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Abstract Background/Objective Cellular immune markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) are frequently used in patient care. The adoption of these markers to elite sports, e.g. soccer could be beneficial when monitoring training and aiming to maximize physical fitness. This study investigated cellular immune inflammation markers and physical fitness in elite male soccer players in relation to changes in training and match exposure during a congested match play period. Methods Fifteen elite male soccer players were evaluated three times (T1, T2, and T3) over 12 weeks (T1–T2: six weeks uncongested period of match play and T2–T3: six weeks congested period of match play). Players performed vertical jump tests (squat jumps [SJ], countermovement jumps [CMJ]), the 20-meter sprint test, and the Yo-Yo intermittent recovery test (YYIRL1) at T1, T2 and T3. Measurements included counts of leucocytes and its subtypes, as well as platelets. Cellular immune inflammation markers (NLR, PLR and SII) were calculatedat T1, T2, and T3. Training session rating of perceived exertion was also recorded on a daily basis. Results Significant increases in leucocyte, neutrophil, eosinophil, basophil and monocyte counts occurred at T3 compared with T2 (0.002

Large ribosomal RNAs (rRNAs) are modified heavily post-transcriptionally in functionally important regions but, paradoxically, individual knockouts (KOs) of the modification enzymes have minimal impact on Escherichia coli growth. Furthermore, we recently constructed a strain with combined KOs of five modification enzymes (RluC, RlmKL, RlmN, RlmM and RluE) of the ‘critical region’ of the peptidyl transferase centre (PTC) in 23S rRNA that exhibited only a minor growth defect at 37°C (although major at 20°C). However, our combined KO of modification enzymes RluC and RlmE (not RluE) resulted in conditional lethality (at 20°C). Although the growth rates for both multiple-KO strains were characterized, the molecular explanations for such deficits remain unclear. Here, we pinpoint biochemical defects in these strains. In vitro fast kinetics at 20°C and 37°C with ribosomes purified from both strains revealed, counterintuitively, the slowing of translocation, not peptide bond formation or peptidyl release. Elongation rates of protein synthesis in vivo, as judged by the kinetics of β-galactosidase induction, were also slowed. For the five-KO strain, the biggest deficit at 37°C was in 70S ribosome assembly, as judged by a dominant 50S peak in ribosome sucrose gradient profiles at 5 mM Mg2+. Reconstitution of this 50S subunit from purified five-KO rRNA and ribosomal proteins supported a direct role in ribosome biogenesis of the PTC region modifications per se, rather than of the modification enzymes. These results clarify the importance and roles of the enigmatic rRNA modifications.

ABSTRACT Aims/Hypothesis In diabetes haptoglobin (Hp) 2 vs Hp 1 allelic product is associated with cardiac and renal complications. Few studies report both Hp phenotype and Hp levels. In a Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial substudy we evaluated the Hp phenotype, Hp levels, and fenofibrate effects. Materials and Methods In 480 adults with type 2 diabetes (T2D) the Hp phenotype was assessed and the Hp level quantified (both using ELISAs assays) in plasma from baseline, after 6 weeks of fenofibrate, and (in n = 200) at 2 years post‐randomization to fenofibrate or placebo. Results The Hp phenotypes 1‐1, 2‐1, and 2‐2 frequencies were 15%, 49%, and 36%, respectively. Baseline Hp levels differed by phenotype (P

Abstract In this paper, we have provided more insights on the relationship between under five morbidity in Nigeria and some background characteristics using a Poisson regression model and the most recent 2018 NDHS data on Acute Respiratory Infection (ARI), diarrhoea and fever. Some of our results are that children 36–47 months old have the highest risk of ARI [OR = 1.45; CI (1.31,1.60)] while children less than 6 months old have the lowest risk of ARI [OR = 0.14; CI (0.11,0.17)]. The prevalence of diarrhoea is generally high among children under 48-59 months old but highest among children 6–11 months old [OR = 4.34; CI (3.69,5.09)]. Compared to children 48–59 months old, children in all other age categories except 24–34 months old have a high risk of fever [OR = 0.95; CI (0.73,1.24)]. ARI is more prevalent among female children [OR = 8.88; CI (8.02,9.82)] while diarrhoea [OR = 21.75; (19.10,24.76)] and fever [OR = 4.78; CI (4.31,5.32)] are more prevalent among male children. Children in urban areas are more likely to suffer ARI [OR = 9.49; CI (8.31,10.85)] while children in rural areas are more likely to suffer both diarrhoea [OR = 21.75; CI (19.10,24.76)] and fever [OR = 4.90; CI (4.26,5.63)]. Children in the South-South have the highest risk of ARI [OR = 4.03; CI (3.65,4.454)] while children in the North Central have the lowest risk of ARI [OR = 1.55; CI (1.38,1.74)] and highest risk of diarrhoea [OR = 3.34; CI (2.30,5.11)]. Children in the Northeast have the highest risk of fever [OR = 1.30; CI (1.14,1.48)]. In the Northcentral region, Kogi state has the highest prevalence of fever [OR = 2.27; CI (1.62,3.17)], while Benue state has the lowest [OR = 0.35; CI (0.20,0.60)]. Children in Abuja state face similar risks of fever and diarrhoea [OR = 0.84; CI (0.55,1.27)], with the risk of diarrhoea in Abuja being comparable to that in Plateau state [OR = 1.57; CI (0.92,2.70)]. Nasarawa state records the highest incidence of diarrhoea in the Northcentral [OR = 5.12; CI (3.03,8.65)], whereas Kogi state reports the lowest [OR = 0.29; CI (0.16,0.53)]. In the Northeast, Borno state has the highest rate of fever [OR = 3.28; CI (2.80,3.84)], and Bauchi state the lowest [OR = 0.38; CI (0.29,0.50)]. In Adamawa state, the risks of fever and diarrhoea are nearly equivalent [OR = 1.17; CI (0.97,1.41)], and the risk of fever there is similar to that in Taraba state [OR = 0.92; CI (0.75,1.12)]. Diarrhoea is most prevalent in Yobe state [OR = 3.17; CI (2.37,4.23)] and least prevalent in Borno state [OR = 0.26; CI (0.20,0.33)]. In the Northwest, the risk of fever is similarly high in Zamfara and Kebbi states [OR = 1.04; CI (0.93,1.17)], with Kastina state showing the lowest risk [OR = 0.39; CI (0.34,0.46)]. Children in Zamfara state experience notably different risks of fever and diarrhoea [OR = 0.07; CI (0.05,0.10)]. Kaduna state reports the highest incidence of diarrhoea [OR = 21.88; CI (15.54,30.82)], while Kano state has the lowest [OR = 2.50; CI (1.73,3.63)]. In the Southeast, Imo state leads in fever incidence [OR = 8.20; CI (5.61,11.98)], while Anambra state has the lowest [OR = 0.40; CI (0.21,0.78)]. In Abia state, the risk of fever is comparable to that in Enugu state [OR = 1.03; CI (0.63,1.71)], but the risks of fever and diarrhoea in Abia differ significantly [OR = 2.67; CI (1.75,4.06)]. Abia state also has the highest diarrhoea rate in the Southeast [OR = 2.67; CI (1.75,4.06)], with Ebonyi state having the lowest [OR = 0.05; CI (0.03,0.09)]. In the South-South region, Bayelsa and Edo states have similar risks of fever [OR = 1.28; CI (0.84,1.95)], with Akwa Ibom state reporting the highest fever rate [OR = 4.62; CI (3.27,6.52)] and Delta state the lowest [OR = 0.08; CI (0.02,0.25)]. Children in Bayelsa state face distinctly different risks of fever and diarrhoea [OR = 0.56; CI (0.34,0.95)]. Rivers state shows the highest incidence of diarrhoea in the South-South [OR = 10.50; CI (4.78,23.06)], while Akwa Ibom state has the lowest [OR = 0.30; CI (0.15,0.57)]. In the Southwest, Lagos and Osun states have similar risks of fever [OR = 1.00; CI (0.59,1.69)], with Ogun state experiencing the highest incidence [OR = 3.47; CI (2.28,5.28)] and Oyo state the lowest [OR = 0.18; CI (0.07,0.46)]. In Lagos state, the risks of fever and diarrhoea are comparable [OR = 0.96; CI (0.57,1.64)], and the risk of diarrhoea is similar to those in Ekiti, Ogun, and Ondo states. Oyo state has the highest diarrhoea rate in the Southwest [OR = 10.99; CI (3.81,31.67)], with Ogun state reporting the lowest [OR = 0.77; CI (0.42,1.42)]. Children of mothers with more than secondary education are significantly less likely to suffer ARI [OR = 0.35; CI (0.29,0.42)], whereas children of mothers without any education run a higher risk of diarrhoea [OR = 2.12; CI (1.89,2.38)] and fever [OR = 2.61; CI (2.34,2.91)]. Our analysis also indicated that household wealth quintile is a significant determinant of morbidity. The results in this paper could help the government and non-governmental agencies to focus and target intervention programs for ARI, diarrhoea and fever on the most vulnerable and risky under five groups and populations in Nigeria.

