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There are no reports in LATAM related to longitudinal humoral and cellular response to adenovirus based COVID-19 vaccines in people with Multiple Sclerosis (pwMS) under different disease modifying therapies (DMTs) and neutralization of the Omicron and Wuhan variants of SARS-COV-2. IgG anti- SARS-COV-2 spike titer were measured in a cohort of 101 pwMS under fingolimod, dimethyl fumarate, cladribine and antiCD20, as well as 28 healthy controls (HC) were measured 6 weeks after vaccination with 2 dose (Sputnik V or AZD1222) and 3 dose (homologous or heterologous schedule). Neutralizing capacity was against Omicron (BA.1) and Wuhan (D614G) variants and pseudotyped particles and Cellular response were analyzed. Multivariate regression analysis showed anti-cd20 (β= -,349, 95% CI: -3655.6 - -369.01, p=0.017) and fingolimod (β=-,399, 95% CI: -3363.8 - -250.9, p=0.023) treatments as an independent factor associated with low antibody response (r adjusted=0.157). After the 2nd dose we found a correlation between total and neutralizing titers against D614G (rho=0.6; p<0.001; slope 0.8, 95%CI:0.4-1.3), with no differences between DMTs. Neutralization capacity was lower for BA.1 (slope 0.3, 95%CI:0.1-0.4). After the 3rd dose, neutralization of BA.1 improved (slope: 0.9 95%CI:0.6-1.2), without differences between DMTs. A fraction of pwMS generated anti-Spike CD4+ and CD8+ T cell response. In contrast, pwMS under antiCD20 generated CD8+TNF+IL2+ response without differences with HC, even in the absence of humoral response. The 3rd dose significantly increased the neutralization against the Omicron, as observed in the immunocompetent population. Findings regarding humoral and cellular response are consistent with previous reports.

This paper presents a fault signal reconstruction method for current sensors in an interleaved buck DC–DC converter, utilizing a sliding mode observer (SMO). A filter bank is used to design the observer within an extended-order system, effectively treating sensor faults as actuator faults, which enables precise estimation of the fault signal. Thus, the proposed approach allows for the identification of the faulty sensor and supports the implementation of fault-tolerant strategies. The paper provides an in-depth analysis of current sensor faults, verifies their impact on current balancing control, and demonstrates the challenge of achieving error-free current estimation in one phase using observers. A comprehensive set of simulation results is carried out, validating the method’s effectiveness and showing a strong correlation with theoretical principles.

Background The difference between MRI (Magnetic resonance imaging)-R2* and T2 mapping sequences regarding their superiority in the detection of microstructural cartilage changes in knees with limited ROM (range of motion) was unknown. Methods Twenty male cynomolgus monkeys (mean age: 10.65 ± 0.97 years) underwent knee ROM evaluations and were divided into three groups: Group A ( n  = 10), with similar left and right knee ROM; Group B ( n  = 5), with left knee ROM superior to right; and Group C ( n  = 5), with left knee ROM inferior to right. Twenty-eight ROIs (regions of interest) in the cartilage of the lateral (L) and medial (M) femoral trochlea (FT), anterior (A)/central (C)/posterior (P) femoral condyle (FC) and tibial plateau (TP) of both knees were identified in each monkey. The corresponding ROI values in R2* and T2 mapping sequences were recorded for analysis. One-way ANOVA, Chi-square tests and Pearson’s correlation analysis were used for statistical analyses. Results Among the total 1120 ROIs, significant differences in R2* values among the three groups existed in two ROIs: cartilage of the right MPTP ( F  = 5.216, P  = 0.017) and left MAFC ( F  = 4.919, P  = 0.021). However, the T2 mapping values of all ROIs were similar among the three groups. Microstructural cartilage changes occurred more frequently in the medial (40 ROIs) than in the lateral (0 ROIs) knee compartment (χ 2  = 43.077, P  < 0.001). The Group B cartilage R2* value of the right MPTP increased with the difference in bilateral knee ROM ( r  = 0.913, P  = 0.030). Conclusions In knees with limited ROM, MRI-R2* sequence is superior to T2 mapping in the detection of microstructural cartilage changes, which the medial knee compartment was more susceptible to. Cartilage R2* values tend to increase with the amount of knee ROM loss.

Study DesignMatched cohort study.PurposeTo compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids.Overview of LiteratureChronic opioid use is common among lumbar-spine surgery patients. The decision to undergo elective lumbar surgery is influenced by the expected surgery outcomes. However, the effects of opioids on patients’ expectations of lumbar surgery outcomes remain to be rigorously assessed.MethodsA total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0–100) based on the number of items expected and degree of improvement expected.ResultsThe mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “greater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003).ConclusionsPatient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users.

