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Calcific aortic valve disease (CAVD) is an active pathobiological process leading to severe aortic stenosis, where the only treatment is valve replacement. Late-stage CAVD is characterized by calcification, disorganization of collagen, and deposition of glycosaminoglycans, such as chondroitin sulfate (CS), in the fibrosa. We developed a three-dimensional microfluidic device of the aortic valve fibrosa to study the effects of shear stress (1 or 20 dyne per cm

La situación actual a causa de la pandemia ocasionada por el coronavirus SARS-CoV-2 conlleva a la comunidad odontológica el plantearse medidas estrictas de prevención y control que puedan reducir el riesgo de infección y evitar efectivamente la propagación de la epidemia al considerar que la comunidad odontológica posee un elevado riesgo de transmisión viral, con lo cual se eleva el peligro de infección cruzada. Los odontólogos como equipo de salud deben estar preparados y con el conocimiento necesario para disminuir a posibilidad de contagio, sabiéndose que la saliva es la principal fuente de transmisión.

Electronic waste (e-waste) is a global issue brought about by the short lifespan of electronics. Viable methods to relieve the inundated disposal system by repurposing the enormous amount of e-waste remain elusive. Inspired by the need for sustainable solutions, this study resulted in a multifaceted approach to upcycling compact discs (CDs). The once-ubiquitous plates can be transformed into stretchable and flexible biosensors. Our experiments and advanced prototypes show that effective, innovative biosensors can be developed at a low-cost. An affordable craft-based mechanical cutter allows pre-determined patterns to be scored on the recycled metal, an essential first step for producing stretchable, wearable electronics. The active metal harvested from the CDs was inert, cytocompatible, and capable of vital biopotential measurements. Additional studies examined the material’s resistive emittance, temperature sensing, real-time metabolite monitoring performance, and moisture-triggered transience. This sustainable approach for upcycling e-waste provides an advantageous research-based waste stream that does not require cutting-edge microfabrication facilities, expensive materials, and high-caliber engineering skills.

Electronic waste is a global issue brought about by the short lifespan of electronics. Viable methods to relieve the inundated disposal system by repurposing the enormous amount of electronic waste remain elusive. Inspired by the need for sustainable solutions, this study resulted in a multifaceted approach to upcycling compact discs. The once-ubiquitous plates can be transformed into stretchable and flexible biosensors. Our experiments and advanced prototypes show that effective, innovative biosensors can be developed at a low-cost. An affordable craft-based mechanical cutter allows pre-determined patterns to be scored on the recycled metal, an essential first step for producing stretchable, wearable electronics. The active metal harvested from the compact discs was inert, cytocompatible, and capable of vital biopotential measurements. Additional studies examined the material’s resistive emittance, temperature sensing, real-time metabolite monitoring performance, and moisture-triggered transience. This sustainable approach for upcycling electronic waste provides an advantageous research-based waste stream that does not require cutting-edge microfabrication facilities, expensive materials, and high-caliber engineering skills.

Key Points Question Were infections in patients who received umbilical cord blood products marketed as stem cell treatment associated with product contamination? Findings In this case series, 20 patients in 8 states developed bacterial infections after receiving unapproved products marketed as treatment for conditions including chronic pain and degenerative joint conditions. This national investigation found widespread bacterial contamination of undistributed and distributed products from multiple donors, with whole-genome sequencing indicating a common source. Meaning The findings from this outbreak underscore that unapproved and unproven stem cell products can expose patients to serious risks without clear benefit, including the possibility of product contamination., This case series examines bacterial infections in 20 patients who received umbilical cord blood–derived products marketed as stem cell treatment., Importance The number of clinics marketing stem cell products for joint diseases, chronic pain, and most recently, COVID-19, has increased despite warnings from the US Food and Drug Administration that stem cell products for these and other indications have not been proven safe or effective. Objective To examine bacterial infections in 20 patients who received umbilical cord blood–derived products marketed as stem cell treatment. Design, Setting, and Participants This case series is a national public health investigation including case-finding, medical record review and abstraction, and laboratory investigation, including sterility testing of products and whole-genome sequencing of patient and product isolates. Participants included patients who developed bacterial infections following administration of umbilical cord blood–derived products marketed as stem cell treatment during August 2017 to September 2018. Data analysis was performed from March 2019 to September 2021. Exposures Umbilical cord blood–derived products marketed as stem cell treatment. Main Outcomes and Measures Data were collected on patient infections and exposures. The Centers for Disease Control and Prevention performed sterility testing on undistributed and distributed vials of product marketed as stem cell treatment and performed whole-genome sequencing to compare patient and product bacterial isolates. Results Culture-confirmed bacterial infections were identified in 20 patients (median [range] age, 63 [2-89] years; 13 male patients [65%]) from 8 US states who sought stem cell treatment for conditions including pain, osteoarthritis, rheumatoid arthritis, and injury; all but 1 required hospitalization. The most frequently isolated bacteria from patients with infections were common enteric species, including Escherichia coli (14 patients) and Enterobacter cloacae (7 patients). Of unopened, undistributed products sampled for testing, 65% (22 of 34 vials) were contaminated with at least 1 of 16 bacterial species, mostly enteric. A patient isolate from Arizona matched isolates obtained from products administered to patients in Florida, and patient isolates from Texas matched undistributed product sent from the company in California. Conclusions and Relevance Unapproved stem cell products can expose patients to serious risks without proven benefit. Sequencing results suggest a common source of extensive contamination, likely occurring during the processing of cord blood into product. Patients and health care practitioners who are considering the use of unapproved products marketed as stem cell treatment should be aware of their unproven benefits and potential risks, including serious infections.

