Midlife health crisis of former competitive athletes: dissecting their experiences via qualitative study.

Sports participation confers many health benefits yet greatly increases injury risk. Long-term health outcomes in former athletes and transition to life after competitive sports are understudied. Ending a sport may pose physical and psychosocial challenges. The purpose was to determine the lived experiences of former competitive athletes and how their sports participation impacted their long-term health and well-being. Former college varsity athletes participated in semistructured interviews focusing on their experiences, including past and current health, the impact of injuries, activity, exercise, diet and transition to life after competitive sport. Thematic analysis was completed using a collaborative, iterative process. Thirty-one (16 female, 15 male) former college athletes aged 51.3±7.4 years were interviewed. Six themes emerged: (1) lifelong athlete identity; (2) structure, support and challenges of the college athlete experience; (3) a big transition to life beyond competitive sport; (4) impact of competitive sport on long-term health; (5) facilitators and barriers to long-term health after sport and (6) transferable life skills. Continuing sports eased the transition for many but often delayed their postathlete void. Challenges included managing pain and prior injury (eg, If I didn't have my knee injury, I would definitely be more active), reducing energy needs and intake (eg, When I was an athlete, I could eat anything; and unfortunately, that's carried into my regular life), lack of accountability, changed identity and lost resources and social support. Participants suggested a programme, toolkit, mentoring or exit course to facilitate the transition. While former athletes benefit from transferrable life skills and often continue sports and exercise, they face unique challenges such as managing pain and prior injury, staying active, reducing energy intake and changing identity. Future research should develop and evaluate a toolkit, programme and other resources to facilitate life after ending competitive sports under 'normal' conditions (eg, retirement) and after a career-ending injury.

Nurses' and midwives' experiences of managing parental postnatal depression: A scoping review.

AIM: To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND). DESIGN: The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work. DATA SOURCES: A systematic search of PubMed, CINAHL, Embase, MEDLINE, PsycINFO and Scopus databases was conducted in January and February 2023. REVIEW METHODS: Peer-reviewed primary research articles published in English between 2012 and 2023 that involved nurses or midwives managing PPND were included. Rayyan was used to screen titles, abstracts and full-text articles. A spreadsheet was used to organize extracted data and synthesize results. RESULTS: Twenty-nine articles met the inclusion criteria. Most study samples were of mothers, and few were from middle- and lower-income countries. Nurses and midwives lacked knowledge about PPND, yet they felt responsible for its management. Nurses and midwives faced significant organizational and systems-level challenges in managing PPND. However, nurses and midwives facilitated PPND care in collaboration with other healthcare providers. CONCLUSION: The review highlights significant gaps in the nurses' and midwives' care of PPND. Educational programmes are necessary to increase nurse and midwife knowledge of PPND and strategies for its management, including facilitating collaboration across the healthcare system and eliminating organizational and systemic-related barriers. Additional focused research is needed on nurses' and midwives' knowledge, perception of and experience with PPND beyond mothers, such as with fathers, sexually and gender-minoritized parents and surrogate mothers. Finally, additional research is needed in middle- and lower-income countries where nurses and midwives may face a higher burden of and unique cultural considerations in managing PPND. IMPACT: PPND can affect the parent's mental and physical health and relationship with their child. If left untreated, PPND can lead to long-term consequences, including child developmental delays, behavioural problems and difficulties with parental-child attachment. REPORTING METHOD: This scoping review adheres to PRISMA Extension for Scoping Review guidelines and the Joanna Briggs Institute scoping review method. PATIENT OR PUBLIC CONTRIBUTION: This research is a scoping review of published peer-reviewed studies.

The contributors to dosage calculation ability and its applicability to nursing education: An integrative review.

