Initial Results Research Articles

Curso de Especialização em Direito Sanitário: uma formação necessária

The review presents the work 'Specialization Course in Health Law – EAD: A Virtual Journey of Reflections and Knowledge,' the result of an important pedagogical initiative developed in the field of Health Law, which made the outcome of this work available to the general public. The book, available electronically and free of charge, stimulates critical thinking and contributes to the consolidation of knowledge on relevant health issues. Submission: 09/12/24| Review: 09/12/24| Approval: 09/12/24

Hagnýting menntunar meðal háskólamenntaðs starfsfólks einkarekinna fyrirtækja og opinberra stofnana

Markmið greinarinnar er að kanna hvort munur sé á hagnýtingu þekkingar meðal háskólamenntaðs fólks sem vinnur annars vegar í einkareknum fyrirtækjum og í opinberum stofnunum hins vegar. Úrtak rannsóknarinnar byggðist á tilviljunarúrtaki úr þjóðskrá sem Þjóðmálakönnun Félagsvísindastofnunar Háskóla Íslands framkvæmdi 9. mars til 9. apríl 2016. Könnunin náði til 2.001 einstaklings á aldrinum 18 ára og eldri á landinu öllu og svöruðu 1.210 þeirra könnuninni. Í þessari rannsókn var aðeins litið til þeirra þátttakenda í úrtakinu sem höfðu lokið háskólanámi og voru í launaðri vinnu á Íslandi hjá hinu opinbera eða í einkafyrirtæki. Eftir hreinsun gagna voru þátttakendur 374, þar af voru 178 karlar og 196 konur. Niðurstöður rannsóknar sýndu að 20,3% þátttakenda voru ofmenntuð. Meirihluti kvenna vinnur hjá hinu opinbera en meirihluti karla hjá einkafyrirtækjum. Vanmenntaðir starfsmenn eru líklegri til að starfa hjá hinu opinbera á meðan ofmenntaðir eru líklegri til að starfa hjá einkafyrirtækjum (sá munur skýrist af van- eða ofmenntun kvenna). Hjá opinberum fyrirtækjum starfa frekar þeir sem lokið hafa námi á sviði mennta- og heilbrigðisvísinda meðan starfsfólk af verk- og náttúruvísindasviði er helst hjá einkafyrirtækjum. Laun eru hærri hjá einkafyrirtækjum.

Pengaruh Budaya Religius Terhadap Kecerdasan Spiritual Peserta Didik Di SD Negeri 2 Cihaur

Culture is the result of human work, creativity and initiative that can be accepted by society, or a certain community, and carried out consciously without coercion in everyday life, and taught to the next generation simultaneously. Religious is a student's way of thinking and behaving based on religious values. Spiritual intelligence is intelligence that comes from within us and is associated with knowledge that exists outside our ego or conscious soul. Based on the problem formulation, the aim of this research is first, to find out whether there is an influence of religious culture on the spiritual intelligence of students at SD Negeri 2 Cihaur. second, to find out how religious culture influences the spiritual intelligence of students at SD Negeri 2 Cihaur. This type of research uses a quantitative approach with survey methods. The research results show that religious culture has a significant effect on students' spiritual intelligence. This is proven based on the results of analysis using tests in the form of questionnaires, calculations carried out using the Pearson product moment correlation test to determine the sig value. 0.008 < 0.05, then H0 is rejected and Ha is accepted, so the researcher concludes that there is an influence of religious culture on the spiritual intelligence of students at SD Negeri 2 Cihaur.

OBSERVE: guidelines for the refinement of rodent cancer models.

