BP-M345 as a Basis for the Discovery of New Diarylpentanoids with Promising Antimitotic Activity.

Recently, the diarylpentanoid BP-M345 (5) has been identified as a potent in vitro growth inhibitor of cancer cells, with a GI50 value between 0.17 and 0.45 µM, showing low toxicity in non-tumor cells. BP-M345 (5) promotes mitotic arrest by interfering with mitotic spindle assembly, leading to apoptotic cell death. Following on from our previous work, we designed and synthesized a library of BP-M345 (5) analogs and evaluated the cell growth inhibitory activity of three human cancer cell lines within this library in order to perform structure-activity relationship (SAR) studies and to obtain compounds with improved antimitotic effects. Four compounds (7, 9, 13, and 16) were active, and the growth inhibition effects of compounds 7, 13, and 16 were associated with a pronounced arrest in mitosis. These compounds exhibited a similar or even higher mitotic index than BP-M345 (5), with compound 13 displaying the highest antimitotic activity, associated with the interference with mitotic spindle dynamics, inducing spindle collapse and, consequently, prolonged mitotic arrest, culminating in massive cancer cell death by apoptosis.

The Business Process Management for Healthcare (BPM+ Health) Consortium: motivation, methodology, and deliverables for enabling clinical knowledge interoperability (CKI).

OBJECTIVES: To enhance the Business Process Management (BPM)+ Healthcare language portfolio by incorporating knowledge types not previously covered and to improve the overall effectiveness and expressiveness of the suite to improve Clinical Knowledge Interoperability. METHODS: We used the BPM+ Health and Object Management Group (OMG) standards development methodology to develop new languages, following a gap analysis between existing BPM+ Health languages and clinical practice guideline knowledge types. Proposal requests were developed based on these requirements, and submission teams were formed to respond to them. The resulting proposals were submitted to OMG for ratification. RESULTS: The BPM+ Health family of languages, which initially consisted of the Business Process Model and Notation, Decision Model and Notation, and Case Model and Notation, was expanded by adding 5 new language standards through the OMG. These include Pedigree and Provenance Model and Notation for expressing epistemic knowledge, Knowledge Package Model and Notation for supporting packaging knowledge, Shared Data Model and Notation for expressing ontic knowledge, Party Model and Notation for representing entities and organizations, and Specification Common Elements, a language providing a standard abstract and reusable library that underpins the 4 new languages. DISCUSSION AND CONCLUSION: In this effort, we adopted a strategy of separation of concerns to promote a portfolio of domain-agnostic, independent, but integrated domain-specific languages for authoring medical knowledge. This strategy is a practical and effective approach to expressing complex medical knowledge. These new domain-specific languages offer various knowledge-type options for clinical knowledge authors to choose from without potentially adding unnecessary overhead or complexity.

Heart rate responses, agreement and accuracy among persons with severe disabilities participating in the indirect movement program: Team Twin-an observational study.

Introduction: Heart rate (HR) monitors are rarely used by people living with disabilities (PLWD), and their accuracy is undocumented. Thus, this study aims to describe the HR response during the Team Twin co-running program and, secondly, to assess the agreement and accuracy of using HR monitors among PLWD. Methods: This 16-week single-arm observational study included 18 people with various disabilities. During the study, the subjects wore a Garmin Vivosmart 4 watch (wrist). To evaluate the agreement and accuracy we applied Garmin's HRM-DUAL™ chest-worn HR monitors for comparison with the Vivosmart 4. The HR response analysis was performed descriptively and with a mixed regression model. The HR agreement and accuracy procedure was conducted on a subsample of five subjects and analyzed using Lin's concordance analysis, Bland and Altman's limits of agreement, and Cohen's kappa analysis of intensity zone agreement. This study was prospectively registered at Clinical Trials.gov (NCT04536779). Results: The subjects had a mean age of 35 (±12.6), 61% were male, 72% had cerebral palsy were 85% had GMFCS V-IV. HR was monitored for 202:10:33 (HH:MM:SS), with a mean HR of 90 ± 17 bpm during training and race. A total of 19% of the time was spent in intensity zones between light and moderate (30%-59% HR reserve) and 1% in vigorous (60%-84% HR reserve). The remaining 80% were in the very light intensity zone (<29% HR reserve). HR was highest at the start of race and training and steadily decreased. Inter-rater agreement was high (k = 0.75), limits of agreement were between -16 and 13 bpm, and accuracy was acceptable (Rc = 0.86). Conclusion: Disability type, individual, and contextual factors will likely affect HR responses and the agreement and accuracy for PLWD. The Vivosmart 4, while overall accurate, had low precision due to high variability in the estimation. These findings implicate the methodical and practical difficulties of utilizing HR monitors to measure HR and thus physical activity in adapted sports activities for severely disabled individuals.

