bluuebunny/crossref_metadata_2025 huggingface dataset:
Coassembly of hypoxia-sensitive macrocyclic amphiphiles and extracellular vesicles for targeted kidney injury imaging and therapy
Authors: Cheng Yuan-Qiu , Yue Yu-Xin , Cao Hong-Mei , Geng Wen-Chao , Wang Lan-Xing , Hu Xin-Yue , Li Hua-Bin , Bian Qiang , Kong Xiang-Lei , Liu Jian-Feng , Kong De-Ling , Guo Dong-Sheng , Wang Yue-Bing
Published: December 2021

Background

Hypoxia is a major contributor to global kidney diseases. Targeting hypoxia is a promising therapeutic option against both acute kidney injury and chronic kidney disease; however, an effective strategy that can achieve simultaneous targeted kidney hypoxia imaging and therapy has yet to be established. Herein, we fabricated a unique nano-sized hypoxia-sensitive coassembly (Pc/C5A@EVs) via molecular recognition and self-assembly, which is composed of the macrocyclic amphiphile C5A, the commercial dye sulfonated aluminum phthalocyanine (Pc) and mesenchymal stem cell-excreted extracellular vesicles (MSC-EVs).

Results

In murine models of unilateral or bilateral ischemia/reperfusion injury, MSC-EVs protected the Pc/C5A complex from immune metabolism, prolonged the circulation time of the complex, and specifically led Pc/C5A to hypoxic kidneys via surface integrin receptor α4β1 and αLβ2, where Pc/C5A released the near-infrared fluorescence of Pc and achieved enhanced hypoxia-sensitive imaging. Meanwhile, the coassembly significantly recovered kidney function by attenuating cell apoptosis, inhibiting the progression of renal fibrosis and reducing tubulointerstitial inflammation. Mechanistically, the Pc/C5A coassembly induced M1-to-M2 macrophage transition by inhibiting the HIF-1α expression in hypoxic renal tubular epithelial cells (TECs) and downstream NF-κB signaling pathway to exert their regenerative effects.

Conclusion

This synergetic nanoscale coassembly with great translational potential provides a novel strategy for precise kidney hypoxia diagnosis and efficient kidney injury treatment. Furthermore, our strategy of coassembling exogenous macrocyclic receptors with endogenous cell-derived membranous structures may offer a functional platform to address multiple clinical needs.

Graphical Abstract
Ankle resistance with a unilateral soft exosuit increases plantarflexor effort during pushoff in unimpaired individuals
Authors: Swaminathan Krithika , Park Sungwoo , Raza Fouzia , Porciuncula Franchino , Lee Sangjun , Nuckols Richard W. , Awad Louis N. , Walsh Conor J.
Published: December 2021

Background

Ankle-targeting resistance training for improving plantarflexion function during walking increases rehabilitation intensity, an important factor for motor recovery after stroke. However, understanding of the effects of resisting plantarflexion during stance on joint kinetics and muscle activity—key outcomes in evaluating its potential value in rehabilitation—remains limited. This initial study uses a unilateral exosuit that resists plantarflexion during mid-late stance in unimpaired individuals to test the hypotheses that when plantarflexion is resisted, individuals would (1) increase plantarflexor ankle torque and muscle activity locally at the resisted ipsilateral ankle, but (2) at higher forces, exhibit a generalized response that also uses the unresisted joints and limb. Further, we expected (3) short-term retention into gait immediately after removal of resistance.

Methods

Ten healthy young adults walked at 1.25 m s−1for four 10-min discrete bouts, each comprising baseline, exposure to active exosuit-applied resistance, and post-active sections. In each bout, a different force magnitude was applied based on individual baseline ankle torques. The peak resistance torque applied by the exosuit was 0.13 ± 0.01, 0.19 ± 0.01, 0.26 ± 0.02, and 0.32 ± 0.02 N m kg−1, in the LOW, MED, HIGH, and MAX bouts, respectively.

Results

(1) Across all bouts, participants increased peak ipsilateral biological ankle torque by 0.13–0.25 N m kg−1(p < 0.001) during exosuit-applied resistance compared to corresponding baselines. Additionally, ipsilateral soleus activity during stance increased by 5.4–11.3% (p < 0.05) in all but the LOW bout. (2) In the HIGH and MAX bouts, vertical ground reaction force decreased on the ipsilateral limb while increasing on the contralateral limb (p < 0.01). Secondary analysis found that the force magnitude that maximized increases in biological ankle torque without significant changes in limb loading varied by subject. (3) Finally, peak ipsilateral plantarflexion angle increased significantly during post-exposure in the intermediate HIGH resistance bout (p < 0.05), which corresponded to the greatest average increase in soleus activity (p > 0.10).

Conclusions

Targeted resistance of ankle plantarflexion during stance by an exosuit consistently increased local ipsilateral plantarflexor effort during active resistance, but force magnitude will be an important parameter to tune for minimizing the involvement of the unresisted joints and limb during training.
A comparative study of R functions for clustered data analysis
Authors: Wang Wei , Harhay Michael O.
Published: December 2021

Background

Clustered or correlated outcome data is common in medical research studies, such as the analysis of national or international disease registries, or cluster-randomized trials, where groups of trial participants, instead of each trial participant, are randomized to interventions. Within-group correlation in studies with clustered data requires the use of specific statistical methods, such as generalized estimating equations and mixed-effects models, to account for this correlation and support unbiased statistical inference.

