytical subsets. Here, we provide evidence for negative cross-temporal changes in narcissism from 1982 to 2023 globally, thus contrasting the idea of a Narcissism Epidemic having taken place at any point during the past four decades. Changes appear to generalize across different regions and participant sex, although mean scores were differentiated, yielding higher narcissism values for North American and younger samples.

Student composition, equity, and mathematics learning outcomes during a time of educational reforms in Ethiopia

ABSTRACT This paper assesses the extent to which the implementation of a complex educational reform in Ethiopia was associated with changes in mathematics test scores for Grade 4 pupils from 2012–13 to 2018–19. During this period, while mathematics teachers’ educational qualifications and teacher content knowledge in mathematics improved, students in 2018–19 achieved, on average, lower test scores in mathematics than those in 2012–13. However, they also showed, on average, greater progress in mathematics test scores. Progress in mathematics test scores over the school year was associated with teacher content knowledge, but the magnitude of this association was larger in 2018–19 and was especially important for weaker students. The key to reconciling these paradoxical findings is to recognise that the reforms that underpin these improvements in school quality may well be working in multiple ways, changing the composition of the student body who attend school as well as increasing the amount of learning that takes place in the classroom, particularly among disadvantaged students.

Correlation of sino-nasal outcome test and nasal polyp score in dupilumab-treated chronic rhinosinusitis with nasal polyps

BackgroundThe alignment between objective scores and patient-reported outcome measures (PROMs) is underexplored. This study aimed to assess changes in Nasal Polyp Score (NPS) and Sino-Nasal Outcome Test (SNOT) scores in chronic rhinosinusitis with nasal polyps (CRSwNP) patients undergoing dupilumab treatment and explore correlations between these scores.MethodsCRSwNP patients received dupilumab therapy for six months. SNOT-20 German Adapted Version (GAV)/SNOT-22 scores were assessed weekly, and NPS was measured at baseline and after one, three, and six months. Correlations were analyzed using Spearman’s rank correlation and regression analysis.Results69 patients were included. After one, three and six months of dupilumab therapy, SNOT and NPS scores improved significantly. Correlation analysis of SNOT and NPS showed significant correlations only within the nasal subscores, along with a weak trend for SNOT-20. Absolute changes over time lacked significance. However, correlation analysis revealed significant associations between relative changes in SNOT score and NPS, irrespective of timing, and when stratified by baseline NPS of 8, 6, and 4 (r = -0.54, p = 0.01; r = -0.44, p < 0.001; r = -0.7, p < 0.001). This was supported by linear regression modeling, suggesting potential predictive capability of NPS reduction on relative SNOT score improvement.ConclusionDupilumab therapy significantly improved subjective and objective CRSwNP scores, exhibiting weak correlations in absolute values for nasal subscores. Furthermore, evidence indicated a correlation between relative changes in SNOT score and NPS, substantiated by predictive capability. This might be due to subjective perception variability, highlighting the suitability of relative change correlation analysis.

Measuring the value of teachers from traditional certification pathways in Texas: A comprehensive study

While teacher preparation in the United States continues a long period of decline, the largest-producing state, Texas, is experiencing substantial changes in how it prepares teachers. The number of teachers prepared by traditional university pathways continues to decline, and the number from alternative pathways is rising. Using extensive data from Texas, we find that traditionally prepared teachers from universities obtain significantly higher student learning gains than alternatives. We use value-added models to estimate changes in student test scores in many grade levels and test subjects as a function of teacher preparation pathway. We compare all Traditional programs to all Alternative programs, and we compare all For-Profit programs to all Not for-Profit programs. For most subjects and grade levels, students learn significantly more from Traditional or Not for-Profit program teachers: 0.02 to 0.05 in standard deviation units. There is not one significant estimate in any model where students learn more from Alternative and For-Profit programs teachers than they do from Traditional and Not For-Profit program teachers.

Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts quality of life and often presents therapeutic challenges, with biologics like dupilumab showing promise in managing severe, uncontrolled cases. The aim of this study was to assess the influence of overweight on the effectiveness of dupilumab in patients with uncontrolled CRSwNP. This retrospective study analyzed treatment outcomes of 75 CRSwNP patients receiving dupilumab, categorizing them into underweight/normal-weight (BMI ≤ 24.9 kg/m2) and overweight/obese (BMI ≥ 25 kg/m2) groups. Outcome measures included changes in nasal polyp score (NPS) and sinonasal outcome test (SNOT-22) scores. Results demonstrated that the underweight/normal-weight group experienced significantly greater improvements in NPS and a higher rate of total NPS improvement compared to the overweight/obese group. While SNOT-22 scores improved in both groups, no significant differences were observed. Among patients with comorbid asthma, the underweight/normal-weight subgroup also showed significantly better outcomes, including greater reductions in both NPS and SNOT-22 scores. Multiple regression analysis identified BMI as an independent prognostic factor for NPS outcomes. The findings suggest that overweight/obesity adversely affects the response to dupilumab in CRSwNP, emphasizing the need for personalized treatment strategies considering BMI.

