bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing gastric and esophageal ESD surgery: a study protocol for a prospective randomized controlled trial
Authors: Chang Xin-Lu , Liu Xu-Ming , An Li-Xin , Zheng Jian-Yong , Zhang Ke
Published: July 2023

Background

Post-operative pain of endoscopic submucosal dissection (ESD) is always be overlooked and undertreated by endoscopists. However, the incidence of moderate to severe pain after ESD is as high as 44.9% to 62.8%, which can greatly affect the patient’s recovery, reduce their satisfaction, and extend their hospital stay. Transcutaneous electrical acupoint stimulation (TEAS) have been shown to reduce postoperative pain and enhance gastrointestinal (GI) function recovery in patients undergoing abdomen surgery. However, there is no evidence regarding on the effect of TEAS on post-operative pain and complications in patients undergoing ESD. Therefore, we aim to investigate whether perioperative TEAS treatment is superior to the sham acupuncture in terms of post-ESD pain and GI function recovery.

Methods

This study is a prospective, randomized controlled trail, which is single-blinded and in single center. A total of 120 patients undergoing elective gastric and esophageal ESD surgery in Beijing Friendship Hospital, Capital Medical University, will be involved in this study. These individuals will be stratified according to the type of ESD surgery (i.e. gastric or esophageal procedure) and be randomly divided into two groups. L14, PC6, ST36 and ST37 will be stimulated at the TEAS treatment group, and the control group will receive simulation at four sham acupoints. The primary outcome is post-EDS VAS score at the time of entering PACU, 10 min, 20 min, 30 min, 1 h, 2 h, 4 h, 6 h, 18 h, 24 h, 48 h after the surgery. The secondary outcomes include the anesthesia-associated parameters, sedation score, nausea and vomiting score, shivering score, recovery of gastrointestinal function, satisfaction of patients to anesthesia, incidence of postoperative complications, QLQ-C30 life quality scale, and the economic indicators.

Discussion

The results of this study will confirm that continuous preventive application of TEAS can alleviate the postoperative pain among patients with gastric and esophageal ESD surgery and accelerate the recovery of post-ESD gastrointestinal function.

Trial registration

Chinese Clinical Trial Registry, ID: ChiCTR2100052837, registered on November 6, 2021. http://www.chictr.org.cn/showproj.aspx?proj=135892.
Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapy in Multiple Myeloma: Moving Into the Future
Authors: Holstein Sarah A. , Grant Shakira J. , Wildes Tanya M.
Published: July 2023

Great hope for the future: CAR T-cell and bispecific antibody therapies in multiple myeloma.
Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline Rapid Recommendation Update
Authors: Singh Navneet , Daly Megan E. , Ismaila Nofisat ,   for the Management of Stage III NSCLC Guideline Expert Panel, Daly Megan E. , Singh Navneet , Antonoff Mara B. , Arenberg Douglas A. , Bradley Jeffrey , David Elizabeth , Detterbeck Frank , Früh Martin , Gubens Matthew A. , Moore Amy C. , Padda Sukhmani K. , Patel Jyoti D. , Phillips Tanyanika , Qin Angel , Robinson Clifford , Simone Charles B.
Published: July 2023

ASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. See the Appendix for disclaimers and other important information ( Appendix 1 and Appendix 2 , online only).
Supramolecular–Polymer Composite Hydrogels: From In Situ Network Observation to Functional Properties
Authors: Kubota Ryou
Published: July 2023

Living cells and organisms are composed of numerous biomolecules and control their concentrations and spatial distribution in a spatiotemporal manner to exhibit intricate biological functions. Inspired by the extracellular matrix, synthetic multi-network hydrogels have attracted attention due to their remarkable properties like extremely high toughness. This account summarizes our research progress on one emerging class of the multi-network hydrogels, supramolecular–polymer composite hydrogel. Composite hydrogels can rationally integrate stimulus response of supramolecular gels and stiffness of polymer gels. Super-resolution microscopy visualizes four types of network patterns at the µm scale: an orthogonal and three interactive networks, which may influence the viscoelastic properties of composite hydrogels. We found a kind of composite hydrogel that shows autonomous network remodeling, enabling fracture-induced 3D gel patterning. Furthermore, we demonstrated that supramolecular–polymer composite hydrogels are applicable as a matrix for controlled release of protein biopharmaceuticals in response to antibodies through incorporation of functional molecules such as enzymes and their inhibitors. Supramolecular–polymer composite hydrogels hold promise as the next-generation smart and responsive soft materials for biomedical applications, including tissue engineering and regenerative medicine.
Breakthrough COVID-19 infections – Analyzing our experience
Authors: Hussain Aneela , Sarfaraz Samreen , Anis Sabiha , Shaikh Quratulain , Rahim Anum , Behram Shameem , Shah Rabeea , Khan Owais
Published: July 2023

Objective: There are many cases of post-vaccination COVID-19 globally. Also, literature on serum antibodies after vaccination is abundant. Our research focuses on breakthrough infections reported at our institution during the third wave of COVID-19.

Methods: A total of 177 people recruited at the Indus Hospital Karachi between May to September 2021 with COVID-19 infection were divided into vaccinated, partially vaccinated, and unvaccinated cohorts. Furthermore, a subset of the vaccinated cohort was tested for anti-NP and anti-S antibodies.

