Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis

Purpose: Although invasive intracranial devices (IIDs) are the gold standard for intracranial pressure (ICP) measurement, ultrasonography of the optic nerve sheath diameter (ONSD) has been suggested as a potential non-invasive ICP estimator. We performed a meta-analysis to evaluate the diagnostic accuracy of sonographic ONSD measurement for assessment of intracranial hypertension (IH) in adult patients. Methods: We searched on electronic databases (MEDLINE/PubMed\uae, Scopus\uae, Web of Science\uae, ScienceDirect\uae, Cochrane Library\uae) until 31 May 2018 for comparative studies that evaluated the efficacy of sonographic ONSD vs. ICP measurement with IID. Data were extracted independently by two authors. We used the QUADAS-2 tool for assessing the risk of bias (RB) of each study. A diagnostic meta-analysis following the bivariate approach and random-effects model was performed. Results: Seven prospective studies (320 patients) were evaluated for IH detection (assumed with ICP > 20 mmHg or > 25 cmH2O). The accuracy of included studies ranged from 0.811 (95% CI 0.678\u20120.847) to 0.954 (95% CI 0.853\u20120.983). Three studies were at high RB. No significant heterogeneity was found for the diagnostic odds ratio (DOR), positive likelihood ratio (PLR) and negative likelihood ratio (NLR), with I2< 50% for each parameter. The pooled DOR, PLR and NLR were 67.5 (95% CI 29\u2012135), 5.35 (95% CI 3.76\u20127.53) and 0.088 (95% CI 0.046\u20120.152), respectively. The area under the hierarchical summary receiver-operating characteristic curve (AUHSROC) was 0.938. In the subset of five studies (275 patients) with IH defined for ICP > 20 mmHg, the pooled DOR, PLR and NLR were 68.10 (95% CI 26.8\u2012144), 5.18 (95% CI 3.59\u20127.37) and 0.087 (95% CI 0.041\u20120.158), respectively, while the AUHSROC was 0.932. Conclusions: Although the wide 95% CI in our pooled DOR suggests caution, ultrasonographic ONSD may be a potentially useful approach for assessing IH when IIDs are not indicated or available (CRD42018089137, PROSPERO)

Cannabis Essential Oil: A Preliminary Study for the Evaluation of the Brain Effects

We examined the effects of essential oil from legal (THC <0.2% w/v) hemp variety on the nervous system in 5 healthy volunteers. GC/EIMS and GC/FID analysis of the EO showed that the main components were myrcene and β-caryophyllene. The experiment consisted of measuring autonomic nervous system (ANS) parameters; evaluations of the mood state; and electroencephalography (EEG) recording before treatment, during treatment, and after hemp inhalation periods as compared with control conditions. The results revealed decreased diastolic blood pressure, increased heart rate, and significant increased skin temperature. The subjects described themselves as more energetic, relaxed, and calm. The analysis EEG showed a significant increase in the mean frequency of alpha (8–13 Hz) and significant decreased mean frequency and relative power of beta 2 (18,5–30 Hz) waves. Moreover, an increased power, relative power, and amplitude of theta (4–8 Hz) and alpha brain waves activities and an increment in the delta wave (0,5–4 Hz) power and relative power was recorded in the posterior region of the brain. These results suggest that the brain wave activity and ANS are affected by the inhalation of the EO of Cannabis sativa suggesting a neuromodular activity in cases of stress, depression, and anxiety

Thermal analysis of the antineutrino 144Ce source calorimeter for the SOX experiment

The technical note describes the calorimeter which will be used to measure the activity of the antineutrino 144Ce source of the SOX experiment at the Gran Sasso Laboratories. The principle of the calorimeter is based on the measurement of both mass flow and temperature increase of the water circulating in the heat exchanger surrounding the source. The calorimeter is vacuum insulated in order to minimize the heat losses. The preliminary design and thermal Finite Element Analysis (FEA) are reported in the note

Repeated Sprint Ability in Young Basketball Players (Part 2): The Chronic Effects of Multidirection and of One Change of Direction Are Comparable in Terms of Physiological and Performance Responses

The aim of this study was to examine the effects of a 5-week training program, consisting of repeated 30-m sprints, on two repeated sprint ability (RSA) test formats: one with one change of direction (RSA) and the other with multiple changes of direction (RSM). Thirty-six young male and female basketball players (age 16.1 ± 0.9 years), divided into two experimental groups, were tested for RSA, RSM, squat jump, counter-movement jump, and the Yo-Yo Intermittent Recovery-Level-1 (Yo-Yo IR1) test, before and after a 4-week training program and 1 week of tapering. One group performed 30-m sprints with one change of direction (RSA group, RSAG), whereas the other group performed multidirectional 30-m sprints (RSM group, RSMG). Both groups improved in all scores in the post-intervention measurements (P < 0.05), except for the fatigue index in the RSM test. However, when comparing the two groups, similar effects were found for almost all parameters of the tests applied, except for RPE in the RSA test, which had a greater decrease in the RSAG (from 8.7 to 5.9) than in the RSMG (from 8.5 to 6.6, P = 0.021). We can conclude that repeated 30-m sprints, either with one change of direction or multidirectional, induce similar physiological and performance responses in young basketball players, but have a different psycho-physiological impact