Methods

We compare different approaches to estimating generalized estimating equations and mixed effects models for a continuous outcome in R through a simulation study and a data example. The methods are implemented through four popular functions of the statistical softwareR, “geese”, “gls”, “lme”, and “lmer”. In the simulation study, we compare the mean squared error of estimating all the model parameters and compare the coverage proportion of the 95% confidence intervals. In the data analysis, we compare estimation of the intervention effect and the intra-class correlation.

Results

In the simulation study, the function “lme” takes the least computation time. There is no difference in the mean squared error of the four functions. The “lmer” function provides better coverage of the fixed effects when the number of clusters is small as 10. The function “gls” produces close to nominal scale confidence intervals of the intra-class correlation. In the data analysis and the “gls” function yields a positive estimate of the intra-class correlation while the “geese” function gives a negative estimate. Neither of the confidence intervals contains the value zero.

Conclusions

The “gls” function efficiently produces an estimate of the intra-class correlation with a confidence interval. When the within-group correlation is as high as 0.5, the confidence interval is not always obtainable.
Evaluation of efficacy and safety of Qiangzhu-qinggan formula as an adjunctive therapy in adult patients with severe influenza: study protocol for a randomized parallel placebo-controlled double-blind multicenter trial
Authors: Qiu Lei , Wu Xian-wei , Zhang Shao-yan , Yang Ming , Zhang Shun-xian , Fu Ji-you , Li Cui , Zhang Zhi-jie , Zheng Pei-yong , Lu Zhen-hui
Published: December 2021

Abstracts

Background

Influenza can fall into three categories according to severity: mild influenza, severe influenza, and critical influenza. Severe influenza can result in critical illness and sometimes death particularly in patients with comorbidities, advanced age, or pregnancy. Neuraminidase inhibitors (NAIs) are the only antiviral drugs in widespread use for influenza. However, the effectiveness of NAIs against severe influenza is uncertain. New effective drugs or regimens are therefore urgently needed. Qiangzhu-qinggan (QZQG) formula has been found to be effective against influenza virus infection during long-term application in China, which lacks support of evidence-based clinical trial till now. This study is designed to assess the efficacy and safety of QZQG formula as an adjuvant therapy in adult patients with severe influenza.

Methods

This protocol is drawn up in accordance with the SPIRIT guidelines and CONSORT Extension for Chinese herbal medicine formulas. This is a randomized, placebo-controlled, double-blind, multicenter trial. Two hundred twenty-eight adults with severe influenza are randomly assigned in a 1:1 ratio to QZQG or placebo for 7 days. All participants need to receive 1 day of screening before randomization, 7 days of intervention, and 21 days of observation after randomization. The primary outcome is the proportion of clinical improvement, defined as the proportion of patients who met the criteria of 3 points or less in the seven-category ordinal scale or 2 points or less in National Early Warning Score 2 within 7 days after randomization.

Discussion

This is the first randomized, controlled, parallel, double-blind clinical trial to evaluate the efficacy and safety of traditional Chinese herbal formula granules as an adjuvant therapy in adult patients with severe influenza. This study aims to redefine the value of traditional Chinese herbal medicines in the treatment of virus-related respiratory infectious diseases and serves as an example of evidence-based clinical trials of other Chinese herbal medicines.
Study protocol of a randomized controlled clinical trial investigating the effects of omega-3 supplementation on endothelial function, vascular structure, and metabolic parameters in adolescents with type 1 diabetes
Authors: Khorshidi Masoud , Sayyari Aliakbar , Olang Beheshteh , Alaei Mohammad Reza , Shab-Bidar Sakineh , Khalili Mitra , Salehi Masoud , Aryaeian Naheed
Published: December 2021

Background

Type 1 diabetes is a main health burden with several related comorbidities. It has been shown that endothelial function, vascular structure, and metabolic parameters are considerably disrupted in patients with type 1 diabetes. Omega-3 as an adjuvant therapy may exert profitable effects on type 1 diabetes and its complications by improving inflammation, oxidative stress, immune responses, and metabolic status. Because no randomized clinical trial has examined the effects of omega-3 consumption in children and adolescents with type 1 diabetes; the present study aims to close this gap.

Methods

This investigation is a randomized clinical trial, in which sixty adolescents with type 1 diabetes will be randomly assigned to receive either omega-3 (600 mg/day) or placebo capsules for 12 weeks. Evaluation of anthropometric parameters, flow-mediated dilation (FMD) as an endothelial function marker, carotid intima-media thickness (CIMT) as a vascular structure marker, proteinuria, biochemical factors including glycemic and lipid profile, blood urea nitrogen (BUN), creatinine, high-sensitivity C-reactive protein (hs-CRP), and erythrocyte sedimentation rate (ESR), as well as blood pressure will be done at the baseline and end of the trial. Also, dietary intake and physical activity will be assessed throughout the study. Statistical analysis will be performed using the SPSS software (Version 24), and P < 0.05 will be considered statistically meaningful.

Discussion

It is hypothesized that omega-3 supplementation may be beneficial for the management of type 1 diabetes and its complications by reducing inflammation and oxidative stress and also modulating immune responses and glucose and lipid metabolism through various mechanisms. The present study aims to investigate any effect of omega-3 on patients with type 1 diabetes.

