Search

Abstract Background Vaccines have increasingly become some of the most effective public health tools for promoting health and reducing the burden of infectious diseases. The availability of a malaria vaccine for routine use will be a major milestone, nonetheless, trust by the public for the vaccine could pose a major challenge for its acceptance. Documented evidence such as the boycott of the oral polio vaccine in northern Nigeria and the failure of the Ebola vaccine trial in Ghana among others highlight the impact of public trust on vaccine acceptance. Methods This is an explorative cross-sectional mixed-method study conducted in the Kassena Nankana districts. The study was conducted in the Kassena Nankana Districts between May and December 2020. A total of 390 structured questionnaires were administrated to mothers and caregivers of children under five years of age while 15 in-depth interviews were conducted with mothers and health workers. STATA software Version 16.0 was used to interpret the quantitative data, where bivariate and multivariate regression analysis was performed to determine the influence of trust on vaccine acceptance while QSR NVivo 12 software was used to code the qualitative data to aid the thematic analysis. Results The results revealed that the level of knowledge of the RTS,S vaccine among participants was high. About 95.4% of the mothers had good knowledge of the malaria vaccine and more than half 61.2% of them got information about the vaccine from the health facility. The level of trust for the malaria vaccine was equally high with 91.4% of the mothers reporting that the vaccine treats childhood malaria. In a bivariate analysis, educational status (P = 0.013), ethnicity (P = 0.008), marital status (P = 0.041), education on the vaccine and perceived ineffectiveness P

Purpose: This paper aims to explore how one elementary school administrative team responded to their changing student populations to include Latin(x) within their black community. The responses included looping practices, relationship building with families and culturally relevant pedagogies. In particular, this paper considers how the three aspects of the change worked together toward the goal of providing its students with quality educational opportunities and enhancements. Design/methodology/approach: The research presented here is part of a longitudinal (four-year) qualitative study where ethnographic approaches to data collection were adopted. Findings: The four-year immersion in the values of culturally relevant pedagogy created a reciprocal growth in understanding among the teachers and the students of the black and Latin(x) populations, sustained the overarching ideas of deep family connections and contributed to asset-driven curriculum. Originality/value: A national trend shows rapid changing demographics where Latin(x) families are moving into black neighborhoods and schools. This change in schools' student populations finds educators facing new challenges in addressing the educational and cultural needs of two minoritized populations. This research adds to the existing scholarship by documenting how one school shifts their learning atmosphere to deeply engage students in culturally relevant pedagogies.

The national policy context regarding transgender students' rights has been volatile in recent years. New York State's Department of Education has a transgender policy in place, yet local school districts around New York State do not. This qualitative case study examined how district and school staff perceived the knowledge and effectiveness of transgender policies. Findings suggest a policy breakdown created by key stakeholders at both the district and school levels that leave transgender students vulnerable.

Abstract Immunotherapy agents are now widely used in the treatment of metastatic melanoma. Immune‐related adverse events (irAEs) may occur, including cutaneous pathologies in 50% of patients. We report a case of Sweet syndrome (SS) in a patient who was prescribed ipilimumab and nivolumab for metastatic melanoma.

Chronic exertional compartment syndrome is well documented in the distal extremities, but is rare in the thighs. We present the case of a 19-year-old male who presented with chronic, recurrent bilateral thigh pain induced by physical activity, which settled with rest but recurred on immediate return to exercise. Postexercise MRI of both thighs demonstrated changes of symmetrical edema in the proximal quadriceps muscles, reflecting exercise-induce compartment syndrome. The patient underwent selective fasciotomies of each anterior thigh with improvement of symptoms. The patient is now doing well, with some residual milder symptoms and appearances on follow-up MR imaging are not as pronounced. This case describes the clinical presentation and imaging appearance of a rare case of chronic compartment syndrome in the quadriceps femoris.

