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Neurotherapeutics : the Journal of the... Jun 2024The precise oxygen content thresholds of ischemic deep parenchymal (OCIDP) and that in cortical microcirculation (OCCM), which leads to ischemic penumbra converting into...
The precise oxygen content thresholds of ischemic deep parenchymal (OCIDP) and that in cortical microcirculation (OCCM), which leads to ischemic penumbra converting into the infarcted core, remain uncertain. This study employed an invasive fiber-optic oxygen meter and a newly developed oxygen-responsive probe called RuA-Cy5-rtPA (RC-rtPA) based on recombinant tissue-type plasminogen activator (rtPA) to examine the oxygen content thresholds. A mouse model of middle cerebral artery occlusion was generated and animals were randomly divided into a sham, 24-h reperfusion after 3-h ischemia (IR 3-h), and IR 6-h groups, all of which were sacrificed following reperfusion. Stroke severity was evaluated based on the infarction area, neurological symptoms, microcirculation perfusion, and microemboli in microcirculation. OCIDP was characterized based on its extent and distribution, whereas OCCM was measured using RC-rtPA. During ischemia, stroke severity escalation manifested as increasing infarction area, severe neurologic symptoms, and poorer microcirculation perfusion with more microthrombi depositions. OCIDP presented rapid decline following artery occlusion along with a gradual increase in the hypoxic area. Within 3 h following ischemia induction, the ischemic tissue that experienced hypoxia could be rescued, and this reversibility would disappear after 6 h. Within 6 h, OCCM continued to decrease. A significant decrease in oxygen content in cortical venules and cortical parenchyma was observed. These findings assist in establishing the extent of the ischemic penumbra at the microcirculation level and offer a foundation for assessing the ischemic penumbra that could respond positively to reperfusion therapy beyond the typical time window.
PubMed: 38918128
DOI: 10.1016/j.neurot.2024.e00387 -
Pediatric Cardiology Jun 2024Virtual reality (VR) as a distraction tool decreases anxiety and fear in children undergoing procedures, but its use has not been studied during transthoracic...
Virtual reality (VR) as a distraction tool decreases anxiety and fear in children undergoing procedures, but its use has not been studied during transthoracic echocardiograms (TTEs). We hypothesized that VR in children undergoing pre-intervention TTEs decreases anxiety and fear and increases TTE study comprehensiveness and diagnostic accuracy when compared with standard distractors (television, mobile devices). Patients (6-18 years old) scheduled for pre-intervention TTEs at Lucile Packard Children's Hospital in 2021 and 2022 were prospectively enrolled and randomized to VR and non-VR groups. Patients completed pre- and post-TTE surveys using the Children's Anxiety Meter-State (CAM-S) and Children's Fear Scale (CFS). Patients, parents, and sonographers completed post-TTE experience surveys. TTEs were reviewed by pediatric cardiologists for study comprehensiveness and compared with electronic medical records for diagnostic accuracy. Among 67 enrolled patients, 6 declined VR, 31 randomized to the VR group, and 30 to the non-VR group. Anxiety (average CAM-S difference 0.78 ± 1.80, p = 0.0012) and fear (average CFS difference 0.36 ± 0.74, p = 0.0005) decreased in both groups. There was no difference between groups in the change in anxiety and fear pre- and post-TTE (p = 0.96-1.00). TTE study comprehensiveness and diagnostic accuracy were high in both groups. Procedure time (time in the echocardiography room) was less for the VR group (48.4 ± 18.1 min) than the non-VR group (58.8 ± 24.4 min), but without a statistically significant difference (p = 0.075). VR is similar to standard distractors and may decrease procedure time. Patients, parents, and sonographers rated the VR experience highly and encouraged its use with future procedures.
PubMed: 38916669
DOI: 10.1007/s00246-024-03555-0 -
ACS Applied Materials & Interfaces Jun 2024Point-of-care testing (POCT) technologies facilitate onsite detection of pathogens in minutes to hours. Among various POCT approaches, pressure-based sensors that...
