Protocol: Using single-case experimental design to evaluate whole-body dynamic seating on activity, participation, and quality of life in dystonic cerebral palsy

INTRODUCTION: People with hyperkinetic movement disorders, including dystonia, experience often painful, involuntary movements affecting functioning. Seating comfort is a key unmet need identified by families. This paper reports a protocol to assess the feasibility and preliminary evidence for the efficacy of dynamic seating to improve functional outcomes for young children with dystonic cerebral palsy (DCP). DESIGN: A series of single-case experimental design N-of-1 trials, with replications across participants, with a random baseline interval, and one treatment period (n = 6). METHODS: Inclusion criteria: DCP; 21.5 cm < popliteal fossa to posterior sacrum < 35 cm; Gross Motor Function Classification System level IV–V; mini-Manual Ability Classification System level IV–V; difficulties with seating. INTERVENTION: Trial of the seat (8 weeks), with multiple baseline before, during and after intervention and 2 month follow up. The baseline duration will be randomised per child (2–7 weeks). PRIMARY OUTCOMES: Performance Quality Rating Scale; Canadian Occupational Performance Measure; seating tolerance. The statistician will create the randomization, with allocation concealment by registration of participants prior to sending the allocation arm to the principal investigator. Primary outcomes will be assessed from video by an assessor blind to allocation. ANALYSIS: Participant outcome data will be plotted over time, with parametric and non-parametric analysis including estimated size effect for N-of-1 trials

Modelling water temperature in the lower Olifants River and the implications for climate change

Freshwater systems in southern Africa are under threat of climate change, not only from altered flow regimes as rainfall patterns change, but also from biologically significant increases in water temperature. Statistical models can predict water temperatures from air temperatures, and air temperatures may rise by up to 7 °C by 2100. Statistical water temperature models require less data input than physical models, which is particularly useful in data deficient regions. We validated a statistical water temperature model in the lower Olifants River, South Africa, and verified its spatial applicability in the upper Klaserie River. Monthly and daily temporal scale calibrations and validations were conducted. The results show that simulated water temperatures in all cases closely mimicked those of the observed data for both temporal resolutions and across sites (NSE&gt;0.75 for the Olifants River and NSE&gt;0.8 for the Klaserie). Overall, the model performed better at a monthly than a daily scale, while generally underestimating from the observed (indicated by negative percentage bias values). The statistical models can be used to predict water temperature variance using air temperature and this use can have implications for future climate projections and the effects climate change will have on aquatic species. Significance:• Statistical modelling can be used to simulate water temperature variance from observed air temperature, which has implications for future projections and climate change scenarios.• While there are many other factors affecting water temperature, air temperature accounts for up to 95% of water temperature variance.• The model used can successfully simulate water temperature variance for different rivers

A comparison of food portion size estimation by older adults, young adults and nutritionists

Objectives To investigate the ability of older adults, younger adults and nutritionists to assess portion size using traditional methods versus a computer-based method. This was to inform the development of a novel dietary assessment method for older adults “The NANA system”. Design Older and younger adults assessed the portion size of self-served portions of foods from a buffet style set up using traditional and computerised portion size assessment aids. Nutritionists assessed the portion size of foods from digital photographs using computerised portion size aids. These estimates were compared to known weights of foods using univariate analyses of covariance (ANCOVA). Setting The University of Sheffield, United Kingdom. Subjects Forty older adults (aged 65 years and over), 41 younger adults (aged between 18 and 40 years) and 25 nutritionists. Results There was little difference in the abilities of older and younger adults to assess portion size using both assessment aids with the exception of small pieces morphology. Even though the methods were not directly comparable among the test groups, there was less variability in portion size estimates made by the nutritionists. Conclusion Older adults and younger adults are similar in their ability to assess food portion size and demonstrate wide variability of estimation compared to the ability of nutritionists to estimate portion size from photographs. The results suggest that the use of photographs of meals consumed for portion size assessment by a nutritionist may improve the accuracy of dietary assessment. Improved portion size assessment aids are required for all age groups

Glycosylated haemoglobin and prognosis in 10,536 people with cancer and pre-existing diabetes: a meta-analysis with dose-response analysis

