State of research, feasibility, safety, acceptability, and outcomes examined on remotely delivered exercises using technology for older adult with cancer: a scoping review.

INTRODUCTION: Technology-based exercise is gaining attention as a promising strategy for increasing physical activity (PA) in older adults with cancer (OACA). However, a comprehensive understanding of the interventions, their feasibility, outcomes, and safety is limited. This scoping review (1) assessed the prevalence and type of technology-based remotely delivered exercise interventions for OACA and (2) explored the feasibility, safety, acceptability, and outcomes in these interventions. METHODS: Studies with participant mean/median age ≥ 65 reporting at least one outcome measure were included. Databases searched included the following: PubMed, CINAHL, Embase, Cochrane Library Online, SPORTDiscus, and PsycINFO. Multiple independent reviewers completed screening and data abstractions of articles in English, French, and Spanish. RESULTS: The search yielded 2339 citations after removing duplicates. Following title and abstract screening, 96 full texts were review, and 15 were included. Study designs were heterogeneous, and sample sizes were diverse (range 14-478). The most common technologies used were website/web portal (n = 6), videos (n = 5), exergaming (n = 2), accelerometer/pedometer with video and/or website (n = 4), and live-videoconferencing (n = 2). Over half (9/15) of the studies examined feasibility using various definitions; feasibility outcomes were reached in all. Common outcomes examined include lower body function and quality of life. Adverse events were uncommon and minor were reported. Qualitative studies identified cost- and time-savings, healthcare professional support, and technology features that encourage engagement as facilitators. CONCLUSION: Remote exercise interventions using technology appear to be feasible and acceptable in OACA. IMPLICATIONS FOR CANCER SURVIVORS: Some remote exercise interventions may be a viable way to increase PA for OACA.

Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey.

INTRODUCTION AND HYPOTHESIS: Pelvic floor dysfunction (PFD) affects many women and participation in elite sport and high-impact exercise has been reported as a potential risk. However, few studies have investigated the effects of exercising at recreational levels on PFD. Our aim was to investigate levels of PFD in women exercising at, or above, UK guidelines for health and compare them with levels in non-exercisers. METHOD: Data on levels of PFD and potential risk factors (age, hormonal status, body mass index, constipation, parity, forceps delivery, and recreational exercise) were collected using a cross-sectional survey distributed via social media. The International Consultation Incontinence Questionnaire (ICIQ) Urinary Incontinence Short Form was used to estimate prevalence of urinary incontinence (UI). Selected questions from the ICIQ vaginal symptom and bowel symptom questionnaires were used to estimate prevalence of anal incontinence (AI) and pelvic organ prolapse (POP). Logistic regression analysis was used to compare exercisers and non-exercisers after adjusting for potential confounders. RESULTS: We recruited 1,598 adult women (1,141 exercisers and 457 non-exercisers). The majority were parous. High prevalence of UI (70%), AI (52%) and POP (18%) was reported. No significant association was found between recreational exercise and PFD despite adjustment for confounders, or further investigation regarding exercise involving impact, although some increased reporting of AI was seen in those exercising for over 10 hours per week. CONCLUSION: High levels of all PFD were reported but no significant association was found between recreational exercise and symptoms. However, data suggest that women modify their exercise regimes as required. Few symptomatic women sought professional help.

Cardiac myosin motor deficits are associated with left ventricular dysfunction in human ischemic heart failure.

