Search

IntroductionL-carnitine (LC) has been associated with inflammatory mediator reduction and with downregulating the angiotensin-converting enzyme-2 (ACE2) receptor, which is the target of SARS-CoV-2 attachment.MethodsThis pilot phase 2 randomized, double-blind placebo-controlled trial contained two cohorts. Cohort 1 comprised 101 individuals with negative RT-PCR SARS-CoV-2 test results who cohabitated with an individual diagnosed with SARS-CoV-2 infection. Cohort 2 comprised 122 individuals with positive SARS-CoV-2 RT-PCR test results who were asymptomatic or had mild COVID-19 pneumonia symptoms. Participants in each cohort were randomized 1:1 to receive either 2 g elemental oral LC supplementation or placebo daily for 21 days. Primary endpoints included adverse events, SARS-CoV-2 infection incidence in Cohort 1, and disease progressions in Cohort 2. Secondary endpoints included between-group laboratory profile comparisons and Cohort 2 ACE1/ACE2 plasma levels. Disease progression was compared between the Cohort 2 groups using chest computed tomography.ResultsIn Cohort 1, two SARS-CoV-2 infections occurred in each group. The common adverse events included headache, dyspnea, and tiredness. In Cohort 2, platelet counts were elevated, and fibrinogen levels reduced in the LC group compared with those of the placebo group.ConclusionOur study showed that LC was well-tolerated and suggests it modulates coagulation pathways. Furthermore, chest computed tomography images of the Cohort 2 LC group showed significant lung lesion improvement, suggesting that LC may slow COVID-19 progression.

At each cell division, nanometer-scale components self-organize to build a micron-scale spindle. In mammalian spindles, microtubule bundles called kinetochore-fibers attach to chromosomes and focus into spindle poles. Despite evidence suggesting that poles can set spindle length, their role remains poorly understood. In fact, many species do not have spindle poles. Here, we probe the pole’s contribution to mammalian spindle length, dynamics, and function by inhibiting dynein to generate spindles whose kinetochore-fibers do not focus into poles, yet maintain a metaphase steady-state length. We find that unfocused kinetochore-fibers have a mean length indistinguishable from control, but a broader length distribution, and reduced length coordination between sisters and neighbors. Further, we show that unfocused kinetochore-fibers, like control, can grow back to their steady-state length if acutely shortened by drug treatment or laser ablation: they recover their length by tuning their end dynamics, albeit slower due to their reduced baseline dynamics. Thus, kinetochore-fiber dynamics are regulated by their length, not just pole-focusing forces. Finally, we show that spindles with unfocused kinetochore-fibers can segregate chromosomes but fail to correctly do so. We propose that mammalian spindle length emerges locally from individual k-fibers while spindle poles globally coordinate k-fibers across space and time.

The transcription factor ONECUT2 (OC2) is a master transcriptional regulator operating in metastatic castration-resistant prostate cancer that suppresses androgen receptor activity and promotes neural differentiation and tumor cell survival. OC2 mRNA possesses an unusually long (14,575 nt), evolutionarily conserved 3′ untranslated region (3′ UTR) with many microRNA binding sites, including up to 26 miR-9 sites. This is notable because miR-9 targets many of the same genes regulated by the OC2 protein. Paradoxically, OC2 expression is high in tissues with high miR-9 expression. The length and complex secondary structure of OC2 mRNA suggests that it is a potent master competing endogenous RNA (ceRNA) capable of sequestering miRNAs. Here, we describe a novel role for OC2 3′ UTR in lethal prostate cancer consistent with a function as a ceRNA. A plausible ceRNA network in OC2-driven tumors was constructed computationally and then confirmed in prostate cancer cell lines. Genes regulated by OC2 3′ UTR exhibited high overlap (up to 45%) with genes driven by the overexpression of the OC2 protein in the absence of 3′ UTR, indicating a cooperative functional relationship between the OC2 protein and its 3′ UTR. These overlapping networks suggest an evolutionarily conserved mechanism to reinforce OC2 transcription by protection of OC2-regulated mRNAs from miRNA suppression. Both the protein and 3′ UTR showed increased polycomb-repressive complex activity. The expression of OC2 3′ UTR mRNA alone (without protein) dramatically increased the metastatic potential by in vitro assays. Additionally, OC2 3′ UTR increased the expression of Aldo-Keto reductase and UDP-glucuronyl transferase family genes responsible for altering the androgen synthesis pathway. ONECUT2 represents the first-described dual-modality transcript that operates as both a key transcription factor driving castration-resistant prostate cancer and a master ceRNA that promotes and protects the same transcriptional network.

Underutilized dates are considered as a socioeconomically important fruit for local and global communities, such as Degla-Beida, a common date fruit variety. The aim of this research was to elucidate, for the first time, the efficiency of UV-C light treatment (over different irradiation durations 5, 10, 20, and 40 min) in the enhancement of soluble carbohydrates and phenolic compounds, and to evaluate its effect on the antioxidant capacity. Furthermore, the content of dietary fiber was analyzed: insoluble dietary fiber (11.89 g/100 g); soluble dietary fiber (5.15 g/100 g); and total dietary fiber (17.06 g/100 g). The techno-functional properties were also determined: swelling capacity (3.94 mL/g); oil holding capacity (7.38 g/g); water holding capacity (9.30 g/g); and bulk density (1.81 g/mL). All were carried out to study the potential of exploiting this underutilized fruit for other applications as for feed or food. The results suggest that UV-C technology changes minimally the total water-soluble carbohydrate content; however, this preservation technology can affect the availability of different soluble carbohydrates depending on the irradiation time (IT), increasing the high molecular weight polysaccharides with IT up to 20 min, and some oligosaccharides with IT up to 5 min. The polyphenolic content determined by HPLC-QTOF was increased when the samples were submitted to UV-C reaching the maximum at 20 min (111.62 mg/100 g) and then to decrease in those submitted to IT of 40 min (12.05 mg/100 g). Regarding antioxidant capacity in the UV-C treated samples, FRAP decreased and EC50 on DPPH increased when IT was increased, while ORAC was hardly maintained. In addition, considering UV-C radiation associated with preservation and the studied date fruit as a rich source of dietary fiber with adequate techno-functional properties, this study presents valuable information for its potential use as a new food ingredient.