Existing guidelines on the preparation (Planning Research and Experimental Procedures on Animals: Recommendations for Excellence (PREPARE)) and reporting (Animal Research: Reporting of In Vivo Experiments (ARRIVE)) of animal experiments do not provide a clear and standardized approach for refinement during in vivo cancer studies, resulting in the publication of generic methodological sections that poorly reflect the attempts made at accurately monitoring different pathologies. Compliance with the 3Rs guidelines has mainly focused on reduction and replacement; however, refinement has been harder to implement. The Oncology Best-practices: Signs, Endpoints and Refinements for in Vivo Experiments (OBSERVE) guidelines are the result of a European initiative supported by EurOPDX and INFRAFRONTIER, and aim to facilitate the refinement of studies using in vivo cancer models by offering robust and practical recommendations on approaches to research scientists and animal care staff. We listed cancer-specific clinical signs as a reference point and from there developed sets of guidelines for a wide variety of rodent models, including genetically engineered models and patient derived xenografts. In this Consensus Statement, we systematically and comprehensively address refinement and monitoring approaches during the design and execution of murine cancer studies. We elaborate on the appropriate preparation of tumor-initiating biologicals and the refinement of tumor-implantation methods. We describe the clinical signs to monitor associated with tumor growth, the appropriate follow-up of animals tailored to varying clinical signs and humane endpoints, and an overview of severity assessment in relation to clinical signs, implantation method and tumor characteristics. The guidelines provide oncology researchers clear and robust guidance for the refinement of in vivo cancer models.

EVALUATION OF THE RESULTS OF ESG PROJECT IMPLEMENTATION

The article explores the issue of evaluating the outcomes of implementing ESG (Environmental, Social, and Governance) projects across various economic sectors. It analyzes the main problems organizations face when implementing ESG initiatives, including inadequate methodological approaches to performance evaluation and the diversity of standards. The primary aspects of ESG projects' impact on environmental, social, and economic development are characterized. A comprehensive methodology for assessing the results of ESG initiatives has been developed, considering key performance indicators (KPIs) across different areas of activity. Recommendations are proposed to improve the efficiency of ESG project implementation, contributing to the sustainable development of enterprises. The study delves into the various challenges that organizations encounter, such as high implementation costs, resistance to change within the organization, and the lack of necessary experience and expertise. Additionally, it addresses the uncertainty regarding the impact of ESG projects on companies' financial performance. By calculating a composite ESG index for agro-industrial enterprises in Ukraine, the research allows for comparing the effectiveness of ESG project implementation and identifying leaders and laggards in the field of sustainable development. The study also underscores the role of independent experts in conducting external audits of results and obtaining certification from recognized organizations to confirm compliance with ESG standards. Continuous improvement of ESG projects involves implementing mechanisms for regular monitoring and updating goals and KPIs in response to changes in the external environment and internal processes. The practical implications of this research are significant for business leaders, investors, policymakers, and all stakeholders aiming to enhance responsibility and sustainability in their operations. The insights provided in this article can help organizations improve the added value created by ESG projects and identify steps necessary to achieve maximum results.

A novel intrasaccular aneurysm device with high complete occlusion rate: initial results in a rabbit model

BackgroundIntrasaccular flow-disrupting devices are a safe and effective treatment strategy for intracranial aneurysms. We utilized high-frequency optical coherence tomography (HF-OCT) and digital subtraction angiography (DSA) to evaluate SEAL Arc, a...

Explainable Detection of Fake News on Social Media Using Pyramidal Co-Attention Network

In today’s world, fake news on social media is a universal trend and has severe consequences. There has been a wide variety of countermeasures developed to offset the effect and propagation of Fake News. The most common are linguistic-based techniques, which mostly use deep learning (DL) and natural language processing (NLP). Even government-sponsored organizations spread fake news as a cyberwar strategy. In literature, computational-based detection of fake news has been investigated to minimize it. The initial results of these studies are good but not significant. However, we argue that the explainability of such detection, particularly why a certain news item is detected as fake, is a vital missing element of the studies. In real-world settings, the explainability of the system’s decisions is just as important as its accuracy. This article explores explainable fake news detection and proposes a sentence-comment-based co-attention sub-network model. The proposed model uses user comments and news contents to mutually apprehend top- <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$k$</tex-math> </inline-formula> explainable check-worthy user comments and sentences for detecting fake news. The experimental result on real-world datasets shows that our proposed model outperforms state-of-the-art techniques by 5.56% in the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$F$</tex-math> </inline-formula> 1 score. In addition, our model outperforms other baselines by 16.4% in normalized cumulative gain (NDCG) and 22.1% in Precision in identifying top- <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$k$</tex-math> </inline-formula> comments from users, which indicates why a news article can be fake.

