Total Test Score Research Articles

Posterior-approach total shoulder arthroplasty: a case series with a minimum of 2-year outcomes.

A posterior approach to shoulder arthroplasty has been described that may improve exposure to the retroverted glenoid and spare the rotator cuff. The purpose of this study was to evaluate posterior total shoulder arthroplasty (PTSA) at a minimum of 2 years. Between September 2016 and October 2017, 28 patients (30 shoulders) who underwent PTSA were retrospectively identified. Patients were monitored at baseline and at 6 weeks, 3 months, 6 months, 1 year, and a minimum of 2 years after surgery for range of motion, American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test scores, radiographic outcomes, complications, and patient satisfaction. Radiographs were assessed for head height, neck-shaft angle, humeral head centering, and the presence or absence of glenoid-component cement lines. Repeated-measures analysis-of-variance models were implemented to compare the means for each outcome variable over time. Of the 28 patients (30 shoulders), 24 patients (26 shoulders) (87%) were available for follow-up at a minimum of 2 years (average, 31.2 months; range, 23-40 months). At latest follow-up, the average ASES pain score was 45.2 (standard deviation [SD], 10.9; range, 20-50; 95% confidence interval [CI], 40.8-49.6); average ASES function score, 42.3 (SD, 8.9; range, 21.7-50; 95% CI, 38.7-45.8); average ASES total score, 87.5 (SD, 18.8; range, 31.7-100; 95% CI, 79.8-95.1); and average Simple Shoulder Test score, 10.2 (SD, 2.0; range, 5-12; 95% CI, 9.4-11.0). Average forward flexion was 164° (SD, 13.9°; range, 130°-180°; 95% CI, 158.3°-170.4°); average external rotation, 78° (SD, 9.2°; range, 55°-90°; 95% CI, 74.3°-82.3°); and average internal rotation, T10 (SD, 2; range, L3 to T6; 95% CI, T10 to T8). The average head height was 0.86 mm above the greater tuberosity (range, -6.5 to 6.9 mm), the average neck-shaft angle was 128° (range, 113°-148°), and the average implant placement was 0.12 mm superior to the center of the neck cut (range, -3.3 to 3.5 mm). Six implants were considered malpositioned based on the criterion of >5 mm of head height above or below the tuberosity or >2 mm off-center. Glenoid cement lines were present in 7 shoulders. Two patients experienced complications: 1 patient had symptomatic glenoid loosening 29 months postoperatively that required revision to an anterior reverse total shoulder arthroplasty, and 1 patient had postoperative weakness that resolved by 6 months. PTSA is safe and efficacious at 2 years, spares the rotator cuff, and may improve early postoperative function. PTSA is more easily performed with stemless arthroplasty. Challenges with creation of the humeral head osteotomy and identification of the center of the cut humeral head surface can affect the accuracy of implant positioning. Further improvements in technique will likely improve the feasibility of this approach.

Estimating Clinically Meaningful Change of Efficacy Outcomes in Inadequately Controlled Chronic Rhinosinusitis with Nasal Polyposis.

Objectives/HypothesisClinical trials of biologics to treat chronic rhinosinusitis with nasal polyposis (CRSwNP) have evaluated objective outcomes (e.g., University of Pennsylvania Smell Identification Test [UPSIT], nasal polyps score [NPS], and computed tomography Lund‐Mackay score [CT‐LMK]) and patient‐reported symptoms (e.g., nasal congestion/obstruction [NC], loss of smell [LoS], and total symptom score [TSS]). We estimated anchor‐based thresholds for clinically meaningful change in objective and patient‐reported outcomes in patients with CRSwNP using data from LIBERTY NP SINUS‐24 and SINUS‐52 trials (NCT02912468; NCT02898454).MethodsTarget patient‐reported outcomes were NC, LoS, and TSS; target objective outcomes were UPSIT, NPS, and CT‐LMK. Anchor measures were the 22‐item sinonasal outcome test (SNOT‐22) rhinologic symptoms domain and total score and rhinosinusitis visual analog scale (VAS). The appropriateness of each anchor measure was evaluated by reviewing correlations between change in anchor measures and target outcomes and descriptive scores on target outcomes by levels of change in the anchor measure. Established thresholds for anchor measures (3.8 points for SNOT‐22 rhinologic symptoms, 8.9 points for SNOT‐22 total, 1‐category improvement for rhinosinusitis VAS) were used to estimate clinically meaningful score changes for each target outcome.ResultsBased on correlations between change in anchor measures and target outcomes, SNOT‐22 rhinologic symptoms domain was deemed the most appropriate anchor measure. Using this anchor measure, thresholds for clinically meaningful within‐patient change were NC: 1 point; LoS: 1 point; TSS: 3 points; UPSIT: 8 points; NPS: 1 point; and CT‐LMK: 5 points.ConclusionThese thresholds support interpretation of efficacy results for target outcomes in CRSwNP trials.Level of Evidence2 Laryngoscope, 132:265–271, 2022

