A Novel Use of Concussion Protocols in the Management of the Cognitive Effects in Long Haul COVID

Some individuals diagnosed with Long Haul COVID (lCOVID) have concurrently reported cognitive issues such as confusion, forgetfulness, decreased attention time, and difficulty focusing. This series of symptoms is termed brain fog. PURPOSE: Patients with reports of brain fog may benefit from the utilization of protocols associated with concussion rehabilitation to reduce the effects of confusion, frustration, and difficulty focusing on exercise instructions. This study looked at the novel application of the concussion rehabilitation protocol to mitigate the cognitive issues linked to brain fog through a course of physical therapy for lCOVID recovery. METHODS: This case report tracked a 57-year-old female who was being seen for cardiorespiratory and strengthening rehabilitation after a diagnosis of lCOVID. The patient underwent a pre- and post-Mini-Mental State Exam (MMSE) as well as a treatment satisfaction survey at the end of the study. Oxygen saturation was measured before, during, and after each date of visit. During the initial 10-week course of physical therapy, she expressed issues with confusion and occasional difficulty understanding tasks needed in physical therapy. A neurologist diagnosed her with brain fog and suggested that concussion protocols that help individuals with similar cognitive symptoms might facilitate her rehabilitation process. The plan of care was overhauled to incorporate salient features of the concussion rehab protocol and the patient continued with the revised care for another 6 weeks, resulting in a total care episode of 16 weeks. RESULTS: The patient completed 16 weeks of therapy with improvement in baseline to exercise O2 saturation with no noted decline during the strengthening and cardiovascular phase. The patient reported high satisfaction in the ability of the revised treatment plan from week 10 onwards in terms of helping her symptoms and her condition. The patient also reported no associated side effects with the concussion rehabilitation protocol. The patient also stated that there was no difficulty, no inconvenience, and no dissatisfaction associated with the use of the revised plan of care. She stated that the overall treatment plan challenged her, reporting fatigue and tiredness towards both the physical and mental aspects of the therapy. There was no noted cognitive impairment using the MMSE before and after the course of therapy. CONCLUSION: The utilization of the Concussion Rehabilitation Protocol is a no-cost, simple-to-integrate addition to lCOVID physical therapy recovery that may help individuals concurrently deal with brain fog. Individuals diagnosed with brain fog will benefit from concussion protocol hallmarks such as the provision of extended rest periods, when necessary, compensatory techniques when confused, facilitating exercise utilizing one to two-step instructions, monitoring of mood and symptoms, and education towards an optimistic full recovery from symptoms

Theory and Phenomenology of mu in M theory

We consider a solution to the mu-problem within M theory on a G2-manifold. Our study is based upon the discrete symmetry proposed by Witten that forbids the mu-term and solves the doublet-triplet splitting problem. We point out that the symmetry must be broken by moduli stabilization, describing in detail how this can occur. The mu-term is generated via Kahler interactions after strong dynamics in the hidden sector generate a potential which stabilizes all moduli and breaks supersymmetry with m_{3/2} ~ 20 - 30 TeV. We show that mu is suppressed relative to the gravitino mass, by higher dimensional operators, mu ~ 0.1 m_{3/2} ~ 2-3 TeV. This necessarily gives a Higgsino component to the (mostly Wino) LSP, and a small but non-negligible LSP-nucleon scattering cross-section. The maximum, spin-independent cross-sections are not within reach of the current XENON100 experiment, but are within reach of upcoming runs and upgrades.Comment: 34 pages, 3 figure

The transcriptional repressor protein NsrR senses nitric oxide directly via a [2Fe-2S] cluster

The regulatory protein NsrR, a member of the Rrf2 family of transcription repressors, is specifically dedicated to sensing nitric oxide (NO) in a variety of pathogenic and non-pathogenic bacteria. It has been proposed that NO directly modulates NsrR activity by interacting with a predicted [Fe-S] cluster in the NsrR protein, but no experimental evidence has been published to support this hypothesis. Here we report the purification of NsrR from the obligate aerobe Streptomyces coelicolor. We demonstrate using UV-visible, near UV CD and EPR spectroscopy that the protein contains an NO-sensitive [2Fe-2S] cluster when purified from E. coli. Upon exposure of NsrR to NO, the cluster is nitrosylated, which results in the loss of DNA binding activity as detected by bandshift assays. Removal of the [2Fe-2S] cluster to generate apo-NsrR also resulted in loss of DNA binding activity. This is the first demonstration that NsrR contains an NO-sensitive [2Fe-2S] cluster that is required for DNA binding activity

Structural integrity assessment of the welded joints of the constitution of 1812 bridge (Cádiz, Spain)

As required by the current Spanish regulations, an inspection and maintenance plan has been completed for the Constitution of 1812 Bridge over the Bay of Cádiz (Spain), which defines the work to be performed on the different elements of the bridge during its service life. The part of the plan related to the inspection of the steel structure has a section dedicated to the inspection of the defects that may be present in the welded joints of the steel deck, providing critical defect sizes above which the safety of the structure would be compromised. With this purpose, in the most stressed points of the deck, the structural details that are most susceptible to fatigue and fracture phenomena have been identified. Moreover, fatigue tests of these details have been performed to complete a structural integrity assessment that also comprises the determination of the material fracture toughness and the definition of the corresponding critical crack sizes. The tests were carried out on specimens obtained with the same steel grades as those used in the bridge and with the same welding procedures as those practiced in the structure. The results show that the fatigue test results are above the SN curves provided by the Eurocode 3, and also that numerous critical crack sizes would not be detected by the usual inspection techniques used in bridges (visual inspection), so that further research into how to manage this issue is recommended.The authors of this work would like to express their gratitude to the University of Cantabria for the financial support of the project “Aplicación de Técnicas de Integridad Estructural y Fiabilidad de Materiales en la Determinacion del Ciclo de Vida de Puentes Metalicos y Mixtos- Application of Structural Integrity and Materials Reliability Techniques to the Life-Cycle Assessment of Metallic and Steel-Concrete Composite Bridges” (03.DI09.649), programme of industrial doctorates, on the results of which this paper is based