In 2015, Australia updated premigration screening for tuberculosis (TB) disease in children 2–10 years of age to include testing for infection with Mycobacterium tuberculosis and enable detection of latent TB infection (LTBI). We analyzed TB screening results in children

Abstract Background Augmented renal clearance (ARC) remains poorly evaluated in ICU. The objective of this study is to provide a full description of ARC in ICU including prevalence, evolution profile, risk factors and outcomes. Methods This was a retrospective, single-center, observational study. All the patients older than 18 years admitted for the first time in Medical ICU, Bichat, University Hospital, APHP, France, between January 1, 2017, and November 31, 2020 and included into the Outcomerea database with an ICU length of stay longer than 72 h were included. Patients with chronic kidney disease were excluded. Glomerular filtration rate was estimated each day during ICU stay using the measured creatinine renal clearance (CrCl). Augmented renal clearance (ARC) was defined as a 24 h CrCl greater than 130 ml/min/m2. Results 312 patients were included, with a median age of 62.7 years [51.4; 71.8], 106(31.9%) had chronic cardiovascular disease. The main reason for admission was acute respiratory failure (184(59%)) and 196(62.8%) patients had SARS-COV2. The median value for SAPS II score was 32[24; 42.5]; 146(44%) and 154(46.4%) patients were under vasopressors and invasive mechanical ventilation, respectively. The overall prevalence of ARC was 24.6% with a peak prevalence on Day 5 of ICU stay. The risk factors for the occurrence of ARC were young age and absence of cardiovascular comorbidities. The persistence of ARC during more than 10% of the time spent in ICU was significantly associated with a lower risk of death at Day 30. Conclusion ARC is a frequent phenomenon in the ICU with an increased incidence during the first week of ICU stay. Further studies are needed to assess its impact on patient prognosis.

Abstract Fully shaped, morphologically standardized bone tools are generally considered reliable indicators of the emergence of modern behavior. We report the discovery of 23 double-beveled bone tools from ~ 80,000–60,000-year-old archaeological layers at Sibudu Cave in KwaZulu-Natal, South Africa. We analyzed the texture of use-wear on the archaeological bone tools, and on bone tool replicas experimentally used in debarking trees, processing rabbit pelts with and without an ochre compound, digging in sediment in and outside a cave, and on ethnographic artefacts. Debarking trees and digging in humus-rich soil produce use-wear patterns closely matching those observed on most Sibudu tools. This tool type is associated with three different Middle Stone Age cultural traditions at Sibudu that span 20,000 years, yet they are absent at contemporaneous sites. Our results support a scenario in which some southern African early modern human groups developed and locally maintained specific, highly standardized cultural traits while sharing others at a sub-continental scale. We demonstrate that technological and texture analyses are effective means by which to infer past behaviors and assess the significance of prehistoric cultural innovations.

Societal impact statement This investigation addresses the diversity of microbial endosymbionts in cranberry, which are among the least understood and ill‐defined ericoid symbionts. There is excellent potential for Ericaceous plants, such as cranberry and blueberry, to be farmed more sustainably once the properties and functioning of their associated microbiomes are known in more detail. Here, we demonstrate that some bacterial and fungal endosymbionts of cranberry stimulate plant growth and suppress fungal pathogens. They have the potential for field applications as a first step toward sustainable cranberry farming. Summary Virtually, all vascular plants harbor bacterial and fungal endosymbionts, which colonize predominantly but not exclusively, roots. Most common among fungal partners are arbuscular mycorrhizal fungi (AMF; Glomeromycotina) that live within plant roots and provide soil nutrients to the plant while receiving from the plant organic carbon sources. Ericaceae are an exception as they do not host AMF but rather the taxonomically ill‐defined “ericoid mycorrhizal fungi,” including select ascomycete and basidiomycete species. Because the diversity of endosymbionts in Ericaceae is poorly investigated, we set out to explore the microbiome of Vaccinium macrocarpon Aiton (cranberry). Here, we report the isolation and ribotyping of ~180 distinct bacterial and fungal endophytes collected from roots, stems, and leaves of cranberry plants cultivated in Quebec, Canada. Plant growth promotion was assessed after inoculating plant cuttings with these microbes, whereas pathogen suppression was tested on agar plates by growth confrontation. We show that the cranberry microbiome varies substantially between tissues, cultivars, and across fields of the same farm. Among the isolates, 16 bacterial and 8 fungal strains exhibit biofertilization or biocontrol properties with potential application in sustainable cranberry farming. We propose to move towards a more rigorous, molecular‐based definition of ericoid mycorrhiza, accounting for their broad evolutionary and morphological diversity.

Introduction: Dog bite is a public health problem in Bhutan incurring huge cost of treatment. The general objective of the study was to see the impact of COVID-19 pandemic on the burden of dog bite cases and the profile of patients, comparing with that of the year before the COVID-19 pandemic started (2019) at the National Referral Hospital. Methods: This is a retrospective record review of the dog bite cases in the year 2019 and 2020. The target population of the study were people living in Thimphu city. The dog bites that occurred outside Thimphu were excluded from the study. Proportion of dog bite according to demographic and clinical variables were calculated. Univariate and multivariate analysis were done to look for risk factors responsible for dog bite in 2020 compared to 2019. A statistically significant level was set at

Abstract Background Guidelines include several options for average‐risk colorectal cancer (CRC) screening that vary in aspects such as invasiveness, recommended frequency, and precision. Thus, patient and provider preferences can help identify an appropriate screening strategy. This study elicited CRC screening preferences of physicians and individuals at average risk for CRC (IAR). Methods IAR aged 45–75 years and licensed physicians (primary care or gastroenterology) completed an online discrete choice experiment (DCE). Participants were recruited from representative access panels in the US. Within the DCE, participants traded off preferences between screening type, screening frequency, true‐positive, true‐negative, and adenoma true positive (physicians only). A mixed logit model was used to obtain predicted choice probabilities for colonoscopy, multi‐target stool DNA (mt‐sDNA), fecal immunochemical test (FIT), and methylated septin 9 (mSEPT9) blood test. Results Preferences of IAR and physicians were affected by screening precision and screening type. IAR also valued more regular screening. Physicians preferred colonoscopy (96.8%) over mt‐sDNA (2.8%; p

We report the 3D-tracking of irregular sand particles in a wave flume using a cylindrical interferometric particle imaging set-up. The longitudinal position of each particle is deduced from the ellipticity of its speckle-like interferometric image. The size of a particle is determined from the analysis of the 2D Fourier transform of its defocused image. It is further possible to identify some rotation of the particles. Simulations accurately confirm the experimental determination of the different parameters (3D position and size of each particle).

La socioformación como modelo educativo surge como una alternativa para trascender el quehacer académico a niveles adaptados a la realidad actual por lo que su aplicación ha tenido un auge excepcional en los últimos años. La socioformación nace “con la finalidad de centrar las prácticas formativas en la resolución de aquellos problemas que más aquejan a la sociedad, por medio de la colaboración, el pensamiento complejo, la mejora y evaluación continua del desempeño, la flexibilidad curricular”. Por lo tanto, se propone este esquema con el afán de establecer nuevas formas de construcción del conocimiento con el aporte y experiencia de los actores internos y externos que formen parte de las instituciones educativas.

