Search

Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p

Abstract Background Higher cruciferous vegetable intake is associated with lower cardiovascular disease risk in observational studies. The pathways involved remain uncertain. We aimed to determine whether cruciferous vegetable intake (active) lowers 24-h brachial systolic blood pressure (SBP; primary outcome) compared to root and squash vegetables (control) in Australian adults with mildly elevated BP (SBP 120–160 mmHg inclusive). Methods In this randomized, controlled, crossover trial, participants completed two 2-week dietary interventions separated by a 2-week washout. Cruciferous vegetables were compared to root and squash vegetables (~ 300 g/day) consumed with lunch and dinner meals. Participants were blinded to which interventions were the active and control. Adherence was assessed using food diaries and biomarkers (S-methyl cysteine sulfoxide (SMCSO, active) and carotenoids (control)). Twenty-four-hour brachial ambulatory SBP and secondary outcomes were assessed pre- and post each intervention. Differences were tested using linear mixed effects regression. Results Eighteen participants were recruited (median (IQR) age: 68 (66–70); female: n = 16/18; mean ± SD clinic SBP: 135.9 ± 10.0 mmHg). For both interventions, 72% participants had 100% adherence (IQR: 96.4–100%). SMCSO and carotenoids were significantly different between interventions (mean difference active vs. control SMCSO: 22.93 mg/mL, 95%CI 15.62, 30.23, P

Current-induced spin–orbit torque (SOT) facilitates the ultrafast electrical manipulation of magnetic tunnel junction (MTJ), which is a leading non-volatile technology for the microelectronic industry. The key bottleneck to the commercial application of SOT-MTJ is the absence of a practicable symmetry-breaking scheme to switch perpendicular magnetization without an external magnetic field. Here, we demonstrate the wafer-scale realization of internalized field-free switching in perpendicular SOT-MTJ using conventional materials and device structure. We utilize a dual-function tungsten (W) spacer, which generates sizable SOT while concomitantly breaking symmetry via interlayer exchange coupling (IEC). Tuning the W thickness enables field-free switching with two types of IEC. An optimized combination of SOT and IEC ensures competitive switching performance, with our device exhibiting excellent thermal stability, low switching current density, and fast operating speed. This work builds the long-sought bridge between SOT manipulation of magnetization and wafer-scale field-free perpendicular MTJ. It underscores the urgent need to incorporate perpendicular SOT-MTJ in integrated circuits for applications in logic, memory, and unconventional computing.

AbstractRecently, Generation Z, born from 1995 to 2010, started entering the labor market and is becoming an important human resource. They will account for 27% of the workforce by 2025, therefore, studying this cohort and how they perceive careers is critically significant. However, literature on Generation Z’s self-perceived careers lacks literature summaries that can shed light on the current landscape of the research field. This study employs bibliometric methodologies to identify current research trends, assess state-of-the-art, and indicate future research direction. Results show 108 papers published between 2016 and 2022. Growth trends, geographical locations, leading sources, and authors are identified. Top documents are indicated, with main and trending topics, which provide suggestions for researchers who conduct research in this area.

The trade – off between protection and weight is a constant consideration when designing a portable protective solution. Greater mobility is a desirable attribute and protection must therefore adapt, prompting a demand for lightweight, simple to construct, low-cost and effective ballistic protection systems. High strength and ductility, wave spreading capability and good energy absorption are key properties for ballistic protection. Four materials, polycarbonate, Kevlar®-epoxy, polyurethane foam, and aluminium alloy, possess these properties and were selected for analysis by numerical simulation. Multi-layered configurations were proven to be an optimal solution, by exploiting the advantages of each material without having large penalties of mass and cost. Numerical modelling using ANSYS AUTODYN® is used to simulate monolithic and multi-layered target configurations, to obtain the penetration mitigation performance. The results are analysed to select configurations based on different requirements, such as lowest cost, lowest mass, best performance, and optimal configuration which balanced the three key parameters mentioned. The optimal configuration of Aluminium, Kevlar-Epoxy, Polyurethane, and Polycarbonate has layers with thickness of 7, 3, 38, 2 mm respectively with a total mass of 7.97 kg, total cost of $39.86 and penetration of 29.34% (14.67 mm). Polynomial relationships between performance and mass/cost are also determined.