Abstract Background Registry-based randomised controlled trials (rRCTs) have been described as pragmatic studies utilising patient data embedded in large-scale registries to facilitate key clinical trial procedures including recruitment, randomisation and the collection of outcome data. Whilst the practice of utilising registries to support the conduct of randomised trials is increasing, the use of the registries within rRCTs is inconsistent. The purpose of this systematic review is to explore the conduct of rRCTs using a patient registry to facilitate trial recruitment and the collection of outcome data, and to discuss the advantages and challenges of rRCTs. Methods A systematic search of the literature was conducted using five databases from inception to June 2020: PubMed, Embase (through Ovid), CINAHL, Scopus and the Cochrane Controlled Register of Trials (CENTRAL). The search strategy comprised of MESH terms and key words related to rRCTs. Study selection was performed independently by two reviewers. A risk of bias for each study was completed. A narrative synthesis was conducted. Results A total 47,862 titles were screened and 24 rRCTs were included. Eleven rRCTs (45.8%) used more than one registry to facilitate trial conduct. Six rRCTs (25%) randomised participants via a specific randomisation module embedded within a registry. Recruitment ranged between 209 to 106,000 participants. Advantages of rRCTs are recruitment efficiency, shorter trial times, cost effectiveness, outcome data completeness, smaller carbon footprint, lower participant burden and the ability to conduct multiple trials from the same registry. Challenges are data collection/management, quality assurance issues and the timing of informed consent. Conclusions Optimising the design of rRCTs is dependent on the capabilities of the registry. New registries should be designed and existing registries reviewed to enable the conduct of rRCTs. At all times, data management and quality assurance of all registry data should be given key consideration. We suggest the inclusion of the term ‘registry-based’ in the title of all rRCT manuscripts and a clear simple breakdown of the registry-based conduct of the trial in the abstract to facilitate indexing in the major databases.

Objective This study aims to investigate the interactive effect of a glycine equivalent (Glyequi) and standardized ileal digestible threonine (SID Thr) levels in low crude protein diets on performance, blood biochemistry, pectoral muscular creatine content and oxidative stability of meat in broiler chickens from 21 to 42 days. Methods A total of 1,500, twenty-one-day-old Cobb-Vantress male broiler chickens were distributed in a completely randomized 5×3 factorial arrangement of Glyequi×SID Thr with five replicates of 20 birds each. Fifteen dietary treatments of 16.5% CP were formulated to contain five levels of total Glyequi (1.16%, 1.26%, 1.36%, 1.46%, and 1.56%) and three levels of SID Thr (0.58%; 0.68% and 0.78%). Results Interaction effects (p

In 2020, STEM training programs across the country were challenged to provide support to students during a nation-wide shutdown of research institutions in response to the COVID-19 pandemic. Five U.S. high school science internship programs funded by the Doris Duke Charitable Foundation, with a history of collaboration, developed innovative strategies for distance-learning (DL) opportunities during the pandemic. Forty under-represented high school and undergraduate students were paired with scientific mentors at one of the programs for a DL scientific internship. Summer training combined synchronous and asynchronous programming with research projects adapted for DL success. Ninety-five percent of students who participated were satisfied with the training experience, nearly identical to exit survey responses from 2019 when our programs were held in-person. More students were interested in pursuing a career in research at the end of the program and credited the DL experience with increasing interest in research careers. Some DL elements were ideal for underrepresented youth, including a more flexible schedule and elimination of cost and time for travel. While the lack of in-person instruction challenged our ability to create a strong student community, we found that preparation, communication, and flexibility were key elements to these successful DL programs. The increased emphasis on interpretation and analysis of data, rather than data collection, enhanced student learning. This manuscript highlights the changes made to our curricula, elements which were most successful, and recommends strategies for future distance-learning programming.

Summary: Background: In children with severe acute malnutrition (SAM) tuberculosis is common, challenging to diagnose, and often fatal. We developed tuberculosis treatment decision algorithms (TDAs) for children under the age of 5 years with SAM. Methods: In this prospective diagnostic study, we enrolled and followed up children aged

Second language anxiety is an emotional reaction that diminishes second language learners' academic performance. Researchers have identified cognitive and affective factors as contributors to students' classroom anxiety reactions, yet few studies have examined the concurrent effect of those factors. This study employed survey questionnaires to investigate the effects of native language learning history, second language learning attitude, intrinsic/extrinsic motivation, and self-efficacy on students' second language classroom anxiety. Multiple regression results indicated that the affective factors, self-efficacy and attitudes about learning the target language, were significant predictors of students' English communication apprehension in the classroom.