Validation of the Spanish-language version of the Montreal Cognitive Assessment as a screening test for cognitive impairment in multiple sclerosis

BackgroundThe neuropsychological batteries traditionally used for the assessment of cognitive impairment (CI) in patients with multiple sclerosis are complex tests requiring a long time to administer. Simpler tests are needed to detect cognitive impairment in daily clinical practice. ObjectiveWe aimed to evaluate the diagnostic validity and reliability of the Montreal Cognitive Assessment (MoCA) test as a screening tool for CI in patients with multiple sclerosis, as compared against the Brief Neuropsychological Battery. Material and methodsWe recruited 52 patients with multiple sclerosis (61.5% women; mean age [standard deviation]: 41.7 [11.5] years). We analysed the reliability (internal consistency, interobserver reliability, and test-retest reliability), construct validity (factor analysis, Pearson correlation coefficient, and coefficient of determination), and criterion validity (ROC curve, sensitivity, specificity, total agreement, positive and negative predictive values, positive and negative likelihood ratios, and Fagan nomogram) of the MoCA test in this population. ResultsThe prevalence of CI was 21.2% according to findings from the Brief Neuropsychological Battery, and 25% according to the MoCA test. The MoCA test showed good internal consistency (Cronbach alpha, 0.822) and interobserver and test-retest reliability (intraclass correlation coefficient 0.80 and 0.96, respectively). The correlation coefficient between total Brief Neuropsychological Battery and MoCA test scores was 0.82. The optimal cut-off point on the ROC curve was 25-26, yielding 91% sensitivity and 93% specificity. ConclusionThe MoCA test is a valid and reliable tool for screening for CI in patients with multiple sclerosis.

Clinical Utility of the Electrocardiographic P-Wave Axis in Patients with Chronic Obstructive Pulmonary Disease

Background: The vertical P-wave axis on electrocardiography (ECG) is a useful criterion for screening patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the clinical characteristics of patients with COPD with a vertical P-wave axis as they have not yet been elucidated. Methods: Keio University and its affiliated hospitals conducted an observational COPD cohort study over 3 years. We analyzed 201 patients using ECG and chest computed tomography. Results: The severity of airflow limitation was higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. Patients with a P-wave axis >75° exhibited significantly higher total COPD assessment test scores and increased St. George’s Respiratory Questionnaire total, activity, and impact scores than those with a P-wave axis ≤75°. The incidence of exacerbations over 1 and 3 years was significantly higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. The optimal cutoff for the P-wave axis for a percentage of the predicted forced expiratory volume in 1 s <50% and future exacerbations over 3 years was 70° (the areas under the curve [AUC]: 0.788; sensitivity: 65.3%; specificity: 78.3%) and 79° (AUC: 0.642; sensitivity: 36.7%; specificity: 92.6%). The ratio of the low attenuation area was also significantly higher in patients with a P-wave axis >75° than in those with a P-wave axis ≤75°. However, the ratio of the airway wall area did not differ between the 2 groups. Conclusions: Patients with COPD with a vertical P-wave axis exhibited severe airflow limitation and emphysema, a worse health status, and more frequent exacerbation than patients without a vertical P-wave. Detection of the vertical P-wave axis by ECG is beneficial for the management of patients with COPD.

