Comparison of Jump and Hop Test Measures Between NAIA and Division III Male Collegiate Basketball Players

Purpose: To report normative data for two functional performance tests (FPTs) (the standing long jump [SLJ] and the single-leg hop [SLH]) in a population of male collegiate basketball players and to identify differences in measures between athletes based on level of competition, starter status, and position. Methods: Eighty-six male collegiate basketball players from six teams were recruited for this study. Each athlete performed three SLJs and three SLHs (bilaterally). Results: Mean (± SD) FPT measures (normalized to height) for all basketball players were: SLJ = 1.0 ± 0.1, right SLH = 0.84 ± 0.1, and left SLH = 0.85 ± 0.1. Significant differences in FPT measures were observed both within and between groups based on: level of competition, by player position, and by starter status. Conclusions: The data presented in this study can be used by coaches and athletic trainers to assess aspects of athletic readiness in male collegiate basketball players

Diabetic Kidney Disease in FVB/NJ Akita Mice: Temporal Pattern of Kidney Injury and Urinary Nephrin Excretion

Akita mice are a genetic model of type 1 diabetes. In the present studies, we investigated the phenotype of Akita mice on the FVB/NJ background and examined urinary nephrin excretion as a marker of kidney injury. Male Akita mice were compared with non-diabetic controls for functional and structural characteristics of renal and cardiac disease. Podocyte number and apoptosis as well as urinary nephrin excretion were determined in both groups. Male FVB/NJ Akita mice developed sustained hyperglycemia and albuminuria by 4 and 8 weeks of age, respectively. These abnormalities were accompanied by a significant increase in systolic blood pressure in 10-week old Akita mice, which was associated with functional, structural and molecular characteristics of cardiac hypertrophy. By 20 weeks of age, Akita mice developed a 10-fold increase in albuminuria, renal and glomerular hypertrophy and a decrease in the number of podocytes. Mild-to-moderate glomerular mesangial expansion was observed in Akita mice at 30 weeks of age. In 4-week old Akita mice, the onset of hyperglycemia was accompanied by increased podocyte apoptosis and enhanced excretion of nephrin in urine before the development of albuminuria. Urinary nephrin excretion was also significantly increased in albuminuric Akita mice at 16 and 20 weeks of age and correlated with the albumin excretion rate. These data suggest that: 1. FVB/NJ Akita mice have phenotypic characteristics that may be useful for studying the mechanisms of kidney and cardiac injury in diabetes, and 2. Enhanced urinary nephrin excretion is associated with kidney injury in FVB/NJ Akita mice and is detectable early in the disease process

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

The natural history of untreated estrogen receptor-positive, Her2-negative invasive breast cancer

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Background: Using prior mammograms from patients with delays in their breast cancer diagnoses, we sought to describe in-vivo growth kinetics of untreated breast cancer to determine if the time they became clinically apparent can be predicted. Methods: Patient and tumor characteristics were collected from those who presented with “missed,” untreated breast cancer to a breast center in a single institution. Only patients whose biopsied masses revealed estrogen receptor-positive, Her2-negative (ER+/Her2−) invasive cancers were included. Two attending radiologists reviewed images from prior mammograms. Rates of change in volume were calculated in mm3/day, and a logarithmic equation was used to calculate tumor volume doubling time (TVDT). A Spearman\u27s Rho correlation was performed for the continuous variables, and the Mann–Whitney U and Kruskal–Wallis tests were used to compare categorical data. A p value \u3c 0.05 was considered statistically significant. Logistic regression was performed to determine if patient or tumor characteristics were correlated to tumor growth velocity. Results: Of the 36 ER+/Her2− invasive breast cancers included in the analysis, 13 (36%) were at least cT2 (of TNM), 7 (19%) were grade 3, and 7 (19%) were node positive at diagnosis. Grade (p = 0.043) and pathologic invasive tumor size (p = 0.001) were positively correlated to tumor growth velocity. Median TVDT was 385 days (23–1897). Age, nodal positivity, Oncotype Dx® Recurrence Score, time of diagnostic delay, and spheroid-ellipsoid discrepancy (SED) were not related to tumor growth velocity in this sample. Conclusion: In this cohort of patients with untreated ER+/Her2− invasive breast cancers, grade and pathologic tumor size were found to be positively correlated to growth velocity. The growth rates in a homogeneous group of tumors varied widely and could not be predicted. One possible explanation for this finding is that other difficult-to-measure biologic factors such as tumor microenvironment may play a greater role in tumor progression than traditional clinicopathologic characteristics

Kidney phenotype at 30 weeks of age.

<p>Values are means ± SEM; n, number of mice;</p>*<p>P<0.05 between diabetic and control animals.</p

Kidney weight and glomerular filtration rate (GFR) in male Akita mice.

<p>(A) Kidney-to-body weight ratio was significantly increased in diabetic Akita mice (n = 6 to 8) compared to controls (n = 6 to 8) at 12 and 20 weeks of age. (B) There was a significant increase in GFR at 12 weeks of age in diabetic Akita mice (n = 3 to 5) compared to controls (n = 5). Black bars = control; white bars = Akita. Data are mean ± SEM. *P<0.05 or **P<0.001 vs. age-matched controls.</p

Urinary albumin excretion (UAE) in male Akita mice.

<p>(A) UAE was significantly elevated compared with controls in diabetic Akita mice by 8 weeks of age. By 20 weeks of age, there was a >10-fold increase in albuminuria in diabetic mice compared to control animals. (B) Albumin-to-creatinine ratio (ACR) was also significantly increased in diabetic mice compared to age-matched controls. (C) There was a linear relationship between 24-hour UAE and ACR in all mice (R² = 0.71; P<0.0001). Black bars = control (n = 6 to 8); white bars = Akita (n = 6 to 8). Black circles = control; white circles = Akita. Data are mean ± SEM. *P<0.05 or †P<0.0001 vs. age-matched controls.</p

Gene expression in cardiac tissue.

<p>Cardiac gene expression at 10 weeks of age; mRNA levels in diabetic mice relative to controls (assigned as 1.0) normalized to β-actin mRNA level. Values are means ± SE; n, number of mice; TGFβ, transforming growth factorβ; MCP-1, monocyte chemoatactic protein-1; IL1β, interleukin 1β; TNFα, tumor necrosis factor-α; CTGF, connective tissue growth factor.</p>*<p>P = 0.001 between diabetic and control animals.</p

Fasting blood glucose levels and urine output in male Akita mice.

<p>(A) FVB/NJ-<i>Ins2</i>^+/C96Y mice developed sustained hyperglycemia by 4 weeks of age, which persisted throughout the duration of the study. (B) Urine output in FVB/NJ-<i>Ins2</i>^+/C96Y was significantly increased by 8 weeks of age and further increased during the study period. Black bars = control (n = 6 to 8); white bars = Akita (n = 6 to 8). Data are mean ± SEM. *P<0.05 †P<0.001 or **P<0.01 vs. age-matched controls.</p