Medication errors are a major patient safety issue and account for 1-2 million hospitalizations and between 100,000 and 200,000 deaths annually. Approximately 41 % of all medication errors are due to improper dose calculations. Studies have shown mean scores on the medication dosage calculation test for nursing students range from 35 to 71 %. Despite new technology created to aid in dosage calculations, the issue is still prevalent among nurses. It is critical that the elements contributing to the nurses' ability to complete dosage calculations be determined so that calculation curriculum in nursing schools can be updated to better prepare students for practice. An integrative review was completed using the databases of PubMed, CINAHL, and Embase to answer the research question: What contributors impact nurses' and nursing students' ability to complete dosage calculations? Four articles met the specified inclusion criteria and were used for this review. The three most common contributing themes among the review sample included mathematical medication calculation ability, medication calculation frequencies, and dosage calculation education. Results from this review can inform the issue of dosage calculations and highlight the need for further research regarding the medication administration competencies taught in undergraduate nursing studies.

Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019-2020 Texas School Physical Activity and Nutrition Survey.

BACKGROUND: Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas. METHODS: We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (n = 4730, weighted n = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019-2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from "Never" to "Always") and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0-100), a Healthy Foods Index (HFI) score (0-100), and an Unhealthy Foods Index (UFI) score (0-100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school. RESULTS: A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = -4.30, 95%CI: -6.25, -2.34). A dose-response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (ORrange = 1.31-3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (ORrange = 0.48-0.68) compared to students who reported never/almost never using the Nutrition Facts label. CONCLUSIONS: Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States.

Shared Risk Factors Among Women for Intimate Partner Violence in the United States: A Secondary Analysis.

Multilevel risk factors may increase the risk of experiencing intimate partner violence among women. The overall goal of this study was to provide a comprehensive view of factors that may be associated with three forms of intimate partner violence. The primary aim was to explore associations between understudied factors and women's experiences of physical and sexual violence and stalking by an intimate partner. Secondary analysis of existing health registry data was conducted. Our evidence-driven strategy was based on a multipronged analytical approach informed by existing literature and the social-ecological model. We created an evidence-based hierarchical list comprised of three tiers. Three separate multiple logistic regression analyses were performed. Several shared risk factors were retained across all three forms including low levels of formal education, past experiences of non- partner sexual violence, residential instability, presence of children, experiences of a traumatic event and panic attacks, status of receiving US government benefits, and barriers to healthcare access. Results contribute to future research on intimate partner violence prevention by providing preliminary evidence of emerging factors associated with experiencing three forms of intimate partner violence.

Long-term function, body composition and cardiometabolic health in midlife former athletes: a scoping review.

While sports medicine has traditionally focused on recovering from injury and returning athletes to sport safely after injury, there is a growing interest in the long-term health of athletes. The purpose of this scoping review was to (1) summarise the literature (methodologies and findings) on physical function, body composition and cardiometabolic health in midlife (age 40-65 years) former competitive athletes compared with non-athlete controls, (2) identify areas for future study in long-term health in athletes and (3) determine outcomes that could be evaluated in a future systematic review(s). We searched PubMed, CINAHL, Web of Science and SPORTDiscus for studies published between 2000 and 2022 evaluating former athletes and controls on physical function, body composition and/or cardiometabolic measures using MeSH terms. We identified 20 articles that met our criteria. Outcomes varied considerably across studies, most of which were cross-sectional and evaluated only males. Limited data suggest that former endurance athletes have leaner body compositions, higher aerobic capacity and better cardiometabolic indicators than controls; former athletes who maintain higher physical activity (ie, self-reported exercise) are healthier than those who do not; and former team sport athletes, who have higher injury prevalence, may have poorer functional performance than controls who were recreationally active in college. Studies rarely evaluated functional performance, did not control for prior injury or diet and seldom assessed current physical activity levels. Future research should include females and evaluate sex differences, control for prior sports-related injury(ies), quantify physical activity, use standardised outcome measures including performance-based functional assessments and incorporate longitudinal designs.

Majority of new patient referrals to a large pediatric rheumatology center result in non-rheumatic diagnosis.