Construct Validity of the Upper-Limb Interlimb Coordination Test in Stroke

Background Coordination impairments are under-evaluated in patients with stroke due to the lack of validated assessments resulting in an unclear relationship between coordination deficits and functional limitations. Objective Determine the construct validity of the new clinical upper-limb (UL) Interlimb Coordination test (ILC2) in individuals with chronic stroke. Methods Thirteen individuals with stroke, ≥40 years, with ≥30° isolated supination of the more-affected (MAff) arm, who could understand instructions and 13 healthy controls of similar age participated in a cross-sectional study. Participants performed synchronous bilateral anti-phase forearm rotations for 10 seconds in 4 conditions: self-paced internally-paced (IP1), fast internally-paced (IP2), slow externally-paced (EP1), and fast externally-paced (EP2). Primary (continuous relative phase-CRP, cross-correlation, lag) and secondary outcome measures (UL and trunk kinematics) were compared between groups. Results Participants with stroke made slower UL movements than controls in all conditions, except EP1. Cross-correlation coefficients were lower (i.e., closer to 0) in stroke in IP1, but CRP and lag were similar between groups. In IP1 and matched-speed conditions (IP1 for healthy and IP2 for stroke), stroke participants used compensatory trunk and shoulder movements. The synchronicity sub-scale and total scores of ILC2 were related to temporal coordination in IP2. Interlimb Coordination test total score was related to greater shoulder rotation of the MAff arm. Interlimb Coordination test scores were not related to clinical scores. Conclusion Interlimb Coordination test is a valid clinical measure that may be used to objectively assess UL interlimb coordination in individuals with chronic stroke. Further reliability testing is needed to determine the clinical utility of the scale.

Investigation of taste function and eating behavior in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that is associated with eating disorders and disordered eating. No data is available regarding taste function in women with PCOS. The aim of this study was to assess taste function and eating behavior in patients with PCOS compared to healthy women and investigate potential impact of oral contraceptive (OC) use on those. Forty-four patients with PCOS and 36 age and body-mass-index matched healthy controls were enrolled. Gustatory function was assessed by taste strips (sweet, sour, salty, bitter) and Food Cravings Questionnaire-Trait (FCQ-T), Night Eating Questionnaire (NEQ) and Three Factor Eating Questionnaire-R18 (TFEQ-R18) were applied. All measurements were repeated in patients after receiving an OC along with general lifestyle advice for 3 months. At baseline, PCOS group had lower total taste strip test (TST) scores compared to controls (11.7 ± 2.2 vs. 13.1 ± 1.4; p = 0.001). Subgroup analysis showed lower sour and salty taste scores in PCOS group (2.4 ± 0.9 vs. 2.9 ± 0.7; p = 0.004; and 2.6 ± 1 vs. 3.1 ± 0.7; p = 0.01 respectively). Sweet and bitter taste scores were similar. No difference was determined in eating behavior. Linear regression analysis revealed that hyperandrogenism was significant predictor for total TST score (R2 = 0.22, p < 0.001). Higher free androgen index (FAI) was associated with lower total TST score (p = 0.01). Total TST score, TFEQ-R18 and NEQ scores remained unaltered after treatment in the PCOS group whereas FCQ-T scores showed significant reduction (p = 0.02), mainly due to a decrease in lack of control subscale (p = 0.01). Our results suggest that taste perception is reduced in PCOS, and short-term OC use does not alter taste functions in the syndrome.

The Effect of Intravitreal Ocriplasmin on Hue Discrimination.

We report 13 patients who received ocriplasmin for symptomatic vitreomacular adhesion. Farnsworth-Munsell 100 (FM 100) hue test total error score (TES) increased from baseline to month 1, before recovering at year 1. Ocriplasmin may alter hue discrimination. This study aimed to determine whether intravitreal ocriplasmin affects hue discrimination. Thirteen patients with symptomatic vitreomacular adhesion received intravitreal ocriplasmin 125 μg. Patients underwent full ocular examination, optical coherence tomography, and FM 100 hue test at baseline, 1 week, 1 month, and 1 year. Mean age was 74.8 years. The median baseline FM 100 TES was similar in the injected and fellow eyes (272 vs. 252, respectively). Median TES in the injected eye increased from 272 to 348 at 1 week (median difference compared with baseline, +52.0; 98.8% confidence interval of difference, -64.0 to 184.0; P = .29), decreased to 324 at 1 month (median difference compared with baseline, -4.0; 98.8% confidence interval of difference, -44.0 to 256.0; P = .40), and decreased to 268 at 1 year (median difference compared with baseline, -108.0; 93.8% confidence interval of difference, -200.0 to 52.0; P = .19). Two patients (15.4%) had anatomic release of vitreomacular adhesion, occurring within 1 month of injection. Ocriplasmin may alter hue discrimination, but larger studies are required to provide sufficient power to detect or exclude a statistically significant effect. Longer follow-up is needed to determine the duration of any effect.