AIMS: To assess whether glycaemic control is associated with prognosis in people with cancer and pre-existing diabetes. METHODS: In this pre-registered systematic review (PROSPERO: CRD42020223956), PubMed and Web of Science were searched on 25th Nov 2021 for studies investigating associations between glycosylated haemoglobin (HbA1c) and prognosis in people with diabetes and cancer. Summary relative risks (RRs) and 95% Confidence Intervals (CIs) for associations between poorly controlled HbA1c or per 1-unit HbA1c increment and cancer outcomes were estimated using a random-effects meta-analysis. We also investigated the impact of potential small-study effects using the trim-and-fill method and potential sources of heterogeneity using subgroup analyses. RESULTS: Fifteen eligible observational studies, reporting data on 10,536 patients with cancer and pre-existing diabetes, were included. Random-effects meta-analyses indicated that HbA1c ≥ 7% (53 mmol/mol) was associated with increased risks of: all-cause mortality (14 studies; RR: 1.14 [95% CI: 1.03-1.27]; p-value: 0.012), cancer-specific mortality (5; 1.68 [1.13-2.49]; p-value: 0.011) and cancer recurrence (8; 1.68 [1.18-2.38; p-value: 0.004]), with moderate to high heterogeneity. Dose-response meta-analyses indicated that 1-unit increment of HbA1c (%) was associated with increased risks of all-cause mortality (13 studies; 1.04 [1.01-1.08]; p-value: 0.016) and cancer-specific mortality (4; 1.11 [1.04-1.20]; p-value: 0.003). All RRs were attenuated in trim-and-fill analyses. CONCLUSIONS: Our findings suggested that glycaemic control might be a modifiable risk factor for mortality and cancer recurrence in people with cancer and pre-existing diabetes. High-quality studies with a larger sample size are warranted to confirm these findings due to heterogeneity and potential small-study effects. In the interim, it makes clinical sense to recommend continued optimal glycaemic control

Lesson study: an inter-professional collaboration approach for Educational Psychologists to improve teaching and learning

This is the author accepted manuscript. The final version is available from Taylor & Francis (Routledge) via the DOI in this record.Educational psychologists’ (EP) involvement in collaborative problem solving to support teachers has mainly focussed on social behaviour with leading roles for outside professionals. This paper describes an innovative use of lesson study (LS), an internationally used collaborative approach in which teachers develop their teaching knowledge and practices. This study aimed to evaluate how EPs join teachers in LS teams using working memory and other knowledge to inform the teaching of pupils with learning difficulties. The study uses a case study methodology to evaluate LS teams (3 teachers and EP) in a primary, secondary and special school. The findings show how working memory knowledge is used in reviewing and planning research lessons, how the teams interact, including the perceived EP contribution to the lesson study process. The paper illustrates the potential of an inter-professional LS study to embody collaborative reflective practice to improve the teaching of pupils with learning difficulties

Equivalence problem for the orthogonal webs on the sphere

We solve the equivalence problem for the orthogonally separable webs on the three-sphere under the action of the isometry group. This continues a classical project initiated by Olevsky in which he solved the corresponding canonical forms problem. The solution to the equivalence problem together with the results by Olevsky forms a complete solution to the problem of orthogonal separation of variables to the Hamilton-Jacobi equation defined on the three-sphere via orthogonal separation of variables. It is based on invariant properties of the characteristic Killing two-tensors in addition to properties of the corresponding algebraic curvature tensor and the associated Ricci tensor. The result is illustrated by a non-trivial application to a natural Hamiltonian defined on the three-sphere.Comment: 32 page

Glucose influences endometrial receptivity to embryo implantation through O-GlcNAcylation-mediated regulation of the cytoskeleton

Phenotypic changes to endometrial epithelial cells underpin receptivity to embryo implantation at the onset of pregnancy but the effect of hyperglycaemia on these processes remains poorly understood. Here we show that physiological levels of glucose (5mM) abolished receptivity in the endometrial epithelial cell line, Ishikawa. However, embryo attachment was supported by 17mM glucose as a result of glucose flux through the hexosamine biosynthetic pathway (HBP) and modulation of cell function via protein O-GlcNAcylation. Pharmacological inhibition of HBP or protein O-GlcNAcylation reduced embryo attachment in co-cultures at 17mM glucose. Mass spectrometry analysis of the O-GlcNAcylated proteome in Ishikawa cells revealed that myosin phosphatase target subunit 1 (MYPT1) is more highly O-GlcNAcylated in 17mM glucose, correlating with loss of its target protein, phospho-myosin light chain 2, from apical cell junctions of polarised epithelium. 2D and 3D morphologic analysis demonstrated that the higher glucose level attenuates epithelial polarity through O-GlcNAcylation. Inhibition of RhoA-associated kinase (ROCK) or myosin II led to reduced polarity and enhanced receptivity in cells cultured in 5mM glucose, consistent with data showing that MYPT1 acts downstream of ROCK signalling. These data implicate regulation of endometrial epithelial polarity through RhoA signaling upstream of actomyosin contractility in the acquisition of endometrial receptivity. Glucose levels impinge on this pathway through O-GlcNAcylation of MYPT1, which may impact endometrial receptivity to an implanting embryo in women with diabetes