Chronodisruption and Gut Microbiota: Triggering Glycemic Imbalance in People with Type 2 Diabetes.

The desynchronization of physiological and behavioral mechanisms influences the gut microbiota and eating behavior in mammals, as shown in both rodents and humans, leading to the development of pathologies such as Type 2 diabetes (T2D), obesity, and metabolic syndrome. Recent studies propose resynchronization as a key input controlling metabolic cycles and contributing to reducing the risk of suffering some chronic diseases such as diabetes, obesity, or metabolic syndrome. In this analytical review, we present an overview of how desynchronization and its implications for the gut microbiome make people vulnerable to intestinal dysbiosis and consequent chronic diseases. In particular, we explore the eubiosis-dysbiosis phenomenon and, finally, propose some topics aimed at addressing chronotherapy as a key strategy in the prevention of chronic diseases.

Future trends of additive manufacturing in medical applications: An overview.

Additive Manufacturing (AM) has recently demonstrated significant medical progress. Due to advancements in materials and methodologies, various processes have been developed to cater to the medical sector's requirements, including bioprinting and 4D, 5D, and 6D printing. However, only a few studies have captured these emerging trends and their medical applications. Therefore, this overview presents an analysis of the advancements and achievements obtained in AM for the medical industry, focusing on the principal trends identified in the annual report of AM3DP.

Study of the physicochemical characteristics, antimicrobial activity, and in vitro multiplication of wild blackberry species from the Peruvian highlands.

The Peruvian Andes are the natural habitat of several wild blackberry species that are little known and exploited due to the lack of technological and scientific development to support their agricultural potential. In this context, a study was conducted to understand the physicochemical composition, bioactive compounds, antimicrobial activity, and in vitro multiplication of four wild blackberry (Rubus sp.) species from the northern Peruvian highlands. The results indicate that fruits of R. floribundus presented the highest content of total soluble solids (9.58 ± 1.83°Brix) and titratable acidity (1.88 ± 0.07% citric acid). The fruits of R. weberbaueri recorded the highest total phenolic content (415.06 ± 8.69 mg GAE/100 g Ff). The antioxidant capacity determined by the DPPH assay varied significantly among species, with the highest value found in fruits of R. andicola (50.27 ± 0.11 mg TE/100 g Ff). The fruit extracts of R. weberbaueri and R. andicola showed better antimicrobial activity, with Staphylococcus aureus being the most sensitive bacterium. In the in vitro multiplication phase, the results show that BAP (6-Benzylaminopurine) has a significant effect at a dose of 1.5 mg l-1 on shoot number, leaf number, and shoot length. The results may help in the management of genetic resources.

Xerophthalmia secondary to bowel malabsorption after Roux-en-Y gastric bypass.

Introduction: Vitamin A is a fat-soluble vitamin, obtained through diet. Vitamin A deficiency is the leading cause of preventable blindness in children in developing countries due to impaired intake (Phanachet et al. 2018). Nevertheless, it is uncommon in the developed world where malabsorption takes a prominent role. Case description: A fifty-one-year-old female presented complaining of foreign body sensation, pain, tearing, fluctuating visual acuity, nyctalopia, diarrhea, polyphagia and weight loss. She had history of Roux-en-Y gastro-jejunal bypass, Lynch syndrome and right hemicolectomy with ileo-colonic anastomosis, she also referred to an additional unspecified bowel resection. In the ophthalmologic examination, best corrected visual acuity was 20/30, intraocular pressure was 11 mmHg in both eyes. Anterior segment biomicroscopy revealed a dry and thickened conjunctiva with wrinkles, multiple grey-white small, round, confluent, foamy lesions in the interpalpebral conjunctiva of both eyes, compatible with Bitot's spots, and superficial punctate keratitis. Discussion: The rise of bariatric surgery, inflammatory bowel disease and end stage liver disease has led to an increase in cases of malabsorption syndrome and nutrient deficiencies in the developed world. Retinoids are essential for corneal and conjunctival epithelial cells differentiation and its deficiency is associated with a wide spectrum of ocular surface manifestations known as xerophthalmia. In this case, a gastric bypass and another unspecified bowel resection should raise the suspicion of malabsorption and nutrient deficiencies. In our patient, the diagnosis was made early and appropriate treatment was implemented before irreversible damage arose, however, vitamin A deficiency can be easily overlooked. Conclusion: In patients with xerophthalmia, interrogation should include previous history of gastrointestinal surgery, especially since bariatric surgery has become a popular technique. This is, to our knowledge, the first case report of xerophthalmia in a patient with Lynch syndrome.

PCP and Septins govern the polarized organization of the actin cytoskeleton during convergent extension.

Convergent extension (CE) requires the coordinated action of the planar cell polarity (PCP) proteins1,2 and the actin cytoskeleton,3,4,5,6 but this relationship remains incompletely understood. For example, PCP signaling orients actomyosin contractions, yet actomyosin is also required for the polarized localization of PCP proteins.7,8 Moreover, the actin-regulating Septins play key roles in actin organization9 and are implicated in PCP and CE in frogs, mice, and fish5,6,10,11,12 but execute only a subset of PCP-dependent cell behaviors. Septin loss recapitulates the severe tissue-level CE defects seen after core PCP disruption yet leaves overt cell polarity intact.5 Together, these results highlight the general fact that cell movement requires coordinated action by distinct but integrated actin populations, such as lamella and lamellipodia in migrating cells13 or medial and junctional actin populations in cells engaged in apical constriction.14,15 In the context of Xenopus mesoderm CE, three such actin populations are important, a superficial meshwork known as the "node-and-cable" system,4,16,17,18 a contractile network at deep cell-cell junctions,6,19 and mediolaterally oriented actin-rich protrusions, which are present both superficially and deeply.4,19,20,21 Here, we exploited the amenability of the uniquely "two-dimensional" node and cable system to probe the relationship between PCP proteins, Septins, and the polarization of this actin network. We find that the PCP proteins Vangl2 and Prickle2 and Septins co-localize at nodes, and that the node and cable system displays a cryptic, PCP- and Septin-dependent anteroposterior (AP) polarity in its organization and dynamics.

Regulation of mitochondrial metabolism by autophagy supports leptin-induced cell migration.

Leptin is an adipokine secreted by adipose tissue, which promotes tumor progression by activating canonical signaling pathways such as MAPK/ERK. Recent studies have shown that leptin induces autophagy, and this process is involved in leptin-induced characteristics of malignancy. Autophagy is an intracellular degradation process associated with different hallmarks of cancer, such as cell survival, migration, and metabolic reprogramming. However, its relationship with metabolic reprogramming has not been clearly described. The purpose of this study was to determine the role of leptin-induced autophagy in cancer cell metabolism and its association with cellular proliferation and migration in breast cancer cells. We used ER+/PR+ and triple-negative breast cancer cell lines treated with leptin, autophagy inhibition, or mitochondrial metabolism inhibitors. Our results show that leptin induces autophagy, increases proliferation, mitochondrial ATP production and mitochondrial function in ER+/PR+ cells. Importantly, autophagy was required to maintain metabolic changes and cell proliferation driven by leptin. In triple-negative cells, leptin did not induce autophagy or cell proliferation but increased glycolytic and mitochondrial ATP production, mitochondrial function, and cell migration. In triple negative cells, autophagy was required to support metabolic changes and cell migration, and autophagy inhibition decreased cellular migration similar to mitochondrial inhibitors. In conclusion, leptin-induced autophagy supports mitochondrial metabolism in breast cancer cells as well as glycolysis in triple negative cells. Importantly, leptin-induced mitochondrial metabolism promoted cancer cell migration.

Optimizing RNNs for EMG Signal Classification: A Novel Strategy Using Grey Wolf Optimization.

Accurate classification of electromyographic (EMG) signals is vital in biomedical applications. This study evaluates different architectures of recurrent neural networks for the classification of EMG signals associated with five movements of the right upper extremity. A Butterworth filter was implemented for signal preprocessing, followed by segmentation into 250 ms windows, with an overlap of 190 ms. The resulting dataset was divided into training, validation, and testing subsets. The Grey Wolf Optimization algorithm was applied to the gated recurrent unit (GRU), long short-term memory (LSTM) architectures, and bidirectional recurrent neural networks. In parallel, a performance comparison with support vector machines (SVMs) was performed. The results obtained in the first experimental phase revealed that all the RNN networks evaluated reached a 100% accuracy, standing above the 93% achieved by the SVM. Regarding classification speed, LSTM ranked as the fastest architecture, recording a time of 0.12 ms, followed by GRU with 0.134 ms. Bidirectional recurrent neural networks showed a response time of 0.2 ms, while SVM had the longest time at 2.7 ms. In the second experimental phase, a slight decrease in the accuracy of the RNN models was observed, standing at 98.46% for LSTM, 96.38% for GRU, and 97.63% for the bidirectional network. The findings of this study highlight the effectiveness and speed of recurrent neural networks in the EMG signal classification task.

LAPAROSCOPIC SLEEVE GASTRECTOMY VERSUS LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS FOR WEIGHT LOSS IN OBESE PATIENTS: WHICH IS MORE EFFECTIVE? A SYSTEMATIC REVIEW AND META-ANALYSIS.

BACKGROUND: Bariatric surgery is the most effective option to reduce weight in morbid obesity patients. The techniques most employed are the restrictive surgery laparoscopic sleeve gastrectomy (LSG), surgical procedures of intestinal malabsorption, and both types (restrictive and intestinal malabsorption) such as the Roux-en-Y laparoscopic gastric bypass (RYLGB). AIMS: To determine if LSG is more effective than RYLGB for weight loss. METHODS: A systematic review and meta-analysis was carried out, including five clinical trials and sixteen cohorts comparing LSG versus RYLGB in weight loss and secondary outcomes: resolution of comorbidities, postoperative complications, operative time, hospital stay, and improvement in quality of life. RESULTS: Excess weight loss was 10.2% (mean difference [MD] 10.2; 95%CI -10.14; -9.90) higher in patients undergoing LSG than in patients submitted to RYLGB. Diabetes mellitus type 2 was resolved in 17% (relative risk [RR] 0.83; 95%CI 0.77-0.90) of cases, more significantly after LSG, arterial hypertension in 23% (RR 0.77; 95%CI 0.69-0.84), and dyslipidemia in 17% (RR 0.83; 95%CI 0.77-0.90). Postoperative complications were 73% higher in patients undergoing RYLGB (MD 0.73; 95%CI 0.63-0.83). The operative time was 35.76 minutes shorter in the LSG (MD -35.76; 95%CI -37.28; -34.24). Finally, the quality of life improved more in patients operated by LSG (MD 0.37; 95%CI -0.48; -0.26). CONCLUSIONS: The study demonstrated that LSG could be more effective than RYLGB in reducing the percentage of excess weight, comorbidities, postoperative complications, operative time, hospital stay, and in improving quality of life.

Optimal mechanical interactions direct multicellular network formation on elastic substrates.

Cells self-organize into functional, ordered structures during tissue morphogenesis, a process that is evocative of colloidal self-assembly into engineered soft materials. Understanding how intercellular mechanical interactions may drive the formation of ordered and functional multicellular structures is important in developmental biology and tissue engineering. Here, by combining an agent-based model for contractile cells on elastic substrates with endothelial cell culture experiments, we show that substrate deformation-mediated mechanical interactions between cells can cluster and align them into branched networks. Motivated by the structure and function of vasculogenic networks, we predict how measures of network connectivity like percolation probability and fractal dimension as well as local morphological features including junctions, branches, and rings depend on cell contractility and density and on substrate elastic properties including stiffness and compressibility. We predict and confirm with experiments that cell network formation is substrate stiffness dependent, being optimal at intermediate stiffness. We also show the agreement between experimental data and predicted cell cluster types by mapping a combined phase diagram in cell density substrate stiffness. Overall, we show that long-range, mechanical interactions provide an optimal and general strategy for multicellular self-organization, leading to more robust and efficient realizations of space-spanning networks than through just local intercellular interactions.

New tools reveal PCP-dependent polarized mechanics in the cortex and cytoplasm of single cells during convergent extension.

Understanding biomechanics of biological systems is crucial for unraveling complex processes like tissue morphogenesis. However, current methods for studying cellular mechanics in vivo are limited by the need for specialized equipment and often provide limited spatiotemporal resolution. Here we introduce two new techniques, Tension by Transverse Fluctuation (TFlux) and in vivo microrheology, that overcome these limitations. They both offer time-resolved, subcellular biomechanical analysis using only fluorescent reporters and widely available microscopes. Employing these two techniques, we have revealed a planar cell polarity (PCP)-dependent mechanical gradient both in the cell cortex and the cytoplasm of individual cells engaged in convergent extension. Importantly, the non-invasive nature of these methods holds great promise for its application for uncovering subcellular mechanical variations across a wide array of biological contexts. Summary: Non-invasive imaging-based techniques providing time-resolved biomechanical analysis at subcellular scales in developing vertebrate embryos.

Prediction of neonatal death in pregnant women in an intensive care unit: Application of machine learning models.

Introduction: Neonatal mortality remains a critical concern, particularly in developing countries. The advent of machine learning offers a promising avenue for predicting the survival of at-risk neonates. Further research is required to effectively deploy this approach within distinct clinical contexts. Objective: This study aimed to assess the applicability of machine learning models in predicting neonatal mortality, drawing from maternal and clinical characteristics of pregnant women within an intensive care unit (ICU). Methods: Conducted as an observational cross-sectional study, the research enrolled pregnant women receiving care in a level III national hospital's ICU in Peru. Detailed data encompassing maternal diagnosis, maternal characteristics, obstetric characteristics, and newborn outcomes (survival or demise) were meticulously collected. Employing machine learning, predictive models were developed for neonatal mortality. Estimations of beta coefficients in the training dataset informed the model application to the validation dataset. Results: A cohort of 280 pregnant women in the ICU were included in this study. The Gradient Boosting approach was selected following rigorous experimentation with diverse model types due to its superior F1-score, ROC curve performance, computational efficiency, and learning rate. The final model incorporated variables deemed pertinent to its efficacy, including gestational age, eclampsia, kidney infection, maternal age, previous placenta complications accompanied by hemorrhage, severe preeclampsia, number of prenatal checkups, and history of miscarriages. By incorporating optimized hyperparameter values, the model exhibited an impressive area under the curve (AUC) of 0.98 (95 % CI: 0.95-1), along with a sensitivity of 0.98 (95 % CI: 0.94-1) and specificity of 0.98 (95 % CI: 0.93-1). Conclusion: The findings underscore the utility of machine learning models, specifically Gradient Boosting, in foreseeing neonatal mortality among pregnant women admitted to the ICU, even when confronted with maternal morbidities. This insight can enhance clinical decision-making and ultimately reduce neonatal mortality rates.

Effect of high-intensity interval training compared to moderate-intensity continuous training on body composition and insulin sensitivity in overweight and obese adults: A systematic review and meta-analysis.

Objective: To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on adults with overweight and obesity. Outcomes, including changes in insulin sensitivity, weight, body mass index (BMI), waist circumference, and body fat, were analyzed. Methods: A systematic literature review was conducted. This review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42021281899. Clinical trials involving individuals who are overweight and obese and comparing HIIT with MICT effects on insulin sensitivity, weight, BMI, body fat percentage, and waist circumference were included. PubMed, Web of Science, Embase, and Scopus databases were searched using controlled vocabulary and free-text terms related to HIIT, obesity, and overweight. The search included studies published until September 2022. The Rob2 tool was used to assess the risk of bias. The results were presented through meta-analyses that provided summary estimators and confidence intervals. Subgroup analyses were conducted to assess the effect of the risk of bias on the outcomes. This research did not receive any specific funding. Results: Of the 2534 articles, 30 met the eligibility criteria. The intervention duration ranged from 4 to 16 weeks. The observed effects for each outcome were as follows: insulin sensitivity (p = 0.02), weight (p = 0.58), BMI (p = 0.53), waist circumference (p = 0.87), body fat percentage (p = 0.07), body fat mass in kilograms (p = 0.39). The level of evidence obtained was moderate except for waist circumference, which was rated as low. Limitations included heterogeneity in training protocols, measurements, and study duration. Additionally, a risk of bias was identified in these studies. Conclusion: HIIT and MICT did not significantly differ in their effects on weight, BMI, waist circumference, or body fat mass in adults with overweight and obesity. However, a moderate beneficial effect of HIIT was observed on insulin sensitivity. Therefore, further evidence is required to confirm these findings.

Using 81Kr and isotopic tracers to characterise old groundwater in the Bangkok metropolitan and vicinity areas.

Krypton-81 was applied to investigate the age of groundwater in the aquifer system in the Bangkok metropolitan and vicinity areas. Stable (2H, 18O and 13C) and radioactive (3H, 85Kr and 14C) isotopes and noble gases were applied in parallel. Low levels of 14C and significant radiogenic 4He confirm that groundwater in the deep aquifers is older than 30 ka. 81Kr analysis identified groundwater with ages ranging from 17 to 300 ka. At some sites, large age discrepancies between 81Kr and 14C indicated that inter-aquifer mixing is likely occurring. The interpretation of the noble gases suggests that groundwaters in the deeper aquifers, with apparent ages of 300 to 10 ka, have recharged in slightly colder and wetter climates than those found in the upper aquifers with apparent ages < 10 ka. Degradation of water quality from seawater intrusion was identified in the upper four aquifers. This was also evidenced by higher δ18O and δ2H values, typical of seawater. The four deeper aquifers contain high quality water characterised by less enriched 18O and 2H. This work presents new findings of very old groundwater in the Bangkok aquifer system.

Factores de riesgo para covid-19 en trabajadores de la salud del primer nivel de atención / Risk factors for covid-19 in first-level health-care workers

Introducción: El SARS-Cov2, es causante de la pandemia COVID-19 que inició en febrero del 2020 en México. Según datos de Amnistía internacional de agosto del 2020, México era uno de los países con más muertes en personal sanitario. Objetivo: Identificar los factores de riesgo para COVID-19 en trabajadores de salud del IMSS que reciben atención medica en la Unidad de Medicina Familiar #10. Materiales y Metodos: Se realizó un estudio descriptivo retrospectivo en la Unidad de Medicina Familiar N° 10 del Instituto Mexicano del Seguro Social, en el periodo de marzo del 2020 a Marzo del 2021. Se incluyeron trabajadores del área de la salud, ambos sexos, adscritos a la Unidad de Medicina Familiar N° 10 de Xalapa, Veracruz en México, con edad entre 18 a 65 años, con definición operacional compatible para casos confirmados de COVID-19, cuyo expediente electrónico se encontró completo en el SIMF. Posterior se realizó un análisis estadístico descriptivo que incluyó frecuencias y porcentajes de los factores de riesgo encontrados. Resultados: Se obtuvo una muestra total de 137 sujetos (56 masculinos y 81 femeninos), con estudios de licenciatura y carrera técnica (64,2% y 13,1% respectivamente). El personal administrativo (24,1%) y el personal de enfermería (26,3%) destacó en frecuencia. Un 18% del total, trabajaba en un área de atención exclusiva de pacientes con COVID-19, un 4,4% presentaba obesidad, 4,4% tabaquismo, 5,1% diabetes mellitus y un 6,6% hipertensión. Conclusión: Probablemente existan otros factores distintos a los identificados por lo cual convendría hacer más estudios al respecto.

Terapia con antibióticos versus apendicectomía en la apendicitis aguda no complicada: Una revisión sistemática y metaanálisis

Introducción: Existe una controversia acerca del mejor enfoque para el tratamiento de la apendicitis aguda no complicada. Este metaanálisis buscó evaluar la eficacia, recurrencia de la patología, presencia de complicaciones mayores, y duración de la estancia hospitalaria en adultos con apendicitis aguda no complicada. Materiales y Método: Se realizó una búsqueda sistemática de ensayos clínicos aleatorizados en las bases de datos PubMed, Scopus, Web of Science, Embase y Cochrane Library hasta finales de octubre del 2022. El riesgo de sesgo y calidad de los estudios incluidos en el estudio fueron evaluados mediante la herramienta RoB 2.0. de la Colaboración Cochrane. La síntesis de datos fue realizada a través del software Cochrane Review Manager (RevMan; version 5.3). Resultados: 6 estudios fueron incluidos, con un total de 1.862 pacientes. La probabilidad de presentar una mejoría clínica definitiva en el grupo que recibió antibioticoterapia fue menor (RR 0,5; IC95% 0,92-0,98; p = 0,004; IC2 = 44%). La probabilidad de presentar una recurrencia de la apendicitis en el grupo que recibió antibioticoterapia fue notablemente superior (RR 94,86; IC95% 30,73-292,81; p < 0,00001; IC2 = 0%). El grupo conservador presentó un menor riesgo de presentar una complicación mayor (RR 0,55; IC95% 0,36-0,85; p = 0,007; IC2 = 0%). El tratamiento conservador presentó una duración de la estancia hospitalaria superior que la apendicectomía (MD 0,34; IC95% 0,25-0,42; p < 0,00001; IC2 = 64%). Conclusiones: Esta revisión sistemática demuestra que, en términos de eficacia, recurrencia del cuadro y duración de la estancia hospitalaria, la antibioticoterapia es inferior a la apendicectomía en adultos con apendicitis aguda no complicada y superior en evitar la presencia de complicaciones mayores.

Introduction: There is controversy about the best approach for the treatment of uncomplicated acute appendicitis. This meta-analysis sought to assess efficacy, disease recurrence, presence of major complications, and length of hospital stay in adults with uncomplicated acute appendicitis. Materials and Method: A systematic search for randomized clinical trials was performed in the PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases up to the end of October 2022. The risk of bias and quality of the studies included in the study were assessed. using the RoB 2.0 tool. of the Cochrane Collaboration. Data synthesis was performed using the Cochrane Review Manager software (RevMan; version 5.3). Results: 6 studies were included, with a total of 1.862 patients. The probability of presenting a definitive clinical improvement in the group that received antibiotic therapy was lower (RR 0.5; CI95% 0.92-0.98; p = 0.004; CI2 = 44%). The probability of presenting a recurrence of appendicitis in the group that received antibiotic therapy was notably higher (RR 94.86; 95%CI 30.73-292.81; p < 0.00001; CI2 = 0%). The conservative group presented a lower risk of presenting a major complication (RR 0.55; CI95% 0.36-0.85; p = 0.007; CI2 = 0%). Conservative treatment had a longer hospital stay than appendectomy (MD 0.34; 95%CI 0.250.42; p < 0.00001; CI2 = 64%). Conclusions: This systematic review shows that, in terms of efficacy, recurrence of the condition, and length of hospital stay, antibiotic therapy is inferior to appendectomy in adults with uncomplicated acute appendicitis, and superior in avoiding the presence of major complications.

Crowding alters F-actin secondary structure and hydration.

Actin, an important component of eukaryotic cell cytoskeleton, regulates cell shape and transport. The morphology and biochemical properties of actin filaments are determined by their structure and protein-protein contacts. Crowded environments can organize filaments into bundles, but less is known about how they affect F-actin structure. This study used 2D IR spectroscopy and spectral calculations to examine how crowding and bundling impact the secondary structure and local environments in filaments and weakly or strongly bundled networks. The results reveal that bundling induces changes in actin's secondary structure, leading to a decrease in ß-sheet and an increase in loop conformations. Strongly bundled networks exhibit a decrease in backbone solvent exposure, with less perturbed α-helices and nearly "locked" ß-sheets. Similarly, the loops become less hydrated but maintain a dynamic environment. These findings highlight the role of loop structure in actin network morphology and stability under morphology control by PEG.

Ranibizumab for the treatment of retinopathy of prematurity: systematic review and meta-analysis.

Anti-VEGF drugs like ranibizumab can be used to treat retinopathy of prematurity (ROP) by halting the formation of abnormal blood vessels, or lasers can be used to burn the edges of the retina where these vessels are present. The objective is to compare the efficacy for ROP between ranibizumab and laser therapy. Material and methods: Electronic searches will be carried out in medical databases with key words and controlled vocabulary terms. Randomized controlled trials (RCT) will be assessed. The primary outcome will be the full ROP regression. Two reviewers will extract the data using predefined forms and, to assess the quality of the study, we will use RoB 2.0, the tool for randomized controlled trials developed by the Cochrane Collaboration. We used a combination of the inverse-variance approach and random-effects models for the meta-analysis. Results: The eyes of 182 preterm infants who had ranibizumab treatment were assessed in a total of 364 eyes, and 135 infants received laser therapy. The follow-up period was between 6 and 24 months. Ranibizumab was not associated with greater regression of ROP compared to laser therapy in preterm infants (RR: 1.09, CI 95%: 0.95-1.24; p: 0.22). Also, ranibizumab was not associated with recurrence of ROP compared to laser therapy in preterm infants (RR: 3.77, CI 95%: 0.55-25.81; p: 0.22). Conclusions: The efficacy of ranibizumab compared to laser is very uncertain in terms of ROP regression and decreased ROP recurrence in preterm infants. Systematic Review Registration: identifier PROSPERO (CRD42022324150).

A High-Efficiency Capacitor-Based Battery Equalizer for Electric Vehicles.

Technology in electric vehicles has increased substantially in the past decade. Moreover, it is projected to grow at record highs in the coming years since these vehicles are needed to reduce the contamination related to the transportation sector. One of the essential elements of an electric car is its battery, due to its cost. Batteries comprise parallel and series-connected cell arrangements to meet the power system requirements. Therefore, they require a cell equalizer circuit to preserve their safety and correct operation. These circuits keep a specific variable of all cells, such as the voltage, within a particular range. Within cell equalizers, capacitor-based ones are very common as they have many desirable characteristics of the ideal equalizer. In this work, an equalizer based on the switched-capacitor is proposed. A switch is added to this technology that allows the disconnection of the capacitor from the circuit. In this way, an equalization process can be achieved without excess transfers. Therefore, a more efficient and faster process can be completed. In addition, it allows another equalization variable to be used, such as the state of charge. This paper studies the operation, power design, and controller design of the converter. Moreover, the proposed equalizer was compared to other capacitor-based architectures. Finally, simulation results were presented to validate the theoretical analysis.