Hasil untuk "Medical technology"

W. Gwenzi, L. Mangori, C. Danha et al.

Recent studies show that high-technology rare earth elements (REEs) of anthropogenic origin occur in the environment including in aquatic systems, suggesting REEs are contaminants of emerging concern. However, compared to organic contaminants, there is a lack of comprehensive reviews on the anthropogenic sources, environmental behaviour, and public and ecological health risks of REEs. The current review aims to: (1) identify anthropogenic sources, transfer mechanisms, and environmental behaviour of REEs; (2) highlight the human and ecological health risks of REEs and propose mitigation measures; and (3) identify knowledge gaps and future research directions. Out of the 17 REEs, La, Gd, Ce and Eu are the most studied. The main sources of anthropogenic REE include; medical facilities, petroleum refining, mining and technology industries, fertilizers, livestock feeds, and electronic wastes and recycling plants. REEs are mobilized and transported in the environment by hydrological and wind-driven processes. Ecotoxicological effects include reduced plant growth, function and nutritional quality, genotoxicity and neurotoxicity in animals, trophic bioaccumulation, chronic and acute toxicities in soil organisms. Human exposure to REEs occurs via ingestion of contaminated water and food, inhalation, and direct intake during medical administration. REEs have been detected in human hair, nails, and biofluids. In humans, REEs cause nephrogenic systemic fibrosis and severe damage to nephrological systems associated with Gd-based contrast agents, dysfunctional neurological disorder, fibrotic tissue injury, oxidative stress, pneumoconiosis, cytotoxicity, anti-testicular effects, and male sterility. Barring REEs in medical devices, epidemiological evidence directly linking REEs in the environment to human health conditions remains weak. To minimize health risks, a conceptual framework and possible mitigation measures are highlighted. Future research is needed to better understand sources, environmental behaviour, ecotoxicology, and human epidemiology. Moreover, research on REEs in developing regions, including Africa, is needed given prevailing conditions predisposing humans to health risks (e.g., untreated drinking water).

Kai Siang Chan, N. Zary

Background Since the advent of artificial intelligence (AI) in 1955, the applications of AI have increased over the years within a rapidly changing digital landscape where public expectations are on the rise, fed by social media, industry leaders, and medical practitioners. However, there has been little interest in AI in medical education until the last two decades, with only a recent increase in the number of publications and citations in the field. To our knowledge, thus far, a limited number of articles have discussed or reviewed the current use of AI in medical education. Objective This study aims to review the current applications of AI in medical education as well as the challenges of implementing AI in medical education. Methods Medline (Ovid), EBSCOhost Education Resources Information Center (ERIC) and Education Source, and Web of Science were searched with explicit inclusion and exclusion criteria. Full text of the selected articles was analyzed using the Extension of Technology Acceptance Model and the Diffusions of Innovations theory. Data were subsequently pooled together and analyzed quantitatively. Results A total of 37 articles were identified. Three primary uses of AI in medical education were identified: learning support (n=32), assessment of students’ learning (n=4), and curriculum review (n=1). The main reasons for use of AI are its ability to provide feedback and a guided learning pathway and to decrease costs. Subgroup analysis revealed that medical undergraduates are the primary target audience for AI use. In addition, 34 articles described the challenges of AI implementation in medical education; two main reasons were identified: difficulty in assessing the effectiveness of AI in medical education and technical challenges while developing AI applications. Conclusions The primary use of AI in medical education was for learning support mainly due to its ability to provide individualized feedback. Little emphasis was placed on curriculum review and assessment of students’ learning due to the lack of digitalization and sensitive nature of examinations, respectively. Big data manipulation also warrants the need to ensure data integrity. Methodological improvements are required to increase AI adoption by addressing the technical difficulties of creating an AI application and using novel methods to assess the effectiveness of AI. To better integrate AI into the medical profession, measures should be taken to introduce AI into the medical school curriculum for medical professionals to better understand AI algorithms and maximize its use.