Results: There were 119 patients with breakthrough infection, however, 74% had mild symptoms. The antibodies against NP and S were found at a higher level in those who had a breakthrough infection in comparison to healthy vaccinated controls.

Conclusion: Vaccination does not prevent disease but does confer some immunity causing less severe infection.

doi: https://doi.org/10.12669/pjms.39.5.6724

How to cite this: Hussain A, Sarfaraz S, Anis S, Sheikh Q, Rahim A, Behram S, et al. Breakthrough COVID-19 infections – Analyzing our experience. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.6724

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η ενσυνείδητη ηγεσία στο χώρο της υγείας
Authors: Νταφοπούλου Χρυσάνθη
Published: July 2023

Εισαγωγή: H αποτελεσματική ηγεσία μπορεί να συμβάλει στην καλύτερη διαχείριση του ανθρώπινου δυναμικού έτσι ώστε να εξασφαλιστεί η καλύτερη δυνατή παροχή υπηρεσιών υγείας στους ασθενείς. Η εφαρμογή της ενσυνειδητότητας σε επίπεδο διοίκησης οργανισμών νοσοκομείων, συμβάλει στην αποτελεσματική ηγεσία καθώς, έχει ευεργετικά αποτελέσματα στην αντιμετώπιση πολύπλοκων καταστάσεων από ηγέτες και εργαζομένους, γεγονός που οδηγεί στη μείωση των λαθών, στην αύξηση της αποδοτικότητας και στην ευημερία του αντίστοιχου οργανισμού.Σκοπός: Η διερεύνηση του κυρίαρχου στυλ ηγεσίας και του επιπέδου της ενσυνειδητότητας στα υψηλόβαθμα στελέχη των στρατιωτικών νοσοκομείων της Ελλάδας. Επιπρόσθετοι στόχοι είναι η διερεύνηση συσχέτισης της ενσυνειδητότητας με το στυλ ηγεσίας και την έκβαση ηγεσίας, καθώς και την επίδραση των δημογραφικών χαρακτηριστικών.Μεθοδολογία: Η παρούσα μελέτη είναι πολυκεντρική, ποσοτική, συγχρονική, περιγραφική και συσχέτισης, στην οποία χρησιμοποιήθηκαν κλίμακες μέτρησης για τη συλλογή δεδομένων και πολλαπλές μέθοδοι ανάλυσης δεδομένων. Για τη διερεύνηση του στυλ ηγεσίας χρησιμοποιήθηκε η κλίμακα μέτρησης Multifactor Leadership Questionnaire (MLQ) και για τη μέτρηση της ενσυνειδητότητας το Mindful Attention Awareness Scale (MAAS). Το δείγμα αποτέλεσαν στελέχη που βρίσκονται σε ηγετικές θέσεις (διοικητή, αναπληρωτή διοικητή, διευθυντή, υποδιευθυντή, τομεάρχη) του ιατρικού, νοσηλευτικού και διοικητικού προσωπικού των στρατιωτικών νοσοκομείων. Η στατιστική ανάλυση των δεδομένων έγινε με το στατιστικό πακέτο SPSS vr 26.00. Αποτελέσματα: Συμμετείχαν 381 άτομα (ποσοστό ανταπόκρισης 83,1%). Η μέση ηλικία των συμμετεχόντων ήταν τα 44 έτη. Η πλειοψηφία των συμμετεχόντων ήταν γυναίκες (56%), έγγαμοι (70%) και απόφοιτοι ανώτερης εκπαίδευσης (46%). Ο μέσος χρόνος προϋπηρεσίας τους ήταν τα 15 έτη και ο μέσος χρόνος προϋπηρεσίας στην παρούσα τους θέση τα 4 έτη. Από τα αποτελέσματα προκύπτουν ότι τα κυρίαρχα στυλ ηγεσίας είναι το μετασχηματιστικό και το συναλλακτικό. Παρατηρήθηκε θετική συσχέτιση μεταξύ του μετασχηματιστικού και του συναλλακτικού στυλ ηγεσίας με την έκβαση ηγεσίας. Η ενσυνειδητότητα συσχετίστηκε χαμηλά προς μέτρια θετικά με όλες τις υποκλίμακες του ΜLQ, εκτός από τις υποκλίμακες της παθητικής ηγεσίας που συσχετίστηκαν χαμηλά προς μέτρια αρνητικά. Επίσης, οι συμμετέχοντες εμφανίζουν υψηλό ποσοστό ενσυνειδητότητας με τις γυναίκες, το ιατρικό και διοικητικό προσωπικό να εμφανίζουν το υψηλότερο. Οι παράγοντες φύλο, επαγγελματική κατηγορία, ηλικία και προϋπηρεσία στο νοσοκομείο επηρεάζουν σημαντικά την ενσυνειδητότητα. Συμπεράσματα: Τα αποτελέσματα της μελέτης συμβάλλουν στην ανάπτυξη της γνώσης σχετικά με την ενσυνείδητη ηγεσία και μπορούν να χρησιμοποιηθούν ως βάση για την ανάπτυξη κατευθυντήριων γραμμών ή τη δημιουργία προγραμμάτων ενσυνείδητης ηγεσίας, προσαρμοσμένα στις ανάγκες των στρατιωτικών νοσοκομείων. Χρήσιμες πληροφορίες προσφέρονται για την αποτελεσματική άσκηση ηγεσίας και διοίκησης των νοσοκομείων, εμπλουτίζοντας την περιορισμένη ελληνική και παγκόσμια βιβλιογραφία γύρω από τις συγκεκριμένες έννοιες.
Dispelling the Digital Enchantment: how can we move beyond its destructive influence and reclaim our right to an open future?
Authors: Yeung Karen
Published: July 2023

