Human Neural Larva Migrans Caused by Ophidascaris robertsi Ascarid.

We describe a case in Australia of human neural larva migrans caused by the ascarid Ophidascaris robertsi, for which Australian carpet pythons are definitive hosts. We made the diagnosis after a live nematode was removed from the brain of a 64-year-old woman who was immunosuppressed for a hypereosinophilic syndrome diagnosed 12 months earlier.

Carbon-Shielded Selenium-Rich Trimetallic Selenides as Advanced Electrode Material for Durable Li-Ion Batteries and Supercapacitors.

In order to achieve a sustainable future, researchers must continue to research improved electrode materials. Considering the high electronic conductivity, versatile redox activity, and enhanced energy storage performance, nanostructures have been employed as a novel electrode material for high-performance lithium-ion batteries (LIBs) and supercapacitors. Herein, carbon-coated selenium-rich trimetallic selenide (Cu2 NiSnSe4 @C) nanoparticles (NPs) as an efficient electrode material in energy storage devices are prepared. The prepared core-shell Cu2 NiSnSe4 @C NPs electrode is employed as an anode material for LIBs, which demonstrated a high reversible specific capacity of 988.46 mA h g-1 over 100 cycles at 0.1 A g-1 with good rate capability. Additionally, the core-shell Cu2 NiSnSe4 @C NPs electrode exhibited an outstanding capacity of 202.5 mA h g-1 at 5 A g-1 even after 10 000 cycles. Exploiting the synergistic characteristics, the core-shell Cu2 NiSnSe4 @C NPs material is also investigated as a battery-type electrode for hybrid supercapacitors. The assembled hybrid supercapacitor with Cu2 NiSnSe4 @C NPs and activated carbon showed excellent rate capability including high power (5597.77 W kg-1 ) and energy (64.26 Wh kg-1 ) densities. Considering the simple synthesis and enhanced energy storage properties, carbon-coated selenium-rich trimetallic selenide can be used as a durable electrode material for practical energy storage devices.

Hydrogen Peroxide Tuned Morphology and Crystal Structure of Barium Vanadate-Based Nanostructures for Aqueous Zinc-Ion Storage Properties.

Improving the layered-structure stability and suppressing vanadium (V) dissolution during repeated Zn2+ insertion/extraction processes are key to promoting the electrochemical stability of V-based cathodes for aqueous zinc (Zn)-ion batteries (AZIBs). In this study, barium vanadate (Ba2 V2 O7 , BVO) nanostructures (NSs) are synthesized using a facile hydrothermal method. The formation process of the BVO NSs is controlled by adjusting the concentration of hydrogen peroxide (H2 O2 ), and these NSs are employed as potential cathode materials for AZIBs. As the H2 O2 content increases, the corresponding electrochemical properties demonstrate a discernible parabolic trend, with an initial increase, followed by a subsequent decrease. Benefiting from the effect of H2 O2 concentration, the optimized BVO electrode with 20 mL H2 O2 delivers a specific capacity of 180.15 mA h g-1 at 1 A g-1 with good rate capability and a long-term cyclability of 158.34 mA h g-1 at 3 A g-1 over 2000 cycles. Thus, this study provides a method for designing cathode materials with robust structures to boost the electrochemical performance of AZIBs.

Development of a Machine Learning-Based Prescriptive Tool to Address Racial Disparities in Access to Care After Penetrating Trauma.

Importance: The use of artificial intelligence (AI) in clinical medicine risks perpetuating existing bias in care, such as disparities in access to postinjury rehabilitation services. Objective: To leverage a novel, interpretable AI-based technology to uncover racial disparities in access to postinjury rehabilitation care and create an AI-based prescriptive tool to address these disparities. Design, Setting, and Participants: This cohort study used data from the 2010-2016 American College of Surgeons Trauma Quality Improvement Program database for Black and White patients with a penetrating mechanism of injury. An interpretable AI methodology called optimal classification trees (OCTs) was applied in an 80:20 derivation/validation split to predict discharge disposition (home vs postacute care [PAC]). The interpretable nature of OCTs allowed for examination of the AI logic to identify racial disparities. A prescriptive mixed-integer optimization model using age, injury, and gender data was allowed to "fairness-flip" the recommended discharge destination for a subset of patients while minimizing the ratio of imbalance between Black and White patients. Three OCTs were developed to predict discharge disposition: the first 2 trees used unadjusted data (one without and one with the race variable), and the third tree used fairness-adjusted data. Main Outcomes and Measures: Disparities and the discriminative performance (C statistic) were compared among fairness-adjusted and unadjusted OCTs. Results: A total of 52 468 patients were included; the median (IQR) age was 29 (22-40) years, 46 189 patients (88.0%) were male, 31 470 (60.0%) were Black, and 20 998 (40.0%) were White. A total of 3800 Black patients (12.1%) were discharged to PAC, compared with 4504 White patients (21.5%; P < .001). Examining the AI logic uncovered significant disparities in PAC discharge destination access, with race playing the second most important role. The prescriptive fairness adjustment recommended flipping the discharge destination of 4.5% of the patients, with the performance of the adjusted model increasing from a C statistic of 0.79 to 0.87. After fairness adjustment, disparities disappeared, and a similar percentage of Black and White patients (15.8% vs 15.8%; P = .87) had a recommended discharge to PAC. Conclusions and Relevance: In this study, we developed an accurate, machine learning-based, fairness-adjusted model that can identify barriers to discharge to postacute care. Instead of accidentally encoding bias, interpretable AI methodologies are powerful tools to diagnose and remedy system-related bias in care, such as disparities in access to postinjury rehabilitation care.