Minuman herbal merupakan warisan budaya yang di ajarkan oleh orang tua terdahulu yang sangat bermanfaat untuk meningkatkan kekebalan tubuh. Hingga saat ini masih banyak masyarakat yang memilih mengkonsumsi minuman herbal dikarenakan bersumber dari bahan yang alami sehingga tidak menyebabkan efek samping dan reaksi berbehaya terhadap tubuh. Mitra pada perogram pengabdian masyarakat merupakan pengerajin minuman herbal hingga dikenal kota Kisaran Sumatera Utara. Mitra memproduksi minuman herbal yang berbahan utama jahe untuk di jual kepada masyarakat sekitar. Semakin hari, permintaan minuman herbal yang di produksi mitra semakin meningkat dan mitra merasa sulit untuk memenuhi permintan karena minimnya alat produksi dan masih dikerjakan secara manual. Dengan memberikan mesin-mesin produksi, permasalahan yang dihadapi mitra saat ini dapat teratasi. Produksi minuman herbal yang di awal hanya mampu memproduksi 20 kg/hari, kini dengan menggunakan mesin penggiling basah, mesin pengaduk otomatis, dan mesin penggiling kering produksi minuman herbal meningkat 90% yaitu sekitar 180 kg/hari

La conservación de las áreas verdes urbanas proporcionan beneficios de mitigación y adaptación al cambio climático, además de ofrecer servicios ecosistémicos para las poblaciones locales, donde la valoración económica de los bienes resulta una alternativa confiable para dicha finalidad. El objetivo del presente estudio fue determinar la biomasa total y el valor económico de la reserva de Carbono del recurso arbóreo del Parque Dr. Claudio Pavetti. Fue realizado un inventario forestal identificando y midiendo todos los árboles con d1,30 cm ≥ 10 cm. Para la estimación de la biomasa total se aplicó la ecuación alométrica para la ecorregión Chaco Húmedo. Para la valoración económica se utilizó el precio promedio del primer semestre del año 2020, del valor de los Derechos de Emisión de la Unión Europea (EUA) reflejados en la Bolsa del Sistema Europeo de Negociación de CO2 (SENDECO2). Fueron identificados 94 individuos, pertenecientes a 22 especies, 21 géneros y 13 familias botánicas. Las especies que obtuvieron mayor valor de Carbono acumulado fueron Peltophorum dubium (54,62 Mg ha-1), Anadenanthera colubrina var. cebil (23,56 Mg ha-1), Pterogyne nitens (18,75 Mg ha-1) y Parapiptadenia rigida (12,21 Mg ha-1). La biomasa total estimada fue de 281,86 Mg ha-1, lo que equivale a 132,47 Mg ha-1 de C y 485,74 Mg ha-1 de CO2 eq. El valor económico del servicio ecosistémico de la reserva de C asciende a 168,11 US$ ha-1.

The original synthesis of gamma-(2-bromo-2-methylpropionate)-epsilon-caprolactone (BMPCL), in use since 1999, has an overall yield of 17% and uses a Cr(VI) reagent for a key oxidation. Despite these liabilities, this synthetic procedure has been reported in all subsequent uses of BMPCL. This is due to BMPCL’s desirable capacity as an inimer – the tertiary alpha-bromo ester functionality allows initiation of controlled radical polymerization while the strained lactone moiety can act as a monomer in ring-opening polymerizations. These orthogonal capacities make BMPCL useful for the synthesis of complex polymer architectures such as combs. This paper reports a higher yielding, telescoped BMPCL synthesis that reduces the use of toxic reagents. Utilizing a mild and near-quantitative activated-DMSO mechanism, the Swern oxidation, in place of pyridinium chlorochromate increases the yield by approximately half to 25% (average of three trials) while eliminating heavy metal usage. In an additional effort for synthetic efficiency, the number of chromatographic purifications was reduced from three to one.

Durante a pandemia ao mesmo tempo em que foi evidenciada a exclusão de jovens no acesso à Internet e aparelhos móveis, também foi maximizado o uso das redes sociais na Internet. Este artigo foi elaborado a partir de informações obtidas em pesquisa desenvolvida junto a jovens universitários de diferentes identidades sociais inseridos no Instagram. O objetivo foi recolher as manifestações e expressões de emoções em seus perfis para analisar as relações sociais por meio da interação nessa rede social durante a pandemia da Covid-19, no período de julho do ano de 2021 a junho de 2022. Para tanto, recorremos a informações obtidas por meio de etnografia na Internet e de entrevistas realizadas junto a esses jovens. Os resultados apontaram que durante a pandemia ocorreu o aumento de interações entre os perfis desses jovens no Instagram. Nesse contexto, segundo os jovens, as suas relações sociais foram estabelecidas por meio de gerenciamento de emoções mais positivas do que negativas entre as publicações compartilhadas por eles no feed e nos stories.

Watershed prioritization is considered an important tool for soil and watershed management. This study focuses on the watershed prioritization of the Kailali district in terms of soil erosion, considering morphometric parameters and land use/landcover (LULC) datasets using GIS. ALOS DEM of 30 m resolution was used to delineate sub-watersheds and calculate linear, areal, and relief morphometric parameters. Similarly, Esri LULC 2021 (Sentinel-2 imagery at 10 m resolution) was used to calculate LULC parameters. An integrated approach of Principal Component Analysis (PCA) and Weighted Sum Analysis (WSA) was used for prioritization. PCA was used to reduce selected parameters, calculate the correlation matrix, and define the significant parameters. WSA was used to define weightage value, and Compound Value (CV) was calculated for the ranking of sub-watersheds. 22 sub-watersheds with at least 3rd order stream and 15 parameters were selected for prioritization. PCA integrated with WSA was found to be effective for prioritization. The findings showed that about 61.58% of the watershed area is in the high-priority category, suggesting those areas are at a higher risk of erosion. Therefore, different land rehabilitation programs and bioengineering techniques should be focused on the sub-watershed of high-priority categories followed by medium and low-priority categories to control further soil erosion. The adopted methodology of prioritization can also be performed for multi-hazard mapping.

Intraplacental choriocarcinoma (IC), or choriocarcinoma in situ, is a rare disease on the gestational trophoblastic disease (GTD) spectrum, with

Background: Many studies reported of menstrual disturbances as possible side effects of COVID-19 vaccination. Our objective was to evaluate the association between vaccination and the occurrence of menstrual disturbances among Iranian women. Methods: We used to google form questionnaires to collect reports of menstrual disturbances from 455 women aged 15–55 years in Iran. We estimated the relative risk of menstrual disturbances according to vaccination in a self-controlled case-series design after vaccination. We examined the occurrence of such disorders after the first, second and third doses of vaccine. Results: Findings The prevalence of menstrual disturbance was more in latency and heavy bleeding than others disorder after vaccination, although ֮ %50 of women doesn't have any disturbance. We observed increased risks after vaccination also for other menstrual disturbances, in menopausal women too (>10%). Discussion: Menstrual disturbances were generally common regardless of vaccination. We found a significant increase in menstrual disturbances after vaccination, particularly for latency and heavier bleeding than usual, longer duration and for short interval between menstruations. Mechanisms underlying these findings may involve bleeding disturbances in general, as well as endocrine alterations of immune system stimulation and relation to hormonal secretion.

Pelvic involvement of chronic lymphocytic leukemia (CLL) is exceptionally rare. Herein, we present a case series of a 61-year-old, 88-year-old, and 79-year-old female, all with a history of CLL who underwent exploratory surgery with gynecologic oncologists for newly diagnosed pelvic masses and endometrial pathology. Intraoperative findings and pathology were consistent with CLL.

