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Background and objective: Toxicity from local salvage therapy for radiorecurrent prostate cancer (PCa) remains a concern. This phase 2 study evaluates the outcomes of salvage magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (sTULSA). Methods: Men with biochemically relapsed, biopsy-proven PCa following definitive radiotherapy underwent whole- or partial-gland sTULSA (NCT03350529). Prostate-confined recurrence was confirmed by MRI and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT). The primary endpoints were safety (Clavien-Dindo classification) and efficacy (prostate-specific antigen [PSA], PSMA PET-CT, and MRI-targeted biopsy at 12 mo). The secondary endpoints included functional and survival outcomes. Key findings and limitations: Thirty-nine patients underwent sTULSA (64% whole gland), with a median age of 73 yr (interquartile range [IQR]: 69–77) and PSA of 3.3 ng/ml (IQR: 2–6.2). Three patients had undergone prior salvage therapy, 16 were receiving hormonal therapy at enrollment, and 12 had a history of transurethral interventions. Eighteen patients had incidental urethral strictures on baseline cystoscopy. Over a median follow-up of 40 mo (IQR: 24–55), 56% experienced adverse events. Severe genitourinary toxicity (Clavien-Dindo ≥3 or hospitalization) occurred in 28%, including three patients with puboprostatic fistulas and two patients requiring cystectomy. Leak-free continence was maintained in 53%. At 12 mo, 89% showed no cancer in the targeted area, with a median PSA reduction of 95% (p

A significant way to contribute in the analysis of deficiencies in school performance, a known issue particularly in mathematics, is by delving into children's development of informal mathematics during their early childhood, and thus have better elements to intervene in a more timely, effective manner. From this point of view, this study analyzes how the relationship between parenting behavior and early mathematics can be mediated by the development of self-regulation in children. The sample of the study is made of 85 students, between 5 and 6 years old, who are in their last year of preschool in two public schools in Lima. The instruments used are the Spanish translations of the Test of Early Mathematics Ability--3, Head-Toes-Knees-Shoulders task and Parent Behavior Inventory. The main results show that self-regulation in children and their caregivers' parenting behavior are significant predicting variables in early mathematical development. Specifically, the findings suggest that self-regulation in children can significantly mediate the relationship between the dimension of support/engagement in parenting behavior and the development of early mathematics in children during preschool.

One of the strongest predictors of future academic achievement is the early and informal math skills children begin their school studies. Because of this, it is essential to have proper tools for measuring the development of mathematical thinking at an early age to be able to intervene in a timelier, more effective way. The purpose of this research is to calibrate the items of informal mathematics from the test of early mathematics ability--third edition (TEMA-3) by applying the Rasch model. A total of 148 Peruvian preschool children (ranging in age from five to six years) participated in the study. The results show good psychometric properties of the informal mathematics dimension of the instrument, which indicates a good fit of the student sample, the items to the proposed model and a tendency toward unbiased items. We further determined that the items analyzed exhibit a consistent internal structure at the theoretical level.

BACKGROUND: These clinical standards aim to provide guidance for diagnosis, treatment, and management of drug-susceptible TB in children and adolescents.METHODS: Fifty-two global experts in paediatric TB participated in a Delphi consensus process. After eight rounds of revisions, 51/52 (98%) participants endorsed the final document.RESULTS: Eight standards were identified: Standard 1, Age and developmental stage are critical considerations in the assessment and management of TB; Standard 2, Children and adolescents with symptoms and signs of TB disease should undergo prompt evaluation, and diagnosis and treatment initiation should not depend on microbiological confirmation; Standard 3, Treatment initiation is particularly urgent in children and adolescents with presumptive TB meningitis and disseminated (miliary) TB; Standard 4, Children and adolescents should be treated with an appropriate weight-based regimen; Standard 5, Treating TB infection (TBI) is important to prevent disease; Standard 6, Children and adolescents should receive home-based/community-based treatment support whenever possible; Standard 7, Children, adolescents, and their families should be provided age-appropriate support to optimise engagement in care and clinical outcomes; and Standard 8, Case reporting and contact tracing should be conducted for each child and adolescent.CONCLUSION: These consensus-based clinical standards, which should be adapted to local contexts, will improve the care of children and adolescents affected by TB.

