Stroke is a prevalent neurological event that often induces significant motor impairments in the upper extremities, such as hemiplegia, which impacts bimanual coordination and fine motor skills. Robotic-assisted therapy has gained prominence as a contemporary rehabilitation modality, providing augmented motor repetitions and proprioceptive feedback, thereby potentiating neuroplasticity and functional recovery. This pilot study aimed to examine the therapeutic efficacy of a robotic intervention for wrist rehabilitation in two post-stroke adults aged 50–70 years. The intervention protocol, implemented biweekly over four weeks, encompassed 45-minute sessions consisting of passive muscle elongation (5 min) and robotic-facilitated exercises targeting pronation-supination (10 min), flexion-extension (10 min), and radial-ulnar deviation (10 min). Outcome measures included pre- and post-intervention assessments utilizing the motor activity log, Fugl-Meyer Scale, and robotic metrics for muscular strength. Results indicated enhancements in joint range of motion, motor precision, and neuromuscular control, with patient “B” demonstrating superior improvements, particularly in complex motor patterns. In contrast, patient “A” exhibited attenuated progress, attributable to pronounced baseline deficits and fatigue. Specific gains were observed in flexion-extension for patient “A” and pronation-supination for patient “B,” with minimal advancements in radial-ulnar deviation across both subjects. These findings provide preliminary evidence supporting the efficacy of robotic-assisted therapy in motor rehabilitation post-stroke with the novel proposed wrist rehabilitation device.

In health care systems based upon the principles of managed competition, health insurers are expected to act as prudent buyers of care. Consumers are expected to switch between insurers based upon the performance of insurers in this role. Yet, the Dutch experience shows that trust of consumers in health insurers is low and that switching consumers focus primarily on price. The question arises if consumers do in fact perceive and trust insurers as prudent buyers of care. We addressed this question by using a mixed-method approach. The results show that most people know that insurers buy health care and feel that the purchasing tasks suit their role. They even have reasonable, though fragile, trust in the purchasing competencies of the insurer. However, the results also revealed that consumers have insufficient information to cast a judgement about insurers as purchasers and incorrectly think that insurers are commercial organisations. Hence, improving the public information about insurers and their purchasing role seems to be crucial. Given the inherent complexity in the system, it remains to be seen if this objective can be reached in the (near) future. For that reason, policymakers should also consider additional measures to encourage that insurers will take integral purchasing responsibility.

In this article, we study the behavior of complete two-sided hypersurfaces immersed in the hyperbolic space $\mathbb H^{n+1}$. Initially, we introduce the concept of the linearized curvature function $\mathcal {F}_{r,s}$ of a two-sided hypersurface, its associated modified Newton transformation $\mathcal {P}_{r,s}$ and its naturally attached differential operator $\mathcal {L}_{r,s}$. Then, we obtain two formulas for differential operator $\mathcal {L}_{r,s}$ acting on the height function of a two-sided hypersurface and, for the case where their support functions are related by a negative constant, we derive two new formulas for the Newton transformation $P_{r}$ and the modified Newton transformation $\mathcal {P}_{r,s}$ acting on a gradient of the height function. Finally, these formulas, jointly with suitable maximum principles, enable us to establish our rigidity and nonexistence results concerning complete two-sided hypersurfaces in $\mathbb H^{n+1}$.

Introduction: Recurrent major depressive disorder (MDD) has been associated with cognitive impairment and hippocampus atrophy. Additionally, in older adults it is related to increased dementia risk, as well as being dementia’s prodromal syndrome.

Case Report: A 68-year-old female patient, with a history of MDD beginning in 2014, has been under the care of the Psychogeriatrics service at HC-UFMG. In 2015, she was 60-year-old and underwent her first MRI scan. At that time, the Medial Temporal Atrophy Score (MTA) was 2 and she had a treatment resistant depression (TRD). She began multimodal treatments, including ECT, achieving only partial remission. Since then, the patient had recurrences of depression without the remission of cognitive impairment. In 2021, her MTA Score was still 2 with TDR symptoms. Currently, she is on Venlafaxine 150mg, Mirtazapine 30mg, Lithium 300mg, Olanzapine 5mg, Clonazepam 0.25mg and maintenance ECT every 45 days. The patient remains with cognitive impairment that leads to disabilities but had not significantly progressed. On the other hand, the main impact in functionality is related to depressive symptoms, especially to the loss of interest and apathy.

Discussion: This case stands out due to the combination of hippocampal atrophy at a relatively young age and severe depression with cognitive impairment that has not progressed to dementia in 9 years. Severe depression can lead to significant cognitive deficits, as well as, hippocampus atrophy. While depression is related to hippocampus atrophy, it has not been related to TRD in a review study with Voxel-Based Morphometry. Conversely, Alzheimer’s Disease is related to MTA ≥2 scores, as well as depressive symptoms. MTA 2 in a person of 60 years of age is not considered normal. When combined with cognitive impairment, these findings are generally related to neurodegeneration. Since both MTA and cognitive deficits were relatively stable, the hypothesis of a cognitive impairment and hippocampus atrophy due to depression were more likely.

Conclusions: MDD leads to cognitive impairment in older adults, as well as hippocampus atrophy. Nevertheless, depression and age are important risk factors for dementia and, therefore, a progression to dementia due to a neurodegenerative disease is still possible.

Background: The Cognitive Domains and Functional Assessment Questionnaire (CDFAQ) assess cognitive and functional decline based on the DSM-5 criteria for Neurocognitive Disorders. Its accuracy has been assessed and was translated and validated into English. The informant version (CDFAQ-IV) is a 30-item questionnaire that assesses six cognitive domains with 5 items each: Complex Attention (CA), Executive Functions (EF), Learning and

Memory (LM), Language (L), Perceptual-Motor (PM) and Social Cognition. The development of CDFAQ-IV was based on theDSM-5 cognitive domains, but its factor analysis has not been done yet.

Objectives: To perform a Confirmatory Factor Analysis of the CDFAQ-IV to assess the six-factor cognitive domain model.

Methods: Older adults and their informants were invited to participate in this study. The CDFAQ-IV was applied in 292 older adults’ informants. We used the JASP for a Confirmatory Factor Analysis based on Lavaan R Packages. The confirmatory factor analysis was chosen to manual six-factor model. This study was approved by the ethics committee of UFMG.

Results: Concerning model fitness in the confirmatory factor analysis the X2 was significant (p < .001), standardized root mean square residual (SRMR) was .059 (accepted < .08) and the goodness of fit index (GFI) .984 (accepted > .9). However, the root mean square error of approximation (RMSEA) was marginal to the accepted fitness .066 (accepted < .06) and the comparative fit index CFI was .839 under the accepted cutoff (accepted > .9).

Conclusions: The six-factor model of the showed a good fit for three parameters, marginal for one and negative for the CFI. These results point to a convergence of the questionnaire and factors the DSM-5 cognitive domains. These are still preliminary results and we aim to increase our sample to further assess the confirmatory factor analysis.

Summary: Disorders related to progressive cognitive decline constituting an important cause of global death and disability-adjusted life years because conditions are also associated to impairment of several brain functions, psychological and behavioral changes, regardless of economic status. Brain-derived neurotrophic factor (BDNF) is a neurotrophin highly relevant in memory, learning and neuroplasticity processes in adults. The amount of plasma BDNF has been considered to partly reflect its secretion in the brain. Its deficiency is associated with affective disorders and neurodegenerative pathologies such as Alzheimer disease and Parkinson’sdisease.

The aim of this study was to identify quantifiable biomarkers (serum levels of BDNF) and clinical marker (state of depression and anxiety) that allow early detection of cognitive impairment risk. We made an analytic and transversal study with a representative sample (n:307) of the population over 50 years old in the south of Chile (X region). We determine the cognitive condition of the population by applying cognitive functionality tests, such as the minimental status examination (MMSE) test and identify demographic and psychosocial characteristics that constitute impairment cognitive risk. Subsequently, we determined depression status (scale of Yesavage) and anxiety status (Beck inventory), and finally we made a quantitative determination of human BDNF at the blood level using ELISA technique.

Our results revealed that 26.7% of the participants exhibited some degree of cognitive impairment, being higher in women (55.7%) with average age of 70,7. A 18,2% of subjects manifested indicators of depression and 33,2% have a very hight level of anxiety. The correlation analysis revealed a significant positive correlation between MMSE test (p < 0.001) and both BDNF plasma levels (p < 0.001) and education level (p < 0.001) scores. The results additionally indicated a negative correlation between cognitive functions and age range/anxiety state, suggesting low age level/hight level of anxiety in subjects with more pronounced cognitive decline (p < 0.001),. In consistent, the results of our study point towards decreases plasma BDNF levels and hight levels of anxiety in cognitive impairment subjects compared with cognitive normal subjects, which may be due to the early and middle stages of neurodegeneration process.

Dioctophyme renale, the giant kidney worm, is a nematode related to Trichuris sp and is distributed worldwide. These parasites locate in the kidney of their definitive hosts (mainly belonging to the order Carnivora) and have an indirect life cycle with an annelid as the main intermediate host. Humans are rarely affected, but in those that are, 1 or both kidneys are destroyed. In South America, D. renale is widespread in riparian regions where changing climatic conditions, environmental degradation, and compromised sanitation are increasing the risk of distribution of this parasite, including humans. Here, we provide the descriptions of the genetic diversity of the parasite in the region by analysing 73 adult D. renale samples collected from domestic and wild carnivores. The most common hosts were (Canis lupus familiaris) and maned wolf (Chrysocyon brachyurus Fam. Canidae) among domestic and wild carnivores, respectively. This work shows the descriptions of the genetic diversity of this parasite complementing molecular methods and classical and probabilistic phylogeography. Our results strongly suggest that this parasite has been present on the continent long enough to develop local genetic variants. Also, the phylogenies show transmission between localities and bidirectional transmission between domestic and wild species. We now have new tools to understand the ecological dynamics of this parasite such as molecular markers to study its genetic diversity as well as for identification and reporting in cryptic cases.

Eukaryotic swimming cells such as spermatozoa, algae or protozoa use flagella or cilia to move in viscous fluids. The motion of their flexible appendages in the surrounding fluid induces propulsive forces that balance viscous drag on the cells and lead to a directed swimming motion. Here, we use our recently built database of cell motility (BOSO-Micro) to investigate the extent to which the shapes of eukaryotic swimming cells may be optimal from a hydrodynamic standpoint. We first examine the morphology of flexible flagella undergoing waving deformation and show that their amplitude-to-wavelength ratio is near that predicted theoretically to optimise the propulsive efficiency of active filaments. Next, we consider ciliates, for which locomotion is induced by the collective beating of short cilia covering their surface. We show that the aspect ratios of ciliates are close to that predicted to minimise the viscous drag of the cell body. Both results strongly suggest a key role played by hydrodynamic constraints, in particular viscous drag, in shaping eukaryotic swimming cells.

Unproven economic returns at the farm level are a major barrier to large-scale adoption of cover crops. The objective of this study was to evaluate the short-run private net returns to producers implementing a cereal rye (Secale cereale L.) cover crop preceding the no-till corn (Zea mays L.) phase of a US Midwest corn–soybean (Glycine max [L.] Merr.) rotation in an integrated crop and cow–calf operation. We used experimental agronomic data from six location-years in Iowa to estimate private net returns to cereal rye across alternative scenarios in a partial budget framework. Net returns in the absence of grazing averaged −$123.74 ha−1 and were negative for 82.2% of the treatments, while net returns under partial grazing averaged −$15.24 ha−1 and were negative for 54.8% of the treatments. Early-broadcast cereal rye produced higher biomass and larger net cost savings in the livestock enterprise than late-drilled cereal rye, but it also resulted in higher corn yield penalties. In the no-grazing scenario, net losses for early-broadcast cereal rye were $165.97 ha−1 larger, on average, than for late-drilled cereal rye. Our findings should raise awareness about the low probability of obtaining positive annual private net returns to cereal rye in Iowa in the absence of sizable targeted financial incentives, and inform the policy discussion on the cost-effectiveness of government-sponsored conservation programs.

We investigate geometric aspects of complete spacelike mean curvature flow solitons of codimension one in a generalized Robertson–Walker (GRW) spacetime $-I\times _{f}M^n$, with base $I\subset \mathbb R$, Riemannian fiber $M^n$ and warping function $f\in C^\infty (I)$. For this, we apply suitable maximum principles to guarantee that such a mean curvature flow soliton is a slice of the ambient space and to obtain nonexistence results concerning these solitons. In particular, we deal with entire graphs constructed over the Riemannian fiber $M^n$, which are spacelike mean curvature flow solitons, and we also explore the geometry of a conformal vector field to establish topological and further rigidity results for compact (without boundary) mean curvature flow solitons in a GRW spacetime. Moreover, we study the stability of spacelike mean curvature flow solitons with respect to an appropriate stability operator. Standard examples of spacelike mean curvature flow solitons in GRW spacetimes are exhibited, and applications related to these examples are given.

We present the third data release from the Parkes Pulsar Timing Array (PPTA) project. The release contains observations of 32 pulsars obtained using the 64-m Parkes ‘Murriyang’ radio telescope. The data span is up to 18 yr with a typical cadence of 3 weeks. This data release is formed by combining an updated version of our second data release with $\sim$3 yr of more recent data primarily obtained using an ultra-wide-bandwidth receiver system that operates between 704 and 4032 MHz. We provide calibrated pulse profiles, flux density dynamic spectra, pulse times of arrival, and initial pulsar timing models. We describe methods for processing such wide-bandwidth observations and compare this data release with our previous release.

Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4–17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4–11 (not 12–17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology.