Test Protocol Research Articles

The Challenges for EU User Testing Policies for Patient Information Leaflets.

Patient information leaflets (PILs) are essential tools in healthcare, providing crucial information about medication use. In the European Union, the European Medicines Agency (EMA) oversees the regulation and standardisation of PILs to ensure their readability and accessibility. However, challenges persist in ensuring these documents are comprehensible and user-friendly. This study employs a qualitative analytical approach, reviewing existing literature and regulatory documents to identify gaps in the EU user testing policies for PILs. It focuses on the diversity of participant samples, the independence of the testing process, and the robustness of user testing protocols. Findings indicate that current user testing practices often lack diversity and may be biased when pharmaceutical companies conduct their own tests. Additionally, there is a lack of user testing protocols for translated PILs, potentially compromising their accuracy and cultural relevance. To improve the efficacy of PILs, it is essential to include diverse and representative samples in user testing, mandate independent third-party evaluations, implement protocols for user testing on translated PILs, and ensure continuous updates to guidelines based on the latest best practices in health communication. These measures will enhance patient safety and understanding of medication information.

Human Immunodeficiency Virus - a Review of the clinical aspects and detection of the infection

Introduction: Currently, many people are infected with the human immunodeficiency virus (HIV). Transmission is primarily through sexual contact, with additional routes including mother-infant exposure to needles and needle sharing. Since the HIV/AIDS pandemic was first identified in 1981, more than 75 million people have been infected. Numerous new cases continue to be reported, and infection can become the starting point for the development of HIV. Clinical manifestations include acute retroviral syndrome, opportunistic infections, and dermatological, neuromuscular, and other complications. Despite advances in antiretroviral therapy (ART), challenges remain, including drug resistance, opportunistic infections, and persistent HIV reservoirs in some cell types. Early and accurate diagnosis is essential, and recommended testing protocols include fourth-generation serological tests and point-of-care (POC) testing. ART, which includes combinations of antiretroviral drugs, is the standard treatment, and ongoing research into gene therapy shows promise for the future. Purpose of the work: The aim of this study is to review and characterize the clinical aspects and detection of human immunodeficiency virus infection. Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: HIV, human immunodeficiency virus, ART, HIV manifestation, HIV detection, HIV diagnosis, HIV treatment.

Improved Understanding of PEMFC Stack Durability Testing through Comprehensive In-Situ and Ex-Situ Characterization Techniques

Durability testing of Proton Exchange Membrane Fuel Cells for mobile applications remains a critical challenge. While most academic studies focus on single-cell testing, there are only few publications on stack testing of technical relevant sizes. This study utilizes comprehensive characterization techniques to enhance understanding of PEMFC stack durability, aiming to meet the currently targeted durability targets. A 5,500-hour long-term test, based on the Auto Stack Industry (ASI) test protocol, was performed on a 7-cell short stack of 240 cm² active area. In-situ techniques, such as spatially resolved current density measurement, cyclic voltammetry, and electrochemical impedance spectroscopy, provided real-time degradation insights, while ex-situ methods, including FIB-SEM analysis, infrared thermography or contact angle measurements provided information on material degradation mechanisms. Membrane degradation was found to be negligible. Slight thinning of the cathode indicates carbon corrosion of the catalyst support. Catalyst aging was observed in the form of Pt band formation and Co leaching. Gas diffusion layers showed hydrophobicity loss, and increased resistance in bipolar plates contributed to reduced performance. Our findings demonstrate that PEMFC stacks operated under automotive drive cycle protocols can meet the actual targeted durability objectives. Moreover, it illustrates the degradation phenomena that occur under realistic operating conditions and modes, and how they evolve over the duration of thousands of hours of operation.