During ischemic heart failure (IHF), cardiac muscle contraction is typically impaired, though the molecular changes within the myocardium are not fully understood. Thus, we aimed to characterize the biophysical properties of cardiac myosin in IHF. Cardiac tissue was harvested from 10 age-matched males, either with a history of IHF or nonfailing (NF) controls that had no history of structural or functional cardiac abnormalities. Clinical measures before cardiac biopsy demonstrated significant differences in measures of ejection fraction and left ventricular dimensions. Myofibrils and myosin were extracted from left ventricular free wall cardiac samples. There were no changes in myofibrillar ATPase activity or calcium sensitivity between groups. Using isolated myosin, we found a 15% reduction in the IHF group in actin sliding velocity in the in vitro motility assay, which was observed in the absence of a myosin isoform shift. Oxidative damage (carbonylation) of isolated myosin was compared, in which there were no significant differences between groups. Synthetic thick filaments were formed from purified myosin and the ATPase activity was similar in both basal and actin-activated conditions (20 µM actin). Correlation analysis and Deming linear regression were performed between all studied parameters, in which we found statistically significant correlations between clinical measures of contractility with molecular measures of sliding velocity and ELC carbonylation. Our data indicate that subtle deficits in myosin mechanochemical properties are associated with reduced contractile function and pathological remodeling of the heart, suggesting that the myosin motor may be an effective pharmacological intervention in ischemia.NEW & NOTEWORTHY Ischemic heart failure is associated with impairments in contractile performance of the heart. This study revealed that cardiac myosin isolated from patients with ischemic heart failure had reduced mechanical activity, which correlated with the impaired clinical phenotype of the patients. The results suggest that restoring myosin function with pharmacological intervention may be a viable method for therapeutic intervention.

Event boundaries structure the contents of long-term memory in younger and older adults.

Event boundaries impose structure on how events are stored in long-term memory. Research with young adults has shown that associations within events are stronger than those that cross event boundaries. Recently, this effect was observed in both young and old adults using movie stimuli (Davis, Chemnitz, et al., 2021). Here, we test whether this effect extends to written narratives. Young and old participants read a series of narratives that were interspersed with temporal shifts in the storyline meant to elicit the perception of an event boundary. Later, participants were cued with sentences and were asked to recall the sentence that immediately followed. We expected participants would have worse memory when a cue and correct answer flanked a boundary than when it did not. In Experiment 1, we found that despite older adults' lower performance overall, both age groups had lower accuracy for cues that flanked a boundary, compared to cues that elicited a response from within the same event. Experiment 2 replicated the results from Experiment 1. Our results support past work that did not find age differences in event perception and demonstrate that older and younger adults may store events similarly in long-term memory.

medna-metadata: an open-source data management system for tracking environmental DNA samples and metadata.

MOTIVATION: Environmental DNA (eDNA), as a rapidly expanding research field, stands to benefit from shared resources including sampling protocols, study designs, discovered sequences, and taxonomic assignments to sequences. High-quality community shareable eDNA resources rely heavily on comprehensive metadata documentation that captures the complex workflows covering field sampling, molecular biology lab work, and bioinformatic analyses. There are limited sources that provide documentation of database development on comprehensive metadata for eDNA and these workflows and no open-source software. RESULTS: We present medna-metadata, an open-source, modular system that aligns with Findable, Accessible, Interoperable, and Reusable guiding principles that support scholarly data reuse and the database and application development of a standardized metadata collection structure that encapsulates critical aspects of field data collection, wet lab processing, and bioinformatic analysis. Medna-metadata is showcased with metabarcoding data from the Gulf of Maine (Polinski et al., 2019). AVAILABILITY AND IMPLEMENTATION: The source code of the medna-metadata web application is hosted on GitHub (https://github.com/Maine-eDNA/medna-metadata). Medna-metadata is a docker-compose installable package. Documentation can be found at https://medna-metadata.readthedocs.io/en/latest/?badge=latest. The application is implemented in Python, PostgreSQL and PostGIS, RabbitMQ, and NGINX, with all major browsers supported. A demo can be found at https://demo.metadata.maine-edna.org/. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Fermion-Parity-Based Computation and Its Majorana-Zero-Mode Implementation.

Majorana zero modes (MZMs) promise a platform for topologically protected fermionic quantum computation. However, creating multiple MZMs and generating (directly or via measurements) the requisite transformations (e.g., braids) pose significant challenges. We introduce fermion-parity-based computation (FPBC): a measurement-based scheme, modeled on Pauli-based computation, that uses efficient classical processing to virtually increase the number of available MZMs and which, given magic state inputs, operates without transformations. FPBC requires all MZM parities to be measurable, but this conflicts with constraints in proposed MZM hardware. We thus introduce a design in which all parities are directly measurable and which is hence well suited for FPBC. While developing FPBC, we identify the "logical braid group" as the fermionic analog of the Clifford group.

