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Background The inability of users to directly and intuitively control their state-of-the-art commercial prosthesis contributes to a low device acceptance rate. Since Electromyography (EMG)-based control has the potential to address those inabilities, research has flourished on investigating its incorporation in microprocessor-controlled lower limb prostheses (MLLPs). However, despite the proposed benefits of doing so, there is no clear explanation regarding the absence of a commercial product, in contrast to their upper limb counterparts. Objective and methodologies This manuscript aims to provide a comparative overview of EMG-driven control methods for MLLPs, to identify their prospects and limitations, and to formulate suggestions on future research and development. This is done by systematically reviewing academical studies on EMG MLLPs. In particular, this review is structured by considering four major topics: (1) type of neuro-control, which discusses methods that allow the nervous system to control prosthetic devices through the muscles; (2) type of EMG-driven controllers, which defines the different classes of EMG controllers proposed in the literature; (3) type of neural input and processing, which describes how EMG-driven controllers are implemented; (4) type of performance assessment, which reports the performance of the current state of the art controllers. Results and conclusions The obtained results show that the lack of quantitative and standardized measures hinders the possibility to analytically compare the performances of different EMG-driven controllers. In relation to this issue, the real efficacy of EMG-driven controllers for MLLPs have yet to be validated. Nevertheless, in anticipation of the development of a standardized approach for validating EMG MLLPs, the literature suggests that combining multiple neuro-controller types has the potential to develop a more seamless and reliable EMG-driven control. This solution has the promise to retain the high performance of the currently employed non-EMG-driven controllers for rhythmic activities such as walking, whilst improving the performance of volitional activities such as task switching or non-repetitive movements. Although EMG-driven controllers suffer from many drawbacks, such as high sensitivity to noise, recent progress in invasive neural interfaces for prosthetic control (bionics) will allow to build a more reliable connection between the user and the MLLPs. Therefore, advancements in powered MLLPs with integrated EMG-driven control have the potential to strongly reduce the effects of psychosomatic conditions and musculoskeletal degenerative pathologies that are currently affecting lower limb amputees.

In this work, the reducing action of four reducing agents—ascorbic acid, inorganic salt, sodium hydrosulfite and polysaccharide—was investigated. Some reducing agents, in addition to being environmentally friendly, are good substitutes for dangerous chemicals used industrially. Graphene oxide (GO) was synthesized by the modified Hummers method and was reduced with ascorbic acid (RGO-AA), inorganic salt (RGO-SI), sodium hydrosulfite (RGO-HS) and polysaccharide (RGO-PS). The microstructural, morphological, optical, electrochemical and thermal properties of GO, RGO-AA, RGO-SI, RGO-HS and RGO-PS were characterized by x-ray diffraction (XRD), Raman spectroscopy, Fourier transform infrared spectroscopy/attenuated total reflectance (FTIR-ATR), x-ray photoelectron spectroscopy (XPS), high-resolution transmission electron microscopy (HRTEM)/energy-dispersive x-ray spectroscopy (EDS), field-emission scanning electron microscopy (FEG-SEM), UV–Vis, zeta potential, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The conclusive results showed that the four agents demonstrated reducing capability. It was observed that the reducing agent derived from inverted sugar (polysaccharide) was the most efficient because it presented a reduction in GO with fewer microstructural defects, a lower number of sheets, and electrochemical and thermal properties superior to the properties obtained from conventional reducing agents. Therefore, with these impressive results obtained with polysaccharide, it was concluded that an effective GO reducing agent was obtained using this green and ecological product, resulting in a reduced graphene oxide (RGO) with few sheets and fewer defects and, consequently, with greater supercapacitor application potential.

The interactions between tumor and immune cells along the course of breast cancer progression remain largely unknown. Here, we extensively characterize multiple sequential and parallel multiregion tumor and blood specimens of an index patient and a cohort of metastatic triple-negative breast cancers. We demonstrate that a continuous increase in tumor genomic heterogeneity and distinct molecular clocks correlated with resistance to treatment, eventually allowing tumors to escape from immune control. TCR repertoire loses diversity over time, leading to convergent evolution as breast cancer progresses. Although mixed populations of effector memory and cytotoxic single T cells coexist in the peripheral blood, defects in the antigen presentation machinery coupled with subdued T cell recruitment into metastases are observed, indicating a potent immune avoidance microenvironment not compatible with an effective antitumor response in lethal metastatic disease. Our results demonstrate that the immune responses against cancer are not static, but rather follow dynamic processes that match cancer genomic progression, illustrating the complex nature of tumor and immune cell interactions. Immune response during breast cancer progression remains to be explored. Here, the characterisation of sequential and parallel multiregion samples of an index patient and a cohort of metastatic triple-negative breast cancers reveals convergent immune evasion mechanisms and an increase in tumor genomic heterogeneity.

