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Background: Predicting neurological recovery in patients with severe brain injury remains challenging. Continuous EEG monitoring can detect malignant patterns but is resource-intensive, and its role in long-term functional outcome prediction is unclear. This study evaluates the utility of parameterized short-segment EEG, acquired via EEG cap, in predicting neurological recovery. Methods: We analyzed short-segment high-density EEGs from 42 patients in the NET-ICU cohort with acute neurological injury. EEGs were pre-processed into standard clinical formats and parameterized using five visual EEG features associated with outcome prediction. Random Forest Classifier (RFC) models were trained and cross-validated to predict recovery of responsiveness (following 1-2 step commands during or after ICU admission) using: EEG features alone; clinician prediction combined with EEG features. Results: EEG-based prediction outperformed clinician bedside assessment (AUC ROC: 0.80 vs. 0.67) under the RFC model. Combining clinician Glasgow Outcome Scale–Extended (GOSE) scores with EEG features improved overall predictive performance (AUC ROC: 0.91). Conclusions: Standardized EEG features obtained using EEG caps can improve the accuracy of neurological recovery predictions in patients with acute severe brain injury. This suggests that automated extraction of background brain signals has the potential to provide clinically meaningful prognostic information in critical care settings, enhancing accessibility and resource efficiency.
The objective was to evaluate the use of resveratrol conjugated with silica nanoparticles during the in vitro maturation of bovine oocytes. The oocytes were divided into the following treatment groups during the maturation process: control (n = 159), resveratrol 0.5 μM (n = 158), resveratrol 1 μM (n = 155), nanoparticles conjugated with 0.5 μM resveratrol (n = 159), and nanoparticles conjugated with 1 μM resveratrol (n = 158). Several parameters were assessed, including cumulus oophorus size, reactive oxygen species (ROS) production, oocyte nuclear maturation, cell apoptosis, cleavage rates, and blastocyst production rates. Statistical analysis was conducted using Sigma Plot software (version 11) and SAS Studio, with statistical significance defined as P ≤ 0.05 for the main effects and interactions. The results indicated that the cumulus oophorus size was smaller in the resveratrol 1 μM treatment group, and the oocyte size was reduced in the nanoparticle 1 μM treatment group. No significant differences were detected between the treatment groups in terms of ROS production, oocyte maturation, or cell apoptosis. However, the resveratrol 1 μM treatment group exhibited decreased rates of cleavage and blastocyst formation. In contrast, the nanoparticles 0.5 μM and 1.0 μM treatments showed improved cleavage and blastocyst rates compared with the resveratrol 1.0 μM treatment group. In summary, while resveratrol alone at 1 μM concentration had a negative impact on cleavage and blastocyst rates, the use of silica nanoparticles conjugated with resveratrol (both 0.5 μM and 1 μM) enhanced these outcomes, suggesting a potential advantage in using nanoparticle-conjugated resveratrol for the in vitro maturation of bovine oocytes.
This article examines socialist globalization from the perspective of technical-labor internationalism in Mozambique, focusing on the final stage of the Cold War. First, it analyzes the four main pathways through which international technicians arrived in Mozambique: Latin American exile, socialist intergovernmental cooperation, European postcolonial humanitarianism, and African regionalism. It offers a cosmopolitan perspective on the relations that socialist Mozambique forged with the world. It then provides an inventory of the models of integration of these international technicians into the Mozambican state apparatus, presenting a framework emphasizing organizational rather than ideological aspects. It concludes that, while these paths were singular, they were not mutually exclusive. More importantly, they were instrumental in shaping the political affinities and frictions between international technicians in that cosmopolitan universe.
Prolonged childhood and adolescent loneliness (CAL) is linked to various adverse mental health outcomes, yet its impact on schizophrenia spectrum disorders (SSD) has been understudied. While loneliness is associated with psychosis and worsens symptoms in SSD, few studies have explored the long-term effects of early loneliness on SSD risk. Understanding how CAL interacts with genetic liability to schizophrenia is essential for identification of high-risk individuals.
Aims
This study evaluated whether prolonged CAL is associated with increased SSD risk and examined the interaction between CAL and genetic liability for schizophrenia. Gender differences in these associations were also explored.