We propose a model for the QCD running coupling constant based on the analytical inverse QCD coupling constant concept with an additional regularization in the low momentum region. Analyticity in the q2-complex plane, where q is the four-momentum transfer, is imposed by methods of the Analytic Perturbation Theory. The model incorporates a peculiar low-momentum behavior for αs(q2) as a divergence at q2=0 to retrieve color confinement, without spoiling its correct high-momentum behavior. This was achieved by means of a two-parameter regularization function, for which we considered three possible analytic expressions. In fact, within the framework of the Analytic Perturbation Theory, αs(q2) assumes a finite value for q2=0, at all perturbative orders (infrared stability), hence the infrared divergence cannot be implemented. For this reason, we found it more straightforward to work with its reciprocal, namely, εs(q2)=1/αs(q2), imposing its vanishing at the origin of the q2-complex plane via the multiplication of the aforementioned regularizing functions and the spectral density. Once the two free parameters of the regularization functions were settled by fitting to the experimental values of αs(q2) at the momenta where these data were available and reliable, the model could reproduce the QCD running coupling constant at any other momentum transferred.

Summary: Background: With increasing recognition of the value of incorporating prognostic markers into amyotrophic lateral sclerosis (ALS) trial design and analysis plans, there is a pressing need to understand which among the prevailing clinical and biochemical markers have real value, and how they can be optimally used. Methods: A subset of patients with ALS recruited through the multi-center Phenotype-Genotype-Biomarker study (clinicaltrials.gov: NCT02327845) was identified as “trial-like” based on meeting common trial eligibility criteria. Clinical phenotyping was performed by evaluators trained in relevant assessments. Serum neurofilament light (NfL) and phosphorylated neurofilament heavy (pNfH), urinary p75ECD, plasma microRNA-181, and an array of biochemical and clinical measures were evaluated for their prognostic value. Associations with functional progression were estimated by random-slopes mixed models of ALS functional rating scale-revised (ALSFRS-R) score. Associations with survival were estimated by log-rank test and Cox proportional hazards regression. Potential sample size savings from adjusting for given biomarkers in a hypothetical trial were estimated. Findings: Baseline serum NfL is a powerful prognostic biomarker, predicting survival and ALSFRS-R rate of decline. Serum NfL 100 pg/mL correspond to future ALSFRS-R slopes of ∼0.5 and ∼1.5 points/month, respectively. Serum NfL also adds value to the best available clinical predictors, encapsulated by the European Network to Cure ALS (ENCALS) predictor score. In models of functional decline, the addition of NfL yields ∼25% sample size saving above those achieved by inclusion of either clinical predictors or ENCALS score alone. The prognostic value of serum pNfH, urinary p75ECD, and plasma miR-181ab is more limited. Interpretation: Among the multitude of biomarkers considered, only blood NfL adds value to the ENCALS prediction model and should be incorporated into analysis plans for all ongoing and future ALS trials. Defined thresholds of NfL might also be used in trial design, for enrichment or stratified randomisation, to improve trial efficiency. Funding: NIH (U01-NS107027, U54-NS092091). ALSA (16-TACL-242).

Many lines of evidence have highlighted the role played by heterogeneous nuclear ribonucleoproteins in amyotrophic lateral sclerosis. In this study, we have aimed to identify transcripts co-regulated by TAR DNA-binding protein 43 kDa and highly conserved heterogeneous nuclear ribonucleoproteins which have been previously shown to regulate TAR DNA-binding protein 43 kDa toxicity (deleted in azoospermia-associated protein 1, heterogeneous nuclear ribonucleoprotein -Q, -D, -K and -U). Using the transcriptome analyses, we have uncovered that Nitric Oxide Synthase 1 Adaptor Protein mRNA is a direct TAR DNA-binding protein 43 kDa target, and in flies, its modulation alone can rescue TAR DNA-binding protein 43 kDa pathology. In primary mouse cortical neurons, we show that TAR DNA-binding protein 43 kDa mediated downregulation of Nitric Oxide Synthase 1 Adaptor Protein expression strongly affects the NMDA-receptor signalling pathway. In human patients, the downregulation of Nitric Oxide Synthase 1 Adaptor Protein mRNA strongly correlates with TAR DNA-binding protein 43 kDa proteinopathy as measured by cryptic Stathmin-2 and Unc-13 homolog A cryptic exon inclusion. Overall, our results demonstrate that Nitric Oxide Synthase 1 Adaptor Protein may represent a novel disease-relevant gene, potentially suitable for the development of new therapeutic strategies.