OBJECTIVE: Pediatric rheumatology faces a looming supply-demand crisis. While strategies have been proposed to address the supply shortfall, investigation into the increased demand for pediatric rheumatic care has been limited. Herein, we analyze new patient visits to a large tertiary care pediatric rheumatology center to identify emerging trends in referrals and areas for potential intervention to meet this increased demand. METHODS: All patients referred to and seen by the University of Alabama at Birmingham Pediatric Rheumatology Division between January 2019 and December 2021 for a new patient evaluation were identified. Patient data was retrospectively abstracted, de-identified, and analyzed to develop trends in referrals and frequency of rheumatic disease, non-rheumatic disease, and specific diagnoses. RESULTS: During the study period, 2638 patients were referred to and seen in by the pediatric rheumatology division. Six hundred and ten patients (23.1%) were diagnosed with rheumatic disease. The most common rheumatic disease was juvenile idiopathic arthritis (JIA) at 45.6%, followed by primary Raynaud phenomenon (7.4%), recurrent fever syndromes (6.9%), vasculitides (6.7%), and inflammatory eye disease (6.2%). Of the 2028 patients (76.9%) diagnosed with a non-rheumatic condition, benign musculoskeletal pain was the most common (61.8%), followed by a combination of somatic conditions (11.6%), and non-inflammatory rash (7.7%). CONCLUSION: In this analysis of new patient referrals to a large pediatric rheumatology center, the majority of patients were diagnosed with a non-rheumatic condition. As a worsening supply-demand gap threatens the field of pediatric rheumatology, increased emphasis should be placed on reducing non-rheumatic disease referrals.

Critical Care Nurses' Attitudes About Family Presence During Resuscitation: An Integrative Review.

BACKGROUND: Family presence during resuscitation was introduced into clinical practice 30 years ago. Despite adoption of family-centered care by several health organizations and support for family presence during resuscitation by professional organizations such as the American Heart Association, critical care nurses' attitudes about family presence during resuscitation vary widely. OBJECTIVE: To examine current evidence on critical care nurses' attitudes about, perceptions of, and behaviors related to practicing family presence during resuscitation. METHODS: The method of Whittemore and Knafl guided the integrative review. Databases searched were CINAHL, PubMed, and Scopus. Articles included were English-language studies published from 2008 to 2022 that examined the perceptions of critical and emergency care nurses from adult units regarding family presence during resuscitation. RESULTS: Twenty-two articles were included. Levels and strength of evidence were assessed with the Johns Hopkins nursing evidence-based model. The articles in this integrative review included a total sample size of 4780 health care professionals; 3808 were critical and acute care nurses. DISCUSSION: Themes synthesized from current evidence included attitudes, benefits, barriers, demographic influence, cultural influence, and facilitators. Barriers and facilitators were associated with nursing practice in rural versus urban settings, age-related factors, years of experience, and unit-based differences in practice. Developing interventions to address identified factors can increase the practice of family presence during resuscitation in critical care settings. CONCLUSIONS: Several factors influence the practice of family presence during resuscitation in critical care settings. Nurse leaders should consider these factors to enhance the practice of family presence during resuscitation.

The influences of sociocultural norms on women's decision to disclose intimate partner violence: Integrative review.

Sociocultural norms against women can contribute to promoting intimate partner violence (IPV) and shape women's decision to disclose IPV. A cross-cultural analysis of the existing literature is needed to present an overview of the influences of sociocultural norms on women's decisions regarding the disclosure of IPV across different cultural contexts. The purpose of the review was to synthesize published quantitative, qualitative, and mixed methods (MMs) studies to identify known sociocultural norms across different cultures that may influence women's decision to disclose IPV. The Whittemore and Knafl framework, Rayyan software, and PRISMA flow diagram were used. Databases included APA PsycInfo, CINAHL, PubMed, SocINDEX, and Women's Studies International. The quality of studies was assessed by the MMs appraisal tool. A total of 15 research articles written in English and published in peer-reviewed journals were included. Main categories emerged: (1) stigma surrounding IPV disclosure, victimization, and divorce; (2) gender roles; (3) preserving family honor; and (4) Children's well-being and future. A one-size-fits-all approach is not adequate for women who are considering disclosing IPV. Findings underscore that regardless of residing in individualistic countries, those sociocultural norms related to traditional gender roles and gender inequality are still important barriers to the disclosure of IPV among women with collectivist roots.

Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers.

Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].

Increased rates of brain protein synthesis during [N1,N2] sleep: L-[1-11C]leucine PET studies in human subjects.

During sleep, reduced brain energy demands provide an opportunity for biosynthetic processes like protein synthesis. Sleep is required for some forms of memory consolidation which requires de novo protein synthesis. We measured regional cerebral protein synthesis rates (rCPS) in human subjects to ascertain how rCPS is affected during sleep. Subjects underwent three consecutive L-[1-11C]leucine PET scans with simultaneous polysomnography: 1. rested awake, 2. sleep-deprived awake, 3. sleep. Measured rCPS were similar across the three conditions. Variations in sleep stage times during sleep scans were used to estimate rCPS in sleep stages under the assumption that measured rCPS is the weighted sum of rCPS in each stage, with weights reflecting time and availability of [11C]leucine in that stage. During sleep scans, subjects spent most of the time in N2, N3, and awake and very little time in N1 and REM; rCPS in N1 and REM could not be reliably estimated. When stages N1 and N2 were combined [N1,N2], estimates of rCPS were more robust. In selective regions, estimated rCPS were statistically significantly higher (30-39%) in [N1,N2] compared with N3; estimated rCPS in N3 were similar to values measured in sleep-deprived awake scans. Results indicate increased rates of protein synthesis linked to [N1,N2] sleep.

Reviving a successful blunt chest wall injury protocol.

ABSTRACT: This article describes a quality improvement project that assessed nurses' knowledge and practices for patients admitted with a blunt chest wall injury and utilized interactive learning to revive the use of the protocol.

Self-esteem in the context of intimate partner violence: A concept analysis.

AIM: To explore the meaning of self-esteem in the context of intimate partner violence (IPV). BACKGROUND: IPV is a preventable public health issue. The dynamic of IPV diminishes women's self-esteem. Defining self-esteem will guide the development of IPV interventions in healthcare settings. DESIGN: Walker and Avant's eight-step approach was used. DATA SOURCE: The search was conducted from Oxford Dictionary of English online, CINAHL, APA PsycInfo, PubMed, Women's Studies International, and Google Scholar. REVIEW METHODS: No limits on the year of publication were applied. RESULTS: Defining attributes of self-esteem are self-concept, self-affirmation, and self-respect. Antecedents of self-esteem are exposure to IPV and victim-blaming attitudes by healthcare professionals. Consequences include depression, substance abuse, and posttraumatic stress disorder. Empirical referents include self-worth, self-competence, self-blame, self-evaluation, self-confidence, and self-determination. CONCLUSIONS: Current literature is limited in its definition of self-esteem in the context of IPV. Women experiencing IPV with low self-esteem might not seek help for IPV from nurses. Nurses could develop culturally appropriate IPV screening tools that assess the changes in self-esteem among women from different sociodemographic and cultural backgrounds. The defining attributes could contribute to developing comprehensive IPV screening tools in healthcare settings.

Confirmation of Decreased Rates of Cerebral Protein Synthesis In Vivo in a Mouse Model of Tuberous Sclerosis Complex.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder that results in intellectual disability and, in ∼50% of patients, autism spectrum disorder. The protein products that are altered in TSC (TSC1 and TSC2) form a complex to inhibit the mammalian target of rapamycin [mTOR; mTOR complex 1 (mTORC1)] pathway. This pathway has been shown to affect the process of mRNA translation through its action on ribosomal protein S6 and 4-elongation binding protein 1. It is thought that mutations in the TSC proteins lead to upregulation of the mTORC1 pathway and consequently an increase in protein synthesis. Unexpectedly, our previous study of a mouse model of TSC (Tsc2Djk +/) demonstrated decreased in vivo rates of protein synthesis throughout the brain. In the present study, we confirm those results in another Tsc2+/- mouse model, one with a different mutation locus and on a mixed background (Tsc2Mjg +/-). We also examine mTORC1 signaling and possible effects of prior isoflurane anesthesia. Because measurements of protein synthesis rates in vivo require surgical preparation of the animal and anesthesia, we examine mTORC1 signaling pathways both under baseline conditions and following recovery from anesthesia. Our results demonstrate regionally selective effects of prior anesthesia. Overall, our results in both in vivo models suggest differences to the central hypothesis regarding TSC and show the importance of studying protein synthesis in vivo Significance StatementProtein synthesis is an important process for brain function. In the disorder, tuberous sclerosis complex (TSC), the inhibition of the mammalian target of rapamycin (mTOR) pathway is reduced and this is thought to lead to excessive protein synthesis. Most studies of protein synthesis in models of TSC have been conducted in vitro We report here confirmation of our previous in vivo study showing decreased brain protein synthesis rates in a second mouse model of TSC, results counter to the central hypothesis regarding TSC. We also explore the possible influence of prior isoflurane exposure on signaling pathways involved in regulation of protein synthesis. This study highlights a novel aspect of TSC and the importance of studying cellular processes in vivo.

