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(1) Background: Due to similar clinical presentation and a lack of specific biomarkers, initial differentiation between Takotsubo syndrome (TTS) and non-ST-segment elevation myocardial infarction (NSTEMI) remains challenging in daily practice. Heat Shock Protein 70 (HSP70) is a novel biomarker that is recognized for its potential in the diagnosis and differentiation of cardiovascular conditions. (2) Methods: Data from a total of 156 patients were analyzed (32.1% NSTEMI, 32.7% TTS, and 35.3% controls). Serum concentrations of HSP70 were determined using ELISA and compared between patients and controls. ROC curve analysis, logistic regression analysis and propensity-score-weighted logistic regression were conducted. (3) Results: Concentrations of HSP70 were highest in patients with TTS (median 1727 pg/mL vs. ACS: median 1545 pg/mL vs. controls: median 583 pg/mL, p < 0.0001). HSP70 was predictive for TTS in binary logistic regression analysis (B(SE) = 0.634(0.22), p = 0.004), which even remained significant after correction for possible confounders in propensity-score-weighted analysis. ROC curve analysis also revealed a significant association of HSP70 with TTS (AUC: 0.633, p = 0.008). (4) Conclusions: Based on our findings, HSP70 constitutes a promising biomarker for discrimination between TTS and NSTEMI, especially in combination with established cardiovascular biomarkers like pBNP or high-sensitivity cardiac troponin. [ABSTRACT FROM AUTHOR]

Neurodegenerative diseases (NDs), including Parkinson's and Alzheimer's disease, pose a significant challenge to global health, and early detection tools are crucial for effective intervention. The adaptation of online screening forms and machine learning methods can lead to better and wider diagnosis, potentially altering the progression of NDs. Therefore, this study examines the diagnostic efficiency of machine learning models using Montreal Cognitive Assessment test results (MoCA) to classify scores of people with Parkinson's disease (PD) and healthy subjects. For data analysis, we implemented both rule-based modeling using rough set theory (RST) and classic machine learning (ML) techniques such as logistic regression, support vector machines, and random forests. Importantly, the diagnostic accuracy of the best performing model (RST) increased from 80.0% to 93.4% and diagnostic specificity increased from 57.2% to 93.4% when the MoCA score was combined with temporal metrics such as IRT—instrumental reaction time and TTS—submission time. This highlights that online platforms are able to detect subtle signs of bradykinesia (a hallmark symptom of Parkinson's disease) and use this as a biomarker to provide more precise and specific diagnosis. Despite the constrained number of participants (15 Parkinson's disease patients and 16 healthy controls), the results suggest that incorporating time-based metrics into cognitive screening algorithms may significantly improve their diagnostic capabilities. Therefore, these findings recommend the inclusion of temporal dynamics in MoCA assessments, which may potentially improve the early detection of NDs. [ABSTRACT FROM AUTHOR]

Simple Summary: Takotsubo syndrome (TTS), also known as "broken heart" syndrome, is a rare but serious heart event associated with physical or emotional stress. Patients usually complain about intense chest pain and difficulty in breathing, resembling acute myocardial infarction. Cancer patients are more likely to suffer from TTS and the condition has been linked with the use of several anticancer remedies, such as chemotherapy and targeted therapy. Immunotherapy is a new, viable option for many patients and is currently used in the management of several cancers. There are emerging reports of TTS in cancer patients treated with immunotherapy; however, its causality on TTS development remains uncertain. As TTS may be life-threatening and impact anticancer management, it is crucial to identify any possible association with immunotherapy. In this literature review, we tried to explore the extent of the condition in immunotherapy-treated patients, and to provide information regarding accurate diagnosis, management, and outcomes. Background: There are emerging reports of Takotsubo syndrome (TTS) in cancer patients treated with immune checkpoint inhibitors (ICIs); however, the association of the two remains uncertain. Methods: A systematic literature review was performed in the PubMed database and web sources (Google Scholar) according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. Case reports/series or studies including cancer patients treated with ICIs and presenting with TTS were considered. Results: Seventeen cases were included in the systematic review. Most patients were males (59%) with median age of 70 years (30–83). Most common tumor types were lung cancer (35%) and melanoma (29%). Most patients were on first-line immunotherapy (35%) and after the first cycle (54%) of treatment. The median time on immunotherapy at the time of TTS presentation was 77 days (1–450). The most used agents were pembrolizumab and the combination of nivolumab–ipilimumab (35%, respectively). Potential stressors were recognized in 12 cases (80%). Six patients (35%) presented with concurrent cardiac complications. Corticosteroids were used in the management of eight patients (50%). Fifteen patients (88%) recovered from TTS, two patients (12%) relapsed, and one patient died. Immunotherapy was reintroduced in five cases (50%). Conclusion: TTS may be associated with immunotherapy for cancer. Physicians should be alert for TTS diagnosis in any patient with myocardial infarction-like presentation under treatment with ICIs. [ABSTRACT FROM AUTHOR]