This paper outlines the content and contours of a fictional tale called the ‘Digital Enchantment’, based on the author’s observations and experience of high-level policy discussions concerning digital policy and regulation as an academic lawyer with expertise in the governance of emerging technology. Peddled primarily by technology industry representatives, the Digital Enchantment captured the imagination of many contemporary policy-makers from the early to mid-1990s onwards as the early internet emerged. It celebrates the remarkable powers of digital innovation, capable of solving intractable social problems with an accompanying moral message exhorting its audience to recognize the importance of leaving the market free and unfettered, enabling innovation to flourish freely. The Digital Enchantment rests on three core tenets: (1) digital solutionism, (2) the absence of ill-effects doctrine and (3) the extraordinary value of unfettered innovation. This paper outlines and critically evaluates each tenet, demonstrating that they are based on alluring simplifications and half-truths that purport to offer reassurance in the face of our growing unease and anxiety about the kind of future that the digital revolution might portend, while providing clear guideposts to policy-makers to refrain from legal intervention. It argues that we must work towards permanently dispelling the hold which Digital Enchantment still exerts over the mind of many policy-makers in favour of a richer, deeper and more clear-eyed, evidence-based understanding of the power and perils posed by digital innovation and its relationship to law, regulation and society in our networked digital age.
Untrue Reports: Colonial Promotional Literature, Factional Rhetoric, and the Dissolution of the Virginia Company of London
Authors: Mohlmann Nicholas K.
Published: July 2023

abstract: This article examines the use of promotional rhetoric in the factional texts that record the dissolution of the Virginia Company of London in order to demonstrate that the individual forms and tropes of colonial promotional literature carried political connotations and effects beyond the general political nature of promotional literature as a whole. Through close analysis of the differences of the forms and rhetorical figures used by different Virginia Company factions, this article recovers how particular promotional tropes draw connections between commercial and colonial practices and contemporary arguments over political authority in order to support different approaches to organization. Ultimately, the article argues that close formal and rhetorical attention to colonial promotional texts is necessary if we are to fully understand their ideological effects.
Gene signature discovery and systematic validation across diverse clinical cohorts for TB prognosis and response to treatment
Authors: Vargas Roger , Abbott Liam , Bower Daniel , Frahm Nicole , Shaffer Mike , Yu Wen-Han
Published: July 2023

While blood gene signatures have shown promise in tuberculosis (TB) diagnosis and treatment monitoring, most signatures derived from a single cohort may be insufficient to capture TB heterogeneity in populations and individuals. Here we report a new generalized approach combining a network-based meta-analysis with machine-learning modeling to leverage the power of heterogeneity among studies. The transcriptome datasets from 57 studies (37 TB and 20 viral infections) across demographics and TB disease states were used for gene signature discovery and model training and validation. The network-based meta-analysis identified a common 45-gene signature specific to active TB disease across studies. Two optimized random forest regression models, using the full or partial 45-gene signature, were then established to model the continuum from Mycobacterium tuberculosis infection to disease and treatment response. In model validation, using pooled multi-cohort datasets to mimic the real-world setting, the model provides robust predictive performance for incipient to active TB risk over a 2.5-year period with an AUROC of 0.85, 74.2% sensitivity, and 78.3% specificity, which approximates the minimum criteria (>75% sensitivity and >75% specificity) within the WHO target product profile for prediction of progression to TB. Moreover, the model strongly discriminates active TB from viral infection (AUROC 0.93, 95% CI 0.91–0.94). For treatment monitoring, the TB scores generated by the model statistically correlate with treatment responses over time and were predictive, even before treatment initiation, of standard treatment clinical outcomes. We demonstrate an end-to-end gene signature model development scheme that considers heterogeneity for TB risk estimation and treatment monitoring.
Congenital hypothyroidism in Bogotá, Colombia: a current description (2015–2021)
Authors: Pineda-Sanabria Pablo , Portilla-Rojas Esteban , León-Sanabria María Camila , Beltrán-Barriga Daniela-Sofía , Salazar-Reviakina Alexander , Urueña Serrano Ana María , Sarmiento Karen , Zarante Ignacio
Published: July 2023

Objectives

Congenital hypothyroidism (CH) is a decrease in thyroid hormone function in newborns, being one of the leading causes of neurological deficits and long-term metabolic complications. This study aims to determine the prevalence and characteristics of CH cases in Bogotá, Colombia, between 2015 and 2021, as notified through the mandatory report to the Public Health Surveillance System (PHSS).

Methods

A retrospective cross-sectional study was conducted. All live births (LB) with a weight ≥500 g, diagnosed with CH with or without goiter (ICD-10 codes E030 and E031, respectively) in Bogotá during 2015–2021 were analyzed.

Results

For a total of 201 cases, the prevalence rate was 3.29 cases per 10,000 LB. 92.54 % were classified as isolated cases of CH, 4.48 % syndromic, and 2.98 % polymalformated. A total of 16.92 % was small for gestational age. The mean gestational age was 37.38 weeks (SD 2.76), 26.87 % were preterm births. Among the mothers, 8.96 % suffered from pregnancy-related or chronic diseases, the most common being hypertensive disorders of pregnancy and pre-existant hypothyroidism (without clarity concerning etiology). A total of 66.67 % of cases did not receive treatment after diagnosis. Treatment was established by an average age of 27 days after birth (SD 36.02) and 17 days after case notification to the PHSS (SD 36.13).