Effect of transcranial direct current stimulation with concurrent cognitive performance targeting posterior parietal cortex vs prefrontal cortex on working memory in schizophrenia: a randomized clinical trial

Working memory deficits are linked to irregularities in the dorsolateral prefrontal cortex (DLPFC) and the posterior parietal cortex (PPC) in schizophrenia, effective intervention strategies are lacking. We evaluated the differential efficacy and underlying neuromechanisms of targeting transcranial direct current stimulation (tDCS) at the DLPFC and the PPC with concurrent cognitive performance for working memory in schizophrenia. In a randomized and double-blind clinical trial, sixty clinically stable schizophrenic patients with below-average working memory were randomly assigned to active DLPFC, active PPC, and sham tDCS groups. Two sessions of tDCS during N-back task were delivered daily for five days. The primary outcome was changes in spatial span test scores from baseline to week 1. The secondary outcomes included changes in scores of color delay-estimation task, other cognitive tasks, and mismatch negativity (biomarker of N-methyl-d-aspartate receptor functioning). Compared with the active DLPFC group, the active PPC group demonstrated significantly greater improvement in spatial span test scores (p = 0.008, d = 0.94) and an augmentation in color delay-estimation task capacity at week 1; the latter sustained to week 2. Compared with the sham tDCS group, the active PPC group did not show a significant improvement in spatial span test scores at week 1 and 2; however, significant enhancement was observed in their color delay-estimation task capacity at week 2. Additionally, mismatch negativity amplitude was enhanced, and changes in theta band measures were positively correlated with working memory improvement in the active PPC group, while no such correlations were observed in the active DLPFC group or the sham tDCS group. Our results suggest that tDCS targeting the PPC relative to the DLPFC during concurrent cognitive performance may improve working memory in schizophrenia, meriting further investigation. The improvement in working memory appears to be linked to enhanced N-methyl-d-aspartate receptor functioning.

Effects of Dry Land Speed Training on 100-Meter Freestyle Swimming in Adolescent Swimming

Background and Aim: The specific strength development in swimming tends to start at a younger age, so it becomes particularly important to conduct effective Specific strength training during adolescence. It is essential to utilize training methods and means that align with the developmental characteristics of Specific strengths in young swimmers. Thus, this study has developed a specific dry-land training program to enhance the 100-meter freestyle swimming speed of adolescent swimmers. Methods: This study selected 30 male adolescent swimmers from the Shaanxi Provincial Swimming Team and divided them into an experimental group and a control group (15 individuals in each group) based on their 100-meter freestyle speed. Both groups underwent a 12-week training intervention, with 12 training sessions per week, each lasting 2 hours. The total training time and water-based training content were the same for both groups, but the content of dry-land training differed. The experimental group followed a specific dry-land training program, while the control group followed a traditional training program. Comprehensive tests were conducted before and after the 12-week training intervention for both groups, using the physical fitness and test scores of swimmers in the experimental and control groups as research indicators. Experimental and analytical methods, including experimental and statistical methods, were employed to conduct a targeted study on the changes in physical fitness and test scores before and after the training. Results: show that after 12 weeks of training, the scores for both groups are as follows: Pull-ups (Experimental group: P=0.000&lt;0.01, Control group: P=0.777&gt;0.05), Vertical jump (Experimental group: P=0.032&lt;0.05, Control group: P=0.848&gt;0.05), Abdominal muscle endurance (Experimental group: P=0.000&lt;0.01, Control group: P=0.396&gt;0.05), and Back muscle endurance (Experimental group: P=0.004&lt;0.01, Control group: P=0.583&gt;0.05). The post-test results reveal that swimmers in the experimental group performed significantly better in pull-ups, vertical jumps, abdominal muscle endurance, and back muscle endurance compared to the control group. Conclusion: The specialized training program effectively increased the upper limb strength of the participants, with no significant advantage over the traditional training program.

Anti–IL-4R versus anti–IL-5/5R after anti–IL-5/5R failure in asthma: An emulated target trial

Switching biologics is now common practice in severe eosinophilic asthma. After insufficient response to anti-IL-5 or 5 receptor (anti-IL-5/5R), the optimal switch between an anti-IL-4R mAb (interclass) or another anti-IL-5/5R drug (intraclass) remains unknown. We sought to compare the effectiveness of these 2 strategies in asthma control in patients with severe eosinophilic asthma and insufficient response to an anti-IL-5/5R mAb. We emulated a target randomized trial using observational data from the Recherche sur les AsthMes SEvèreS (RAMSES) cohort. Eligible patients were switched to an anti-IL-4R mAb or another anti-IL-5/5R drug after insufficient response to an anti-IL-5/5R mAb. The primary outcome was the change in Asthma Control Test score at 6 months. Among the 2046 patients in the cohort, 151 were included in the study: 103 switched to an anti-IL-4R mAb and 48 to another anti-IL-5/5R. At 6 months, the difference in Asthma Control Test score improvement was not statistically significant (mean difference groups, 0.82 [-0.47 to 2.10], P=.213). The interclass group exhibited greater cumulative reduction in oral corticosteroid dose (Pinter-intra, -1.05 g [-1.76 to -0.34], P= .041). The interclass group had a better effect, although not significantly, on reducing exacerbations (Δinter-intra, -0.37 [-0.77 to 0.02], P= .124) and increasing lung function (FEV1) (126.8 mL [-12.7 to 266.4], P= .124). After anti-IL-5/5R mAb insufficient response, switching to dupilumab demonstrated similar improvement in Asthma Control Test scores compared with intraclass switching. However, it appeared more effective in reducing oral corticosteroid use. Larger studies are warranted to confirm these results.