Short Intervals Research Articles

Probabilistic estimation of the source component of seismic hazard in North-Eastern Brazil

Stable continental regions pose unique challenges for conducting Probabilistic Seismic Hazard Analysis because the earthquake activity driving mechanisms are poorly understood. For instance, the lower seismicity (hence the paucity of data) and the absence of well-defined active fault systems complicate accurately determining seismic source parameters. Northeastern Brazil is a stable continental region exhibiting moderate-size events recorded with significant seismic intensities and provoking the collapse of poorly constructed buildings in the last century. Thus, assessing the seismic hazard is critical for seismic risk mitigation. The seismic hazard depends on three components: source, path, and site, and here, we present the probabilistic seismic hazard analysis of the source component for NE Brazil. Spatial aggregation of earthquake sources outlined four areal seismic zones. A goodness-of-fit test rejected the Gutenberg-Richter model of magnitude frequency distribution in one of the studied seismic zones. For this reason, we estimated the magnitude probability distribution function in that zone using a nonparametric adaptive kernel estimator. In other zones the Gutenberg-Richter magnitude frequency model was applied. In either way of the magnitude probability distribution modelling we considered the upper bound for magnitude equal to 6.6 mR, based on the upper bound of a 95 % confidence interval for the standard normal distribution of palaeoearthquake sizes. Our findings suggests that potentially damaging events are likely to occur, and we cannot neglect chances for the occurrence of earthquakes exceeding 5.2 mR. The calculated mean return periods indicate significantly shorter intervals between consecutive large events than palaeoseismic records.

Association between serum mineral levels and reproductive performance in primiparous dairy cows during the peripartum period.

To the best of the authors' knowledge, no study has previously investigated whether the concentration of minerals is related to reproductive outcomes in primiparous cows. For this reason, two objectives were set in the present study: (i) to assess serum mineral levels, macrominerals, and trace elements during the transition period (period of high nutritional requirements) in primiparous cows, considering reproductive efficiency, and (ii) to address if the serum mineral levels of primiparous cows are related to reproductive efficiency. Blood samples were taken (i) one month before calving, (ii) one week before calving, (iii) one week postpartum, and (iv) one month postpartum. At the beginning and the end of the study, a body condition score (BCS) was assigned to each lactating cow with no clinical signs of disease. The difference between one month before and one month after calving was the body condition loss (ΔBCS). Optimal prepartum concentrations of K and Cl were associated with fewer days open and a shorter interval calving. Furthermore, macrominerals in the serum decreased immediately after calving (one week) but recovered at one month postpartum. In contrast, the highest concentration of trace elements was found at one week postpartum. Primiparous cows with higher postpartum Se, Mn, Co, and Mo concentrations exhibited better reproductive efficiency, and the concentrations of trace elements in serum were correlated with interval calving and the number of inseminations. Finally, primiparous cows with a greater ΔBCS (at least one point) in period 4 exhibited both a longer calving interval and a greater number of days open. In summary, this study showed, for the first time in primiparous cows, that the concentration of some serum minerals not only plays a crucial role during the transition period but is also related to crucial reproductive parameters, such as interval calving and days open.

Early-onset Colorectal Cancer Patients Do Not Require Shorter Intervals for Post-surgical Surveillance Colonoscopy