Conclusions

Observed prevalence is similar to the rate reported by health authorities in Colombia but inferior to reports from high-income countries, highlighting the importance of improvements in the Colombian LB’s screening program. Time to diagnosis and treatment was observed to be prolonged, suggesting that new pathways are required for timely CH treatment.
Siria: el largo camino hacia la revolución
Authors: Ruiz de Elvira Laura
Published: July 2023

El invierno del año 2011 ha sido testigo del inicio de diversas revoluciones, revueltas y protestas de gran magnitud en numerosos países árabes. En este contexto de revuelta generalizada, Siria parecía emerger en un primer momento como la gran excepción regional. En efecto, a diferencia de lo acaecido en el resto de países árabes, hasta mediados del mes de Marzo los vientos de revuelta no soplarían con suficiente fuerza en este país. En este marco, el objetivo que motiva este breve artículo es el de entender por qué el pueblo sirio ha tardado casi tres meses en movilizarse contra su régimen y por qué, finalmente, se ha rebelado.                                                                                                              AbstractThe winter of the year 2011 has witnessed the beginning of several revolutions, revolts and protests of great importance in many Arab countries. In this context of widespread revolt, Syria seemed to appear in the first moment as the main regional exception. Actually, in contrast with what was happening in the rest of the Arab countries, Syria wouldn’t be affected by the revolutionary winds until the middle of March. In this framework, the aim of this article is to understand why the Syrian people have taken almost three months to mobilize against the baathist regime and why they have finally revolted.
Feedstock pretreatment strategies for producing ethanol from wood, bark, and forest residues
Authors: Hu Gang , Heitmann John A. , Rojas Orlando J.
Published: July 2023

Energy and environmental issues are among the major concerns facing the global community today. Transportation fuel represents a large proportion of energy consumption, not only in the US, but also world-wide. As fossil fuel is being depleted, new substitutes are needed to provide energy. Ethanol, which has been produced mainly from the fermentation of corn starch in the US, has been regarded as one of the main liquid transportation fuels that can take the place of fossil fuel. However, limitations in the supply of starch are creating a need for different substrates. Forest biomass is believed to be one of the most abundant sources of sugars, although much research has been reported on herbaceous grass, agricultural residue, and municipal waste. The use of biomass sugars entails pretreatment to disrupt the lignin-carbohydrate complex and expose carbohydrates to enzymes. This paper reviews pretreatment technologies from the perspective of their potential use with wood, bark, and forest residues. Acetic acid catalysis is suggested for the first time to be used in steam explosion pretreatment. Its pretreat-ment economics, as well as that for ammonia fiber explosion pretreatment, is estimated. This analysis suggests that both are promising techniques worthy of further exploration or optimization for commercialization.
Clinical Study of Local Application of Insulin on Diabetic Foot Ulcer Healing
Authors: Bhamre Sudhir , Godbole Yash
Published: July 2023

Introduction: Foot complications are a major cause of hospitalization in patients with Diabetes Mellitus (DM), which consumes a high number of hospital days because of multiple surgical procedures and prolonged length of stay. Patients with DM have up to a 25% lifetime risk of developing a foot ulcer, which precedes amputation in up to 85% of cases. A mainstay of Diabetic Foot Ulcer (DFU) therapy is debridement of all necrotic, callus, and fibrous tissue, with a primary goal to obtain wound closure. Materials and Methods: Cases with diabetic foot ulcer presenting to our OPD/IPD and signing the informed consent form before study as well as fulfilling the inclusion criteria mentioned along with detailed clinical examination of the patient as well as laboratory workup the study was an open labelled randomised control trial. Results: The study was carried out with 64 patients selected randomly and sorted into two groups, i.e. the control and test subjects. No difference was observed in two groups with respect to wound depth after debridement (p-0.85). However, the depth of wound was significantly less in insulin group at week 1, 2 and 3 as compared to control group. The percentage decrease in wound depth was more in insulin group than control group by the end of 3rd week. Primary closure was observed in 62.5% and 84.4% patients while STSG was required in 37.5% and 15.6% cases of control and insulin group respectively.
Comparative Outcome Study between Resolved and Unresolved St Segment in St Segment Elevation Acutemyocardial Infarction (STEMI) after Thrombolytic Therapy
Authors: Kamthe Satish , Chafekar Deodatta , Chafekar Neelima
Published: July 2023