Method
Data from the European Gene–Environment Interactions in Schizophrenia (EU-GEI) study were analysed, including 1261 individuals with SSD, 1282 unaffected siblings and 1525 healthy controls. CAL was retrospectively assessed for periods before age 12 years and age 12–16 years. Genetic risk was measured using polygenic risk scores for schizophrenia. Logistic regression models and the Relative Excess Risk due to Interaction (RERI) method were used to examine gene–environment interactions, with stratification by gender.
Results
Prolonged CAL was associated with higher odds of SSD (odds ratio [95% CI] = 5.20 [3.85−7.01] for loneliness before age 12; odds ratio [95% CI] = 7.26 [5.63−9.38] for loneliness during adolescence). The interaction between CAL and genetic risk was strongest during adolescence (RERI [95% CI] = 23.46 [10.75−53.53]). Females showed a greater effect (odds ratio [95 %CI] = 10.04 [6.80−14.94]) than males (odds ratio [95% CI] = 5.50 [3.95−7.66]). Incorporating CAL and genetic interaction increased predictive values to 17% for SSD risk − rising to 22.5% in females − compared with 2.6 and 2.8%, respectively, for genetic risk alone.
Conclusions
Prolonged CAL significantly increases SSD risk, particularly in females. The inclusion of CAL alongside genetic risk substantially enhances predictive accuracy. Early identification of CAL could inform preventive strategies, especially in genetically vulnerable populations.
Schistosomiasis, a parasitic disease caused by Schistosoma species, remains highly prevalent in tropical regions, where it contributes significantly to hepatic and vascular complications. Despite the well-established role of parasitic eggs in driving inflammation and organ damage, the specific vascular mechanisms remain poorly understood. Given the role of angiogenesis and vascular remodelling in tissue repair, the angiopoietins (ANGs) could be promising biomarkers to evaluate disease progression. This study aims to explore the relationship between ANG levels with parasitic load in patients with schistosomiasis. In this cross-sectional study, 126 schistosomiasis patients were stratified into three groups based on parasitic egg burden: negative, low, and moderate/high. Demographic, clinical, and laboratory data were collected, and serum ANGs were quantified via enzyme-linked immunosorbent assays. Parasitic load was assessed through stool examination, quantifying the number of Schistosoma eggs per gram of faeces. Additional clinical parameters, including liver abnormalities and blood chemistry, were evaluated. The ANG-2 levels and the ANG-2/ANG-1 ratio were significantly elevated in patients with higher egg burdens, particularly in the moderate/high group. The ANG-2/ANG-1 ratio was notably higher in patients with hepatosplenic schistosomiasis. While systemic blood pressure and oxygen saturation showed no significant differences between groups, patients with elevated triglycerides had lower ANG-2 levels. Elevated ANG-2 levels and an increased ANG-2/ANG-1 ratio correlate with higher parasitic burdens, reinforcing their potential as biomarkers for disease severity. These findings underscore the role of egg-induced inflammation in schistosomiasis pathophysiology and suggest that ANGs could aid in early diagnosis and treatment decisions, particularly in populations with high parasitic loads.
Despite the increased awareness and action towards Equality, Diversity and Inclusion (EDI), the glaciological community still experiences and perpetuates examples of exclusionary and discriminatory behavior. We here discuss the challenges and visions from a group predominantly composed of early-career researchers from the 2023 edition of the Karthaus Summer School on Ice Sheets and Glaciers in the Climate System. This paper presents the results of an EDI-focused workshop that the 36 students and 12 lecturers who attended the summer school actively participated in. We identify common threads from participant responses and distill them into collective visions for the future of the glaciological research community, built on actionable steps toward change. In this paper, we address the following questions that guided the workshop: What do we see as current EDI challenges in the glaciology research community and which improvements would we like to see in the next fifty years? Contributions have been sorted into three main challenges we want and need to face: making glaciology (1) more accessible, (2) more equitable and (3) more responsible.
We perform an experiment which provides a laboratory replica of some important features of the welfare state. In the experiment, all individuals in a group decide whether to make a costly effort, which produces a random (independent) outcome for each one of them. The group members then vote on whether to redistribute the resulting and commonly known total sum of earnings equally amongst themselves. This game has two equilibria, if played once. In one of them, all players make effort and there is little redistribution. In the other one, there is no effort and nothing to redistribute. A solution to the repeated game allows for redistribution and high effort, sustained by the threat to revert to the worst of these equilibria. Our results show that redistribution with high effort is not sustainable. The main reason for the absence of redistribution is that rich agents do not act differently depending on whether the poor have worked hard or not. The equilibrium in which redistribution may be sustained by the threat of punishing the poor if they do not exert effort is not observed in the experiment. Thus, the explanation of the behavior of the subjects lies in Hobbes, not in Rousseau.