Abstract Evidence suggests vitamin D3 (VD) supplementation can reduce accumulation of adipose tissue and inflammation and promote myogenesis in obese individuals, and thus could mitigate obesity‐induced reductions in skeletal muscle (SkM) contractility. However, this is yet to be directly investigated. This study, using the work‐loop technique, examined effects of VD (cholecalciferol) supplementation on isolated SkM contractility. Female mice (n = 37) consumed standard low‐fat diet (SLD) or high‐fat diet (HFD), with or without VD (20,000 IU/kg−1) for 12 weeks. Soleus and EDL (n = 8–10 per muscle per group) were isolated and absolute and normalized (to muscle size and body mass) isometric force and power output (PO) were measured, and fatigue resistance determined. Absolute and normalized isometric force and PO of soleus were unaffected by diet (P > 0.087). However, PO normalized to body mass was reduced in HFD groups (P 0.588). HFD reduced EDL isometric stress (P = 0.048) and absolute and normalized PO (P 0.493). Cumulative work during fatiguing contractions was lower in HFD groups (P 0.060). This study uniquely demonstrated that high‐dose VD had limited effects on SkM contractility and did not offset demonstrated adverse effects of HFD. However, small and moderate effect sizes suggest improvement in EDL muscle performance and animal morphology in HFD VD groups. Given effect sizes observed, coupled with proposed inverted U‐shaped dose‐effect curve, future investigations are needed to determine dose/duration specific responses to VD, which may culminate in improved function of HFD SkM.

This study assessed whether trunk flexor and extensor strength were predictors of time to stability (TTS) and center of pressure (CoP) during hop and hold tasks in children. Seventeen boys (age, 10.1 ± 1.6 years; height, 1.45 ± 0.11 m; mass, 26.7 ± 7.83 kg) undertook isokinetic strength assessments of concentric and eccentric trunk flexors/extensors at 60°/s, and anterior/medial hop tasks. Hierarchical multiple regressions determined whether concentric and eccentric trunk flexor/extensor peak torques predict TTS using a composite score (Comp[subscript X] Comp[subscript Y] Comp[subscript Z]) and CoP[subscript X] and CoP[subscript Y]. Concentric trunk flexors were the strongest predictor for TTS Comp[subscript XY], with concentric flexion and eccentric extension predicting TTS Comp[subscript Y]. All muscle actions were also strong predictors for CoP[subscript Y] during hop tasks. These findings have implications for the assessment of trunk musculature strength and measures of postural control within a young healthy population. The development of trunk musculature strength may aid improvements in dynamic balance tasks in children, with implications for fall and injury risk. To improve trunk musculature strength and the potential to maintain postural control, a combination of concentric and eccentric exercises with other training modalities appears relevant due to the increased relevance to the demands of balance maintenance.

Background: Immune checkpoint inhibitors (ICIs) have significantly improved outcomes in various cancers. ICI treatment is associated with the incidence of immune-related adverse events (irAEs) which can affect any organ. Data on irAEs occurrence in relation to sex- differentiation and their association with gender-specific factors are limited. Aims: The primary objective of the G-DEFINER study is to compare the irAEs incidence in female and male patients who undergo ICI treatment. Secondary objectives are: to compare the irAEs incidence in pre- and postmenopausal female patients; to compare the irAEs incidence in female and male patients according to different clinical and gender-related factors (lifestyle, psychosocial, and behavioral factors). Exploratory objectives of the study are to compare and contrast hormonal, gene-expression, SNPs, cytokines, and gut microbiota profiles in relation to irAEs incidence in female and male patients. Methods and Results: The patients are recruited from Fondazione IRCCS Istituto Nazionale dei Tumori, Italy, St Vincent’s University Hospital, Ireland, Oslo University Hospital, Norway, and Karolinska Insitutet/Karolinska University Hospital, Sweden. The inclusion of patients was delayed due to the Covid pandemic, leading to a total of 250 patients recruited versus a planned number of 400 patients. Clinical and translational data will be analyzed. Interpretation: The expected outcomes are to improve the management of cancer patients treated with ICIs, leading to more personalized clinical approaches that consider potential toxicity profiles. The real world nature of the trial makes it highly applicable for timely irAEs diagnosis.

The current focus on STEM education is based on the idea that science, technology, engineering and math be taught in an interdisciplinary and applied approach in grades K-12. There is growing attention to integrating the arts as an equal partner to STEM learning (STEAM). The purpose of this cluster random sample experimental study was to examine the effect of visual art instruction, specifically drawing, on long-term retention of science content. Fifty-five fifth and sixth grade students participated in this study, 31 in the experimental group and 24 in the control group. Both groups received instruction based on a modified science lesson developed by Arizona State University in cooperation with the National Aeronautics and Space Administration. The experimental group received instruction on art techniques to be used for drawing and the development of visual notes while the control group used traditional note taking and writing. A delayed post-test revealed that the drawing group scored significantly higher for retention of content. Implications for authentic arts integration revealed by this study suggest that the arts play a significant role in learning and content retention in art and science. More significantly, the participants in this study were at the level of proficiency and labeled gifted (minimum IQ of 130), demonstrating that arts integration is effective with a more diverse population than marginalized students studied in previously investigations.