Ethical aspects

This trial received approval from Medical Ethics Committee of Iran University of Medical Sciences, Tehran, Iran (IR.IUMS.REC.1400.070).

Trial registration

Iranian Registry of Clinical Trials IRCT20210419051010N1. Registered on 29 April 2021
The CombinADO study to assess the impact of a combination intervention strategy on viral suppression, antiretroviral therapy adherence, and retention in HIV care among adolescents and young people living with HIV: protocol for a cluster-randomized controlled trial
Authors: Mogoba Phepo , Lesosky Maia , Zerbe Allison , Falcao Joana , Mellins Claude Ann , Desmond Christopher , Arnaldo Carlos , Kapogiannis Bill , Myer Landon , Abrams Elaine J.
Published: December 2021

Background

Adolescents and youth living with HIV (AYAHIV) have worse HIV outcomes than other age groups, particularly in sub-Saharan Africa (SSA). AYAHIV in SSA face formidable health system, interpersonal- and individual-level barriers to retention in HIV care, uptake of ART, and achievement of viral suppression (VS), underscoring an urgent need for multi-component interventions to address these challenges. This cluster-randomized control trial (cRCT) aims to evaluate the effectiveness and monitor implementation of a community-informed multi-component intervention (“CombinADO strategy”) addressing individual-, facility-, and community-level factors to improve health outcomes for AYAHIV.

Methods

This trial will be conducted in 12 clinics in Nampula Province, Northern Mozambique. All clinics will implement an optimized standard of care (control) including (1) billboards/posters and radio shows, (2) healthcare worker (HCW) training, (3) one-stop adolescent and youth-friendly services, (4) information/motivation walls, (5) pill containers, and (6) tools to be used by HCW during clinical visits. The CombinADO strategy (intervention) will be superadded to control conditions at 6 randomly selected clinics. It will include five additional components: (1) peer support, (2) informational/motivational video, (3) support groups for AYAHIV caregivers, (4) AYAHIV support groups, and (5) mental health screening and linkage to adolescent-focused mental health support. The study conditions will be in place for 12 months; all AYAHIV (ages 10–24 years, on ART) seeking care in the participating sites will be exposed to either the control or intervention condition based on the clinic they attend. The primary outcome is VS (viral load < 50 copies/mL) at 12 months among AYAHIV attending participating clinics. Secondary outcomes include ART adherence (self-reported and TDF levels) and retention in care (engagement in the preceding 90 days). Uptake, feasibility, acceptability, and fidelity of the CombinADO strategy during implementation will be measured. Trial outcomes will be assessed in AYAHIV, caregivers, healthcare workers, and key informants. Statistical analyses will be conducted and reported in line with CONSORT guidelines for cRCTs.

Discussion

The CombinADO study will provide evidence on effectiveness and inform implementation of a novel community-informed multi-component intervention to improve retention, adherence, and VS among AYAHIV. If found effective, results will strengthen the rationale for scale up in SSA.

Trial registration

ClinicalTrials.gov NCT04930367. Registered on 18 June 2021
Maresin conjugates in tissue regeneration-1 suppresses ferroptosis in septic acute kidney injury
Authors: Xiao Ji , Yang Qian , Zhang Ye’an , Xu Haoran , Ye Yang , Li Linchao , Yang Yi , Jin Shengwei
Published: December 2021

Background

Ferroptosis is unique among different types of regulated cell death and closely related to organ injury. Whether ferroptosis occurs in sepsis-associated acute kidney injury (SA-AKI) is not clear. Nuclear factor-erythroid-2-related factor 2 (Nrf2) is crucial to the regulation of ferroptosis. We and others have shown that Maresin conjugates in tissue regeneration 1 (MCTR1) or other members of specialized pro-resolving mediators (SPMs) can actively regulate inflammation resolution and protect organs against injury in inflammatory diseases by activating the Nrf2 signaling. The aim of this study was to determine whether ferroptosis occurs in SA-AKI. Furthermore, we investigated the potential role and mechanism of MCTR1 in the regulation of ferroptosis in SA-AKI, which mainly focus on the Nrf2 signaling.

Results

We demonstrated for the first time that ferroptosis is present in SA-AKI. Moreover, MCTR1 effectively suppressed ferroptosis in SA-AKI. Meanwhile, MCTR1 upregulated the expression of Nrf2 in the kidney of septic mice. Nrf2 inhibitor ML-385 reversed MCTR1-regulated ferroptosis and AKI, implying that Nrf2 is involved in the inhibitory effects of MCTR1 on ferroptosis in SA-AKI. Further, MCTR1 inhibited ferroptosis and elevated the expression of Nrf2 in LPS-induced HK-2 cells. However, Nrf2 siRNA offset the effect of MCTR1 on ferroptosis. Finally, we observed that MCTR1 ameliorates multi-organ injury and improves survival in animal models of sepsis.