Background: To study the comparative outcome between resolved an unresolved ST segment in ST Segment Elevation Acute Myocardial Infarction (STEMI), after thrombolytic therapy. Method: A study was carried out on patients admitted with 1st episode of ST elevated myocardial infarction in MICU of a tertiary health care center of a teaching hospital. On admission detailed history was taken and a complete clinical examination was done. Thrombolysis was done using streptokinase, 2D ECHOs were performed before and after thrombolytic therapy. Result: Most of the study population in both the group (Unresolved STEMI and Successful thrombolysis), belonged to the age group of 41 to 50 years. Co-morbidities like hypertension were present in 83% of Unresolved STEMI and 53% of Resolved STEMI. Comorbidities like diabetes were present in 66.7% of Unresolved STEMI and 52.6% of Resolved STEMI. RWMA on 2D-Echo before thrombolysis was present in 58.3% of Unresolved STEMI and 47.4% of Resolved STEMI. RWMA on 2D-Echo after thrombolysis was present in 66.7% of Unresolved STEMI and 18.5% of Resolved STEMI. Conclusion: Symptom to needle time is an important predictor of whether thrombolysis will be successful or not in acute myocardial infarction patients. Hence it is important to educate the public about prompt recognition of symptoms and seeking medical help urgently. As the rate of unsuccessful thrombolysis is higher in patients with old age, diabetes, hypertension and dyslipidemia, such patients should be monitored and treated aggressively.
Impact of Organic Nutrient Management Practices on Growth Dynamics and Economics of Short-duration Cassava (Manihot esculenta Crantz.)
Authors: Aravind S. Ashokh , Somasundaram E. , Sanbagavalli S. , Kavitha P.S. , Venkatachalam S.R. , Sunitha R.
Published: July 2023

Background: A series of field experiments were conducted at the Tapioca and Castor Research Station (TCRS), Tamil Nadu Agricultural University, Yethapur, Salem from 2022 to 2023. The purpose was to investigate the growth dynamics and economics of short-duration cassava under different nutrient management practices including both integrated and organic approaches. Methods: Twelve treatments were carried out consisting of various combinations of organic manures, liquid organic foliar sprays, integrated nutrient management treatments and a control treatment (no manures/fertilizers/sprays). The experiments were carried out in a randomized block design (RBD) with three replications at the same location. Results: The results revealed that the different nutrient management practices had a significant impact on the physiological response throughout the various stages of plant growth. Based on the average data from two experiments, the INM treatment (FYM @ 25 t ha-1 + 100% recommended dose of fertilizers and cassava booster spray) showed the highest physiological response during the final phase of growth. This treatment showed superior performance in terms of leaf area index (LAI), crop growth rate (CGR), relative growth rate (RGR), net assimilation rate (NAR), tuber bulking rate (TBR) and mean TBR. The organic treatment (wood ash @ 2 t ha-1 and 3% panchagavya foliar spray) recorded comparable performance to the INM treatment in major parameters such as LAI, CGR, RGR and NAR. However, it followed the INM treatment in terms of mean TBR. Economic analysis revealed that the INM treatment yielded the highest net income and benefit-cost ratio (BCR), followed by the organic treatment. The control resulted in the least returns. In conclusion, the findings highlight the effectiveness of the INM treatment and the promising performance of the organic treatment which can contribute to sustainable and profitable cassava cultivation.
A self-reported Brazilian registry of spinal muscular atrophy: data from natural history, genetic characteristics, and multidisciplinary care
Authors: Mendonca Rodrigo Holanda , de Godoi Juliane Suellen Arndt , Zanoteli Edmar
Published: July 2023

Background. Spinal muscular atrophy (SMA) is a neurodegenerative disorder caused by mutations in the SMN1 gene. This study is intended to describe the key demographic, clinical and genetic characteristics, and natural history data of patients with SMA registered through a self-reported survey by patients or their parents.
Results. By January 2022, 706 patients with 5q SMA had completed the questionnaire and had confirmatory molecular testing. Most patients reported having type 1 SMA (42%); 33% had type 2 SMA, and 23% had type 3 SMA. Six hundred sixty-seven patients (94.4%) had a homozygous SMN1-exon 7 deletion. One hundred thirty-one (18.6%) patients had a previous family history, and the familial recurrence rate was higher in patients with type 3 SMA, at 25.6%. The consanguinity rate was 5.2% in the studied population. Type 1 patients had a mean age of 3 months at the onset of symptoms and a delay of more than 3 months until genetic diagnosis. The median survival of patients with type 1 SMA without invasive ventilation was 27 months. Before 2018, the median age at the endpoint was 16 months, and after 2018, most patients (71%) were not submitted to invasive ventilation. About 50% of patients with type 3 SMA lost their walking ability by 37 years of age. Three hundred eighty-four (54.4%) patients claimed to have had access to some disease-modifying therapy, and 62.3% of type 1 patients were in treatment, while only 47.2% of type 2 SMA patients and 31.9% of type 3 SMA patients were in treatment.
Conclusions. This is the first Brazilian registry of SMA and evidenced the accuracy and reliability of patient-reported data compared to previous studies. There is still a substantial diagnostic delay, especially in those patients with types 2 and 3 SMA. However, the study demonstrated prolonged survival, especially in type 1 patients.
A Study on the Heterogeneity of Social Engagement among Older Adults: An Empirical Analysis based on the 2018 CLASS Data
Authors: Liu Yan
Published: July 2023

