Background Previous studies indicate that transcranial direct current stimulation (tDCS) with anode over motor cortex (M1) and cathode over contralateral supraorbital region (SO) may be effective in reducing pain, but these studies are limited in number and have not focused on older adults with osteoarthritis (OA). Objective To evaluate the preliminary efficacy and safety of M1-SO applied tDCS on clinical pain severity and mobility performance in adults with knee OA pain. Methods Forty 50- to 70-year-old community-dwelling participants with knee OA were randomly assigned to receive five daily sessions of 2 mA tDCS for 20 min (n = 20) or sham tDCS (n = 20). We measured clinical pain severity via Numeric Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index, and Short-Form McGill Pain Questionnaire. In addition, we measured mobility performance using the 6-Minute Walk Test and the Short Physical Performance Battery. Moreover, we obtained a sensation/safety questionnaire and measured cognition changes using the PROMIS-Applied Cognition-Abilities-Short Form 8a. Results Active tDCS over M1-SO significantly reduced Numeric Rating Scale of pain compared to sham tDCS after completion of the five daily sessions, and remained up to three weeks. No other measures were significantly different from sham. Participants tolerated tDCS over M1-SO well without serious adverse effects or cognition changes. Conclusion Although not consistent in all pain measurements, our findings demonstrate promising clinical efficacy for reduction in pain perception for older adults with knee OA. Trial registration ClinicalTrials.gov Identifier NCT02512393.

Shape memory materials (SMMs) in 3D printing (3DP) technology garnered much attention due to their ability to respond to external stimuli, which direct this technology toward an emerging area of research, “4D printing (4DP) technology.” In contrast to classical 3D printed objects, the fourth dimension, time, allows printed objects to undergo significant changes in shape, size, or color when subjected to external stimuli. Highly precise and calibrated 4D materials, which can perform together to achieve robust 4D objects, are in great demand in various fields such as military applications, space suits, robotic systems, apparel, healthcare, sports, etc. This review, for the first time, to the best of the authors’ knowledge, focuses on recent advances in SMMs (e.g., polymers, metals, etc.) based wearable smart textiles and fashion goods. This review integrates the basic overview of 3DP technology, fabrication methods, the transition of 3DP to 4DP, the chemistry behind the fundamental working principles of 4D printed objects, materials selection for smart textiles and fashion goods. The central part summarizes the effect of major external stimuli on 4D textile materials followed by the major applications. Lastly, prospects and challenges are discussed, so that future researchers can continue the progress of this technology.

Background Coronavirus-associated acute respiratory distress syndrome (CARDS) has limited effective therapy to date. NLRP3 inflammasome activation induced by SARS-CoV-2 in COVID-19 contributes to cytokine storm. Methods This randomised, multinational study enrolled hospitalised patients (18–80 years) with COVID-19-associated pneumonia and impaired respiratory function. Eligible patients were randomised (1:1) via Interactive Response Technology to DFV890 + standard-of-care (SoC) or SoC alone for 14 days. Primary endpoint was APACHE II score at Day 14 or on day-of-discharge (whichever-came-first) with worst-case imputation for death. Other key assessments included clinical status, CRP levels, SARS-CoV-2 detection, other inflammatory markers, in-hospital outcomes, and safety. Findings Between May 27, 2020 and December 24, 2020, 143 patients (31 clinical sites, 12 countries) were randomly assigned to DFV890 + SoC ( n = 71) or SoC alone ( n = 72). Primary endpoint to establish clinical efficacy of DFV890 vs. SoC, based on combined APACHE II score, was not met; LSM (SE), 8·7 (1.06) vs. 8·6 (1.05); p = 0.467. More patients treated with DFV890 vs. SoC showed ≥ 1-level improvement in clinical status (84.3% vs. 73.6% at Day 14), earlier clearance of SARS-CoV-2 (76.4% vs. 57.4% at Day 7), and mechanical ventilation-free survival (85.7% vs. 80.6% through Day 28), and there were fewer fatal events in DFV890 group (8.6% vs. 11.1% through Day 28). DFV890 was well tolerated with no unexpected safety signals. Interpretation DFV890 did not meet statistical significance for superiority vs. SoC in primary endpoint of combined APACHE II score at Day 14. However, early SARS-CoV-2 clearance, improved clinical status and in-hospital outcomes, and fewer fatal events occurred with DFV890 vs. SoC, and it may be considered as a protective therapy for CARDS. Trial registration ClinicalTrials.gov, NCT04382053. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-022-01904-w.

A novel receptor-free polydiacetylene (PDA) nanofiber composite was prepared with polyurethane (PU) via electrospinning, resulting in a flexible biosensor capable of detecting Escherichia coli (E. coli) via colorimetric changes....