Introduction: Calcific aortic valve disease (CAVD) is an active pathological process leading to severe valve calcification. Late-stage CAVD is characterized by increased leaflet stiffness, disorganized collagen bundles and the deposition of glycosaminoglycans, such as chondroitin sulfate (CS), in the fibrosa layer. However, many details of the cellular pathological cascade remain unknown. Animal models such as mice, rabbits, and pigs are used in understanding human CAVD, but mice do not have similar anatomy, rabbits cannot spontaneously develop atherosclerotic lesions, and pigs require long, expensive and complex studies. Here we utilize microfluidic devices of the aortic valve fibrosa to model late-stage CAVD. Hypothesis: We assessed the hypothesis that microfluidic calcification will increase with increased shear rates and CS content. Methods: Valve-on-a-chip devices contained a hydrogel of 1.5 mg/mL collagen I-only healthy controls or 1.5 mg/mL collagen I with 1 mg/mL or 20 mg/mL CS. Porcine aortic valve interstitial cells (PAVIC) were embedded within and endothelial cells (PAVEC) were seeded onto the matrix. Steady shear stress at 1 dyne/cm 2 and 20 dyne/cm 2 were applied using a peristaltic pump for 14 days. Alizarin Red S (ARS), an assay to assess calcium deposition, was used to quantify calcific nodule formation. Scanning electron microscopy with energy dispersive x-ray (SEM/EDX) was used to further analyze sample mineralization. Results: Co-cultures in the presence of increasing shear stress and CS exhibit increased calcific nodule formation compared to static controls, both qualitatively and quantitatively (n≥3). SEM revealed the microstructure of calcified nodules and EDX confirmed calcium phosphate mineralization with physiologically-relevant calcium to phosphorous ratios (Ca/P= 0.88 - 1.4). Conclusions: These results show that in vitro calcification is driven by shear stress in the presence of PAVEC and CS. As seen in ex vivo studies of human calcification, these microfluidic-derived nodules are similarly composed of a range of naturally-occurring calcium phosphates. Given that CAVD has no targeted therapy, the creation of a physiologically relevant model of the aortic valve can provide a test bed for novel therapeutic interventions.

