BACKGROUND/OBJECTIVES
In the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study, a multifactorial intervention was associated with a nonsignificant 8% reduction in time to ...first serious fall injury but a significant 10% reduction in time to first self‐reported fall injury relative to enhanced usual care. The effect of the intervention on other outcomes important to patients has not yet been reported. We aimed to evaluate the effect of the intervention on patient well‐being including concern about falling, anxiety, depression, physical function, and disability.
DESIGN
Pragmatic cluster‐randomized trial of 5,451 community‐living persons at high risk for serious fall injuries.
SETTING
A total of 86 primary care practices within 10 U.S. healthcare systems.
PARTICIPANTS
A random subsample of 743 persons aged 75 and older.
MEASUREMENTS
The well‐being measures, assessed at baseline, 12 months, and 24 months, included a modified version of the Fall Efficacy Scale, Patient‐Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scales, and Late‐Life Function and Disability Instrument.
RESULTS
Participants in the intervention (n = 384) and control groups (n = 359) were comparable in age: mean (standard deviation) of 81.9 (4.7) versus 81.8 (5.0) years. Mean scores were similar between groups at 12 and 24 months for concern about falling, physical function, and disability, whereas the intervention group's mean scores on anxiety and depression were .7 points lower (i.e., better) at 12 months and .6 to .8 points lower at 24 months. For each of these outcomes, differences between the groups' adjusted least square mean changes from baseline to 12 and 24 months, respectively, were quantitatively small. The overall difference in means between groups over 2 years was statistically significant only for depression, favoring the intervention: −1.19 (99% confidence interval, −2.36 to −.02), with 3.5 points representing a minimally important difference.
CONCLUSIONS
STRIDE's multifactorial intervention to reduce fall injuries was not associated with clinically meaningful improvements in patient well‐being.
The COVID-19 pandemic has impacted urology residents and their training. However, several new technologies or knowledge platforms as social media (SoMe) and web-based learning solutions have filled ...this gap. Therefore, we aimed to analyze resident's learning curves of new learning modalities, identify the evidence that is provided in the literature, and evaluate the possible impact of such solutions in the future. We conducted a non-systematic literature search using Medline, PubMed, and Embase. In addition, online resources of national and international urology resident societies were queried. The identified paper described SoMe, webinars, podcasts, pre-recorded surgical videos, educational platforms, and mobile apps in the field of urology that are used to gain access to information, teach and provide feedback to residents, and were used under the conditions of the pandemic. The application of those technologies harbors the risk of mis- and disinformation, but have the potential to provide access to education and validated knowledge, training, and feedback and thereby might democratize training of residents in urology globally.
Autism spectrum disorders (ASDs) are common and have a strong genetic basis, yet the cause of ∼70-80% ASDs remains unknown. By clinical cytogenetic testing, we identified a family in which two ...brothers had ASD, mild intellectual disability and a chromosome 22 pericentric inversion, not detected in either parent, indicating de novo mutation with parental germinal mosaicism. We hypothesised that the rearrangement was causative of their ASD and localised the chromosome 22 breakpoints.
The rearrangement was characterised using fluorescence in situ hybridisation, Southern blotting, inverse PCR and dideoxy-sequencing. Open reading frames and intron/exon boundaries of the two physically disrupted genes identified, TCF20 and TNRC6B, were sequenced in 342 families (260 multiplex and 82 simplex) ascertained by the International Molecular Genetic Study of Autism Consortium (IMGSAC).
IMGSAC family screening identified a de novo missense mutation of TCF20 in a single case and significant association of a different missense mutation of TCF20 with ASD in three further families. Through exome sequencing in another project, we independently identified a de novo frameshifting mutation of TCF20 in a woman with ASD and moderate intellectual disability. We did not identify a significant association of TNRC6B mutations with ASD.
TCF20 encodes a transcriptional coregulator (also termed SPBP) that is structurally and functionally related to RAI1, the critical dosage-sensitive protein implicated in the behavioural phenotypes of the Smith-Magenis and Potocki-Lupski 17p11.2 deletion/duplication syndromes, in which ASD is frequently diagnosed. This study provides the first evidence that mutations in TCF20 are also associated with ASD.
•Over-one-year-long test results for low-k dielectric TDDB are reported.•A methodology has been set up to compare different models that predict lifetime.•The lucky-electron model shows a higher ...ability to predict dielectric lifetime.•The fitting parameters are determined independently from the MTTF fit.
In the present paper, different analytical lifetime models have been assessed on porous low-k dielectrics (in CMOS 28nm structures) to predict lifetimes. Quantitative comparisons are made thanks to over-one-year-long low-field reliability tests. The lucky electron model (fitted at high fields) shows its higher ability to predict the dielectric mean-time-to-failure (MTTF) at low-field. Then the fitting parameters of this model (α=32 et γ=14.5) have been determined independently from this MTTF fitting procedure: these new values (α=31 et γ=14), extracted from the analysis of both Poole–Frenkel conduction and initial leakage current, are in very good agreement with the MTTF-fitted ones. The consequences of this model are discussed.
Background:
The impact of coronavirus disease 2019 (COVID-19) has been overwhelming on patients with cancer, who may be at higher risk of developing severe disease. During the second COVID-19 ...outbreak in Italy, we planned universal microbiologic screening for patients scheduled for antineoplastic treatment.
Methods:
All patients with planned active treatment at Brescia University Radiation Oncology Department were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA with repeated nasopharyngeal swabs (NPS) from October 31, 2020. Treatment continuation, suspension, or delay was modulated for patients testing positive according to clinical presentation.
Results:
From October 31, 2020, to February 6, 2021, 636 patients were enrolled and 1243 NPS were performed, of which 28 (2.25%) were positive. The infection rate was 2.52%; 81.3% of the patients with a positive NPS were asymptomatic, 2 had mild disease, and 1 severe disease that led to death. All patients already on treatment with mild or asymptomatic COVID-19 carried on the therapy with no or minimal delay. Median delay for patients with infection detected before treatment start was 16.5 days.
Conclusions:
Detected incidence of COVID-19 was lower during the second outbreak in our patients (2.52% vs 3.23%), despite the extensive testing schedule, and substantiates the high rate of asymptomatic infections and the low mortality among patients with COVID-19 (6.3% vs 38.5% during the first outbreak). Universal SARS-CoV-2 screening for all patients with planned treatment might allow early identification of patients with COVID-19, resulting in timely management that could improve clinical outcomes and prevent spread of the infection.
Context. Several early-type colliding-wind binaries are known to emit synchrotron radiation due to relativistic electrons, which are most probably accelerated by the Fermi mechanism. By studying such ...systems we can learn more about this mechanism, which is also relevant in other astrophysical contexts. Colliding-wind binaries are furthermore important for binary frequency determination in clusters and for understanding clumping and porosity in stellar winds. Aims. We study the non-thermal radio emission of the binary Cyg OB2 No. 8A, to see if it is variable and if that variability is locked to the orbital phase. We investigate if the synchrotron emission generated in the colliding-wind region of this binary can explain the observations and we verify that our proposed model is compatible with the X-ray data. Methods. We use both new and archive radio data from the Very Large Array (VLA) to construct a light curve as a function of orbital phase. We also present new X-ray data that allow us to improve the X-ray light curve. We develop a numerical model for the colliding-wind region and the synchrotron emission it generates. The model also includes free-free absorption and emission due to the stellar winds of both stars. In this way we construct artificial radio light curves and compare them with the observed one. Results. The observed radio fluxes show phase-locked variability. Our model can explain this variability because the synchrotron emitting region is not completely hidden by the free-free absorption. In order to obtain a better agreement for the phases of minimum and maximum flux we need to use stellar wind parameters for the binary components which are somewhat different from typical values for single stars. We verify that the change in stellar parameters does not influence the interpretation of the X-ray light curve. Our model has trouble explaining the observed radio spectral index. This could indicate the presence of clumping or porosity in the stellar wind, which – through its influence on both the Razin effect and the free-free absorption – can considerably influence the spectral index. Non-thermal radio emitters could therefore open a valuable pathway to investigate the difficult issue of clumping in stellar winds.
Cell-free extrachromosomal circular DNA (eccDNA) as a distinct topological form from linear DNA has recently gained increasing research interest, with possible clinical applications as a class of ...biomarkers. In this study, we aimed to explore the relationship between nucleases and eccDNA characteristics in plasma. By using knockout mouse models with deficiencies in deoxyribonuclease 1 (DNASE1) or deoxyribonuclease 1 like 3 (DNASE1L3), we found that cell-free eccDNA in Dnase1l3-/- mice exhibited larger size distributions than that in wild-type mice. Such size alterations were not found in tissue eccDNA of either Dnase1-/- or Dnase1l3-/- mice, suggesting that DNASE1L3 could digest eccDNA extracellularly but did not seem to affect intracellular eccDNA. Using a mouse pregnancy model, we observed that in Dnase1l3-/- mice pregnant with Dnase1l3+/- fetuses, the eccDNA in the maternal plasma was shorter compared with that of Dnase1l3-/- mice carrying Dnase1l3-/- fetuses, highlighting the systemic effects of circulating fetal DNASE1L3 degrading the maternal eccDNA extracellularly. Furthermore, plasma eccDNA in patients with DNASE1L3 mutations also exhibited longer size distributions than that in healthy controls. Taken together, this study provided a hitherto missing link between nuclease activity and the biological manifestations of eccDNA in plasma, paving the way for future biomarker development of this special form of DNA molecules.
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