Relationship of Alberta Stroke Program Early CT Score (ASPECTS) with the outcome of ischemic stroke and the neurocognitive stroke biomarkers

BackgroundReliable and acceptable biomarkers are needed to anticipate the outcome and cognitive impairment following ischemic stroke. The goal of this research is to examine the association of ASPECTS with cognitive decline, biomarkers of stroke, and acute ischemic stroke outcomes. This study included 120 patients with ischemic stroke in the middle cerebral artery region. The initial NIHSS, non-contrast CT brain assessed by ASPECTS, and the biomarkers of cognitive decline such as ESR, CRP, S100B, MMP9, and glutamate were investigated. The Montreal Cognitive Assessment and modified Rankin scale (mRS) were evaluated after 3 months. Correlations between ASPECTS, MoCA, biomarkers of cognitive impairment, and mRS were done by Spearman correlation.ResultsThe incidence of cognitive impairment in our patients was 25.8%. Stroke biomarkers (ESR, CRP, S100B, MMP9, and glutamate) were significantly increased in cognitively disabled individuals with significantly lower mean MoCA scores than in cognitively intact patients. There was a strong direct correlation linking the initial ASPECTS and total MoCA test score after 3 months follow-up. Cases with unfavorable outcomes were older, more incidence of hypertension, and had higher average initial NIHSS (P < 0.05). While the average ASPECTS scores for the favorable outcome group of patients were significantly higher and there was a significant negative correlation between the initial ASPECTS and modified Rankin Scale score.ConclusionsASPECTS is a reliable scale to identify the extent of acute ischemic injury and could participate in assessing the outcome. ASPECTS and particular neurocognitive stroke biomarkers will enable the early detection of post-stroke cognitive impairment.Trial registration Registration of Clinical Trial Research: ClinicalTrials.gov ID: NCT04235920

The Auditory Consonant Trigram (ACT) Test: A norm updating study for university students

The Auditory Consonant Trigram (ACT) Test is accepted as a pure measurement of verbal working memory, but its norm study and psychometric properties have not been sufficiently researched. This study aims to update the norm data of the ACT, validity and reliability studies of which have been previously conducted on an adult Turkish sample, on a broader young sample and in a way that would end some methodological limitations. For this purpose, the data is collected from 304 voluntary healthy young adults (aged 18–26, 152 females–152 males). According to the results, a difference is found among all delay intervals. While the test scores decrease in females as delay interval increases, there is no difference in males between the delay intervals of 9 and 18 sec. While there is no difference between the genders for very short delay intervals (0–3 sec), males show a more successful performance than females as the delay interval increases (9–18 sec). Males are also more successful than females in terms of total test scores of the ACT. In this respect, it is concluded that the ACT measurement of working memory with a total score reliability coefficient of 0.75 is reliable.

Predictive ability of the G8 screening test to determine probable sarcopenia and abnormal comprehensive geriatric assessment in older patients with solid malignancies

BackgroundPre-treatment evaluation for sarcopenia is recommended in cancer patients. New screening tests that are less time-consuming and can identify patients who will potentially benefit from geriatric assessment are being developed; the G8 geriatric screening test is one such example. We aimed to investigate whether the G8 screening test can detect probable sarcopenia and is valid and reliable compared to a comprehensive geriatric assessment (CGA) in Turkish older adults with solid cancers.MethodsWe included solid cancer patients referred to a single center. Probable sarcopenia and abnormal CGA were defined as low handgrip strength. Cut-offs for handgrip strength in the Turkish population have been previously determined to be 32 kg for males and 22 kg for females and impairment in at least one of the CGA tests, respectively. The CGA tests comprised KATZ Basic Activities of Daily Living Scale Lawton–Brody Instrumental Activities of Daily Living Scale, Mini-Mental-State Examination Scale, Geriatric Depression Scale-15, and Mini-Nutritional Assessment Short Form. Receiver operating characteristic curve analyses evaluated the test’s predictive ability. Intra-rater and inter-rater reliabilities were assessed.ResultsThe median age of the 76 patients included was 72 (65–91) years. There was a moderate correlation between handgrip strength and the G8 test total score. The sensitivity and specificity of the G8 test to detect probable sarcopenia alone (cut off score = 12.5) were 50 and 92%, respectively (AUC: 0.747; p < 0.001); to determine abnormal CGA plus probable sarcopenia (cut off score = 13) were 93.33 and 86.89%, respectively (AUC: 0.939; p < 0.001); and to detect abnormal CGA alone (cut off score = 14) were 79.63 and 95.45%, respectively (AUC: 0.893; p < 0.001). The G8 test results agreed with those of CGA (κ = 0.638; p < 0.001). Both inter- and intra-rater assessments of G8 scores revealed a strong agreement (Interclass correlation coefficient = 0.979, p < 0.001 and ρ = 0.994, p < 0.001, respectively).ConclusionsThe Turkish version of the G8 test is a good screening tool to detect probable sarcopenia alone and in conjunction with abnormal CGA in older patients with solid malignancies. The G8 screening tool may thus be useful in detecting probable sarcopenia in Turkish older adults with solid cancers.