Abstract HER2-positive (HER2+) breast cancer accounts for 20–25% of all breast cancers. Predictive biomarkers of neoadjuvant therapy response are needed to better identify patients with early stage disease who may benefit from tailored treatments in the adjuvant setting. As part of the TCHL phase-II clinical trial (ICORG10–05/NCT01485926) whole exome DNA sequencing was carried out on normal-tumour pairs collected from 22 patients. Here we report predictive modelling of neoadjuvant therapy response using clinicopathological and genomic features of pre-treatment tumour biopsies identified age, estrogen receptor (ER) status and level of immune cell infiltration may together be important for predicting response. Clonal evolution analysis of longitudinally collected tumour samples show subclonal diversity and dynamics are evident with potential therapy resistant subclones detected. The sources of greater pre-treatment immunogenicity associated with a pathological complete response is largely unexplored in HER2+ tumours. However, here we point to the possibility of APOBEC associated mutagenesis, specifically in the ER-neg/HER2+ subtype as a potential mediator of this immunogenic phenotype.

The use of novel and inexpensive catalysts as replacements for platinum is desirable. In this study, we demonstrate for the first time that cost-effective metal oxide nanomaterials and the conductive polymer polyaniline (PANI) can be directly chemically synthesized on carbon microfiber electrodes to improve the performance of lake sediment inoculated MFCs. Nanomaterial of MnO2, MnO2/polyaniline (PANI), ZnO/NiO and ZnO/NiO/PANI attachments were directly chemically synthesized on the carbon material and used as cathode electrodes. The maximum power densities recorded for the different treatments were; MnO2 78.5 mW/m2, MnO2/PANI (Polyaniline) 141.6 mW/m2, ZnO/NiO 67.6 mW/m2, and ZnO/NiO/PANI 129.4 mW/m2. Current and power densities were more than six-fold higher in ZnO/NiO/PANI and MnO2/PANI nanoparticle modified cathodes compared to the control MFCs with no catalyst and more than 2.5 fold higher compared to Pt loaded conventional cathodes. In-excess of 50-fold reductions in catalyst application costs to obtain a unit amount of power was demonstrated with the novel nanomaterials direct deposition method when compared to traditional catalysts such as Pt. This study demonstrates that nanomaterials-incorporated carbon microfiber cathodes bring about significant enhancements to power densities and may potentially have applications in cost-effective MFCs.

Background People with intellectual disabilities have poorer health and die earlier than their peers without identified disabilities. This difference represents a significant inequality. Until recently, it was considered that cancer was less common in this population, mainly because they did not live long enough to develop age-related cancers. However, recent evidence has identified that people with intellectual disabilities may be at an increased risk of developing cancer but more likely to present for medical treatment at a later stage when cancer has spread. Nonetheless, the evidence is lacking and there is a need to understand the prevalence and incidence of cancer and subtypes of cancer in adults with intellectual disabilities. Methods A systematic review and meta-analysis will be undertaken to investigate the prevalence and incidence of cancer and subtypes of cancer in adults with an intellectual disability. The JBI Systematic reviews of prevalence and incidence and the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to develop this protocol. Electronic databases will be searched using predefined search terms to identify relevant studies using the Condition Context Population (CoCoPop) framework. Eligible studies should be observational and have published baseline data that have estimated or presented data on the prevalence or incidence of cancer in adults with intellectual disabilities. To assess the methodological quality of studies included in this review a modified version of the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data will be used. Prevalence and incidence proportions will be analysed separately with individual study data being pooled using the DerSimonian-Laird proportion method and a random effects meta-analysis will be undertaken. Discussion This review will advance the epidemiological evidence to identify where targeted cancer care interventions are needed to help reduce the inequalities that this population experiences. Systematic review registration PROSPERO registration number: CRD42023423584

