Search Results (126)

In the trauma resuscitation literature, there are inconsistent definitions of what constitutes massive transfusion and a unit of blood, complicating the use of transfusion cut-points to declare futility. This is problematic as it can lead to the inefficient use of blood products, further exacerbating current blood product shortages. Previous studies have used various transfusion cut-points per hour to define futility in retrospective analyses but have not accurately defined futility at the bedside due to patient survival even at large rates and volumes of blood transfused. In an attempt to use transfusion cut-points as a marker to help define futility, guidelines have been proposed to limit blood product waste in transfusions for severely bleeding trauma patients, such as Suspension of Transfusion and Other Procedures (STOP) for patients older than 15 and the Futility of Resuscitation Measure (FoRM), used to determine futility in patients older than 60. In an effort to construct effective bedside futile resuscitation criteria with 100% positive predictive value and specificity, this review proposes the use of specific blood component transfusion cut-points combined with parameters from both STOP and FoRM to allow for a comprehensive and accurate method of declaring futility in severely bleeding trauma patients. Full article

Background/Objectives: Low folate intake before and during pregnancy increases the risk of neural tube defects and other adverse outcomes. Gene variants such as MTHFR 677C>T (rs1801133) may increase risks associated with suboptimal folate intake. Our objective was to use BALB/cJ Mthfr^677C>T mice to evaluate the effects of the TT genotype and low folate diets on embryonic development and MTHFR protein expression in pregnant mice. Methods: Female 677CC (mCC) and 677TT (mTT) mice were fed control (2 mg folic acid/kg (2D)), 1 mg folic acid/kg (1D) and 0.3 mg folic acid/kg (0.3D) diets before and during pregnancy. Embryos and maternal tissues were collected at embryonic day 10.5. Embryos were examined for developmental delays and defects. Methyltetrahydrofolate (methylTHF) and total homocysteine (tHcy) were measured in maternal plasma, and MTHFR protein expression was evaluated in maternal liver. Results: MethylTHF decreased due to the experimental diets and mTT genotype. tHcy increased due to 0.3D and mTT genotype; mTT 0.3D mice had significantly higher tHcy than the other groups. MTHFR expression was lower in mTT liver than mCC. MTHFR protein expression increased due to low folate diets in mCC mice, whereas in mTT mice, MTHFR expression increased only due to 1D. Developmental delays were increased in the litters of mTT mice fed 1D and 0.3D. Conclusions: The Mthfr^677C>T mouse models the effects of the MTHFR 677TT genotype in humans and provides a folate-responsive model for examination of the effects of folate intake and the MTHFR 677C>T variant during gestation. Full article

Accurate body condition score (BCS) monitoring in dairy cows is essential for optimizing health, productivity, and welfare. Traditional manual scoring methods are labor-intensive and subjective, driving interest in automated imaging-based systems. This study evaluated the effectiveness of 2D imaging and deep learning for BCS classification using three camera perspectives—front, back, and top-down—to identify the most reliable viewpoint. The research involved 56 Norwegian Red milking cows at the Center for Livestock Experiments (SHF) of Norges Miljo-og Biovitenskaplige Universitet (NMBU) in Norway. Images were classified into BCS categories of 2.5, 3.0, and 3.5 using a YOLOv8 model. The back view achieved the highest classification precision (mAP@0.5 = 0.439), confirming that key morphological features for BCS assessment are best captured from this angle. Challenges included misclassification due to overlapping features, especially in Class 2.5 and background data. The study recommends improvements in algorithmic feature extraction, dataset expansion, and multi-view integration to enhance accuracy. Integration with precision farming tools enables continuous monitoring and early detection of health issues. This research highlights the potential of 2D imaging as a cost-effective alternative to 3D systems, particularly for small and medium-sized farms, supporting more effective herd management and improved animal welfare. Full article