Point-of-care testing (POCT) technologies facilitate onsite detection of pathogens in minutes to hours. Among various POCT approaches, pressure-based sensors that utilize gas-generating reactions, particularly those catalyzed by nanozymes (e.g., platinum nanoparticles, PtNPs, or platinum-coated gold nanoparticles, and Au@PtNPs) have been shown to provide rapid and sensitive detection capabilities. The current study introduces Au-Pt alloy-coated gold nanoparticles (Au@AuPtNPs), an innovative nanozyme with enhanced catalytic activity and relatively high stability. For pathogen detection, Au@AuPtNPs are modified with H1 or H2 hairpin DNAs that can be triggered to undergo a hybridization chain reaction (HCR) that leads to their aggregation upon recognition by an initiator strand (Ini) with H1-/H2-complementary aptamers tethered to magnetic beads (MBs). Pathogen binding to the aptamer exposes Ini, which then binds Au@AuPtNPs and initiates a HCR, resulting in Au@AuPtNP aggregation on MBs. These Au@AuPtNP aggregates exhibit strong catalysis of O from the HO substrate, which is measured by a pressure meter, enabling detection of O157:H7 at concentrations as low as 3 CFU/mL with high specificity. Additionally, O157:H7 could also be detected in simulated water and tea samples. This method eliminates the need for costly, labor- and training-intensive instruments, supporting its further testing and validation for deployment as a rapid-response POCT application in the detection of bacterial contaminants.
PubMed: 38916478
DOI: 10.1021/acsami.4c05351 -
JBI Evidence Synthesis Jun 2024The objective of this review was to evaluate the effectiveness of physical rehabilitation versus non-rehabilitation comparators on physical functioning and quality of...
OBJECTIVE
The objective of this review was to evaluate the effectiveness of physical rehabilitation versus non-rehabilitation comparators on physical functioning and quality of life for long-term care (LTC) residents with dementia.
INTRODUCTION
LTC residents living with dementia often have impaired physical functioning and quality of life. Physical rehabilitation can improve physical functioning and quality of life for individuals living with dementia; however, many LTC residents with dementia do not receive physical rehabilitation and providers are unsure what interventions to employ. A synthesis of studies examining physical rehabilitation will help guide practice in the LTC sector where most residents live with dementia. Previous syntheses have focused on all residents in LTC, specific professions, interventions, or people with dementia in the community. Our review focuses on LTC residents with dementia and a broader definition of physical rehabilitation.
INCLUSION CRITERIA
This review includes studies that evaluate physical rehabilitation in comparison with non-rehabilitation controls among LTC residents with any severity of dementia. We included studies that measure the effect on activities of daily living, performance-based physical functioning, and self- or proxy-rated quality of life.
METHODS
Searches were conducted in APA PsycINFO (EBSCOhost), CINAHL (EBSCOhost), PubMed (National Library of Medicine), Embase, Scopus, and the Cochrane CENTRAL database with no date or language limitations. Two independent reviews assessed the studies against the inclusion criteria. Two independent reviewers extracted data and conducted a quality assessment using a structured extraction form. Certainty of evidence was ascertained using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Where possible, studies were pooled in meta-analyses; otherwise, a narrative synthesis was performed.
RESULTS
Thirty-three studies were included (n = 3072 participants); 27 were randomized control trials and the remaining 6 were non-randomized trials. The overall risk of bias of the included studies was low to unclear. Many of the included studies focused on increasing activity or walking, while few were individually tailored or at an intensity appropriate to induce therapeutic effects on physical function. Physical function was also measured via several outcome measures, limiting our ability to pool results. There was low certainty evidence that physical rehabilitation improved activities of daily living (12 RCTs, 1348 participants, SMD 0.78; 95% CI 0.27 to 1.30) and the Short Physical Performance Battery Score (3 RCTs, 258 participants, MD 3.01 points; 95% CI 1.37 to 4.66) compared with non-rehabilitation interventions. There was low to moderate certainty evidence that physical rehabilitation demonstrated no change in the 30-Second Sit to Stand Test (2 RCTs, 293 participants, MD 0.79 repetitions; 95% CI -0.45 to 2.03), 6-Minute Walk Test (4 RCTs, 363 participants, MD 17.32 meters; 95% CI -29.41 to 64.05), gait speed (4 RCTs, 400 participants, MD 0.10 meters/seconds; 95% CI -0.02 to 0.22), Timed Up and Go Test (3 studies, 275 participants, MD -2.89 seconds; 95% CI -6.62 to 0.84), or quality of life (4 RCTs, 419 participants, SMD 0.20; 95% CI -0.08 to 0.47).
CONCLUSIONS
This review demonstrates that physical rehabilitation may improve activities of daily living for LTC residents living with dementia, though the evidence is of low certainty. The effect of physical rehabilitation on specific functional tasks, like gait speed and quality of life, are less clear. Future research should examine the effects of individualized, progressive interventions on outcome measures that reflect the capacity and preferences of LTC residents with more advanced dementia.