Objective: To investigate the prevalence and features of protracted COVID-19 symptoms in non-hospitalized university students who experienced mild-to-moderate acute illness. Participants: COVID-19 positive participants with symptoms = 28days (N=22), herein referred to as post-COVID syndrome, were compared to those who fully recovered (N=21) and those never diagnosed with the disease (N=58). Methods: Students completed online study to earn research credit for class. Results: 51% of COVID-19 positive participants were classified with post-COVID syndrome. During acute illness, those with post-COVID syndrome experienced more chest pain, fatigue, fever, olfactory impairment, headaches, and diarrhea compared to fully recovered participants. They also reported more current exercise intolerance, dyspnea, chest pain, olfactory impairment, lymphadenopathy, gustatory impairment, and appetite loss than students who never contracted COVID-19. Conclusions: Our results contradict the perception that this yet to be defined post-COVID syndrome predominantly affects middle-aged adults. Student health centers should closely monitor those who contract COVID-19 for lingering effects.

Rare coding variation has historically provided the most direct connections between gene function and disease pathogenesis. By meta-analysing the whole exomes of 24,248 schizophrenia cases and 97,322 controls, we implicate ultra-rare coding variants (URVs) in 10 genes as conferring substantial risk for schizophrenia (odds ratios of 3-50, P

Significant progress has been made in understanding the pre-symptomatic phase of amyotrophic lateral sclerosis. While much is still unknown, advances in other neurodegenerative diseases offer valuable insights. Indeed, it is increasingly clear that the well-recognized clinical syndromes of Alzheimer's disease, Parkinson's disease, Huntington's disease, spinal muscular atrophy and frontotemporal dementia are also each preceded by a pre-symptomatic or prodromal period of varying duration, during which the underlying disease process unfolds, with associated compensatory changes and loss of inherent system redundancy. Key insights from these diseases highlight opportunities for discovery in amyotrophic lateral sclerosis. The development of biomarkers reflecting amyloid and tau has led to a shift in defining Alzheimer's disease based on inferred underlying histopathology. Parkinson's disease is unique among neurodegenerative diseases in the number and diversity of non-genetic biomarkers of pre-symptomatic disease, most notably REM sleep behaviour disorder. Huntington's disease benefits from an ability to predict the likely timing of clinically manifest disease based on age and CAG-repeat length alongside reliable neuroimaging markers of atrophy. Spinal muscular atrophy clinical trials have highlighted the transformational value of early therapeutic intervention, and studies in frontotemporal dementia illustrate the differential role of biomarkers based on genotype. Similar advances in amyotrophic lateral sclerosis would transform our understanding of key events in pathogenesis, thereby dramatically accelerating progress towards disease prevention. Deciphering the biology of pre-symptomatic amyotrophic lateral sclerosis relies on a clear conceptual framework for defining the earliest stages of disease. Clinically manifest amyotrophic lateral sclerosis may emerge abruptly, especially among those who harbour genetic mutations associated with rapidly progressive amyotrophic lateral sclerosis. However, the disease may also evolve more gradually, revealing a prodromal period of mild motor impairment preceding phenoconversion to clinically manifest disease. Similarly, cognitive and behavioural impairment, when present, may emerge gradually, evolving through a prodromal period of mild cognitive impairment or mild behavioural impairment before progression to amyotrophic lateral sclerosis. Biomarkers are critically important to studying pre-symptomatic amyotrophic lateral sclerosis and essential to efforts to intervene therapeutically before clinically manifest disease emerges. The use of non-genetic biomarkers, however, presents challenges related to counselling, informed consent, communication of results and limited protections afforded by existing legislation. Experiences from pre-symptomatic genetic testing and counselling, and the legal protections against discrimination based on genetic data, may serve as a guide. Building on what we have learned-more broadly from other pre-symptomatic neurodegenerative diseases and specifically from amyotrophic lateral sclerosis gene mutation carriers-we present a road map to early intervention, and perhaps even disease prevention, for all forms of amyotrophic lateral sclerosis.

Water-stable proteins may offer a new field of applications in smart materials for buildings and infrastructures where hydraulic reactions are involved. In this study, cement mortars modified through water-soluble silk fibroin (SF) are proposed. Water-soluble SF obtained by redissolving SF films in phosphate buffer solution (PBS) showed the formation of a gel with the β sheet features of silk II. Electrical measurements of SF indicate that calcium ions are primarily involved in the conductivity mechanism. By exploiting the water solubility properties of silk II and Ca2+ ion transport phenomena as well as their trapping effect on water molecules, SF provides piezoresistive and piezocapacitive properties to cement mortars, thus enabling self-sensing of mechanical strain, which is quite attractive in structural health monitoring applications. The SF/cement-based composite introduces a capacitive gauge factor which surpasses the traditional resistive gauge factor reported in the literature by threefold. Cyclic voltammetry measurements demonstrated that the SF/cement mortars possessed memcapacitive behavior for positive potentials near +5 V, which was attributed to an interfacial charge build-up modulated by the SF concentration and the working electrode. Electrical square-biphasic excitation combined with cyclic compressive loads revealed memristive behavior during the unloading stages. These findings, along with the availability and sustainability of SF, pave the way for the design of novel multifunctional materials, particularly for applications in masonry and concrete structures.