Conclusions

These data demonstrate that MCTR1 suppresses ferroptosis in SA-AKI through the Nrf2 signaling. Our study enriches the pathophysiological mechanism of SA-AKI and provides new therapeutic ideas and potential intervention targets for SA-AKI.
What determine the price of Bonga sheep at the market level in Southwestern Ethiopia? A hedonic price analysis
Authors: Tarekegn Kassa
Published: December 2021

Background

Bonga sheep is a mutton type breed with a long-fat-tail and better body weight at maturity. The breed is especially located in the Southwestern mid and highland land areas of Ethiopia. Currently, the breed was well known in Ethiopia and also its price is higher as compared to other sheep breeds in the country. However, empirical evidence is lacking on price determinants of the breed in Ethiopia. Therefore, this research aims at identifying sheep attributes and other factors that determine the market prices of Bonga sheep in Southwestern Ethiopia.

Methodology

Data from 300 traded sheep and sheep marketers were collected from five major sheep marketing centers in the Kaffa zone. A hedonic price model adjusted for heteroscedasticity was employed to analyze the observed price data.

Results

The model result showed that the attributes of the sheep are important guiding criteria in price formulation. Among the attributes age, sex (male), colour (red), body condition (good), tail type (very fat) and absence of horn significantly and positively determine the sheep price. As well, market place (Gojebi and Bonga) near to big cities and season (holiday) and purpose of purchase are also significant determinants of bong sheep price out of the sheep attributes in Southwestern Ethiopia.

Conclusion

Targeting in systematic improvement of the significant attributes which are demanded by the market and establishment of a breeding program to make sheep improvement in a sustainable way. Besides, effort should be geared to transform the system into a market-oriented system using a value chain framework by improving access to market information.
Emergence of distinct and heterogeneous strains of amyloid beta with advanced Alzheimer’s disease pathology in Down syndrome
Authors: Maxwell Alison M. , Yuan Peng , Rivera Brianna M. , Schaaf Wilder , Mladinov Mihovil , Prasher Vee P. , Robinson Andrew C. , DeGrado William F. , Condello Carlo
Published: December 2021

Amyloid beta (Aβ) is thought to play a critical role in the pathogenesis of Alzheimer’s disease (AD). Prion-like Aβ polymorphs, or “strains”, can have varying pathogenicity and may underlie the phenotypic heterogeneity of the disease. In order to develop effective AD therapies, it is critical to identify the strains of Aβ that might arise prior to the onset of clinical symptoms and understand how they may change with progressing disease. Down syndrome (DS), as the most common genetic cause of AD, presents promising opportunities to compare such features between early and advanced AD. In this work, we evaluate the neuropathology and Aβ strain profile in the post-mortem brain tissues of 210 DS, AD, and control individuals. We assayed the levels of various Aβ and tau species and used conformation-sensitive fluorescent probes to detect differences in Aβ strains among individuals and populations. We found that these cohorts have some common but also some distinct strains from one another, with the most heterogeneous populations of Aβ emerging in subjects with high levels of AD pathology. The emergence of distinct strains in DS at these later stages of disease suggests that the confluence of aging, pathology, and other DS-linked factors may favor conditions that generate strains that are unique from sporadic AD.
Mandibular incisor inclination and gingival recession after treatment with the Jasper Jumper: a 10-year follow-up
Authors: Moura Wilana , Henriques José Fernanado C. , Gambardela-Tkacz Caroline M. , Cotrin Paula , Garib Daniela , Janson Guilherme
Published: December 2021

Objective

To evaluate the long-term outcomes of Class II treatment with the Jasper Jumper appliance and comprehensive orthodontic treatment concerning inclination of the mandibular incisors and gingival recession.

Methods

Sixteen patients with Class II malocclusion at a mean age of 12.54y (SD = 1.17) were treated with the Jasper Jumper appliance and comprehensive orthodontic treatment. The mean treatment time was 2.05y (SD = 0.21). Dental records were taken before (T1), after treatment (T2) and 11.90y (SD = 0.48) after debonding (T3). The frequency of gingival recession, clinical crown height and mandibular incisor position were evaluated using intraoral photographs, digital models and lateral cephalograms. Interphase changes were evaluated using dependent t and McNemar’s tests. Correlation between clinical crown height and final position of the mandibular incisors was evaluated using Pearson correlation test (P < 0.05).

Results

The frequency of gingival recessions increased over time and was observed in 6 (9.4%), 12 (18.8%) and 24 (37.5%) of the mandibular incisors at T1, T2 and T3, respectively. A significant increase in labial inclination and protrusion of the mandibular incisors was observed between T1 and T2 interval. The clinical crown height significantly increased in the follow-up period (T3–T2) and in the complete observation time (T3–T1). There was no correlation between the amount of labial inclination and protrusion of the mandibular incisors and clinical crown height for all time intervals.

Conclusion

No significant correlation between the amount of labial movement of the mandibular incisor and clinical crown height increase was found.
National pharmacy associations in the commonwealth: current scenario and future needs to maximise effective contributions of the pharmacy profession towards universal health coverage
Authors: Iqbal Ayesha , Rutter Victoria , Gülpınar Gizem , Halai Manjula , Awele Briella , Elshenawy Rasha Abdelsalam , Anderson Claire , Hussain Rabia , Chan Amy Hai Yan
Published: December 2021

Background

The Commonwealth Pharmacists Association (CPA) is a charity representing pharmacists across the Commonwealth, with the vision of empowering and collaboratively develop the profession and fully utilise the potential of pharmacists to strengthen health systems through supporting better access to, quality and use of medicines and related services. Commonwealth comprises predominantly of low- and middle-income countries, where limited data often exists in pharmacy practice. There is a recognised need across the Commonwealth to focus on developing, implementing and fully utilising pharmacy professional services to progress universal health coverage and achieve the sustainable development goals, particularly in low and middle-income countries; however, currently a knowledge gap exists in understanding the national priorities in Commonwealth nations. CPA is ideally positioned to access to these nations. The aim of this study was thus to explore the priorities and focus areas of NPAs across the Commonwealth and create evidence for a needs-based approach to inform the support that the Commonwealth pharmacists association can collaboratively and strategically provide to its members to progress towards shared goals.