Introduction Alcohol use disorder (AUD) ranks among the most prevalent psychiatric disorders worldwide. Despite current treatments, more than half of patients relapse within weeks after treatment. In animal models, exposure to environmental enrichment (EE) has been shown to be a promising approach to reduce relapse. However, controlled, multimodal EE is difficult to transpose to humans. To address this gap, this study aims at assessing the effectiveness of exposure to a newly designed EE protocol during AUD treatment in reducing relapse to alcohol use. Our EE will allow an enhancement of the standard intervention, and will combine several promising enrichment factors identified in the literature—physical activity, cognitive stimulation, mindfulness and virtual reality (VR).Methods and analysis A randomised controlled trial involving 135 participants receiving treatment for severe AUD will be conducted. Patients will be randomised to an intervention enhancement group or a control group. The enhanced intervention will consist of six 40-min sessions of EE spread over 9 days. During the first 20 min of these sessions, patients will practise mindfulness in multisensory VR, in virtual environments designed to practise mindfulness and use it to regulate craving induced by virtual cues or stress. Then, participants will practise indoor cycling combined with cognitive training exercises. The control group will undergo standard management for AUD. The primary outcome is relapse assessed at 2 weeks after treatment, using a questionnaire and biological indicators. Relapse will be defined as drinking at least five drinks per occasion or drinking at least five times a week. It is predicted that the group receiving the EE intervention will have a lower relapse rate than the control group. The secondary outcomes are relapse at 1 month and 3 months after treatment, craving and drug-seeking behaviour, mindfulness skills acquisition and the effect of the intervention enhancement on the perceived richness of the daily environment, assessed by questionnaires and neuropsychological tasks.Ethics and dissemination All participants have to give written informed consent to the investigator. This study is approved by the Ethics Committee Nord Ouest IV of Lille (reference number 2022-A01156-37). Results will be disseminated through presentations, peer-reviewed journals and seminar conferences. All information on ethical considerations and open science practices can be accessed at https://osf.io/b57uj/Trial registration number NCT05577741.

Necrotizing enterocolitis (NEC) is a deadly gastrointestinal disease of premature infants that is associated with an exaggerated inflammatory response, dysbiosis of the gut microbiome, decreased epithelial cell proliferation, and gut barrier disruption. We describe an in vitro model of the human neonatal small intestinal epithelium (Neonatal-Intestine-on-a-Chip) that mimics key features of intestinal physiology. This model utilizes intestinal enteroids grown from surgically harvested intestinal tissue from premature infants and cocultured with human intestinal microvascular endothelial cells within a microfluidic device. We used our Neonatal-Intestine-on-a-Chip to recapitulate NEC pathophysiology by adding infant-derived microbiota. This model, named NEC-on-a-Chip, simulates the predominant features of NEC, including significant upregulation of proinflammatory cytokines, decreased intestinal epithelial cell markers, reduced epithelial proliferation, and disrupted epithelial barrier integrity. NEC-on-a-Chip provides an improved preclinical model of NEC that facilitates comprehensive analysis of the pathophysiology of NEC using precious clinical samples. This model is an advance toward a personalized medicine approach to test new therapeutics for this devastating disease.

The leaves of Phlomis crinita are traditionally used in Algerian medicine for the treatment of pain and inflammatory conditions. In order to find a potential application for this native species, the anti-inflammatory and antioxidant effects were investigated on various in vivo experimental models, and the total phenolic compounds and flavonoid contents were determined. The carrageenan-induced paw edema method was used to evaluate the anti-inflammatory activity of the extract in vivo, while the in vivo antioxidant effect was assessed by estimating oxidative stress parameters (MDA, CAT, and SOD). Phytochemical screening revealed the presence of substances with high therapeutic values. In vivo anti-inflammatory studies show that plant extract has a significant and dose-dependent impact on the inhibition of edema formation. The maximum percentage inhibition value was 87.79% after 4 h at a concentration of 500 mg/kg. Moreover, the administration of the extract significantly enhanced the activities of antioxidant enzymes in the livers of mice. It significantly (p ˂ 0.05) increased CAT and SOD activities and significantly (p ˂ 0.05) decreased the MDA level activity, compared to the control inflammatory group. Our findings support that Phlomis crinita can be considered as a promising source of therapeutic bioactive compounds. DOI: http://dx.doi.org/10.5281/zenodo.7860334

Zolpidem is a sedative drug that has been shown to induce a paradoxical effect, restoring brain function in wide range of neurological disorders. The underlying functional mechanism of the effect of zolpidem in the brain in clinical improvement is still poorly understood. Thus, we aimed to investigate rest brain function to study zolpidem-induced symptom improvement in a patient who developed postoperative pediatric cerebellar mutism syndrome, a postoperative complication characterized by delayed onset transient mutism/reduced speech that can occur after medulloblastoma resection. The patient experienced clinical recovery after a single dose of zolpidem. Brain function was investigated using arterial spin labeling MRI and resting-state functional MRI. Imaging was performed at three time-points: preoperative, postoperative during symptoms, and after zolpidem intake when the symptoms regressed. Whole brain rest cerebral blood flow (CBF) and resting state functional connectivity using Pearson coefficient correlations between pairs of regions of interest were investigated two-by-two at the different time points. A comparison between postoperative and preoperative images showed a significant decrease in rest CBF in the left supplementary motor area, Broca’s area, and the left striatum and a decrease in functional connectivity within the dentato-thalamo-cortical and cortico-striato-pallido-thalamo-cortical loops. Post-zolpidem images showed increased CBF in the left striatum and increased functional connectivity within the disrupted loops relative to postoperative images. Thus, we observed functional changes within the broader speech network and thalamo-subcortical interactions associated with the paradoxical effect of zolpidem in promoting clinical recovery. This should encourage further functional investigations in the brain to better understand the mechanism of zolpidem in neurological recovery.

The survey of medicinal plants used by people in the Fazenda Nova district, Brejo da Madre de Deus Municipality, Pernambuco State, Brazil was the main aim of this work. Data collection was conducted through semi-structured interviews. The botanical material was identified and incorporated at the Herbarium Professor Vasconcelos Sobrinho (PEUFR) of the Universidade Federal Rural de Pernambuco. 79 species were recorded, distributed in 40 families. The most representative families were: Fabaceae (14 ssp.), Lamiaceae (7 ssp.), Euphorbiaceae (6 ssp.), Asteraceae (3 ssp.), Bignoniaceae (3 ssp.) and Solanaceae (3 ssp.), the most cited therapeutic indications were for treating respiratory problems (24.54%), gastrointestinal disorders (17.47%) and inflammation in general (11.52%) . The tea was the main form of preparation and the leafs were the part of the plant most used in the production of natural remedies. The species of Angico (Anadenanthera macrocarpa (Benth.) Brenan., Aroeira (Astronium urundeuva (M.Allemão) Engl.), Babosa (Aloe vera L. Burm. f.), Colônia (Alpinia zerumbet (Pers.) Burtt. R. M. Sm), Hortelã-miúda (Mentha crispa L.) and Romã (Punica granatum L.) stood out because, besides being mentioned by all of the informants, there was complete consensus regarding the main use of the plants, reaching the ROP 100.