Background The relationship between the width of surgical margins and local and distant recurrence of colorectal liver metastases (CRLM) remain controversial. We analyzed the impact of surgical margins in laparoscopic liver resections (LLR) for CRLM, using the parenchymal-sparing approach on overall (OS) and recurrence-free survival (RFS). Methods From January 2005 to October 2012, 114 first LLR for CRLM were performed and retrospectively analyzed. The ultrasonic aspirator was used for parenchyma division. R1 margins were defined when the tissue width was <1 mm. Results After a mean follow-up of 30.9 ± 1.71 months, OS was 97.1–73.9–58.9 % and the RFS 64.2–35.2–31 % at 1–3–5 years, respectively. The major resection rate was 7 %. The median margin width was 3 (0–40) mm, and R1 resection was recorded in 14 (12.3 %) cases. Twenty-two patients (33.3 %) with hepatic recurrence underwent a repeat hepatectomy. R1 margins were significantly related to lower RFS survival ( p  = 0.038) but did not affect OS. Multivariate analysis showed that lesions located in postero-superior segments (HR = 2.4, 95 % CI 1.24–4.61, p  = 0.009) as well as blood loss (HR = 3.2, 95 % CI 1.23–7.99, p  = 0.012) were independent risk factors for tumor recurrence. The carcinoembryonic antigen level >10 mcg/L affected OS (HR = 4.2 95 % CI 2.02–16.9, p  = 0.001), and the resection of more than two tumors was significantly associated with R1 margins (HR = 9.32, 95 % CI 1.14–32.5, p  = 0.037). Discussion Laparoscopic parenchymal-sparing surgery of CRLM does not compromise the oncological outcome, allowing a higher percentage of repeat hepatectomy. R1 margins are a risk factor for tumor recurrence but not for overall survival. The presence of multiple lesions is the only independent risk factor of R1 margins and also the major disadvantage of this technique.

The Canadian Bleeding Disorders Registry (CBDR) captures data from 24 hemophilia treatment centers and patients directly. Nonacog beta pegol (N9‐GP) was approved in Canada in 2018. To assess treatment outcomes following switching to N9‐GP in a real‐world setting. CBDR data for Canadian male patients (aged 7–72 years) with hemophilia B receiving prophylactic N9‐GP for ≥6 months as of March 31, 2021, were included. To allow comparison with the previously used products, only patients for whom data were available in the CBDR for at least 6 months before the switch to N9‐GP were included in this retrospective analysis. Forty‐two patients were included in the analysis (total observation period: 148.0 patient‐years). The distribution of disease severity was 62% severe, 36% moderate, 2% mild, with 62% of patients previously receiving recombinant factor IX‐Fc‐fusion protein (rFIXFc) and 38% previously receiving standard half‐life (SHL) recombinant factor IX (rFIX). During a median follow‐up period of 2.3 years on N9‐GP prophylaxis, 232 bleeds were reported in 30 patients, 29% of patients reported zero bleeds. The median overall annualized bleeding rate on N9‐GP was 0.73 for patients switching from rFIXFc (previously 1.44) and 2.10 for patients switching from SHL rFIX (previously 6.06). Median total annualized factor consumption (IU/kg) was lower with N9‐GP than with previous SHL rFIX (2152 vs 3018) and previous rFIXFc (1766 vs 2278). Results from this first real‐world study of N9‐GP in patients with hemophilia B suggest optimal bleeding control with low factor consumption after switching to N9‐GP, irrespective of the previous product. [Display omitted]

To combat the high prevalence of physical inactivity among children, there is an urgent need to develop and implement real-world interventions and policies that promote physical activity (PA) and reduce sedentary behaviour (SB). To inform policy makers, the current body of evidence for children's PA/SB interventions needs to be translated. The current systematic review and meta-analysis aimed to identify modifiable determinants of device-measured PA and SB targeted in available intervention studies with randomized controlled trial (RCT) and controlled trial (CT) designs in children and early adolescents (5-12 years) and to quantify the effects of the interventions within their respective settings on the determinants of PA/SB and the outcomes PA and SB. A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, SPORTDiscus and CENTRAL. Studies were considered if they were randomized controlled trials (RCTs) or controlled trials (CTs), included children and/or early adolescents (5-12 years; henceforth termed children), measured PA and/or SB using device-based methods and measured PA and/or SB and determinants of PA/SB at least at two timepoints. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB2) for RCTs and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for CTs. The quality of the generated evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Robust Bayesian meta-analysis was conducted to quantify the effects of the interventions on the determinants of PA/SB, and the outcomes PA and SB, stratifying by study design, duration of PA/SB measurement, intervention setting and duration of follow-up measurement. Study characteristics and interventions were summarized. Thirty-eight studies were included with a total sample size of n = 14,258 (67% girls). Settings identified were school, family/home, community and combinations of these. The review identified 38 modifiable determinants, spanning seven categories on individual, interpersonal and physical environmental levels, with 66% of determinants on the individual level. Overall, the results indicated trivial-to-moderate effects of the interventions on the determinants of PA and SB, with mostly trivial level of evidence for the presence of an effect (as indicated by a small Bayes factor; BF  < 3.00). The exceptions were moderate effects on parental PA modelling in the family/home setting and SB measured during specific parts of the school day. Higher quality of evidence was found in the family/home setting compared with other settings. Overall, the results indicated that interventions have neither been effective in modifying the determinants of PA/SB, nor changing the PA/SB outcomes in children. In general, the approach in the current review revealed the breadth of methodological variability in children's PA interventions. Research is needed to address novel approaches to children's PA research and to identify potential determinants to inform policy and future interventions. International prospective register of systematic reviews (PROSPERO): CRD42021282874.