Methods

Data were collected virtually on Zoom by conducting interviews using a semi-structured interview guide developed for this study with CPA councillors representing NPAs or their equivalents if no official body existed. An inductive, reflexive, thematic analysis was performed for data analysis.

Results

In total, 30 councillors were interviewed from 30 low- and medium-income countries. The three main overarching priority areas identified across respective Commonwealth nations developing extended pharmacy services, improving pharmacy education, and developing and redefining the role of NPAs.

Conclusions

This novel study highlights the collective priorities for the pharmacy profession across the low and middle-income countries of the Commonwealth and the urgent need for supporting NPAs around the three identified overarching priority areas. The mapped-out priorities will inform an evidence-based approach for the CPA to better support NPAs in their mission through advocacy and practitioner development, to fully harness pharmacists’ unique skill set and maximise their contribution to progressing universal health coverage.
Dental implants in patients suffering from systemic sclerosis: a retrospective analysis of clinical outcomes in a case series with 24 patients
Authors: Jackowski Jochen , Strietzel Frank Peter , Hunzelmann Nicolas , Parwani Parwana , Jackowski Angelika , Benz Korbinian
Published: December 2021

Purpose

Patients with systemic sclerosis (SSc) often suffer from premature tooth loss. This is a retrospective case series of patients with systemic sclerosis who were treated with dental implants.

Methods

SSc patients treated with at least one dental implant between 5 August 1998 and 31 December 2018 were included in this long-term retrospective study. The primary study variables were the plaque index (PLI), sulcus bleeding index (SBI), peri-implant pocket depth (PPD) and interincisal distance (ID). The test for marginal homogeneity analysed whether the SBI and PLI values changed between examination and follow-up. A linear regression was performed for the PPD measurement. The rank correlation coefficient compared the SBI with the PLI and the PPD with the PLI. The survival rate data for the implants were analysed by the Kaplan–Meier procedure. P < .05 was considered significant.

Results

Twenty-four patients [(age: mean 59.6 years (SD ± 13.08)] received a total of 72 implants. ID resulted in a mean value of 29.54 mm (SD ± 6.4 mm). The mean value of the PPD was between 2.4 mm and 2.8 mm. A comparison of the SBI with the PLI and the PPD with the PLI showed a significantly positive correlation between the SBI and the PLI and between the PPD and the PLI. The correlation between the PPD and the PLI (Spearman rho: 0.36, p < 0.001) was less pronounced than that between the SBI and the PLI (Spearman rho: 0.61, p < 0.001). Kaplan–Meier analysis showed a post-10-year implant survival rate of 87.6% (95%-KI: 75.5–94.0).

Conclusion

Implant-supported oral rehabilitation can be carried out and maintained successfully in SSc patients.
Long-term recovery of upper limb motor function and self-reported health: results from a multicenter observational study 1 year after discharge from rehabilitation
Authors: Ingwersen Thies , Wolf Silke , Birke Gunnar , Schlemm Eckhard , Bartling Christian , Bender Gabriele , Meyer Alfons , Nolte Achim , Ottes Katharina , Pade Oliver , Peller Martin , Steinmetz Jochen , Gerloff Christian , Thomalla Götz
Published: December 2021

Background

Impaired motor functions after stroke are common and negatively affect patients' activities of daily living and quality of life. In particular, hand motor function is essential for daily activities, but often returns slowly and incompletely after stroke. However, few data are available on the long-term dynamics of motor recovery and self-reported health status after stroke. The Interdisciplinary Platform for Rehabilitation Research and Innovative Care of Stroke Patients (IMPROVE) project aims to address this knowledge gap by studying the clinical course of recovery after inpatient rehabilitation.

Methods

In this prospective observational longitudinal multicenter study, patients were included towards the end of inpatient rehabilitation after ischemic or hemorrhagic stroke. Follow-up examination was performed at three, six, and twelve months after enrollment. Motor function was assessed by the Upper Extremity Fugl-Meyer Assessment (FMA), grip and pinch strength, and the nine-hole peg test. In addition, Patient-Reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10) was included. Linear mixed effect models were fitted to analyze change over time. To study determinants of hand motor function, patients with impaired hand function at baseline were grouped into improvers and non-improvers according to hand motor function after twelve months.

Results

A total of 176 patients were included in the analysis. Improvement in all motor function scores and PROMIS-10 was shown up to 1 year after inpatient rehabilitation. FMA scores improved by an estimate of 5.0 (3.7–6.4) points per year. In addition, patient-reported outcome measures increased by 2.5 (1.4–3.6) and 2.4 (1.4–3.4) per year in the physical and mental domain of PROMIS-10. In the subgroup analysis non-improvers showed to be more often female (15% vs. 55%,p = 0.0155) and scored lower in the Montreal Cognitive Assessment (25 [23–27] vs. 22 [20.5–24],p = 0.0252).