Improved Understanding of PEMFC Stack Durability Testing through Comprehensive In-Situ and Ex-Situ Characterization Techniques

Durability testing of Proton Exchange Membrane Fuel Cells for mobile applications remains a critical challenge. While most academic studies focus on single-cell testing, there are only few publications on stack testing of technical relevant sizes. This study utilizes comprehensive characterization techniques to enhance understanding of PEMFC stack durability, aiming to meet the currently targeted durability targets. A 5,500-hour long-term test, based on the Auto Stack Industry (ASI) test protocol, was performed on a 7-cell short stack of 240 cm² active area. In-situ techniques, such as spatially resolved current density measurement, cyclic voltammetry, and electrochemical impedance spectroscopy, provided real-time degradation insights, while ex-situ methods, including FIB-SEM analysis, infrared thermography or contact angle measurements provided information on material degradation mechanisms. Membrane degradation was found to be negligible. Slight thinning of the cathode indicates carbon corrosion of the catalyst support. Catalyst aging was observed in the form of Pt band formation and Co leaching. Gas diffusion layers showed hydrophobicity loss, and increased resistance in bipolar plates contributed to reduced performance. Our findings demonstrate that PEMFC stacks operated under automotive drive cycle protocols can meet the actual targeted durability objectives. Moreover, it illustrates the degradation phenomena that occur under realistic operating conditions and modes, and how they evolve over the duration of thousands of hours of operation.

Biomechanical Comparison of Three Modified Kessler Techniques for Flexor Tendon Repair: Implications in Surgical Practice and Early Active Mobilization.

Objective: Managing flexor tendon injuries surgically remains challenging due to the ongoing debate over the most effective suture technique and materials. An optimal repair must be technically feasible while providing enough strength to allow for early active mobilization during the post-operative phase. This study aimed to assess the biomechanical properties of three modified Kessler repair techniques using two different suture materials: a conventional two-strand and a modified four-strand Kirchmayr-Kessler repair using 3-0 Prolene® (2s-KK-P and 4s-KK-P respectively), and a four-strand Kessler-Tsuge repair using 4-0 FiberLoop® (4s-KT-FL). Methods: Human flexor digitorum profundus (FDP) tendons were retrieved from Thiel-embalmed prosections. For each tendon, a full-thickness cross-sectional incision was created, and the ends were reattached using either a 2s-KK-P (n = 30), a 4s-KK-P (n = 30), or a 4s-KT-FL repair (n = 30). The repaired tendons were tested using either a quasi-static (n = 45) or cyclic testing protocol (n = 45). Maximum force (Fmax), 2 mm gap force (F2mm), and primary failure modes were recorded. Results: In both quasi-static and cyclic testing groups, tendons repaired using the 4s-KT-FL approach exhibited higher Fmax and F2mm values compared to the 2s-KK-P or 4s-KK-P repairs. Fmax was significantly higher with a 4s-KK-P versus 2s-KK-P repair, but there was no significant difference in F2mm. Suture pull-out was the main failure mode for the 4s-KT-FL repair, while suture breakage was the primary failure mode in 2s- and 4s-KK-P repairs. Conclusions: FDP tendons repaired using the 4s-KT-FL approach demonstrated superior biomechanical performance compared to 2s- and 4s-KK-P repairs, suggesting that the 4s-KT-FL tendon repair could potentially reduce the risk of gapping or re-rupture during early active mobilization.

The Importance of Orthostatic Increase in Pulse Wave Velocity in the Diagnosis of Early Vascular Aging.

Background/Objectives: Vascular aging can be assessed by arterial stiffness measured through pulse wave velocity (PWV). Increased PWV predicts arterial hypertension, cardiovascular events and all-cause mortality. Detection of early signs of vascular aging remains an unmet problem. To search for the most sensitive markers for the early increase in vascular stiffness in a healthy population. Methods: One-hundred and twenty healthy subjects were divided in three equal age groups: <30 years, 30-45 years and >45 years. Head-up tilt test (HUTT) protocol was applied, providing a standardized hydrostatic column height. PWV at the brachial-ankle artery site (baPWV) was measured using a multichannel sphygmomanometer ABI System 100 PWV in three positions: in the baseline horizontal (supine) position-baPWVb; during the head tilt-up with an individual angle of inclination-baPWVt; and when returning to supine. Results: The most sensitive marker of early stiffness increase in a healthy population is the relative orthostatic increase in baPWV, ΔbaPWV/baPWVb, where ΔbaPWV = baPWVt - baPWVb. The significance of differences in this parameter between the young and elderly groups reached p = 0.000075 and p = 0.000006, respectively. Conclusions: The proposed index ΔbaPWV/baPWVb can be considered as a promising sensitive early biomarker of vascular aging and as a potential effective indicator in cardiovascular prevention. A longitudinal cohort study is needed to confirm this assumption.