Early-onset colorectal cancer (EO-CRC), diagnosed before age 50, is rising in incidence worldwide. Although post-surgical colonoscopy surveillance strategies exist, appropriate intervals in EO-CRC remain elusive, as long-term surveillance outcomes remain scant. We sought to compare findings of surveillance colonoscopies of EO-CRC with patients with average onset colorectal cancer (AO-CRC) to help define surveillance outcomes in these groups. Single-institution retrospective chart review identified EO-CRC and AO-CRC patients with colonoscopy and no evidence of disease. Surveillance intervals and time to development of advanced neoplasia (CRC and advanced polyps [adenoma/sessile serrated]) were examined. For each group, 3 serial surveillance colonoscopies were evaluated. Statistical analyses were performed utilizing log-ranked Kaplan-Meier method and Cox proportional hazards. A total of 1259 patients with CRC were identified, with 612 and 647 patients in the EO-CRC and AO-CRC groups, respectively. Compared with patients with AO-CRC, patients with EO-CRC had a 29% decreased risk of developing advanced neoplasia from time of initial surgery to first surveillance colonoscopy (hazard ratio, 0.71; 95% confidence interval, 0.52-1.0). Average follow-up time from surgical resection to first surveillance colonoscopy was 12.6 months for both cohorts. Overall surveillance findings differed between cohorts (P= .003), and patients with EO-CRC were found to have less advanced neoplasia compared with their counterparts with AO-CRC (12.4% vs 16.0%, respectively). Subsequent colonoscopies found that, while patients with EO-CRC returned for follow-up surveillance colonoscopy earlier than patients with AO-CRC, the EO-CRC cohort did not have more advanced neoplasia nor non-advanced adenomas. Patients with EO-CRC do not have an increased risk of advanced neoplasia compared with patients with AO-CRC and therefore do not require more frequent colonoscopy surveillance than current guidelines recommend.

Evaluating Contraception Counseling and Desire for Immediate Postpartum Long-Acting Contraception in Publicly Insured Adolescents [ID 2683512

INTRODUCTION: Adolescent pregnancy is associated with a high prevalence of short interval birth and unplanned pregnancy, along with other risks. Immediate postpartum long-acting reversible contraception (IPP LARC) has the potential to improve these outcomes. This study aimed to examine the presence of counseling, desire, and obtainment of IPP LARC during hospitalization. METHODS: This retrospective cohort analysis used electronic health records to capture demographics, pregnancy details, and contraceptive discussions and plans for pregnant patients admitted for delivery in one East Tennessee hospital. Exclusion criteria included those with private insurance or received permanent sterilization during hospitalization. Adolescence was defined as age less than 20 years at the time of delivery. Data were extracted from March 2018 to June 2023. Chi-squared tests were conducted in SPSS. RESULTS: 10,492 patients that met inclusion criteria delivered between March 2018 and June 2023. Of these, 10.8% (n=1,128) were adolescents. Desire for IPP LARC upon admission was higher among adolescents (31.6% versus 25.1%; P<.001). IPP LARC placement was significantly higher among adolescents (overall, 24.0% [n=2,523]; adolescents, 27.5%, versus age 20 and older, 23.6%; P=.005). Adolescents who self-reported receiving contraceptive counseling during prenatal care were more likely to receive IPP LARC (66.5% versus 42.4%; P<.001). CONCLUSION: In this study, prenatal contraception counseling increased patient obtainment of desired postpartum contraceptive plan, including IPP LARC. Adolescents both desired and obtained IPP LARC more frequently than their older counterparts. Improved contraceptive counseling and access to all contraceptive options, including IPP LARC, may improve teen pregnancy and birth rates.

Stride Velocity 95th Centile Detects Decline in Ambulatory Function Over Shorter Intervals than the 6-Minute Walk Test or North Star Ambulatory Assessment in Duchenne Muscular Dystrophy.

Stride Velocity 95th Centile (SV95C) is the first wearable device-derived clinical outcome assessment (COA) to receive European Medicines Agency (EMA) qualification as a primary endpoint in ambulant patients with Duchenne muscular dystrophy (DMD) aged ≥4 years. To compare SV95C-in its first-ever clinical trial application as a secondary endpoint-with established motor function COAs used in the trial (Four-Stair Climb [4SC] velocity, North Star Ambulatory Assessment [NSAA], and Six-Minute Walk Distance [6MWD]). SV95C was a secondary endpoint in a subset (n = 47) of participants in the SPITFIRE/WN40227 trial of taldefgrobep alfa, which was discontinued due to lack of clinical benefit. Participants in the ≤48-week SV95C sub-study were 6-11 years old and received corticosteroids for ≥6 months pre-treatment. Pearson correlations were used to compare SV95C with the other COAs. Responsiveness and changes over time were respectively assessed via standardized response means (SRMs) based on absolute changes and mixed models for repeated measures. SV95C change at Week 24 was -0.07 m/s, with limited variability (standard deviation: 0.16, n = 27). The SRM for SV95C indicated moderate responsiveness to clinical change at the earliest timepoint (Week 12, n = 46), while those of the other COAs did not indicate moderate responsiveness until Week 36 (6MWD, n = 33) or Week 48 (4SC velocity, n = 20; NSAA total score, n = 20). Baseline correlations between SV95C and other COAs were strong (r = 0.611-0.695). Correlations between SV95C change from baseline to Week 48 and changes in other COAs were moderate to strong (r = 0.443-0.678).∥. Overall, SV95C demonstrated sensitivity to ambulatory decline over short intervals, low variability, and correlation with established COAs. Although the negative trial precluded demonstration of SV95C's sensitivity to drug effect, these findings support the continued use of SV95C in DMD clinical trials.