La pérdida, degradación y fragmentación de bosques es un problema mundial normalmente relacionado a actividades forestales ilegales; la Restauración del Paisaje Forestal (RPF) se presenta como una alternativa para enfrentar estas problemáticas, consiguiendo involucrar y comprender a los actores interesados para lograr un proyecto exitoso. Esta investigación se enfocó en mujeres rurales organizadas del distrito de Yaguarón a objeto de proponer modelos innovadores para proyectos de RPF, considerando la cobertura forestal actual y actores clave, buscando mantener la equidad de género, transparencia y ética. Para esta investigación se analizó la cobertura forestal actual, se obtuvieron datos de fragmentación de los bosques; mediante talleres con investigadores se identificaron modelos forestales implementables, así como especies recomendadas. Para conocer la percepción de los actores clave se diseñó un cuestionario y se realizaron dos talleres, uno en cada comité de mujeres, en el mes de octubre de 2021. En éstos se buscó comprender qué modelos de proyectos de RPF serían de mayor interés para los actores locales. La cobertura forestal del distrito se clasificó en 6.487 ha de cobertura boscosa (≥ 2 ha) y 753 ha de cobertura arbórea (˂ 2 ha). La cobertura boscosa estuvo distribuida en 258 fragmentos y la cobertura arbórea en 1.881. Se identificaron 85 modelos forestales implementables clasificados según uso actual de la tierra. Entre ellos, el Sistema de Plantación Forestal con especies frutales fue el más seleccionado por las mujeres. Estos insumos servirán de base para la Planificación de la RPF de Yaguarón.

Available research suggests using Blockchain in electronic medical files to aggregate and integrate information. While reviewing authoritative articles and books, we analyzed the challenges and opportunities of using Blockchain this way. By using the specialists' opinion, completing a specialist questionnaire, using the DEMETEL technique and interpretive structural modeling (ISM) technique, this research investigated and analyzed the possibilities of using Blockchain in electronic medical files. The pair comparison technique was used to study and analyze the challenges of using Blockchain this way. The results are stated in this research. Research achievements include the design of a model using Blockchain for electronic medical files, analysis of Block chain's opportunities and challenges, measurement of the components, design and presentation of the model, and prioritizing the challenges of using Blockchain. This research suggests that the use of Blockchain in electronic medical files can reduce extra costs, create a comprehensive system for medical records to avoid additional costs, facilitate access to patient information, and reduce medical errors. The results obtained reveal that the components of immutability and the impossibility of data forgery of patient records (based on data integration in Blockchain) have the most impact on the system. Examination of the challenges reveals that blockchain technology's challenges (low speed, difficulty working with Blockchain, poor integrations between the software for various electronic health records) are of the utmost importance.

Abstract Background Nearly 50% of men living with HIV in many countries are unaware of their HIV status; men also have lower uptake of HIV treatment and pre-exposure prophylaxis (PrEP). In SSA, highly mobile men such as those working in fishing communities alongside Lake Victoria have low uptake of HIV testing and low rates of linkage to HIV treatment and PrEP, despite increasing availability of these services. HIV self-testing (HIVST) kits hold promise for overcoming barriers to HIV testing and linkage to services for HIV-positive and HIV-negative men. We describe here a protocol for an HIV status-neutral, social network-based approach to promote HIV testing, linkage to care and prevention, and better health outcomes, including adherence, in fishermen around Lake Victoria. Methods Utilizing beach management unit (BMU) registries of fishermen operating in three Lake Victoria fishing communities in Siaya County, Kenya, we completed a census and social network mapping to identify close social networks of men. Network clusters identified by a socially-central lead (“promotor”) and selected to ensure maximal separation between treatment and control will be randomized. Promotors in both arms will receive basic HIV training; intervention promotors are further trained in HIVST to distribute kits to their cluster, while control promotors will distribute to their cluster vouchers for free HIVST at nearby clinics. We will test whether these promoters can enhance linkage to ART and PrEP after self-testing, thereby addressing a key limitation of HIVST. We will also measure 6- and 12-month viral load in those living with HIV and PrEP adherence among those without HIV via urine tenofovir levels as objective markers of adherence. Discussion This study has the potential to improve HIV health and promote HIV prevention among a hard to reach, at-risk, and highly mobile population of men in Western Kenya—a critical population in Kenya’s HIV prevention and treatment program. Further, if successful, this innovative social networks-based model could be scaled at the regional level to address HIV prevention and care among similarly at-risk populations of men in eastern Africa and inland fisheries settings across the continent. Trial registration Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men, registered on February 26, 2021, registration # NCT04772469 .

Abstract An optimized sol–gel protocol was carried out to produce an yttrium aluminum garnet (YAG) xerogel from aluminum alkoxide and an yttrium salt on a semi-pilot scale. This xerogel was successfully used without prior pyrolysis as a solid load with the aid of additives in the preparation of pastes. Thermal treatment of the green bodies, obtained by robocasting of the paste, led to cohesive single-phase YAG ceramics. Manufacturing ceramic pieces by additive methods will allow shaping complex forms, while the single step conversion/consolidation would simplify the technological process, reducing global energy costs. Since YAG possesses high strength and good creep behavior at high temperatures, these refractory pieces could replace the metal alloys used in turbine blades for deep space exploration. Structural, thermal and chemical characterizations were performed on xerogel powders, pastes, and YAG ceramics.

Objective: Oral health is a public health challenge that must be addressed by integrating its social and biological dimensions to adopt a dental practice with a sense of integrality that takes into account the needs and potentialities of each person and context. The objective of this study was to analyze the oral health status of schoolchildren in a socio-environmentally vulnerable urban area of the city of Córdoba, Argentina, within the framework of a comprehensive collective intervention, conducted in the period 2013-2015 at the María del Tránsito Cabanillas school. Material and Methods: The intervention was organized in 3 stages: diagnosis, collective design and implementation of oral health promotion strategies, and evaluation, applying qualitative and quantitative logics appropriate to the object of study. Diagnosis was carried out in 2013, performing a clinical-dental examination of schoolchildren aged 6 to 8 years and a participatory study of the school environment. Results: Based on the diagnostic data, the stage of collective design and implementation of promotion strategies and oral health care was carried out. The evaluation of the intervention was performed through the clinical-dental examination of schoolchildren aged 10 to 12 years who attended the school in 2015, and who, also having attended the same institution in 2013, participated in the diagnostic study and analysis of the qualitative records related to the intervention. Healthy clinical trends and positive assessments by the different actors were observed. Conclusion: The results encourage continuing conducting comprehensive intervention strategies for oral health promotion and care.