Peripartum cardiomyopathy: a global effort to find the cause and cure for the rare and little understood disease.

In this review, we present our current understanding of peripartum cardiomyopathy (PPCM) based on reports of the incidence, diagnosis and current treatment options. We summarise opinions on whether PPCM is triggered by vascular and/or hormonal causes and examine the influence of comorbidities such as preeclampsia. Two articles published in 2021 strongly support the hypothesis that PPCM may be a familial disease. Using large cohorts of PPCM patients, they summarised the available genomic DNA sequence data that are expressed in human cardiomyocytes. While PPCM is considered a disease predominately affecting the left ventricle, there are data to suggest that some cases also involve right ventricular failure. Finally, we conclude that there is sufficient evidence to warrant an RNAseq investigation and that this would be most informative if performed at the cardiomyocytes level rather than analysing genomic DNA from the peripheral circulation. Given the rarity of PPCM, the combined resources of international human heart tissue biobanks have assembled 30 ventricular tissue samples from PPCM patients, and we are actively seeking to enlarge this patient base by collaborating with human heart tissue banks and research laboratories who would like to join this endeavour.

Management of urinary incontinence in athletic women: the POsITIve feasibility study.

OBJECTIVES: To investigate the feasibility and acceptability of conducting a future trial of physiotherapy to manage urinary incontinence (UI) in athletic women. DESIGN: Feasibility study with nested qualitative interviews. SETTING: Community clinics: university and private. PARTICIPANTS: Adult women who i) lived locally, ii) provided informed consent iii) self-reported UI iv) exercised at high/moderate intensity for over 150 minutes and over three times a week. INTERVENTIONS: Up to seven sessions of tailored physiotherapy delivered over 6-months. Despite some variation in prescription and progression, all programmes included elements of pelvic floor muscle training undertaken in clinic and at home. MAIN OUTCOME MEASURES: Recruitment, eligibility of those screened, consent, data completion and attendance rates: assessed to determine feasibility of progression to a definitive trial. The acceptability of specific outcome measures, the intervention and of randomisation within a future trial was also examined. RESULTS: Direct recruitment of athletic women from sporting venues was feasible and acceptable. Most women not only consented to an intimate examination as part of the assessment, but described this as an important part of the intervention. Attendance rates and data completion was generally high but the return of 3-day fluid charts was poor: this was also reflected in comments by participants that these were difficult to incorporate into daily life. The addition of a smartphone app to aid motivation and monitoring was welcomed but further education in its use may enhance compliance. CONCLUSIONS: Direct recruitment from sporting venues was acceptable and feasible. Women valued assessment and treatment for UI. CLINICAL TRIAL REGISTRATION NUMBER: NCT03986411.

A DNA functionalized advanced electrochemical biosensor for identification of the foodborne pathogen Salmonella enterica serovar Typhi in real samples.

An efficient platform for the detection of Salmonella enterica serovar Typhi (S. Typhi) is essential for early-stage diagnosis of typhoid to prevent and contain outbreaks. Here, we fabricated an electrochemical DNA biosensor for selective identification of S. Typhi in real samples. The biosensor has been fabricated by immobilizing an amine labelled S. Typhi specific single-strand capture probe on the surface of gold nanoparticles (AuNP) and poly cysteine (P-Cys) modified screen-printed electrode. Differential pulse voltammetry (DPV) of anthraquinone-2-sulfonic acid monohydrate sodium salt (AQMS) as a signal indicator was monitored to detect S. Typhi by hybridization of target DNA with the probe DNA. The fabricated biosensor shows a detection range of 1 × 10-6 to 1 × 10-22 molL-1 with a LOD of 6.8 × 10-25 molL-1 in S. Typhi complementary linear target and 1.8 × 105 to 1.8 CFUml-1 with a LOD of 1 CFUml-1 in a real S. Typhi sample. The biosensor shows excellent discrimination ability to some bases mismatched and different bacterial cultures (same and distant genera). The most beneficial points of the proposed DNA biosensor are the lower limit of detection and the ability to reuse the biosensor more than 6 to 7 times. In addition, the practicability of the biosensor was investigated via detecting S. Typhi in blood, poultry feces, egg, and milk whereby excellent recoveries ranging from 96.54 to 103.47% were demonstrated indicating that this biosensor might be the most promising diagnostic tool for monitoring S. Typhi in clinical and food samples.