The identification of light stress is crucial for light control in plant factories. Image-based lighting classification of leafy vegetables has exhibited remarkable performance with high convenience and economy. Convolutional Neural Network (CNN) has been widely used for crop image analysis because of its architecture, high accuracy and efficiency. Among them, large intra-class differences and small inter-class differences are important factors affecting crop identification and a critical challenge for fine-grained classification tasks based on CNN. To address this problem, we took the Lettuce (Lactuca sativa L.) widely grown in plant factories as the research object and constructed a leaf image set containing four stress levels. Then a light stress grading model combined with classic pre-trained CNN and Triplet loss function is constructed, which is named Tr-CNN. The model uses the Triplet loss function to constrain the distance of images in the feature space, which can reduce the Euclidean distance of the samples from the same class and increase the heterogeneous Euclidean distance. Multiple sets of experimental results indicate that the model proposed in this paper (Tr-CNN) has obvious advantages in light stress grading dataset and generalized dataset.

Background To combat the high prevalence of physical inactivity among children, there is an urgent need to develop and implement real-world interventions and policies that promote physical activity (PA) and reduce sedentary behaviour (SB). To inform policy makers, the current body of evidence for children’s PA/SB interventions needs to be translated. Objectives The current systematic review and meta-analysis aimed to identify modifiable determinants of device-measured PA and SB targeted in available intervention studies with randomized controlled trial (RCT) and controlled trial (CT) designs in children and early adolescents (5–12 years) and to quantify the effects of the interventions within their respective settings on the determinants of PA/SB and the outcomes PA and SB. Methods A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, SPORTDiscus and CENTRAL. Studies were considered if they were randomized controlled trials (RCTs) or controlled trials (CTs), included children and/or early adolescents (5–12 years; henceforth termed children), measured PA and/or SB using device-based methods and measured PA and/or SB and determinants of PA/SB at least at two timepoints. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB2) for RCTs and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for CTs. The quality of the generated evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Robust Bayesian meta-analysis was conducted to quantify the effects of the interventions on the determinants of PA/SB, and the outcomes PA and SB, stratifying by study design, duration of PA/SB measurement, intervention setting and duration of follow-up measurement. Study characteristics and interventions were summarized. Results Thirty-eight studies were included with a total sample size of n  = 14,258 (67% girls). Settings identified were school, family/home, community and combinations of these. The review identified 38 modifiable determinants, spanning seven categories on individual, interpersonal and physical environmental levels, with 66% of determinants on the individual level. Overall, the results indicated trivial-to-moderate effects of the interventions on the determinants of PA and SB, with mostly trivial level of evidence for the presence of an effect (as indicated by a small Bayes factor; BF 10  < 3.00). The exceptions were moderate effects on parental PA modelling in the family/home setting and SB measured during specific parts of the school day. Higher quality of evidence was found in the family/home setting compared with other settings. Discussion Overall, the results indicated that interventions have neither been effective in modifying the determinants of PA/SB, nor changing the PA/SB outcomes in children. In general, the approach in the current review revealed the breadth of methodological variability in children’s PA interventions. Research is needed to address novel approaches to children’s PA research and to identify potential determinants to inform policy and future interventions. Registration International prospective register of systematic reviews (PROSPERO): CRD42021282874.

Abstract People with depression often present with co-existing somatic conditions, which impact survival and steer patients’ clinical management. This study aimed to identify unique patterns of somatic comorbidity in people with depression and examine their associated mortality. We used population-based electronic health records from the Clinical Data Analysis and Reporting System in Hong Kong. People aged 40+ who had an incident depression diagnosis between 2001 and 2015 were included and followed up until 31 December 2018. Latent class analysis was applied, separately by decades, to individuals with depression and at least one comorbid somatic condition. Cox proportional hazard models were used to examine the risk of mortality associated with specific comorbidity patterns, adjusting for sociodemographic and clinical characteristics. We identified 38,889 eligible individuals (mean age: 62.8; 68.7% women). Latent class analysis identified an increasing number of patterns with age (two to seven). Compared with the unspecific pattern, the following patterns were associated with the highest mortality risk in different age groups: cardiometabolic and cerebrovascular diseases in individuals aged 40-49 (hazard ratio [HR] 2.5 [95% CI 1.7-3.7]), cardiometabolic diseases and anemia in those aged 50-59 (HR 3.4 [2.6-4.5]) and 70-79 (2.7 [2.3-3.3]), cardiometabolic, cerebrovascular diseases, and anemia in those aged 60-69 (HR 2.5 [2.0-3.2]), and cardiorespiratory disease in those aged 80+ (HR 2.0 [1.8-2.3]). Specific somatic comorbidity patterns were independently and substantially associated with the risk of mortality. This highlights the importance of taking combinations of somatic conditions into account when tailoring the clinical and care approach to people with depression.