Abstrak Enterprise Resource Planning (ERP) system merupakan perangkat lunak yang mendukung efektivitas dan efisiensi perusahaan. Syspro 7 sebagai ERP system telah mendukung PT. Asri Pancawarna dalam pengelolaan produktivitasnya. Penelitian ini bertujuan untuk mengetahui kesukesan implementasi Syspro 7 di PT. Asri Pancawarna. Untuk mengetahui kesuksesan implementasi sistem, peneliti menggunakan beberapa dimensi dari Critical sucsess factor implementasi sistem dari Denolf. Metode yang digunakan pada penelitian ini adalah survey dengan menggunakan responden seluruh karyawan PT. Asri Pancawarna yang menggunakan Syspro 7. Hasil pengumpulan data didapat bahwa seluruh responden setuju bahwa PT. Asri Pancawarna telah sukses mengimplementasikan syspro 7 dengan dipengaruhi oleh variabel pelaksanan. Penelitian ini dapat dimanfaatkan oleh PT. Asri Pancawarna sebagai bahan pertimbangan dalam implementasi sistem berikutnya. Abstract Enterprise Resource Planning (ERP) system is software that supports the effectiveness and efficiency of the company. Syspro 7 as an ERP system has supported PT. Asri Pancawarna in managing her productivity. This study aims to determine the successful implementation of Syspro 7 at PT. Beautiful Pancawarna. To determine the success of system implementation, the researcher uses several dimensions of the Critical success factor for system implementation from Denolf. The method used in this study is a survey using respondents all employees of PT. Asri Pancawarna who uses Syspro 7. The results of data collection showed that all respondents agreed that PT. Asri Pancawarna has successfully implemented syspro 7 by being influenced by the implementation variables. This research can be utilized by PT. Asri Pancawarna as a material for consideration in the implementation of the next system.

Abstract Objective Obesity is stigmatized and people with obesity report experiencing stigmatizing situations when seeking health care. The implications of these experiences are not well understood. This study tests an indirect effects model of negative care experiences as an intermediate variable between obesity and care avoidance/utilization and switching primary care doctors. Methods A survey was completed by 2380 primary care patients in the Learning Health Systems Network (LHSNet) Clinical Data Research Network with a BMI >25 kg/m2. Measures included scales assessing stigmatizing situations, perceived patient‐centered communication, perceived respect, having delayed needed care, and having looked for a new primary doctor in the past 12 months. Sequential and serial indirect effects of care experiences and respect in the association between BMI and care utilization outcomes was modeled. Results The hypothesized model was supported by findings. The associations between BMI and delaying needed care (OR = 1.06, p

The influence of different supplement types on the performance and nutrient dynamics of goats stocked in woodlands is not known. The objective of this study was to evaluate the effect of supplement type on the performance and the concentration of fecal nutrients of nursing does and the performance of kids raised in woodlands. One group of goats (SG, 9 does; 18 kids) was allowed supplemental grazing in adjacent silvopasture plots for 3–4 h daily and another group (SF, 8 does; 15 kids) was supplemented with corn (0.5% of metabolic weight) and ad libitum hay. Vegetation samples were collected and analyzed for productivity and quality (crude protein, CP; acid detergent fiber, ADF; neutral detergent fiber, NDF). The quality of the hay (N, ADF, NDF) and fecal samples (N, P, Ca) was analyzed. The animals’ live weight, FAMACHA score, and body condition score were collected. The browsing height for does consuming woodland vegetation was measured. Data were analyzed using the GLM procedure, Mixed procedure, and MEANS procedure in SAS 9.4. SG does showed better FAMACHA scores vs. SF does (p < 0.05). Fecal N and ADF were greater (p < 0.0001) in SG does vs. SF does. The findings showed a better performance and greater concentration of fecal nutrients in SG does vs. SF does, suggesting grazing quality pastures is a better option than using feedstuffs to supplement nursing does in woodland.

The Coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is an ongoing threat to global public health. To this end, intense efforts are underway to develop reagents to aid in diagnostics, enhance preventative measures, and provide therapeutics for managing COVID-19. The recent emergence of SARS-CoV-2 Omicron variants with enhanced transmissibility, altered antigenicity, and significant escape of existing monoclonal antibodies and vaccines underlines the importance of the continued development of such agents. The SARS-CoV-2 spike protein and its receptor binding domain (RBD) are critical to viral attachment and host cell entry and are primary targets for antibodies elicited from both vaccination and natural infection. In this study, mice were immunized with two synthetic peptides (Pep 1 and Pep 2) within the RBD of the original Wuhan SARS-CoV-2, as well as the whole RBD as a recombinant protein (rRBD). Hybridomas were generated, and a panel of three monoclonal antibodies, mAb CU-P1-1 against Pep 1, mAb CU-P2-20 against Pep 2, and mAb CU-28-24 against rRBD, was generated and further characterized. These mAbs were shown by ELISA to be specific for each immunogen/antigen. Monoclonal antibody CU-P1-1 has limited applicability other than in ELISA approaches and basic immunoblotting. Monoclonal antibody CU-P2-20 is shown to be favorable for ELISA, immunoblotting, and immunohistochemistry (IHC), however, not live virus neutralization. In contrast, mAb CU-28-24 is most effective at live virus neutralization as well as ELISA and IHC. Moreover, mAb CU-28-24 is active against rRBD proteins from Omicron variants BA.2 and BA.4.5 as determined by ELISA, suggesting this mAb may neutralize live virus of these variants. Each of the immunoglobulin genes has been sequenced using Next Generation Sequencing, which allows the expression of respective recombinant proteins, thereby eliminating the need for long-term hybridoma maintenance. The synthetic peptides and hybridomas/mAbs and quantitative antigen-binding data are under the intellectual property management of the Clemson University Research Foundation, and the three CDRs have been submitted as an invention disclosure for further patenting and commercialization.

The ability to navigate and orient in spatial surroundings is critical for effective daily functioning. Such ability is perturbed in clinically diagnosed mood and anxiety disorders, with patients exhibiting poor navigational skills. Here, we investigated the effects of depression and anxiety traits (not the clinical manifestation of the disorders) on the healthy population and hypothesized that greater levels of depression and anxiety traits would manifest in poorer spatial orientation skills and, in particular, with a poor ability to form mental representations of the environment, i.e., cognitive maps. We asked 1237 participants to perform a battery of spatial orientation tasks and complete two questionnaires assessing their anxiety and depression traits. Contrary to our hypothesis, we did not find any correlation between participants’ anxiety and depression traits and their ability to form cognitive maps. These findings may imply a significant difference between the clinical and non-clinical manifestations of anxiety and depression as affecting spatial orientation and navigational abilities.

Superconducting qubits are a leading system for realizing large-scale quantum processors, but overall gate fidelities suffer from coherence times limited by microwave dielectric loss. Recently discovered tantalum-based qubits exhibit record lifetimes exceeding 0.3 ms. Here, we perform systematic, detailed measurements of superconducting tantalum resonators in order to disentangle sources of loss that limit state-of-the-art tantalum devices. By studying the dependence of loss on temperature, microwave photon number, and device geometry, we quantify materials-related losses and observe that the losses are dominated by several types of saturable two-level systems (TLSs), with evidence that both surface and bulk related TLSs contribute to loss. Moreover, we show that surface TLSs can be altered with chemical processing. With four different surface conditions, we quantitatively extract the linear absorption associated with different surface TLS sources. Finally, we quantify the impact of the chemical processing at single-photon powers, the relevant conditions for qubit device performance. In this regime, we measure resonators with internal quality factors ranging from 5 to 15×10^{6}, comparable to the best qubits reported. In these devices, the surface and bulk TLS contributions to loss are comparable, showing that systematic improvements in materials on both fronts are necessary to improve qubit coherence further.