Detection of imidacloprid and metabolites in Northern Leopard frog (Rana pipiens) brains.

Neonicotinoids are a new type of highly water-soluble insecticide used in agricultural practices to eliminate pests. Neonicotinoids bind almost irreversibly to postsynaptic nicotinic acetylcholine receptors in the central nervous system of invertebrates, resulting in overstimulation, paralysis, and death. Imidacloprid, the most commonly used neonicotinoid, is often transported to nearby wetlands through subsurface tile drains and has been identified as a neurotoxin in several aquatic non-target organisms. The aim of the present study was to determine if imidacloprid could cross the blood-brain barrier in adult Northern Leopard frogs (Rana pipiens) following exposure to 0, 0.1, 1, 5, or 10 µg/L for 21 days. Additionally, we quantified the breakdown product of imidacloprid, imidacloprid-olefin, and conducted feeding trials to better understand how imidacloprid affects foraging behavior over time. Exposure groups had 12 to 313 times more imidacloprid in the brain relative to the control and breakdown products showed a dose-response relationship. Moreover, imidacloprid brain concentrations were approximately 14 times higher in the 10 µg/L treatment compared to the water exposure concentration, indicating imidacloprid can bioaccumulate in the amphibian brain. Reaction times to a food stimulus were 1.5 to 3.2 times slower among treatment groups compared to the control. Furthermore, there was a positive relationship between mean response time and log-transformed imidacloprid brain concentration. These results indicate imidacloprid can successfully cross the blood-brain barrier and bioaccumulate in adult amphibians. Our results also provide insights into the relationship between imidacloprid brain concentration and subsequent altered foraging behavior.

Isolated IgG2 deficiency is an independent risk factor for exacerbations in bronchiectasis.

BACKGROUND: Immunoglobulin G (IgG) subclass 2 deficiency is the most frequent IgG subclass deficiency identified in patients with bronchiectasis, but its clinical significance is not known. AIM: To analyse if bronchiectasis patients with isolated IgG2 deficiency at risk of recurrent exacerbations and/or hospitalization? Do patients with IgG2 deficiency have worse disease progression? DESIGN AND METHODS: This is a retrospective study (2015-20) exploring independent risk factors for recurrent exacerbations (3 or more per year) and/or hospitalization with bronchiectasis exacerbations using multivariable models using binary logistic regression. There was no patient with IgG deficiency, IgG 1, 3 or 4 deficiency, or IgA or IgM deficiency included. In this model, the authors included: serum IgG2 level; lung function; body mass index; MRC breathlessness scale; age; sex; number of bronchiectatic lobes; bacterial colonization; comorbidities; and the use of long-term immunosuppressant drugs or antibiotics for more than 28 days. Analysing 2-year longitudinal data, one-way ANOVA and Mann-Whitney U-test were used to compare bronchiectasis severity between patients with different IgG2 levels. RESULTS: Serum IgG2 levels (<2.68 g/l, 2.68-3.53 g/l and 3.54-4.45 g/l); hospital admission in the preceding 2 years; bacterial colonization with potentially pathogenic organisms and asthma were independent predictors for three or more bronchiectasis exacerbations. Those with low IgG2 levels (<2.68 g/l and 2.68-3.53 g/l), had worsening progression of their bronchiectasis, using the Bronchiectasis Severity Index, over 1 year compared with those who were IgG2 replete (>4.45 g/l) (P = 0.003, 0.013). CONCLUSION: Reduced IgG2 levels were an independent predictor for bronchiectasis exacerbations and have increased disease progression.

[D-CBP study: Evaluation of lung cancer management times]. / Étude D-CBP : Évaluation des délais de prise en charge du cancer broncho- pulmonaire au sein du service de Pneumologie et d'Oncologie Thoracique du CHU de Caen.