A high-performance versatile computer-assisted pronunciation training (CAPT) system that provides the learner immediate feedback as to whether their pronunciation is correct is very helpful in learning correct pronunciation and allows learners to practice this at any time and with unlimited repetitions, without the presence of an instructor. In this paper, we propose deep learning-based techniques to build a high-performance versatile CAPT system for mispronunciation detection and diagnosis (MDD) and articulatory feedback generation for non-native Arabic learners. The proposed system can locate the error in pronunciation, recognize the mispronounced phonemes, and detect the corresponding articulatory features (AFs), not only in words but even in sentences. We formulate the recognition of phonemes and corresponding AFs as a multi-label object recognition problem, where the objects are the phonemes and their AFs in a spectral image. Moreover, we investigate the use of cutting-edge neural text-to-speech (TTS) technology to generate a new corpus of high-quality speech from predefined text that has the most common substitution errors among Arabic learners. The proposed model and its various enhanced versions achieved excellent results. We compared the performance of the different proposed models with the state-of-the-art end-to-end technique of MDD, and our system had a better performance. In addition, we proposed using fusion between the proposed model and the end-to-end model and obtained a better performance. Our best model achieved a 3.83% phoneme error rate (PER) in the phoneme recognition task, a 70.53% F1-score in the MDD task, and a detection error rate (DER) of 2.6% for the AF detection task. [ABSTRACT FROM AUTHOR]

Since the appearance of the 3D printing in the 1980s it has revolutionized many research fields including the pharmaceutical industry. The main goal is to manufacture complex, personalized products in a low-cost manufacturing process on-demand. In the last few decades, 3D printing has attracted the attention of numerous research groups for the manufacturing of different drug delivery systems. Since the 2015 approval of the first 3D-printed drug product, the number of publications has multiplied. In our review, we focused on summarizing the evolution of the produced drug delivery systems in the last 20 years and especially in the last 5 years. The drug delivery systems are sub-grouped into tablets, capsules, orodispersible films, implants, transdermal delivery systems, microneedles, vaginal drug delivery systems, and micro- and nanoscale dosage forms. Our classification may provide guidance for researchers to more easily examine the publications and to find further research directions. [ABSTRACT FROM AUTHOR]

Antibodies against platelet factor 4 (PF4), a protein released from alpha-granules of activated platelets, may cause a number of pathophysiological conditions. The most commonly known is heparin-induced thrombocytopenia (HIT), which develops in a small proportion of people treated with the anticoagulant drug heparin. Notably, PF4 binds with high affinity to heparin, and in HIT, complexes of PF4/H may, in a small proportion of susceptible patients, trigger the development of anti-PF4 antibodies and subsequent platelet activation and aggregation, ultimately leading to the development of pathological thrombosis at sites of vessel occlusion. Of more modern interest, antibodies against PF4 may also arise in patients with COVID-19 (Coronavirus Disease 2019) or in patients who have been vaccinated against COVID-19, especially in recipients of adenovirus-based vaccines. For this latter group of patients, the terms VITT (vaccine-induced [immune] thrombotic thrombocytopenia) and TTS (thrombotic thrombocytopenia syndrome) have been coined. Another category associated with this pathophysiology comprises those in whom a precipitating event is not clear; this category is referred to as 'spontaneous HIT-like syndrome'. Despite its name, it arises as an HIT-mimicking disorder but without antecedent heparin exposure. In this narrative review, we describe the development of antibodies against PF4, and associated pathophysiology, in such conditions. [ABSTRACT FROM AUTHOR]