Comprehensive management of chronic ear disease: Consecutive patient analysis at a tertiary children's hospital

ObjectiveTo characterize medical complexity and advanced interventions necessary to treat pediatric patients with chronic ear disease. MethodsA retrospective case review of children who received surgery for chronic otitis media, cholesteatoma, or tympanic membrane perforation at a tertiary children's hospital from 2020 to 2024 was performed. The frequency and type of medical complexities as well as distribution and success of advanced otologic interventions were recorded. ResultsOperations were performed on 80 ears. Forty-five percent were in medically complex patients. Twenty-five percent had a syndrome, 13 % had American Society for Anesthesiologists Severity Class 3 or more, and 38 % attended multi-disciplinary programs. Advanced audiology testing protocols were utilized in 53 % of patients, and multiple children received complex sleep and airway operations. Advanced surgical techniques were required in 58 %. Post-operatively, an intact tympanic membrane was achieved in 95 % of operated ears (p < 0.01). Residual and recurrent cholesteatoma were each present in 5 % of cases, with mean follow-up of 11.6 months. Otorrhea reduced from 64 % of patients pre-operatively to 2 % post-operatively (p < 0.01), including cessation in all individuals who reported social/bullying issues related to ear drainage/odor. Unrestricted water exposure was achieved in 99 % of individuals (p < 0.01). Patients showed a mean improvement after surgery of 7.6 dB, as measured by the change in air-bone gap (p < 0.05). Conclusions: Comprehensive treatment of otologic conditions included care that was holistic of all medical needs, integrated with other services, developmentally appropriate, encompassing of non-otologic procedures, technically advanced, effective, and functionally-focused. Surgical teams should endeavor together to provide this combination of services.

Concept and Experimental Validation of Using Titanium Alloy Bars (TiABs) as Flexural Reinforcing in Concrete Beams

The research focuses on the use of Titanium Alloy Bars (TiABs) in concrete cap beams. TiABs offer good ductility, high strength, lightweight, superior corrosion resistance, lower overstrength, and better fatigue performance. TiABs have recently been used in several existing bridges in Oregon and Texas in the United States to increase shear and flexural capacities of concrete beams. While TiABs have been implemented in retrofitting of existing bridges in the United States, their application in new structures have not been tested and compared against conventional steel rebars. The research in this paper proposes concept for an innovative cap beam reinforced with longitudinal TiABs. The cap beam integrates both structural performance and durability. Flexural and shear design procedures for the cap beam in accordance with the AASHTO LRFD Design are discussed. To investigate structural performance, a large-scale cap beam reinforced with longitudinal grade 5 titanium alloy (Ti-6Al-4V) is tested under three-point bending test protocol. The results are compared against a benchmark cast-in-place beam with normal rebars under the same testing arrangement and loading protocol.

Micronutrient availability alters Candida albicans growth and farnesol accumulation: implications for studies using RPMI-1640.

The dimorphic fungus Candida albicans is a major opportunistic pathogen of humans. RPMI-1640 is a chemically defined growth medium commonly used with C. albicans. We identified over 32,000 publications with keywords RPMI and C. albicans. Additionally, Antifungal Susceptibility Testing (AFST) protocols in the United States (CLSI) and Europe (EUCAST) utilize RPMI as a base media to assess drug efficacy against clinical fungal isolates. RPMI contains many nutrients but no added trace metals. We found that the growth characteristics with RPMI were dependent on which MOPS buffer was chosen and the contamination of that buffer by trace levels of Mn(II) and Zn(II). Added Mn(II) was most needed for cell growth while added Zn(II) was most needed for secretion of farnesol and other signaling molecules.

Determining the Levels of Cortisol, Testosterone, Lactic Acid and Anaerobic Performance in Athletes Using Various Forms of Coffee.