Jiawei Hao, Ping Wang, Quan Shen et al.

Abstract The lysosome is a cell’s endogenous machinery responsible for degrading proteins. Here we describe two lysosome-targeting live attenuated vaccine approaches, LYTAR 1.0 and LYTAR 2.0, by harnessing the lysosome to conditionally degrade viral proteins of influenza virus. LYTAR 1.0 incorporates a conditionally removable lysosome-targeting motif at the N- or C-terminus of viral proteins. LYTAR 2.0 allows flexible placement of lysosome-targeting motifs at internal or terminal sites of viral proteins. The resulting lysosome-targeting vaccine strains are attenuated by lysosome-mediated viral protein degradation in conventional cells, while maintaining replication efficiencies comparable to the wild-type virus in producer cell lines. In mouse models, these vaccine candidates are attenuated, induce strong and broad adaptive immune responses, and provide cross-reactive protection against H1N1 and H3N2 influenza viral challenges. This study establishes a lysosome-targeting vaccine platform for developing safe and effective live attenuated vaccines.

Xuan Chen, Zihang Li, Yong Han et al.

Abstract The persistence of drug memories accounts for the high risk of drug relapse, which is a major challenge in the treatment of substance use disorders. However, the neurobiological underpinnings, especially the dynamic changes of brain networks underlying long-term drug memories, remain unclear. Here we utilized cocaine conditioned place preference (CPP) in rats combined with c-Fos mapping in multiple brain regions and network analysis to assess dynamic patterns of neural activity and functional memory networks following the recall of short-term and long-term cocaine memory. Furthermore, we employed chemogenetic interventions to disrupt the core nodes within the long-term memory network. Our results showed that the recall of long-term cocaine memory is characterized by more extensive and stronger neuronal activation, greater interregional co-activation, and a more coordinated and stable brain network, compared to short-term cocaine memory. Within this reorganized network, the retrosplenial cortex (RSC) emerged as a key hub. Chronic inhibition of RSC disrupted the network and impaired the recall of the long-term memory. These findings demonstrate that the persistence of cocaine memory is encoded by a large-scale reorganization toward a more integrated and stable brain state, and identify the RSC as a critical cortical node orchestrating this process, offering a potential target for relapse prevention strategies.

Faridokht Salahshoori, Majid Jangi, Ebrahim Sadeghi‐demneh et al.

ABSTRACT Background and Aim Telerehabilitation has emerged as a promising solution to address accessibility, cost‐effectiveness, and continuity of care for patients requiring long‐term rehabilitation, like cerebral palsy (CP) patients. This study aimed to qualitatively explore the perceptions of clinical specialists, and CP patients regarding the feasibility, barriers, and facilitators of home‐based telerehabilitation. Methods This qualitative study conducted a thematic analysis approach. Participants include two groups: 17 medical informatics and rehabilitation professionals and 13 CP patients and/or their caregivers. Participants were selected via expert and snowball sampling. Interviews were semi‐structured, transcribed, and analyzed using the Braun‐Clarke thematic analysis technique and MAXQDA software. Results Thematic analysis revealed four dominant themes including feasibility, barriers, facilitators, and advantages. Feasibility was affected by technological infrastructure (internet connectivity, data security), human resources (availability of multidisciplinary specialists), legal aspects (patient data privacy), and financial sustainability. Key barriers included low digital literacy, limited access to specialized rehabilitation technologies, cultural resistance, legal regulations, and financial constraints. The findings also highlighted several advantages of home‐based telerehabilitation, including cost savings, improved accessibility to rehabilitation, and enhanced patient engagement in therapy. Conclusion The current study suggested that home‐based telerehabilitation can be a feasible alternative for CP patients in Iran, but a variety of technological, financial, legal, and cultural barriers must first be addressed for its successful development. Overcoming such barriers requires targeted investments, supportive policies, and cultural education for successful implementation.

Tian F, Xie N, Sun W et al.