The Impact of the Age at the Cochlear Implantation on the Pragmatic Development of the Prelingual Hearing Impaired Egyptian Arabic Speaking Children

Abstract Background Hearing impaired children have delayed development of pragmatic skills as hearing impairment (HI) deprives them from exposure to natural communication interactions. The rehabilitation of children with HI aims to improve their listening skills for better language development and better communication and social interactions. Aim of this work to compare the pragmatic language development of the prelingual hearing impaired children who were cochlearly implanted before the age of 3 years and those who were cochlearly implanted after the age of 3 years. Methods Sixty Egyptian Arabic-speaking children with prelingual severe to profound sensory neural hearing loss, thirty children who were cochlearly implanted before the age of 3.0 years compared to thirty children who were cochlearly implanted after the age of 3.0 years. Language assessment was done by Modified Preschool Language Scale – 4th edition (PLS–4), the Arabic version and pragmatic development was assessed by Standardized Egyptian Arabic Pragmatic Language Test (EAPLT). Results The two study groups showed no significant differences regarding the receptive, expressive, and total language test scores by PLS-4. Group I showed a significant difference (improvement) regarding the pragmatic factors while there were no significant differences between the two study groups regarding the rest of the pragmatics scores by EAPLT. Conclusion The pragmatic language of cochlearly implanted children either who have been implanted before or after 3 years old is affected. This higher susceptibility to pragmatic impairment in prelingual cochlearly implanted children, as well as the importance of pragmatic skills for further social-communicative and academic careers, should be considered in their rehabilitative plan and advocate the importance for early incorporation of pragmatic behaviors into their intervention programs.

Appraisal of the Real-World Effectiveness of Biologic Therapies in Aspirin-Exacerbated Respiratory Disease

There are no head-to-head studies for patients with aspirin-exacerbated respiratory disease (AERD) comparing any of the 5 Food and Drug Administration-approved respiratory biologic therapies. Explore outcomes in subjects with AERD using biologic therapies in a real-world clinic setting. A retrospective pilot study was conducted for subjects with AERD who had been prescribed omalizumab (anti-IgE), mepolizumab (anti-IL-5), reslizumab (anti-IL-5), benralizumab (anti-IL-5 receptor alpha [anti-IL-5Rα]), or dupilumab (anti-IL-4 receptor alpha [anti-IL-4Rα]). Clinical outcomes pre- versus postinitiation of biologic therapy were explored including symptoms, 22-item sino-nasal outcome test scores, systemic corticosteroid and antibiotic prescriptions, and emergency room visits related to AERD. Of the 74 subjects, 58.1% (n= 43) had used 1 biologic, though many (41.9%, n= 31) trialed more than 1 biologic. Of the 50 subjects who had used anti-IL-4Rα therapy, 98% (49 of 50) still had this therapy prescribed at study completion compared with 48.6% (17 of 35) and 26.9% (7 of 26) of those who used anti-IgE and anti-IL-5 and anti-IL-5 receptor alpha (anti-IL-5/IL-5Rα) therapy, respectively. Among those on anti-IL-4Rα therapy, there was a significant reduction in median total 22-item sino-nasal outcome test scores (51 to 19, P= .0002), corticosteroid bursts (2 to 0, P < .0001), and median number of antibiotic courses for respiratory disease (1 to 0, P= .0469) prebiologic versus postbiologic initiation. No statistically significant difference in those outcomes was observed for individuals on anti-IgE or anti-IL-5/IL-5Rα therapy. Anti-IL-4Rα therapy led to significantly higher rates of clinical improvement in AERD when compared with anti-IL-5/IL-5Rα and anti-IgE biologic therapies. Prospective studies would help clarify best practices for the use of biologic therapies in AERD.

Effect of Brain Gym Technique on Community Health Nursing Students’ Multiple Intelligences, Knowledge and Information Retention

Background: Brain Gym is a simple and pleasant movements, consists of 26 simple movements that are believed to enhance academic and behavioral performance by activating both hemispheres of the brain through neurological re-patterning to promote whole brain learning. Settings: this study was carried out at community Nursing Department, Faculty of Nursing- Alexandria University. Method: A quasi experimental research design was used to conduct this study using two tools “Tool I Howard Gardner Multiple Intelligence Test, Tool II: Achievement Retention Test” Sample: systemic random sample (every other one) was used. Results: of the present study revealed that there were statistically significant differences between study and control groups and within study group before and after the application of brain gym technique in the favor of study group after the application regarding all types of multiple intelligence and achievement retention test total score. Conclusion: Community health nursing students who were subjected to brain gym technique had better intelligence, knowledge and retention score than those of the control group. Recommendations of this study included that brain gym technique should be incorporated in nursing theory and clinical education to improve the level of students’ knowledge and retention.

Modeling protein structures with the coarse-grained UNRES force field in the CASP14 experiment

The UNited RESidue (UNRES) force field was tested in the 14th Community Wide Experiment on the Critical Assessment of Techniques for Protein Structure Prediction (CASP14), in which larger oligomeric and multimeric targets were present compared to previous editions. Three prediction modes were tested (i) ab initio (the UNRES group), (ii) contact-assisted (the UNRES-contact group), and (iii) template-assisted (the UNRES-template group). For most of the targets, the contact restraints were derived from the server models top-ranked by the DeepQA method, while the DNCON2 method was used for 11 targets. Our consensus-fragment procedure was used to run template-assisted predictions. Each group also processed the Nuclear Magnetic Resonance (NMR)- and Small Angle X-Ray Scattering (SAXS)-data assisted targets. The average Global Distance Test Total Score (GDT_TS) of the ‘Model 1’ predictions were 29.17, 39.32, and 56.37 for the UNRES, UNRES-contact, and UNRES-template predictions, respectively, increasing by 0.53, 2.24, and 3.76, respectively, compared to CASP13. It was also found that the GDT_TS of the UNRES models obtained in ab initio mode and in the contact-assisted mode decreases with the square root of chain length, while the exponent in this relationship is 0.20 for the UNRES-template group models and 0.11 for the best performing AlphaFold2 models, which suggests that incorporation of database information, which stems from protein evolution, brings in long-range correlations, thus enabling the correction of force-field inaccuracies.

Regenerative Almond Production Systems Improve Soil Health, Biodiversity, and Profit

Regenerative agriculture aims to improve soil health and promote biodiversity while producing nutritious food profitably. Almonds are the dominant crop in California agriculture in terms of acreage and revenue generated. We examined the soil health, biodiversity, yield, and profit of regenerative and conventional almond production systems that represented farmer-derived best management practices. Regenerative practices included abandoning some or all synthetic agrichemicals, planting perennial ground covers, integrating livestock, maintaining non-crop habitat, and using composts and compost teas. Total soil carbon (TSC), soil organic matter (SOM), total soil nitrogen (TSN), total soil phosphorous, calcium, sulfur, and soil health test scores were all significantly greater in regenerative soils. Water infiltrated regenerative soils six-fold faster than conventional soils. Total microbial biomass, total bacterial biomass, Gram+ bacteria, and Actinobacteria were significantly greater in regenerative soils. There was more plant biomass, species diversity, and percent cover in regenerative orchards. Invertebrate richness and diversity, and earthworm abundance and biomass were significantly greater in regenerative orchards. Pest populations, yields, and nutrient density of the almonds were similar in the two systems. Profit was twice as high in the regenerative orchards relative to their conventional counterparts. No one practice was responsible for the success of regenerative farms; their success was the result of simultaneously combining multiple regenerative practices into a single, functional farm system. This style of farming may assist in combatting planetary scale problems (e.g., climate change, biodiversity loss, agricultural pollution, chronic human health problems, and declining rural communities) while making farms more profitable and resilient.

Dissociation Pattern in Default-Mode Network Homogeneity in Drug-Naive Bipolar Disorder.