Agricultural monoculture negatively impacts soil quality, particularly in fragile soils that yield limited crop production and are highly susceptible to degradation. Increasing plant diversity in production systems can be an alternative for maintaining soil ecosystem services and increasing crop yields. This study investigated the influence of increased plant diversity on soil health and its impact on soybean and cotton yield in an Ultisol in the Brazilian savanna in Mato Grosso State, Brazil. Tested five rates of plant diversity after soybean harvest: (1) very low (VL), (2) low, (3) average, (4) long-term average and (5) high (integrated crop–livestock systems (ICLS)) were tested. Plant diversity improves the health of sandy loam soil, increases C and N fractions in particulate organic matter (POM-C and POM-N) and leads to differences in C utilization by the soil microbial community. High ICLS diversity raises total organic carbon content, being POM-C and POM-N, the labile fractions, more efficient to show changes in sandy loam soil, in the short term, over a period of three years. High diversity promoted yield gains of up to 251 % for cotton and 82 % for soybean in relation to VL plant diversity. Changes in soil microbial composition are able to partially explain crop yield in diversified production systems (R2 ranging from 0.51 to 0.80). Diversifying production components is a sustainable way to maintain biological functions and agricultural quality of loam sandy soil in the Brazilian Cerrado in Mato Grosso.
The root elongation rate represents a biophysical process that can be directly affected by mechanical, water, thermal, and gaseous stresses in the soil to be used as a soil physical quality indicator. The objective of this study was to determine sugarcane root growth parameters under soil physical stress for different root diameter classes in an Oxisol from the Southeast of Brazil. The experimental design was entirely randomized in a factorial scheme 5 × 2 (mechanical × water stress) with three replications. The factor mechanical stress was composed of five compaction levels (1.04; 1.12; 1.19; 1.28; 1.36 Mg m–3). The factor water stress was composed of two matric potentials (–6 kPa and –33 kPa). Soil samples were collected from the 0.0–0.2 m layer of an Oxisol with a clayey texture. Pre-sprouted sugarcane seedlings were transplanted and conditioned in a growth chamber. Root length, volume, surface area, and diameter were quantified to generate root growth models as a function of physical stresses in the soil. Soil penetration resistance increases from 1.4 to 5 MPa reduced root elongation rate from 3.5 to 1.35 cm day–1 (–59%) and the average number of roots from 11 to 6 segments (–45%), respectively. The root volume, surface area, and length were reduced because of the increase in the compaction level. Coarse root diameter (1–2 mm) was weakly impacted by mechanical stress, whereas fine root diameter (0.5–1 mm) was more growth limited in compacted soils. The root elongation rate of sugarcane was modelled as a function of mechanical and water stress. Mechanical stress mainly affects the growth of sugarcane roots with small diameter.
The synonymies of the echinochasmid genera Mesorchis Dietz, 1909 and Monilifer Dietz, 1909 with Stephanoprora Odhner, 1902 remain contentious and unresolved with morphology. To explore the matter, we herein provide a supplemental description of the type species of Stephanoprora, Stephanoprora ornata Odhner, 1902, based on specimens we collected from the intestine of a Nile crocodile Crocodylus niloticus Laurenti, 1768 (Crocodylia: Crocodylidae) captured in the Kavango River, Namibia. No nucleotide information was available previously for S. ornata. Morphology plus 28S and ITS2 phylogenetic analyses suggested Stephanoprora is a monotypic genus that can be differentiated from other genera by having 26 collar spines. Stephanoprora differs from Mesorchis by the number and distribution of collar spines (26 [2 dorsal spines, 12 lateral spines, 12 corner spines] vs. 22 [2 dorsal spines, 12 lateral spines, 8 corner spines] in Mesorchis), length of the pre-pharyngeal oesophagus, pharynx position posterior to collar (vs. pre-pharyngeal oesophagus short, pharynx anterior to or at level of corner spines), and testes shape (elongate-ovoid, irregular in outline vs. ovoid, atypically elongated). Our 28S and ITS2 phylogenies recovered the new sequence of S. ornata (having 26 collar spines) sister to all remaining echinochasmid sequences, representing species that have 20–24 collar spines. Echinochasmus Dietz, 1909 and Mesorchis were recovered as paraphyletic. We retain Monilifer as a junior subjective synonym of Echinochasmus based a suite of morphological features related to body shape and genitalia and because the designated type for Monilifer was reassigned to Echinochasmus. We accept 25 species of Mesorchis.
Studies have demonstrated that the quality and transparency of reporting clinical practice guidelines (CPG) in health care are low. This meta-research aimed to evaluate the adherence of nutrition CPG for critically ill adults to the Reporting Items for practice Guidelines in HealTh care (RIGHT) checklist and its association with the methodological quality assessed by the Appraisal of Guidelines for Research and Evaluation II (AGREE II), along with other potential publication-related factors. A systematic search for CPG until December 2024 was conducted. RIGHT and AGREE II were applied. Eleven CPG were identified, none demonstrated adherence greater than 60 % to the RIGHT checklist and the mean RIGHT score was 33·5 ± 15·5 %. There was a strong correlation between the RIGHT score and AGREE II (r 0·886). A development CPG team including methodologist and/or statistician was associated with a higher RIGHT score (48·9 ± 4·5 v. 27·2 ± 11·0), and it was higher in CPG recommended or recommended with modifications by AGREE II in comparison to those not recommended (50·1 ± 4·6 v. 37·7 ± 8·1 v. 17·0 ± 6·8), and in those with acceptable and moderate compared with those with low methodological quality (50·1 ± 4·6 v. 32·2 ± 14·5 v. 19·3 ± 6·2). It was also related to the language of publication, being higher in those published in English. The reporting completeness in CPG for critically ill adults was low, with a strong correlation with the methodological quality. High values of reporting completeness scores were observed between CPG recommended by AGREE II (with moderate or acceptable quality) and in those including a methodologist/statistician in the development team.
To characterize the clinical and microbiological features of carbapenem-resistant Enterobacterales (CRE) compared to carbapenem-susceptible Enterobacterales (CSE) in the Dominican Republic (DR), and to assess risk factors associated with CRE.
Design:
Retrospective case-control study.
Setting:
Hospital General Plaza de la Salud, a tertiary teaching hospital in Santo Domingo, DR, from January 2015 to June 2024.
Patients:
Patients with CRE infections were identified from microbiology records. For each year, a matched group of CSE cases was selected at a 2.5:1 ratio. A total of 101 CRE cases and 280 CSE cases were included.
Methods:
Data were collected on demographics, comorbidities, infection sources, hospital stay duration, antibiotic use, and microbiology results. Statistical analysis included univariate and multivariate logistic regression to identify independent risk factors for CRE.
Results:
CRE cases showed higher prevalence of Enterobacter (36.5%) and Klebsiella (38.5%), while Escherichia predominated in CSE (65.5%). CRE patients had longer hospital stays (mean 18.7 vs 4.6 days, P < 0.001), higher ICU admission rates (34.7% vs 3.6%, P < 0.001), and increased invasive procedure use (eg central venous catheters, 36.6% vs 5.4%, P < 0.001). Key risk factors included antibiotic use (OR 3.09, P < 0.001) and ICU stay (OR 3.60, P= 0.012). The peak CRE resistance rate was 3.47% in 2022, a 64% increase from pre-pandemic levels.
Conclusions:
CRE infections in the DR increased during the COVID-19 pandemic, associated with prolonged hospitalizations and critical care. Enhanced antimicrobial stewardship is essential to curb resistance.
Maintaining jaguar Panthera onca subpopulations throughout Mesoamerica is vital to range-wide jaguar conservation. Corcovado National Park in Costa Rica is critical habitat for the Osa Peninsula jaguar subpopulation. There is a debate regarding whether the jaguars in this National Park are in a state of crisis. To examine this, we implemented long-term camera-trap monitoring throughout Corcovado National Park during 2015–2021. Using a spatially explicit Jolly–Seber model we estimated jaguar populations and distribution throughout our study area. Additionally, we reran our model using a constrained study area to compare our findings with those of a previous study. Trends in jaguar abundance indices and population estimates during 2015–2021 indicate that jaguar abundance has increased over time. Our jaguar density estimates also fall within the range of jaguar densities reported for relatively stable populations elsewhere. Using the same study area as that of a prior study, jaguar densities also increased over the duration of our study and were mostly comparable to previous density estimates. Our results suggest that jaguars within Corcovado National Park may not be in a state of crisis. Rather, our findings provide further hope for the jaguars of the Osa Peninsula. They do not, however, diminish the importance of continued conservation efforts. These will remain critical both inside and outside Corcovado National Park, as threats appear to have persisted over time.