INTRODUCTION: Lung cancer is the leading cause of cancer-related death. Delays may have an impact on patient survival. The objective of this study was to evaluate the diagnostic and therapeutic management times for patients admitted for lung cancer treatment in the Respiratory Department of CHU de Caen Normandie. MATERIALS AND METHODS: This is a retrospective, single-center and observational study, conducted on all patients treated for lung cancer from June 2017 to January 2018 in our department of pneumology in the Caen Normandie CHU. The main median times were investigated were: Global Time (abnormal imaging-treatment), Diagnosis time (abnormal imaging-diagnosis) and Treatment Time (diagnosis-treatment). RESULTS: One hundred and twenty-seven (127) patients were included. Median global time was 55.5 days [31,25; 393], median diagnosis time was 22 days [13; 49], and median treatment time was 24.5 days [12,25; 45]. DISCUSSION: Our treatment times are consistent with those previously published. Areas for improvement are being developed in accordance with the 2014-2019 cancer plan, in particularly the creation in our institution of a specific care pathway for patients with lung cancer.

Predictors of Poor Functional Status in Adult Fontan Patients Living at Moderate Altitude.

Patients who have undergone Fontan palliation have reduced exercise tolerance measured by maximal oxygen consumption (VO2 max). Declining exercise capacity is associated with increased morbidity and mortality. The impact of hemodynamics and other variables on this population's functional status is not well understood. This study sought to identify variables that predict low VO2 max in Fontan patients living at moderate altitude (5,000-8,000 feet). We performed a retrospective cohort study of 44 adult Fontan patients living at moderate altitude who had undergone cardiopulmonary exercise testing (CPET) and cardiac catheterization. We evaluated hemodynamic parameters measured during catheterization, imaging results, and laboratory studies for correlation with VO2 max measured during CPET. Our study cohort (median age 30 years, 52% female) had exercise impairment with mean VO2 max of 21.6 mL/kg/min. Higher trans-pulmonary gradient (TPG) (p < 0.001) and mean pulmonary artery (PA) pressure (p = 0.013) were predictors of lower maximal and submaximal VO2. Higher BNP values correlated with lower VO2 max (p = 0.01). Platelet count, GGT, albumin, and pulmonary vasodilator therapy did not correlate with VO2 max. None of the studied variables were associated with higher minute ventilation to peak carbon dioxide production (VE/VCO2 slope) or change in VO2 max over time. In conclusion, higher TPG and mean PA pressure predicted lower exercise tolerance amongst our cohort of adult Fontan patients living at moderate altitude. Future studies are needed to determine if these clinical variables represent viable therapeutic targets that could result in improved exercise tolerance and outcomes in patients with Fontan circulation.

Physical activity recommendations for cancer survivors living with bony metastases: views of oncologic healthcare providers.

PURPOSE: The potential of physical activity to improve function and quality of life of an individual with advanced cancer is now established. The purpose of this survey of oncologic healthcare providers (OHPs) is to understand their attitude towards physical activity for individuals living with bony metastases and to assess requirements to confidently provide physical activity recommendations. METHODS: A web-based survey administered through Qualtrics™ included questions on participant demographics and attitude questions ranked on a Likert scale. Eligibility was a physician or nurse practitioner currently providing care in the cancer care system of a public healthcare system in Canada. 338 participants were identified and invited to participate in this survey. RESULTS: The response rate was 34.6%. The majority of OHPs believed physical activity is important (89%) and safe (82%) in individuals living with bony metastases. OHPs agreed that these individuals looked to them for physical activity recommendations (74%) and that these recommendations would be followed (58%). Yet, 86% of OHPs felt they required more information before they could recommend physical activity to individuals living with bony metastases, and less than half (43%) of OHPs felt confident enough to prescribe physical activity. CONCLUSIONS: OHPs agree that physical activity for individuals living with bony metastatic cancer is beneficial and safe. However, OHPs are not confident in their ability to recommend physical activity to this population. IMPLICATIONS FOR CANCER SURVIVORS: There is a need to create physical activity guidelines for individuals living with bony metastases and improve access to rehabilitation services.