Default mode network (DMN) plays a key role in the pathophysiology of in bipolar disorder (BD). However, the homogeneity of this network in BD is still poorly understood. This study aimed to investigate abnormalities in the NH of the DMN at rest and the correlation between the NH of DMN and clinical variables in patients with BD. Forty drug-naive patients with BD and thirty-seven healthy control subjects participated in the study. Network homogeneity (NH) and independent component analysis (ICA) methods were used for data analysis. Support vector machines (SVM) method was used to analyze NH in different brain regions. Compared with healthy controls, significantly increased NH in the left superior medial prefrontal cortex (MPFC) and decreased NH in the right posterior cingulate cortex (PCC) and bilateral precuneus were found in patients with BD. NH in the right PCC was positively correlated with the verbal fluency test and verbal function total scores. NH in the left superior MPFC was negatively correlated with triglyceride (TG). NH in the right PCC was positively correlated with TG but negatively correlated with high-density lipoprotein cholesterol (HDL-C). NH in the bilateral precuneus was positively correlated with cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, NH in the left superior MPFC showed high sensitivity (80.00%), specificity (71.43%), and accuracy (75.61%) in the SVM results. These findings contribute new evidence of the participation of the altered NH of the DMN in the pathophysiology of BD.

The Rett Syndrome Gross Motor Scale – Dutch Version (RSGMS-NL) Can Reliably Assess Gross Motor Skills in Dutch Individuals with Rett Syndrome

ABSTRACT Aim The Rett Syndrome Gross Motor Scale (RSGMS) is an observational measurement, assessing gross motor skills in individuals with Rett syndrome. A Dutch version is lacking. The current study aims to translate and cross-culturally adapt the original RSMGS to Dutch and assess its inter-rater and intra-rater reliability. Design Translation and cross-cultural adaptation were performed in concordance with internationally accepted guidelines. A pretest was performed, and expert validation was assured. Video data of three girls with Rett syndrome was independently assessed by 27 physiotherapists via an online webinar to measure inter-rater reliability. Additionally, videos of 17 individuals with Rett syndrome were scored twice by two raters to assess intra-rater reliability. The reliability of the total score, the three subscale scores and the new items were analyzed using Intraclass Correlation Coefficients (ICC). Results Good comprehensibility and expert validation of the RSMGS-NL was achieved, and four items were added to the original scale. Inter-rater reliability for the total score was excellent (ICC 0.97, 95% CI 0.89–0.99), and good to perfect inter-rater reliability for the three subscales; Sitting, Standing & walking and Challenge was found (ICC values 1.0 (95% CI 0), 0.98 (95% CI 0.91–0.99) and 0.82 (95% CI 0.93–0.99) respectively). The intra-rater reliability was excellent for the total test score (ICC 0.98, 95% CI 0.97–0.99) and good to excellent for the subscale scores (ICC values 0.87 (95% CI 0.75–0.94), 0.99 (95% CI 0.98–1.0) and 0.97 (95% CI 0.95–0.99) respectively). The four new items (Standing to sitting, walking down a slope, ascending the stairs, descending the stairs) showed good to excellent intra-rater reliability. Conclusion The RSGMS-NL is a reliable measure of gross motor skills in Dutch individuals with Rett syndrome.

The Correlation Between Physical Fitness Of Preschool Children And Physical Cognition Of Their Parents

PURPOSE: Parents are playing a more important role than before in promoting the physical development of preschool children. This study was aimed to analyze the characteristics of Chinese preschool children’s physical fitness and the physical cognition of children’s parents, and to explore the relationship between the two. METHODS: 459 Chinese preschool children (223 boys & 236 girls) aged 3-6 years (M ± SD: 4.57 ± 1.12) were recruited from 9 kindergartens in Shanghai, China. Physical fitness of the children was tested based on the Chinese National Fitness Standards (for preschool children). Physical cognition of parents was measured by the cognitive questionnaire on decisional balance scale for exercise. Correlation between children’s physical fitness test score and physical cognition score from the questionnaire was checked. RESULTS: The total score of the physical test is (24.99 ± 4.72) points. In terms of physical shape, standard weight and height scores are 3.88 and 3.94 points respectively; physical fitness included the following subtests (points): standing long jump (2.97), sit and reach (2.77), continuous foot jumping (3.43), balance beam (2.38), 15-meter obstacle run (2.68), and grip strength (2.99). Fail rate 11.4%, qualified rate 50.0%, good rate 29.8%, excellent rate 8.7%. Parents’ exercise benefit score was (3.88 ± 0.54) points, exercise cost is (2.62 ± 0.65) points, exercise decision balance score is (1.26 ± 0.99) points, the parents with a score of more than 0 accounted for 90.4%. Parents’ exercise decision balance score is significantly correlated with children’s physical fitness test scores (r = 0.286, p < 0.01). CONCLUSIONS: The current physical fitness of Chinese children is not optimistic. Most children have fair physical fitness level but rare of them are excellent. The development of various physical fitness is unbalanced. The proportion of Chinese parents who are aware of physical behavior is relatively high, and there is a significant correlation with the physical fitness of children. This shows that most parents now recognize the benefits of physical behavior and their attitudes towards physical exercise may affect children’s physical fitness. Behavior has an impact on the physical fitness of preschool children.