The amount of irradiance incident on a photovoltaic module and the module temperature are essential parameters to estimate its performance and forecast its energy output. These data are often available only where there are meteorological stations. Consequently, other methods are required to estimate these data. The objective of this work was to estimate the irradiance and temperature from different models and further estimate the annual energy output for Bambili, Cameroon. To this effect, mathematical models such as Angstrom–Prescott (A-P), Kaplanis, Duffie and Beckman, and Collares-Pereira and Rabl were employed for the estimation of irradiance, while the WAVE, SOYGRO, and Parton and Logan models were used for temperature computations. Collares-Pereira and Rabl irradiance models showed a lower percentage root mean square error (RMSE) value of 6.71 with respect to the National Aeronautics and Space Administration (NASA), while for temperature models, Parton and Logan performed better from 6 a.m. to noon and SOYGRO from 1 to 6 p.m. with percentage RMSE values of 7.17 and 9.86, respectively. With the estimated irradiance and temperatures from the models, the monthly and annual energy outputs were computed using mathematical models of the PV module. The percentage RMSE of the annual energy estimated with respect to the Photovoltaic Geographical Information System (PVGIS) was found to be 1.95 and 4.40 for BP3125 and BP3180 modules, respectively, while the percentage RMSE of the annual energy estimated with respect to Photovoltaic Software (PVsyst) was found to be 2.14 and 4.22 for BP3125 and BP3180 modules, respectively. In conclusion, the results showed that Collares-Pereira and Rabl, SOYGRO, and PV model equations can be employed with BP3125 and BP3180 PV modules for the estimation of energy output for Bambili and other locations with no meteorological stations or internet services.

AimsPatients diagnosed with idiopathic pulmonary fibrosis (IPF) have a high symptom burden and numerous needs that remain largely unaddressed despite advances in available treatment options. There is a need to comprehensively identify patients' needs and create opportunities to address them. This scoping review aimed to synthesise the available evidence and identify gaps in the literature regarding the unmet needs of patients diagnosed with IPF.MethodsThe protocol for the review was registered with Open Science Framework (DOI 10.17605/OSF.IO/SY4KM). A systematic search was performed in March 2022, in CINAHL, MEDLINE, Embase, PsychInfo, Web of Science Core Collection and ASSIA Applied Social Science Index. A comprehensive review of grey literature was also completed. Inclusion criteria included patients diagnosed with IPF and date range 2011-2022. A range of review types were included. Data was extracted using a data extraction form. Data was analysed using descriptive and thematic analysis. A total of 884 citations were reviewed. Ethical approval was not required.Results52 citations were selected for final inclusion. Five themes were identified: 1.) psychological impact of an IPF diagnosis. 2.) adequate information and education: at the right time and in the right way. 3.) high symptom burden support needs. 4.) referral to palliative care and advance care planning (ACP). 5.) health service provision-a systems approach.ConclusionThis review highlights the myriad of needs patients with IPF have and highlights the urgent need for a systems approach to care, underpinned by an appropriately resourced multi-disciplinary team. The range of needs experienced by patients with IPF are broad and varied and require a holistic approach to care including targeted research, coupled with the continuing development of patient-focused services and establishment of clinical care programmes.

Our qualitative analysis of interviews with remote Australian healthcare professionals found that they require reliable, local antimicrobial resistance (AMR) data reflecting the geographical diversity of the population they serve. The optimal use of AMR data must consider challenges within this setting, including high staff turnover, limited diagnostic capacity, and antibiotic shortages.

In the Bamenda Municipality of Cameroon households are adopting Solar Photovoltaic Systems (SPVS). The penetration of SPVS in this Municipality depends on their technical performance. The study aimed to evaluate the technical installation of SPVS within the Municipality. A field inspection and administration of a questionnaire was conducted. The field inspection evaluated the respect of technical installation norms for SPVS. The questionnaire captured data on the technical situation of the SPVS. The SPVS installed included PV and grid to power separate loads, and PV and grid to power same loads. The installed loads were a mix of AC and DC loads of capacity from 360 W to 10000 W. The load powered by the installed SPVS varied from 300 W to 7000 W. The PV array varied from 200 W to 3200 W and battery bank capacity of 100 Ah to 800 Ah. The PV arrays were mostly installed on roof tops. Only 5% of the SPVS were installed by certified personnel. More than 50% of the installed SPVS operated below designed operation time. Failures in installed systems were related to inverters (36 %) and battery banks (36 %). Most of the PV arrays were installed on rooftops at tilt angles between 20° and 50°. More than 50 % of the PV arrays were oriented to directions other than South. Protective devices were installed in only 14 % of the installed systems. Some of the SPVS were not properly dimensioned. It may be concluded that most of the installed SPVS do not respect the technical installation norms and were not dimensioned according to users’ needs. The survival and penetration of SPVS technology in the Bamenda Municipality, Cameroon, and other sub-Saharan communities requires awareness and capacity building, policies, and regulations in the design and installation of this technology.

In this study, we present a mathematical model for the codynamics of taeniasis and neurocysticercosis and rigorously analyze it. To understand the underlying dynamics of the proposed model, basic system properties such as the positivity and boundedness of solutions are investigated through the completing differential process. The basic reproduction number was calculated using the next-generation matrix method, and the analysis showed that when R01, the diseases persist. Local stability of the equilibria was analyzed using the Jacobian matrix, and Lyapunov function techniques were used to determine the global analysis, which showed that the endemic equilibrium point was globally stable when R0>1. On the other hand, the disease-free equilibrium was determined to be globally stable when R0

BackgroundBreast cancer is the second most common cause of cancer mortality among women in Tanzania and thus, early detection and treatment methods are central to improving breast cancer outcomes. However, in low- and middle-income countries in Sub-Saharan Africa, the survival rates remains low due to late presentation. Hence, a significant number of deaths could be prevented if barriers and facilitators to early detection are known.PurposeThis qualitative case descriptive study explored the possible barriers to awareness and early breast cancer diagnostic services among midlife women in rural Tanzania.MethodsTen key informant interviews with health systems managers and community health workers and eight focus group discussions with women aged 40-65 years and their spouses were conducted to elicit the study data conducted from July to August 2021.ResultsThe data revealed nine themes describing the barriers to early detection methods across five Socio-Ecological levels of influence, namely: 1) limited knowledge and 2) witchcraft beliefs (individual level); 3) limited male support (interpersonal level); 4) age and gender factors and 5) procrastination (community level) 6) limited availability of services 7) emphasis of curative over preventive care (institutional level); 8) poverty/inability to pay and 9) limitations of health insurance (societal/policy level).ConclusionsThe study findings suggest a need to further the design, implementation and evaluation of evidence-based community breast health awareness and education interventions to promote early detection of breast cancer in Tanzania. Specifically, the study highlights the need to address multiple level determinants of influence in breast cancer control as part of the country's Community Health Strategy.

IntroductionVisual naming ability reflects semantic memory retrieval and is a hallmark deficit of Alzheimer’s disease (AD). Naming impairment is most prominently observed in the late-onset amnestic and logopenic variant Primary Progressive Aphasia (lvPPA) syndromes. However, little is known about how other patients across the atypical AD syndromic spectrum perform on tests of auditory naming, particularly those with primary visuospatial deficits (Posterior Cortical Atrophy; PCA) and early onset (EOAD) syndromes. Auditory naming tests may be of particular relevance to more accurately measuring anomia in PCA syndrome and in others with visual perceptual deficits.MethodsForty-six patients with biomarker-confirmed AD (16 PCA, 12 lvPPA, 18 multi-domain EOAD), at the stage of mild cognitive impairment or mild dementia, were administered the Auditory Naming Test (ANT). Performance differences between groups were evaluated using one-way ANOVA and post-hoc t-tests. Correlation analyses were used to examine ANT performance in relation to measures of working memory and word retrieval to elucidate cognitive mechanisms underlying word retrieval deficits. Whole-cortex general linear models were generated to determine the relationship between ANT performance and cortical atrophy.ResultsBased on published cutoffs, out of a total possible score of 50 on the ANT, 56% of PCA patients (mean score = 45.3), 83% of EOAD patients (mean = 39.2), and 83% of lvPPA patients (mean = 29.8) were impaired. Total uncued ANT performance differed across groups, with lvPPA performing most poorly, followed by EOAD, and then PCA. ANT performance was still impaired in lvPPA and EOAD after cuing, while performance in PCA patients improved to the normal range with phonemic cues. ANT performance was also directly correlated with measures of verbal fluency and working memory, and was associated with cortical atrophy in a circumscribed semantic language network.DiscussionAuditory confrontation naming is impaired across the syndromic spectrum of AD including in PCA and EOAD, and is likely related to auditory-verbal working memory and verbal fluency which represent the nexus of language and executive functions. The left-lateralized semantic language network was implicated in ANT performance. Auditory naming, in the absence of a visual perceptual demand, may be particularly sensitive to measuring naming deficits in PCA.