Fangbing Tian,1 Nana Xie,1 Wenjin Sun,2 Wencong Zhang,1 Wenyuan Zhang,1 Jia Chen,1 Qiurong Ruan,3,* Jianxin Song1,* 1Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Infectious Diseases, Ezhou Central Hospital, Ezhou, People’s Republic of China; 3Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianxin Song, Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email songsingsjx@sina.com Qiurong Ruan, Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email ruanqiurong@sina.comPurpose: Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome with a high mortality rate. In clinical practice, some patients with fever of unknown origin (FUO) can develop HLH, further complicating the diagnosis and treatment. However, studies on HLH in adults with FUO are limited. This study aimed to investigate the clinical characteristics of adult patients with FUO to facilitate the early identification of those at high risk of developing HLH.Patients and Methods: We collected data from hospitalized patients with FUO between January 2014 and December 2020. Risk factors for HLH in adults with FUO were analyzed using univariate and multivariate analysis.Results: A total of 988 patients with FUO were included in the study. The incidence of HLH in adults with FUO was 6.4%, with hematological tumors being the primary cause. Multivariate analysis indicated that skin rash and elevated alanine aminotransferase, total bilirubin, triglycerides, lactate dehydrogenase, and ferritin levels were independent risk factors for HLH in adults with FUO.Conclusion: This study revealed the incidence rate, etiology distribution, and risk factors for HLH in adults with FUO. Comprehensive assessment of clinical and laboratory data at admission can assist in the early identification of FUO patients at risk for HLH.Keywords: Hemophagocytic lymphohistiocytosis, fever of unknown origin, etiology distribution, risk factors

Fen Li, Yu-Ting Si, Jia-Wei Tang et al.

WHO classified Helicobacter pylori as a Group I carcinogen for gastric cancer as early as 1994. However, despite the high prevalence of H. pylori infection, only about 3 % of infected individuals eventually develop gastric cancer, with the highly virulent H. pylori strains expressing cytotoxin-associated protein (CagA) and vacuolating cytotoxin (VacA) being critical factors in gastric carcinogenesis. It is well known that H. pylori infection is divided into two types in terms of the presence and absence of CagA and VacA toxins in serum, that is, carcinogenic Type I infection (CagA+/VacA+, CagA+/VacA-, CagA-/VacA+) and non-carcinogenic Type II infection (CagA-/VacA-). Currently, detecting the two carcinogenic toxins in active modes is mainly done by diagnosing their serological antibodies. However, the method is restricted by expensive reagents and intricate procedures. Therefore, establishing a rapid, accurate, and cost-effective way for serological profiling of carcinogenic H. pylori infection holds significant implications for effectively guiding H. pylori eradication and gastric cancer prevention. In this study, we developed a novel method by combining surface-enhanced Raman spectroscopy with the deep learning algorithm convolutional neural network to create a model for distinguishing between serum samples with Type I and Type II H. pylori infections. This method holds the potential to facilitate rapid screening of H. pylori infections with high risks of carcinogenesis at the population level, which can have long-term benefits in reducing gastric cancer incidence when used for guiding the eradication of H. pylori infections.

Nour al dain Marzouka, Halima Alnaqbi, Amira Al-Aamri et al.

