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Background: The Crohn's Disease (CD) Activity Index (CDAI), Inflammatory Bowel Disease (IBD) Questionnaire (IBDQ), and IBD-Fatigue (IBD-F) scale are useful patient-reported outcome (PRO) tools for assessing the treatment benefits of vedolizumab (VDZ) beyond clinical trial endpoints in patients with CD. Objectives: To assess clinical response, clinical remission, steroid-free remission, changes from baseline for PROs, and safety in a real-world cohort of patients with moderate-to-severe active CD treated with VDZ. Design: POLONEZ II was a multicenter, observational, prospective study across 10 Polish centers from April 2020 to October 2023 for 54 weeks in patients with CD eligible for reimbursed VDZ. Methods: Primary endpoints at week 54 (W54) were clinical response (⩾70-point reduction in CDAI and >25% reduction vs baseline), remission (CDAI score ⩽150), and steroid-free remission. Other outcomes were changes in PROs (CDAI score and health-related quality of life) and safety. Kaplan–Meier survival analyses were performed. Results: Of 98 patients with CD, the mean age was 35.2 years, 57.1% were male, and 72.4% had an ileocolonic disease. At W54 (n = 98), 63.3% of patients achieved clinical response, 48.0% remission, and 36.0% steroid-free remission. The durability of clinical response, remission, and steroid-free remission (W14–W54) were 68.9%, 62.9%, and 57.1%, respectively. By W54, a significant reduction in the PROs, such as the total CDAI score (p < 0.001), stool frequency (p < 0.001), abdominal pain score (p < 0.001), IBDQ (p < 0.001), IBD-F (p < 0.05), and fatigue impact on daily activities (p < 0.001), was observed. During VDZ treatment, arthralgia (23.7%–8.7%) and anemia (22.6%–15.9%) decreased between baseline and W54. Non-serious adverse events (SAEs; 12.2%), SAEs (7.1%), and VDZ-related rash (1.0%) were reported. Mean CD-related hospitalization duration decreased from baseline (10.2 days) to the end of the study (5.3 days). Conclusion: POLONEZ II demonstrated long-term real-world benefits of VDZ toward effectiveness, safety, and improved PROs and patients' quality of life. Trial registration: ENCePP (EUPAS32716). Plain language summary: Effect of vedolizumab treatment on Crohn's disease and fatigue The goal of this study was to thoroughly assess the effectiveness and safety of vedolizumab (VDZ), a monoclonal antibody, as a treatment for Crohn's disease (CD), a weakening inflammatory gut condition. This study used a selection of assessment tools to measure patient-reported outcomes (PROs), which are commonly used to evaluate the benefits of a treatment in terms of features important to patients. These tools included the CD Activity Index (CDAI), which measures disease activity; the Inflammatory Bowel Disease (IBD) Questionnaire (IBDQ), which evaluates patients' quality of life; and IBD-Fatigue (IBD-F), which assesses fatigue. Medical records of patients treated with VDZ for moderate to severely active CD for 54 weeks were examined. Treatment outcomes showed marked improvements, with 63.3% of patients showing a favorable response and fewer CD symptoms. Approximately 48.0% of patients achieved clinical remission, showing better control of their symptoms and a long period of symptom improvement. Notably, the benefits of the treatment continued during the treatment period, and a total of 57.1% of patients were corticosteroid-free while maintaining good outcomes. From the start of the trial until W54, the CDAI, IBDQ, and IBD-F scores decreased, likely owing to a reduction in disease symptoms. Patients also described decreased abdominal pain and a lower stool frequency. Furthermore, VDZ treatment reduced fatigue, a common problem in CD. Side effects were reported in 7.1% of patients with CD, with only one patient reporting a VDZ-related rash. Although some patients had to stop using VDZ due to the ineffectiveness of treatment, the majority of patients (67.3%) continued their treatment. Overall, VDZ effectively reduced CD symptoms and improved the patients' quality of life while showing clinical effectiveness and a safety profile consistent with the approved label. [ABSTRACT FROM AUTHOR]

Background: Parkinson’s disease is a progressive neurodegenerative disease characterized by clinical motor signs and non-motor symptoms that severely impact quality of life. There is an urgent need for therapies that might slow, halt or even reverse the progression of existing symptoms or delay the onset of new symptoms. Photobiomodulation is a therapy that has shown potential to alleviate some symptoms of Parkinson’s disease in animal studies and in small clinical trials. Objective: To assess long-term effectiveness of photobiomodulation therapy in a cohort of Parkinson’s disease individuals after five years of continuing therapy. Methods: Eight participants of the initial 12 in a previously published study agreed to be reassessed after five years. Seven of these participants had continued home-based, self-applied photobiomodulation therapy three times per week for five years. One participant had discontinued treatment after one year. Participants were assessed for a range of clinical motor signs, including MDS-UPDRS-III, measures of mobility and balance. Cognition was assessed objectively, and quality of life and sleep quality were assessed using self-reported questionnaires. A Wilcoxon Signed Ranks test was used to evaluate change in outcome measures between baseline (before treatment) and after five years, with the alpha value set to 0.05. Results: Of the seven participants who had continued photobiomodulation therapy, one had a preliminary diagnosis of multisystem atrophy and was excluded from the group analysis. For the remaining six participants, there was a significant improvement in walk speed, stride length, timed up-and-go tests, tests of dynamic balance, and cognition compared to baseline and nonsignificant improvements in all other measures, apart from MDS-UPDRS-III, which was unchanged and one measure of static balance (single leg stance, standing on the unaffected leg with eyes open) which declined. Five of six participants either improved or showed no decline in MDS-UPDRS-III score and most participants showed improvement or no decline in all other outcome measures. No adverse effects of the photobiomodulation therapy were reported. Conclusions: This study provides a signal that photobiomodulation therapy might safely reduce important clinical motor signs and non-motor symptoms in some Parkinson’s disease patients, with improvements maintained over several years. Home-based photobiomodulation therapy has the potential to complement standard therapies to manage symptoms and potentially delay Parkinson’s symptom progression. Trial registration: Australian New Zealand Clinical Trials Registry, registration number ACTRN12618000038291p, registered on 12/01/2018. [ABSTRACT FROM AUTHOR]

To advance the foundation of one-particle reduced density matrix functional theory (1RDMFT), we refine and relate some of its fundamental features and underlying concepts. We define by concise means the scope of a 1RDMFT, identify its possible natural variables, and explain how symmetries could be exploited. In particular, for systems with time-reversal symmetry, we explain why there exist six equivalent universal functionals, prove concise relations among them, and conclude that the important notion of v-representability is relative to the scope and choice of variable. All these fundamental concepts are then comprehensively discussed and illustrated for the Hubbard dimer and its generalization to arbitrary pair interactions W. For this, we derive by analytical means the pure and ensemble functionals with respect to both the real- and complex-valued Hilbert space. The comparison of various functionals allows us to solve the underlying v-representability problems analytically, and the dependence of its solution on the pair interaction is demonstrated. Intriguingly, the gradient of each universal functional is found to always diverge repulsively on the boundary of the domain. In that sense, this key finding emphasizes the universal character of the fermionic exchange force, recently discovered and proven in the context of translationally invariant one-band lattice models. [ABSTRACT FROM AUTHOR]