Computational mathematical modeling in the cocoa fermentation process in four isolated systems

In the southern region of Bahia, the cocoa culture has been a source of income and moved the economy for a long time, but the emergence of the “witch's broom” (Moniliophthora Perniciosa) caused the decline of this productive sector. Given the importance of cocoa for the region, makes sense to use it as an object of study for the development of academic research that can foster the reheating of this branch of the economy. In this context, for the processing of cocoa to occur to be able to use in the manufacture of chocolate and derivatives it needs to go through 5 distinct stages, being: harvesting, breaking, fermentation, drying, and storage. The stages in question are responsible for more than 45% of the organoleptic properties of cocoa, i.e. affect the final quality of the product. Fermentation is one of the most important stages since it is through fermentation that cocoa develops most of its characteristics, such as color, flavor, and aroma. The step by step of cocoa fermentation is to let the mass ferment, without stirring, until the temperature reaches 32ºC or if it does not reach the ideal temperature, wait to complete 48h. There are cases in which temperatures can be reached between 40ºC to 60ºC. Thus, the idea arose to create a cocoa fermenter model that could increase the efficiency of the fermentation cycle, and boost its scale and quality. Nowadays the process is done manually, requiring the worker to perform the laborious task of monitoring and stirring the cocoa mass at short intervals, over hours. This work compares four fermenter models through the analysis of heat diffusion. The method is theoretical with the help of computer modeling, where the propagation of heat from a source throughout the system filled with a mass of cocoa is evaluated.

Not so fast: Million-years of metal precipitation in Mississippi Valley type deposits inferred from in-situ petrochronology of hydrothermal carbonates

Mississippi Valley-type (MVT) deposits contain about 20% of global zinc resources and host critical raw materials crucial to the development of green technologies. Despite their economic and strategic importance, there is a lack of consensus on the duration of mineralizing fluid flow events in MVT systems. This study couples in-situ U-Pb dating with Sr-isotope and trace element analysis of syn- and post-ore gangue carbonates to establish: (1) timing and duration, (2) redox evolution, and (3) flow rates of mineralizing fluids in the world-class San Vicente Zn-(Pb) deposit (Peru). New radiometric ages bracket the crystallization of syn-mineralization dolomite, characterized by high Fe and Mn contents and Sr isotopic values overlapping with that of host carbonates, between 103.2 ± 4.1 Ma and 70.6 ± 5.6 Ma. This age interval reveals a direct genetic relationship between flow of mineralizing fluids and late Cretaceous Andean compressional tectonics. Basinal fluid expulsion coeval with known tectonic events continues in the district until Pliocene times, driving episodic crystallization of post-ore hydrothermal carbonates between 61.6 ± 9.3 and 2.7 ± 0.2 Ma. The low Mn and Fe content and high 87Sr/86Sr values characteristic of these post-ore, bedding-parallel and cross-cutting carbonate veins indicate a colder, oxidized environment. Our findings highlight the contribution of paired carbonate geochemistry and U-Pb geochronology in drawing links between tectonic events, fluid expulsion and the waxing and waning of mineralization potential in foreland basins. The results of this study challenge our understanding of timescales in MVT systems and imply that anomalous metal enrichment in basinal fluids over a short temporal interval is not a necessary precondition to form economic-sized, sediment-hosted Zn-Pb deposits. Rather, it is the coexistence of a focused fluid flow in an interconnected aquifer with suitable metal depositional mechanisms over a prolonged period of time (106–107 yr) that allows precipitation of economic amount of base metals at a specific site in the upper crust.