Synchronous malignant B-cell lymphoma and gastric tubular adenocarcinoma associated with paraneoplastic cutaneous vasculitis: hypereosinophilic syndrome with mixed cryoglobulinemia is an important sign of paraneoplastic syndrome

Gastric adenocarcinoma developing concomitantly with a lymphoma is rare. Furthermore, B-cell lymphoma, originating from lymph nodes, with eosinophilia is extremely rare. We report here a case with a synchronous diffuse large B-cell lymphoma (DLBCL) and an early adenocarcinoma of the stomach. In addition, this case seemed to be associated with paraneoplastic cutaneous vasculitis caused by hypereosinophilic syndrome (HES) with mixed cryoglobulinemia (MC). Many neoplastic diseases that affect internal organs display cutaneous manifestations, which may be the presenting signs and symptoms of the underlying malignancy. In particular, the association between cutaneous vasculitis and malignancy has been widely reviewed, and recently neoplasms have been suggested to produce antigens and the resultant immune complex formations, activating the serum complement, thus cause paraneoplastic vasculitis. In this case, severe eosinophilia and cryoglobulinemia with low complements were observed in a laboratory test. A biopsy specimen from a skin lesion revealed leukocytoclastic vasculitis with severe perivascular infiltration of eosinophils. The cutaneous vasuculitis was considered to be a manifestation of HES with MC, although there were no etiological factors of HES and MC. Therefore, the vasculitis seems to be a symptom of paraneoplastic syndrome in this case. Our finding suggests that the potential presence of malignancies should be kept in mind as a possible underlying disorder especially in the presence of HES with MC; this possibility is interesting also as regards at least part of the pathogenesis for paraneplastic syndrome

A systematic review of outcomes reported inpediatric perioperative research: A report from the Pediatric Perioperative Outcomes Group

The Pediatric Perioperative Outcomes Group (PPOG) is an international collaborative of clinical investigators and clinicians within the subspecialty of pediatric anesthesiology and perioperative care which aims to use COMET (Core Outcomes Measures in Effectiveness Trials) methodology to develop core outcome sets for infants, children, and young people that are tailored to the priorities of the pediatric surgical population. Focusing on four age‐dependent patient subpopulations determined a priori for core outcome set development: (a) neonates and former preterm infants (up to 60 weeks postmenstrual age); (b) infants (>60 weeks postmenstrual age—1‐13‐<18 years), we conducted a systematic review of outcomes reported in perioperative studies that include participants within age‐dependent pediatric subpopulations. Our review of pediatric perioperative controlled trials published from 2008 to 2018 identified 724 articles reporting 3192 outcome measures. The proportion of published trials and the most frequently reported outcomes varied across predetermined age‐groups. Outcomes related to patient comfort, particularly pain and analgesic requirement, were the most frequent domain for infants, children, and adolescents. Clinical indicators, particularly cardiorespiratory or medication‐related adverse events, were the most common outcomes for neonates and infants <60 weeks and were the second most frequent domain at all other ages. Neonates and infants <60 weeks of age were significantly under‐represented in perioperative trials. Patient‐centered outcomes, healthcare utilization, and bleeding/transfusion‐related outcomes were less often reported. In most studies, outcomes were measured in the immediate perioperative period, with the duration often restricted to the postanesthesia care unit or the first 24 postoperative hours. The outcomes identified with this systematic review will be combined with patient‐centered outcomes identified through a subsequent stakeholder engagement study to arrive at a core outcome set for each age‐specific group

Somatic ‘Soluble’ Adenylyl Cyclase Isoforms Are Unaffected in Sacytm1Lex/Sacytm1Lex ‘Knockout’ Mice

BACKGROUND: Mammalian Soluble adenylyl cyclase (sAC, Adcy10, or Sacy) represents a source of the second messenger cAMP distinct from the widely studied, G protein-regulated transmembrane adenylyl cyclases. Genetic deletion of the second through fourth coding exons in Sacy(tm1Lex)/Sacy(tm1Lex) knockout mice results in a male sterile phenotype. The absence of any major somatic phenotype is inconsistent with the variety of somatic functions identified for sAC using pharmacological inhibitors and RNA interference. PRINCIPAL FINDINGS: We now use immunological and molecular biological methods to demonstrate that somatic tissues express a previously unknown isoform of sAC, which utilizes a unique start site, and which 'escapes' the design of the Sacy(tm1Lex) knockout allele. CONCLUSIONS/SIGNIFICANCE: These studies reveal increased complexity at the sAC locus, and they suggest that the known isoforms of sAC play a unique function in male germ cells

Improving interMediAte Risk management. MARK study

<p>Abstract</p> <p>Background</p> <p>Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.</p> <p>Methods/Design</p> <p>This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors.</p> <p>Discussion</p> <p>Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect.</p> <p>Trial Registration</p> <p>Clinical Trials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01428934">NCT01428934</a></p

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente