Follow the Arrows: Using a Co-Created Causal Loop Diagram to Explore Leverage Points to Strengthen Population Physical Activity Promotion in British Columbia, Canada.

BACKGROUND: Population physical activity promotion (PPAP) is one of the most effective noncommunicable disease prevention strategies, yet coordination is lacking around the world. Whole-of-system approaches and complex systems methods are called for to advance PPAP. This paper reports on a project which (1) used an Attributes Framework with system mapping (group model building and causal loop diagramming of feedback loops) and (2) identified potential leverage points to address the challenge of effective coordination of multisectoral PPAP in British Columbia. METHODS: Key findings from stakeholder interviews and workshops described the current system for PPAP in terms of attributes and dimensions in the framework. These were translated into variables and used in group model building. Participants prioritized the importance of variables to address the coordination challenge and then created causal loop diagrams in 3 small groups. One collective causal loop diagram was created, and top priority variables and associated feedback loops were highlighted to explore potential leverage points. RESULTS: Leverage points included the relationships and feedback loops among priority variables: political leadership, visible policy support and governance, connectivity for knowledge translation, collaborative multisector grants, multisector collaboration, and integrating co-benefits. Leveraging and altering "vicious" cyclical patterns to increase coordinated multisector PPAP are key. CONCLUSIONS: The Attributes Framework, group model building and causal loop diagrams, and emergent feedback loops were useful to explore potential leverage points to address the challenge of multisectoral coordination of PPAP. Future research could apply the same methods in other jurisdictions and compare and contrast resultant frameworks, variables, feedback loops, and leverage points.

Rich essential properties of silicon-substituted graphene nanoribbons: a comprehensive computational study.

The diverse structural, electronic, and magnetic properties of silicon (Si)-substituted armchair and zigzag graphene nanoribbons (AGNRs and ZGNRs) were investigated using spin-polarized density functional theory (DFT) calculations. Pristine AGNRs belong to a nonmagnetic semiconductor with a direct bandgap of 1.63/1.92 eV determined by PBE/HSE06 functionals. Under various Si substitutions, nonmagnetic bandgaps were tuned at 1.49/1.87, 1.06/1.84, 0.81/1.45, 1.04/1.71, 0.89/1.05, and 2.38/3.0 eV (PBE/HSE06) in the single Si edge-, single Si non-edge-, double Si ortho-, double Si meta-, double Si para-, and 100% Si-substituted AGNR configurations, respectively. Meanwhile, pristine ZGNRs displayed antiferromagnetic semiconducting behavior with a spin degenerate bandgap of 0.52/0.81 eV (PBE/HSE06) and becomes a ferromagnetic semimetal in the single Si configurations or an unusual ferromagnetic semiconductor in the 100% Si configuration. Under the developed first-principles theoretical framework, the formation of quasi π (C-2pz and Si-3pz) and quasi σ (C-2s, -2pxy and Si-3s and -3pxy) bands was identified in the Si-substituted configurations. These quasi π and quasi σ bands showed weak separation, resulting in weak quasi sp2 hybridization in Si-C bonds, in which the identified hybridization mechanism was a strong evidence for the formation of stable planar 1D structures in the Si-substituted configurations. Our complete revelation of the essential properties of Si-substituted GNRs can provide a complete understanding of their chemically doped 1D materials for various practical applications.

Navigating Living Kidney Donation and Transplantation Among South Asian Canadians: The ACTION Project.

RATIONALE & OBJECTIVE: South Asian (SA) Canadians with kidney failure have a 50%-77% lower likelihood of kidney transplant and are less likely to identify potential living donors (LDs). This study aimed to identify health system-, patient-, and community-level barriers and facilitators for accessing LD kidney transplantation in the SA community to inform the development of health system- and community-level interventions to address barriers. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: 20 SA recipients of an LD or deceased-donor kidney transplant, 10 SA LDs, and 41 general SA community members. ANALYTICAL APPROACH: In-depth multilingual interviews were conducted with recipients and LDs. Gender-, language-, and age-stratified focus groups were conducted with general SA community members. Summative content analysis was used to analyze the data. RESULTS: Hesitancy in approaching potential donors, fear about the health of potential LDs, information gaps, language barriers, and challenges evaluating out-of-country donors were highlighted as significant barriers by recipients, and financial concerns and information gaps were identified by donors. Cultural barriers in the SA community were highlighted by donors, recipients, and community members as critical factors when considering donation and transplant; women and elderly SA Canadians highlighted nuanced challenges. Participants reported generally a favorable perception of their health care teams, citing SA representation in the teams as important to providing culturally and linguistically sensitive care. LIMITATIONS: Limited geographic, race, and cultural representation and reliance on virtual data collection. CONCLUSIONS: This study highlights several culturally relevant barriers to donation and transplant that are potentially modifiable through patient-, health system-, and community-focused engagement and education.