Abstract Background Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB. Methods In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30 mg oral Dydrogesterone daily, 250 mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery. Results Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06 ± 17.29 vs. 29.44 ± 15.6 and 22.20 ± 4.51 days, respectively; P

Abstract Background Rheumatoid arthritis (RA) is a chronic inflammatory disease of joint, but there is no known cure. 3′-sialyllactose (3′-SL) is an oligosaccharide that is abundant in breast milk of mammals, and has anti-inflammatory properties. However, the efficacy of 3′-SL on RA remains unclear. The objective of the present study was to evaluate the therapeutic effect of 3′-SL after it was directly injected into the knee joint cavity of a RA minipig model. Results Minipig RA model was induced by intra-articular injection of bovine type II collagen emulsified with complete or incomplete Freund’s adjuvant into left knee joint. In clinical assessment, lameness and swelling of the hindlimb and increased knee joint width were observed in all animals. After the onset of arthritis, 3′-SL (0, 2, 10, and 50 mg/kg) was directly administered to the left knee joint cavity once a week for 4 weeks. Compared to the vehicle control group, no significant difference in macroscopic observation of the synovial pathology or the expression of inflammation-related genes (IL-1β, TNF-α, and COX2) in the synovial membrane of the knee joint was found. In microscopic observation, cell cloning of the articular cartilage was significantly reduced in proportion to the concentration of 3′-SL administered. Conclusions Our results suggest that intra-articular injected 3′-SL had a therapeutic effect on collagen-induced arthritis at the cellular level with potential as a medication for RA.

Abstract Background Posttraumatic stress disorder occurs in as many as one in five combat veterans and is associated with a host of negative, long-term consequences to the individual, their families, and society at large. Trauma-focused treatments, such as Prolonged Exposure, result in clinically significant symptom relief for many. Adherence to these treatments (i.e., session attendance and homework compliance) is vital to ensuring recovery but can be challenging for patients. Engaging families in veterans’ treatment could prove to be an effective strategy for promoting treatment adherence while also addressing long-standing calls for better family inclusion in treatment for posttraumatic stress disorder. This paper describes the methods of a pragmatic randomized controlled trial designed to evaluate if family inclusion in Prolonged Exposure can improve treatment adherence. Methods One hundred fifty-six veterans, with clinically significant symptoms of posttraumatic stress disorder, will be randomized to receive either standard Prolonged Exposure or Prolonged Exposure enhanced through family inclusion (Family-Supported Prolonged Exposure) across three different VA facilities. Our primary outcomes are session attendance and homework compliance. Secondary outcomes include posttraumatic stress disorder symptom severity, depression, quality of life, and relationship functioning. The study includes a concurrent process evaluation to identify potential implementation facilitators and barriers to family involvement in Prolonged Exposure within VA. Discussion While the importance of family involvement in posttraumatic stress disorder treatment is non-controversial, there is no evidence base supporting best practices on how to integrate families into PE or any other individually focused trauma-focused treatments for posttraumatic stress disorder. This study is an important step in addressing this gap, contributing to the literature for both retention and family involvement in trauma-focused treatments. Trial registration ClinicalTrials.gov NCT03256227 . Registered on August 21, 2017.

COVID-19 pandemic has created a new economic crisis worldwide. Islamic Bank which was reportedly resilient against the financial crisis is expected to be stable in this period. Apart from that, Islamic Bank has channeled financing fund to various business sectors with different portions leading to a question whether they have different impact on Bank. This paper aims to discover the impact of COVID-19 pandemic and financing to business sectors on Islamic Bank profitability. An ARDL approach is employed for analysis. The result of the study shows that COVID-19 pandemic has a negative relationship with Islamic Bank profitability in the long-run. Furthermore, financing to transportation, warehousing and communication sectors is associated with higher profitability in the short-run. On the other hand, financing to wholesale and retail trade sectors hurt Islamic Bank profitability. Based on this result, it is suggested that Government impose some measures in stabilizing Islamic Bank’s performance during COVID-19 pandemic. In addition, Islamic Banks are expected to make adjustment on financing to business sectors ratio accordingly in order to maintain the profitability of Islamic Bank.

Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.

In the Neolithic Period, megalithic cultures emerged that worshiped ancestral spirits, because they were considered to provide welfare and protection to the living. One of the community's activities is the burial of corpses which produces different forms of megalithic buildings. One of the cultural products of the Megalithic tradition is the Doro Mpana site. The excavation findings from 2018 to 2019 were in the form of pottery fragments, ceramic fragments, Dimpa stones, stone artifacts, fragmentary skeletons (skulls, bones and human teeth), and metal objects. The purpose of this study is to understand the burial system and the aspects behind it using religious theory and social stratification theory. Data collection methods consist of observation, interview, literature study, and documentation techniques. Typological, Contextual, Comparative, and Ethnoarcheological analysis methods are also used. The results of this study can reveal the burial system at the Doro Mpana site, namely secondary burial and primary burial carried out in a sitting/folded posture with an orientation (original home of forefather) and a supine position with an orientation (celestial orientation) and accompanied by grave provisions.

Summary: More than a third of the global burden of blindness is due to cataracts, yet cataract surgery is one of the most cost-effective surgical treatments in medicine. Poor surgical outcomes in many settings remain a major challenge, raising concerns about the quality and efficacy of surgical training. Reflective learning from video recordings of a trainees' surgical performance has a high educational impact and is available routinely for surgical training within high-resource institutions. However, the prohibitive cost and limited portability of current surgical video recording systems make its use problematic in low-resource settings and outreach environments. Objective: The study's aim was to evaluate the potential of smartphone-captured surgical videos for surgeon learning via self-recording and self-review as well as the potential to support live telesurgical consultation. Methodology: A quantitative and qualitative methodology was used to explore and describe the utility and acceptance of smartphone videos in two training facilities in Nepal. Twenty surgeries were recorded on the smartphone for surgeon self-review, to assess image quality, and its application to measure performance against the International Council of Ophthalmology (ICO) Ophthalmology Surgical Competency Assessment Rubrics (OSCAR) SICS Rubric. The same system was used to transmit 15 different surgeries live via Skype from Nepal to an ophthalmologist surgical trainer in South Africa to evaluate the feasibility of live consultation. Findings: Overall video quality was described as high in 65% and moderate in 35% for the videos recorded for self-review. In the surgeries streamed via Skype, quality was described as high in 92.9% and moderate in 7.1%. There were no instances where the video quality was described as poor. The video quality was good enough that the surgeons could measure against ICO-OSCAR rubric in all cases. Discussion: The video quality of smartphone-captured surgical videos was found to be high and gained acceptance for reflective teaching and learning purposes. The extended telesurgical potential and portability of the smartphone enables use across many settings. More studies over a longer period are needed to determine how they can support training and learning in cataract surgery.