Some immigrants become more religious after migration due to isolation, marginalization, and difficulties adjusting to a new culture. The purpose of this research is twofold: to explore the level of religiosity among Kyrgyzstani migrants who self-identify as religious and to ascertain the extent to which Muslim Kyrgyz in the United States are able to fulfill their religious yearnings. The data are drawn from a survey of Kyrgyz migrants in the Chicago metropolitan area. This study sheds light on the diversity of the Muslim community, demonstrating that former Soviet Muslims practice Islam in ways that are different from other Muslims. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate whether artifacts on contrast-enhanced (CE) breast MRI maximum intensity projections (MIPs) might already be forecast before gadolinium-based contrast agent (GBCA) administration during an ongoing examination by analyzing the unenhanced T1-weighted images acquired before the GBCA injection. Materials and methods: This IRB-approved retrospective analysis consisted of n = 2884 breast CE MRI examinations after intravenous administration of GBCA, acquired with n = 4 different MRI devices at different field strengths (1.5 T/3 T) during clinical routine. CE-derived subtraction MIPs were used to conduct a multi-class multi-reader evaluation of the presence and severity of artifacts with three independent readers. An ensemble classifier (EC) of five DenseNet models was used to predict artifacts for the post-contrast subtraction MIPs, giving as the input source only the pre-contrast T1-weighted sequence. Thus, the acquisition directly preceded the GBCA injection. The area under ROC (AuROC) and diagnostics accuracy scores were used to assess the performance of the neural network in an independent holdout test set (n = 285). Results: After majority voting, potentially significant artifacts were detected in 53.6% (n = 1521) of all breast MRI examinations (age 49.6 ± 12.6 years). In the holdout test set (mean age 49.7 ± 11.8 years), at a specificity level of 89%, the EC could forecast around one-third of artifacts (sensitivity 31%) before GBCA administration, with an AuROC = 0.66. Conclusion: This study demonstrates the capability of a neural network to forecast the occurrence of artifacts on CE subtraction data before the GBCA administration. If confirmed in larger studies, this might enable a workflow-blended approach to prevent breast MRI artifacts by implementing in-scan personalized predictive algorithms. Clinical relevance statement: Some artifacts in contrast-enhanced breast MRI maximum intensity projections might be predictable before gadolinium-based contrast agent injection using a neural network. Key Points: • Potentially significant artifacts can be observed in a relevant proportion of breast MRI subtraction sequences after gadolinium-based contrast agent administration (GBCA). • Forecasting the occurrence of such artifacts in subtraction maximum intensity projections before GBCA administration for individual patients was feasible at 89% specificity, which allowed correctly predicting one in three future artifacts. • Further research is necessary to investigate the clinical value of such smart personalized imaging approaches. [ABSTRACT FROM AUTHOR]

Introduction: The pathogenesis of chronic subdural hematoma (CSDH) has not been completely understood. However, different mechanisms can result in space-occupying subdural fluid collections, one pathway can be the transformation of an original trauma-induced acute subdural hematoma (ASDH) into a CSDH. Materials and Methods: All patients with unilateral CSDH, requiring burr hole trephination between 2018 and 2023 were included. The population was distributed into an acute-to-chronic group (group A, n = 41) and into a conventional group (group B, n = 282). Clinical and radiographic parameters were analyzed. In analysis A, changes of parameters after trauma within group A are compared. In analysis B, parameters between the two groups before surgery were correlated. Results: In group A, volume and midline shift increased significantly during the progression from acute-to-chronic (p < 0.001, resp.). Clinical performance (modified Rankin scale, Glasgow Coma Scale) dropped significantly (p = 0.035, p < 0.001, resp.). Median time between trauma with ASDH and surgery for CSDH was 12 days. Patients treated up to the 12th day presented with larger volume of ASDH (p = 0.012). Before burr hole trephination, patients in group A presented with disturbance of consciousness (DOC) more often (p = 0.002), however less commonly with a new motor deficit (p = 0.014). Despite similar midline shift between the groups (p = 0.8), the maximal hematoma width was greater in group B (p < 0.001). Conclusion: If ASDH transforms to CSDH, treatment may become mandatory early due to increase in volume and midline shift. Close monitoring of these patients is crucial since DOC and rapid deterioration is common in this type of SDH. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions The hypothalamic–pituitary–adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high‐income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution.We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2–86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post‐waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output.Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults (p < .05). Sex was not a significant predictor of cortisol levels (p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline (p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high‐income populations.This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings. [ABSTRACT FROM AUTHOR]