The use of β-blockers is mandatory for counteracting heart failure (HF)-induced chronic sympathetic hyperactivity, cardiac dysfunction and remodeling. Importantly, aerobic exercise training, an efficient nonpharmacological therapy to HF, also counteracts sympathetic hyperactivity in HF and improves exercise tolerance and cardiac contractility; the latter associated with changes in cardiac Ca(2+) handling. This study was undertaken to test whether combined β-blocker and aerobic exercise training would integrate the beneficial effects of isolated therapies on cardiac structure, contractility and cardiomyocyte Ca(2+) handling in a genetic model of sympathetic hyperactivity-induced HF (α2A/α2C- adrenergic receptor knockout mice, KO). We used a cohort of 5-7 mo male wild-type (WT) and congenic mice (KO) with C57Bl6/J genetic background randomly assigned into 5 groups: control (WT), saline-treated KO (KOS), exercise trained KO (KOT), carvedilol-treated KO (KOC) and, combined carvedilol-treated and exercise-trained KO (KOCT). Isolated and combined therapies reduced mortality compared with KOS mice. Both KOT and KOCT groups had increased exercise tolerance, while groups receiving carvedilol had increased left ventricular fractional shortening and reduced cardiac collagen volume fraction compared with KOS group. Cellular data confirmed that cardiomyocytes from KOS mice displayed abnormal Ca(2+) handling. KOT group had increased intracellular peak of Ca(2+) transient and reduced diastolic Ca(2+) decay compared with KOS group, while KOC had increased Ca(2+) decay compared with KOS group. Notably, combined therapies re-established cardiomyocyte Ca(2+) transient paralleled by increased SERCA2 expression and SERCA2:PLN ratio toward WT levels. Aerobic exercise trained increased the phosphorylation of PLN at Ser(16) and Thr(17) residues in both KOT and KOCT groups, but carvedilol treatment reduced lipid peroxidation in KOC and KOCT groups compared with KOS group. The present findings provide evidence that the combination of carvedilol and aerobic exercise training therapies lead to a better integrative outcome than carvedilol or exercise training used in isolation.

COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1–10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2–6.5), breathing difficulty OR: 3.4 (CI95%: 1.4–8.2), vomiting OR: 3.3 (CI95%: 1.4–7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9–16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.

Sugarcane (Saccharum spp.) is the most promising crop for renewable energy. Among the diverse stresses that affect plant productivity, drought stress frequently causes losses in sugarcane fields. Although several studies have addressed plant responses to drought using controlled environments, plant responses under field conditions are largely unknown. Recently, microRNA (miRNA)-mediated post-transcriptional regulation has been described as an important and decisive component in vegetal development and stress resistance modulation. The role of miRNAs in sugarcane responses to drought under field conditions is currently not known. Two sugarcane cultivars differing in drought tolerance were grown in the field with and without irrigation (rainfed) for 7 months. By using small RNA deep sequencing, we were able to identify 18 miRNA families comprising 30 mature miRNA sequences. Among these families, we found 13 mature miRNAs that were differentially expressed in drought-stressed plants. Seven miRNAs were differentially expressed in both cultivars. The target genes for many of the differentially expressed mature miRNAs were predicted, and some of them were validated by quantitative reverse transcription PCR. Among the targets, we found transcription factors, transporters, proteins associated with senescence, and proteins involved with flower development. All of these data increase our understanding of the role of miRNAs in the complex regulation of drought stress in field-grown sugarcane, providing valuable tools to develop new sugarcane cultivars tolerant to drought stress.

During the COVID-19 pandemic, fungal infections, especially pulmonary aspergillosis, mucormycosis, and invasive candidiasis, have emerged as a significant health concern. Beyond Candida albicans, the most common cause of invasive candidiasis, other rare ascomycetous yeast species have been described in tertiary care units, potentially posing a broader health threat. We have isolated, from September 2020 to June 2021, nine Diutina catenulata strains from urine samples of six patients. This was intriguing as this fungus had not been previously identified in our institution, nor after June 2021. Therefore, we decided to outline the clinical features of the patients with this rare pathogen, to describe phenotypic characteristics, including antifungal susceptibility profiles, of this yeast species and to identify the genetic makeup through whole-genome sequencing analysis to evaluate if this was a cluster of genetically similar D. catenulata isolates in our institution. The strains were identified through MALDI-TOF MS analyses and Sanger sequencing of two rDNA regions. All patients yielding D. catenulata from urine samples needed ventilator support and used urinary catheters during hospitalization for treatment of COVID-19. None of them had received COVID-19 vaccines. Morphological and biochemical profiles of the nine strains were largely consistent, although fluconazole susceptibility varied, ranging from 4 to 32 μg/mL. Phylogenomic analysis revealed minimal genetic variation among the isolates, with low intrapopulation variation, supported by the identification of only 84 SNPs across all strains. Therefore, we propose that the yeast strains isolated were part of a cluster of D. catenulata funguria in the context of COVID-19.