REVIEW REGISTRATION
PROSPERO CRD42022308444.
PubMed: 38915237
DOI: 10.11124/JBIES-23-00431 -
Spinal Cord Jun 2024Cross-sectional study.
STUDY DESIGN
Cross-sectional study.
OBJECTIVES
To evaluate etiologic factors associated with spinal cord injury (SCI) severity and to identify predictive factors of reduction in SCI severity in six countries.
SETTING
SCI centers in Bangladesh, India, Malaysia, Nepal, Sri Lanka, and Thailand.
METHODS
Data from centers collected between October 2015 and February 2021 were analyzed using descriptive statistics and logistic regression.
RESULTS
Among 2634 individuals, the leading cause of SCIs was falls (n = 1410, 54%); most occurred from ≥1 meter (n = 1078). Most single-level neurological injuries occurred in the thoracic region (n = 977, 39%). Greater than half of SCIs (n = 1423, 54%) were graded American Spinal Injury Association Impairment Scale (AIS) A. Thoracic SCIs accounted for 53% (n = 757) of all one-level AIS A SCIs. The percentage of thoracic SCIs graded AIS A (78%) was significantly higher than high cervical (52%), low cervical (48%), lumbar (24%), and sacral (31%) SCIs (p < 0.001). Regression analyses isolated predictive factors both of SCI severity and inpatient improvement. Four factors predicted severity: age, neurological level, etiology, and country of residence. Four factors predicted improvement: age, neurological level, AIS grade on intake, and country of residence.
CONCLUSIONS
Findings can be used by healthcare providers and public health agencies in these countries to inform the public of the risk of SCI due to falls. Future studies should examine the social and occupational milieux of falls. Country-to-country comparisons of prehospital and inpatient care are also justified. Fall prevention policies can encourage the use of safety equipment when performing tasks at heights ≥1 meter.
PubMed: 38914754
DOI: 10.1038/s41393-024-01003-7 -
JAMA Network Open Jun 2024Major concerns regarding individuals who adhere to a vegan diet are whether they meet protein and essential amino acid recommendations and how reliant they are on...
IMPORTANCE
Major concerns regarding individuals who adhere to a vegan diet are whether they meet protein and essential amino acid recommendations and how reliant they are on ultraprocessed foods.
OBJECTIVES
To investigate whether individuals who adhere to a vegan diet meet protein and essential amino acid recommendations and, as secondary objectives, to determine ultraprocessed food intake and potential factors associated with inadequate protein intake in this population.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional survey study was conducted between September 2021 and January 2023 in Brazil among male and female adults (aged 18 years or older) who adhered to a vegan diet recruited from social media platforms.
EXPOSURE
Adherence to a vegan diet and unprocessed and minimally processed foods and ultraprocessed food consumption.
MAIN OUTCOMES AND MEASURES
Protein and essential amino acid intake and food consumption by processing level were assessed using a 1-day food diary. Nutrient adequacy ratios were calculated by dividing nutrient intake by its recommendation (using scores truncated at 1) for each participant and then finding the mean across participants for each nutrient. The mean adequacy ratio was the mean of all nutrient adequacy ratios.
RESULTS
Of 1014 participants who completed the survey, 774 individuals (median [IQR] age, 29 [24-35] years; 637 female [82.3%]) were confirmed as adhering to a vegan diet and provided adequate food recalls, among whom 558 individuals reported body weight and so had relative protein and amino acid intake values available. The median (IQR) body mass index (calculated as weight in kilograms divided by height in meters squared) of participants was 22.6 (20.3-24.8). The nutrient adequacy ratio of protein was 0.93 (95% CI, 0.91-0.94); for essential amino acids, ratios ranged from 0.90 (95% CI, 0.89-0.92) for lysine to 0.98 (95% CI, 0.97-0.99) for phenylalanine and tyrosine. The mean adequacy ratio for protein and all amino acids was 0.95 (95% CI, 0.94-0.96). The median intake level was 66.5% (95% CI, 65.0%-67.9%) of total energy intake for unprocessed and minimally processed food and 13.2% (95% CI, 12.4%-14.4%) of total energy intake for ultraprocessed food. Adjusted logistic regression models showed that consuming protein supplements (odds ratio [OR], 0.06 [95% CI 0.02-0.14]; P < .001) or textured soy protein (OR, 0.32 [95% CI, 0.17-0.59]; P < .001) was associated with decreased odds of inadequate protein intake. Higher ultraprocessed food intake levels were also associated with decreased odds of inadequate protein intake (eg, fourth vs first quartile of intake: OR, 0.16 [95% CI, 0.07-0.33]; P < .001), and higher unprocessed and minimally processed protein intake levels were associated with increased odds of inadequate protein intake (eg, fourth vs first quartile of intake: OR, 12.42 [95% CI, 5.56-29.51]; P < .001).
CONCLUSIONS AND RELEVANCE
In this study, most individuals who adhered to a vegan diet attained protein and essential amino acid intake recommendations, largely based their diet of unprocessed and minimally processed food, and had a significantly lower proportion of ultraprocessed food intake compared with previous reports. Participants consuming less ultraprocessed food were more likely to have inadequate protein intake, suggesting a significant reliance on ultraprocessed proteins for this population.
Topics: Humans; Female; Male; Adult; Brazil; Cross-Sectional Studies; Dietary Proteins; Vegans; Young Adult; Diet, Vegan; Food Handling; Middle Aged; Eating; Amino Acids; Amino Acids, Essential
PubMed: 38913373
DOI: 10.1001/jamanetworkopen.2024.18226 -
The New England Journal of Medicine Jun 2024Obstructive sleep apnea is characterized by disordered breathing during sleep and is associated with major cardiovascular complications; excess adiposity is an etiologic...
BACKGROUND
Obstructive sleep apnea is characterized by disordered breathing during sleep and is associated with major cardiovascular complications; excess adiposity is an etiologic risk factor. Tirzepatide may be a potential treatment.
METHODS
We conducted two phase 3, double-blind, randomized, controlled trials involving adults with moderate-to-severe obstructive sleep apnea and obesity. Participants who were not receiving treatment with positive airway pressure (PAP) at baseline were enrolled in trial 1, and those who were receiving PAP therapy at baseline were enrolled in trial 2. The participants were assigned in a 1:1 ratio to receive either the maximum tolerated dose of tirzepatide (10 mg or 15 mg) or placebo for 52 weeks. The primary end point was the change in the apnea-hypopnea index (AHI, the number of apneas and hypopneas during an hour of sleep) from baseline. Key multiplicity-controlled secondary end points included the percent change in AHI and body weight and changes in hypoxic burden, patient-reported sleep impairment and disturbance, high-sensitivity C-reactive protein (hsCRP) concentration, and systolic blood pressure.
RESULTS
At baseline, the mean AHI was 51.5 events per hour in trial 1 and 49.5 events per hour in trial 2, and the mean body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) was 39.1 and 38.7, respectively. In trial 1, the mean change in AHI at week 52 was -25.3 events per hour (95% confidence interval [CI], -29.3 to -21.2) with tirzepatide and -5.3 events per hour (95% CI, -9.4 to -1.1) with placebo, for an estimated treatment difference of -20.0 events per hour (95% CI, -25.8 to -14.2) (P<0.001). In trial 2, the mean change in AHI at week 52 was -29.3 events per hour (95% CI, -33.2 to -25.4) with tirzepatide and -5.5 events per hour (95% CI, -9.9 to -1.2) with placebo, for an estimated treatment difference of -23.8 events per hour (95% CI, -29.6 to -17.9) (P<0.001). Significant improvements in the measurements for all prespecified key secondary end points were observed with tirzepatide as compared with placebo. The most frequently reported adverse events with tirzepatide were gastrointestinal in nature and mostly mild to moderate in severity.
CONCLUSIONS
Among persons with moderate-to-severe obstructive sleep apnea and obesity, tirzepatide reduced the AHI, body weight, hypoxic burden, hsCRP concentration, and systolic blood pressure and improved sleep-related patient-reported outcomes. (Funded by Eli Lilly; SURMOUNT-OSA ClinicalTrials.gov number, NCT05412004.).
PubMed: 38912654
DOI: 10.1056/NEJMoa2404881 -
Heliyon Jun 2024The discrepancy between the operating and design capacities of solar plants in eastern Uganda is alarming; about 35 % underperformance in solar power generation is...