Digital disruption of dietetics: are we ready?

Digital health is transforming the delivery of health care around the world to meet the growing challenges presented by ageing populations with multiple chronic conditions. Digital health technologies can support the delivery of personalised nutrition care through the standardised Nutrition Care Process (NCP) by using personal data and technology-supported delivery modalities. The digital disruption of traditional dietetic services is occurring worldwide, supporting responsive and high-quality nutrition care. These disruptive technologies include integrated electronic and personal health records, mobile apps, wearables, artificial intelligence and machine learning, conversation agents, chatbots, and social robots. Here, we outline how digital health is disrupting the traditional model of nutrition care delivery and outline the potential for dietitians to not only embrace digital disruption, but also take ownership in shaping it, aiming to enhance patient care. An overview is provided of digital health concepts and disruptive technologies according to the four steps in the NCP: nutrition assessment, diagnosis, intervention, and monitoring and evaluation. It is imperative that dietitians stay abreast of these technological developments and be the leaders of the disruption, not simply subject to it. By doing so, dietitians now, as well as in the future, will maximise their impact and continue to champion evidence-based nutrition practice.

Evaluation of Mass Sensitive Micro-Array biosensors for their feasibility in multiplex detection of low molecular weight toxins using mycotoxins as model compounds.

Mycotoxins produced by Fusarium species including trichothecenes, zearalenone and fumonisins, can co-contaminate food and feed throughout the supply chain, including cereal grains and animal feeds. There is an increasing demand to enhance global food security by improving the monitoring of mycotoxins throughout our food supply chain. For time and cost-efficient analysis, rapid tests capable of detecting multiple toxins from a single sample are ideal. Considering these current trends in mycotoxin testing, this project examined the feasibility of using both a portable and non-portable mass-based biosensor for multiplex mycotoxin detection. The biosensor was a mass sensitive microarray (MSMA) which consisted of 4 × 16 miniaturized mass sensitive transducer pixels based on solidly mounted resonator (SMR) technology. Functionalisation of individual pixels on the sensor surface using nano-spotting technology for the simultaneous and semi-quantitative detection of three regulated mycotoxins: T2-toxin (T2) zearalenone (ZEN), and fumonisin B1 (FumB1) was examined. With the integration of portable and non-portable microfluidic devices for antibody and standard sample injections, competitive inhibition assays were developed followed by singleplex and multiplex calibration curves. The characteristics and performance of the MSMA were evaluated including sensitivity which was determined as the concentration causing 50% inhibition. Sensitivity of singleplex assays using the portable microfluidic device (PMD) were 1.3 ng/ml, 2.0 ng/ml and 6.8 ng/ml for T2, FumB1 and ZEN, respectively. Sensitivity of the multiplex assay again using the PMD was 6.1 ng/ml, 3.6 ng/ml and 2.4 ng/ml for T2, FumB1 and ZEN, respectively. The PMD was an easy to use and highly sensitive screening tool which has been demonstrated for the multiplex detection of three regulated mycotoxins. Analysis was in real time and results were fully digital. Since detection of analytes was by mass it was both a label-free and cost-efficient method proposed method of analysis for mycotoxins.

Temporally Distinct Roles for the Zinc Finger Transcription Factor Sp8 in the Generation and Migration of Dorsal Lateral Ganglionic Eminence (dLGE)-Derived Neuronal Subtypes in the Mouse.