Conclusions

Continuous improvement in motor function and self-reported health status is observed up to 1 year after inpatient stroke rehabilitation. Demographic and clinical parameters associated with these improvements need further investigation. These results may contribute to the further development of the post-inpatient phase of stroke rehabilitation.

Trial registration: The trial is registered at ClinicalTrials.gov (NCT04119479).
Disease awareness and dietary habits of patients with epilepsy in western China: a cross-sectional study
Authors: Zhang Qi , Li Wenjing , Li Enzhi , Yang Xiao , Hao Nanya , Yan Bo , Zhou Dong , Hao Xiaoting
Published: December 2021

Background

The optimal management of epilepsy includes engaging patients through education on knowledge of the disease, its treatment and diet control.

Methods

This was a cross-sectional survey-based cohort study, aimed to investigate the awareness of epilepsy in Chinese patients and to understand their dietary habits. Participants were consecutively enrolled from epileptic patients treated in a single epilepsy center from October 1, 2019 to February 29, 2020. A self-reported questionnaire (Cronbach’s α = 0.758) consisting of 3 parts was sent to 407 patients with epilepsy. The questionnaire included items on demographic information, epilepsy features, awareness of epilepsy treatment and dietary habits.

Results

About half of the patients (53.8%, 219/407) thought epilepsy was curable and only 80% knew that the first choice of treatment is medication. While 58.6% of the patients with low educational level preferred the use of antiepileptic drugs (p = 0.014), 52.7% believed that the medication should not be stopped immediately after seizure control (p = 0.026), especially after surgery (40.5%, p = 0.011). Patients with lower household monthly incomes had less awareness of the use of antiepileptic drugs than patients with higher incomes: only 39.2 and 49.8% of patients with lower incomes thought that the drugs could be stopped after epilepsy surgery or seizure control, respectively, compared to 51.6 and 66.1% with higher incomes. Alcohol (86.2%), caffeine (56.8%) and strong tea (49.1%) were top three foods considered by the patients to be avoided to prevent seizures. Approximately 30.2% of patients identified at least one food that made them susceptible to seizures.

Conclusions

Patient education on epilepsy, antiepileptic drugs and diet for management of seizures should be provided especially to patients with less education, lower income or inaccurate beliefs of epilepsy in Western China.
Equivariant filtering framework for inertial-integrated navigation
Authors: Luo Yarong , Guo Chi , Liu Jingnan
Published: December 2021

This paper proposes an Equivariant Filtering (EqF) framework for the inertial-integrated state estimation. As the kinematic system of the inertial-integrated navigation can be naturally modeled on the matrix Lie group SE2(3), the symmetry of the Lie group can be exploited to design an equivariant filter which extends the invariant extended Kalman filtering on the group-affine system and overcomes the inconsitency issue of the traditional extend Kalman filter. We firstly formulate the inertial-integrated dynamics as the group-affine systems. Then, we prove the left equivariant properties of the inertial-integrated dynamics. Finally, we design an equivariant filtering framework on the earth-centered earth-fixed frame and the local geodetic navigation frame. The experiments show the superiority of the proposed filters when confronting large misalignment angles in Global Navigation Satellite Navigation (GNSS)/Inertial Navigation System (INS) loosely integrated navigation experiments.
The GnRH Antagonist Degarelix Suppresses Gonadotropin Secretion and Pituitary Sensitivity in Midgestation Sheep Fetuses
Authors: Amodei Rebecka , Jonker Sonnet S , Whitler William , Estill Charles T , Roselli Charles E
Published: December 2021

The specific role of gonadotropin-releasing hormone (GnRH) on brain sexual differentiation remains unclear. To investigate whether gonadotropin and, in turn, testosterone (T) secretion is regulated by GnRH during the critical period for brain differentiation in sheep fetuses, we attempted to selectively suppress pituitary-testicular activation during midgestation with the long-acting GnRH antagonist degarelix. Fetuses received subcutaneous injections of the antagonist or vehicle on day 62 of gestation. After 2 to 3 weeks we examined consequences of the intervention on baseline and GnRH-stimulated plasma luteinizing hormone (LH) and T levels. In addition, we measured the effect of degarelix-treatment on messenger RNA (mRNA) expression for the pituitary gonadotropins and key gonadal steroidogenic enzymes. Baseline and GnRH-stimulated plasma LH levels were significantly suppressed in degarelix-treated male and female fetuses compared to control values. Similarly, T concentrations were suppressed in degarelix-treated males. The percentage of LHβ-immunoreactive cells colocalizing c-fos was significantly reduced by degarelix treatment indicating that pituitary sensitivity was inhibited. Degarelix treatment also led to the significant suppression of mRNA expression coding for the pituitary gonadotropin subunits and for the gonadal enzymes involved in androgen synthesis. These findings demonstrate that pharmacologic inhibition of GnRH early in gestation results in suppression of LH secretion and deficits in the plasma T levels of male lamb fetuses. We conclude that GnRH signaling plays a pivotal role for regulating T exposure during the critical period of sheep gestation when the brain is masculinized. Thus, disturbance to gonadotropin secretion during this phase of gestation could have long-term consequence on adult sexual behaviors and fertility.
Deviations from the covered interest parity: The role of fundamentals, financial and political turmoil, and market frictions
Authors: Marçal Emerson Fernandes , Costa Marisa Gomes da
Published: December 2021