Coffee is considered one of the most preferred and consumed beverage types in the world, and caffeine is known to increase physical performance due to its ergogenic properties. The aim of this study is to examine the effects of coffee consumption in different forms on cortisol, testosterone, lactic acid and anaerobic performance levels. A total of 15 licensed male football players participated in the research voluntarily. The research was implemented in a single-blind, counterbalanced, randomized and crossover study design. Participants were given caffeinated coffee (CK), decaffeinated coffee (placebo) (DK), powdered caffeine (in a gelatin capsule) (PC) and powdered placebo (maltodextrin in a capsule) (PM) on different days, and the Wingate test protocol was performed after the warm-up protocol. Blood samples were collected post-test. Cortisol, testosterone and lactic acid levels in the serum samples taken were determined by the ELISA method. As a result, it was revealed that caffeinated coffee given to participants who exercise increased anaerobic power. However, it was observed that lactic acid levels were higher in placebo and decaffeinated coffee. The highest level of cortisol was found in caffeinated coffee and powdered caffeine compared to the placebo. Testosterone values were observed to be highest in caffeinated coffee and decaffeinated coffee compared to a placebo. The study suggests that the type of caffeine is a factor that affects absorption rate, which impacts performance and hormone levels.

Phytotoxicity Testing of Atmospheric Polycyclic Aromatic Hydrocarbons

Atmospheric polycyclic aromatic hydrocarbons (PAHs) have well-known phytotoxicity on higher plants. However, while numerous bioindication studies have been targeted on how different symptoms indicate the deleterious effects of PAHs in the field, laboratory-scale phytotoxicity tests are much rarer. While ecotoxicity tests might rely on the very same end-points as bioindication studies, they have to comply with quality assurance criteria, repeatability being the most important. As such, proper reporting involves the description of the test compound, experimental design and conditions, test organism used, and end-points measured. The recent review intends to give an overview of studies available in the literature complying with these requirements. PAHs occur in the atmosphere both in gaseous form and bound to particles. As plants are exposed to both phases, test protocols available represent different exposure pathways, fumigation chambers vs. direct foliar treatment. Reported studies, therefore, are grouped based on the exposure route they intend to simulate.

Monitoring Cognitive Functions During Deep Brain Stimulation Interventions by Real Time Neuropsychological Testing.

We monitored cognition in 14 Parkinson's disease (PD) patients during deep brain stimulation (DBS) surgery when the electrode was positioned at the target subthalamic nucleus (STN) (i.e., the STN motor area). We present the DBS-real-time neuropsychological testing (DBS-RTNT) protocol and our preliminary experience with it; we also compared the intraoperative patient performance with the baseline data. Compared with the baseline data, patients undergoing DBS-RTNT in the target area demonstrated a significantly decreased performance on some tasks belonging to the memory and executive function domains. Patients undergoing right hemisphere DBS-RTNT had significantly lower short-term memory and sequencing scores than did patients undergoing left hemisphere DBS-RTNT. PD patient cognitive performance should be monitored during DBS surgery, as STN-DBS may induce changes. These preliminary data contribute to improving our understanding of the anatomo-functional topography of the STN during DBS surgery, which will enable the identification of the best site for producing positive motor effects without causing negative cognitive and/or emotional changes in individual patients in the future. In principle, medications (i.e., patients who underwent surgery in a levodopa-off state) could have influenced our results; therefore, future studies are needed to address the possible confounding effects of levodopa use.

Reliability and usability of a novel inertial sensor-based system to test craniocervical flexion movement control