The neurophysiological Behavioral Perspective Model of consumer choice and its contribution to the intentional behaviorist research programme.

Cognitive explanations raise epistemological problems not faced by accounts confined to observable variables. Many explanatory components of cognitive models are unobservable: beliefs, attitudes, and intentions, for instance, must be made empirically available to the researcher in the form of measures of observable behavior from which the latent variables are inferred. The explanatory variables are abstract and theoretical and rely, if they are to enter investigations and explanations, on reasoned agreement on how they can be captured by proxy variables derived from what people say and how they behave. Psychometrics must be founded upon a firm, intersubjective agreement among researchers and users of research on the relationship of behavioral measures to the intentional constructs to which they point and the latent variables they seek to operationalize. Only if these considerations are adequately addressed can we arrive at consistent interpretations of the data. This problem provides the substance of the intentional behaviorist research programme which seeks to provide a rationale for the cognitive explanation. Within this programme, two versions of the Behavioral Perspective Model (BPM), an extensional portrayal of socioeconomic behavior and a corresponding intentional approach, address the task of identifying where intentional explanation becomes necessary and the form it should take. This study explores a third version, based on neurophysiological substrates of consumer choice as a contributor to this task. The nature of "value" is closely related to the rationale for a neurophysiological model of consumer choice. The variables involved are operationally specified and measured with high intersubjective agreement. The intentional model (BPM-I), depicting consumer action in terms of mental processes such as perception, deliberation, and choice, extends the purview of the BPM to new situations and areas of explanation.

Heart rate estimation from ballistocardiogram signals processing via low-cost telemedicine architectures: a comparative performance evaluation.

Medical devices (MDs) have been designed for monitoring the parameters of patients in many sectors. Nonetheless, despite being high-performing and reliable, they often turn out to be expensive and intrusive. In addition, MDs are almost exclusively used in controlled, hospital-based environments. Paving a path of technological innovation in the clinical field, a very active line of research is currently dealing with the possibility to rely on non-medical-graded low-cost devices, to develop unattended telemedicine (TM) solutions aimed at non-invasively gathering data, signals, and images. In this article, a TM solution is proposed for monitoring the heart rate (HR) of patients during sleep. A remote patient monitoring system (RPMS) featuring a smart belt equipped with pressure sensors for ballistocardiogram (BCG) signals sampling was deployed. A field trial was then conducted over a 2-month period on 24 volunteers, who also agreed to wear a finger pulse oximeter capable of producing a photoplethysmography (PPG) signal as the gold standard, to examine the feasibility of the solution via the estimation of HR values from the collected BCG signals. For this purpose, two of the highest-performing approaches for HR estimation from BCG signals, one algorithmic and the other based on a convolutional neural network (CNN), were retrieved from the literature and updated for a TM-related use case. Finally, HR estimation performances were assessed in terms of patient-wise mean absolute error (MAE). Results retrieved from the literature (controlled environment) outperformed those achieved in the experimentation (TM environment) by 29% (MAE = 4.24 vs. 5.46, algorithmic approach) and 52% (MAE = 2.32 vs. 3.54, CNN-based approach), respectively. Nonetheless, a low packet loss ratio, restrained elaboration time of the collected biomedical big data, low-cost deployment, and positive feedback from the users, demonstrate the robustness, reliability, and applicability of the proposed TM solution. In light of this, further steps will be planned to fulfill new targets, such as evaluation of respiratory rate (RR), and pattern assessment of the movement of the participants overnight.

Análisis preliminar de alimentos para la población vegana/vegetariana. ¿son buenos aportadores de minerales de interés nutricional? / Preliminary analysis of foods for the vegan/vegetarian population. Are they good suppliers of minerals of nutritional interest?

Resumen Introducción: recientemente, se ha evidenciado gran desarrollo de variados productos destinados a la población vegetariana/vegana. Sin embargo, su valor nutricional no ha sido estudiado en profundidad. El objetivo del presente estudio fue evaluar aporte potencial (AP) y porcentaje de cobertura de requerimientos diarios (%RD) de hierro, calcio y zinc de alimentos dirigidos a poblaciones adolescente y adulta vegetariana/vegana. Materiales y método: se analizaron cinco medallones (4 comerciales, 1 casero) y once bebidas (9 comerciales, 4 de ellas c/jugo frutal y 2 caseras) elaborados con materias primas vegetales. Se estableció el AP de Fe, Ca y Zn en los productos considerando su contenido y dializabilidad porcentual (D%). Se calculó, para una porción de alimento, el porcentaje de cobertura del requerimiento diario de estos minerales. Resultados: el contenido de los minerales en los medallones fue: [Fe] 1,64-4,21 mg%; [Ca] 104-213 mg% y [Zn] 0,53-3,57 mg%; en las bebidas se observó: [Fe] 0,24-2,39 mg%; [Ca] 71-214 mg% y [Zn] 0,18-0,79 mg%. La D% en medallones fue: Fe 7,3-11,9; Ca 10,2-18,2 y Zn 17,0-21,4 y para las bebidas, Fe 5,2-32,8; Ca 6,4-35,7 y Zn 5,9-33,9. El %RD para adolescentes, considerando una porción de medallones fue: Fe mujeres 3,0-9,0%; hombres 5,0-16%; Ca 0,7-6,8% y Zn 1,5-3,9% y para adultos fue: Fe mujeres 3,0-10%; hombres 7,0-20%; Ca 0,6-5,8% y Zn 2,0-5,1%. Al considerar las bebidas, el %RD para adolescentes fue: Fe mujeres 2,0-28%; hombres 4,0-53%; Ca 0,4-22% y Zn 1,3-9,5%. Para adultos fue: Fe mujeres 2,0-31%; hombres 5,0-64%; Ca 0,3-19% y Zn 1,8-12%. Conclusiones: en los medallones se observó bajo %RD para los minerales estudiados. Las bebidas con agregado de jugos de naranja o manzana aportaron cantidades significativas de hierro. El %RD para zinc y calcio de los dieciséis alimentos fue bajo (ambos grupos estudiados). Consecuentemente, para cubrir los requerimientos de estos minerales habría que combinar adecuadamente los alimentos que se consumen.

Abstract Introduction: recently, there has been great development of various products aimed at the vegetarian/vegan population. However, its nutritional value has not been studied in depth. The objective of this study was to evaluate potential intake (PI) and percentage of coverage of daily requirements (% RD) of iron, calcium and zinc from foods aimed at adolescent and adult vegetarian/vegan populations Materials and method: five medallions (4 commercial, 1 homemade) and eleven beverages (9 commercial, 4 of them with fruit juice and 2 homemade) made with vegetable raw materials were analyzed. The PI of Fe, Ca and Zn was established in the products considering their content and percentage dialyzability (D%). It was calculated, for a portion of food, the percentage of coverage of the daily requirement of these minerals. Results: the mineral content in the medallions was: [Fe] 1.64-4.21 mg%; [Ca] 104-213 mg% and [Zn] 0.53-3.57 mg%; in beverages it was observed: [Fe] 0.24-2.39 mg%; [Ca] 71-214 mg% and [Zn] 0.18-0.79 mg%. The D% in medallions was: Fe 7,3-11,9; Ca 10.2-18.2 and Zn 17.0-21.4 and for beverages, Fe 5.2-32.8; Ca 6.4-35.7 and Zn 5.9-33.9. The %RD for adolescents, considering a portion of medallions was: Fe women 3.0-9.0%; men 5.0-16%; Ca 0.7-6.8% and Zn 1.5-3.9% and for adults it was: Fe women 3.0-10%; men 7.0-20%; Ca 0.6-5.8% and Zn 2.0-5.1%. When considering beverages, the %RD for adolescents was: Fe women 2.0-28%; men 4.0-53%; Ca 0.4-22% and Zn 1.3-9.5%. For adults it was: Fe women 2.0-31%; men 5.0-64%; Ca 0.3-19% and Zn 1.8-12%. Conclusions: in the medallions, low % RD was observed for the minerals studied. Drinks with added orange or apple juices provided significant amounts of iron. The %RD for zinc and calcium of the sixteen foods was low (both groups studied). Consequently, to meet the requirements of these minerals, it would be necessary to properly combine the foods consumed.

Precision Heart Rate Estimation Using a PPG Sensor Patch Equipped with New Algorithms of Pre-Quality Checking and Hankel Decomposition.

A new method for accurately estimating heart rates based on a single photoplethysmography (PPG) signal and accelerations is proposed in this study, considering motion artifacts due to subjects' hand motions and walking. The method comprises two sub-algorithms: pre-quality checking and motion artifact removal (MAR) via Hankel decomposition. PPGs and accelerations were collected using a wearable device equipped with a PPG sensor patch and a 3-axis accelerometer. The motion artifacts caused by hand movements and walking were effectively mitigated by the two aforementioned sub-algorithms. The first sub-algorithm utilized a new quality-assessment criterion to identify highly noise-contaminated PPG signals and exclude them from subsequent processing. The second sub-algorithm employed the Hankel matrix and singular value decomposition (SVD) to effectively identify, decompose, and remove motion artifacts. Experimental data collected during hand-moving and walking were considered for evaluation. The performance of the proposed algorithms was assessed using the datasets from the IEEE Signal Processing Cup 2015. The obtained results demonstrated an average error of merely 0.7345 ± 8.1129 beats per minute (bpm) and a mean absolute error of 1.86 bpm for walking, making it the second most accurate method to date that employs a single PPG and a 3-axis accelerometer. The proposed method also achieved the best accuracy of 3.78 bpm in mean absolute errors among all previously reported studies for hand-moving scenarios.

A Compact Polarization MMI Combiner Using Silicon Slot-Waveguide Structures.

The study of designing a compact transverse electric (TE)/transverse magnetic (TM) polarization multimode interference (MMI) combiner based on silicon slot-waveguide technology is proposed for solving the high demands for high-speed ability alongside more energy power and minimizing the environmental impact of power consumption, achieving a balance between high-speed performance and energy efficiency has become an important consideration in an optical communication system. The MMI coupler has a significant difference in light coupling (beat-length) for TM and TE at 1550 nm wavelength. By controlling the light propagation mechanism inside the MMI coupler, a lower order of mode can be obtained which can lead to a shorter device. The polarization combiner was solved using the full-vectorial beam propagation method (FV-BPM), and the main geometrical parameters were analyzed using Matlab codes. Results show that after a short light propagation of 16.15 µm, the device can function as TM or TE combiner polarization with an excellent extinction ratio of 10.94 dB for TE mode and 13.08 dB for TM mode with low insertion losses of 0.76 dB (TE) and 0.56 dB (TM) and the combiner function well over the C-band spectrum. The polarization combiner also has a robust MMI coupler length tolerance of 400 nm. These attributes make it a good candidate for using this proposed device in photonic integrated circuits for improving power ability at the transmitter system.

Extending a Data Management Maturity Model for Process Mining in Healthcare.

BACKGROUND: Many components must work together to continuously improve processes in healthcare organizations. Process mining has recently developed into a discipline that can make a significant contribution here. OBJECTIVES: We want to extend an existing management tool to assess and improve the capability of organizations in this area. METHOD: We add a dimension to the adoption readiness assessment and maturity model for sharable clinical pathways to assess and improve event data quality. RESULTS: We present different approaches for formal and checkpoint assessments and an embedding of the improvement strategy with examples. CONCLUSION: The additional dimension from the process mining domain integrates with the existing model. At all levels, links can be established between the various aspects of event data quality with existing dimensions. The model has yet to be tested in a real-world use case.

Brassica napus Plants Gain Improved Salt-Stress Tolerance and Increased Storage Oil Biosynthesis by Interfering with CRL3BPM Activities.

Generating new strategies to improve plant performance and yield in crop plants becomes increasingly relevant with ongoing and predicted global climate changes. E3 ligases that function as key regulators within the ubiquitin proteasome pathway often are involved in abiotic stress responses, development, and metabolism in plants. The aim of this research was to transiently downregulate an E3 ligase that uses BTB/POZ-MATH proteins as substrate adaptors in a tissue-specific manner. Interfering with the E3 ligase at the seedling stage and in developing seeds results in increased salt-stress tolerance and elevated fatty acid levels, respectively. This novel approach can help to improve specific traits in crop plants to maintain sustainable agriculture.

Upper-Arm Photoplethysmographic Sensor with One-Time Calibration for Long-Term Blood Pressure Monitoring.

Wearable cuffless photoplethysmographic blood pressure monitors have garnered widespread attention in recent years; however, the long-term performance values of these devices are questionable. Most cuffless blood pressure monitors require initial baseline calibration and regular recalibrations with a cuffed blood pressure monitor to ensure accurate blood pressure estimation, and their estimation accuracy may vary over time if left uncalibrated. Therefore, this study assessed the accuracy and long-term performance of an upper-arm, cuffless photoplethysmographic blood pressure monitor according to the ISO 81060-2 standard. This device was based on a nonlinear machine-learning model architecture with a fine-tuning optimized method. The blood pressure measurement protocol followed a validation procedure according to the standard, with an additional four weekly blood pressure measurements over a 1-month period, to assess the long-term performance values of the upper-arm, cuffless photoplethysmographic blood pressure monitor. The results showed that the photoplethysmographic signals obtained from the upper arm had better qualities when compared with those measured from the wrist. When compared with the cuffed blood pressure monitor, the means ± standard deviations of the difference in BP at week 1 (baseline) were -1.36 ± 7.24 and -2.11 ± 5.71 mmHg for systolic and diastolic blood pressure, respectively, which met the first criterion of ≤5 ± ≤8.0 mmHg and met the second criterion of a systolic blood pressure ≤ 6.89 mmHg and a diastolic blood pressure ≤ 6.84 mmHg. The differences in the uncalibrated blood pressure values between the test and reference blood pressure monitors measured from week 2 to week 5 remained stable and met both criteria 1 and 2 of the ISO 81060-2 standard. The upper-arm, cuffless photoplethysmographic blood pressure monitor in this study generated high-quality photoplethysmographic signals with satisfactory accuracy at both initial calibration and 1-month follow-ups. This device could be a convenient and practical tool to continuously measure blood pressure over long periods of time.

A compound Kinoform/Fresnel zone plate lens with 15 nm resolution and high efficiency in soft x-ray.

X-ray microscope as an important nanoprobing tool plays a prevailing role in nano-inspections of materials. Despite the fast advances of high resolution focusing/imaging reported, the efficiency of existing high-resolution zone plates is mostly around 5% in soft x-ray and rapidly goes down to 1%-2% when the resolution approaches 10 nm. It is well known that the rectangular zone shape, beamstop, limited height/width ratios, material absorption of light and structural defects are likely responsible for the limited efficiency. Although zone plates with Kinoform profile are supposed to be efficient, progress for achieving both high resolution (<30 nm) and high efficiency (>5%) have hardly been addressed in soft x-ray. In this work, we propose a compound Kinoform/Fresnel zone plate (CKZP) by combing a dielectric Kinoform zone plate with a 15 nm resolution zone plate. Greyscale electron beam lithography was applied to form the 3D Kinoform zone plate and atomic layer deposition was carried out to form the binary zone plate. Optical characterizations demonstrated 15 nm resolution focusing/imaging with over 7.8% efficiency in soft x-ray. The origin of the efficiency improvement behind the proposed compound lens is theoretically analyzed and discussed.

Free floating aorto-iliac thrombosis: A rare complication of COVID-19 pneumonia.

Arterial thrombosis encountered during sars-cov2 infections is a rare complication with a poor prognosis compared to venous ones. They generally occur in severe and critical clinical forms of covid19 [1,2]. The physiopathology of arterial thrombosis, even if not completely understood highlights hypercoagulability and excessive inflammation as risk factors with a major role of the endothelial lesions in their occurrence. The presence of cardiovascular risk factors in patients infected with covid19 is also discussed as a predisposing factor for arterial thrombosis [2,3]. We report the case of a North African male patient hospitalized for acute respiratory distress syndrome (ARDS) secondary to covid19 pneumonia, complicated by the occurrence of multiple arterial thrombosis of the aorto-iliac axis with the rare finding of two free floating thrombus in the aorta and the right common iliac artery. Clinically, the patient had developed acute bilateral lower limb ischemia and multi-organ failure and the evolution was dramatic with rapid worsening of the patient...s health and eventually his death. Thromboembolic complications are frequent during covid19 infection but the aortic localization is very rare. Its diagnosis is difficult and it has a poor prognosis. Our objective through this case report is to increase knowledge about arterial thromboembolic events while discussing their link to the sars-cov2 viral infection.

Cerebrospinal fluid ctDNA testing shows an advantage over plasma ctDNA testing in advanced non-small cell lung cancer patients with brain metastases.

Background: Brain metastases (BM), including brain parenchyma metastases (BPM) and leptomeningeal metastases (LM), are devastating metastatic complications in advanced cancer patients. Next-generation sequencing (NGS) is emerging as a new promising tool for profiling cancer mutation, which could facilitate the diagnosis of cancer. This retrospective study aimed to investigate the molecular genetic characteristics of non-small cell lung cancer (NSCLC) patients with BPM and LM using NGS. Methods: Cerebrospinal fluid (CSF) samples and paired plasma samples were collected from 37 patients of NSCLC-BM. We profiled genetic mutation characteristics using NGS from NSCLC-BM by comparing CSF circulating tumour DNA (ctDNA) with plasma ctDNA and primary tumour tissues. Results: Among the 37 patients with NSCLC-BM, 28 patients had LM with or without BPM, while 9 patients only had BPM. Driver and drug-resistant mutations in primary tumours with LM included: EGFR L858R (10, 35.7%), EGFR 19del (6, 21.4%), EGFR L858R+MET (1, 3.6%), EGFR L858R+S768I (1, 3.6%), ALK (2, 7.1%), ROS1 (1, 3.6%), negative (5, 17.9%), and unknown (2, 7.1%). In patients with NSCLC-LM, the detection rate and abundance of ctDNA in the CSF were significantly higher than those in paired plasma. The main driver mutations of NSCLC-LM remained highly consistent with those of the primary tumours, along with other unique mutations. Circulating tumour DNA was negative in the CSF samples of BPM patients. Patients with BMP had a higher ratio of EGFR 19del than L858R mutation (55.6% vs 11.1.%), whereas NSCLC patients with LM had a higher ratio of EGFR L858R than 19del mutation (50.0% vs 25.0%). Most patients with positive plasma ctDNA results were male (p = 0.058) and in an unstable state (p = 0.003). Conclusion: Our study indicated that the CSF ctDNA detected by NGS may reflect the molecular characteristics and heterogeneity of NSCLC-LM. Timely screening of patients with NSCLC for CSF ctDNA, especially for patients with positive plasma ctDNA, may facilitate the early detection of LM. Furthermore, patients with the EGFR 19del may have a higher risk of developing BPM.

Using CRL3BPM E3 ligase substrate recognition sites as tools to impact plant development and stress tolerance in Arabidopsis thaliana.

Cullin-based RING E3 ligases that use BTB/POZ-MATH (BPM) proteins as substrate receptors have been established over the last decade as critical regulators in plant development and abiotic stress tolerance. As such they affect general aspects of shoot and root development, flowering time, embryo development, and different abiotic stress responses, such as heat, drought and salt stress. To generate tools that can help to understand the role of CRL3BPM E3 ligases in plants, we developed a novel system using two conserved protein-binding motifs from BPM substrates to transiently block CRL3BPM activity. The work investigates in vitro and in planta this novel approach, and shows that it can affect stress tolerance in plants as well as developmental aspects. It thereby can serve as a new tool for studying this E3 ligase in plants.

Osteoblastogenesis of adipose-derived mesenchymal stem cells in chronic kidney disease patient with regular hemodialysis.

Background: Chronic kidney disease (CKD) is a health problem associated with high morbidity and mortality. Mineral and bone disorders are complications of CKD with a risk of fractures and cardiovascular disease. Mesenchymal stem cells can differentiate into osteoblasts and regulate their regulation by a network of cytokines and transcription factors. Objective: Analyzing differences in osteoblastogenesis of adipose mesenchymal stem cells in CKD patients and healthy people. Methods: The study sample was adipose mesenchymal stem cells from CKD patient undergoing hemodialysis and healthy people. Osteoblastogenesis was assessed by measuring the concentrations of transforming growth factor-ß1 (TGF-ß1), bone morphogenetic protein-2 (BMP-2), and (DKK-1) in culture media. The Elisa method measured the concentration of these parameters on days 4, 7, 14, and 21. Data were analyzed using an independent t-test and post hoc test with p-value <0.05. Result: There was a significant difference in CKD patients with increasing TGF-ß1 on day 4 (t = 2.821; 95% CI = 30,498-199,727; p = 0.010) and decreased on day 14. In the BMP-2 parameter, there was an increase on day 7 (t = 4.291; 95% CI = 0.289-0.831; p <0.001). Similar conditions were also found in the DKK-1 parameter, increasing on the 7th day, but there was no significant difference (p = 0.583). Conclusion: Osteoblastogenesis in adipose mesenchymal stem cells in CKD patients differs from that in healthy individuals. Osteoblasts fail in maturation and cause failure in matrix mineralization.

Suctioning of clear amniotic fluid at birth: A systematic review.

Context: Upper airway suctioning at birth was considered standard procedure and is still commonly practiced. Negative effects could exceed benefits of suction. Question: In infants born through clear amniotic fluid (P) does suctioning of the mouth and nose (I) vs no suctioning (C) improve outcomes (O). Data sources: Information specialist conducted literature search (12th September 2021, re-run 17th June 2022) using Medline, Embase, Cochrane Databases, Database of Abstracts of Reviews of Effects, and CINAHL. RCTs, non-RCTs and observational studies with a defined selection strategy were included. Unpublished studies, reviews, editorials, animal and manikin studies were excluded. Data extraction: Two authors independently extracted data, risk of bias was assessed using the Cochrane ROB2 and ROBINS-I tools. Certainty of evidence was assed using the GRADE framework. Review Manager was used to analyse data and GRADEPro to develop summary of evidence tables. Meta-analyses were performed if ≥2 RCTs were available. Outcomes: Primary: assisted ventilation. Secondary: advanced resuscitation, oxygen supplementation, adverse effects of suctioning, unanticipated NICU admission. Results: Nine RCTs (n = 1096) and 2 observational studies (n = 418) were identified. Two RCTs (n = 280) with data concerns were excluded post-hoc. Meta-analysis of 3 RCTs, (n = 702) showed no difference in primary outcome. Two RCTs (n = 200) and 2 prospective observational studies (n = 418) found lower oxygen saturations in first 10 minutes of life with suctioning. Two RCTs (n = 200) showed suctioned newborns took longer to achieve target saturations. Limitations: Certainty of evidence was low or very low for all outcomes. Most studies selected healthy newborns limiting generalisability and insufficient data was available for planned subgroup analyses. Conclusions: Despite low certainty evidence, this review suggests no clinical benefit from suctioning clear amniotic fluid from infants following birth, with some evidence suggesting a resulting desaturation. These finding support current guideline recommendations that this practice is not used as a routine step in birth. Funding: The International Liaison Committee on Resuscitation provided access to software platforms, an information specialist and teleconferencing. Clinical Trial Registration: This systematic review was registered with the Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/prospero/) (identifier: CRD42021286258).

Assessing Electroencephalography as a Stress Indicator: A VR High-Altitude Scenario Monitored through EEG and ECG.

Over the last decade, virtual reality (VR) has become an increasingly accessible commodity. Head-mounted display (HMD) immersive technologies allow researchers to simulate experimental scenarios that would be unfeasible or risky in real life. An example is extreme heights exposure simulations, which can be utilized in research on stress system mobilization. Until recently, electroencephalography (EEG)-related research was focused on mental stress prompted by social or mathematical challenges, with only a few studies employing HMD VR techniques to induce stress. In this study, we combine a state-of-the-art EEG wearable device and an electrocardiography (ECG) sensor with a VR headset to provoke stress in a high-altitude scenarios while monitoring EEG and ECG biomarkers in real time. A robust pipeline for signal clearing is implemented to preprocess the noise-infiltrated (due to movement) EEG data. Statistical and correlation analysis is employed to explore the relationship between these biomarkers with stress. The participant pool is divided into two groups based on their heart rate increase, where statistically important EEG biomarker differences emerged between them. Finally, the occipital-region band power changes and occipital asymmetry alterations were found to be associated with height-related stress and brain activation in beta and gamma bands, which correlates with the results of the self-reported Perceived Stress Scale questionnaire.

Relationship between psychosocial stress-induced prefrontal cortex activity and gut microbiota in healthy Participants-A functional near-infrared spectroscopy study.

Brain and gut microbes communicate in a bidirectional manner with each affecting a person's response to psychosocial stress. Although human studies demonstrated that the intake of probiotics can alter stress-related behavior in both patients and healthy participants, the association between stress-related brain functions and the gut microbiota has mostly been investigated in patients with depression. However, the response to psychosocial stress differs, even among healthy individuals, and elucidating the natural state of the gut microbiota would broaden the understanding of responses to psychosocial stress. We investigated the relationship between psychosocial stress response in the prefrontal cortex and the abundance of gut microbes in healthy male participants. The participants were exposed to psychosocial stress during a task while brain activation data were recorded using functional near-infrared spectroscopy. The heart rate and subjective stress were recorded, and fecal samples were collected. The stressful condition was accompanied by high subjective stress, high heart rate, and higher prefrontal activation in the right pre-motor cortex/supplementary motor area, right dorsolateral prefrontal cortex, right frontal pole, and right inferior prefrontal gyrus. The psychosocial stress response in the prefrontal cortex was also associated with changes in the gut microbiota abundance. The abundance of Alistipes, Clostridium IV, Clostridium XI, Faecalibacterium, and Blautia in healthy participants who had high psychosocial stress resembled that noted in patients with depression. These results suggest that the gut microbiota differs, among healthy participants, depending on the psychosocial stress response. We believe that this study is the first to report a direct relationship between brain function and the gut microbiota in healthy participants, and our findings would shed a new light on this field in the near future.

1 × 4 Wavelength Demultiplexer C-Band Using Cascaded Multimode Interference on SiN Buried Waveguide Structure.

Back reflection losses are a key problem that limits the performances of optical communication systems that work on wavelength division multiplexing (WDM) technology based on silicon (Si) Multimode Interference (MMI) waveguides. In order to overcome this problem, we propose a novel design for a 1 × 4 optical demultiplexer based on the MMI in silicon nitride (SiN) buried waveguide structure that operates at the C-band spectrum. The simulation results show that the proposed device can transmit four channels with a 10 nm spacing between them that work in the C-band with a low power loss range of 1.98-2.35 dB, large bandwidth of 7.68-8.08 nm, and good crosstalk of 20.9-23.6 dB. Thanks to the low refractive index of SiN, a very low back reflection of 40.57 dB is obtained without using a special angled MMI design, which is usually required, using Si MMI technology. Thus, this SiN demultiplexer MMI technology can be used in WDM technique for obtaining a high data bitrate alongside a low back reflection in optical communication systems.