Spinal cord atrophy (SMA) affects one in every 1,000 live births in Spain. Cerebral palsy (CP) is the most common cause of chronic motor disability in children, affecting two to three in every 1,000 live births. The Atlas 2030 exoskeleton is the first portable robotic pediatric exoskeleton aimed at facilitating walking in these children. It is used as a complement to other therapies.
Methods
We aimed to compare the efficacy and safety of the ATLAS 2030 exoskeleton with conventional physiotherapy in children aged between four and 12 years with SMA or CP. We conducted a literature search to identify clinical trials and systematic reviews in the PubMed, Embase, Web of Science, and Cochrane Library databases, finding 201 original articles published between 2017 and 2022. No controlled studies were found on the ATLAS 2030 or any other portable device, even after expanding the searches to any robot-assisted gait devices.
Results
Although systematic reviews evaluating the efficacy and safety of robotic orthoses in general were found, there were no specific controlled studies on the ATLAS 2030. The five studies found (two on CP and three on SMA) were of low quality and did not show conclusive results in terms of efficacy and safety. However, some of them suggested that this technology could provide significant improvements in acceptability, range of motion, and spasticity. With respect to safety there appeared to be no evidence of serious adverse effects from its use, reinforcing the developer’s initial hypothesis that the technology is safe.
Conclusions
Although the available evidence is very limited, the ATLAS 2030 appears to show efficacy in some gait-related outcomes without serious adverse effects. To demonstrate safety and efficacy, randomized controlled trials are required that compare the ATLAS 2030 with conventional physiotherapy, with more participants and a longer duration, and are conducted by independent expert groups without conflicts of interest.
The RedETS horizon scanning (HS) program in Spain is focused on identifying non-pharmaceutical emerging health technologies. HS is organized in three steps: (i) identification using different sources (PubMed, the biomedical press, and others); (ii) screening performed by the HS Working Group and clinicians; and (iii) prioritization using the PriTec tool. This study aimed to evaluate the accuracy of RedETS HS in identifying disruptive emerging technologies for our health system.
Methods
Data from brief files and full reports related to the identified emerging technologies were collected. Full health technology assessment (HTA) reports were also reviewed. The period of analysis was from 2016 to 2023. The information collected included the name, type, category, and indication of the emerging technology and the source of identification. An ad hoc Excel spreadsheet was designed to collect the information. The analysis consisted of a description of the variables and an assessment of concordance between the emerging technologies identified and those with full HTA reports.
Results
There were 338 emerging technologies identified. These technologies were mainly therapeutic (52.1%) or diagnostic (25.7%). In addition, about 45 percent were medical devices and 15.7 percent were in vitro diagnostic tests; imaging comprised 7.4 percent. Most of the emerging technologies were identified through the biomedical press (22.2%), PubMed (23.6%) and industry (20.3%). In a preliminary analysis of these main sources, 31 percent of the technologies identified by HS had full HTA reports, with all of these being identified three years before the HTA.
Conclusions
HS systems might help identify the most relevant technologies for healthcare systems, enabling them to be more ready to incorporate the new technologies. Therefore, HS must be able to detect emerging technologies that will have an impact on the health system. Periodic evaluation of the accuracy of HS programs will improve their impact in the HTA process.
Twenty-five years ago, the publication of an article by Pallier, Colomé, and Sebastián-Gallés (2001) launched a new and rapidly evolving research program on how second language (L2) learners represent the phonological forms of words in their mental lexicons. Many insights are starting to form an overall picture of the unique difficulties for establishing functional and precise phonolexical representations in L2; however, for the field to move forward it is pertinent to outline its major emerging research questions and existing challenges. Among significant obstacles for further research, the paper explores the current lack of theoretical agreement on the concept of phonolexical representations and the underlying mechanism involved in establishing them, as well as the variable use of the related terminology (e.g., fuzziness and target-likeness). Methodological challenges involved in investigating phonological processing and phonolexical representations as well as their theoretical implications are also discussed. To conclude, we explore the significance of L2-specific phonological representations for the bottom-up lexical access during casual, conversational speech and how our emerging knowledge of L2 lexical representations can be applied in an instructional setting as two potentially fruitful research avenues at the forefront of the current research agenda.