In vitro micropropagation and mass multiplication of Stevia rebaudiana Bertoni

Stevia rebaudiana Bertoni, an ancient perennial herb produces steviol glycosides including stevioside and rebaudioside-A that are valuable as low calorie sweeteners, about 300-400 times sweeter than saccharose. Conventional propagation methods are not produce adequate planting material. Micro propagation is an imperative technology that could be extensively exploited to meet the growing demands of elite planting material for commercially cultivated. The prime objective of this study was to established standard protocol for in vitro regeneration and mass multiplication in Stevia. In present investigation, different concentrations of Auxin and Cytokinin were tried for optimization of shoot initiation, shoot multiplication, root initiation and callus induction of Stevia from different explant. BAP and IBA (1.0+0.5) mg/l, IBA (2.0) mg/l shows promising results of shoot multiplication and root initiation respectively.

Gendered Realities: Reforming Juvenile Justice in India

For the past few decades, the juvenile justice system in India has shifted from a rehabilitative to a retributive paradigm, leading researchers to become increasingly interested in the gendered implications of paradigm change that may exacerbate problems of young offenders, especially females. The current article explores the question of how social attitudes, institutional prejudices, and intersectional identities affect the ways in which female offenders are perceived and treated in India. The framework for the current study includes theoretical concepts of rehabilitation, retribution, and feminist theory. The use of secondary analysis and the description of policy changes and historical context studies are included in the research. Employing a data-driven analysis based on a combination of case studies, quantitative data, and inter-state comparison, the research reveals that female offenders face systemicinstitutional and individual problems, including re-victimization, trauma, and inadequate access to quality rehabilitation services. This article argues for genderresponsive and intersectional juvenile justice policies and redirects attention to rehabilitation available results for future policy and research initiatives

Mental Health and Behavior of Teenagers Who Come from Broken Home Families

In this life, humans from birth until now always experience changes, both physically and mentally, both negative and positive changes. These changes are nothing but the result of human work, creativity and initiative which always develops and progresses over time. In broken households, some teenagers often experience mental depression (mental pressure), so that teenagers are not comfortable living in their families, which usually has an impact on teenagers' poor social behavior or giving rise to various forms of delinquency, Not all teenagers can go through their development process and develop well, if there is no full support from internal and external factors that influence their development. A large number of teenagers experience failure in achieving their developmental tasks, one of which is falling into juvenile delinquent behavior. This research uses a library research approach, in the form of research with objects in the form of library works, especially scientific journals, books, articles and information obtained via the internet. And from the results of the research, it was found that teenagers who experienced broken homes had a damaged mentality and experienced forms of bad behavior and various forms of delinquency that they committed. And this research also aims to describe the forms of mental health and delinquency in adolescents in broken home families.

Telemedicine-Enhanced Lung Cancer Screening Using Mobile Computed Tomography Unit with Remote Artificial Intelligence Assistance in Underserved Communities: Initial Results of a Population Cohort Study in Western China.

Introduction: Lung cancer is a leading cause of cancer deaths globally. Despite favorable recommendations, low-dose computed tomography (LDCT) lung screening adoption remains low in China. Barriers such as limited infrastructure, costs, distance, and personnel shortages restrict screening access in disadvantaged regions. We initiated a telemedicine-enabled lung cancer screening (LCS) program in a medical consortium to serve people at risk in underserved communities. The objective of this study was to describe the implementation and initial results of the program. Methods: From 2020 to 2021, individuals aged 40-80 years were invited to take LCS by mobile computed tomography (CT) units in three underserved areas in Western China. Numerous CT scans were remotely reported by radiologists aided by artificial intelligence (AI) diagnostic systems. Abnormal cases were tracked through an integrated hospital network for follow-up. A retrospective cohort study documented participant demographics, health history, LDCT results, and outcomes. Descriptive analysis was conducted to report baseline characteristics and first-year follow-up results. Results: Of the 28,728 individuals registered in the program, 19,517 (67.94%) participated in the screening. The study identified 2.68% of participants with high-risk pulmonary nodules and diagnosed 0.55% with lung cancer after a 1-year follow-up. The majority of high-risk participants received timely treatment in hospitals. Conclusions: This study demonstrated mobile CT units with remote AI assistance improved access to LCS in underserved areas, with high participation and early detection rates. Our implementation supports the feasibility of deploying telemedicine-enabled LCS to increase access to a large scale of basic radiology and diagnostic services in resource-limited settings. Clinical Trial Registration Number: ChiCTR1900024623.