Starch Assisted the ZnS Buffer Layer in Enhancing the Photoluminescence of ZnSe/ZnS:Mn/ZnS Quantum Dots for Detecting E. Coli and MRSA Bacteria Quickly.

In this study, we used a starch paste stabilizer to synthesize ZnSe: Mn/ZnS- Starch and ZnSe/ZnS: Mn/ZnS-starch quantum dot (QDs) in a non-toxic aqueous solvent. The -CH2-OH group of the starch paste promotes dispersibility and improves the compatibility of quantum dots with antibodies, its bonding is observed in the FTIR spectrum. Besides, the Mn-doped ZnS buffer shell with various concentrations (1, 3, 5, 7, and 9%) influence structure, optical, and photoluminescence of QDs properties were investigated in detail. The greatest luminescence intensity is achieved at a molar ratio of 3% Mn2+/Zn2+. Moreover, the ZnS: Mn buffer shell helps to enhance the fluorescence intensity and quantum yield (QY) of the ZnSe/ZnS: Mn/ZnS QDs, which are higher than ZnSe: Mn/ZnS-starch QDs. Through protein A and EDC bridging, ZnSe/ZnS:3%Mn/ZnS- Starch resulted in good signal and sensitivity, with no toxicity to E. coli O157:H7 and MRSA strains.

A novel n-p heterojunction Bi2S3/ZnCo2O4 photocatalyst for boosting visible-light-driven photocatalytic performance toward indigo carmine.

An innovative p-n heterojunction Bi2S3/ZnCo2O4 composite was first fabricated via a two-step co-precipitation and hydrothermal method. By controlling the weight amount of Na2S and Bi(NO3)3 precursor, different heterogeneous xBi2S3/ZnCo2O4 were synthesized (x = 0, 2, 6, 12, and 20). The p-n heterojunction Bi2S3/ZnCo2O4 was characterized by structural, optical, and photochemical properties and the photocatalyst decoloration of indigo carmine. Mott-Schottky plots proved a heterojunction formed between n-Bi2S3 and p-ZnCo2O4. Furthermore, the investigation of the photocurrent response indicated that the Bi2S3/ZnCo2O4 composite displayed an enhanced response, which was respectively 4.6 and 7.3 times (4.76 µA cm-2) greater than that of the pure Bi2S3 (1.02 µA cm-2) and ZnCo2O4 (0.65 µA cm-2). Especially the optimized p-n Bi2S3/ZnCo2O4 heterojunction with 12 wt% Bi2S3 showed the highest photocatalyst efficacy of 92.1% at 40 mg L-1 solutions, a loading of 1.0 g L-1, and a pH of 6 within 90 min of visible light illumination. These studies prove that p-n Bi2S3/ZnCo2O4 heterojunction photocatalysts can greatly boost their photocatalytic performance because the inner electric field enhances the process of separating photogenerated electron-hole pairs. Furthermore, this composite catalyst showed good stability and recyclability for environmental remediation.

One-step hydrothermal preparation of Ta-doped ZnO nanorods for improving decolorization efficiency under visible light.

In this work, Ta-doped ZnO (Ta-ZnO) nanomaterials were synthesized by the hydrothermal method at different temperatures (110, 150, and 170 °C) for the photodegradation of methylene blue (MB) under visible light. Ta doping significantly affects the crystal defects, optical properties, and MB photocatalytic efficiency of ZnO materials. The optical absorption edge of Ta-ZnO 150 was redshifted compared to undoped ZnO, correlating to bandgap narrowing (E gTa-ZnO = 2.92 eV; E gZnO = 3.07 eV), implying that Ta doped ZnO is capable of absorbing visible light. Besides, Ta-doping was the reason for enhanced blue light emission in the photoluminescence spectrum, which is related to the oxygen defect V 0 O. It is also observed in the XPS spectra, where the percentage of oxygen in the oxygen-deficient regions (O531.5 eV) of Ta-ZnO150 is higher than that of ZnO150. It is an important factor in enhancing ZnO's photocatalytic efficiency. The MB degradation efficiency of Ta-doped ZnO reached the highest for Ta-ZnO 150 and was 2.5 times higher than ZnO under a halogen lamp (HL). Notably, the influence of hydrothermal temperature on the structural, morphological, and photoelectrochemical properties was discussed in detail. As a result, the optimal hydrothermal temperature for synthesizing the nanorod is 150 °C. Furthermore, photocatalytic experiments were also performed under simulated sunlight and natural sunlight. The nature of the photo-oxidative degradation of MB was also investigated.

Negative dispersion of a form birefringence in subwavelength gratings.

An achromatic response is required in most optical systems for wideband and straightforward configurations. The chromatic response of the optical system depends on the optical dispersion of the elements in the system. Here we study the dispersion of subwavelength grating (SWG) known to have a form birefringence. The birefringence of SWG was numerically analyzed with Bloch wave analysis (BWA) and finite element method (FEM). The sandwiched SWG with two identical substrates was studied for practical applications. We successfully demonstrated the negative dispersion form birefringence of SWG with an optimal duty cycle. This extraordinary dispersion was also shown considering the intrinsic dispersion of materials. Dispersion- and the angular response were in a tradeoff relationship while they depended on periodicity. The optical interference between the grating and the substrates can be eliminated by controlling the duty cycle. Our analysis offers optimal SWG with achromatic birefringence and high transparency, promising in the widespread applications of polarization control devices.

Endovascular thrombectomy versus standard bridging thrombolytic with endovascular thrombectomy within 4·5 h of stroke onset: an open-label, blinded-endpoint, randomised non-inferiority trial.

BACKGROUND: The benefit of combined treatment with intravenous thrombolysis before endovascular thrombectomy in patients with acute ischaemic stroke caused by large vessel occlusion remains unclear. We hypothesised that the clinical outcomes of patients with stroke with large vessel occlusion treated with direct endovascular thrombectomy within 4·5 h would be non-inferior compared with the outcomes of those treated with standard bridging therapy (intravenous thrombolysis before endovascular thrombectomy). METHODS: DIRECT-SAFE was an international, multicentre, prospective, randomised, open-label, blinded-endpoint trial. Adult patients with stroke and large vessel occlusion in the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or basilar artery, confirmed by non-contrast CT and vascular imaging, and who presented within 4·5 h of stroke onset were recruited from 25 acute-care hospitals in Australia, New Zealand, China, and Vietnam. Eligible patients were randomly assigned (1:1) via a web-based, computer-generated randomisation procedure stratified by site of baseline arterial occlusion and by geographic region to direct endovascular thrombectomy or bridging therapy. Patients assigned to bridging therapy received intravenous thrombolytic (alteplase or tenecteplase) as per standard care at each site; endovascular thrombectomy was also per standard of care, using the Trevo device (Stryker Neurovascular, Fremont, CA, USA) as first-line intervention. Personnel assessing outcomes were masked to group allocation; patients and treating physicians were not. The primary efficacy endpoint was functional independence defined as modified Rankin Scale score 0-2 or return to baseline at 90 days, with a non-inferiority margin of -0·1, analysed by intention to treat (including all randomly assigned and consenting patients) and per protocol. The intention-to-treat population was included in the safety analyses. The trial is registered with ClinicalTrials.gov, NCT03494920, and is closed to new participants. FINDINGS: Between June 2, 2018, and July 8, 2021, 295 patients were randomly assigned to direct endovascular thrombectomy (n=148) or bridging therapy (n=147). Functional independence occurred in 80 (55%) of 146 patients in the direct thrombectomy group and 89 (61%) of 147 patients in the bridging therapy group (intention-to-treat risk difference -0·051, two-sided 95% CI -0·160 to 0·059; per-protocol risk difference -0·062, two-sided 95% CI -0·173 to 0·049). Safety outcomes were similar between groups, with symptomatic intracerebral haemorrhage occurring in two (1%) of 146 patients in the direct group and one (1%) of 147 patients in the bridging group (adjusted odds ratio 1·70, 95% CI 0·22-13·04) and death in 22 (15%) of 146 patients in the direct group and 24 (16%) of 147 patients in the bridging group (adjusted odds ratio 0·92, 95% CI 0·46-1·84). INTERPRETATION: We did not show non-inferiority of direct endovascular thrombectomy compared with bridging therapy. The additional information from our study should inform guidelines to recommend bridging therapy as standard treatment. FUNDING: Australian National Health and Medical Research Council and Stryker USA.

Prediction and Optimization of Process Parameters for Composite Thermoforming Using a Machine Learning Approach.

Thermoforming is a process where the laminated sheet is pre-heated to the desired forming temperature before being pressed and cooled between the molds to give the final formed part. Defects such as wrinkles, matrix-smear or ply-splitting could occur if the process is not optimized. Traditionally, for thermoforming of fiber-reinforced composites, engineers would either have to perform numerous physical trial and error experiments or to run a large number of high-fidelity simulations in order to determine satisfactory combinations of process parameters that would yield a defect-free part. Such methods are expensive in terms of equipment and raw material usage, mold fabrication cost and man-hours. In the last decade, there has been an ongoing trend of applying machine learning methods to engineering problems, but none for woven composite thermoforming. In this paper, two applications of artificial neural networks (ANN) are presented. The first is the use of ANN to analyze full-field contour results from simulation so as to predict the process parameters resulting in the quality of the formed product. Results show that the developed ANN can predict some input parameters reasonably well from just inspecting the images of the thermoformed laminate. The second application is to optimize the process parameters that would result in a quality part through the objectives of minimizing the maximum slip-path length and maximizing the regions of the laminate with a predesignated shear angle range. Our results show that the ANN can provide reasonable optimization of the process parameters to yield improved product quality. Overall, the results from the ANNs are encouraging when compared against experimental data. The image analysis method proposed here for machine learning is novel for composite manufacturing as it can potentially be combined with machine vision in the actual manufacturing operation to provide active feedback to ensure quality products.

Immunomodulation Eliminates Inflammation in the Hippocampus in Experimental Autoimmune Encephalomyelitis, but Does Not Ameliorate Anxiety-Like Behavior.

Multiple sclerosis (MS) is an autoimmune disease targeting the central nervous system, characterized by an unpredictable disease course and a wide range of symptoms. Emotional and cognitive deficits are now recognized as primary disease manifestations and not simply the consequence of living with a chronic condition, raising questions regarding the efficacy of current therapeutics for these specific symptoms. Mechanisms underlying psychiatric sequelae in MS are believed to be similar to those underlying pathogenesis, that is mediated by cytokines and other inflammatory mediators. To gain insight into the pathogenesis of MS depression, we performed behavioral assays in the murine experimental autoimmune encephalomyelitis (EAE) MS model, in the presence or absence of immunomodulation using the drug FTY720, an analogue of the lipid signaling molecule sphingosine-1-phosphate (S1P). Specifically, mice were challenged with the elevated plus maze (EPM) test, a validated experimental paradigm for rodent-specific anxiety-like behavior. FTY720 treatment failed to ameliorate anxiety-like symptoms, irrespective of dosage. On the other hand, it was effective in reducing inflammatory infiltration, microglial reactivity and levels of pro-inflammatory molecules in the hippocampus, confirming the anti-inflammatory capacity of treatment. To explore the absence of FTY720 effect on behavior, we confirmed expression of S1P receptors (S1PR) S1PR1, S1PR3 and S1PR5 in the hippocampus and mapped the dynamics of these receptors in response to drug treatment alone, or in combination with EAE induction. We identified a complex pattern of responses, differing between (1) receptors, (2) dosage and (3) hippocampal sub-field. FTY720 treatment in the absence of EAE resulted in overall downregulation of S1PR1 and S1PR3, while S1PR5 exhibited a dose-dependent upregulation. EAE induction alone resulted in overall downregulation of all three receptors. On the other hand, combined FTY720 and EAE showed generally no effect on S1PR1 and S1PR3 expression except for the fimbrium region, but strong upregulation of S1PR5 over the range of doses examined. These data illustrate a hitherto undescribed complexity of S1PR response to FTY720 in the hippocampus, independent of drug effect on effector immune cells, but simultaneously emphasize the need to explore novel treatment strategies to specifically address mood disorders in MS.

Low-Dose vs. Standard-Dose Intravenous Alteplase in Bridging Therapy Among Patients With Acute Ischemic Stroke: Experience From a Stroke Center in Vietnam.

Background: To date, the role of bridging intravenous thrombolysis before mechanical thrombectomy (MTE) is controversial but still recommended in eligible patients. Different doses of intravenous alteplase have been used for treating patients with acute ischemic stroke from large-vessel occlusion (LVO-AIS) in Asia, largely due to variations in the risks for intracerebral hemorrhage (ICH) and treatment affordability. Uncertainty exists over the potential benefits of treating low-dose alteplase, as opposed to standard-dose alteplase, prior to MTE among patients with LVO-AIS. Aim: The aim of the study was to compare outcomes of low- vs. standard-dose of bridging intravenous alteplase before MTE among LVO-AIS patients. Methods: We performed a retrospective analysis of LVO-AIS patients who were treated with either 0.6 mg/kg or 0.9 mg/kg alteplase prior to MTE at a stroke center in Northern Vietnam. Multivariable logistic regression models, accounting for potential confounding factors including comorbidities and clinical factors (e.g., stroke severity), were used to compare the outcomes between the two groups. Our primary outcome was functional independence at 90 days following stroke (modified Rankin score; mRS ≤ 2). Secondary outcomes included any ICH incidence, early neurological improvement, recanalization rate, and 90-day mortality. Results: We analyzed data of 107 patients receiving bridging therapy, including 73 with low-dose and 34 with standard-dose alteplase before MTE. There were no statistically significant differences between the two groups in functional independence at 90 days (adjusted OR 1.02, 95% CI 0.29-3.52) after accounting for potential confounding factors. Compared to the standard-dose group, patients with low-dose alteplase before MTE had similar rates of successful recanalization, early neurological improvement, 90-day mortality, and ICH complications. Conclusion: In the present study, patients with low-dose alteplase before MTE were found to achieve comparable clinical outcomes compared to those receiving standard-dose alteplase bridging with MTE. The findings suggest potential benefits of low-dose alteplase in bridging therapy for Asian populations, but this needs to be confirmed by further clinical trials.

Values are not enough: qualitative study identifying critical elements for prioritization of health equity in health systems.

BACKGROUND: Health system policies and programs that reduce health inequities and improve health outcomes are essential to address unjust social gradients in health. Prioritization of health equity is fundamental to addressing health inequities but challenging to enact in health systems. Strategies are needed to support effective prioritization of health equity. METHODS: Following provincial policy recommendations to apply a health equity lens in all public health programs, we examined health equity prioritization within British Columbia health authorities during early implementation. We conducted semi-structured qualitative interviews and focus groups with 55 senior executives, public health directors, regional directors, and medical health officers from six health authorities and the Ministry of Health. We used an inductive constant comparative approach to analysis guided by complexity theory to determine critical elements for prioritization. RESULTS: We identified seven critical elements necessary for two fundamental shifts within health systems. 1) Prioritization through informal organization includes creating a systems value for health equity and engaging health equity champions. 2) Prioritization through formal organization requires explicit naming of health equity as a priority, designating resources for health equity, requiring health equity in decision making, building capacity and competency, and coordinating a comprehensive approach across levels of the health system and government. CONCLUSIONS: Although creating a shared value for health equity is essential, health equity - underpinned by social justice - needs to be embedded at the structural level to support effective prioritization. Prioritization within government and ministries is necessary to facilitate prioritization at other levels. All levels within health systems should be accountable for explicitly including health equity in strategic plans and goals. Dedicated resources are needed for health equity initiatives including adequate resourcing of public health infrastructure, training, and hiring of staff with equity expertise to develop competencies and system capacity.

A Comparison of the National Institutes of Health Stroke Scale and the Gugging Swallowing Screen in Predicting Stroke-Associated Pneumonia.

BACKGROUND: There have been many scales to predict pneumonia in stroke patients, but they are so complex, making it difficult to apply in practice. Therefore, we conducted this study to assess the role of the National Institutes of Health Stroke Scale (NIHSS) and the Gugging Swallowing Screen (GUSS) in predicting stroke-associated pneumonia (SAP). These scales are routinely used in stroke patients. Therefore, their application in predicting SAP risk will be of high value in clinical practice. There has been no previous study evaluating the effectiveness of SAP risk prediction for each of these scales. AIM: This study aimed to compare the value of NIHSS and GUSS in SAP prediction and their convenience in clinical practice. METHODS: It was a cohort study. The receiver operating characteristics (ROC) curves were constructed to assess the sensitivity (Se) and specificity (Sp) of the scales. Area under the curves (AUC) were calculated, and we compared them. RESULTS: NIHSS had a medium value of predictor of SAP with AUC 0.764 (95% CI 0.735-0.792), 65.4% Se, 76.5% Sp. GUSS had good value in predicting SAP with AUC 0.858 (95% CI 0.833-0.880), 80.5% Se, 80.1% Sp. Pairwise comparison of ROCs curves demonstrated that the difference between two AUCs was significant (p < 0.01). Performing GUSS required 24.5 ± 6.7 minutes, 2.5 times longer than NIHSS (9.9 ± 2.0 minutes). CONCLUSION: GUSS had a better predictive value of SAP than NIHSS. But NIHSS was more convenient in clinical practice because of its simple instrument and quick performance.

First-principles prediction of chemically functionalized InN monolayers: electronic and optical properties.

In this work, we consider the electronic and optical properties of chemically functionalized InN monolayers with F and Cl atoms (i.e., F-InN-F, F-InN-Cl, Cl-InN-F, Cl-InN-Cl monolayers) using first-principles calculations. The adsorption of the F and Cl atoms on the InN monolayer is determined to be chemically stable and the F-InN-F monolayer is most likely to occur. Our calculations show that the chemical functionalization with Cl and F atoms not only breaks the planar structure of InN monolayer but also increases its band gap. By using both Perdew, Burke, and Ernzerhof (PBE) and the Heyd-Scuseria-Ernzerhof (HSE06) hybrid functionals, all four models of chemically functionalized InN monolayers are found to be semiconductors with direct energy gaps and these gaps depend on the constituent species. When the spin-orbit coupling (SOC) was included, the energy gap of these monolayers was reduced and an energy splitting was found at the Γ-point in the valence band. Chemically functionalized InN monolayers can absorb light in a wide region, especially the F-InN-F and Cl-InN-F monolayers have a strong ability to absorb the visible light. Our findings reveal that the chemically functionalized InN monolayers have potential applications in next-generation optoelectronic devices.

"I can make more from selling medicine when breaking the rules" - understanding the antibiotic supply network in a rural community in Viet Nam.

BACKGROUND: As in many other low and middle income countries (LIMCs), Vietnam has experienced a major growth in the pharmaceutical industry, with large numbers of pharmacies and drug stores, and increasing drug expenditure per capita over the past decade. Despite regulatory frameworks that have been introduced to control the dispensing and use of prescription-only drugs, including antibiotics, compliance has been reported to be strikingly low particularly in rural parts of Vietnam. This qualitative study aimed to understand antibiotic access and use practices in the community from both supplier and consumer perspectives in order to support the identification and development of future interventions. METHODS: This qualitative study was part of a project on community antibiotic access and use (ABACUS) in six LMICs. The focus was Ba Vi district of Hanoi capital city, where we conducted 16 indepth interviews (IDIs) with drug suppliers, and 16 IDIs and 6 focus group discussions (FGDs) with community members. Drug suppliers were sampled based on mapping of all informal and formal antibiotic purchase or dispensing points in the study area. Community members were identified through local networks and relationships with the field collaborators. All IDIs and FGDs were audio-taped, transcribed and analysed using content analysis. RESULTS: We identified a large number of antibiotic suppliers in the locality with widespread infringements of regulatory requirements. Established reciprocal relationships between suppliers and consumers in drug transactions were noted, as was the consumers' trust in the knowledge and services provided by the suppliers. In addition, antibiotic use has become a habitual choice in most illness conditions, driven by both suppliers and consumers. CONCLUSIONS: This study presents an analysis of the practices of antibiotic access and use in a rural Vietnamese setting. It highlights the interactions between antibiotic suppliers and consumers in the community and identifies possible targets for interventions.

The Avant Rehabilitation Program and Cerebrolysin for Treatment of Post-Stroke Dysphagia: A Case Report.

Dysphagia is recorded in approximately a third of ischemic stroke patients and is associated with malnutrition, aspiration, and pneumonia. We report a case study that assessed dysphagia (GUSS, Gugging Swallowing Screen), paralysis (MRC, Medical Research Council), and disability (mRS, modified Rankin Scale) in the AVANT program (Austrian Vietnamese Advancement Neurorehabilitation Treatment) - a collaboration program between Vietnam and Austria to standardize and systemize neurorehabilitation after stroke practice in Vietnam.

A Designed Broadband Absorber Based on ENZ Mode Incorporating Plasmonic Metasurfaces.

In this paper, we present a numerical study of a metamaterial absorber that provides polarization-insensitive absorption over a broad bandwidth of operation over the mid-infrared region. The absorber consists of a periodically patterned metal-dielectric-metal structure integrated with an epsilon-near-zero (ENZ) nanolayer into the insulating dielectric gap region. Such an anomalous broadband absorber is achieved thanks to a couple of resonant modes including plasmon and ENZ modes that are excited under mid-IR light illumination. By adding a 0.06-µm-thick ENZ layer between the patterned gold rectangular grating and the SiO2 dielectric layer, the absorber captures >95% light over a 1.5 µm bandwidth centered at a near-8-µm wavelength over a wide range of oblique incidence under transverse-magnetic and -electric polarizations. The designed ENZ-based wideband absorber has potential for many practical applications, including sensing, imaging and solar energy harvesting over a wide frequency regime.

Platelet Depletion is Effective in Ameliorating Anxiety-Like Behavior and Reducing the Pro-Inflammatory Environment in the Hippocampus in Murine Experimental Autoimmune Encephalomyelitis.

The neuropsychiatric symptoms of multiple sclerosis (MS), such as anxiety and depression, can result from disease activity itself as well as psychological reaction to an unfavorable diagnosis. Accordingly, the literature reports evidence of increased anxiety-like behavior in experimental autoimmune encephalomyelitis (EAE), an accepted MS model. Due to the recently described critical role of platelets in inflammation and autoimmune disease, we examined the relationship between platelets, inflammation, and anxiety-like behavior in EAE. In the elevated plus maze, EAE-induced C57BL/6J mice showed decreased time spent in the open arms relative to vehicle-only controls, demonstrating an increase in anxiety-like behavior. This effect occurred in the presence of platelet⁻neuron association, but absence of lymphocytic infiltration, in the hippocampal parenchyma. Platelet depletion at the pre-clinical disease stage, using antibody-mediated lysis prevented the EAE-induced increase in anxiety-like behavior, while no significant difference in distance moved was recorded. Furthermore, platelet depletion was also associated with reduction of the pro-inflammatory environment to control levels in the hippocampus and prevention of EAE disease symptomology. These studies demonstrate the high efficacy of a platelet-targeting approach in preventing anxiety-like symptoms and clinical manifestations of EAE and have implications for the treatment of neuropsychiatric symptoms in MS.

Nimbandiolactone-21 and nimbandioloxyfuran, two new 28-norlimonoids from the leaves of Azadirachta indica (Meliaceae).

From an EtOAc-soluble fraction of the leaves of Azadirachta indica, two new 28-norlimonoids named nimbandiolactone-21 (1) and nimbandioloxyfuran (2), together with nimbandiolactone-23 (3), were isolated. Their relative structures were elucidated based on NMR spectroscopic interpretation and biosynthetic consideration. Nimbandioloxyfuran (2) and nimbandiolactone-23 (3) showed potent α-glucosidase inhibitory activity, with the IC50 values of 46.2 and 38.7 µM, respectively.