The research investigated how the use of a water-based extract from Euclea divinorum leaves can impact the treatment of Coccidiosis in Broiler chickens. One hundred and twenty (120) broilers were experimentally infected with Eimeria tenella and split into 4 categories T1, T2, T3, and T4, each containing three (3) duplicates. Water-based extract of Euclea divinorum was administered at 5%, 10%, 20% and 0% inclusion levels, in treatments T1, T2, T3and T4 (control), respectively. Statistical methods and procedures used in this study include photochemistry, analysis of variance (ANOVA), and descriptive statistics. A study of the chemicals in Euclea divinorum found the existence of alkaloids, flavonoids, saponins, tannins, phenol, glycosides, and a steroid ring. These substances are known for their beneficial healing properties. ANOVA showed a significant difference between different inclusion levels of Euclea divinorum and their effects in the treatment of Coccidiosis. The reported mortality rates for treatments T1, T2, T3, and T4 were monitored and the estimates are 16.7% (5), 10% (3), 56.7% (17) and 66.7% (20), respectively. Thus, Euclea divinorium has great potentials for the treatment and control Coccidiosis in broilers. This study recommends increased cultivation and utilization of medicinal plants, intensive research on the therapeutic effects of plant extracts, subsidized medical supplies and improved extension services.

Abstract Infectious mononucleosis (IM) is suspected to be associated with inflammatory bowel disease (IBD) development. Using a Danish nationwide cohort of people developing severe IM and their age-, sex-, and socioeconomic (SES) index-matched counterparts, we investigated the subsequent risk of IBD, Crohn’s disease (CD), or ulcerative colitis (UC) development from 1977 to 2021. Among 39,684 severe IM patients we find a sex-, age-, and SES index-adjusted HR for IBD of 1.35 (95% CI: 1.22–1.49). This significantly increased risk was seen for both CD (HR: 1.56; 95% CI: 1.34–1.83) and to a lesser extent UC (HR: 1.23; 95% CI: 1.08–1.40) and remains following negative control matching with a cohort diagnosed with Chlamydia trachomatis infection (HR: 1.39; 95% CI: 1.01–1.91). Those with severe IM at 0–9 years had a particularly increased risk for CD (HR: 1.77; 95% CI: 1.26–2.49). Here we show an increased risk for IBD diagnosis following IM hospitalisation, indicating an association between severe EBV disease and later IBD development. Further exploration of the potential factors contributing to IBD susceptibility following EBV disease is warranted.

Abstract Background Strength training (ST) primarily enhances physical fitness (e.g., muscle strength, power, speed) and bone density in female soccer players. Less information is available on the injury preventive effects of ST in female athletes. Accordingly, this study aimed to investigate the effects of a 12-week in-season ST on measures of physical fitness and injury occurrence in young elite female soccer players. Methods Thirty elite female soccer players (15.4 ± 1.9 years; maturity offset + 2.3 ± 1.1 years) participated in this study, and were randomly assigned to a strength training group (STG, n = 14) or an active control (CG, n = 16) group. ST lasted twelve weeks and included full body muscle strengthening exercises using primarily weight machines at progressive intensities ranging between 40 and 85% of the one-repetition-maximum (1-RM). The CG practiced a traditional soccer training program. Overall, training volumes of the two groups were similar with a training load (rating of perceived exertion × time) of 1158.4 ± 67.7 arbitrary unity (AU) for the STG and 1188.8 ± 44.1 AU for the CG. Pre and post training, the following physical fitness tests were applied: dynamic muscle strength (relative [to body mass] and absolute 1-RM bench/leg press, lat-pull down), jump performance (countermovement jump [CMJ], squat jump [SJ], five-jump-test [5JT]), linear-sprint speed (5-m, 10-m, 30-m), change-of-direction speed (T-test with and without ball), sport-specific performance (Yo-Yo Intermittent Level1 [YYIRTL1], and repeated shuttle sprint ability [RSSA]). The injury rate per 1000-h exposure was monitored throughout the soccer season. Results No significant baseline differences were observed between groups. Statistically significant group-by-time interactions were found for absolute (p

Perovskite solar cells (PSCs) have gained a lot of attention due to their high efficiency and low cost. In this research paper, a methylammonium tin iodide (CH3NH3SnI3) based solar cell was simulated using a one-dimensional solar cell capacitance simulation (SCAPS-1D) tool. The SCAPS-1D tool is based on Poisson and the semiconductor equations. After thorough investigation, the initial device presents the following parameters; power conversion efficiency (PCE)=15.315%, fill factor (FF)=64.580%, current density (Jsc)=29.152 mA/cm2, and open circuit voltage (Voc)=0.813 V. The effect of absorber and ETL thicknesses were explored systematically. The performance of the simulated device was significantly influenced by the thickness of the absorber and ETL. The optimized absorber thickness was 0.5 µm and the ETL thickness was 0.02 µm, giving rise to an optimized PCE of 15.411%, FF of 63.525%, Jsc of 29.812 mA/cm2, and Voc of 0.814 V. Additionally, the effect of temperature on the optimized device was evaluated and found that it affects the performance of the device. This model shows the prospect of CH3NH3SnI3 as a perovskite material to produce toxic-free environment-friendly solar cells with high efficiency.

Abstract We studied clinical AI-supported decision-making as an example of a high-stakes setting in which explainable AI (XAI) has been proposed as useful (by theoretically providing physicians with context for the AI suggestion and thereby helping them to reject unsafe AI recommendations). Here, we used objective neurobehavioural measures (eye-tracking) to see how physicians respond to XAI with N = 19 ICU physicians in a hospital’s clinical simulation suite. Prescription decisions were made both pre- and post-reveal of either a safe or unsafe AI recommendation and four different types of simultaneously presented XAI. We used overt visual attention as a marker for where physician mental attention was directed during the simulations. Unsafe AI recommendations attracted significantly greater attention than safe AI recommendations. However, there was no appreciably higher level of attention placed onto any of the four types of explanation during unsafe AI scenarios (i.e. XAI did not appear to ‘rescue’ decision-makers). Furthermore, self-reported usefulness of explanations by physicians did not correlate with the level of attention they devoted to the explanations reinforcing the notion that using self-reports alone to evaluate XAI tools misses key aspects of the interaction behaviour between human and machine.

This study investigated the impact of intensive endurance exercise on circulating androgenic steroid hormones in women. Fifteen normally menstruating athletic women participated. They completed intensive endurance exercise (treadmill running) until volitional fatigue in their follicular phase, with blood samples collected at pre-exercise, volitional fatigue, 90 min and 24 h into recovery. The steroid hormones (total, free testosterone, dehydroepiandrosterone [DHEA], and DHEA-sulfate [DHEA-S], cortisol) were analyzed in blood sera. Non-parametric statistics were used to assess changes across exercise and recovery. At volitional fatigue, all hormones, except free testosterone, were significantly (p < 0.05) increased compared to pre-exercise levels. Most hormones remained elevated through 90 min of recovery, with DHEA, DHEA-S, and total testosterone changes being significant (p < 0.05). At 24 h of recovery, hormonal levels were reduced; specifically, DHEA, DHEA-S, and total testosterone compared to baseline (p < 0.01 to 0.06). Increases in cortisol levels at volitional fatigue and 90 min of recovery were correlated with reductions in total testosterone, DHEA, and DHEA-S observed at 24 h of recovery (rho > −0.62, p < 0.05). In conclusion, in menstruating women performing intensive endurance exercise during their follicular phase, their androgenic steroid hormones remain elevated during early recovery but are suppressed at 24 h of recovery. The latter finding indicates that establishing a resting endocrine equilibrium requires a longer recovery period than 24 h.