Hybrid Machine Learning Approach for Mosquito Species Classification Using Wingbeat Analysis

Effective and precise techniques for mosquito species identification are required as mosquito-borne illnesses continue to pose serious threats to public health across the world. We provide a new hybrid machine-learning technique in this research work for the classification of mosquito species through the Wingbeat analysis. It analyzes the wingbeat of the mosquito species based on which it can identify the mosquito species. This method makes use of deep learning techniques. The hybrid technique attempts to provide robust and dependable classification performance by utilizing a wide range of machine learning methods, such as k-Nearest Neighbors (KNN), Random Forest, Multi-layer Perceptron (MLP), Support Vector Machines (SVM), and Gradient Boosting. To improve feature extraction and normalization, we apply a rigorous set of preprocessing techniques to a large dataset that includes wingbeat recordings from many mosquito species. By means of comprehensive testing and analysis, we prove that our method is effective in correctly detecting mosquito species, exhibiting better results than using separate machine learning algorithms. Our findings demonstrate how deep learning methods may support more conventional machine learning strategies in problems involving the categorization of mosquito species. We also address the implications of our results for ecological research and disease management initiatives, highlighting the significance of precise species identification in vector monitoring and epidemiological investigations.

Applying an Academic Literacies Lens to the Scholarship of Teaching and Learning (SoTL): A Scoping Review

Scholarship of teaching and learning (SoTL) is central to improving teaching, enhancing students’ learning experiences and ensuring practice is evidence-based. This study explores the insights gained by applying an academic literacies lens to the results of professional development initiatives (programmes, schemes, etc.,) designed to enhance features of faculty colleagues’ SoTL skills. A scoping review was conducted on Journal of University Teaching and Learning Practice (JUTLP) papers published from 2004-2023. Developing teaching practice is a central theme of JUTLP and the papers published across this timeframe provide a rich source from which to explore initial insights as a first step to potentially deeper explorations. The review identified four themes emerging from the qualitative data captured across the review sample: meaning-making together; journey of becoming; flattening of power; and context-specific identities. The analysis points to reasons why collaborative meaning-making opportunities are so valued within professional development initiatives. The academic literacies lens highlights issues of discourse, power, epistemology and identity, and consequently illuminates these collaborative moments as spaces that provide a knowledge and identity-based anchor for colleagues. This lens also stresses the destabilising and emotive nature of ‘becoming’ a pedagogic scholar. Implications of the findings are considered from an academic development perspective. Discussion centres particularly on how academic developers may work to support rather than jeopardise colleagues’ future SoTL trajectories.

Communication as a Key Performance Indicator in Employer Branding in the Context of the Social Economy-A Quantitative Study.

Performance measurement refers to the systematic evaluation and analysis of the performance and results of business processes, initiatives, or strategies. This study discusses the crucial role of communication using signaling theory in employer branding in the context of the social economy organization (SEO). The aim is to measure employee satisfaction in concrete terms and to determine the status quo of the communication culture of the organization under investigation in order to develop an employer branding strategy based on the results. The authors use an employee survey as a quantitative research method and limit the data collection to the EU member state of Germany considering the research background. The results provide insights into the specific communication policy in relation to employer branding. The focus here is on (digital) communication. Organizations need to understand how communication strategies directly influence the perception of the employer brand in the social economy. Furthermore, practical implications are derived in order to increase employer attractiveness. Concrete recommendations of action for SEOs should help them be successful in the competition for qualified specialists and talent.

The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review.