Background Recent literature suggests a bi-directional relationship between COVID-19 infection and diabetes mellitus, with an increasing number of previously normoglycemic adults with COVID-19 being admitted with new-onset diabetic ketoacidosis (DKA). However, the possibility of COVID-19 being a potential trigger for A-β + ketosis-prone diabetes (KPD) in these patients needs elucidation. Our study aimed at analyzing such a cohort of patients and determining their natural course of β-cell recovery on serial follow-up. Methods After initial screening, n = 42 previously non-diabetic patients with new-onset DKA and RT-PCR positive COVID-19, were included in our ten-month follow-up study. Of these, n = 22 were negative (suspected A-β + KPD) and n = 20 were positive (Type 1A DM) for autoantibodies (GAD/IA-2/ZnT8). Subsequently, n = 19 suspected KPD and n = 18 Type 1A DM patients were followed-up over ten months with serial assessments of clinical, biochemical and β-cell secretion. Amongst the former, n = 15 (79%) patients achieved insulin independence, while n = 4 (21%) continued to require insulin at ten-months follow-up. Results On comparison, the suspected KPD patients showed significantly greater BMI, age, Hba1c, IL-6 and worse DKA parameters at presentation. Serial C-peptide estimations demonstrated significant β-cell recovery in KPD group, with complete recovery seen in the 15 patients who became insulin independent on follow-up. Younger age, lower BMI, initial severity of DKA and inflammation (IL-6 levels), along-with reduced 25-hydroxy-Vitamin-D levels were associated with poorer recovery of β-cell secretion at ten-month follow-up amongst the KPD patients, Conclusions This is the first prospective study to demonstrate progressive recovery of β-cell secretion in new-onset A-β + KPD provoked by COVID-19 infection in Indian adults, with a distinctly different profile from Type 1A DM. Given their significant potential for β-cell recovery, meticulous follow-up involving C-peptide estimations can help guide treatment and avoid injudicious use of insulin.

Shaded perennial agroforestry systems (AFS) are regarded as desirable land-use practices that improve soil carbon sequestration. However, most studies assume a positive correlation between above ground and below ground carbon without considering the effect of past and current land management, textural variations (silt and clay percentage), and such other site-specific factors that have a major influence on the extent of soil C sequestration. We assessed SOC stock at various depths (0–10, 10–30, 30–60, and 60–100 cm) in shaded perennial coffee (Coffea arabica L.) AFS in a 17-year-old experimental field at the Centro Agronómico Tropical de Investigación y Enseñanza, (9°53′44′′ N, 83°40′7′′ W; soil type: Ultisols and Inceptisols, Turrialba, Costa Rica. The treatments included coffee (Coffea arabica L.) grown conventionally (with chemical fertilizers) and organically (without chemical fertilizers) under two shade trees, Erythrina poeppigiana (Walp.) O.F. Cook., and Terminalia Amazonia J.F.Gmel., Sun Coffee (Coffea arabica L.) (Sole stand of coffee without shade), and Native Forest. Three replicated composite soil samples were collected from each system for each depth class, and SOC stocks in three soil aggregate fractions (2000–250 µm, 250–53 µm, and <53 µm) and in the whole soil determined. The total SOC stocks were highest under forest (146.6 Mg C ha−1) and lowest under sun coffee (92.5 Mg C ha−1). No significant differences were noted in SOC stock within coffee AFS and sun coffee across fraction sizes and depth classes. Organic management of coffee under heavily pruned E. poeppigiana, with pruned litter returned to soil, increased SOC stocks for 0–10 cm depth soil only. High input of organic materials including pruned litter did not improve SOC stocks in deeper soil, whereas variations in silt and clay percentages had a significant effect on SOC stocks. The study suggests that high amounts of aboveground biomass alone are not a good indicator of increased SOC storage in AFS, particularly for soils of sites with historical characteristics and management similar to this study.

Background: Frankly dislocated hips occur in ∼1% to 3% of infants with developmental dysplasia of the hip and are often difficult to treat. In the most severely dislocated hips, the femoral head is positioned outside the posterior/lateral rim of the acetabulum and is irreducible, that is, the femoral head will not reduce by positioning the leg. The purpose of this study was to determine risk factors, using univariate and multivariate analyses, for Pavlik harness failure in infants who initially presented with irreducible/dislocated hips (confirmed by dynamic sonography). Methods: Following institutional review board approval, 124 infants (170 hips) with frankly dislocated hips treated using a Pavlik harness between 2000 and 2018 were evaluated. Patients' demographic characteristics, clinical findings, dynamic sonographic findings (dislocated-fixed vs. dislocated-mobile), age at onset of Pavlik harness treatment, duration of harness usage, and follow-up treatments were recorded. Univariate analyses were used to determine risk factors for treatment failure. Results: In frankly dislocated hips (confirmed by dynamic sonography to be positioned outside the posterior/lateral rim of the acetabulum), Pavlik harness treatment was successful in 104 of 170 hips (61%) while it failed in 66 hips. Mean follow-up was 4.86 ± 4.20 years. Univariate analysis determined the risk factors to be onset of treatment after the seventh week of age (P = 0.049) and initial mobility (dislocated-fixed group) (P < 0.001) by dynamic sonography. In addition, multivariate analysis (P = 0.007) showed infants of multigravida mothers (non-firstborn) to be another risk factor for failure. Six percent of hips with no risk factors failed Pavlik harness treatment, those with 1 risk factor had 42% failure, 2 risk factors had 69% failure, and all 3 risk factors had 100% failure. Conclusions:In our patients with frankly dislocated irreducible hips, 39% of hip failed Pavlik harness treatment. Independent multivariate, logistic regression analysis, and multivariate analysis determining the risk factors for failure of Pavlik harness treatment were onset of treatment after the seventh week of age, infants of multigravida mothers, and initial hip mobility (fixeddislocated hips) by dynamic sonography. Level of Evidence: Level III.

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