Clinical and genetic spectra in patients with dystrophinopathy in Korea: A single-center study.

Dystrophinopathy is a group of inherited phenotypes arising from pathogenic variants in DMD. We evaluated the clinical and genetic characteristics of Korean patients with genetically confirmed dystrophinopathy. We retrospectively reviewed medical records (January 2004-September 2020) from the myopathy database maintained at the study hospital and found 227 patients from 218 unrelated families with dystrophinopathy. Clinical phenotypes included 120 (53%) Duchenne muscular dystrophy (DMD) cases, 20 (9%) intermediate phenotype muscular dystrophy (IMD) cases, 65 (29%) Becker muscular dystrophy (BMD) cases, 18 (8%) undetermined phenotypes, and 4 (2%) symptomatic carriers. The median ages at symptom onset and diagnosis were 5.0 years (interquartile range [IQR]: 3.8-8.0) and 12.0 years (IQR: 7.0-21.0), respectively. Total manual muscle test (MMT) scores decreased annually in patients with DMD, IMD, and BMD. Overall, when age increased by 1 year, total MMT scores decreased on average by -1.978, -1.681, and -1.303 in patients with DMD (p<0.001), IMD (p<0.001), and BMD (p<0.001), respectively. Exonic deletion and duplication were reported in 147 (67%) and 31 (14%) of the 218 unrelated probands, respectively. A total of 37 different small sequence variants were found in 40 (18%) of the 218 probands. The reading frame rule was applicable to 142 (94%) of the 151 probands. The present results highlight the long-term natural history and genetic spectrum of dystrophinopathy in a large-scale Korean cohort.

Threshold Effects of Total Copper Intake on Cognitive Function in US Older Adults and the Moderating Effect of Fat and Saturated Fatty Acid Intake

BackgroundEvidence for a relationship between total copper intake and cognition is lacking, and few studies have assessed the moderating effect of dietary fat and saturated fatty acid (SFA) intake on this relationship. ObjectiveOur aim was to explore the curvilinear association between total copper intake and cognitive function in older adults, and to clarify the moderating effect of dietary fat and SFA intake on the association. DesignThis was a cross-sectional analysis of data from National Health and Nutrition Examination Surveys 2011-2014. ParticipantsThe analysis included 2,483 participants aged 60 years and older. Main outcome measuresCognitive function was evaluated by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning subtest, the Animal Fluency Test, and the Digit Symbol Substitution Test (DSST). Statistical analyses performedSmooth curve fitting and two-piecewise linear regression models were performed to address the nonlinear association between total copper intake and cognitive function. Multivariable quadratic regression models and analyses stratified by total fat or SFA intake were used to assess the effects of the interaction between copper and fat intake and between copper and SFA intake on cognitive function. ResultsThere was a nonlinear association between total copper intake and cognitive test scores. The inflection point of copper was 0.8 mg/d for the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest and 1.4 mg/d for both the Animal Fluency test and the DSST. When copper intake was below the inflection point, positive associations were apparent for copper intake and Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest scores (β = 3.9; 95% CI 1.2 to 6.5), Animal Fluency test scores (β = 1.7, 95% CI .9 to 2.6), and DSST scores (β = 6.0, 95% CI 3.8 to 8.3). When copper intake was above the inflection point, a nonsignificant downward trend was found. Interactive effects between total copper and total fat intake (P interaction = .000) and between total copper and SFA intake (P interaction = .011) on the DSST scores were observed. In the low fat intake and low SFA intake groups, DSST scores first increased and then decreased with increasing copper. However, in the high fat intake and high SFA intake groups, DSST scores first increased and then flattened with increasing copper. ConclusionsThe present study suggests a nonlinear association between copper intake and cognitive function and identifies threshold effects of copper intake on cognitive function. Copper intake below the inflection point was positively and independently associated with cognitive function. High fat and high SFA intake may protect older adults against a decline in DSST scores related to high copper intake.