Behavioral and Molecular Consequences of Chronic Sleep Restriction During Development in Fragile X Mice.

Sleep is critical for brain development and synaptic plasticity. In male wild-type mice, chronic sleep restriction during development results in long-lasting impairments in behavior including hypoactivity, decreased sociability, and increased repetitive behavior. Disordered sleep is characteristic of many neurodevelopmental disorders. Moreover, the severity of behavioral symptoms is correlated with the degree of disordered sleep. We hypothesized that chronic developmental sleep restriction in a mouse model of fragile X syndrome (FXS) would exacerbate behavioral phenotypes. To test our hypothesis, we sleep-restricted Fmr1 knockout (KO) mice for 3 h per day from P5 to P52 and subjected mice to behavioral tests beginning on P42. Contrary to our expectations, sleep restriction improved the hyperactivity and lack of preference for social novelty phenotypes in Fmr1 KO mice but had no measurable effect on repetitive activity. Sleep restriction also resulted in changes in regional distribution of myelin basic protein, suggesting effects on myelination. These findings have implications for the role of disrupted sleep in the severity of symptoms in FXS.

Effects of Treatment With Hypnotics on Reduced Sleep Duration and Behavior Abnormalities in a Mouse Model of Fragile X Syndrome.

Many patients with fragile X syndrome (FXS) have sleep disturbances, and Fmr1 knockout (KO) mice (a model of FXS) have reduced sleep duration compared to wild type (WT). Sleep is important for brain development, and chronic sleep restriction during development has long-lasting behavioral effects in WT mice. We hypothesized that the sleep abnormalities in FXS may contribute to behavioral impairments and that increasing sleep duration might improve behavior. We treated adult male Fmr1 KO and WT mice subacutely with three different classes of hypnotics (DORA-22, ramelteon, and zolpidem) and caffeine, a methylxanthine stimulant, and we tested the effects of treatments on sleep duration and behavior. Behavior tests included activity response to a novel environment, anxiety-like behavior, and social behavior. As expected, all hypnotics increased, and caffeine decreased sleep duration in the circadian phase in which drugs were administered. Caffeine and DORA-22 treatment significantly reduced activity in the open field regardless of genotype. Other effects were not as apparent.

Workplace Violence Prevention Training, Safety Resources, and Commitment to HHCWs' Safety.