Plumeria rubra L. is an ornamental Caribbean plant widely known for its ethnobotanical uses and pharmacological activities. The ‘Tonda Palermitana’ cultivar, on which no data are to date available, is commonly cultivated in Sicily. The aim of our study was to characterize the micro-morphological features of leaves and flowers of this cultivar by light and Scanning Electron Microscopy and to investigate the phytochemical profile and the biological properties of their food-grade extracts (LE and FE, respectively) by LC-DAD-ESI-MS analysis and different in vitro assays. Numerous branched laticifers were observed, and their secretion contained alkaloids and lipophilic compounds as confirmed by histological analyses. Phytochemical analyses showed the presence of alkaloids (9%), terpenoids (13%) and fatty acids (6%), together with a very abundant presence of iridoids (28%) and polyphenols (39%). The most notable biological activity of both extracts appears to be the antioxidant one, showing half-inhibitory concentrations (IC50) about 5 times lower than those detected in anti-inflammatory assays (383.74 ± 5.65 and 232.05 ± 2.87 vs. 1981.23 ± 12.82 and 1215.13 ± 10.15, for FE and LE, respectively), with LE showing the best, and statistically significant (p < 0.001), biological activity. These results allow us to speculate promising nutraceutical and cosmeceutical applications for this old Sicilian cultivar.

BackgroundStudying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.AimsTo examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.MethodGenome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.ResultsEarlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = -0.34 years, s.e. = 0.08), major depression (β = -0.34 years, s.e. = 0.08), schizophrenia (β = -0.39 years, s.e. = 0.08), and educational attainment (β = -0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.ConclusionsAAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.

ObjectiveTo validate the prognostic accuracy of anti-apolipoprotein A-1 (AAA1) IgG for incident major adverse cardiovascular (CV) events (MACE) in rheumatoid arthritis (RA) and study their associations with the lipid paradox at a multicentric scale.MethodBaseline AAA1 IgG, lipid profile, atherogenic indexes, and cardiac biomarkers were measured on the serum of 1,472 patients with RA included in the prospective Swiss Clinical Quality Management registry with a median follow-up duration of 4.4 years. MACE was the primary endpoint defined as CV death, incident fatal or non-fatal stroke, or myocardial infarction (MI), while elective coronary revascularization (ECR) was the secondary endpoint. Discriminant accuracy and incidence rate ratios (IRR) were respectively assessed using C-statistics and Poisson regression models.ResultsDuring follow-up, 2.4% (35/1,472) of patients had a MACE, consisting of 6 CV deaths, 11 MIs, and 18 strokes; ECR occurred in 2.1% (31/1,472) of patients. C-statistics indicated that AAA1 had a significant discriminant accuracy for incident MACE [C-statistics: 0.60, 95% confidence interval (95% CI): 0.57–0.98, p = 0.03], mostly driven by CV deaths (C-statistics: 0.77; 95% CI: 0.57–0.98, p = 0.01). IRR indicated that each unit of AAA1 IgG increase was associated with a fivefold incident CV death rate, independent of models’ adjustments. At the predefined and validated cut-off, AAA1 displayed negative predictive values above 97% for MACE. AAA1 inversely correlated with total and HDL cholesterol.ConclusionsAAA1 independently predicts CV deaths, and marginally MACE in RA. Further investigations are requested to ascertain whether AAA1 could enhance CV risk stratification by identifying patients with RA at low CV risk.

IntroductionThe following work aims to compare the types and magnitude of risk events in patients with Schizophrenia and Bipolar Disorder and each of those groups with of a group of healthy siblings, exploring differences and similarities of the two psychotic disorders.MethodsRetrospective interviews were conducted with 20 families to investigate maternal and obstetric health, social support and the presence of early trauma for the affected family members and healthy siblings. Mothers were interviewed with the Prenatal Psychosocial Profile and each family participant was assessed with the Early Trauma Inventory, Screening Questionnaire of the Genomic Psychiatry Cohort and the Diagnostic Interview for Psychosis and Affective Disorders.ResultsObstetric and gestational history, pregnancy weight changes and early trauma were associated with offspring’s mental illness, including statistically significant findings for complications of pregnancy, pregnancy weight changes, general trauma, physical punishment and emotional abuse.ConclusionThese findings highlight the different risk factor exposures that occur within a family, which may increase the risk for severe mental illness.