Background
Social participation, as an important part of actively responding to population aging, plays a key role in promoting the utilization of the elderly population dividend in the context of China's longevity society. This article addresses the flaw in social participation research that ignores the heterogeneity of social participation and explores the heterogeneity of social participation among older people from the perspective of socioeconomic status.
Methods
Using latent class analysis to generate a comprehensive index of socioeconomic status, and employing multilevel linear models to examine the differences in social participation outcomes among different socioeconomic status groups.
Results
The results show that the higher the socioeconomic status of the elderly group, the higher their level of social participation. The improvement of the socioeconomic level in the region has a significant positive effect on the social participation of the elderly group with lower socioeconomic status.
Conclusions
Therefore, this article reveals the heterogeneity of social participation among older people in terms of socioeconomic dimensions, highlighting the need for policy intervention to further improve the regional socioeconomic development level to promote the social participation of older people and advance social participation research.
Haemonchus contortus HcL6 promoted goat Th9 immune response by activation STAT6/PU.1/NF-κB Pathway
Authors: Liang Meng , Zhang Yang , Wang Mingyue , Wen Zhaohai , Chen Cheng , Bu Yongqian , Lu Mingmin , Song Xiaokai , Xu Lixin , Li Xiangrui , Yan RuoFeng
Published: July 2023

Th9 cells have been shown to play a crucial role in parasite immunity. The development of Th9 cells is facilitated by several cytokines. The key transcription factors, such as STAT6, STAT5, and PU.1, are known to enhance IL-9 expression within the Th9 immune response. NF-κB mediated transduction pathways participate in the induction of IL-9. In a previous study, we unveiled a unique ribosomal protein derived from Haemonchus contortus excretory-secretory proteins (HcESPs) that interact with host Th9 cells. In the present study, the influence of the Haemonchus contortus ribosomal protein L6 domain DE containing protein (HcL6) on IL-9 secretion, Th9 differentiation, and IL-9 transcription was assessed employing ELISA, flow cytometry, and qPCR methodologies. The observations revealed a transcriptional upregulation of several key genes within the Th9 immune response pathway. Moreover, the silencing of STAT6, PU.1, and NF-κB was found to attenuate the Th9 immune response. In this study, we unveiled the Th9 immune response-inducing capabilities of HcL6 and elucidated some of its underlying mechanisms. These findings suggest that HcL6 is an immunostimulatory antigen capable of inducing the Th9 immune response. These insights could prove instrumental in identifying potential candidate antigens for the development of immunoprophylactic strategies against H. contortus infections.
Aortic valve Replacement compared to Transcatheter Implant and its relationship with COgnitive Impairment (ARTICO) evaluated with neuropsychological and advanced neuroimaging: A Longitudinal Cohort Study
Authors: Gomis Meritxell , Fernández Claudio , Dacosta Rosalia , Carrillo Xavi , Martínez Silvia , Guijosa Christian Muñoz , Berastegui Elisabet , Valentín Antonio Garcia , Puig Josep , Bernal Eva , Ramos Anna , Cáceres Cynthia
Published: July 2023

Background: Aortic stenosis is the most common valvulopathy in Western countries. The treatment of choice had been surgery aortic valve replacement (SAVR), but the improvement in endovascular approaches as transcatheter aortic valve implantation (TAVI), initially reserved for patients with very high surgical risk, has been extended to high and intermediate, and recently also to low-risk patients. Stroke and vascular cognitive impairment are the most important complications. It is not entirely clear which technique is best to avoid these complications as well as their impact. Our goal is to evaluate changes in cognitive performance in the early (1-month) and late (1-year) postoperative period in patients undergoing SAVR or TAVI, by extensive neuropsychological study (NRP) and advanced Magnetic Resonance Imaging (MRI).
Specifically, to compare early and late cognitive changes after the intervention between both groups, the occurrence of stroke during follow-up and to compare the appearance of silent vascular lesions and changes in brain activity and functional connectivity with MRI and functional MRI respectively during follow-up between both groups.
Methods/Design: Prospective longitudinal cohort study. A non-selected representative sample of 80 subjects, 40 SAVR and 40 TAVI to obtain a final sample of 36 eligible subjects in each group, ranging from 70 to 85 years old, with indication for aortic replacement and intermediate or high surgical risk will be study. At baseline, within one month before the treatment, all individuals will undergo an extensive NRP and advanced MRI study. These studies will also be performed 1-month and 1-year after treatment, to assess the appearance of new vascular lesions, as well as changes in cognitive performance with respect to baseline.
Discussion: This study aims to evaluate changes in cognitive performance as well as both clinical and silent vascular events occurring in the early (1-month) and late (1-year) period after SAVR and TAVI. We will also analyze the correlation between neuropsychological and neuroimaging approaches in order to evaluate cognition. Therefore, it may provide high-quality data of cognitive changes and vascular events for both techniques, and be useful to tailor interventions to individual characteristics and ultimately aiding in decision-making.
Trial registration
This study is register in Clinicaltrials.gov with the number (NCT05235529) on 11th February 2022.
Bacterial Fermentation for Protease Production in Fermenters: Impact of Oxygen Transfer Characteristics and Rheological Features on Scale up Process
Authors: Sriniva Sivasubramanian , Paulraj Maheswari , Velladurai Selvakumar , Govindan Karthikeyan , Puvanakrishnan Rengarajulu , Esackimuthu Paramasivam , Dhandapani Prabu
Published: July 2023