BACKGROUND: The threat of workplace violence (WPV) is a primary safety concern for home health care workers (HHCWs). WPV prevention training is a critical tool for HHCWs' safety. Yet, most existing WPV prevention training is limited or not specific to HHCWs' environment, the patient's home, and neighborhood. The purpose of this study was to describe WPV prevention training, resources used, and commitment to HHCWs' safety. METHODS: Using a cross-sectional design, HHCWs from two sites located in Southwestern Ohio completed the Violence Against Home Healthcare and Hospice Workers survey, a 37-item survey used to describe frequency and characteristics of WPV prevention training and resources. Descriptive statistics were used to analyze the data. FINDINGS: Half (n = 25) of the HHCWs received WPV prevention training. Training content focused on characteristics of aggressive/violent patients and family members (n = 19, 82.6%), but limited content about characteristics of hazardous neighborhoods (n = 15, 65.2%). Cellular phones (n = 43, 97.7%) were primarily used as a resource to promote safety, few cellular phones (n = 1, 2.3%) were provided by the agency. CONCLUSIONS/APPLICATION TO PRACTICE: HHCWs described WPV prevention training content and resources used to promote safety. WPV prevention training is deficient in procedures for seeking psychological care, screening patients for violent behavior, skills for self-protection, characteristics of hazardous neighborhoods, and physical maneuvers and verbal methods to diffuse or avoid aggressive behavior. Access to WPV prevention training and resources for HHCWs needs to be strengthened. Occupational Health Nurses can assist their employers with developing WPV prevention training for HHCWs.

Consensus for the Treatment of Tinea Pedis: A Systematic Review of Randomised Controlled Trials.

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0−7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4−19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4−4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1−1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment's for athlete's foot­systematic review with meta-analysis [CRD42020162078].

Decreased rates of cerebral protein synthesis in conscious young adults with fragile X syndrome demonstrated by L-[1-11C]leucine PET.

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability. Fragile X mental retardation protein, a putative translation suppressor, is significantly reduced in FXS. The prevailing hypothesis is that rates of cerebral protein synthesis (rCPS) are increased by the absence of this regulatory protein. We have previously reported increased rCPS in the Fmr1 knockout mouse model of FXS. To address the hypothesis in human subjects, we measured rCPS in young men with FXS with L-[1-11C]leucine PET. In previous studies we had used sedation during imaging, and we did not find increases in rCPS as had been seen in the mouse model. Since mouse measurements were conducted in awake animals, we considered the possibility that sedation may have confounded our results. In the present study we used a modified and validated PET protocol that made it easier for participants with FXS to undergo the study awake. We compared rCPS in 10 fragile X participants and 16 healthy controls all studied while awake. Contrary to the prevailing hypothesis and findings in Fmr1 knockout mice, results indicate that rCPS in awake participants with FXS are decreased in whole brain and most brain regions by 13-21% compared to healthy controls.

Divergent Ca2+/calmodulin feedback regulation of CaV1 and CaV2 voltage-gated calcium channels evolved in the common ancestor of Placozoa and Bilateria.

CaV1 and CaV2 voltage-gated calcium channels evolved from an ancestral CaV1/2 channel via gene duplication somewhere near the stem animal lineage. The divergence of these channel types led to distinguishing functional properties that are conserved among vertebrates and bilaterian invertebrates and contribute to their unique cellular roles. One key difference pertains to their regulation by calmodulin (CaM), wherein bilaterian CaV1 channels are uniquely subject to pronounced, buffer-resistant Ca2+/CaM-dependent inactivation, permitting negative feedback regulation of calcium influx in response to local cytoplasmic Ca2+ rises. Early diverging, nonbilaterian invertebrates also possess CaV1 and CaV2 channels, but it is unclear whether they share these conserved functional features. The most divergent animals to possess both CaV1 and CaV2 channels are placozoans such as Trichoplax adhaerens, which separated from other animals over 600 million years ago shortly after their emergence. Hence, placozoans can provide important insights into the early evolution of CaV1 and CaV2 channels. Here, we build upon previous characterization of Trichoplax CaV channels by determining the cellular expression and ion-conducting properties of the CaV1 channel orthologue, TCaV1. We show that TCaV1 is expressed in neuroendocrine-like gland cells and contractile dorsal epithelial cells. In vitro, this channel conducts dihydropyridine-insensitive, high-voltage-activated Ca2+ currents with kinetics resembling those of rat CaV1.2 but with left-shifted voltage sensitivity for activation and inactivation. Interestingly, TCaV1, but not TCaV2, exhibits buffer-resistant Ca2+/CaM-dependent inactivation, indicating that this functional divergence evolved prior to the emergence of bilaterian animals and may have contributed to their unique adaptation for cytoplasmic Ca2+ signaling within various cellular contexts.