BackgroundNeck pain has a significant global impact, ranking as the fourth leading cause of disability. Recurrent neck pain often leads to impaired sensorimotor control, particularly in craniocervical flexion (CFF). The Craniocervical Flexion Test (CCFT) has been widely investigated to assess the performance of deep cervical flexor muscles. However, its use requires skilled assessors who need to subjectively detect compensations, progressive increases in range of motion (ROM) or excessive superficial flexor activation during the test. The aim of this study was to design and develop a novel Craniocervical Flexion Movement Control Test (CFMCT) based on inertial sensor technology and real-time computer feedback and to evaluate its safety and usability, as well as inter and intra-rater reliability in both healthy individuals and patients with neck pain.MethodsWe used inertial sensor technology associated with new software that provides real-time computer feedback to assess CCF movement control through two independent test protocols, the progressive consecutive stages protocol (including progressive incremental stages of ROM) and the random stages protocol (providing dynamic and less predictable movement patterns). We determined intra and inter-rater reliability and standard error of the measurement for both protocols. The participants rated their usability was analysed through the System Usability Scale (SUS) and possible secondary effects associated with the tests were registered.ResultsThe progressive consecutive stages protocol and the random stages protocol were safe and easy to use (SUS scores of 82.00 ± 11.55 in the pain group and 79.56 ± 13.36 in the asymptomatic group). The progressive consecutive stages protocol demonstrated good inter-rater reliability (intraclass correlation coefficient [ICC] ≥ 0.75) and moderate to good intra-rater reliability (ICC 0.62–0.80). However, the random stages protocol exhibited lower intra-rater reliability, especially in the neck pain group, where the reliability values were poor in some cases (ICC 0.48–0.72).ConclusionThe CFMCT (progressive consecutive stages protocol) is a promising instrument to evaluate CCF motor control in patients with chronic neck pain. It has potential for telehealth assessment and easy adherence for exercise prescription and seems to be a safe and usable tool for patients with pain and asymptomatic individuals. Its use as a test or for exercise needs to be further investigated to facilitate its transfer to clinical practice.

Novel arthrometer for quantitative clinical examination of the knee in three planes: Safety, reliability, minimum detectable changes, and side-to-side differences in healthy subjects

Physical examination of the knee joint is used to diagnose the type and severity of knee ligament injury; however, these exams are qualitative and subjective. To perform common physical examinations, we developed an arthrometer which quantitatively measures the load–displacement response in anterior-posterior (AP) translation, internal-external rotation (IER) and varus-valgus (VV) rotation. Here we describe safety, reliability, minimum detectable changes (MDCs), and absolute side-to-side differences in twenty young, healthy subjects (ten male, ten female, mean age: 28 ± 6 years). The arthrometer consists of an instrumented mechanical linkage, a force-moment sensor, and software for real-time visualization and recording of the load–displacement responses. During testing, the subject sits reclined in a chair with their knee fixed at 30° of flexion. Two examiners tested both knees of each subject twice to assess reliability via intraclass correlation coefficients (ICC). All subjects completed the test protocol with minimal pain and stated that they would volunteer to be tested again. Each knee required on average five minutes to test. All intra-test reliabilities were excellent (≥0.91). Intra-examiner reliabilities ranged from good to excellent (0.62–0.89), and inter-examiner reliabilities were good to excellent (≥0.72). MDCs for repeat measures were ≤ 4.5 mm, 4.6°, and 2.3° for AP, IER, and VV, respectively. The absolute side-to-side differences for this cohort averaged 3.8 mm in AP, 5.5° in IER, and 2.2° in VV. Our arthrometer was safe, testing was time-efficient, and MDCs in our cohort of healthy subjects support utilization of this device for clinical research.

Bicycle Set-Up Dimensions and Cycling Kinematics: A Consensus Statement Using Delphi Methodology.

Bicycle set-up dimensions and cycling kinematic data are important components of bicycle fitting and cyclist testing protocols. However, there are no guidelines on how bicycles should be measured and how kinematic data should be collected to increase the reliability of outcomes. This article proposes a consensus regarding bicycle set-up dimensions and recommendations for collecting cycling-related kinematic data. Four core members recruited panellists, prepared the document to review in each round for panellists, analysed the scores and comments of the expert panellists, reported the decisions and communicated with panellists. Fourteen experts with experience in research involving cycling kinematics and/or bicycle fitting agreed to participate as panellists. An initial list of 17 statements was proposed, rated using a five-point Likert scale and commented on by panellists in three rounds of anonymous surveys following a Delphi procedure. The consensus was agreed upon when more than 80% of the panellists scored the statement with values of 4 and 5 (moderately and strongly agree) with an interquartile range of less than or equal to 1. A consensus was achieved for eight statements addressing bicycle set-up dimensions (e.g. saddle height, saddle setback, etc.) and nine statements for cycling kinematic assessment (e.g. kinematic method, two-dimensional methodology, etc.). This consensus statement provides a list of recommendations about how bicycle set-up dimensions should be measured and the best practices for collecting cycling kinematic data. These recommendations should improve the transparency, reproducibility, standardisation and interpretation of bicycle measurements and cycling kinematic data for researchers, bicycle fitters and cycling related practitioners.