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

The sensitivity of the alternative maximal accumulated oxygen deficit method to discriminate training status

The purpose of the study was to investigate the sensitivity of an alternative maximal accumulated oxygen deficit (MAODALT) method to discriminate the "anaerobic" capacity while comparing: least trained (LT) participants (n = 12), moderately trained (MT) participants (n = 12), endurance trained (ET) participants (n = 16), and rugby (RG) players (n = 11). Participants underwent a graded exercise test on a treadmill and a supramaximal effort for assessing MAODALT. MAODALTwas calculated as the sum of oxygen equivalents from the phosphagen and glycolytic metabolic pathways. MAODALTwas significantly higher (P < 0.05) in RG (64.4 ± 12.1 mL · kg-1) than in ET (56.8 ± 5.4 mL · kg-1; effect size [ES] = 0.77; +13.5%), MT (53.8 ± 5.3 mL · kg-1; ES = 1.08; +19.8%), and LT (49.9 ± 4.5 mL · kg-1; ES = 1.50; +36.4%). In addition, the magnitude-based inference analysis revealed that MAODALTwas likely (LT vs. MT), very likely (MT vs. RG, and ET vs. RG) and most likely (LT vs. ET, and LT vs. RG) different between all groups, except for MT and ET, which presented an unclear difference. In conclusion, MAODALTwas sensitive enough to distinguish the "anaerobic" capacity in individuals with different training status, especially for RG players compared with LT participants and MT participants

An Early Increase of Blood Leukocyte Subsets in Aneurysmal Subarachnoid Hemorrhage Is Predictive of Vasospasm

Objective: Vasospasm is a severe complication in patients with aneurysmal subarachnoid hemorrhage (aSAH) and cannot be reliably predicted. Its pathophysiology remains elusive with the current body of evidence suggesting inflammation as one of the main driving forces. We here aimed to analyze circulating immune cell subsets over time in patients with aSAH with or without vasospasm. Methods: We performed a prospective observational study recruiting patients with spontaneous aSAH. Peripheral blood withdrawn at pre-specified time-points after aSAH, day 0, days 3-4, 6-8, 10-11, 13-15, and 18-21. Flow cytometry analysis, cell blood counts, and laboratory and diagnostic parameters were performed. Patients were monitored by transcranial Doppler for vasospasm as well as by advanced imaging and divided into a group with (VS) and without vasospasm VS (NVS). Results: We included 42 patients for study analysis, 21 VS and 21 NVS. An early significant increase at day 0 in platelet, leukocyte, neutrophil, lymphocyte, NK lymphocyte, monocyte, and CD 14++ CD16- DR+ monocyte counts was found in patients with later ensuing vasospasm. The early differences in platelets, leukocytes, lymphocytes, and NK lymphocytes remained significant on multivariate analysis. Conclusions: An early increase of immune cellular subsets in aSAH may contribute to predict VS

The Role of the Person Focused IARA Model in Reducing Anxiety and Improving Body Awareness and Illness Management in Diabetics with Acquired Lipodystrophy: A Mixed-Method Study

Background: Lipodystrophy is one of the most frequent complications in people with diabetes following subcutaneous insulin therapy, and poor management can lead to several problems, such as impaired glycemic control and adherence to therapy, anxiety, and depression. Poor injection technique represents the main risk factor for lipodystrophies. In order to enhance the patient&rsquo;s insulin injection technique to heal lipodystrophy, improve psychological indices, and promote involvement in their health and care, the efficacy of emerging person-centered care called the IARA model was tested. Methods: A total of 49 patients were randomly allocated to the IARA group (Experimental; n = 25) or standard education (Control; n = 24). The following questionnaires were used in a mixed-method design: (i) State Anxiety Scale; (ii) Beck Depression Inventory; (iii) Italian Summary of Diabetes Self-Care Activities. An ad hoc open-ended questionnaire was structured for the qualitative analysis. Finally, photos were taken in order to verify if injection sites were changed until the follow-up at 12 months. The number of patients who participated until the completion of the study was 17 in the IARA and 11 in the Control group. Results: State anxiety was significantly reduced in people who followed IARA to follow-up at 3 and 6 months (p &lt; 0.05). The IARA group also demonstrated better compliance in blood glucose monitoring and foot-care compared to Control at follow-up at 12 months. The management of insulin injections dramatically improved in participants who received IARA intervention. Conclusions: IARA could be considered an effective strategy to improve well-being and compliance in people affected with diabetes mellitus and lipodystrophy complications