There is a need for program evaluations associated with educating healthcare professionals about the treatment of patients who use tobacco. The purpose of this study was to evaluate a Tobacco Treatment Specialist Training program with a pre-test and post-test (provided six months after the program) to determine if participants-maintained knowledge and practices to help patients with tobacco cessation in a mixed-model analysis. A pre-test survey was administered to attendees of a three-day tobacco treatment training continuing education certification program. After 6 months, the attendees were provided a post-test survey with open-ended and Likert-style questions. There were 98 participants who completed the pre-test and 16 who completed the post-test. Responses to the knowledge, confidence, and skills post-test indicated that there was significant improvement and maintenance at the six-month post-test. For example, knowledge improved from a mean of 61.1% (SD: 25.6%) to a mean of 87.9% (SD: 14.4%); medians of 66.7% and 77.7%, respectively, p < 0.001. The in-depth, intensive, three-day TTS training program had a lasting impact. Providers reported greater commitment to helping their patients quit and maintain tobacco cessation habits.

To improve the predictive capability of long-term stress relaxation of elastomers during thermo-oxidative ageing, a method to separate reversible and irreversible processes was adopted. The separation is performed through the analysis of compression set after tempering. On the basis of this separation, a numerical model for long-term stress relaxation during homogeneous ageing is proposed. The model consists of an additive contribution of physical and chemical relaxation. Computer simulations of compression stress relaxation were performed for long ageing times and the results were validated with the Arrhenius treatment, the kinetic study and the time-temperature superposition technique based on experimental data. For chemical relaxation, two decay functions are introduced each with an activation energy and a degradative process. The first process with the lower activation energy dominates at lower ageing times, while the second one with the higher activation energy at longer ageing times. A degradation-rate based model for the evolution of each process and its contribution to the total system during homogeneous ageing is proposed. The main advantage of the model is the possibility to quickly validate the interpolation at lower temperatures within the range of slower chemical processes without forcing a straight-line extrapolation. [ABSTRACT FROM AUTHOR]

The evolution of fretting wear behavior and damage mechanism in Alloy 690TT with cycle number was investigated via laser scanning confocal microscopy (LSCM), scanning electron microscopy (SEM), focus ion beam (FIB), and transmission electron microscopy (TEM). The results showed that the fretting running status underwent a transition from partial slip and mixed stick-slip to final gross slip with the transformation of Ft–D curves from the ellipse to the parallelogram. The coefficient of friction (COF) experienced three drops throughout the fretting process, which indicated the transformation from high-friction wear to low-friction wear. The first drop was due to the transition from two-body to three-body contact. The second and third drops were mainly related to the evolution of the glaze layer from a localized distribution to completely covering the whole contact surface. The competition between fretting induced fatigue cracking (FIF) and fretting induced wear (FIW) ran through the entire fretting wear process. Before the 1.2 × 104th cycle, the fatigue crack growth was faster than wear, and FIF won the competition. As the fretting cycle continued to increase, the wear velocity was obviously faster than that of FIF, which indicated that FIW defeated FIF. The tribologically transformed structure (TTS) participated in the competition between FIF and FIW. The gain boundaries and dislocations in the TTS were a suitable pathway for crack initiation and propagation and oxygen permeation. [ABSTRACT FROM AUTHOR]

We present a structural and dynamic study on the simplest supramolecular hetero-association, recently investigated by the authors to prepare architectural homogeneous structures in the melt state, based on the bio-inspired hydrogen-bonding of thymine/diaminotriazine (thy–DAT) base-pairs. In the combination with an amorphous low Tg poly(butylene oxide) (PBO), no micellar structures are formed, which is expected for nonpolar polymers because of noncompatibility with the highly polar supramolecular groups. Instead, a clear polymer-like transient architecture is retrieved. This makes the heterocomplementary thy–DAT association an ideal candidate for further exploitation of the hydrogen-bonding ability in the bulk for self-healing purposes, damage management in rubbers or even the development of easily processable branched polymers with built-in plasticizer. In the present work, we investigate the temperature range from Tg + 20 °C to Tg + 150 °C of an oligomeric PBO using small-angle X-ray scattering (SAXS) and linear rheology on the pure thy and pure DAT monofunctionals and on an equimolar mixture of thy/DAT oligomers. The linear rheology performed at low temperature is found to correspond to fully closed-state dimeric configurations. At intermediate temperatures, SAXS probes the equilibrium between open and closed states of the thy–DAT mixtures. The temperature-dependent association constant in the full range between open and closed H-bonds and an enhancement of the monomeric friction coefficient due to the groups is obtained. The thy–DAT association in the melt is more stable than the DAT–DAT, whereas the thy–thy association seems to involve additional long-lived interactions. [ABSTRACT FROM AUTHOR]