Background: PP-007 (SANGUINATE^®, PEGylated carboxyhemoglobin, bovine) is under development to treat conditions of ischemia/hypoxia. Hemorrhagic/hypovolemic shock (H/HVS) becomes a life-threatening comorbidity due in part to hypotension and hypoxia. Blood transfusions are indicated, but supply and compatibility issues may limit subject access or when blood is not an option due to religious restriction or concern for clinical complications. PP-007 is universally compatible with an effective hydrodynamic radius and colloidal osmotic pressure facilitating perfusion without promoting extravasation. Methods: A review of previous clinical trials was performed and revealed an Open-Label Phase 1 safety study of acute severe anemia (hemoglobin ≤ 5 g/dL) in adult (≥18 y) patients unable to receive red blood cell transfusion (NCT02754999). Primary outcomes included safety events with secondary efficacy measures of organ function and survival at 1, 14, and 28 days. Additionally, a retrospective review of published, peer-reviewed case reports was performed, evaluating the administration of Sanguinate for Expanded Access in those patient populations where blood was not an option over the past 12 years. Results: A total of 103 subjects were enrolled in the Phase I safety study with significant co-morbidities that most commonly included hypertension (n = 43), acute and chronic kidney disease (n = 38), diabetes mellitus (n = 29), gastrointestinal bleeds (n = 18), and sickle cell disease (n = 13). Enrollment characteristics included decreased hemoglobin and severe anemia (mean baseline hemoglobin of 4.2 g/dL). Treatments included an average of three infusions [range 1–17]. Secondary efficacy measures were mean Hb levels, respiratory support, and vasopressor requirements, all demonstrating clinically relevant improvements. Fourteen additional cases were identified in the literature. Though one patient died due to pre-treatment conditions, all patients but one were discharged home in stable condition. Conclusion: Collectively, these observations are encouraging and provide support for the continued evaluation of PP-007 in advanced clinical trials in severe anemia including H/HVS. The review of published case reports underscored the potential of Sanguinate to reduce early mortality. Adverse effects included transient hypertension, lethargy, dizziness, and troponin elevation. These findings highlight the need for continued research and funding of blood alternatives to improve outcomes when standard blood transfusions are unavailable or contraindicated. Full article

Background: Drug therapy remains the principal management strategy for malaria but is increasingly challenged by the emergence of drug-resistant malaria parasites. The need for new antimalarial drugs is urgent, yet drug discovery and development are hindered by high costs, long durations, and safety concerns that prevent approval. The current study aimed to determine antiplasmodial activities of approved drugs in combination with artemether (ART) and lumefantrine (LU). Methods: Using the SYBR Green I assay test, this study investigated the efficacy of epirubicin (EPI) and pelitinib (PEL) combined with ART and LU at fixed drug–drug ratios (4:1, 3:1, 1:1, 1:2, 1:3 and 1:4) and volume/volume. These combinations, as well as single drug treatments, were tested against cultured strains of Plasmodium falciparum (W2, DD2, D6, 3D7 and F32-ART) and fresh and cultured clinical isolates. The fifty percent inhibition concentration (IC₅₀) and a mean sum of fifty percent fractional inhibition concentration (FIC₅₀) were determined. Results: Synergism was observed when EPI was combined with both ART and LU across all fixed ratios with a mean of mean FIC₅₀ values of <0.6. The combination of LU and EPI against the 3D7 strain demonstrated the highest efficacy with a synergism FIC₅₀ value of 0.18. Most combinations of PEL with ART and LU showed antagonism (FIC₅₀ > 1) when tested against strains of P. falciparum and clinical isolates. Conclusions: This study underscores the utility of alternative drug discovery and development strategies to bypass cost, time, and safety barriers, thereby enriching the antimalarial drug pipeline and accelerating the transition from lab to market. Full article