This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5-18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations.

Innovative approaches to the formation of a health-saving lifestyle of students under martial law in Ukraine

The purpose of the study was to identify and analyses innovative approaches to the formation of a healthier lifestyle among students in the context of martial law in Ukraine. To achieve this goal, a comprehensive approach was used, including an analysis of scientific literature, surveys and interviews with representatives of the student audience, as well as observation of the results of various programmes and initiatives aimed at promoting a healthy lifestyle. The study found that students are aware of the importance of a healthy lifestyle, but often face a number of obstacles, such as lack of free time, poor motivation, and limited access to sports grounds. Particular attention was paid to the impact of martial law on students' mental and physical health. It was found that the threat during martial law leads to stress and anxiety among students and life-threatening situations, which makes it difficult to maintain their health. The scientific novelty of the study is to identify the problem of forming a health-saving lifestyle among students during martial law and to propose innovative approaches to its solution. In particular, important results are the developed ideas for creating online resources for physical activity, conducting virtual training and promoting a healthy lifestyle through educational activities. The general conclusions of the study confirm the need to introduce innovative programmes to promote a healthy lifestyle among students under martial law. The proposed approaches can contribute to improving the physical and mental well-being of students by providing them with the necessary knowledge and resources to maintain their health. The successful implementation of these programmes requires support from the management of higher education institutions, as well as advanced training of teaching staff in the field of health-saving lifestyle and the level of digital competence in professional activities.

Tele-Urology in the Era of COVID-19: an Experience of the Reconstructive Urology Department in Iran.

The outbreak of coronavirus has put additional pressure on the health care systems of many countries; but telemedicine can be an important way to deal with it, especially for people whose health has been affected by the virus. The present study aims to investigate the Implementation of a Tele-urology Program for Reconstructive Urologic Referrals: Initial Results and Patient Satisfaction. All patients with a history of a urethral reconstructive surgery during last year was entered to our study and two nurses collected data of demographic and past medical history of patients by existed. Telephone visits:Fellowship of reconstructive urology was connected to patients during a phone call and filled the USS-PROM and COVID-19 questionnaires. Face to face visits: All patients were asked to answer the questionnaire about recent exposure and infection by corona virus, recent travel and other risk factors of COVID-19. Mean of USSPROM scale was calculated as 1.65 (+2.91) with a range of 0-15. Based on categorization for USSPROM scale, 74 patients (94.8%) had mild symptoms while 4 patients (5.1%) had moderate symptoms and needed further medical attention. Four patients with moderate USSPROM score were required to cystoscopic evaluation, which one patient with moderate USSPROM score had severe stricture and candidate for redo urethroplasty. Two other patients need for urethral stricture dilatation. Cost was calculated based on taxi-service fee. Accordingly, the average (+SD) cost for in-person visits to the physician was estimated as 4.80 + 4.32 million Rials. In terms of distance, the average distance for receiving medical services according to the patient`s residence area was 373.2 +348.79 kilometres.In terms of the patient`s opinion regarding virtual examination, inappropriateness of virtual visits for physical examination, and patient`s inability to explain the problem correctly, patient`s condition at the time of the virtual visit were the main challenges reported by the respondent. Considering that the present COVID-19 emergency will likely last for months, telehealth could be the safest way to deliver urological care for a large percentage of the patients, such as those who are more at risk of unfavorable outcomes of COVID-19.

Enhancing transition outcomes: A toolkit to facilitate data-driven pre-employment transition services

BACKGROUND: The Rehabilitation Act, as amended in the Workforce Innovation and Opportunity Act of 2014 (WIOA), highlights the need to improve outcomes for transition-age students and youth with disabilities. The amendments require state vocational rehabilitation agencies to allocate 15% of their federal funding to provide pre-employment transition services (Pre-ETS) to an expanded population of transition-age students and youth with disabilities. Rapid implementation of this mandate required state vocational rehabilitation agencies to begin offering the five required Pre-ETS before mechanisms for monitoring and improvement could be created and field-tested. Nearly a decade since the passage of WIOA, many states are still without practical mechanisms for evaluating Pre-ETS despite increasing emphasis on using evidence-based practices in public programs. OBJECTIVE: The objective of this article is to present insights from the systematic implementation of The Transition Readiness Toolkit (TRT) within a state vocational rehabilitation agency. METHODS: We detail the creation of the TRT, our approach for implementing it across multiple states, and how it supports data-driven decision making for Pre-ETS providers and agencies. RESULTS: Initial results of implementation are promising. State VR agencies and Pre-ETS providers are using the data to increase accountability and understand the impact of their services. CONCLUSION: We present reflections on use of the TRT in a state agency and implications from an evidenced-based policy framework.