Progenitors in the dorsal lateral ganglionic eminence (dLGE) are known to give rise to olfactory bulb (OB) interneurons and intercalated cells (ITCs) of the amygdala. The dLGE enriched transcription factor Sp8 is required for the normal generation of ITCs as well as OB interneurons, particularly the calretinin (CR)-expressing subtype. In this study, we used a genetic gain-of-function approach in mice to examine the roles Sp8 plays in controlling the development of dLGE-derived neuronal subtypes. Misexpression of Sp8 throughout the ventral telencephalic subventricular zone (SVZ) from early embryonic stages, led to an increased generation of ITCs which was dependent on Tshz1 gene dosage. Additionally, Sp8 misexpression impaired rostral migration of OB interneurons with clusters of CR interneurons seen in the SVZ along with decreased differentiation of calbindin OB interneurons. Sp8 misexpression throughout the ventral telencephalon also reduced ventral LGE neuronal subtypes including striatal projection neurons. Delaying Sp8 misexpression until E14-15 rescued the striatal and amygdala phenotypes but only partially rescued OB interneuron reductions, consistent with an early window of striatal and amygdala neurogenesis and ongoing OB interneuron generation at this late stage. Our results demonstrate critical roles for the timing and neuronal cell-type specificity of Sp8 expression in mouse LGE neurogenesis.

Basal-IQ technology in the real world: satisfaction and reduction of diabetes burden in individuals with type 1 diabetes.

AIM: To describe person-reported outcomes of the Basal-IQ predictive low-glucose-suspend system (Tandem Diabetes Care, San Diego, CA, USA) in real-world use. METHODS: Adults with type 1 diabetes/caregivers of minors with type 1 diabetes completed the Diabetes Impact and Device Satisfaction questionnaire (11 items scored on 10-point Likert scales) prior to Basal-IQ system initiation, and at 2, 4 and 6 months post-initiation. Analysis was stratified by previous insulin treatment method. Beta mixed models were used to measure change in device satisfaction (e.g. trust, ease of use) and diabetes impact (e.g. hypoglycaemia fear, poor sleep) scores between time points, adjusting for baseline covariates. RESULTS: A total of 967 adults and caregivers [54% women, mean (sd) age 36 (17) years, 57% Tandem pump users, 27% non-Tandem pump users, 17% multiple daily injection users] completed surveys. Device satisfaction significantly increased from baseline to 2 months in all groups (P<0.001 multiple daily injection and non-Tandem pump users; P=0.048 Tandem pump users), and was sustained from 2 to 6 months in all groups. Diabetes impact decreased significantly from baseline to 2 months in all groups (P<0.001 for all), was sustained from 2 to 6 months in multiple daily injection and Tandem pump users, and increased slightly at 4 months/decreased at 6 months in non-Tandem users. CONCLUSION: The Basal-IQ system increased device satisfaction and reduced diabetes impact in all users in the first 2 months of use, and satisfaction was sustained over 6 months, with small fluctuations.

Disseminated Saksenaea infection in an immunocompromised host associated with a good clinical outcome: a case report and review of the literature.

BACKGROUND: Saksenaea species (spp.) are uncommon causes of mucormycosis but are emerging pathogens mostly associated with trauma and soil contamination often in immunocompetent hosts. Due to lack of sporulation in the laboratory, diagnosis and susceptibility testing is difficult so optimal treatment regimens are unknown. CASE PRESENTATION: A 67 year-old man from the Northern Territory in Australia, with a history of eosinophilic granulomatosis with polyangiitis, developed disseminated Saksenaea infection after initially presenting with symptoms consistent with bacterial pyelonephritis. Despite a delay in diagnosis; with aggressive surgical management and dual therapy with amphotericin B and posaconazole, he survived. CONCLUSIONS: We describe an unusual case of disseminated infection with a favourable outcome to date.

Do Adults Utilizing Intermittent Fasting Improve Lipids More Than Those Following a Restricted-Calorie Diet? A Clin-IQ.

With approximately 95 million Americans diagnosed with high cholesterol, and many searching for a nonmedicinal treatment, intermittent fasting as a method to improve health has become increasingly popular in the lay public. We conducted a clinical inquiry to determine whether intermittent fasting is superior to a low-calorie diet in improving lipids, searching the Cochrane, EBSCOhost, Embase, MEDLINE, and Scopus databases using the terms intermittent fasting, lipids, and calorie-restricted diet. Studies that included surgical weight loss or medicine-assisted weight loss were excluded. We identified 6 published studies, 5 of which were randomized controlled trials. In reviewing the selected studies, there did not appear to be a consistent difference in lipid change between restricted-calorie diet and intermittent fasting. Because of differences in study methods and in how intermittent fasting was defined, additional studies are needed.