Development of microbial fermentation and scale up processes for the production of value added metabolites including enzymes derives importance in industrial research. Though there are numerous studies on the production of industrial enzymes especially proteases using shake flasks, scale up studies with respect to mass transfer and hydrodynamics of fermentation in bioreactors are limited. The study deals with the production and scale up of an extracellular alkaline protease using Bacillus sp. S2 MTCC 13117 from shake flask level to 300 L fermenter. Glucose, DO, and pH profiles during scale up were studied in detail. Scale up parameters related to oxygen dynamics such as oxygen uptake rate (OUR), oxygen transfer rate (OTR), specific OUR and volumetric oxygen transfer coefficient (kLa) were evaluated. Results showed that yield coefficients with respect to biomass, product and substrate were reproduced at different levels of protease scale up in the batch mode of fermentation. Protease production was subjected to catabolite repression and it was shown to be derepressed at low specific growth rates. It was observed that the bioprocess of protease production was an aerobic one and was highly influenced by hydrodynamic conditions in the bioreactors. Use of bioreactor systems enabled effective oxygen transfer and the duration for achieving optimal protease production was reached earlier (t = 36 h in 19 L and t = 24 h in 300 L) when compared to shake flask experiments (t = 44 h). Besides, improvement in the productivity of the fermentation was substantiated by several other scale up parameters such as aeration rate, impeller tip speed, gas hold up and superficial gas velocity for effective mixing and rheological properties of the broth during fermentation in 19 and 300 L fermenters.
Neural-network Distributed Event-triggered Consensus Tracking Control for High-Order Nonlinear Strict-Feedback Multiagent Systems
Authors: Su Xiaohang , philip. Chen , Jiehao Li , Xianxian Zeng
Published: July 2023

The problem of communication constraints for multiagent systems has attracted considerable attention, but there still lacks the result to solve communication constraints between neighbor agents. This significant and practical issue shall be addressed by establishing event-triggered mechanisms between neighbor agents, such that neighbor information can be transmitted only when the preset events are activated. Subsequently, this paper proposes a novel consensus control strategy for nonlinear strict-feedback multiagent systems carrying with triggered mechanisms and uncertain functions. These uncertainties are going to be handled by using radial basis function neural network, whose unknown weight vector can be estimated by only one required adaptive law. The stability of the control algorithm is strictly proved by Lyapunov functional theory, while the boundedness of all the closed-loop signals are guaranteed and the consensus errors are ensured to be exponentially converged to an adjustable domain. Simulation studies eventually present the effectiveness of this method.
Composite Based on Babassu (Orbignya SP.) Mesocarp Residue and Palygorskite as Bioplastic
Authors: Santana Moisés Virgens , Pinto Railson Machado , Farias Emanuel A. O. , Alves Kariny Rocha , Araújo Cristiany Marinho , Braz Cristiano José Farias , Barbosa Renata , Alves Tatianny Soares , Bertolino Luiz Carlos , Eiras Carla
Published: July 2023

The solid waste generated by the disposal of plastic materials has become one of society's major problems in recent years. In this sense, several researchers have sought alternatives to minimize environmental pollution. A promising option would be using natural materials, biopolymers, or a mixture of these, also known as composites. In this study, composite films were prepared based on babassu mesocarp (BM) and palygorskite clay mineral (Pal), using the casting technique, as well as the plasticizers sodium alginate (SA) and glycerol (Gl). The films obtained were called BM/SA/Gl/Pal, and for comparison were prepared films containing BM or SA and BM/SA/Gl too. The films presented uniform color, smooth and shiny surfaces, and no fissures. FTIR analysis indicated possible interactions between clay and matrix. The SEM analysis showed that the BM film presented more significant surface irregularity. In contrast, the BM/SA/Gl/Pal film gave a more regular topography and excellent thermal stability. Finally, the BM/SA/Gl/Pal film showed more promising results when compared to the others and is considered an attractive material for use in biodegradable packaging.
Identification of Sarcocystis spp. in synanthropic (Muridae) and wild (Cricetidae) rodents from Argentina
Authors: Rossoli Judith V. Bentancourt , Moré Gastón , Soto-Cabrera Agustina , Moore Dadín P. , Morrell Eleonora L. , Pedrana Julieta , Scioli María V. , Campero Lucía M. , Basso Walter , Hecker Yanina P. , Scioscia Nathalia Paula
Published: July 2023

The occurrence of Sarcocystis species was investigated in synanthropic (Muridae) and wild (Cricetidae) rodents from Argentina. Nine species were captured (n = 356). Sarcocysts were detected in muscles of 8.7% (31/356) and 3.7% (4/106) of the rodents by histopathology and direct microscopy, respectively. PCRs-sequencing targeting the 18S rRNA, cox1 and ITS1 regions were performed on samples with positive histopathology. Four different 18S rRNA sequences or sequence groups with high intra-group identities (99.6–100%) were detected in Mus musculus, Oxymycterus rufus, Akodon azarae and Necromys lasiurus. Eight sequences showed 99.5–99.7% identity with S. dispersa. Thirteen sequences showed low identity (95.3–96.4%) with other Sarcocystis spp. The obtained coxI sequences (n = 9) were almost identical among them and showed a high similarity with S. strixi (99.2–99.5%) and S. lutrae (99.1%), despite the 18S rRNA sequences from the same samples suggested the occurrence of at least two species. This suggests that coxI may not show high variability in Sarcocystis spp. that use rodents as intermediate hosts. Six ITS1 sequences were obtained, showing high identity but low coverage with several Sarcocystis spp. Multilocus sequence typing and BLAST analysis did not allow accurate species identification. Possible reasons are the detection of new species or the lack of molecular information from previously described ones. Phylogeny suggests that the detected Sarcocystis spp. may use raptor birds or snakes as definitive hosts. This study represents the first molecular identification of Sarcocystis spp. in naturally infected rodents of the Cricetidae and Muridae families in South America.
The effect of taVNS on the cerebello-thalamo-cortical pathway: a TMS study
Authors: Midden Vesna M van , Pirtošek Zvezdan , Kojović Maja
Published: July 2023