Unconventional life history in a migratory shorebird: desegregating reproduction and migration.

Conventional life-history theory predicts that energy-demanding events such as reproduction and migration must be temporally segregated to avoid resource limitation. Here, we provide, to our knowledge, the first direct evidence of 'itinerant breeding' in a migratory bird, an incredibly rare breeding strategy (less than 0.1% of extant bird species) that involves the temporal overlap of migratory and reproductive periods of the annual cycle. Based on GPS-tracking of over 200 female American woodcock, most female woodcock (greater than 80%) nested more than once (some up to six times) with short re-nest intervals, and females moved northwards on average 800 km between first and second nests, and then smaller distances (ca 200+ km) between subsequent nesting attempts. Reliance on ephemeral habitat for breeding, ground-nesting and key aspects of life history that reduce both the costs of reproduction and migration probably explain the prevalence of this rare phenotype in woodcock and why itinerant breeding so rarely occurs in other bird species.

Germination-induced modifications of starch structure, flour-processing characteristics, and in vitro digestive properties in maize

Current research on maize germination suffers from long sampling intervals, and the relationship between the starch structure and the processing properties of flour in maize is still unclear. This study observed the effect of germination on the structure and composition of maize starch and the processing properties of maize flour over a 72 h period using a short interval sampling method. At 36 h, the short-range ordered structure, crystallinity, and enthalpy of starch reached the highest values of 1.02, 34.30%, and 9.90 J/g, respectively. At 72 h, the ratios of rapidly-digested starch (RDS) and slowly-digested starch (SDS) enhanced to 29.37% and 28.97%; the RS content reduced to 35.37%; and the flow properties of the starch were improved. This study enhances the understanding of the effects of germination on the processing properties of maize starch and flour, determines the appropriate application, and recommends the use of germination in the food industry.

Comparison of probabilistic cruising-for-parking time estimation models

Models of parking search time predominantly rely on the binomial approximation, the calculation of which is dependent solely on the occupancy of the parking network. This paper sheds light on the importance of accounting for competition between parking searchers and the effects of dynamically changing occupancy. To this end, we investigate the accuracy of two probabilistic models, namely the binomial approximation and a model proposed by Cao and Menéndez (CaM). We utilize an agent-based microscopic parking simulation model as a benchmark for comparison purposes. Our findings highlight the significance of considering the competitive dynamics among drivers in the quest for parking spaces and the fluctuations in parking occupancy rates over short time intervals. We highlight the ranges of occupancies for which the binomial approximation and the CaM model provide more reliable estimations of parking search times. The CaM model provides, in general, more accurate estimations of search times since it accounts for various parking network characteristics such as competition and varying occupancy. The binomial approximation underestimates parking search times more substantially at high occupancies with a large number of searching vehicles, whereas the CaM model performs worse for lower spacing between parking spots and lower parking occupancies. Insights from this research are then used to discuss policy implications of accounting for competition and short-term occupancy variations when designing either parking models or parking-related control strategies.

Collision-free path planning for multiple robots using efficient turn-angle assignment

The ability to avoid collisions with moving robots is critical in many applications. Moreover, if the robots have limited battery life, the goal is not only to avoid collisions but also to design efficient trajectories in terms of energy consumption and total mission time. This paper proposes a novel strategy for assigning turn angles for collision-free path planning in scenarios where a small team of robots cooperate in a certain mission. The algorithm allows each robot to reach a predetermined destination safely. It establishes consecutive, short time intervals, and at each interval, possible conflicts are solved centrally in an optimal manner. This is done by keeping constant speeds but generating a discrete set of possible directions for each robot, and solving efficiently the turn-angle allocation for a collision-free path that minimizes the path deviation from the shortest one. Due to the discretization, the final paths are not optimal, but the system can react to possible failures during execution, as conflicts are resolved at each time interval. Computational results and Software-In-The-Loop simulations are presented in order to evaluate the proposed algorithm. A comparison with a state-of-the-art approach shows that our algorithm is more energy-efficient and achieves lower mission completion time.