Time for micro-RNAs in steatotic liver disease: a case-control study.

One of the challenges of modern-day living is to resist the temptation of overfeeding and sedentariness and maintain a healthy body and mind. On a favorable genetic and epigenetic background, a high-fat diet combined with lack of physical exercise constitutes the foundation for severe metabolic disturbances including steatotic liver disease. In our case-control study, we had the aim of establishing the role of selected micro-RNAs-miR-122, miR-192, miR-33a, and miR-33b-as superior biomarkers for the diagnosis and prognosis of steatotic liver in a 36-patient cohort compared to 12 healthy controls. Initial results confirmed the decline in miR-122 expression as fatty liver is progressing. However, combinations of ΔmiRs, such as ΔmiR33a_192, ΔmiR33a_122, and ΔmiR33b_122, correlate with ultrasound steatosis grade (R 2 = 0.78) while others such as ΔmiR33b_122 provide a high specificity and sensitivity in fatty liver disease with an area under the curve (AUC) of 0.85. Compared to classical biomarkers, micro-RNAs can be used for both diagnostic and prognostic purposes as their diminished expression in severe cases of steatosis is associated with higher risk of emerging hepatocellular carcinoma. Manipulating micro-RNAs through agomirs or antagomirs can be the answer to the yet unsolved problem of efficient therapy in MAFLD.

Clinical safety and feasibility of a novel implantable neuroimmune modulation device for the treatment of rheumatoid arthritis: initial results from the randomized, double-blind, sham-controlled RESET-RA study.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes persistent synovitis, bone damage, and progressive joint destruction. Neuroimmune modulation through electrical stimulation of the vagus nerve activates the inflammatory reflex and has been shown to inhibit the production and release of inflammatory cytokines and decrease clinical signs and symptoms in RA. The RESET-RA study was designed to determine the safety and efficacy of an active implantable device for treating RA. The RESET-RA study is a randomized, double-blind, sham-controlled, multi-center, two-stage pivotal trial that enrolled patients with moderate-to-severe RA who were incomplete responders or intolerant to at least one biologic or targeted synthetic disease-modifying anti-rheumatic drug. A neuroimmune modulation device (SetPoint Medical, Valencia, CA) was implanted on the left cervical vagus nerve within the carotid sheath in all patients. Following post-surgical clearance, patients were randomly assigned (1:1) to active stimulation or non-active (control) stimulation for 1min once per day. A predefined blinded interim analysis was performed in patients enrolled in the study's initial stage (Stage 1) that included demographics, enrollment rates, device implantation rates, and safety of the surgical procedure, device, and stimulation over 12 weeks of treatment. Sixty patients were implanted during Stage 1 of the study. All device implant procedures were completed without intraoperative complications, infections, or surgical revisions. No unanticipated adverse events were reported during the perioperative period and at the end of 12 weeks of follow-up. No study discontinuations were due to adverse events, and no serious adverse events were related to the device or stimulation. Two serious adverse events were related to the implantation procedure: vocal cord paresis and prolonged hoarseness. These were reported in two patients and are known complications of surgical implantation procedures with vagus nerve stimulation devices. The adverse event of vocal cord paresis resolved after vocal cord augmentation injections with filler and speech therapy. The prolonged hoarseness had improved with speech therapy, but mild hoarseness persists. The surgical procedures for implantation of the novel neuroimmune modulation device for the treatment of RA were safe, and the device and its use were well tolerated. NCT04539964; August 31, 2020.