Background: Cervical cancer screening has shifted toward human papillomavirus (HPV)-based testing, but uptake of primary HPV screening in the United States is unknown and previous studies highlight delays in clinician adoption of guideline updates. Methods: We conducted a cross-sectional electronic survey of primary care clinicians (n?=?252; response rate?=?30.9%) assessing awareness and support of primary HPV screening. We assessed factors for association with past use of HPV testing and support of clinician- and patient-collected HPV testing individually using Fisher's exact test and jointly using Firth's logistic regression. Results: Most clinicians (79%) were familiar with one or more primary HPV screening guidelines. Support for clinician-collected (89%) and patient-collected (82%) HPV testing was high, but only 34.5% reported prior use. Guideline familiarity was positively associated with HPV testing in practice (p?=?0.0001). Support of clinician-collected testing was positively associated with more years in practice (p?=?0.03), internal (vs. family) medicine specialty (p?=?0.03), and guideline familiarity (p???0.0001). Male clinicians more frequently supported patient collection for patients overdue for screening (p?=?0.013). Physicians more frequently than advanced practice providers (APPs) supported patient collection for screening-adherent women (p?=?0.021). Multivariable analysis showed those unfamiliar with guidelines were less likely to have used HPV testing [odds ratio, OR: 0.10 (0.03?0.32)] or to support clinician-collected HPV testing [OR: 0.16 (0.07?0.37)]. APPs were less likely than physicians to support patient-collected HPV testing among screening-adherent women [OR: 0.42 (0.20?0.87)]. Conclusions: We observed high levels of guideline awareness and clinician support for primary HPV testing, despite relatively low use. This merits further exploration to inform future interventions to increase uptake.

Dynamic optimization problems in chemical engineering are often described by complex differential equations, In general, Due to the complexity of the model established in practice, it is not easy to solve it with an accurate algorithm, so the study of numerical methods to solve such problems has received much attention. As a new computing model, intelligent optimization algorithm has attracted more attention in solving dynamic optimization problems because of their easy operation. Based on the analysis of the Harris Hawk Optimization algorithm, this paper proposes the Chaos Elite Harris Hawk Optimization algorithm (CEHHO), which is used to improve the performance of CEHHO using control vector parameterization to solve dynamic optimization problems of the chemical industry. First of all, when the population is initialized, the population is initialized by Opposition-based learning Logistic chaos, which improves the diversity of the population and the quality of the solution. Second, the linear decreasing escape energy factor is changed to a nonlinear decreasing escape energy factor to balance the exploration and exploitation capabilities of the algorithm. Finally, through the mutation strategy guided by elite individuals, the algorithm can jump out of the local optimum. We use 8 test functions and 5 classical chemical optimization problems to evaluate the feasibility of the algorithm and compare and analyze the research results with other solving methods, showing the superiority of the CEHHO algorithm.

Abstract Ultrasound-guided hydrodissection with 5% dextrose in water (DW5) creates a peri-nervous compartment, separating the nerve from the neighboring anatomical structures. The aim of this randomized study was to determine the minimum volume of lidocaine 2% with epinephrine 1:200,000 required when using this technique to achieve an effective median nerve block at the elbow in 95% of patients (MEAV95). Fifty-two patients scheduled for elective hand surgery received an ultrasound-guided circumferential perineural injection of 4 ml DW5 and an injection of local anesthetic (LA) following a biased coin up-and-down sequential allocation method. A successful block was defined as a light touch completely suppressed on the two distal phalanges of the index finger within a 30-min evaluation period. The MEAV95 of lidocaine 2% with epinephrine was 4 ml [IQR 3.5–4.0]. Successful median nerve block was obtained in 38 cases (82.6%) with median onset time of 20.0 [10.0–21.2] minutes (95% CI 15–20). The analgesia duration was 248 [208–286] minutes (95% CI 222–276). Using an ultrasound-guided hydrodissection technique with DW5, the MEAV95 to block the median nerve at the elbow with 2% lidocaine with epinephrine was 4 ml [IQR 3.5–4.0]. This volume is close to that usually recommended in clinical practice. Trial registration clinicaltrials.gov. NCT02438657, Date of registration: May 8, 2015.

Abstract Background In patients receiving single lung transplantation for idiopathic pulmonary fibrosis, worsening of fibrosis of the native lung is usually progressive over time, with no significant effects on gas exchange. Case presentation Here, we describe the cases of two Caucasian male recipients of single lung transplants for idiopathic pulmonary fibrosis, 65 and 62 years of age, who exhibited acute worsening of lung fibrosis after an episode of serious viral infection (cytomegalovirus primo-infection in one case and COVID-19 in the other). In both cases, along with opacification of the native lung over several days, the patients presented acute respiratory failure that required the use of high-flow nasal oxygen therapy. Eventually, hypoxemic respiratory failure resolved, but with rapid progression of fibrosis of the native lung. Conclusion We conclude that acute worsening of fibrosis on the native lung secondary to a severe viral infection should be added to the list of potential complications developing on the native lung after single lung transplantation for idiopathic pulmonary fibrosis.

Abstract Background The COVID-19 pandemic jeopardized the traditional academic learning calendars due to the closing of all educational institutions across the globe. To keep up with the flow of learning, most of the educational institutions shifted toward e-learning. However, the students’ e-learning preference and e-learning readiness did not identify, particularly among the Bangladeshi female nursing students, where those can pose serious challenges. A cross-sectional study was carried out among the female nursing students between December 26, 2020, and January 11, 2021. A total of 237 students were recruited who have enrolled in e-learning at least the last 30 days of the participation. Multivariable linear regression models were fitted to find the association of students’ preference, e-learning readiness domains, and other variables. Results A cross-sectional study was conducted among the female nursing students to assess perceived e-learning readiness in the subdomains of readiness; availability, technology use, self-confidence, acceptance and training. The findings of the study revealed that the prevalence of preference for e-learning was 43.46%. The students did not prefer e-learning compared to ‘prefer group’ has significantly less availability of technology (β = − 3.01, 95% CI − 4.46, − 1.56), less use of technology (β = − 3.08, 95% CI − 5.11, − 1.06), less self-confidence (β = − 4.50, 95% CI − 7.02, − 1.98), less acceptance (β = − 5.96, 95% CI − 7.76, − 4.16) and less training need (β = − 1.86, 95% CI − 2.67, − 1.06). The age, degree, residence, parents’ highest education, having a single room, and having any eye problems were significantly associated with the variation of availability of technology, use of technology, self-confidence, acceptance, and training need of e-learning. Conclusions The outcomes of the study could be helpful while developing an effective and productive e-learning infrastructure regarding the preparedness of nursing colleges for the continuation of academia in any adverse circumstances like the COVID-19 pandemic.

Mediastinal masses span a wide histopathological spectrum. Inflammatory pseudotumors are rare and most commonly described in the lungs but these are reported in almost all the organs in the body. Mediastinal involvement is rare and difficult to diagnose. Clinical manifestations and laboratory investigations and radiology are non-specific. Histomorphology and Immunohistochemistry provide a valuable aid. Complete resection usually provides definitive diagnosis and is treatment of choice.