Abstract The Human leukocyte antigen (HLA) molecules are central to immune response and have associations with the phenotypes of various diseases and induced drug toxicity. Further, the role of HLA molecules in presenting antigens significantly affects the transplantation outcome. The objective of this study was to examine the extent of the diversity of HLA alleles in the population of the United Arab Emirates (UAE) using Next-Generation Sequencing methodologies and encompassing a larger cohort of individuals. A cohort of 570 unrelated healthy citizens of the UAE volunteered to provide samples for Whole Genome Sequencing and Whole Exome Sequencing. The definition of the HLA alleles was achieved through the application of the bioinformatics tools, HLA-LA and xHLA. Subsequently, the findings from this study were compared with other local and international datasets. A broad range of HLA alleles in the UAE population, of which some were previously unreported, was identified. A comparison with other populations confirmed the current population’s unique intertwined genetic heritage while highlighting similarities with populations from the Middle East region. Some disease-associated HLA alleles were detected at a frequency of > 5%, such as HLA-B*51:01, HLA-DRB1*03:01, HLA-DRB1*15:01, and HLA-DQB1*02:01. The increase in allele homozygosity, especially for HLA class I genes, was identified in samples with a higher level of genome-wide homozygosity. This highlights a possible effect of consanguinity on the HLA homozygosity. The HLA allele distribution in the UAE population showcases a unique profile, underscoring the need for tailored databases for traditional activities such as unrelated transplant matching and for newer initiatives in precision medicine based on specific populations. This research is part of a concerted effort to improve the knowledge base, particularly in the fields of transplant medicine and investigating disease associations as well as in understanding human migration patterns within the Arabian Peninsula and surrounding regions.

Qingji Zhang, Xiaomei Chao, Yeman Tu et al.

Abstract This study investigates the relationship between labor values and two forms of envy—benign and malicious—as well as the potential mediating role of mindfulness using a mindfulness reperceiving model. Two thousand three hundred sixty three Chinese teenagers participated in a longitudinal study over an eight-month period, completing questionnaires measuring labor values, benign envy, malicious envy, and mindfulness. The cross-sectional data showed that labor values had an immediate negative effect on malicious envy, with mindfulness partially mediating this relationship. Additionally, labor values had an immediate positive effect on benign envy, but mindfulness did not mediate this relationship. Longitudinal data analysis revealed that the delayed effect of labor values on later benign/malicious envy was similar to its immediate effect. However, mindfulness only played a mediating role in the relationship between labor values and later malicious envy. Cross-gender stability was found in both the immediate effect model and the delayed effect model. Overall, this study sheds light on the influence of labor values on the development of social emotions and the potential mediating role of mindfulness in the Chinese cultural context.

Iva Pukleš, Csilla Páger, Nikola Sakač et al.

Amino acids (AAs) have broad nutritional, therapeutic, and medical significance and thus are one of the most common active ingredients of nutritional supplements. Analytical strategies for determining AAs are high-priced and often limited to methods that require modification of AA polarity or incorporation of an aromatic moiety. The aim of this work was to develop a new method for the determination of L-arginine, L-ornithine, and L-lysine on low-cost microchip electrophoresis instrumentation conjugated with capacitively coupled contactless conductivity detection. A solution consisting of 0.3 M acetic acid and 1 × 10⁻⁵ M iminodiacetic acid has been identified as the optimal background electrolyte, ensuring the shortest possible analysis time. The short migration times of amino acids (t ≤ 64 s) and method simplicity resulted in high analysis throughput with high precision and linearity (R²<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>≥</mo></mrow></semantics></math></inline-formula> 0.9971). The limit of detection values ranged from 0.15 to 0.19 × 10⁻⁶ M. The accuracy of the proposed method was confirmed by recovery measurements. The results were compared with CE-UV-VIS and HPLC-DAD methods and showed good agreement. This work represents the first successful demonstration of the ME-C⁴D analysis of L-arginine, L-ornithine, and L-lysine in real samples.