Fertilizer application is a critical component of turfgrass management as it influences growth, color, stress tolerance, and overall quality. However, limited information exists on how fertilizer application, particularly nitrogen (N), affects hybrid bermudagrass performance and actual plant evapotranspiration (ET_a) in both well-watered and deficit irrigation scenarios. A 7-week greenhouse experiment was conducted over two replicated runs to evaluate responses of ‘TifTuf’ hybrid bermudagrass (Cynodon dactylon × C. traansvalensis Burtt Davy) to three nitrogen rates (0, 2.4, and 4.8 g N m⁻² month⁻¹) and three irrigation levels (1.0, 0.65, and 0.30 × ET_a). Fertilized turfgrass exhibited 11–12% greater ET_a compared to unfertilized turfgrass, with no significant differences between the two fertilizer rates. Under well-watered conditions (1.0 × ET_a), the high nitrogen rate significantly improved visual quality (7.8) relative to the unfertilized control (7.1) and the low-rate treatment (7.4). High-rate fertilizer application significantly enhanced visual quality at both deficit levels (7.2 and 6.6, at 0.65 and 0.30 × ET_a, respectively) compared to the unfertilized control (6.2 and 5.9, at 0.65 and 0.30 × ET_a, respectively). At 0.30 × ET_a, low-rate fertilizer application also significantly improved visual quality (7.0) compared to the unfertilized control. Soil nitrate-N levels increased with higher nitrogen application (1.30 ppm, 0.48 ppm, and 0.37 ppm, respectively, for high-rate, low-rate, and unfertilized), and shoot tissue analysis revealed greater N concentration in fertilized turfgrass (1.51%, 1.24%, and 0.85%, respectively, for high-rate, low-rate, and unfertilized). Clipping production and water use efficiency (WUE) were also improved with fertilization, although root development was hindered at the 0.30 × ET_a irrigation level. These findings demonstrate that nitrogen fertilization improves visual quality, shoot growth, WUE, and drought response; however, tradeoffs such as elevated water use and nitrate-N leaching risk necessitate careful management to balance turfgrass performance with water conservation and ecosystem service preservation. Full article

Cardiovascular disease (CVD) is the most common non-cancer cause of death among cancer survivors. Lifestyle and clinical factors associated with cancer mortality are also associated with cardiovascular mortality. The American Heart Association (AHA) has termed these factors “cardiovascular health” (CVH), using Life’s Simple 7 (LS7) or “Life’s Essential 8 (LE8)” to determine poor, intermediate, and high (ideal) CVH. Further, less than ideal CVH is associated with higher cancer mortality. Yet, CVH among cancer survivors remains understudied. This systematic review examined the extant literature, providing a comprehensive report of the findings addressing CVH among cancer survivors. Methods: Using PRISMA guidelines, we systematically examined CVH among cancer survivors (including patients) within PubMed, Scopus, CINAHL, and Embase databases without date limitations from June 2024 to December 2024 using the following keywords: “cancer survivors”, “cancer patient”, “cardiovascular health”, and “cardiovascular risk factors”. Two reviewers independently accessed articles in concordance with LS7 and LE8 metrics. The included studies were examined and assessed for risk of bias and synthesized to elucidate themes of CVH among cancer survivors. Results: We retrieved 2935 studies examining breast, gynecological, endometrial, prostate, colon, lung, lymphoma, and skin cancer survivors published from 2002–2024. Overall, 10 studies met criteria utilizing LS7 or LE8 CVH health outcomes (4 LS7, 5 LE8, and 1 LS7/LE8), ages 40–70 years, with a population (n = 35,980) consisting of mostly female, non-Black individuals; mean survivorship was 7.2 years. Four themes emerged: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and other health outcomes opportunities for CVH awareness. Conclusions: We found that cancer survivors frequently report less than ideal CVH outcomes and would benefit from education/empowerment to support lifestyle changes that improve CVH. Full article

Bermudagrass is a warm-season turfgrass commonly grown in drought-prone areas. Harnessing natural genetic variation available in germplasm is a principal strategy to enhance its resilience to drought stress. This study was carried out to assess the comparative performance of bermudagrass hybrids under drought conditions and their subsequent recovery following the drought period. A total of 48 hybrids, including 2 commercial cultivars, ‘Tifway’ and ‘TifTuf’, were established under optimum growth conditions in the greenhouse and then subjected to drought stress by withholding irrigation for four weeks. The dry-down experiment was laid out in a randomized complete block design with four replications. Turf color, visual quality, and active spectral reflectance data were collected weekly and used to assess the health and vigor of the hybrids during progression of the drought stress for four weeks and through recovery after rewatering. Analysis of variance revealed significant differences among the hybrids for color, visual quality, and spectral vegetation indices. A multivariate analysis grouped the hybrids into drought-tolerant with full recovery after rewatering, moderately tolerant, and susceptible to extended drought stress without recovery. These results showed the prevalence of genetic variation for drought tolerance and proved instrumental in the development of bermudagrass cultivars resilient to drought stress and improved water use efficiency. Full article

The growing global burden of diabetes necessitates the development of glucose sensors that are not only reliable and sensitive but also cost-effective and amenable to point-of-care use. In this work, we report a non-enzymatic electrochemical glucose sensor based on laser-induced graphene (LIG), functionalized with zinc oxide (ZnO) and palladium (Pd) nanostructures. The ZnO nanostructures were systematically optimized on the LIG surface by varying electrochemical deposition parameters, including applied potential, temperature, and deposition time, to enhance the electrocatalytic oxidation of glucose in alkaline medium. Subsequent modification with Pd nanostructures further improved the electrocatalytic activity and sensitivity of the sensor. The performance of the LIG/ZnO/Pd sensor was investigated using chronoamperometric and cyclic voltammetric analysis in 0.1 M NaOH at an applied potential of 0.65 V. The sensor exhibited a wide dynamic range (2–10 mM; 10–24 mM) with a limit of detection of 130 μM, capturing hypo- and hyperglycemia conditions. Moreover, a sensitivity of 25.63 µA·mM⁻¹·cm⁻² was observed. Additionally, the sensor showcased selective response towards glucose in the presence of common interferents. These findings highlight the potential of the LIG/ZnO/Pd platform for integration into next-generation, non-enzymatic glucose monitoring systems for clinical and point-of-care applications. Full article

Game-based learning has emerged as a promising tool in education, particularly for students with disabilities. Educational games can significantly enhance student engagement, motivation, and skill development across subjects by providing personalized learning experiences and immediate feedback. New developments in generative AI offer opportunities to embed advanced features into educational games. Drawing on focus group insights from educators and families (N = 21), we highlight the key features that teachers and parents want to see in educational games. We then discuss how generative AI can potentially supplement and ensure that those key features are included. A case study of applying these features to a game-based tool to support writing across curriculum is provided. This article offers a glimpse into the informal exploration phase of a larger design research project aimed to develop a proof-of-concept for an intervention that builds a bridge between AI, educational games, and scaffolding STEM content for students with all abilities. Full article

Introduction: The World Health Organization has identified dementia as a growing global health concern with 10 million new cases diagnosed every year. The growing number of people living with dementia (PLWD) heightens the need for effective interventions that support PLWD and their caregivers. The most effective interventions supporting PLWD and caregivers combine education, care, and services to increase knowledge, decrease stigma, improve care, heighten empathy, and increase engagement of PLWD in their communities. Dementia Friendly America (DFA), administered by USAging, promotes a Dementia Friendly Community (DFC) initiative designed to engage multiple sectors (e.g., business, healthcare, community services) and engage PLWD in a comprehensive community change process. A center for healthy aging and wellness at a midwestern public university developed a network approach in its regional support of eight DFCs, as a part of its Geriatric Workforce Enhancement Program funded by the U.S. Health Resources and Services Administration. Objective: This article documents a mid-size university’s approach to establishing a regional DFC network of urban and rural communities surrounding the university, describing the support the university provided as well as how communities implemented the four-phase DFC process and emulated guiding principles. Results: A retrospective evaluation found engagement with the DFA guiding principles and varying levels of adherence to DFC phases. Discussion: The project team suggests that there are unique roles that universities can play in supporting the DFC movement and that developing a network of communities is a helpful strategy to use in providing this support. Additionally, the authors propose the integration of a community change model to guide future DFC work. Conclusions: This article helps to fill an existing research gap concerning DFC implementation and explores the unique role academic partners can play in cultivating regional hubs of DFC activity. Full article

Science, technology, engineering, arts, and mathematics (STEAM) education represents an array of fields that have significant promise for the future careers of students. However, in deaf education, little research has been conducted to understand how best to provide access to STEAM learning opportunities for deaf students. This manuscript explores STEAM learning and Deaf Education through the lens of translanguaging. Translanguaging is the use of multiple linguistic resources by multilingual individuals. The authors recorded deaf teens attending a STEAM camp as they engaged in a collaborative problem-solving activity to explore the language resources they used to make sense of and communicate their understanding of the problem during various stages of the activity (gathering information, generating ideas, and evaluating ideas). We viewed their interactions through a translanguaging lens. We found that the campers used an array of both language-based (ASL, spoken English, gesture, and fingerspelling) and tool-based (writing on a whiteboard, engaging with informational papers, using computers or phones) translanguaging activities to gather information and communicate with one another. While selection of language resources did not differ by activity stage, they did differ by group, suggesting that campers were sensitive to the communication needs of their group mates. Full article

Fatigability, a phenotype of poor energy regulation, is associated with lower physical activity in older adults, but independent associations with sedentary behavior are unknown. We examined whether sedentary behavior was associated with fatigability using cross-sectional data from the Study of Muscle, Mobility and Aging. Mean sedentary time, sedentary bout length, and sedentary breaks/day were measured using 7-day waking hour data collected from a thigh-worn accelerometer. Fatigability was assessed using the Pittsburgh Fatigability Scale Physical subscale (PFS, score 0–50, higher = greater fatigability) and the Pittsburgh Performance Fatigability Index (PPFI), a percentage decline of observed cadence to maximal cadence from a wrist-worn accelerometer captured during a usual-paced 400 m walk (range 0–100%, higher = more performance deterioration). The participants (N = 663; 76.4 ± 5.1 years, 58% women, 54% high PFS, median PPFI 1.4%) were sedentary for 614.8 ± 111.7 min/day, with a mean 15.0 ± 5.5 min/day bout length and mean 46.1 ± 13.2 sedentary breaks/day. Higher total sedentary time was associated with greater PFS Physical score (β = 0.71, p = 0.0368), but this association was not independent of step count/day. After adjusting for step count/day, higher sedentary time was associated with lower PPFI score (β = −0.44, p = 0.0039). Sedentary bout length and breaks/day were not associated with perceived or performance fatigability. Future studies should aim to better understand the inter-relatedness of these behaviors. Full article

Background: Fitness is relevant for firefighter occupational performance, but its influence on exertion and cognition during occupational tasks remains unclear. We aim to determine fitness’s influence on performance, exertion, and cognition during simulated firefighter occupational tasks. Methods: Two baseline fitness assessments occurred to measure aerobic fitness, strength, power, and body composition in 33 non-firefighter participants (females/males: 15/18; 25.18 ± 4.06 years; 174.01 ± 9.77 cm; 75.94 ± 13.18 kg). A third visit involved participants completing an occupational task assessment (OTA; four rounds of deadlifts, sandbag carries, and a cognitive assessment at 35 °C/50% humidity) to the best of their ability. Multiple linear regression models, including strength and power, aerobic capacity, and body composition, were used to predict OTA performance and exertion. Our outcomes included time to complete, exertion, and cognitive performance during the OTA. Results: The model predicted OTA time, RPE, skin temperature, and blood lactate (ps < 0.02), but not core temperature (p > 0.24). The model did not predict cognitive errors (ps > 0.06). Conclusions: These metrics of fitness provide meaningful predictive insight into firefighters’ occupational readiness during simulated occupational tasks. Full article

Kalanchoe daigremontiana, a medicinal plant rich in bioactive compounds, has the potential to serve as a feed supplement, reducing reliance on conventional livestock medications while potentially enhancing productivity. This study evaluated the effects of K. daigremontiana supplementation over 52 days on kidney and liver function, metabolism, weight changes, and reproductive efficiency in multiparous Alpine goats during the breeding season. Fifty-five goats were assigned to either a control (CTL, n = 27; 47.6 ± 1.1 kg) or a K. daigremontiana-supplemented (KAL, n = 28; 47.6 ± 1.3 kg) diet. The KAL group received K. daigremontiana at a dry matter-based inclusion rate of 2 kg t⁻¹ of feed, while the CTL group received no supplementation. Blood samples were collected at four time points to assess the biochemical markers of kidney and liver function. Pregnancy was achieved through natural mating, and reproductive efficiency was evaluated. Overall, liver and kidney function did not differ significantly between treatments (p > 0.05). However, KAL supplementation was associated with increased creatinine (p < 0.05), ALP (p < 0.001), and bilirubin (p < 0.05) at specific time points, whereas CTL goats exhibited higher BUN (p < 0.001), AST (p < 0.05), albumin (p < 0.001), total protein (p ≤ 0.05), and phosphorus (p < 0.01) on specific dates. Other metabolic markers, weight gain, and reproductive efficiency did not differ between treatments (p > 0.05). Overall, Kalanchoe daigremontiana supplementation had mild, transient effects on goat health without significantly impacting productivity. Further research is needed to explore its long-term effects and optimal dosage for livestock nutrition. Full article