IntroductionMeningiomas are the most common primary central nervous system (CNS) tumor in adults, comprising one-third of all primary adult CNS tumors. Although several recent publications have identified molecular alterations in meningioma including characteristic mutations, copy number alterations, and gene expression signatures, our understanding of the drivers of meningioma recurrence is limited.ObjectiveTo identify gene expression signatures of 1p-22q-NF2- meningioma recurrence, with concurrent biallelic inactivation of NF2 and loss of chr1p that are heterogenous but enriched for recurrent meningiomas.MethodsTranscriptomic alterations present in recurrent versus primary 1p-22q-NF2- meningiomas were identified using RNA sequencing (RNA-seq) data in a clinically annotated cohort.ResultsRecurrent 1p-22q-NF2- meningiomas were enriched for a newly identified GSTM1 null genotype compared to primary meningiomas that showed variable GSTM1 expression and independent external validation was performed.ConclusionsThe GSTM1 null genotype is a novel biomarker of 1p-22q-NF2- meningioma recurrence that resolves heterogeneity in existing meningioma subtypes and may be used to guide future clinical management decisions on extent of treatment to improve patient outcomes.

Rural communities face significant challenges such as persistent poverty, aging infrastructure, food insecurity, and natural disasters. With agriculture as a primary focus, these communities increasingly depend on external income and technology. Agritourism offers a promising solution by allowing farmers to diversify their income streams while promoting rural development. In Oklahoma, there are over 400 agritourism venues (USDA NASS, 2022). However, urbanization and climate change continue to reshape the agricultural landscape, affecting farmers and rural communities. This study examines the perceptions of agritourism among rural citizens in southwest Oklahoma and its potential for rural development. Utilizing the Community Capitals Framework (Flora et al., 2006) and Chase et al. (2018) agritourism framework, the study surveyed 159 residents, revealing a generally positive perception of agritourism as beneficial for communities and agriculture. Despite recognizing its benefits, respondents indicated a need for more guidance on how to engage in agritourism. The findings suggest that although there is awareness and appreciation of agritourism, there is also a significant opportunity for expansion and support. Extension services and state agencies are recommended to provide targeted education and training to maximize agritourism's economic and community development potential in rural areas.

BackgroundThere are numerous benefits to delivering care via video consultations (VCs). Yet, the willingness of health care professionals (HCPs) to use video as a modality of care is one of the greatest barriers to its adoption. Decisions regarding whether to use video may be based on assumptions and concerns that are not necessarily borne of evidence. To effectively address psychological barriers to VC, it is essential to gain a better understanding of specific factors (eg, attitudes, beliefs, and emotions) that influence HCPs’ VC use. ObjectiveThis study’s aim was to conduct a systematic literature review of psychological factors in HCPs that impair or promote VC use. MethodsDatabases were searched in February 2023 for peer-reviewed primary research papers on VCs that discussed psychological factors of health professionals affecting the use of video to deliver health services. A psychological factor was defined as an intraindividual influence related to, or in reaction to, VC use—in this case, the individual being an HCP. Search terms included variations on “telehealth,” “clinician,” and psychological factors (eg, attitude and beliefs) in combination. Peer-reviewed papers of all methodological approaches were included if they were in an Australian setting and the full text was available in English. Studies where the main intervention was another digital health modality (eg, remote monitoring and telephone) were excluded. Studies were also excluded if they only reported on extrinsic factors (eg, environmental or economic). Information extracted included author, year, medical specialty, psychological component mentioned, explanation as to why the psychological factor was related to VC use, and exemplar quotes from the paper that correspond to a psychological component. Each extracted psychological factor was classified as a positive, negative, ambivalent, or neutral perspective on VC, and a thematic analysis then generated the factors and themes. Theories of behavior were considered and discussed to help frame the interaction between themes. ResultsFrom 4592 studies, data were extracted from 90 peer-reviewed papers. Cognitive and emotional motivators and inhibitors, such as emotional responses, self-efficacy, attitudes, and perceived impact on the clinician as a professional, all interact to influence HCP engagement in VCs. These factors were complex and impacted upon one another. A cyclical relationship between these factors and intention to engage in VCs and actual use of VCs was found. These findings were used to form the psychological attributes of VC engagement (PAVE) model. Evidence suggests that HCPs fall within 4 key user categories based on the amount of cognitive and practical effort needed to deliver VCs. ConclusionsAlthough further research is needed to validate the current findings, this study provides opportunity for more targeted interventions that address psychological factors impeding effective use of VCs.

The study focuses on compliance with road safety media messages by mass transit drivers in South Eastern Nigeria. Based on available literatures that were surveyed, there may not be studies conducted on mass transit operators in Nigeria. This study examines the obstacles around mass transit drivers’ compliance with road safety media messages. A survey of 364 mass transit drivers in Nigeria probed their compliance with road safety messages from the perspective of means of communication, level of compliance, and obstacles to compliance. The multistage sampling technique was adopted in this study. The study used the real limit mean and cutoff mean to analyse data from objectives one and two respectively. Data from objective three were analysed using frequencies and percentage. Factor analysis was used to analyse data from the hypotheses. Findings revealed that the mass transit drivers comply with road safety media messages. However, bad roads (potholes) and overloading to make more money are adduced as obstacles to compliance with road safety media messages. The study recommended that the Federal Road Safety Corps (FRSC) should sustain its dissemination of media messages on road safety; mass transit companies should have phone numbers inscribed on their vehicles to help commuters report the issue of overloading to the appropriate channel(s) and the FRSC should help in calling the attention of the Federal and State governments to bad roads in order to get them fixed.

ABSTRACT Aquatic ecosystems are often negatively affected by invasive species. However, biotic resistance by native species, either by competition or predation, can reduce the impacts of invasions by non‐native species. The Western Mosquitofish (Gambusia affinis) is one of the most impactful invasive species of freshwater fish and cause declines in native fish populations. Using two mesocosm experiments conducted in different years, we examined the ecological interactions between juveniles of the native fish, Bluegill Sunfish (Lepomis macrochirus), and adults of the invasive fish, G. affinis. We found evidence for interactions between L. macrochirus and G. affinis. However, interactions did not appear symmetric, with L. macrochirus generally more affected by intraspecific interactions than interspecific interactions whereas G. affinis was more affected by interspecific interactions than intraspecific interactions. The presence of either species of fish led to a decrease in the number of large zooplankton and a tendency for a decrease in the total number of zooplankton. Based on these results, native L. macrochirus appear to be able to reduce the ability of non‐native G. affinis to establish or maintain populations through both competition and predation (i.e., acting as an intraguild predator). The consistency of our results across both experiments, with their different designs and their occurring in different years, gives weight to these conclusions. The reduction of or prevention of establishment of populations of invasive G. affinis would likely benefit the aquatic communities of ponds with fish, especially small‐bodied native fish.

ObjectivesWe investigated the timing of resistance training (RT) during Ramadan fasting (RF) on muscle strength, hormonal adaptations, and sleep quality.MethodsForty healthy and physically active male Muslims (age = 25.7 ± 5.6 years, body mass = 85.1 ± 17.5 kg, height = 175 ± 9 cm, BMI = 28.3 ± 5.7 kg/m2) were enrolled in this study and 37 completed pre and post-tests. Subjects were randomly allocated into two experimental groups. Group 1 (FAST, n = 20) completed an 8-week whole-body RT in the late afternoon (between 16 h and 18 h) while fasting. Group 2 (FED, n = 20) completed the similar RT protocol compared with FAST at night (between 20 h and 22 h). The following parameters were analyzed at various time-points: 2 weeks before the start of RF (T0), on the 15th day of Ramadan (T1), on the 29th day of Ramadan (T2), and 21 days after the last day of RF (T3) where both groups were in a fed state. One-repetition maximum tests (1-RM) were conducted for the squats (1-RMSQ), the deadlift (1-RMDL) and the bench press (1-RMBP). Sleep quality was assessed using the full Pittsburgh Sleep Quality Index (PSQI). Blood samples were taken to determine cortisol, testosterone and IGF-1 levels. Additionally, acute hormonal responses were evaluated before (BF), immediately after (AF), and 30 min after a RT session (AF-30 min) at T0, T1, T2, and T3.ResultsSignificant group-by-time interactions were identified for 1-RMSQ (p = 0.001; effect size [ES] = 0.43) and 1-RMDL (p = 0.001; ES = 0.36). Post-hoc tests indicated significant 1-RMSQ (p = 0.03; ES = 0.12) and 1-RMDL (p = 0.04; ES = 0.21) improvements from T0-T2 for FED. Additionally, significant group-by-time interactions were observed for the chronic effects on cortisol (p = 0.03; ES = 0.27) and testosterone levels (p = 0.01; ES = 0.32). Post-hoc tests indicated significant increases of cortisol levels among FAST at T1 and T2 compared to T0 (p = 0.05; ES = 0.41, p = 0.03; ES = 0.34) and a significant increase in cortisol levels in FED at T1 (p = 0.05; ES = 0.29) and T2 (p = 0.04; ES = 0.25). However, the observed increase was lower compared to FAST. Post-hoc tests also indicated significant increases of testosterone only among FED at T2 (p = 0.04; ES = 0.31). A significant group-by-time interaction was found for the acute effect of exercise on cortisol level (p = 0.04; ES = 0.34). The cortisol level immediately after RT was higher in FAST only at T1 (p = 0.03; ES = 0.39) and T2 (p = 0.05; ES = 0.22) compared with T0. No significant group-by-time interactions were identified for sleep quality (p = 0.07; ES = 0.43).ConclusionMuslims can safely practice RT during RF. However, training in a fed state during Ramadan might be more effective than during fasted state for the enhancement of maximal strength with better hormonal responses observed.

Abstract Background The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players. Methods Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45–60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season. Results No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014). Conclusions The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players.

Abstract Background Borderline personality disorder (BPD) is considered a disorder of emotion regulation resulting from the expression of a biologically determined emotional vulnerability (that is, heightened sensitivity to emotion, increased emotional intensity/reactivity, and a slow return to emotional baseline) combined with exposure to invalidating environments. Vagal tone has been associated with activity in cortical regions involved in emotion regulation and a lower resting state of vagal tone has been observed in BPD patients relative to healthy controls. Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has been shown to reduce temper outbursts in adults with Prader-Willi Syndrome, to enhance recognition of emotions in healthy students, and to improve depressive and anxiety symptoms. Furthermore, a single session of taVNS has been shown to acutely alter the recognition of facial expressions of negative valence in adolescents with MDD and increase emotion recognition in controls. However, the effect of taVNS on emotional vulnerability and regulation in individuals diagnosed with BPD has not been investigated. Our aims are to determine if taVNS is effective in acutely reducing emotional vulnerability and improve emotional regulation in BPD patients. Methods Forty-two patients will be randomized to a single session of taVNS or sham-taVNS while going through an affect induction procedure. It will consist of the presentation of one neutral and three negative affect-evoking 4-min-long videos in sequence, each of which is followed by a 4-min post-induction period during which participants will rate the quality and intensity of their current self-reported emotions (post-induction ratings) and the perceived effectiveness in managing their emotions during the video presentation. The rating of the current self-reported emotions will be repeated after every post-induction period (recovery ratings). Mixed models with individuals as random effect will be used to investigate the ratings at each stage of the study, taking into account the repeated measures of the same individuals at baseline, pre-induction, post-induction, and recovery. Discussion The study has potential to yield new insights into the role of vagal tone in emotion dysregulation in BPD and offer preliminary data on the effectiveness of taVNS as a possible non-invasive brain stimulation to treat a core symptom of BPD. Trial registration ClinicalTrials.gov NCT05892900. Retrospectively registered on Jun 07, 2023.

Background: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods: It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome. Results: Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, p = 0.005] and lag time [13 (6–20) months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p = 0.002), brain metastasis (22.6%, p

Abstract Objective The purpose of this study was to examine the effects of 10 weeks of high-intensity interval training (HIIT) and HIIT combined with circuit resistance training (HCRT) on selected measures of physical fitness, the expression of miR-9, -15a, -34a, -145, and − 155 as well as metabolic risk factors including lipid profiles and insulin resistance in middle-aged overweight/obese women. Methods Twenty-seven overweight/obese women aged 35–50 yrs. were randomized to HIIT (n = 14) or HCRT (n = 13) groups. The HIIT group performed running exercises (5 reps x 4 min per session) with active recovery between repetitions for 10 weeks with 5 weekly sessions. The HCRT group performed 10 weeks of HIIT and resistance training with 3 weekly HIIT sessions and 2 weekly HCRT sessions. Anthropometric measures (e.g., body mass), selected components of physical fitness (cardiovascular fitness, muscle strength), levels of miRNAs (miR-9, -15a, -34a, -145, and − 155), lipid profiles (total cholesterol; TC, Triglycerides; TG, low-density lipoprotein cholesterol; LDL-C and high-density lipoprotein cholesterol; HDL-C), and insulin resistance; HOMA-IR index, were measured at baseline and week 10. Results An ANOVA analysis indicated no significant group by time interactions (p > 0.05) for all anthropometric measures, and maximum oxygen consumption (VO2max). A significant group by time interaction, however, was found for the one-repetition maximum (IRM; p

Abstract Head and Neck Squamous Cell Carcinoma (HNSCC) is a heterogeneous malignancy that remains a significant challenge in clinical management due to frequent treatment failures and pronounced therapy resistance. While metabolic dysregulation appears to be a critical factor in this scenario, comprehensive analyses of the metabolic HNSCC landscape and its impact on clinical outcomes are lacking. This study utilized transcriptomic data from four independent clinical cohorts to investigate metabolic heterogeneity in HNSCC and define metabolic pathway-based subtypes (MPS). In HPV-negative HNSCCs, MPS1 and MPS2 were identified, while MPS3 was enriched in HPV-positive cases. MPS classification was associated with clinical outcome post adjuvant radio(chemo)therapy, with MPS1 consistently exhibiting the highest risk of therapeutic failure. MPS1 was uniquely characterized by upregulation of glycan (particularly chondroitin/dermatan sulfate) metabolism genes. Immunohistochemistry and pilot mass spectrometry imaging analyses confirmed this at metabolite level. The histological context and single-cell RNA sequencing data identified the malignant cells as key contributors. Globally, MPS1 was distinguished by a unique transcriptomic landscape associated with increased disease aggressiveness, featuring motifs related to epithelial-mesenchymal transition, immune signaling, cancer stemness, tumor microenvironment assembly, and oncogenic signaling. This translated into a distinct histological appearance marked by extensive extracellular matrix remodeling, abundant spindle-shaped cancer-associated fibroblasts, and intimately intertwined populations of malignant and stromal cells. Proof-of-concept data from orthotopic xenotransplants replicated the MPS phenotypes on the histological and transcriptome levels. In summary, this study introduces a metabolic pathway-based classification of HNSCC, pinpointing glycan metabolism-enriched MPS1 as the most challenging subgroup that necessitates alternative therapeutic strategies.

Abstract Introduction Hepatitis B virus infection poses a global health challenge, particularly in low- and middle-income African countries. Illicit drug use exacerbates the problem, with drug users having a higher HBV infection risk and maintaining a quiet transmission pool. This study aimed to determine HBV infection prevalence, immune status, and risk factors among illegal drug users in Enugu State, Nigeria. Materials and methods A cross-sectional study was conducted in Enugu State, using privileged access interviewer methods to enroll drug users. Pre-tested structured questionnaires were administered after informed consent was obtained. Blood samples were tested for HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb using immunochromatographic rapid test kits. Statistical analysis was performed using SPSS version 25. Results One hundred drug users were recruited into the study. Overall, 7% of the drug users had HBV infection. 61% were found to be susceptible to HBV infection, 15% showed serological evidence of immunity from HBV vaccination and 1% developed natural immunity from HBV exposure. Significant risk factors for HBV infection were age less than 20 years, young age (≤ 20 years) at drug initiation, being single, injecting drugs more than or equal to 20 times per month and injecting with used syringes. Conclusion This study shows high intermediate endemicity of HBV infection among drug users, low vaccination uptake, and high susceptibility to HBV infection. This calls for the urgent inclusion of drug users in national HBV vaccination campaigns and the adoption of the World Health Organization’s recommendations on the prevention of viral hepatitis among people who inject drugs.