Umbilical cord-derived mesenchymal stem cells for regenerative therapy are a promising treatment option for chronic illnesses. Umbilical cord-derived mesenchymal stem cells offer several advantages over other sources, which makes them an attractive option in tissue repair and regeneration. This clinical study describes a 1-year follow-up on the safety and tolerance of umbilical cord-derived mesenchymal stem cell therapy on nine patients in Malaysia. Patients were assessed for adverse effects, and liver function tests were carried out on both pre- and post-treatments. Umbilical cord-derived mesenchymal stem cells’ effectiveness and safety were assessed by follow-up evaluations. All nine patients responded positively towards umbilical cord-derived mesenchymal stem cell therapy, without any adverse effects. After umbilical cord-derived mesenchymal stem cell therapy, a significant improvement was observed in liver functioning test outcomes, as haematological parameters and tumour markers were stable. The present study concludes that umbilical cord-derived mesenchymal stem cell therapy is well tolerated by Malaysian patients; however, further clinical screening must be done over a large number of patients population.

Chimeric antigen receptor-natural killer (CAR-NK) cell therapy is a novel immunotherapy targeting cancer cells via the generation of chimeric antigen receptors on NK cells which recognize specific cancer antigens. CAR-NK cell therapy is gaining attention nowadays owing to the ability of CAR-NK cells to release potent cytotoxicity against cancer cells without side effects such as cytokine release syndrome (CRS), neurotoxicity and graft-versus-host disease (GvHD). CAR-NK cells do not require antigen priming, thus enabling them to be used as “off-the-shelf” therapy. Nonetheless, CAR-NK cell therapy still possesses several challenges in eliminating cancer cells which reside in hypoxic and immunosuppressive tumor microenvironment. Therefore, this review is envisioned to explore the current advancements and limitations of CAR-NK cell therapy as well as discuss strategies to overcome the challenges faced by CAR-NK cell therapy. This review also aims to dissect the current status of clinical trials on CAR-NK cells and future recommendations for improving the effectiveness and safety of CAR-NK cell therapy.

AbstractThe COVID-19 pandemic has had significant impacts on the Vietnamese banking sector, leading banks to search for talented employees who can support their business and develop this competent workforce. However, there is currently a lack of research examining the effects of multi-level challenges on talent management (TM) and their on-going changes within the post-pandemic context in the Vietnamese banking industry. This research’s objective is to address this gap by exploring the challenges faced by TM practices in the banking industry with the consideration of the COVID-19 pandemic’s influences. The study used a qualitative approach and purposive sampling method with 20 semi-structured interviews conducted with bank managers from various types of banks. Saturation was achieved in 17 interviews. For better robustness, 3 further interviews were conducted, where similarly, no emergent themes were revealed. Thematic analysis was afterwards employed to examine interview data. The findings revealed different multi-level challenges for TM, including talent mobility, digital transformation, competition for talent between banks, changing customer demands, limited resources, and individual talent expectations. This research would contribute to the theoretical development of TM and contextual impacts on TM, and pave the way for comparison with similar industries in terms of TM related issues.