On the experimental identification of equilibrium relations and the separation of inelastic effects in soft biological tissues

The mechanical characterization of vascular tissues has been mainly focused on the measurement of elastic properties, while the investigation of inelastic effects has received comparatively little attention. Even the relatively simple, purely elastic description of the material behavior requires an appropriate set of experimental data that cannot be easily isolated using standard testing procedures. The presence of viscous and damage-related phenomena poses some challenges in the definition of appropriate testing protocols capable of identifying an equilibrium response, which in general does not solely represent the elastic material behavior. The primary goal of the present study is therefore to devise an experimental procedure that can distinguish and evaluate the different constitutive phenomena separately. To this end, we apply methodologies widely used in the mechanical testing of rubber-like materials and transfer them to the field of biomechanics. We performed two types of experiments in equibiaxial extension on porcine thoracic aorta: a continuous cyclic test followed by a single-step relaxation test and a cyclic multi-step relaxation test, each at varying stretch rates. We demonstrate that the approximation of quasi-stationarity through continuous testing at slow rates is inadequate for the identification of an equilibrium relation. Alternatively, a step-wise protocol allows for the separation of equilibrium and viscous effects. This motivates a thermodynamic discussion of the experimental results in terms of energy dissipation and a closer look at the interplay of inelastic phenomena.

Validation of a refined protocol for mouse oral glucose tolerance testing without gavage.

A glucose tolerance test (GTT) is routinely used to assess glucose homeostasis in clinical settings and in preclinical research studies using rodent models. The procedure assesses the ability of the body to clear glucose from the blood in a defined time after a bolus dose. In the human clinical setting, glucose is ingested via voluntary consumption of a glucose-sweetened drink. Typically, in the rodent GTT oral gavage (gavage-oGTT) or (more commonly) intraperitoneal injection (IPGTT) are used to administer the glucose bolus. Although used less frequently, likely due to investigator technical and experience barriers, the former is the more physiologically relevant as it integrates the gastrointestinal tract (GI), including release of key incretin hormones. However, orally gavaging glucose in the GTT is also not without its limitations: gavaging glucose straight into the stomach bypasses potentially critical early glucose-sensing via the mouth (cephalic phase) and associated physiological responses. Furthermore, gavaging is stressful on mice, and this by itself can increase blood glucose levels. We have developed and validated a refined protocol for mouse oral GTT which uses a voluntary oral glucose dosing method, micropipette-guided drug administration (MDA), without the need for water deprivation. This approach is simple and non-invasive. It is less stressful for the mice, as evidenced by lower circulating corticosterone levels 10 minutes after glucose-dosing compared to oral gavage. This is significant for animal and investigator welfare, and importantly minimising the confounding effect of stress on mouse glucose homeostasis. Using a randomised cross-over design, we have validated the MDA approach in the oGTT against oral gavage in male and female C57BL/6J and C57BL/6N mice. We show the ability of this method to detect changes in glucose tolerance in diet-induced obese animals. Compared to oral gavage there was lower inter-animal variation in the MDA-oGTT. In addition to being more representative of the human procedure, the MDA-oGTT is easy and has lower barriers to adoption than the gavage oGTT as it is non-invasive and requires no specialist equipment or operator training. The MDA-oGTT a more clinically representative, accessible, and refined replacement for the gavage-oGTT for mouse metabolic phenotyping, which is simple yet overcomes significant deficiencies in the current standard experimental approaches.