Abstract Background Previous studies reported differences in genotype frequency of the ACTN3 R577X polymorphisms (rs1815739; RR, RX and XX) in athletes and non-athletic populations. This systematic review with meta-analysis assessed ACTN3 R577X genotype frequencies in power versus endurance athletes and non-athletes. Methods Five electronic databases (PubMed, Web of Science, Scopus, Science Direct, SPORTDiscus) were searched for research articles published until December 31st, 2022. Studies were included if they reported the frequency of the ACTN3 R577X genotypes in power athletes (e.g., weightlifters) and if they included a comparison with endurance athletes (e.g., long-distance runners) or non-athletic controls. A meta-analysis was then performed using either fixed or random-effects models. Pooled odds ratios (OR) were determined. Heterogeneity was detected using I2 and Cochran's Q tests. Publication bias and sensitivity analysis tests were computed. Results After screening 476 initial registrations, 25 studies were included in the final analysis (13 different countries; 14,541 participants). In power athletes, the RX genotype was predominant over the two other genotypes: RR versus RX (OR 0.70; 95% CI 0.57–0.85, p = 0.0005), RR versus XX (OR 4.26; 95% CI 3.19–5.69, p RR > XX. However, the RR genotype and R allele were overrepresented in power athletes compared to non-athletes and endurance athletes. These data suggest that the RR genotype and R allele, which is associated with a normal expression of α-actinin-3 in fast-twitch muscle fibers, may offer some benefit in improving performance development in muscle strength and power.

Cancer patients often experience changes in mental health, prompting an exploration into whether nerves infiltrating tumors contribute to these alterations by impacting brain functions. Using a mouse model for head and neck cancer and neuronal tracing, we show that tumor-infiltrating nerves connect to distinct brain areas. The activation of this neuronal circuitry altered behaviors (decreased nest-building, increased latency to eat a cookie, and reduced wheel running). Tumor-infiltrating nociceptor neurons exhibited heightened calcium activity and brain regions receiving these neural projections showed elevated Fos as well as increased calcium responses compared to non-tumor-bearing counterparts. The genetic elimination of nociceptor neurons decreased brain Fos expression and mitigated the behavioral alterations induced by the presence of the tumor. While analgesic treatment restored nesting and cookie test behaviors, it did not fully restore voluntary wheel running indicating that pain is not the exclusive driver of such behavioral shifts. Unraveling the interaction between the tumor, infiltrating nerves, and the brain is pivotal to developing targeted interventions to alleviate the mental health burdens associated with cancer.

Efficient quantum memories will be an essential building block of large-scale networked quantum systems and provide a link between flying photonic qubits and atomic or quasi-atomic local quantum processors. Memory efficiencies above 50% are required to be operating above the quantum no-cloning limit. High efficiency operation necessitates tailored photon source and memory pairs with matched bandwidths. In this paper, we explore the combination of an ultralow spectral bandwidth source of single photons from cavity-enhanced spontaneous parametric down-conversion with a hot gas-ensemble atomic memory. Our rubidium vapor gradient echo memory achieves 84% ± 3% recall efficiency of single photons: a record for single photon storage in a warm vapor platform that avoids bulky and complex systems, such as high vacuum and low temperature cryogenics.

Background: Dysregulation of adipocyte function occurs in obesity. Meteorin-like protein (Metrnl) is a newly discovered modulator of inflammation, metabolism, and differentiation of human adipocytes. The dietary supplement Chlorella Vulgaris (CV) reduces hyperlipidemia, hyperglycemia, and oxidative stress in clinical trials. Objectives: To explore the impact of 12 wks of interval resistance training (IRT) and CV supplementation on plasma levels of Metrnl and oxidative stress in males with obesity. Methods: Forty-four obese men (BMI: 32.0 ± 1.5 kg/m2, weight: 101.1 ± 2.2 kg, age: 23–35 years) were randomly assigned into 4 groups (n = 11/group): control (CON), CV supplement (CV), IRT, and CV + IRT (CVIRT). The IRT was performed for 12 wks (3 sessions per week). The treatment consisted of a daily intake of CV (1800 mg capsule) or placebo capsules. Blood samples were collected 48 hours before and after the interventions to analyze biomedical measurements. Results: The IRT and CVIRT groups had elevations in plasma Metrnl, superoxide dismutase, and total antioxidant capacity levels (all P < 0.0001), and reductions in malondialdehyde (P < 0.0001). Supplementation with CV significantly reduced malondialdehyde (P < 0.001) and increased total antioxidant capacity (P < 0.0001) but failed to alter superoxide dismutase or Metrnl (P > 0.05). Conclusions: Although IRT and its combination with CV hold promise for improving Metrnl levels and oxidative status in obesity, combining IRT and CV do not yield greater benefits than IRT alone. Although standalone CV supplementation could favorably impact certain markers of oxidative stress, the effectiveness of CV supplementation appears to have a relatively limited effect across assessed biomarkers and requires further investigation.

Objectives Understanding the burden of disease of sepsis is essential for monitoring the effectiveness of international strategies to improve sepsis care. Our objective was to describe the multinational trend of sepsis-related mortality for the period 1985–2019 from the WHO Mortality Database.Design Retrospective analysis of the WHO Mortality Database.Setting We included data from all countries defined by the WHO as having ‘high usability data’ and at least 10 years of total available data.Participants From the WHO list of 50 countries with high usability data, 14 (28%) were excluded due to excessive missingness. We included and analysed data separately for male and female.Primary and secondary outcome measures We analysed age-standardised mortality rates (ASMR) (weighted average of the age-specific mortality rates per 100 000 people, where the weights are the proportions of people in the corresponding age groups of the WHO standard population).Results We included 1104 country-years worth of data from 36 countries with high usability data, accounting for around 15% of the world’s population. The median ASMR for men decreased from 37.8 deaths/100 000 (IQR 28.4–46.7) in 1985–1987 to 25.8 deaths/100 000 (IQR 19.2–37) in 2017–2019, an approximately 12% absolute (31.8% relative) decrease. For women, the overall ASMR decreased from 22.9 deaths/100 000 (IQR 17.7–32.2) to 16.2 deaths/100 000 (IQR 12.6–21.6), an approximately 6.7% absolute decrease (29.3% relative decrease). The analysis of country-level data revealed wide variations in estimates and trends.Conclusions We observed a decrease in reported sepsis-related mortality across the majority of analysed nations between 1985 and 2019. However, significant variability remains between gender and health systems. System-level and population-level factors may contribute to these differences, and additional investigations are necessary to further explain these trends.

Sex differences are widespread during neurodevelopment and play a role in neuropsychiatric conditions such as autism, which is more prevalent in males than females. In humans, males have been shown to have larger brain volumes than females with development of the hippocampus and amygdala showing prominent sex differences. Mechanistically, sex steroids and sex chromosomes drive these differences in brain development, which seem to peak during prenatal and pubertal stages. Animal models have played a crucial role in understanding sex differences, but the study of human sex differences requires an experimental model that can recapitulate complex genetic traits. To fill this gap, human induced pluripotent stem cell–derived brain organoids are now being used to study how complex genetic traits influence prenatal brain development. For example, brain organoids from individuals with autism and individuals with X chromosome–linked Rett syndrome and fragile X syndrome have revealed prenatal differences in cell proliferation, a measure of brain volume differences, and excitatory-inhibitory imbalances. Brain organoids have also revealed increased neurogenesis of excitatory neurons due to androgens. However, despite growing interest in using brain organoids, several key challenges remain that affect its validity as a model system. In this review, we discuss how sex steroids and the sex chromosomes each contribute to sex differences in brain development. Then, we examine the role of X chromosome inactivation as a factor that drives sex differences. Finally, we discuss the combined challenges of modeling X chromosome inactivation and limitations of brain organoids that need to be taken into consideration when studying sex differences.