Ying-jie Gao, Shi-rong Li, Yuan Huang

BackgroundDue to the viral infection, chronic inflammation significantly increases the likelihood of hepatocellular carcinoma (HCC) development. Nevertheless, an inflammation-based signature aimed to predict the prognosis and therapeutic effect in virus-related HCC has rarely been established.MethodBased on the integrated analysis, inflammation-associated genes (IRGs) were systematically assessed. We comprehensively investigated the correlation between inflammation and transcriptional profiles, prognosis, and immune cell infiltration. Then, an inflammation-related risk model (IRM) to predict the overall survival (OS) and response to treatment for virus-related HCC patients was constructed and verified. Also, the potential association between IRGs and tumor microenvironment (TME) was investigated. Ultimately, hub genes were validated in plasma samples and cell lines via qRT-PCR. After transfection with shCCL20 combined with overSLC7A2, morphological change of SMMC7721 and huh7 cells was observed. Tumorigenicity model in nude mouse was established.ResultsAn inflammatory response-related gene signature model, containing MEP1A, CCL20, ADORA2B, TNFSF9, ICAM4, and SLC7A2, was constructed by conjoint analysis of least absolute shrinkage and selection operator (LASSO) Cox regression and gaussian finite mixture model (GMM). Besides, survival analysis attested that higher IRG scores were positively relevant to worse survival outcomes in virus-related HCC patients, which was testified by external validation cohorts (the ICGC cohort and GSE84337 dataset). Univariate and multivariate Cox regression analyses commonly proved that the IRG was an independent prognostic factor for virus-related HCC patients. Thus, a nomogram with clinical factors and IRG was also constructed to superiorly predict the prognosis of patients. Featured with microsatellite instability-high, mutation burden, and immune activation, lower IRG score verified a superior OS for sufferers. Additionally, IRG score was remarkedly correlated with the cancer stem cell index and drug susceptibility. The measurement of plasma samples further validated that CCL20 upexpression and SLC7A2 downexpression were positively related with virus-related HCC patients, which was in accord with the results in cell lines. Furthermore, CCL20 knockdown combined with SLC7A2 overexpression availably weakened the tumor growth in vivo.ConclusionsCollectively, IRG score, serving as a potential candidate, accurately and stably predicted the prognosis and response to immunotherapy in virus-related HCC patients, which could guide individualized treatment decision-making for the sufferers.

Chi Zhang, Chi Zhang, Wei Fang Liao et al.

ObjectiveCOVID-19 has caused great loss of human life and livelihoods. The dissemination of health information in online social networks increased during the pandemic's quarantine. Older people are the most vulnerable group in sudden public health emergencies, and they have the disadvantage of infection rates and online search for health information. This study explores the relationship between the health risk perception and health information search behavior of older people in social networks, to help them make better use of the positive role of social networks in public health emergencies.MethodBased on the Risk Information Search and Processing model, and in the specific context of COVID-19, this study redefines health risk perception as a second-order construct of four first-order factors (perceived probability, perceived severity, perceived controllability, and perceived familiarity), and constructs a research model of the health risk perception and health information search behavior of older people. An online survey of people over 55 years old was conducted through convenience sampling in China from February 2020 to March 2020.ResultsA total of 646 older adults completed the survey. The structural equation model showed that health risk perception is a second-order factor (H1), that health risk perception has significant positive effects on health information search behavior (H2: β = 0.470, T = 11.577, P &lt; 0.001), and that health risk perception has significant positive effects on affective response (H3: β = 0.536, T = 17.356, P &lt; 0.001). In addition, affective response has a significant positive mediating effect on information sufficiency (H4: β = 0.435, T = 12.231, P &lt; 0.001), and information sufficiency has a significant positive mediating effect on health information search behavior (H5: β = 0.136, T = 3.081, P = 0.002).ConclusionThe study results indicate that the health risk perception of older people during the COVID-19 outbreak not only directly affected their health information search behavior, but also had an indirect impact on their health information search behavior by affecting affective response and information sufficiency.

Martin Dreyling, Marc André, Nicola Gökbuget et al.

Di Cao, Mengyi Li, Yang Liu et al.