Severe acute infection and chronic pulmonary disease are risk factors for developing post-COVID-19 conditions.

Post-COVID-19 conditions, also known as "long COVID", has significantly impacted the lives of many individuals, but the risk factors for this condition are poorly understood. In this study, we performed a retrospective EHR analysis of 89,843 individuals at a multi-state health system in the United States with PCR-confirmed COVID-19, including 1,086 patients diagnosed with long COVID and 1,086 matched controls not diagnosed with long COVID. For these two cohorts, we evaluated a wide range of clinical covariates, including laboratory tests, medication orders, phenotypes recorded in the clinical notes, and outcomes. We found that chronic pulmonary disease (CPD) was significantly more common as a pre-existing condition for the long COVID cohort than the control cohort (odds ratio: 1.9, 95% CI: [1.5, 2.6]). Additionally, long-COVID patients were more likely to have a history of migraine (odds ratio: 2.2, 95% CI: [1.6, 3.1]) and fibromyalgia (odds ratio: 2.3, 95% CI: [1.3, 3.8]). During the acute infection phase, the following lab measurements were abnormal in the long COVID cohort: high triglycerides (meanlongCOVID: 278.5 mg/dL vs. meancontrol: 141.4 mg/dL), low HDL cholesterol levels (meanlongCOVID: 38.4 mg/dL vs. meancontrol: 52.5 mg/dL), and high neutrophil-lymphocyte ratio (meanlongCOVID: 10.7 vs. meancontrol: 7.2). The hospitalization rate during the acute infection phase was also higher in the long COVID cohort compared to the control cohort (ratelongCOVID: 5% vs. ratecontrol: 1%). Overall, this study suggests that the severity of acute infection and a history of CPD, migraine, CFS, or fibromyalgia may be risk factors for long COVID symptoms. Our findings motivate clinical studies to evaluate whether suppressing acute disease severity proactively, especially in patients at high risk, can reduce incidence of long COVID.

Exploratory analysis of immunization records highlights decreased SARS-CoV-2 rates in individuals with recent non-COVID-19 vaccinations.

Clinical studies are ongoing to assess whether existing vaccines may afford protection against SARS-CoV-2 infection through trained immunity. In this exploratory study, we analyze immunization records from 137,037 individuals who received SARS-CoV-2 PCR tests. We find that polio, Haemophilus influenzae type-B (HIB), measles-mumps-rubella (MMR), Varicella, pneumococcal conjugate (PCV13), Geriatric Flu, and hepatitis A/hepatitis B (HepA-HepB) vaccines administered in the past 1, 2, and 5 years are associated with decreased SARS-CoV-2 infection rates, even after adjusting for geographic SARS-CoV-2 incidence and testing rates, demographics, comorbidities, and number of other vaccinations. Furthermore, age, race/ethnicity, and blood group stratified analyses reveal significantly lower SARS-CoV-2 rate among black individuals who have taken the PCV13 vaccine, with relative risk of 0.45 at the 5 year time horizon (n: 653, 95% CI (0.32, 0.64), p-value: 6.9e-05). Overall, this study identifies existing approved vaccines which can be promising candidates for pre-clinical research and Randomized Clinical Trials towards combating COVID-19.

Optical tweezer measurements of asymptotic nonlinearities in complex fluids.

This article presents micro-medium-amplitude oscillatory shear (µMAOS), a method to measure the frequency-dependent micromechanical properties of soft materials in the asymptotically nonlinear regime using optical tweezers. We have developed a theoretical framework to extract these nonlinear mechanical properties of the material from experimental measurements and also proposed a physical interpretation of the third-order nonlinearities measured in single-tone oscillatory tests. We validate the method using a well-characterized surfactant solution of wormlike micelles, and subsequently employ this technique to demonstrate that the cytoplasm of a living cell undergoes strain softening and shear thinning when locally subjected to weakly nonlinear oscillatory deformations.

Analysis of the Effectiveness of the Ad26.COV2.S Adenoviral Vector Vaccine for Preventing COVID-19.

Importance: Continuous assessment of the effectiveness and safety of the US Food and Drug Administration-authorized SARS-CoV-2 vaccines is critical to amplify transparency, build public trust, and ultimately improve overall health outcomes. Objective: To evaluate the effectiveness of the Johnson & Johnson Ad26.COV2.S vaccine for preventing SARS-CoV-2 infection. Design, Setting, and Participants: This comparative effectiveness research study used large-scale longitudinal curation of electronic health records from the multistate Mayo Clinic Health System (Minnesota, Arizona, Florida, Wisconsin, and Iowa) to identify vaccinated and unvaccinated adults between February 27 and July 22, 2021. The unvaccinated cohort was matched on a propensity score derived from age, sex, zip code, race, ethnicity, and previous number of SARS-CoV-2 polymerase chain reaction tests. The final study cohort consisted of 8889 patients in the vaccinated group and 88 898 unvaccinated matched patients. Exposure: Single dose of the Ad26.COV2.S vaccine. Main Outcomes and Measures: The incidence rate ratio of SARS-CoV-2 infection in the vaccinated vs unvaccinated control cohorts, measured by SARS-CoV-2 polymerase chain reaction testing. Results: The study was composed of 8889 vaccinated patients (4491 men [50.5%]; mean [SD] age, 52.4 [16.9] years) and 88 898 unvaccinated patients (44 748 men [50.3%]; mean [SD] age, 51.7 [16.7] years). The incidence rate ratio of SARS-CoV-2 infection in the vaccinated vs unvaccinated control cohorts was 0.26 (95% CI, 0.20-0.34) (60 of 8889 vaccinated patients vs 2236 of 88 898 unvaccinated individuals), which corresponds to an effectiveness of 73.6% (95% CI, 65.9%-79.9%) and a 3.73-fold reduction in SARS-CoV-2 infections. Conclusions and Relevance: This study's findings are consistent with the clinical trial-reported efficacy of Ad26.COV2.S and the first retrospective analysis, suggesting that the vaccine is effective at reducing SARS-CoV-2 infection, even with the spread of variants such as Alpha or Delta that were not present in the original studies, and reaffirm the urgent need to continue mass vaccination efforts globally.

Structure, function, and endothelium-derived hyperpolarizing factor in the caudal artery of the SHR and WKY rat.

OBJECTIVE: To quantify structural and functional characteristics of the caudal artery from spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats with particular reference to endothelium-derived hyperpolarizing factor (EDHF). METHODS AND RESULTS: Ultrastructural studies showed that the number of myoendothelial gap junctions, smooth muscle cell (SMC) layers, and medial cross-sectional area were significantly greater in SHR than WKY. Intracellular dye labeling demonstrated hyperplasia of SMCs in SHR. Analysis of nerve-mediated excitatory junction potentials recorded in SMCs at the adventitial and luminal borders demonstrated decreased radial coupling of SMCs in SHR. In both SHR and WKY, in the presence of NG-nitro-L-arginine methyl ester and indomethacin, acetylcholine-elicited EDHF was abolished by charybdotoxin and apamin, while iberiotoxin had no effect, implicating the involvement of small and intermediate, but not large, calcium-activated potassium channels. EDHF was abolished by Gap-mimetic peptides, 18beta-glycyrrhetinic acid, and endothelial removal but not affected by the NO scavengers hydroxocobalamin and carboxy-PTIO. CONCLUSIONS: Significant differences in SMC morphology and homocellular and heterocellular coupling exist between the caudal artery of SHR and WKY rats. In the caudal artery of SHR, significantly greater heterocellular coupling compensates for other structural changes in the media to maintain a functional role for EDHF.

Heart rate variability in overweight health care students: correlation with visceral fat.

BACKGROUND AND OBJECTIVES: Increased sympathetic activity, decreased parasympathetic activity and sympathovagal imbalance (SVI) has been reported in obese individuals. However, the SVI and its association with visceral fat in overweight health care students have not been explored. Therefore, in the present study, we have assessed heart rate variability (HRV) and its association with visceral fat in overweight health care students. MATERIALS AND METHODS: Frequency domain parameters of HRV, body fat distribution and baseline anthropometric parameters were recorded in the control (n=40) and overweight (n=40) individuals. Further, the association of visceral fat with HRV was analysed. RESULTS: There was no significant difference in age and height of overweight group and control group (p = 0.732). The baseline heart rate and blood pressure (p<0.001) were higher in the overweight group. Total body fat, subcutaneous fat and visceral fat were higher in the overweight group (p<0.001). Among frequency domain parameter of HRV, LFnu and LF: HF were more in the overweight group (p<0.001). Further, HFnu was less in the overweight group (p<0.001). CONCLUSION: Sympathovagal imbalance due to increased sympathetic activity and its association with visceral fat was observed in overweight individuals.