Non-contacting laser-based acousto-seismics at the laboratory scale: towards near-real-time monitoring of granular analogue models

SUMMARY In this work we present a novel, experimentally efficient set-up for performing non-contacting laser vibrometry on geologic materials and their analogues. We show it is possible to acoustically monitor a granular material experiment in real time compared to the typical timescale of analogue modelling experiments. We acquire non-contacting waveform data with consistently high signal-to-noise ratio. Compared to previously used standard contacting transducers, the novel joint use of sources and receivers that are both laser-based resulted in measured signals with improved waveforms and temporal bandwidths. These data acquisition improvements, in our case where surface waves are prominent in the data, enable enhanced multichannel surface wave processing, for example, in terms of reliable dispersion curve estimates. We find, given the high waveform fidelity of our acquisition system, that the observed surface waves are highly sensitive to relatively small changes in the medium’s elastic properties, making them a demonstrably reliable to monitor any processes that affect elasticity in these models in near real time. As a demonstration, we continuously monitor a scaled analogue model containing granular glass beads. By continuously monitoring—that is, performing repeatable active-source acousto-seismic surveys at short time-lapse intervals—over a period of 10 hr, we find that an increase of relative humidity of 10 per cent can lead to as much as a factor of two increase in surface wave group velocities. Finally, we discuss future applications of the developed method by considering surface wave inversion for fault and stress monitoring during the deformation of a model.

Vegetation changes through recurrent fire affect soil water behavior and enhance landslides in the mountainous region of Rio de Janeiro state, southeast Brazil

The role of fire in vegetation-soil–water interactions and its implications for soil stability and slope failures is poorly documented in humid tropical regions. This paper focuses on the relationships between vegetation change through recurrent fire and its effects on hydraulic conductivity and soil suction. Two monitoring sites were chosen on steep slopes in the mountainous domain of the Atlantic rainforest: the first is representative of degraded secondary rainforest (DRf) 25–30 years after slash and burn agriculture; the other represents herbaceous-shrubby vegetation (HS) resulting from wildfires in short-time intervals (<5 years). Two fires had previously occurred on the HS slope, one in December 2014 and the other in September 2019. Continuous records of rainfall and soil suction at depths of 10, 20, 50, 100, 150, and 220 cm provided a 6-year data collection from January 2015 to December 2020. Hydraulic conductivity (Ksat) field tests were conducted around the two monitoring sites before and after the September 2019 fire. The main results include: a) soil suction in the topsoil of both vegetation covers follow the rainfall inputs with high values of Ksat (DRf = 195 mm/h; HS = 203 mm/h); b) while quick rainfall-suction responses prevail within the DRf soil profile, soil suction at HS maintains a mean suction value around -27 kPa below 100 cm deep; c) field observations attest to the occurrence of hydrophobicity after the 2019 fire; d) Ksat tests just after this fire indicated a decreasing mean value from 203 mm/h to 46 mm/h; and e) by the end of the dry season after fire, there is a delayed increase in soil suction reaching -143 kPa at a depth of 100 cm and in smaller proportions at 220 cm deep. These results indicate that post-fire soil changes tend to favor the sudden loss of soil stability and slope failure during extreme rainfall events.

Erectile function preservation after salvage radiation therapy for biochemically recurrent prostate cancer after prostatectomy: Five-year results of the SAKK 09/10 randomized phase 3 trial