The magnetospheric systems of ice giants, as the ideal and the unique template of a typical class of exoplanets, have not been sufficiently studied in the past decade. The complexity of these asymmetric and extremely dynamic magnetospheres provides us a great chance to systematically investigate the general mechanism of driving the magnetospheres of such common exoplanets in the Universe, and the key factors of influencing the global and local magnetospheric structures of this type of planets. In this paper, we discuss the science return of probing magnetospheric systems of ice giants for the future missions, throughout different magnetospheric regions, across from the interaction with upstream solar wind to the downstream region of the magnetotail. We emphasize the importance of detecting the magnetospheric systems of ice giants in the next decades, which enables us to deeply understand the space enviroNMent and habitability of not only the ice giants themselves but also the analogous exoplanets which are widely distributed in the Universe.

Neurodegenerative diseases are challenging for systems biology because of the lack of reliable animal models or patient samples at early disease stages. Induced pluripotent stem cells (iPSCs) could address these challenges. We investigated DNA, RNA, epigenetics, and proteins in iPSC-derived motor neurons from patients with ALS carrying hexanucleotide expansions in C9ORF72. Using integrative computational methods combining all omics datasets, we identified novel and known dysregulated pathways. We used a C9ORF72 Drosophila model to distinguish pathways contributing to disease phenotypes from compensatory ones and confirmed alterations in some pathways in postmortem spinal cord tissue of patients with ALS. A different differentiation protocol was used to derive a separate set of C9ORF72 and control motor neurons. Many individual -omics differed by protocol, but some core dysregulated pathways were consistent. This strategy of analyzing patient-specific neurons provides disease-related outcomes with small numbers of heterogeneous lines and reduces variation from single-omics to elucidate network-based signatures.

Metabolic associated fatty liver disease (MAFLD) is considered an indicator of metabolic syndrome, which affects millions of people around the world and no effective treatment is currently available. MAFLD involves a wide spectrum of liver damage, that initiates from steatosis (fatty live) and may progress to more complex pathophysiology. Then, details in lipid metabolism controlling should be explored aiming to control the fatty liver. In this context, the miR-1914-5p can be considered a potential biotechnology tool to control lipid metabolism in hepatic cells. This miRNA finds potential mRNA binding sequences in more than 100 molecules correlated with energy production and lipid metabolism pointed in bioinformatic platforms. The present study addressed the miR-1914-5p effects in hepatic HepG2/LX-2 co-cultured cells in a in vitro steatotic environment stablished by the addition of 400 μM of a mixture of oleic and palmitic acids. The analyses demonstrated that the inhibition of the miRNA reduced energetic metabolites such as total lipids, triglycerides, cholesterol and even glucose. In addition, the miR-inhibitor-transfected cells did not present any deleterious effect in cellular environment by controlling reactive oxygen species production (ROS), mitochondrial membrane potential (ΔΨm) and even the pro-inflammatory environment. Moreover, the functional effect of the investigated miR, suggested its close connection to the modulation of Sirt-1-PGC1-α pathway, a master switch metabolic route that controlls cellular energetic metabolism. Our assays also suggested a synergistic effect of this miR-1914-5p in cell metabolism, which should be considered as a strong candidate to control steatotic environment in future clinical trials.

Cover crops (CC) are increasingly used worldwide within integrated weed management scenarios. They are usually established between two commercial crops and are not harvested, grazed, or incorporated into the soil, but remain on the surface during their growth cycle. The aim of this work was to determine the performance of different CC mixtures and their effects on weed suppression in the south-central region of Buenos Aires province, Argentina. Field experiments were carried out in 2019 and 2020 at the CEI Barrow (MDA-INTA, Tres Arroyos), where both binary and ternary CC mixtures were evaluated. Binary mixtures consisted of winter cereals (Avena sativa, Secale cereale) and legumes (Vicia villosa, Vicia sativa) while ternary mixtures were obtained by combining binary mixtures with canola (Brassica napus). Weed emergence counting was performed on a 14- day basis to determine weed total density. Vegetation cover of the CC mixtures as well as biomass production from crops and weeds were estimated. The specific composition of the mixtures showed a greater influence on vegetation cover than on biomass production, which would depend mainly on the prevailing environmental conditions. The type of vetch used, the addition of canola, as well as, the proportion of cereals in the mixture determined the CC effect on weeds. CC were consistently more effective in suppressing weed biomass than seedling emergence density. However, weed seedling suppression by CC was similar to or even greater than the chemical-based control (p

[This corrects the article DOI: 10.1371/journal.pone.0061626.].