Investigating the Impact of Learning Modality Shifts on K-12 Students’ Physical Activity Participation During the COVID-19 Pandemic

The COVID-19 pandemic created many challenges for K-12 schools during the 2020-2021 school year (e.g., establishing social dis-tancing measures, decisions regarding testing protocols, and transition from in-person to distance learning). Changes in teaching and learning modalities, from in-person to remote learning options, quickly became a reality for many students [an estimated 95%, according to Engzell et al. (2021)]. With an increase in distance learning came changes in stu-dents’ structured and unstructured physical activity participation. The impact of these changes is unknown and justifies research investigating the effect modality shifts held on students’ participation in physical activity and any associated outcomes. A mixed-methods survey was administered to examine changes in K-12 students’ learning modality, 521Chiara et al.participation in physical activity, and associated outcomes. Changes in learning modality from in-person to online were most frequently in-dicated (90%). Respondents stated both challenges and success stories associated with students’ participation in physical activities resulting from modality shifts (e.g., decreased social engagements, decreased ex-posure to structured and facilitated physical education, and increased outdoor play). Positive outcomes were most prevalent in children engaging in moderate PA. However, 85% of respondents indicated a decrease in their child’s physical activity participation. Our findings justify further investigation of the immediate and long-term impact of school modality shifts on students’ engagement in physical activities.

Surgical abortion service reorganization in response to the COVID-19 pandemic: a unique experience of attending second trimester D&E procedures under spinal anesthesia as emergency procedures.

The COVID-19 pandemic created a massive shift in how health care systems interact with COVID testing for patients. To avoid delay in accessing second trimester surgical abortion at our hospital (St. Paul's Hospital Millennium Medical College) during this pandemic, dilation and evacuation (D&E) procedures were attended as emergency cases, instead of as elective surgical procedures, which then required adherence to the universal preoperative COVID-19 testing protocol. This study aimed at documenting the experience of this unique abortion service adjustment in response to the COVID-19 pandemic. This was a retrospective descriptive study conducted at St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, from April 1, 2021 to July 31, 2021. We reviewed second trimester surgical abortion cases managed with D& E procedures, performed under spinal anesthesia using the emergency COVID-19 pre-operative testing protocol. Data were analyzed using SPSS version 23 and simple descriptive statistics were applied. Percentages and proportions were used to present the results. Nineteen cases of second trimester D&E cases were reviewed. The median gestational age of the abortion clients was 21.57 weeks. Eight of 19 cases had cervical preparation with overnight intra-cervical Foley catheter placement while the rest 11 (57.9%) cases had their cervical preparation with Laminaria. The median time interval from initial evaluation of the abortion client to time of doing D& E procedure was 21.83 h. Surgical abortion service reorganization enabled abortion clients to access dilation and evacuation procedures within 24 h of their initial presentation. This prevented significant delays in accessing abortion care that could otherwise have occurred as a result of adhering to the preoperative COVID-19 testing protocols applied to elective surgeries.

A standardized framework to test event-based experiments

The replication crisis in experimental psychology and neuroscience has received much attention recently. This has led to wide acceptance of measures to improve scientific practices, such as preregistration and registered reports. Less effort has been devoted to performing and reporting the results of systematic tests of the functioning of the experimental setup itself. Yet, inaccuracies in the performance of the experimental setup may affect the results of a study, lead to replication failures, and importantly, impede the ability to integrate results across studies. Prompted by challenges we experienced when deploying studies across six laboratories collecting electroencephalography (EEG)/magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), and intracranial EEG (iEEG), here we describe a framework for both testing and reporting the performance of the experimental setup. In addition, 100 researchers were surveyed to provide a snapshot of current common practices and community standards concerning testing in published experiments’ setups. Most researchers reported testing their experimental setups. Almost none, however, published the tests performed or their results. Tests were diverse, targeting different aspects of the setup. Through simulations, we clearly demonstrate how even slight inaccuracies can impact the final results. We end with a standardized, open-source, step-by-step protocol for testing (visual) event-related experiments, shared via protocols.io. The protocol aims to provide researchers with a benchmark for future replications and insights into the research quality to help improve the reproducibility of results, accelerate multicenter studies, increase robustness, and enable integration across studies.