Background: fMRI studies show activation of cerebellum during transcutaneous auricular vagal nerve stimulation (taVNS), however there is no evidence whether taVNS induced activation of the cerebellum translates to the cerebellar closed loops involved in motor functions.
Objective/Hypothesis: We assessed the propensity of taVNS at 25Hz (taVNS25) and 100Hz (taVNS100) to modulate cerebello-thalamo-cortical pathways using transcranial magnetic stimulation.
Methods: Double blind within-subjects study. 32 participants completed one visit during which cerebellar brain inhibition (CBI) was assessed at baseline (no stimulation) and in a randomized order during taVNS100, taVNS25, and sham taVNS (xVNS). Generalized linear mixed models with gamma distribution were built to assess the effect of taVNS on CBI. The estimated marginal means of linear trends during each taVNS condition were computed and compared in a pairwise fashion with Benjamini Hochbeck correction for multiple comparisons.
Results: CBI significantly increased during taVNS100 compared to taVNS25 and xVNS (p = 0.0003 and p = 0.0465, respectively). The taVNS current intensity and CBI conditioning stimulus intensity had no significant effect on CBI.
Conclusion(s): taVNS has a frequency dependent propensity to modulate the cerebello-thalamo-cortical pathway. The cerebellum participates in closed loop circuits involved in motor, cognitive, and affective operations and may serve as an entry for modulating effects of taVNS.
Numerical modelling of weak infills with a central opening in high-strength concrete frames under pseudo-static loading using Applied Element Method
Authors: Karaka Hemanth Kumar , Tripathi Rajesh Kumar
Published: July 2023

High-strength concrete (HSC) is widely used in developed countries for reinforced concrete structures due to benefits like lower concrete usage, smaller columns, increased floor area, and economic advantages. HSC reduces deflections and offers a high elastic modulus and low creep deformations, making it valuable in seismic-prone areas by decreasing inertial loads and lateral drift. However, the lack of new Concrete Standards for HSC challenges structural engineers. Infill walls are essential for separating interior spaces, particularly in seismic regions where weak infill within a strong frame dissipates energy and reduces lateral displacements. Nonetheless, weak infill behaves more brittle under intense seismic loads, posing risks like falling debris and causing casualties. Openings in infill walls are necessary for practical, architectural, or aesthetic reasons, but their strength and stiffness contributions are often neglected in current design practices. Infill walls significantly alter a building's seismic response compared to a bare frame, while frequent openings reduce the infilled frame's lateral stiffness and strength. A micro-modelling study using the Applied Element Method (AEM) examines the role of brick masonry infill with various sizes and positions of openings. Ten single-story, single-bay infilled frames with different percentages of openings undergo displacement-controlled cyclic loading. The lateral load capacities, displacements, and energy dissipation are compared for high-strength concrete frames with openings. Results showed that weak infill-strong frames with and without openings altered lateral load resistance, and severe failure was observed on either side of the central opening. The vertical position and shape of the openings also influence the studied parameters.
Mesenchymal stromal cell therapy for COVID-19 acute respiratory distress syndrome: A double-blind randomised controlled trial
Authors: Duarte Rafael , Martínez-Muñoz María E. , Payares-Herrera Concepción , Lipperheide Inés , de Molina Rosa Malo , Salcedo Isabel , Alonso Rosalía , Martín-Donaire Trinidad , Sánchez Rocío , Zafra Rocío , García-Berciano Miguel , Trisán-Alonso Andrea , Pérez-Torres Manuel , Ramos Antonio , Ussetti Piedad , Rubio Juan , Avendaño-Solà Cristina
Published: July 2023

Mesenchymal stromal cells (MSC) have immunomodulatory and tissue-regenerative properties and have shown promising results in acute respiratory distress syndrome (ARDS) of multiple causes, including COVID-19.
We conducted a randomised (1:1), placebo-controlled, double-blind clinical trial to assess the efficacy and safety of one bone marrow-derived MSC infusion in patients with moderate to severe ARDS caused by COVID-19. The primary endpoint was change in the PaO2/FiO2 ratio from baseline to day 7. Key secondary endpoints included clinical improvement in the WHO 7-point ordinal scale and safety variables.
Twenty patients were included. Clinical improvement at day 7 was greater in the MSC group than in the control (5, 50% vs 0, 0%). Median time to discontinuation of supplemental oxygen was also shorter (14 [IQR 10-18] vs. 23 [IQR 19.5-25] days), resulting in shorter hospital length of stay (17.5 [IQR 11-28] vs. 28 [IQR 26-28] days). PaO2/FiO2 increase from baseline to day 7 was 83.3 in the MSC group vs. 57.6 in the control group. No infusion-related or treatment-related serious adverse events occurred during the one-year follow-up.
MSC therapy is safe in moderate to severe COVID-19 ARDS and may be beneficial, even in a context of low mortality, accelerating clinical recovery and hospital discharge.
Trial Registration
EudraCT Number: 2020-002193-27, registered on July 14th, 2020, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-002193-27/ES.
NCT number: NCT04615429, registered on November 4th, 2020, https://clinicaltrials.gov/ct2/show/NCT04615429.