This study examined the effect of repeated bouts of level and downhill running on physiological markers of effort and exercise-induced muscle soreness in trained female distance runners. Ten participants (Age: 24.4 ± 2.0 years; V̇O2peak: 52.9 ± 1.1 mL·kg−1·min−1), naïve to downhill running, completed six alternate 5 min trials of level and downhill running (−15%) at a 70% velocity at V̇O2peak on two occasions, three weeks apart. Perceived muscle soreness was measured upon completion and in the 72 h post exercise. V̇O2, Heart Rate (HR), Blood Lactate (BLa), and Respiratory Exchange Ratio (RER) were lower running downhill (p < 0.016, ηp2 > 0.541). For the first downhill run, Rating of Perceived Exertion (RPE) was higher compared to that for level running (p = 0.051; d = 0.447), but for the remaining trials, RPE was lower when running downhill (p < 0.004; d > 0.745). V̇O2, HR, and RER were not different in the second bout (p > 0.070, ηp2 < 0.318); however, V̇O2 was lower in each downhill trial (Δ = 1.6–2.2 mL·kg−1·min−1; d = 0.382–0.426). In the second bout, BLa was lower (p = 0.005, ηp2 = 0.602), RPE in the first trial was lower (p = 0.002; d = 0.923), and post exercise perceived soreness of the gastrocnemius, quadriceps, and hamstrings was attenuated (p < 0.002; ηp2 > 0.693). Perceived soreness of the gluteal muscles was lower in the second bout immediately post exercise, 24 h, and 48 h post exercise (p < 0.025; d > 0.922). A repeated bout of downhill running attenuated perceived muscle soreness and may modulate the physiological and perceived physical demand of a second bout of level and downhill running.

This study investigated lead (Pb) and cadmium (Cd) transfer in three dairy farming areas in the Mantaro river headwaters in the central Peruvian Andes and at varying distances from the mining complex at La Oroya. At each of these sites, the transfer of trace metals from the soil to raw milk was estimated, and a hazard assessment for lead and cadmium was carried out in scenarios of minimum, average, and maximum milk consumption in a Peruvian population aged 2–85. Pb and Cd were quantified by flame atomic absorption spectrometry. Significantly, the concentrations of lead and cadmium were found to exceed the maximum limits recommended by the World Health Organization, with a positive geospatial trend correlated with the distance from mining activity. Both Pb and Cd were found to be transferred through the soil–pasture–milk pathway, with the primary source of Cd being phosphate-based fertilizers used in pasture improvement. Pb was found to be the most significant contributor to the Hazard Index (HI) with those under 19 years of age and over 60 recording an HI of >1, with infants being the most vulnerable group due to their greater milk consumption in relation to their body weight. A marginal increase in contamination was observed in the dry season, indicating the need for studies to be expanded over several annual cycles.

Background Previous studies showed that the combination of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) corrector and potentiator, lumacaftor–ivacaftor (LUMA–IVA) provides meaningful clinical benefits in patients with cystic fibrosis who are homozygous for the Phe508del CFTR mutation. However, little is known about the effect of LUMA–IVA on Proinflammatory Cytokines (PICs).Objectives To investigate the impact of LUMA–IVA CFTR modulation on circulatory and airway cytokines before and after 12 months of LUMA–IVA treatment in a real-world setting.Methods We assessed both plasma and sputum PICs, as well as standard clinical outcomes including Forced Expiratory Volume in one second (FEV1) %predicted, Body Mass Index (BMI), sweat chloride and pulmonary exacerbations at baseline and prospectively for one year post commencement of LUMA–IVA in 44 patients with cystic fibrosis aged 16 years and older homozygous for the Phe508del CFTR mutation.Results Significant reduction in plasma cytokines including interleukin (IL)-8 (p

Electrolytes, function as an ion conducting membrane between battery electrodes, are essential for rechargeable batteries. Here, the authors report high-entropy liquid electrolytes and reveal substantial impact of the increasing entropy on lithium-ion solvation structures for highly reversible lithium batteries.

Abstract Background Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-controlled trials have focused specifically on severe/critical COVID, including vaccinated participants. Methods Bari-SolidAct is a phase-3, multicentre, randomised, double-blind, placebo-controlled trial, enrolling participants from June 3, 2021 to March 7, 2022, stopped prematurely for external evidence. Patients with severe/critical COVID-19 were randomised to Baricitinib 4 mg once daily or placebo, added to standard of care. The primary endpoint was all-cause mortality within 60 days. Participants were remotely followed to day 90 for safety and patient related outcome measures. Results Two hundred ninety-nine patients were screened, 284 randomised, and 275 received study drug or placebo and were included in the modified intent-to-treat analyses (139 receiving baricitinib and 136 placebo). Median age was 60 (IQR 49–69) years, 77% were male and 35% had received at least one dose of SARS-CoV2 vaccine. There were 21 deaths at day 60 in each group, 15.1% in the baricitinib group and 15.4% in the placebo group (adjusted absolute difference and 95% CI − 0.1% [− 8·3 to 8·0]). In sensitivity analysis censoring observations after drug discontinuation or rescue therapy (tocilizumab/increased steroid dose), proportions of death were 5.8% versus 8.8% (− 3.2% [− 9.0 to 2.7]), respectively. There were 148 serious adverse events in 46 participants (33.1%) receiving baricitinib and 155 in 51 participants (37.5%) receiving placebo. In subgroup analyses, there was a potential interaction between vaccination status and treatment allocation on 60-day mortality. In a subsequent post hoc analysis there was a significant interaction between vaccination status and treatment allocation on the occurrence of serious adverse events, with more respiratory complications and severe infections in vaccinated participants treated with baricitinib. Vaccinated participants were on average 11 years older, with more comorbidities. Conclusion This clinical trial was prematurely stopped for external evidence and therefore underpowered to conclude on a potential survival benefit of baricitinib in severe/critical COVID-19. We observed a possible safety signal in vaccinated participants, who were older with more comorbidities. Although based on a post-hoc analysis, these findings warrant further investigation in other trials and real-world studies. Trial registration Bari-SolidAct is registered at NCT04891133 (registered May 18, 2021) and EUClinicalTrials.eu ( 2022-500385-99-00 ).

This study was conducted to evaluate glycine equivalent (Glyequi) requirement in low crude protein (CP) diets with different levels of standardised ileal digestible (SID) threonine (Thr) on performance, serum metabolites, and muscle creatine of broiler chickens from 1 to 21 d age. A total of 1275 one-day-old male Cobb-Vantress chicks were distributed in a completely randomised 3 × 5 factorial arrangement for a total of 15 treatments with 5 replicates of 17 birds each. Diets were formulated to comprise three dietary SID of Thr concentrations 6.9, 8.1 and 9.3 g/kg and five dietary Glyequi levels (12.8, 14.3, 15.8, 17.3 and 18.8 g/kg). An interaction (p

Most PV systems are equipped with classical algorithms such as Perturb and Observe, Hill climbing and Incremental Conductance for Maximum Power Point Tracking Control (MPPT). The simplicity and ease of implementation of these conventional techniques are seen as the main reason of their utilization in PV systems. However, researchers’ attention has, in recent years, been attracted by artificial intelligence-based techniques which can better perform within the bounds of the nonlinearity of PV system characteristics. In this paper, an adaptive nonlinear technique is developed for both MPPT control and voltage stabilization of a Single-Ended Primary Inductance Converter. This control scheme based on Radial Basis function (RBF) neural network is equally used for approximation of unmeasurable or unmeasured variables of the PV system. The main objective of this nonlinear controller is to tract the maximum power and to stabilize the DC output voltage under real environmental conditions. The proposed technique has been numerically tested in a Matlab/Simulink environment under real climatic conditions and load variations. The close-loop stability of the controller is verified by Lyapunov’s theory and the proposed algorithm gives satisfactory results compared to Extremum Seeking Control-based MPPT used in the same conditions.

Background: Patient and public involvement (PPI) has the potential to improve the relevance of trial outcomes and improve participant recruitment within clinical trials. However, the literature on PPI approaches, outcomes, and attitudes towards PPI in specific clinical research areas is limited. We are interested to know the current approaches to and views of PPI within maternal and neonatal clinical trials, from the perspective and experience of involved stakeholders. Methods: A qualitative evidence synthesis (QES) of stakeholders’ perspectives and experiences of PPI will be conducted. Stakeholders will include any individual involved in maternal or neonatal clinical trials with experience of PPI in the area or who expresses their views on PPI. The electronic bibliographic databases CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science and the Maternity and Infant Care (OVID) will be searched from inception. Qualitative studies, mixed-methods studies where the qualitative data can be extracted independently, and surveys with open-ended qualitative questions, will be included. Aims: The QES seeks to explore stakeholders’, including PPI contributors, trial participants and guardians, and trial researchers, perspectives and experiences of PPI in maternal and neonatal clinical trials. Discussion: THE QES will provide an understanding of how PPI is understood, operationalised and experienced by stakeholders in maternal and neonatal clinical trials, with the aim of identifying good practice and areas for improvement. PROSPERO registration: CRD42023383878 (2nd March 2023)