BackgroundStroke is a leading cause of lifelong disability worldwide, partially driven by a reduced ability to use the upper limb in daily life causing increased dependence on caregivers. However, post-stroke functional impairments have only been investigated using limited clinical scores, during short-term longitudinal studies in relatively small patient cohorts. With the addition of technology-based assessments, we propose to complement clinical assessments with more sensitive and objective measures that could more holistically inform on upper limb impairment recovery after stroke, its impact on upper limb use in daily life, and on overall quality of life. This paper describes a pragmatic, longitudinal, observational study protocol aiming to gather a uniquely rich multimodal database to comprehensively describe the time course of upper limb recovery in a representative cohort of 400 Asian adults after stroke. Particularly, we will characterize the longitudinal relationship between upper limb recovery, common post-stroke impairments, functional independence and quality of life.MethodsParticipants with stroke will be tested at up to eight time points, from within a month to 3 years post-stroke, to capture the influence of transitioning from hospital to community settings. We will perform a battery of established clinical assessments to describe the factors most likely to influence upper limb recovery. Further, we will gather digital health biomarkers from robotic or wearable sensing technology-assisted assessments to sensitively characterize motor and somatosensory impairments and upper limb use in daily life. We will also use both quantitative and qualitative measures to understand health-related quality of life. Lastly, we will describe neurophysiological motor status using transcranial magnetic stimulation.StatisticsDescriptive analyses will be first performed to understand post-stroke upper limb impairments and recovery at various time points. The relationships between digital biomarkers and various domains will be explored to inform key aspects of upper limb recovery and its dynamics using correlation matrices. Multiple statistical models will be constructed to characterize the time course of upper limb recovery post-stroke. Subgroups of stroke survivors exhibiting distinct recovery profiles will be identified.ConclusionThis is the first study complementing clinical assessments with technology-assisted digital biomarkers to investigate upper limb sensorimotor recovery in Asian stroke survivors. Overall, this study will yield a multimodal data set that longitudinally characterizes post-stroke upper limb recovery in functional impairments, daily-life upper limb use, and health-related quality of life in a large cohort of Asian stroke survivors. This data set generates valuable information on post-stroke upper limb recovery and potentially allows researchers to identify different recovery profiles of subgroups of Asian stroke survivors. This enables the comparisons between the characteristics and recovery profiles of stroke survivors in different regions. Thus, this study lays out the basis to identify early predictors for upper limb recovery, inform clinical decision-making in Asian stroke survivors and establish tailored therapy programs.Clinical trial registrationClinicalTrials.gov, identifier: NCT05322837.

Abstract Background Aging degrades the balance and locomotion ability due to frailty and pathological conditions. This demands balance rehabilitation and assistive technologies that help the affected population to regain mobility, independence, and improve their quality of life. While many overground gait rehabilitation and assistive robots exist in the market, none are designed to be used at home or in community settings. Methods A device named Mobile Robotic Balance Assistant (MRBA) is developed to address this problem. MRBA is a hybrid of a gait assistive robot and a powered wheelchair. When the user is walking around performing activities of daily living, the robot follows the person and provides support at the pelvic area in case of loss of balance. It can also be transformed into a wheelchair if the user wants to sit down or commute. To achieve instability detection, sensory data from the robot are compared with a predefined threshold; a fall is identified if the value exceeds the threshold. The experiments involve both healthy young subjects and an individual with spinal cord injury (SCI). Spatial Parametric Mapping is used to assess the effect of the robot on lower limb joint kinematics during walking. The instability detection algorithm is evaluated by calculating the sensitivity and specificity in identifying normal walking and simulated falls. Results When walking with MRBA, the healthy subjects have a lower speed, smaller step length and longer step time. The SCI subject experiences similar changes as well as a decrease in step width that indicates better stability. Both groups of subjects have reduced joint range of motion. By comparing the force sensor measurement with a calibrated threshold, the instability detection algorithm can identify more than 93% of self-induced falls with a false alarm rate of 0%. Conclusions While there is still room for improvement in the robot compliance and the instability identification, the study demonstrates the first step in bringing gait assistive technologies into homes. We hope that the robot can encourage the balance-impaired population to engage in more activities of daily living to improve their quality of life. Future research includes recruiting more subjects with balance difficulty to further refine the device functionalities.

The Mn3Ga material is a promising candidate for memory and computing devices owing to its rich crystalline structures of tunable ferrimagnetic and collinear and non-collinear antiferromagnetic phases. In particular, Mn3Ga with non-collinear antiferromagnetic order exhibits giant anomalous and topological Hall conductivities and is a potential material platform for hosting spin-related quantum phenomena. In this study, we demonstrate Mn3Ga films grown on thermally oxidized Si substrates, with and without the Ta buffer, under different deposition temperatures (Ts). With increasing Ts, the dominant crystalline structure across all Mn3Ga films evolves from a cubic to hybrid tetragonal and hexagonal texture, wherein the crystalline orientation of spins endows the films with in-plane magnetic anisotropy. For Ta/Mn3Ga and Mn3Ga films grown under high Ts, the inhomogeneity in surface energy of the buffer layer results in a non-uniform granular film in the former. Notably, the Mn3Ga films of hexagonal texture exhibit topological Hall signatures. The density functional theory calculations on the hexagonal Mn3Ga phase corroborated with the experimental magnetic, structural, and transport properties. These findings establish an important platform for tailoring Mn3Ga films toward multifunctional applications.