Association of leukocyte telomere length with oxidative stress in yoga practitioners.

OBJECTIVE: Yoga is a mind-body modulation technique that has been shown to have beneficial effects on various diseases related to various systems in the body. However, the molecular basis of mechanism of action is not clear. Hence, this study was designed to study the leukocyte telomere biology and its relation with homocysteine and oxidative stress in yoga practitioners. MATERIALS AND METHODS: This is a prospective case-control study involving Yoga practitioners aged 30-40 y with minimum of two years yoga practice (Yoga group) and age, gender and body mass index matched sedentary healthy general population with no medical problems (Control group). Leukocyte telomere length (LTL) was measured by using quantitative PCR (qPCR), fasting plasma homocysteine was measured by a rapid high-performance liquid chromatography assay and the oxidative stress was assessed with total antioxidant status (TAOS), malondialdehyde (MDA) measured by calorimetry. RESULTS: The LTL was shorter in control group than in yoga group (p<0.001). The TAOS was more in yoga group when compared to control group (p=0.008), MDA and homocysteine was high in control group when compared to Yoga group (p<0.001). Further, the LTL was positively correlated with TAOS (r=0.841, p<0.001) and negatively correlated with MDA (r=-0.931, p<0.001) and Homocysteine (r=-0.756, p<0.001). CONCLUSION: The LTL is well-preserved in people who practice Yoga regularly with lower systemic oxidative stress compared to those who have a relatively sedentary lifestyle despite lack of any medical disorders. The habitual yoga practice seems to inhibit replicative cellular senescence.

Effect of yoga therapy on heart rate, blood pressure and cardiac autonomic function in heart failure.

BACKGROUND AND OBJECTIVE: It is well known that a hall mark of heart failure is adverse changes in autonomic function. Elevated blood pressure is a powerful predictor of congestive heart failure and other Cardiovascular Disease (CVD) outcomes. In this study, we planned to examine the effects of a 12 week yoga therapy on blood pressure, heart rate, heart rate variability, and rate pressure product (RPP). METHODS: Out of 130 heart failure patients recruited for the study, 65 patients were randomly selected to receive 12 week yoga therapy along with standard medical therapy (yoga group). Other patients (n=65) received only standard medical therapy (control group). Heart rate, blood pressure, cardiac autonomic function (by short-term heart-rate variability analysis) and myocardial oxygen consumption (by RPP) were assessed before and after 12 weeks. In the yoga group, 44 patients and in the control group, 48 patients completed the study. RESULTS: There was a significant decrease in heart rate, blood pressure and RPP in yoga group compared to control group. Also, LFnu and LF-HF ratio decreased significantly and HFnu increased significantly in yoga group compared to control group. CONCLUSION: Twelve-week yoga therapy significantly improved the parasympathetic activity and decreased the sympathetic activity in heart failure patients (NYHA I&II).

A Randomized Controlled Trial to Study the Effect of Yoga Therapy on Cardiac Function and N Terminal Pro BNP in Heart Failure.

AIMS: The purpose of this study was to evaluate whether yoga training in addition to standard medical therapy can improve cardiac function and reduce N terminal pro B-type natriuretic peptide (NT pro BNP) in heart failure (HF). METHODS: 130 patients were recruited and randomized into two groups: Control Group (CG) (n = 65), Yoga Group (YG). In YG, 44 patients and in CG, 48 patients completed the study. Cardiac function using left ventricular ejection fraction (LVEF), myocardial performance index (Tei index), and NT pro BNP, a biomarker of HF, was assessed at baseline and after 12 weeks. RESULT: Improvement in LVEF, Tei index, and NT pro BNP were statistically significant in both the groups. Furthermore, when the changes in before and after 12 weeks were in percentage, LVEF increased 36.88% in the YG and 16.9% in the CG, Tei index was reduced 27.87% in the YG and 2.79% in the CG, NT pro BNP was reduced 63.75% in the YG and 10.77% in the CG. The between group comparisons from pre to post 12 weeks were significant for YG improvements (LVEF, P < 0.01, Tei index, P < 0.01, NT pro BNP, P < 0.01). CONCLUSION: These results indicate that the addition of yoga therapy to standard medical therapy for HF patients has a markedly better effect on cardiac function and reduced myocardial stress measured using NT pro BNP in patients with stable HF.