Aims: To evaluate the effects of 12-week chlorella vulgaris (CV) combined with interval resistance training (IRT) on plasma levels of leptin, adiponectin and neuregulin-4 (Nrg-4) in obese men. Methods: Obese men (n = 44, BMI of 32.1 ± 1.5 kg/m2) were randomly allocated to the following groups of 11 participants per group: Control Placebo group (CP), CV supplement group (CV), Interval Resistance Training group plus Placebo (IRT + P), and Interval Resistance Training plus CV supplement group (IRT + CV). IRT was performed three times a week for 12 weeks using three sets of 10 repetitions at 60 % 1RM, and integrating an active rest interval with 15 repetitions at 20 % 1RM. Participants consumed either CV (1800 mg daily) or a placebo. Pre- and post-intervention blood samples were obtained to assess adipokines which were measured by ELISA. Results: While CV or IRT separately did not alter plasma levels of leptin (p > 0.05), their combination reduced leptin levels (p = 0.007). IRT and IRT plus CV increased the plasma levels of adiponectin and Nrg-4 (p

IntroductionNeuropsychological assessment forms an integral part of the presurgical evaluation for patients with medically refractory focal epilepsy. Our understanding of cognitive impairment in epilepsy is based on seminal lesional studies that have demonstrated important structure-function relationships within the brain. However, a growing body of literature demonstrating heterogeneity in the cognitive profiles of patients with focal epilepsy (e.g., temporal lobe epilepsy; TLE) has led researchers to speculate that cognition may be impacted by regions outside the seizure onset zone, such as those involved in the interictal or “irritative” network.MethodsNeuropsychological data from 48 patients who underwent stereoelectroencephalography (SEEG) monitoring between 2012 and 2023 were reviewed. Patients were categorized based on the site of seizure onset, as well as their irritative network, to determine the impact of wider network activity on cognition. Neuropsychological data were compared with normative standards (i.e., z = 0), and between groups.ResultsThere were very few distinguishing cognitive features between patients when categorized based purely on the seizure onset zone (i.e., frontal lobe vs. temporal lobe epilepsy). In contrast, patients with localized irritative networks (i.e., frontal or temporal interictal epileptiform discharges [IEDs]) demonstrated more circumscribed profiles of impairment compared with those demonstrating wider irritative networks (i.e., frontotemporal IEDs). Furthermore, the directionality of propagation within the irritative network was found to influence the manifestations of cognitive impairment.DiscussionThe findings suggest that neuropsychological assessment is sensitive to network activity beyond the site of seizure onset. As such, an overly focal interpretation may not accurately reflect the distribution of the underlying pathology. This has important implications for presurgical work-up in epilepsy, as well as subsequent surgical outcomes.

Abstract This study provides analytic solutions for the magnetic field of coils and magnets that have a non‐axisymmetric cylindrical geometry with a rectangular cross‐section. New analytic solutions are provided for radially magnetized permanent magnet arcs, thin coil disc sectors, and thick coil sectors. If components of the 3D field are not representable in closed‐form or as canonical Legendre elliptic integrals, the exact solution is given in terms of a series of regularized beta functions. The limit and hence spatial convergence is found to these series, giving a well‐defined and fast solving algorithm for computation. The equations can be readily applied to find the magnetostatic field in linear or non‐linear systems that contain a large set of elements. Example applications are provided to demonstrate how the field can be used to calculate forces and benchmark computational efficiency of the equations. A thorough review of the preceding literature and background theory is provided before a detailed methodology obtaining the analytic solutions contained in this compendium, and further related geometries in cylindrical or spherical coordinates. This is the first study to comprehensively solve the field equations for this collection of electromagnetic geometries.

Abstract Squatting is an active posture test used in assessing baroreflex sensitivity, and the array of patients a physiotherapist handles may benefit from this test to avoid the adverse effects of exercise. Therefore, this study is designed to evaluate the effect of squatting on heart rate and blood pressure among undergraduate students. 35 males (mean age = 22.94 ± 1.846) and 40 females (mean age = 22.28 ± 2.075) participated in this experimental study. Demographic data and baseline cardiovascular parameters (blood pressure and heart rate) were taken before exercise. The exercise protocol, the squatting stress test, was done for 2 min, after which post-exercise blood pressure and heart rate were taken at one minute each. A repeated measure ANOVA and independent t-test were used to analyse the difference at the 0.05 alpha level. It was found that there was a significant difference between pre-exercise in lying and squatting post-exercise blood pressure and heart rate in the first and second minutes (p

Abstract Background Intermittent exercise programs characterized through intensive exercise bouts alternated with passive or active recovery (i.e., interval training), have been proven to enhance measures of cardiorespiratory fitness. However, it is unresolved which recovery type (active or passive) applied during interval training results in larger performance improvements. Objectives This systematic review aimed to summarize recent evidence on the effects of passive or active recovery following long-term interval exercise training on measures of physical fitness and physiological adaptations in healthy trained and untrained individuals. The study protocol was registered in the Open Science Framework (OSF) platform ( https://doi.org/10.17605/OSF.IO/9BUEY ). Methods We searched nine databases including the grey literature (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until February 2023. Key terms as high-intensity interval training, recovery mode, passive or active recover were used. A systematic review rather than a meta-analysis was performed, as a large number of outcome parameters would have produced substantial heterogeneity. Results After screening titles, abstracts, and full texts, 24 studies were eligible for inclusion in our final analysis. Thirteen studies examined the effects of interval training interspersed with passive recovery regimes on physical fitness and physiological responses in trained (6 studies) and untrained (7 studies) individuals. Eleven out of 13 studies reported significant improvements in physical fitness (e.g., maximal aerobic velocity (MAV), Yo-Yo running test, jump performance) and physiological parameters (e.g., maximal oxygen uptake [VO2max], lactate threshold, blood pressure) in trained (effect sizes from single studies: 0.13

Normally, at birth, females have separate perineal orifices for the urinary, reproductive and digestive tracts, while males have individual openings for the urogenital and digestive tracts. However, during fetal development, both sexes pass through a stage when all the systems empty into a common chamber, the cloaca. The cloaca opens to the exterior through a solitary opening until it divides into the various systems. Occasionally, the tracts do not separate and the baby is born with a persistent cloaca. It is a complex anomaly that is often associated with abnormalities in other systems that have to be taken into consideration to manage the patient appropriately.

There is growing interest in the kinematic analysis of human functional upper extremity movement (FUEM) for applications such as health monitoring and rehabilitation. Deconstructing functional movements into activities, actions, and primitives is a necessary procedure for many of these kinematic analyses. Advances in machine learning have led to progress in human activity and action recognition. However, their utility for analyzing the FUEM primitives of reaching and targeting during reach-to-grasp and reach-to-point tasks remains limited. Domain experts use a variety of methods for segmenting the reaching and targeting motion primitives, such as kinematic thresholds, with no consensus on what methods are best to use. Additionally, current studies are small enough that segmentation results can be manually inspected for correctness. As interest in FUEM kinematic analysis expands, such as in the clinic, the amount of data needing segmentation will likely exceed the capacity of existing segmentation workflows used in research laboratories, requiring new methods and workflows for making segmentation less cumbersome. This paper investigates five reaching and targeting motion primitive segmentation methods in two different domains (haptics simulation and real world) and how to evaluate these methods. This work finds that most of the segmentation methods evaluated perform reasonably well given current limitations in our ability to evaluate segmentation results. Furthermore, we propose a method to automatically identify potentially incorrect segmentation results for further review by the human evaluator. Clinical impact: This work supports efforts to automate aspects of processing upper extremity kinematic data used to evaluate reaching and grasping, which will be necessary for more widespread usage in clinical settings.

Large randomized trials in sepsis have generally failed to find effective novel treatments. This is increasingly attributed to patient heterogeneity, including heterogeneous cardiovascular changes in septic shock. We discuss the potential for machine learning systems to personalize cardiovascular resuscitation in sepsis. While the literature is replete with proofs of concept, the technological readiness of current systems is low, with a paucity of clinical trials and proven patient benefit. Systems may be vulnerable to confounding and poor generalization to new patient populations or contemporary patterns of care. Typical electronic health records do not capture rich enough data, at sufficient temporal resolution, to produce systems that make actionable treatment suggestions. To resolve these issues, we recommend a simultaneous focus on technical challenges and removing barriers to translation. This will involve improving data quality, adopting causally grounded models, prioritizing safety assessment and integration into healthcare workflows, conducting randomized clinical trials and aligning with regulatory requirements.

Introduction The literature indicates that pandemics significantly impact the mental health of frontline health workers. While the effects of COVID-19 on the mental health of frontline nurses have been studied, their lived experiences remain insufficiently explored. Objective This study aims to investigate the lived experience of nurses who were deployed to support Wuhan during the COVID-19 pandemic. Methods This study adopted a qualitative study design. A purposive sample of fifteen nurses were recruited from a group of nurses who supported Wuhan during COVID-19 pandemic. The data was collected during May and June 2020. Data collection occurred in May and June 2020, employing semistructured interviews conducted via telephone. Interpretative phenomenological analysis (IPA) was utilized to analyze the collected data by two independent researchers. This report follows the COREQ checklist. Results Frontline nurses supporting Wuhan likened their experience to being on a battlefield. Four superordinate themes emerged: (1) mobilization for combating COVID-19; (2) rapid adaption to a dynamic high-stress environment; (3) navigating psychological distress; and (4) the journey home. Conclusion This study offers comprehensive insights into the lived experience of nurses deployed from other provinces to assist COVID patients in Wuhan. The findings indicate that despite facing a variety of challenges, these frontline nurses were capable of rapid adaptation and successfully fulfilled their roles. Recommendations for future preparedness in public health emergencies are provided. Additionally, follow-up research is warranted to explore the long-term effects of frontline experience on the mental health of the nurses and their family members.

Background Cardiovascular disease is the leading cause of mortality in patients with kidney failure, and their risk of cardiovascular events is 10 to 20 times higher as compared with the general population. Methods and Results We evaluated 508 822 patients who initiated dialysis between January 1, 2005 and December 31, 2014 using the United States Renal Data System with linked Medicare claims. We determined hospitalization rates for cardiovascular events, defined by acute coronary syndrome, heart failure, and stroke. We examined the association of sex with outcome of cardiovascular events, cardiovascular death, and all‐cause death using adjusted time‐to‐event models. The mean age was 70±12 years and 44.7% were women. The cardiovascular event rate was 232 per thousand person‐years (95% CI, 231–233), with a higher rate in women than in men (248 per thousand person‐years [95% CI, 247–250] versus 219 per thousand person‐years [95% CI, 217–220]). Women had a 14% higher risk of cardiovascular events than men (hazard ratio [HR], 1.14 [95% CI, 1.13–1.16]). Women had a 16% higher risk of heart failure (HR, 1.16 [95% CI, 1.15–1.18]), a 31% higher risk of stroke (HR, 1.31 [95% CI, 1.28–1.34]), and no difference in risk of acute coronary syndrome (HR, 1.01 [95% CI, 0.99–1.03]). Women had a lower risk of cardiovascular death (HR, 0.89 [95% CI, 0.88–0.90]) and a lower risk of all‐cause death than men (HR, 0.96 [95% CI, 0.95–0.97]). Conclusions Among patients undergoing dialysis, women have a higher risk of cardiovascular events of heart failure and stroke than men. Women have a lower adjusted risk of cardiovascular mortality and all‐cause mortality.

Photovoltaic technology has been widely recognized as a means to advance green energy solutions in the sub-Saharan region. In the real-time operation of solar modules, temperature plays a crucial role, making it necessary to evaluate the thermal impact on the performance of the solar devices, especially in high-insolation environments. Hence, this paper investigates the effect of operating temperature on the performance of two types of organometallic halide perovskites (OHP) - formamidinium tin iodide (FASnI3) and methylammonium lead iodide (MAPbI3). The solar cells were evaluated under a typical Nigerian climate in two different cities before and after graphene passivation. Using a one-dimensional solar capacitance simulation software (SCAPS-1D) program, the simulation results show that graphene passivation improved the conversion efficiency of the solar cells by 0.51 % (FASnI3 device) and 3.11 % (MAPbI3 device). The presence of graphene played a vital role in resisting charge recombination and metal diffusion, which are responsible for the losses in OHP. Thermal analysis revealed that the MAPbI3 device exhibited an increased fill factor (FF) in the temperature range of 20–64 °C, increasing the power conversion efficiency (PCE). This ensured that the MAPbI3 solar cell performed better in the city and the season with harsher thermal conditions (Kaduna, dry season). Thus, MAPbI3 solar cells can thrive excellently in environments where the operating temperature is below 65 °C. Overall, this study shows that the application of OHP devices in sub-Saharan climatic conditions is empirically possible with the right material modification.

Abstract Introduction Digital delivery of pre‐operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre‐ and post‐operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks. Objective To develop a pre‐operative TKR education and prehabilitation digital intervention, the ‘Virtual Knee School’ (VKS). Methods The VKS was developed using an evidence‐, theory‐ and person‐based approach. This involved a mixed methods design with four phases. The first three focused on planning the VKS. The final phase involved creating a VKS prototype and iteratively refining it through concurrent think‐aloud interviews with nine patients who were awaiting/had undergone TKR. Meta‐inferences were generated by integrating findings from all the phases. ISRCTN registration of the overall project was obtained on 24 April 2020 (ISRCTN11759773). Results Most participants found the VKS prototype acceptable overall and considered it a valuable resource. Conversely, a minority of participants felt the prototype's digital format or content did not meet their individual needs. Participants' feedback was used to refine the prototype's information architecture, design and content. Two meta‐inferences were generated and recommend: 1. Comprehensive pre‐operative TKR education and prehabilitation support should be rapidly accessible in digital and non‐digital formats. 2. Pre‐operative TKR digital interventions should employ computer‐ and self‐tailoring to account for patients' individual needs and preferences. Conclusions Integrating evidence, theory and stakeholders' perspectives enabled the development of a promising VKS digital intervention for patients awaiting TKR. The findings suggest future research evaluating the VKS is warranted and provide recommendations for optimising pre‐operative TKR care. Patient or Public Contribution Patient and Public Involvement (PPI) was central throughout the project. For example, PPI representatives contributed to the project planning, were valued members of the Project Advisory Group, had key roles in developing the VKS prototype and helped disseminate the project findings.

Abstract The influence of AI recommendations on physician behaviour remains poorly characterised. We assess how clinicians’ decisions may be influenced by additional information more broadly, and how this influence can be modified by either the source of the information (human peers or AI) and the presence or absence of an AI explanation (XAI, here using simple feature importance). We used a modified between-subjects design where intensive care doctors (N = 86) were presented on a computer for each of 16 trials with a patient case and prompted to prescribe continuous values for two drugs. We used a multi-factorial experimental design with four arms, where each clinician experienced all four arms on different subsets of our 24 patients. The four arms were (i) baseline (control), (ii) peer human clinician scenario showing what doses had been prescribed by other doctors, (iii) AI suggestion and (iv) XAI suggestion. We found that additional information (peer, AI or XAI) had a strong influence on prescriptions (significantly for AI, not so for peers) but simple XAI did not have higher influence than AI alone. There was no correlation between attitudes to AI or clinical experience on the AI-supported decisions and nor was there correlation between what doctors self-reported about how useful they found the XAI and whether the XAI actually influenced their prescriptions. Our findings suggest that the marginal impact of simple XAI was low in this setting and we also cast doubt on the utility of self-reports as a valid metric for assessing XAI in clinical experts.

We consider optimal designs for clinical trials when response variance depends on treatment and covariates are included in the response model. These designs are generalizations of Neyman allocation, and commonly employed in personalized medicine where external covariates linearly affect the response. Very often, these designs aim at maximizing the amount of information gathered but fail to assure ethical requirements. We analyze compound optimal designs that maximize a criterion weighting the amount of information and the reward of allocating the patients to the most effective/least risky treatment. We develop a general representation for static (a priori) allocation and propose a semidefinite programming (SDP) formulation to support their numerical computation. This setup is extended assuming the variance and the parameters of the response of all treatments are unknown and an adaptive sequential optimal design scheme is implemented and used for demonstration. Purely information theoretic designs for the same allocation have been addressed elsewhere, and we use them to support the techniques applied to compound designs.

The reaction of indigo with two equivalents of the electrophile ethyl bromoacetate with caesium carbonate as a base result in the formation of structurally complex polyheterocyclics, including a fused spiroimidazole and a spiro[1,3]oxazino derivative, together with a biindigoid-type derivative, through a convenient one-pot reaction. Further assessment of the reaction using five equivalents of the electrophile gave rise to other molecules incorporating the 2-(7,13,14-trioxo-6,7,13,14-tetrahydropyrazino[1,2-a:4,3-a′]diindol-6-yl) scaffold. The reaction of ethyl bromoacetate with the less reactive indirubin resulted in the synthesis of three derivatives of a new class of polyheterocyclic system via a cascade process, although yields were low. These compounds were derived from the parent indolo[1,2-b]pyrrolo[4,3,2-de]isoquinoline skeleton. Despite the modest yields of the reactions, they represent quick cascade routes to a variety of heterocycles from cheap starting materials, with these structures otherwise being difficult to synthesise in a traditional stepwise manner. These outcomes also contribute significantly to the detailed understanding of the indigo/indirubin cascade reaction pathways initiated by base-catalysed N-alkylation.

Tetrahydroacridines arouse particular interest due to the potential possibilities of application in the medical field and protection against corrosion. Bis-tetrahydroacridines were newly synthesized by Pfitzinger condensation of 5,5′-(ethane-1,2-diyl) diindoline-2,3-dione with several cyclanones. NMR, MS, and FT-IR were used to prove their molecular structure. In addition, a computer-aided study was performed for the lowest energy conformers of each structure, in vacuum conditions, at ground state using DFT models to assess their electronic properties. UV–Vis and voltammetric methods (cyclic voltammetry, differential pulse voltammetry, and rotating disk electrode voltammetry) were used to investigate their optical and electrochemical properties. The results obtained for these π-conjugated heteroaromatic compounds lead to the conclusion that they have real potential in applications in different fields such as pharmaceuticals and especially as corrosion inhibitors.

Greenhouse production of high-quality young annual bedding plants (plugs) at northern latitudes often requires supplemental lighting to compensate for a low natural daily light integral (DLI), but radiation interception by plugs is limited by a low leaf area index. Some species show an increase in leaf area in response to growth under a low ratio of red to far-red radiation (R:FR), and an early increase in leaf area may allow for more effective radiation capture by seedlings and a reduction in wasted radiation. Thus, the objective of this study was to examine the effects of end-of-day far-red (EOD-FR) radiation treatments varying in intensity, R:FR (600–700 nm/700–780 nm), and duration on early leaf expansion and plug quality for petunia (Petunia ×hybrida) ‘Wave Purple’ and ‘Dreams Midnight’. Seedlings were grown in 128-cell trays in a common greenhouse environment under a simulated winter DLI (∼5.3 mol·m−2·s−1) and received one of four EOD-FR treatments, control conditions (no EOD-FR or supplemental lighting), or supplemental lighting (target photosynthetic photon flux density of 70 μmol·m−2·s−1). The EOD-FR treatments were provided for 3 weeks on cotyledon emergence and included the following: 10 μmol·m−2·s−1 of far-red radiation for 30 minutes with a R:FR of ∼0.8 (EODFL), 10 or 20 μmol·m−2·s−1 of far-red radiation for 30 minutes with a R:FR of ∼0.15 (EOD10:30 and EOD20:30, respectively), or 20 μmol·m−2·s−1 of far-red radiation for 240 minutes with a R:FR of ∼0.15 (EOD20:240). Destructive data were collected 14 and 21 days after cotyledon emergence. Seedlings that received EOD-FR treatments did not show any increase in leaf area compared with control or supplemental lighting treatments. Stem length generally increased under EOD-FR treatments compared with supplemental lighting and control treatments; greater elongation was observed when the R:FR decreased from 0.8 to 0.15, and when treatment duration increased from 30 minutes to 240 minutes. However, at a R:FR of 0.15 and a treatment duration of 30 minutes, an increase in far-red radiation intensity from 10 to 20 μmol·m−2·s−1 did not promote further stem elongation resulting in similar stem lengths for both cultivars under EOD10:30 and EOD20:30. Results of this study indicate that under low DLIs, EOD-FR radiation applied in the first 3 weeks of seedling production does not promote early leaf area expansion, and generally decreases seedling quality for petunia. As responses to far-red radiation may vary based on study taxa, incident radiation, and DLI, future research examining EOD-FR–induced morphological changes is warranted.

ABSTRACTA key challenge for mitigating poaching within protected areas is to understand the geospatial data that are collected by practitioners in protected areas and to characterize the ability to synthesize those data with landscape-level data to form a holistic picture of the movement patterns of humans and animals. Literature reviewed from the past 15 years on geospatial data collected by practitioners to mitigate wildlife poaching reveals a gap in our knowledge on how protected area practitioners make sense of geospatial data that are collected within protected areas. Geospatial data collected within protected areas provide an understanding of movement patterns of humans and animals, which can provide insight on best practices for poaching mitigation, to include where to emplace new geospatial sensors. We classify these data as device-based and human-generated, and their potential to provide geospatially referenced information that forms patterns of poaching activity. This article examines two primary types of geospatial data collected in protected areas, highlights the challenges associated with this data, and discusses knowledge gaps regarding how protected areas make sense of spatial data. We conclude with recommendations for future research on characterizing how geospatial data is represented in protected areas, and filling knowledge gaps on how protected area personnel use those data.

New therapies and vaccines based on nucleic acids combined with an efficient nanoparticle delivery vehicle have a broad applicability for different disease indications. An alternative delivery technology for the successfully applied lipid nanoparticles in mRNA SARS-CoV-2 vaccines are nanoparticles composed of biodegradable poly(amido)amine-based polymers with mRNA payload. To show that these polymeric nanoparticles can efficiently deliver influenza hemagglutinin mRNA to target tissues and elicit protective immune responses, a relevant ferret influenza challenge model was used. In this model, our nanoparticle-based vaccine elicited strong humoral and cellular immune responses in the absence of local and systemic reactogenicity. Upon virus challenge, vaccinated animals exhibited reduced clinical signs and virus load relative to unvaccinated control animals. Based on these findings, further investigation of the polymeric nanoparticles in the context of prophylactic vaccination is warranted. Future studies will focus on optimizing the payload, the nanoparticle stability, the efficacy in the context of pre-existing immunity, and the applicability of the technology to prevent other infectious diseases.

Summary: Anaplastic thyroid carcinoma is arguably the most lethal human malignancy. It often co-occurs with differentiated thyroid cancers, yet the molecular origins of its aggressivity are unknown. We sequenced tumor DNA from 329 regions of thyroid cancer, including 213 from patients with primary anaplastic thyroid carcinomas. We also whole genome sequenced 9 patients using multi-region sequencing of both differentiated and anaplastic thyroid cancer components. Using these data, we demonstrate thatanaplastic thyroid carcinomas have a higher burden of mutations than other thyroid cancers, with distinct mutational signatures and molecular subtypes. Further, different cancer driver genes are mutated in anaplastic and differentiated thyroid carcinomas, even those arising in a single patient. Finally, we unambiguously demonstrate that anaplastic thyroid carcinomas share a genomic origin with co-occurring differentiated carcinomas and emerge from a common malignant field through acquisition of characteristic clonal driver mutations.

Introduction COVID-19 catalysed a rapid move to provide care away from the hospital using online communication platforms. Technology enabled care (TEC) continues to be an important driver in progressing future healthcare services. Due to the complex and chronic nature of conditions seen within paediatric rheumatology, TEC may lead to better outcomes. Despite some growth in published literature into the adoption of TEC in paediatric rheumatology, there is limited synthesis. The aim of this review is to provide a comprehensive understanding and evaluation of the adoption of TEC by patients in paediatric rheumatology services, to establish best practices.Methods and analysis This proposed mixed-methods systematic review will be conducted by searching a wide variety of healthcare databases, grey literature resources and associated charities and societies, for articles reported in English language. Data extraction will include population demographics, technology intervention, factors affecting adoption of intervention and consequent study outcomes. A parallel-results convergent synthesis design is planned, with independent syntheses of quantitative and qualitative data, followed by comparison of the findings of each synthesis using a narrative approach. Normalisation process theory will be used to identify, characterise and explain implementation factors. The quality of included articles will be assessed using the Mixed Methods Appraisal Tool for research papers and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for grey literature. Overall confidence in quality and strength of evidence will be assessed using the Confidence in the Evidence from Reviews of Qualitative Research tool.Ethics and dissemination Ethical approval is not required due to the nature of this mixed-methods systematic review. The findings will be disseminated via a peer-reviewed journal, relevant conferences and any other methods (eg, via NHS Trust or NIHR YouTube channels) as advised by paediatric rheumatology patients.PROSPERO registration number CRD42023443058.

Here, we describe a spontaneous mouse mutant with a deletion in a predicted gene 2310061I04Rik (Rik) of unknown function located on chromosome 17. A 59 base pair long deletion occurred in the first intron of the Rik gene and disrupted its expression. Riknull mice were born healthy and appeared anatomically normal up to two weeks of age. After that, these mice showed inhibited growth, ataxic gait, and died shortly after postnatal day 24 (P24). Transcriptome analysis at P14 and P23 revealed significantly reduced expression of mitochondrial genes in Riknull brains compared to wild type controls including mt-Nd4, mt-Cytb, mt-Nd2, mt-Co1, mt-Atp6, and others. Similarly, genes specific for myelinating oligodendrocytes also showed reduced expression in P23 Riknull brains compared to controls. Histological examination of anterior thalamic nuclei demonstrated decreased myelination of anteroventral nuclei but not of anterodorsal nuclei in P23 Riknull mice. Myelination of the anterior commissure was also impaired and displayed extensive vacuolation. Consistently with these findings, immunohistochemistry showed reduced expression of Opalin, a glycoprotein expressed in differentiated oligodendrocytes. Taken together, these results suggest that RIK is important for oligodendrocyte maturation and myelination in the developing brain.