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The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema. A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken. Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema. Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events. This review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema. There was no evidence that controlled localised heat therapy was unsafe. The current evidence-base is at a point where no specific clinical recommendations can be made. The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess  the vitamin D supplementation intake status among children from different nationalities in the UAE,  to determine vitamin D intake practices through diet and lifestyle, and the barriers that parents in the UAE  face with providing vitamin D supplementation to their children.   Methods: A cross-sectional observational questionnaire-based survey study design was used.. The study was conducted in the U.A.E and the study participants were parents of children from ages 4-15 years. The questionnaire used in this study was both self-administered and interviewer-administered while inquiring the questions from the parents. A convenience sampling technique was used to collect the data. The response rate of participants was expected to be 63%, the margin of error was 5% and the level of confidence was 95%.   Results: A total of 248 participants (203 mothers, 39 fathers and 6 caregivers) completed the study. Participants reported that the supplements used the most by children were vitamin D supplements (21.85%), followed by multivitamins (21.8%) and calcium supplements (5.6%) and 27.8% of participants in this study reported  to  no  supplementation at all. The rate of vitamin D supplementation among children was higher in those families with higher income levels, parents/caregivers who were more educated, those families who attained health insurance. However, there was no statistical significance between these correlations. Conclusion: The study concluded that challenges like the educational and financial background of parents, family-income level, and health insurance status could help aid in addressing the overall burden of vitamin D deficiency among young children in the UAE. Pediatricians and health care professionals could use our study and use it as an aid to provide screening on lifestyle, sun light exposure, and dietary modifications and also educate parents why and how vitamin D is crucial for their children., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Sharafi N et al.)

Background: Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients., Materials and Methods: This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients., Results: The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11-30.63) was the strongest predictors of mortality., Conclusion: Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Research in Medical Sciences.)

Covariant Lyapunov vectors characterize the directions along which perturbations in dynamical systems grow. They have also been studied as predictors of critical transitions and extreme events. For many applications, it is necessary to estimate these vectors from data since model equations are unknown for many interesting phenomena. We propose an approach for estimating covariant Lyapunov vectors based on data records without knowing the underlying equations of the system. In contrast to previous approaches, our approach can be applied to high-dimensional datasets. We demonstrate that this purely data-driven approach can accurately estimate covariant Lyapunov vectors from data records generated by several low- and high-dimensional dynamical systems. The highest dimension of a time series from which covariant Lyapunov vectors are estimated in this contribution is 128.

Species richness and abundance within the genus Capoeta has been depleted. As such, there is great need for developing assisted reproductive technologies for controlling reproduction in captivity. Here, we conducted in vivo studies with single administrations of human chorionic gonadotropin (hCG) and Ovaprim™ [(D-Arg 6 , Pro 9 NEt)-sGnRH + domperidone] in wild-caught Levantine scraper, Capoeta damascina and then evaluated milt characteristics, fertilization success, serum sex steroids, and spermatogenesis via histological testicular development. Spermiation responses were significantly stronger for Ovaprim injected fish than those injected with hCG or saline. hCG had a negative effect on milt quality by reducing the percentage of motile sperm and fertilization success at 12-48 h post injection (hpi), which was not observed after treatment with Ovaprim or the saline injection. Hormonal therapy resulted in higher sperm densities and spermatocrit, although sperm longevity was not impacted. Sex steroids were not impacted by hCG or saline injection, but Ovaprim effectively induced androgen and progestin release, as evident by higher serum levels of testosterone, and 17α,20β-dihydroxy-4-pregnen-3-one. Consequently, their levels peaked at 12 hpi, which coincided with maximal milt production. Histological analysis of the testes and quantification of germ cell types revealed that Ovaprim significantly stimulated spermiogenesis, as a higher number of accumulated spermatozoa were observed at 12 h and 24 hpi. Testes from saline and hCG-injected fish remained unchanged through the experiment, and contained all stages of germ cells, predominantly spermatocytes with few spermatozoa. In conclusion, Ovaprim treatment successfully induced steroidogenesis and maturation of spermatogenic germ cells, leading to spermiation and milt production without having any negative impacts on sperm quality and fertility in wild-caught C. damascina., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Critical transitions occur in a variety of dynamical systems. Here we employ quantifiers of chaos to identify changes in the dynamical structure of complex systems preceding critical transitions. As suitable indicator variables for critical transitions, we consider changes in growth rates and directions of covariant Lyapunov vectors. Studying critical transitions in several models of fast-slow systems, i.e., a network of coupled FitzHugh-Nagumo oscillators, models for Josephson junctions, and the Hindmarsh-Rose model, we find that tangencies between covariant Lyapunov vectors are a common and maybe generic feature during critical transitions. We further demonstrate that this deviation from hyperbolic dynamics is linked to the occurrence of critical transitions by using it as an indicator variable and evaluating the prediction success through receiver operating characteristic curves. In the presence of noise, we find the alignment of covariant Lyapunov vectors and changes in finite-time Lyapunov exponents to be more successful in announcing critical transitions than common indicator variables as, e.g., finite-time estimates of the variance. Additionally, we propose a new method for estimating approximations of covariant Lyapunov vectors without knowledge of the future trajectory of the system. We find that these approximated covariant Lyapunov vectors can also be applied to predict critical transitions.

Introduction: Using physical wedges (PWs) to modify dose distribution and more homogeneous target coverage is a well-established technique. However, there are many problems with PWs known as beam hardening, which made them problematic. This can be overcome by dynamic wedges which do not filter beam. Comparison of physical properties of physical and enhanced dynamic wedges (EDWs) restricted to homogeneous medium. Hence, the main aim of this study is to compare dosimetric properties of physical and EDWs at bladder inhomogeneous phantom as a most common case implementing wedges., Materials and Methods: An inhomogeneous pelvic phantom with homogeneities of uterus, femur, soft tissue, rectum, and bladder was designed. Eclipse treatment planning system with the aim of bladder target was used for calculations. All dose distributions were measured with EBT3 films., Results: Comparison between beam profiles of physical and EDWs at wedged and nonwedged directions shows a greater difference at near inhomogeneous soft tissue interface and also at heel side of wedges., Conclusion: Little difference observed between dose distribution of physical and EDWs shows neglectable effect of beam hardening produced by PW compared to EDW at inhomogeneous medium. Furthermore, EBT3 films present good feature to measure dose distributions at EDW fields.

Information about time-dependent sensory stimuli is encoded by the spike trains of neurons. Here we consider a population of uncoupled but noisy neurons (each subject to some intrinsic noise) that are driven by a common broadband signal. We ask specifically how much information is encoded in the synchronous activity of the population and how this information transfer is distributed with respect to frequency bands. In order to obtain some insight into the mechanism of information filtering effects found previously in the literature, we develop a mathematical framework to calculate the coherence of the synchronous output with the common stimulus for populations of simple neuron models. Within this frame, the synchronous activity is treated as the product of filtered versions of the spike trains of a subset of neurons. We compare our results for the simple cases of (1) a Poisson neuron with a rate modulation and (2) an LIF neuron with intrinsic white current noise and a current stimulus. For the Poisson neuron, formulas are particularly simple but show only a low-pass behavior of the coherence of synchronous activity. For the LIF model, in contrast, the coherence function of the synchronous activity shows a clear peak at high frequencies, comparable to recent experimental findings. We uncover the mechanism for this shift in the maximum of the coherence and discuss some biological implications of our findings.