Myocardial injury (MI), defined by troponin elevation, has been associated with increased mortality and adverse outcomes in patients with coronavirus disease 2019 (COVID-19), but the role of this biomarker as a risk predictor remains unclear. Data from adult patients hospitalized with COVID-19 were recorded prospectively. A multiple logistic regression model was used to quantify associations of all variables with in-hospital mortality, including the calculation of odds ratios (ORs) and confidence intervals (CI). Troponin measurement was performed in 1476 of 4628 included patients, and MI was detected in 353 patients, with a prevalence of 23.9%; [95% CI, 21.8–26.1%]. The total in-hospital mortality rate was 10.9% [95% CI, 9.8–12.0%]. The mortality was much higher among patients with MI than among those without MI, with a prevalence of 22.7% [95% CI, 18.5–27.3%] vs. 5.5% [95% CI, 4.3–7.0%] and increased with each troponin level. After adjustment for age and comorbidities, the model revealed that the mortality risk was greater for patients with MI [OR = 2.99; 95% CI, 2.06–4.36%], and for those who did not undergo troponin measurement [OR = 2.2; 95% CI, 1.62–2.97%], compared to those without MI. Our data support the role of troponin as an important risk predictor for these patients, capable of discriminating between those with a low or increased mortality rate. In addition, our findings suggest that this biomarker has a remarkable negative predictive value in COVID-19.

Abstract Aim Urbanization leads to rapid changes in ecosystem structure and function. Wetlands on university campuses under urbanization pressure could be used as case studies of multidisciplinary aquatic research and good environmental practices promoting sustainability. Methods A paleolimnological study was undertaken in a semi-artificial lake on a university campus in southern Brazil to trace historical impacts and ecological changes back to the mid-1970s through complementary approaches: historical data, nutrients, δ13C and δ15N stable isotopes, diatoms, microplastics and associated microbial community analysis. Results The eutrophication process started to intensify after the lake was used for nocturnal roosting by waterbirds, and especially after the establishment of constructions along the margins with septic tank sanitary sewage, which eventually spilled and leached into the lake. Over decades, we identified a limnological hypertrophication process leading to recurrent cyanobacterial blooms and massive macrophyte proliferation coupled with changes in isotopic ratios and algal occupation with several transitions between shallow lake alternative states. Such a limnological process has resembled the paleolimnological eutrophication trends and isotopic changes in sedimentary organic matter. The microplastic deposition was detected as a proxy for the intensification of urbanization, especially during the construction of the University facilities. Conclusions The combined use of paleolimnological and historical limnological data represents a powerful approach for inferring both natural and cultural impacts on the lake, and identifying management strategies based on such scientific information. Resumo Objetivo A urbanização leva a mudanças rápidas na estrutura e função do ecossistema. Terras úmidas em câmpus universitários sujeitos ao desenvolvimento da urbanização podem ser usados como estudos de caso de pesquisa aquática multidisciplinar e boas práticas ambientais que promovam a sustentabilidade. Métodos Foi realizado um estudo paleolimnológico em um lago semiartificial em um campus universitário no sul do Brasil para inferir impactos históricos e mudanças ecológicas desde a década de 1970 por meio de abordagens complementares: dados históricos, nutrientes, isótopos estáveis δ13C e δ15N, diatomáceas, microplásticos e análise da comunidade microbiana associada. Resultados O processo de eutrofização começou a se intensificar após o uso noturno por aves aquáticas de árvores como poleiros, e especialmente após o estabelecimento de construções ao longo das margens com fossa séptica de esgoto sanitário, que ocasionalmente transbordava e carreava material para o lago. Ao longo de décadas, identificamos um processo limnológico de hipertrofização que induziu a florações recorrentes de cianobactérias e proliferação maciça de macrófitas, juntamente com mudanças isotópicas e ocupação de algas com várias transições entre estados alternativos de lagos rasos. Tal processo limnológico foi claramente espelhado nas tendências de eutrofização paleolimnológica e mudanças isotópicas da matéria orgânica sedimentar. A deposição de microplásticos foi detectada como proxy para a intensificação da urbanização especialmente durante a construção das instalações da Universidade. Conclusões O uso combinado de dados paleolimnológicos e limnológicos históricos representa uma abordagem poderosa para identificar os impactos naturais e culturais no lago e identificar estratégias de manejo baseadas em tais informações científicas.