Abstract Background The magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) has become popular for quantifying liver fat content. However, the variability of the region-of-interest (ROI) sampling strategy may result in a lack of standardisation of this technology. In an effort to establish an accurate and effective PDFF measurement scheme, this study assessed the pathological correlation, the reader agreement, and time-burden of different sampling strategies with variable ROI size, location, and number. Methods Six-echo spoiled gradient-recalled-echo magnitude-based fat quantification was performed for 50 patients with obesity, using a 3.0-T MRI scanner. Two readers used different ROI sampling strategies to measure liver PDFF, three times. Intra-reader and inter-reader agreement was evaluated using intra-class correlation coefficients and Bland‒Altman analysis. Pearson correlations were used to assess the correlation between PDFFs and liver biopsy. Time-burden was recorded. Results For pathological correlations, the correlations for the strategy of using three large ROIs in Couinaud segment 3 (S3 3L-ROI) were significantly greater than those for all sampling strategies at the whole-liver level (P < 0.05). For inter-reader agreement, the sampling strategies at the segmental level for S3 3L-ROI and using three large ROIs in Couinaud segment 6 (S6 3L-ROI) and the sampling strategies at the whole-liver level for three small ROIs per Couinaud segment (27S-ROI), one large ROI per Couinaud segment (9L-ROI), and three large ROIs per Couinaud segment (27S-ROI) had limits of agreement (LOA) < 1.5%. For intra-reader agreement, the sampling strategies at the whole-liver level for 27S-ROI, 9L-ROI, and 27L-ROI had both intraclass coefficients > 0.995 and LOAs < 1.5%. The change in the time-burden was the largest (100.80 s) when 9L-ROI was changed to 27L-ROI. Conclusions For hepatic PDFF measurement without liver puncture biopsy as the gold standard, and for general hepatic PDFF assessment, 9L-ROI sampling strategy at the whole-liver level should be used preferentially. For hepatic PDFF with liver puncture biopsy as the gold standard, 3L-ROI sampling strategy at the puncture site segment is recommended.

Anne Dorothée Rösch, Ethan Taub, Ute Gschwandtner et al.

Background:Recent studies suggest movements of speech and gait in patients with Parkinson's Disease (PD) are impaired by a common underlying rhythmic dysfunction. If this being the case, motor deficits in speech and gait should equally benefit from rhythmic interventions regardless of whether it is a speech-specific or step-training-specific approach.Objective:In this intervention trial, we studied the effects of two rhythmic interventions on speech and gait. These rhythmic intervention programs are similar in terms of intensity and frequency (i.e., 3x per week, 45 min-long sessions for 4 weeks in total), but differ regarding therapeutic approach (rhythmic speech vs. rhythmic balance-mobility training).Methods:This study is a cross-over, parallel multi-arms, single blind intervention trial, in which PD patients treated with rhythmic speech-language therapy (rSLT; N = 16), rhythmic balance-mobility training (rBMT; N = 10), or no therapy (NT; N = 18) were compared to healthy controls (HC; N = 17; matched by age, sex, and education: p &gt; 0.82). Velocity and cadence in speech and gait were evaluated at baseline (BL), 4 weeks (4W-T1), and 6 months (6M-T2) and correlated.Results:Parameters in speech and gait (i.e., speaking and walking velocity, as well as speech rhythm with gait cadence) were positively correlated across groups (p &lt; 0.01). Statistical analyses involved repeated measures ANOVA across groups and time, as well as independent and one-samples t-tests for within groups analyses. Statistical analyses were amplified using Reliable Change (RC) and Reliable Change Indexes (RCI) to calculate true clinically significant changes due to the treatment on a patient individual level. Rhythmic intervention groups improved across variables and time (total Mean Difference: 3.07 [SD 1.8]; 95% CI 0.2–11.36]) compared to the NT group, whose performance declined significantly at 6 months (p &lt; 0.01). HC outperformed rBMT and NT groups across variables and time (p &lt; 0.001); the rSLT performed similarly to HC at 4 weeks and 6 months in speech rhythm and respiration.Conclusions:Speech and gait deficits in PD may share a common mechanism in the underlying cortical circuits. Further, rSLT was more beneficial to dysrhythmic PD patients than rBMT, likely because of the nature of the rhythmic cue.

Mengbi SHEN, Zixia WANG, Jiaqi ZHENG et al.