Recent studies of mature markets on covered interest parity suggest that deviations are mean-reverting, but persistent, particularly after the 2008 crisis (Du et al., 2018). Our study contributes to the literature by modeling the deviations from covered interest rate parity (CIP) of an important emerging-market economy. We focus on Brazilian data, given the importance of its derivative market. One of the strengths of our study is the use of an agnostic approach, based on an automatic model-selection technique that is robust to structural change, the Autometrics algorithm (Hendry and Doornik, 2014), to unveil the possible determinants of CIP deviations from a wide information data set. We show that CIP deviations are highly sensitive to changes in Brazilian federal government total debt, level of reserves, inflation, and degree of trade openness. We also document the existence of instability in the model due to financial and political turmoil. We reach these conclusions based on the algorithm’s intercept correction, which can be seen as a byproduct of our methodology. Finally, we find evidence that, even after correction for fundamentals and instability points, CIP deviations still have persistence, suggesting that market frictions play an important role in the dynamics of CIP deviations.
Redução de risco no crédito com duplicatas
Authors: Bonelli Matheus Fortes , Schiozer Rafael Felipe , De Vasconcelos Lucas Nogueira Cabral
Published: December 2021

Esse estudo investiga o risco de crédito com duplicatas no Brasil. Usamos dados proprietários de uma central de registros de recebíveis que permitem a consulta de informações sobre o documento fiscal das transações comerciais junto às Secretarias de Fazenda estaduais. Analisamos 129 mil notas fiscais eletrônicas (NF-e) de 3.459 empresas, que realizaram operações com 240 agentes financeiros, no valor total de R$633 milhões. Usamos 10 tipos de eventos relativos às NF-e, seu valor e prazo de envio ao agente financeiro para identificar determinantes do posterior cancelamento dessas NF-e. Os resultados sugerem que essas variáveis estão associadas à probabilidade de cancelamento da NF-e e, portanto, à qualidade do recebível como colateral. Esses indicadores podem ser integrados aos processos de concessão de crédito dos agentes financeiros como forma de avaliar o risco der crédito, reduzir a necessidade de garantias adicionais, aumentar o volume de crédito ofertado e permitir a melhor precificação dos empréstimos.
Análise epidemiológica e avaliação dos gastos/efetividade nas internações por tétano no Brasil
Authors: Martins Marcos Vinicius Teixeira , Mendes Gabriel Junes , Soares Layanne Cintra , Silva Andressa Ribeiro Lopes da , Oliveira Stefan Vilges de
Published: December 2021

Objetivo: descrever o perfil epidemiológico do tétano acidental no Brasil e analisar a efetividade dos custos das internações associadas à doença. Metodologia: estudo descritivo e quantitativo sobre as internações decorrentes do tétano acidental no País, de 2008 a 2019, com dados do Sistema de Informações Hospitalares do Departamento de Informática do SUS (SIH/DATASUS). Resultados: foram registrados 2334 internações e 464 óbitos, com um valor médio de R$ 5.431,14 gastos por paciente internado. As idades entre 40 e 69 anos foram as mais acometidas (57,55%), com uma tendência de aumento da permanência hospitalar, taxa de mortalidade e valores investidos com o aumento da idade. Homens representaram 80,37% das internações, e as etnias parda (54,62%) e branca (39,89%) foram as mais afetadas. As regiões Nordeste (35,51%) e Norte (21,55%) apresentaram as maiores taxas de internações e mortalidade, respectivamente. Entre os estados, Minas Gerais (11,39%) e Rio Grande do Sul (9,94%) registraram mais internações, e Alagoas (43,10%) e Sergipe (37,93%), as maiores taxas de mortalidade. Além disso, constataram-se diferenças significativas nas participações (69,06% e 30,94%) e taxas de mortalidade (19,16% e 27,02%) dos setores público e privado, respectivamente. Conclusão: os dados levantados neste estudo favorecem a atuação preventiva contra o tétano acidental no País, pois ampliam o conhecimento de seu padrão epidemiológico. Por fim, deixam clara a importância das campanhas de vacinação para reduzir a incidência e os gastos com internações.
To Assess the Activities of Self-Regulatory Organizations of Auditors
Authors: Guttsayt E. , Mar'yasin Anton
Published: December 2021

In the article, from the standpoint of economic theory, the construction of partial and integral assessments of the activity of the SROA is considered through the assessment of the quality of this activity (and not its effectiveness or efficiency). The expediency of using the method of point estimates and its specific application in the construction of these estimates is shown - both from the standpoint of the national economic approach and from the standpoint of the SROA itself. A table of 18 main activities of the SROA is compiled, based mainly on legislative acts. A number of organizational aspects of the evaluation of the SROA activity are analyzed.
Role and Features of External and Internal Audit in Universities
Authors: Anohova E.
Published: December 2021

The article substantiates the feasibility of auditing at universities, examines the main diff erences between the goals, objectives, features of external and internal audit in universities and its impact on the effi ciency of fi nancial and economic activities. New in the article is the identifi cation of the peculiarities of external and internal audit in higher educational institutions, the formulation of the concept of «internal audit at the university», the defi nition of tasks that can be set for internal audit as well as consideration of options for the formation of a subordination scheme of the internal audit unit at the university to ensure maximum the possible level of independence. The results of this study are of theoretical and practical importance for the management of the university, which forms the development strategy and is responsible for the eff ectiveness of the functioning of the university.
Continuous Course of Information Security at School in the System of Forming Digital Skills of the XXI Century
Authors: Tsvetkova Marina
Published: December 2021

