Early Physical Therapist Interventions for Patients With COVID-19 in the Acute Care Hospital: A Case Report Series.

The aim of this case series was to describe the experience of Swiss physical therapists in the treatment of patients with COVID-19 during their acute care hospital stay and to discuss challenges and potential strategies in the clinical management of these patients. We report 11 cases of patients with COVID-19 from 5 Swiss hospitals that illustrate the various indications for physical therapy, clinical challenges, potential treatment methods, and short-term response to treatment. Physical therapists actively treated patients with COVID-19 on wards and in the intensive care unit. Interventions ranged from patient education, to prone positioning, to early mobilization and respiratory therapy. Patients were often unstable with quick exacerbation of symptoms and a slow and fluctuant recovery. Additionally, many patients who were critically ill developed severe weakness, postextubation dysphagia, weaning failure, or presented with anxiety or delirium. In this setting, physical therapy was challenging and required specialized and individualized therapeutic strategies. Most patients adopted the proposed treatment strategies, and lung function and physical strength improved over time. Physical therapists clearly have a role in the COVID-19 pandemic. Based on our experience in Switzerland, we recommend that physical therapists routinely screen and assess patients for respiratory symptoms and exercise tolerance on acute wards. Treatment of patients who are critically ill should start as soon as possible to limit further sequelae. More research is needed for awake prone positioning and early breathing exercises as well as post-COVID rehabilitation. To date, there are few data on the physical therapist management of patients with COVID-19. This article is among the first to describe the role of physical therapists in the complex pandemic environment and to describe the potential treatment strategies for countering the various challenges in the treatment of these patients

Converse mode piezoelectric coefficient for lead zirconate titanate thin film with interdigitated electrode

The use of interdigitated electrodes (IDEs) in conjunction with ferroelectric thin films shows many attractive features for piezoelectric MEMS applications. In this work, growth of {1 0 0}-textured lead zirconate titanate (PZT) thin films was achieved on insulating MgO buffered, oxidized silicon substrates. IDEs were fabricated by lift-off techniques and cantilevers were formed by dicing. The deflection upon application of a sweeping voltage was measured as large signal response in parallel to the ferroelectric polarization (PV loop). Likewise, the small signal piezoelectric response was measured in parallel to the capacitance-voltage (CV) measurement. In this way, a complete picture of the ferroelectric-piezoelectric element was obtained. From the deflection, the in-plane piezoelectric stress in the PZT thin film was derived and, from this, the effective piezoelectric coefficients. For the latter, two types were defined: an engineering type corresponding to the average value along the IDE, which can directly be compared to coefficient of a parallel plate electrode (PPE) capacitor and a second one that approximately yields the idealized coefficient governing between the electrode fingers. The IDE structures were experimentally compared with PPE structures of identical film thickness. The resulting coefficients were of opposite sign, as expected. In spite of a much better polarization loop, the IDE device showed a lower average piezoelectric stress. The estimated peak value between the fingers was about the same as in the PPE device, corresponding to about 20 C m(-2). Nevertheless, the result is very promising for cases where compressive piezoelectric stresses are required and for preventing cracking due to large piezoelectric tensile stresses in PPE systems

Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

\ua9 2024 The AuthorsBackground: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% \ub1 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% \ub1 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920

The FANCM:p.Arg658* truncating variant is associated with risk of triple-negative breast cancer

Breast cancer is a common disease partially caused by genetic risk factors. Germline pathogenic variants in DNA repair genes BRCA1, BRCA2, PALB2, ATM, and CHEK2 are associated with breast cancer risk. FANCM, which encodes for a DNA translocase, has been proposed as a breast cancer predisposition gene, with greater effects for the ER-negative and triple-negative breast cancer (TNBC) subtypes. We tested the three recurrent protein-truncating variants FANCM:p.Arg658*, p.Gln1701*, and p.Arg1931* for association with breast cancer risk in 67,112 cases, 53,766 controls, and 26,662 carriers of pathogenic variants of BRCA1 or BRCA2. These three variants were also studied functionally by measuring survival and chromosome fragility in FANCM (-/-) patient-derived immortalized fibroblasts treated with diepoxybutane or olaparib. We observed that FANCM:p.Arg658* was associated with increased risk of ER-negative disease and TNBC (OR = 2.44, P = 0.034 and OR = 3.79; P = 0.009, respectively). In a country-restricted analysis, we confirmed the associations detected for FANCM:p.Arg658* and found that also FANCM:p.Arg1931* was associated with ER-negative breast cancer risk (OR = 1.96; P = 0.006). The functional results indicated that all three variants were deleterious affecting cell survival and chromosome stability with FANCM:p.Arg658* causing more severe phenotypes. In conclusion, we confirmed that the two rare FANCM deleterious variants p.Arg658* and p.Arg1931* are risk factors for ER-negative and TNBC subtypes. Overall our data suggest that the effect of truncating variants on breast cancer risk may depend on their position in the gene. Cell sensitivity to olaparib exposure, identifies a possible therapeutic option to treat FANCM-associated tumors

Resonant driving of a nonlinear Hamiltonian system

As a proof of principle, we show how a classical nonlinear Hamiltonian system can be driven resonantly over reasonably long times by appropriately shaped pulses. To keep the parameter space reasonably small, we limit ourselves to a driving force which consists of periodic pulses additionally modulated by a sinusoidal function. The main observables are the average increase of kinetic energy and of the action variable (of the non-driven system) with time. Applications of our scheme aim for driving high frequencies of a nonlinear system with a fixed modulation signal

The use of cross species SSR primers to study genetic diversity of okra from Burkina Faso

Sixteen pairs of primers designed to amplify SSR regions of Medicago truncatula were used to amplify genomic DNA samples of 20 different okra accessions collected from different regions Burkina Faso.These primers amplified a number of fragments that range from 1-16 with the sizes of 396-506 bp. Each accession was scored for the presence or absence of the bands and phylogenetic analysis of thesedata clustered the 20 accessions into five different groups. Two okra accessions were distinctly different from other 18, based on the molecular marker as well as on morphological features of theirfruits. One of the primers, MT-27 amplified a unique 440 bp PCR product in these 2 okra accessions. This PCR product was sequenced and based on the sequence information, sequence specific primerswere designed to PCR amplify the genomic DNA of all the okra accessions. This pair of primer amplified PCR products only in the two okra accessions where the amplification of the PCR productswas seen with MT-27 primers. Our data indicate that cross species SSR primer developed for Medicago truncatula can also be used to analyze genetic diversity in unrelated species, like Okra

Preliminary results of a new boron coated neutron detector

The proliferation of neutron detection applications based upon 3He counter has triggered a critical shortage of 3He gas. Nowadays there is an increasing demand for alternative neutron detectors that can cover large solid angles, have low sensitivity to gamma background and low cost. We present a low cost neutron detector based upon 3 cm diameter, 150 cm long cylindrical metal tube coated on the inside with a thin layer of 10B-enriched boron carbide fulfilled by 1 atm nitroge