BackgroundExercise during pregnancy is closely related to maternal and infant health. Previous studies in developed countries have linked maternal exercise during pregnancy with newborn body weight as well as subcutaneous fat thickness. However, the relevant studies in China are limited, and the conclusions remain inconsistent. ObjectiveTo investigate the effects of maternal exercise during pregnancy on neonatal weight and subcutaneous fat thickness. MethodsBased on the Shanghai Birth Cohort, 959 maternal-infant pairs were included in this study. The International Physical Activity Questionnaire was used to collect average weekly frequency and daily minutes of walking in the first and second trimesters, and entropy weight method was used to calculate the cumulative exercise index in the two trimesters. Birth weight was measured using a calibrated weigh scale. Subcutaneous fat thickness was measured at abdomen, scapula, and triceps with a Harpenden skinfold caliper for all newborns and the sum of the thickness for the three sites was then calculated. A multiple linear regression model was employed to estimate the relationships of cumulative exercise index during pregnancy with neonatal body weight and subcutaneous fat thickness. Subgroup analyses stratified by pre-pregnancy body mass index (BMI) and sex of newborns were also performed. ResultsThe mean age of pregnant women was (28.5±3.8) years, and the pre-pregnancy BMI was (21.4±3.0) kg·m−2. Newborn boys were slightly more than newborn girls (54.3% vs 45.7%), and the neonatal weight was (3374.0±427.5) g. The means of newborns' abdominal, scapular, and triceps subcutaneous fat thickness were (4.4±1.3), (5.4±1.4), and (6.0±1.5) mm, respectively, and the sum of subcutaneous fat thickness was (15.8±3.9) mm. In the first and second trimesters, 77.3% and 88.7% of pregnant women walked 4 d per week and more, respectively; the daily minutes of walking was (36.9±27.2) min and (43.3±26.3) min, respectively; the cumulative exercise index was 25.6±17.7 and 35.9±21.1, respectively. The results of multiple linear regression analysis showed that the cumulative exercise index in the second trimester was negatively associated with newborns' abdominal (b=−0.006, 95%CI: −0.010-−0.003), scapular (b=−0.005, 95%CI: −0.009-−0.002), triceps (b=−0.006, 95%CI: −0.010-−0.002), and their sum of (b=−0.018, 95%CI: −0.028-−0.007) subcutaneous fat thickness (P<0.05); in the first and second trimesters, however, the relationship between maternal cumulative exercise and newborns' body weight was not significant. The results of stratified analyses showed that the negative associations between maternal cumulative exercise index and newborns' subcutaneous fat thickness for the second trimester remained significant in the subgroups of boys and neonates whose mothers had normal pre-pregnancy BMI (P<0.05). ConclusionCumulative exercise index in the second trimester is negatively correlated with the neonatal thickness of subcutaneous fat, and the association may be altered by neonatal sexes and maternal pre-pregnancy BMI levels.

Sahar Esfandyari, Ashraf Aleyasin, Zahra Noroozi et al.

Objective: Sulforaphane (SFN) is a natural free radical scavenger that can reduce oxidative stress (OS) through mediating nuclear factor (erythroid-derived 2)-like 2 (NF-E2-related factor 2 or NRF2)/antioxidant response element (ARE) signaling pathway and the downstream antioxidant enzymes. Here, we intended to study the role of SFN in OSinduced human granulosa cells (GCs) by investigating the intracellular levels of reactive oxygen species (ROS), cell death, and NRF2-ARE pathway. Materials and Methods: This experimental study was conducted on GCs of 12 healthy women who had normal menstrual cycles with no history of polycystic ovary syndrome (PCOS), endometriosis, menstrual disorders, hyperprolactinemia, or hormonal therapy. After isolation of GCs, the MTT assay was performed to explore GCs viability after treatment with SFN in the presence or absence of H2O2. Flow cytometry was utilized to determine the intracellular ROS production and the apoptosis rate. Evaluation of the mRNA and protein expression levels of NRF2 and phase II enzymes including superoxide dismutase (SOD) and catalase (CAT) was performed by quantitative real-time polymerase chain reaction (PCR) and western blotting. Finally, the data were analyzed by SPSS software using One-way ANOVA and the suitable post-hoc test. Significance level was considered as P<0.05. Results: Pretreatment of GCs with SFN attenuated intracellular ROS production and apoptosis rate in the H2O2-exposed cells. Moreover, SFN treatment increased the mRNA expression level of NRF2, SOD, and CAT. Higher expression of NRF2 and SOD was also observed at the protein level. Conclusion: Our study demonstrated that SFN protects human GCs against H2O2 induced-OS by reducing the intracellular ROS production and the following apoptosis through a mechanism by which NRF2 increases the antioxidant enzymes such as SOD and CAT. This result may have a potential application in assisted reproduction cycles by improving the quality of GCs and the embedded oocyte, especially in PCOS patients.

Sara Abbaspour, Autumn Naber, Max Ortiz-Catalan et al.

Pattern recognition algorithms have been widely used to map surface electromyographic signals to target movements as a source for prosthetic control. However, most investigations have been conducted offline by performing the analysis on pre-recorded datasets. While real-time data analysis (i.e., classification when new data becomes available, with limits on latency under 200–300 milliseconds) plays an important role in the control of prosthetics, less knowledge has been gained with respect to real-time performance. Recent literature has underscored the differences between offline classification accuracy, the most common performance metric, and the usability of upper limb prostheses. Therefore, a comparative offline and real-time performance analysis between common algorithms had yet to be performed. In this study, we investigated the offline and real-time performance of nine different classification algorithms, decoding ten individual hand and wrist movements. Surface myoelectric signals were recorded from fifteen able-bodied subjects while performing the ten movements. The offline decoding demonstrated that linear discriminant analysis (LDA) and maximum likelihood estimation (MLE) significantly (<i>p</i> < 0.05) outperformed other classifiers, with an average classification accuracy of above 97%. On the other hand, the real-time investigation revealed that, in addition to the LDA and MLE, multilayer perceptron also outperformed the other algorithms and achieved a classification accuracy and completion rate of above 68% and 69%, respectively.

Binyamin Ben Avraham, Marisa Generosa Crespo‐Leiro, Gerasimos Filippatos et al.

Abstract The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD‐supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD‐supported patients. The expected and non‐expected device‐related and patient–device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD‐supported patients, mainly those supported with the ‘destination therapy’ indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD‐supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non‐LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non‐LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast‐growing population of LVAD‐supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD‐supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD‐supported patients.

Hussein Sabit, Shaimaa Nazir, Shimaa Abdel-Ghany et al.

Being the most common cause of female deaths worldwide, breast cancer (BC) is intensively studied over the last two decades. In the present investigation, we evaluated the promoter methylation of three cancer-related genes; PARP-1, p21, and Rb in 10 bi-matched BC samples (ductal carcinoma and lobular carcinoma) included the core tumor and the adjacent normal tissue. H&E-stained histopathological sectioning revealed grade 2 and grade 3 tumor cells. Methylation-specific PCR (MSP) was performed using methylated (M) and unmethylated (U) primers for the three genes understudy. Histone acetyltransferase was measured in tumor and healthy tissues. A variation in the methylation state of the promoter region of the three genes were observed in core tumor and healthy tissue. PARP and Rb were hypermethylated in tumor tissues while p21 was partially methylated. HAT activities were positively correlated with the methylation pattern observed in healthy tissues, as HAT was highly expressed in healthy vs. tumor tissues. The obtained data might indicate that patients might be at risk of BC recurrence after being subjected to mastectomy. These data could be employed as a core in epigenetic-based data mining to establish a model for predicting the breast cancer-predisposed patients. However, further investigations are needed to fulfill this goal.