ObjectivesTo evaluate effects of dose intensified salvage radiotherapy (sRT) on erectile function in biochemically recurrent prostate cancer (PC) after radical prostatectomy (RP). Materials and methodsEligible patients had evidence of biochemical failure after RP and a PSA at randomization of ≤ 2 ng/ml. Erectile dysfunction (ED) was investigated as secondary endpoint within the multicentre randomized trial (February 2011 to April 2014) in patients receiving either 64 Gy or 70 Gy sRT. ED and quality of life (QoL) were assessed using CTCAE v4.0 and the EORTC QoL questionnaires C30 and PR25 at baseline and up to 5 years after sRT. Results344 patients were evaluable. After RP 197 (57.3 %) patients had G0-2 ED while G3 ED was recorded in 147 (42.7 %) patients. Subsequently, sexual activity and functioning was impaired. 5 years after sRT, 101 (29.4 %) patients noted G0-2 ED. During follow-up, 44.2 % of patients with baseline G3 ED showed any improvement and 61.4 % of patients with baseline G0-2 ED showed worsening. Shorter time interval between RP and start of sRT (p = 0.007) and older age at randomization (p = 0.005) were significant predictors to more baseline ED and low sexual activity in the long-term. Age (p = 0.010) and RT technique (p = 0.031) had a significant impact on occurrence of long-term ED grade 3 and worse sexual functioning. During follow-up, no differences were found in erectile function, sexual activity, and sexual functioning between the 64 Gy and 70 Gy arm. ConclusionED after RP is a known long-term side effect with significant impact on patients’ QoL. ED was further affected by sRT, but dose intensification of sRT showed no significant impact on erectile function recovery or prevalence of de novo ED after sRT. Age, tumor stage, prostatectomy and RT-techniques, nerve-sparing and observation time were associated with long-term erectile function outcome.ClinicalTrials.gov. Identifier: NCT01272050.

SAGES White Paper on the importance of diversity in surgical leadership: creating the fundamentals of leadership development (FLD) curriculum.

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery.

Determinants of chronic energy deficiency (CED) incidence in pregnant women: A cross-sectional study in Banyumas, Indonesia.

Chronic energy deficiency (CED) in pregnant women is a condition of energy and protein deficiency that lasts for years and causes problems in the mother and fetus. Due to its significant consequences, determining the determinants associated with CED incidence is of utmost importance. The aim of this study was to determine the determinants of the incidence of CED in pregnant women in Indonesia. A cross-sectional study was conducted on pregnant women in Banyumas, Central Java, Indonesia, in 2022. Plausible determinants included maternal age, pregnancy interval, parity, educational attainment, nutritional knowledge, employment, frequency of antenatal care (ANC), and nutritional intake. The Chi-squared test followed by multivariate logistic regression were used to determine the factors associated with the incidence of CED. Our data indicated that 32% of the pregnant women had CED. Univariate analysis found that maternal age (p=0.022), pregnancy interval (p=0.009), educational attainment (p=0.012), knowledge of nutrition and CED (p=0.023), frequency of utilization of ANC services (p=0.028), energy intake (p=0.002), protein intake (p=0.006), vitamin C intake (p=0.016), folate intake (p=0.011), and calcium intake (p=0.004) were significantly associated with CED incidence in the pregnant women. Multivariate analysis indicated that extreme maternal age (OR; 3.49; 95%CI: 1.10-11.05), low educational attainment (OR: 4.12; 95%CI: 1.37-12.33), short pregnancy interval (OR; 7.30; 95%CI: 1.84-28.99), low frequency of ANC (OR: 3.06; 95%CI: 1.01-9.19) and low protein intake (OR: 6.80; 95%CI: 1.62-28.59) were associated with CED incidence. This study underscores the importance of increasing nutritional intake, frequency of ANC, and pregnancy interval among pregnant women to reduce the risk of CED and its adverse health outcomes.

Postsynaptic potentials of soleus motor neurons produced by transspinal stimulation: a human single-motor unit study.

Transspinal (or transcutaneous spinal cord) stimulation is a noninvasive, cost-effective, easily applied method with great potential as a therapeutic modality for recovering somatic and nonsomatic functions in upper motor neuron disorders. However, how transspinal stimulation affects motor neuron depolarization is poorly understood, limiting the development of effective transspinal stimulation protocols for rehabilitation. In this study, we characterized the responses of soleus α motor neurons to single-pulse transspinal stimulation using single-motor unit (SMU) discharges as a proxy given the 1:1 discharge activation between the motor neuron and the motor unit. Peristimulus time histogram, peristimulus frequencygram, and surface electromyography (sEMG) were used to characterize the postsynaptic potentials of soleus motor neurons. Transspinal stimulation produced short-latency excitatory postsynaptic potentials (EPSPs) followed by two distinct phases of inhibitory postsynaptic potentials (IPSPs) in most soleus motor neurons and only IPSPs in others. Transspinal stimulation generated double discharges at short interspike intervals in a few motor units. The short-latency EPSPs were likely mediated by muscle spindle group Ia and II afferents, and the IPSPs via excitation of group Ib afferents and recurrent collaterals of motor neurons leading to activation of diverse spinal inhibitory interneuronal circuits. Further studies are warranted to understand better how transspinal stimulation affects depolarization of α motor neurons over multiple spinal segments. This knowledge will be seminal for developing effective transspinal stimulation protocols in upper motor neuron lesions.NEW & NOTEWORTHY Transspinal stimulation produces distinct actions on soleus motor neurons: an early short-latency excitation followed by two inhibitions or only inhibition and doublets. These results show how transspinal stimulation affects depolarization of soleus α motor neurons in healthy humans.

Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data

BackgroundComposite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model.MethodsThe study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF.ResultsThe prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia.ConclusionsThe burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother’s education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.

Impact of time interval from cesarean delivery to frozen embryo transfer on reproductive and neonatal outcomes

To evaluate differences in reproductive and neonatal outcomes on the basis of the time interval from cesarean delivery to subsequent frozen embryo transfer (FET). Retrospective cohort. Multicenter fertility practice. Women undergoing autologous elective single embryo transfer FET after prior cesarean delivery. Time from prior cesarean delivery to subsequent FET. live birth (LB). A total of 6,556 autologous elective single embryo transfer FET cycles were included. Frozen embryo transfer cycles were divided into eight groups on the basis of the time interval from prior cesarean delivery to subsequent FET in months. A secondary analysis was then performed with time as a continuous variable. The proportion of LBs did not differ significantly across all time interval groups and over continuous time (range: 40.0%-45.6%). The mean gestational age at the time of delivery did not significantly differ as the time between prior cesarean delivery and subsequent FET increased (range: 37.3-38.4). When time was evaluated continuously, the proportion of preterm births was higher with a shorter time between cesarean delivery and subsequent FET. The mean birth weight ranged from 3,181-3,470g, with a statistically significant increase over time. However, the proportions of extremely low birth weight, very low birth weight, and low birth weight did not significantly differ. There were no significant differences in reproductive outcomes on the basis of the time interval from cesarean delivery to FET, including LB. The proportion of preterm deliveries decreased with a longer time between cesarean delivery and FET. Differences in mean neonatal birth weight were not clinically significant because the proportion of low birth weight neonates was not significantly different over time. Although large, this sample cannot address all outcomes associated with short interpregnancy intervals, particularly rarer outcomes such as uterine rupture. When counseling patients, the timing of FET after cesarean delivery must be balanced against the risks of increasing maternal age on reproductive and neonatal outcomes.

Adjuvant chemotherapy is associated with better oncological outcomes after ALPPS for colorectal liver metastases.

ALPPS enables complete tumor resection in a shorter interval and a larger number of patients than classic two-stage hepatectomies. However, there is little evidence regarding long-term outcomes in patients with colorectal liver metastases (CLM). This study aims to evaluate the short and long-term outcomes of ALPPS in patients with CRM. Single-cohort, prospective, observational study. Patients with unresectable CLM due to insufficient liver remnant who underwent ALPPS between June 2011 and June 2021 were included. Of 32 patients treated, 21 were male (66%) and the median age was 56years (range = 29-81). Both stages were completed in 30 patients (93.7%), with an R0 rate of 75% (24/32). Major morbidity was 37.5% and the mortality nil. Median overall survival (OS) and recurrence-free survival (RFS) were 28.1 and 8.8months, respectively. The 1-3, and 5-year OS was 86%, 45%, and 21%, and RFS was 42%, 14%, and 14%, respectively. The only independent risk factor associated with poor RFS (5.7 vs 11.6months; p = 0.038) and OS (15 vs 37months; p = 0.009) was not receiving adjuvant chemotherapy. KRAS mutation was associated with worse OS from disease diagnosis (24.3 vs. 38.9months; p = 0.025). ALPPS is associated with favorable oncological outcomes, comparable to traditional strategies to increase resectability in patients with CLM and high tumor burden. Our results suggest for the first time that adjuvant chemotherapy is independently associated with better short- and long-term outcomes after ALPPS. Selection of patients with KRAS mutations should be performed with caution, as this could affect oncological outcomes.