The normative and methodological support of a continuous course on information security is considered on the basis of an approximate program of the training course and textbooks "Information Security" from the Federal list of textbooks at the levels of general education.
Analytical Review of Research in the Framework of the Scientifi c School of Existential Approaches in Pedagogy M.I. Rozhkova
Authors: Ivanova Irina
Published: December 2021

Based on the study of publication activity in the Journal of Pedagogical Research, trends in the development of modern domestic pedagogical science are analyzed in the framework of the implementation of theoretical, methodological and practice-oriented ideas developed in the scientific school of existential approaches in pedagogy under the guidance of Doctor of Pedagogy, Professor Mikhail Iosifovich Rozhkov. It is shown that in modern socio-cultural conditions, the implementation of educational practices based on ideas that embody the meanings of the existential strategy of educating a free personality is especially relevant. Our research has shown that the leading trends in the development of domestic education at the present stage, embodying the ideas of existential approaches in pedagogy, are: the use of subject-oriented technologies in the educational process, the organization of a personality-developing educational environment at school, pedagogical support for the self-development of children and adolescents in conditions additional education, the specificity of the forms of training teachers for the implementation of pedagogical support for self-development and self-realization of students in conditions of additional education, stimulating self-development and self-realization of students in a value-oriented educational environment. The study was carried out with the financial support of the Russian Foundation for Basic Research within the framework of scientific project No. 20-013-00616.
High diversity of bees detected in guarana crop and natural habitat due to the use of combined sampling methods
Authors: Krug Cristiane , Hipólito Juliana , Schoeninger Karine , Montefusco Matheus , Gomes Flávia Batista , Luiz de Oliveira Marcio , Mahlmann Thiago
Published: December 2021

Bees are the main pollinators of native and agricultural plants. Identifying and knowing these insects responsible for the environmental service of pollination is essential for the maintenance and management of pollination in agricultural systems, especially in a high diversity biome as the Amazon rainforest. Some crops in this region are dependent of benefited by wild pollinators, especially native plants like guarana. To address methodological aspects of monitoring bee diversity, samplings were carried out in an agricultural environment (guarana crop, Paullinia cupana) surrounded by Amazon natural habitat at Manaus, Amazonas State. We used three combined methods (two passive traps: Malaise and yellow pan-traps, and one active: hand nets) in different periods, with the same number of samplings (12 each). In total, 4,143 native bees belonging to 171 species were sampled; 117 species (1,926 individuals) were collected with Malaise trap, 15 (91 individuals) with pan-traps, and 114 (2,126 individuals) through active sampling. Only seven species were common to all methods, 60 species on two methods and 104 species were unique to one sampling method (50 with Malaise, two with pan-traps, and 52 with hand nets). We reinforce the need for complementary sampling to known bee diversity as the best strategy here was the joint use of active samples and Malaise traps. Recently the concern with Amazon preservation has aroused worldwide interest, a fact that shreds of evidence the need for studies of biodiversity and taxonomy in several areas, since very little is known of this vast region.
The Expert Perception on Development and Usability of Teaching Aids ‘Kit’ Mini Model (Cage System) for Aquaculture Course
Authors: Harun Hafizi , Ismail Zalina , Abdul Mutalib Asilah , Ab Latif Zahidah , Che Man Shaibatul Islamiah
Published: December 2021

The increasing technology as changed the learning methods nowadays which clearly presents a new challenge to educators. Moreover, following the COVID-19 pandemic that hit the world at this time completely inhibits the teaching and learning process to be done entirely online. This clearly presents difficulties to teachers and students, as there are subjects that require practice to improve skills and better understanding. Among the limited access for teachers during the online learning and teaching process is that teachers can only explain and display pictures and show videos. At the same time, students need skills and understanding related to a subject studied. Also, students may not be able to accurately identify the types of systems found in the subjects studied. For example, for aquaculture subjects, the process of online teaching and learning can actually be done. However, this subject also requires practical and field work for students. In aquaculture subjects, in particular, teaching aids play an important role in understanding the cage farming system concept in the teaching process because there are various farming systems used in the aquaculture industry. The development of teaching aid is a crucial phase to make sure the teaching aids develop in accordance with the objectives and topics learning. Therefore, it is important to have an expert perception of the development and usability of the Teaching Aids kit mini model (Cage system). This study consisted of 9 experts as an evaluator consisting of experienced lecturers in the technical field of Faculty Technical. This study uses a quantitative assessment method (questionnaire).Â Â A set of questionnaires was distributed to the experts to obtain the required information and data. All data obtained were analyzed using computer software' Statistical Package For Social Science SPSS version 24 to obtain the frequency, percentage and mean through descriptive statistic. The study's findings show that the level of experts' perception ofÂ â€œTeaching Aids kit mini model (Cage system) development and usability is necessary and positive. The study's conclusion illustrates the need for the development of a teaching aids kit mini model (cage system) for teachers to increase the level of understanding and skills of individual students in the teaching and learning process for aquaculture subjects.