Introduction/Background At the time of diagnosis, locally advanced stages in cervical cancer is a common finding and considered the most important prognostic factor, accounting for up to 70% of cases in low-middle-income countries. Recurrence of disease is more frequent in the first two years (8 to 61% depending on the clinical stage). Late recurrence (beyond 5 years) is relatively common (0.4–7.5%). Overall survival after diagnosis of recurrence is 50.5% at two years and 22.3% at five years. This study aims to analyse the recurrence patterns according to presentation time in patients with locally advanced cervical cancer (LACC). Methodology This is a retrospective study in patients with LACC who had complete response after treatment with concurrent chemoradiotherapy followed by brachytherapy treated from January 2005 to December of 2014 at the National Cancer Institute in Mexico City. Results Of 1045 patients with LACC and complete response, 334 (32%) presented recurrence of disease. Two hundred patients (59.9%) relapsed before 2 years (group 1), 88 (26.3%) between 2–5 years (group 2), and 45 (13.5%) after 5 years (group 3). The median age was 50 years of age (range 22–75 years), with no differences between groups. Distant recurrence occurred in 81% of the patients in group 1, 75% in group 2 and 57.8% in group 3, p= 0.007. There are no differences in survival after recurrence between the groups. Most patients who presented distant disease presented metastases in more than one site, and the more frequent site was lung. Median survival after the diagnosis of recurrence was 15 months (95% CI: 11–18.9) in group 1, 15 months (95% CI: 7.3–22.68) in group 2 and 25 months in group 3 (95% CI: 0–63), p=0.187. Conclusion Late recurrence is a common event in LACC, these patients have less risk of having distant disease at time of diagnosis; the prognosis after the recurrence depends on the site, with statistically significant differences between local recurrence vs. locoregional and distant recurrence but not when the disease recurs. In a high-volume centre, it is important to continue follow-up of patients with LACC because of the risk of having recurrent disease after five years of treatment. Disclosures The authors reports no conflicts of interest.

Objective: Calcific aortic valve disease (CAVD) is a progressive disease ranging from aortic sclerosis to severe aortic stenosis. Current treatments include total valve replacement and drug interve...

We examined the effects of a self-instructional and feedback package on participants' implementation of a paired-stimulus preference assessment. Specifically, in Experiment 1, we used a multiple baseline design across participants to replicate and extend the results of Graff and Karsten (2012) by evaluating the effectiveness of their self-instructional manual. A majority of the participants (i.e., 5 of 7 undergraduate students and 4 of 5 in-home behavior technicians) achieved mastery with the self-instructional package. The remaining participants met the mastery criterion after brief modeling and feedback sessions. In Experiment 2, we identified the most effective component of the feedback condition from Experiment 1 when a self-instructional package was not sufficient. Brief feedback sessions in which participants received a list of the targeted responses plus information regarding accuracy of emitted responses was sufficient for 5 of 6 participants to achieve mastery.

Background/Aims: Hemodialysis (HD) patients are less active than their healthy counterparts and frequently experience poor sleep. Our aims were to objectively quantify activity and sleep quality in HD patients of an urban population and to determine the effect of providing feedback on activity. Methods: Activity parameters and sleep parameters were collected by a commercially available activity tracker in 29 chronic HD patients. Patients in the feedback group were provided with their activity and sleep data during each HD treatment. Questionnaires were administered at the beginning and at the end of the study. Results: On average, patients walked 8,454 steps/day and slept 349 min/night. Only 28% of the patients were sedentary, defined as walking Conclusion: Interventions to increase physical activity on Sundays could improve physical activity levels overall. Prospective studies are necessary to further explore the use of tracking devices to identify patients at risk and to implement targeted interventions.

We examined the effects of a self-instructional and feedback package on participants' implementation of a paired-stimulus preference assessment. Specifically, in Experiment 1, we used a multiple baseline design across participants to replicate and extend the results of Graff and Karsten (2012) by evaluating the effectiveness of their self-instructional manual. A majority of the participants (i.e., 5 of 7 undergraduate students and 4 of 5 in-home behavior technicians) achieved mastery with the self-instructional package. The remaining participants met the mastery criterion after brief modeling and feedback sessions. In Experiment 2, we identified the most effective component of the feedback condition from Experiment 1 when a self-instructional package was not sufficient. Brief feedback sessions in which participants received a list of the targeted responses plus information regarding accuracy of emitted responses was sufficient for 5 of 6 participants to achieve mastery.

Hemodialysis (HD) patients are less active than their healthy counterparts; this is associated with higher mortality. Healthcare workers observe their patients only during HD, which accounts for about 7% of the week. Knowing more about what occurs in between sessions, particularly with respect to physical activity, may improve patient care and prognosis. Yet without a standard method to measure interdialytic activity, it is difficult to compare the effect of interventions. However, it is unclear how interdialytic activity can be accurately measured. Since activity associated with quality of life is multi-dimensional, objective and subjective tools should be used in conjunction. While commercially available tracking devices can be seamlessly incorporated into everyday life and can increase awareness of user's activity, their validation is needed in the HD population. Fertile topics for research should include the relationship between objective and subjective measures in HD patients, and the investigation of physical activity in non-ambulatory HD patients.