The discrepancy between the operating and design capacities of solar plants in eastern Uganda is alarming; about 35 % underperformance in solar power generation is observed. The goal of the current study is to minimize this disparity by improving the design models. Considering only cell temperature in the power generation model is responsible for the observed difference in design and operational solar power generated, the present study used a thermocouple to directly measure cell temperature, an anemometer to measure wind speed, and a solar power meter to measure irradiance. These extrinsic factors were used to modify the power generation model based only on cell temperature through the direct correlation of cell temperature, wind speed, and irradiance with solar power generation. Thus, the absence of extrinsic factors (wind speed and irradiance) in the design models is responsible for the colossal drop in solar power generated. Empirically, the missing extrinsic factors were used to transform the implicit solar power model into an explicit model. The development of a solar power generation model, multiple differential models, simulation and experimentation with a pilot solar rig served as alternate model for the prediction of solar power generation. The second-order differential model validated well with empirical solar power generated in Busitema, Mayuge, Soroti, and Tororo study areas based on RMSEs (0.6437, 0.6692, 0.2008, 0.1804, respectively), thus, narrowing the gap between the designed and operational solar power generated. Mayuge and Soroti recorded the highest solar power generation of 9.028 MW compared to Busitema (8.622 MW) and Tororo (8.345 MW), suggesting that it has a conducive site for installing future solar plants. The above results support the use of empirical explicit (triple) and second-order differential models for the design and operation of power plants.
PubMed: 38912472
DOI: 10.1016/j.heliyon.2024.e32353 -
Heliyon Jun 2024In recent years, the use of solar photovoltaic (PV) energy, which is one of the leading renewable energy sources, has become increasingly widespread around the world due...
In recent years, the use of solar photovoltaic (PV) energy, which is one of the leading renewable energy sources, has become increasingly widespread around the world due to its numerous advantages. However, PV-based electricity generation necessitates a large amount of land. Agrivoltaic (AV) systems, an innovative approach to combining agricultural and electricity production in the same area through solar modules positioned several meters above the surface of the ground, are growing rapidly in renewable energy and farming communities. This study explores Turkey's solar power generation and agricultural activities, combining crop cultivation and electricity generation for sustainable development on the same land. Furthermore, the AV potential for the most agriculture ten cities in different climate zones in Turkey is investigated using the PVsyst program. A list of the most commonly grown crops in the ten selected cities and the types of AV systems that can be employed with these crops is provided. The results show that AV systems present a great opportunity for the optimal integration of solar power generation with food production, especially for the cities of Konya, Kayseri, and Manisa, with the most ideal conditions for agricultural and solar power production. By combining the solar power potential of the country with the production capacity of arable lands, the increasing energy needs can be met and more efficient agricultural production can be provided. This study is expected to demonstrate that in specific regions of Turkey, AV farming will be suitable for certain crops.
PubMed: 38912471
DOI: 10.1016/j.heliyon.2024.e32300 -
Frontiers in Plant Science 2024The expanding cannabis production sector faces economic challenges, intensified by freshwater scarcity in the main US production areas. Greenhouse cultivation harnesses...
The expanding cannabis production sector faces economic challenges, intensified by freshwater scarcity in the main US production areas. Greenhouse cultivation harnesses sunlight to reduce production costs, yet the impact of greenhouse light levels on crucial production components, such as plant growth, branching, and water use efficiency (WUE), remains poorly understood. This study aimed to assess the effects of combined sunlight and supplemental lighting on the crop's main production components and leaf gas exchange of 'Suver Haze' in the vegetative stage. Within a greenhouse, LED lighting provided at intensities of ~150, 300, 500, and 700 µmol m s (18-hour photoperiod), combined with solar radiation, resulted in average daily light integrals of 17.9, 29.8, 39.5, and 51.8 mol m d. Increasing light levels linearly increased biomass, leaf area, and the number of branches per plant and square meter, with respective rates of 0.26 g, 32.5 cm, and 0.41 branches per mole of additional light. As anticipated, crop evapotranspiration increased by 1.8-fold with the increase in light intensity yet crop WUE improved by 1.6-fold when comparing the lowest and highest light treatments. Moreover, water requirements per unit of plant biomass decreased from 0.37 to 0.24 liters per gram when lighting increased from ~18 to 52 mol m d, marking a 35% reduction in evapotranspiration. These results were supported by increments in leaf photosynthesis and WUE with light enhancement. Furthermore, our findings indicate that even 52 mol m d of supplemental lighting did not saturate any of the crop responses to light and can be economically viable for cannabis nurseries. In conclusion, light supplementation strongly enhanced photosynthesis and plant growth while increasing WUE. Additionally, a comprehensive discussion highlights the shared physiological mechanisms governing WUE in diverse plant species and their potential for water conservation under enhanced lighting conditions.
PubMed: 38911978
DOI: 10.3389/fpls.2024.1371702