Objective: The objective is to identify risk factors that potentially prolong the hospital stay in patients after undergoing first single-level open lumbar microdiscectomy. Methods: A retrospective single-centre study was conducted. Demographic data, medical records, intraoperative course, and imaging studies were analysed. The outcome measure was defined by the number of days stayed after the operation. A prolonged length of stay (LOS) stay was defined as a minimum of one additional day beyond the median hospital stay in our patient collective. Bivariate analysis and multiple stepwise regression were used to identify independent factors related to the prolonged hospital stay. Results: Two hundred consecutive patients who underwent first lumbar microdiscectomy between 2018 and 2022 at our clinic were included in this study. Statistical analysis of factors potentially prolonging postoperative hospital stay was done for a total of 24 factors, seven of them were significantly related to prolonged LOS in bivariate analysis. Sex (p = 0.002, median 5 vs. 4 days for females vs. males) and age (rs = 0.35, p ≤ 0.001, N = 200) were identified among the examined demographic factors. Regarding preoperative physical status, preoperative immobility reached statistical significance (p ≤ 0.001, median 5 vs. 4 days). Diabetes mellitus (p = 0.043, median 5 vs. 4 days), anticoagulation and/or antiplatelet agents (p = 0.045, median 5 vs. 4 days), and postoperative narcotic consumption (p ≤ 0.001, median 5 vs. 4 days) as comorbidities were associated with a prolonged hospital stay. Performance of nucleotomy (p = 0.023, median 5 vs. 4 days) was a significant intraoperative factor. After linear stepwise multivariable regression, only preoperative immobility (p ≤ 0.001) was identified as independent risk factors for prolonged length of postoperative hospital stay. Conclusion: Our study identified preoperative immobility as a significant predictor of prolonged hospital stay, highlighting its value in preoperative assessments and as a tool to pinpoint at-risk patients. Prospective clinical trials with detailed assessment of mobility, including grading, need to be done to verify our results. [ABSTRACT FROM AUTHOR]

Objective: The objective is to identify risk factors that potentially prolong the hospital stay in patients after undergoing first single-level open lumbar microdiscectomy. Methods: A retrospective single-centre study was conducted. Demographic data, medical records, intraoperative course, and imaging studies were analysed. The outcome measure was defined by the number of days stayed after the operation. A prolonged length of stay (LOS) stay was defined as a minimum of one additional day beyond the median hospital stay in our patient collective. Bivariate analysis and multiple stepwise regression were used to identify independent factors related to the prolonged hospital stay. Results: Two hundred consecutive patients who underwent first lumbar microdiscectomy between 2018 and 2022 at our clinic were included in this study. Statistical analysis of factors potentially prolonging postoperative hospital stay was done for a total of 24 factors, seven of them were significantly related to prolonged LOS in bivariate analysis. Sex (p = 0.002, median 5 vs. 4 days for females vs. males) and age (rs = 0.35, p ≤ 0.001, N = 200) were identified among the examined demographic factors. Regarding preoperative physical status, preoperative immobility reached statistical significance (p ≤ 0.001, median 5 vs. 4 days). Diabetes mellitus (p = 0.043, median 5 vs. 4 days), anticoagulation and/or antiplatelet agents (p = 0.045, median 5 vs. 4 days), and postoperative narcotic consumption (p ≤ 0.001, median 5 vs. 4 days) as comorbidities were associated with a prolonged hospital stay. Performance of nucleotomy (p = 0.023, median 5 vs. 4 days) was a significant intraoperative factor. After linear stepwise multivariable regression, only preoperative immobility (p ≤ 0.001) was identified as independent risk factors for prolonged length of postoperative hospital stay. Conclusion: Our study identified preoperative immobility as a significant predictor of prolonged hospital stay, highlighting its value in preoperative assessments and as a tool to pinpoint at-risk patients. Prospective clinical trials with detailed assessment of mobility, including grading, need to be done to verify our results. [ABSTRACT FROM AUTHOR]

Parkinson's disease is the second most common neurodegenerative disease and is increasing in incidence. The combination of motor and non-motor symptoms makes this a devastating disease for people with Parkinson's disease and their care givers. Parkinson's disease is characterised by mitochondrial dysfunction and neuronal death in the substantia nigra, a reduction in dopamine, accumulation of α-synuclein aggregates and neuroinflammation. The microbiome–gut–brain axis is also important in Parkinson's disease, involved in the spread of inflammation and aggregated α-synuclein. The mainstay of Parkinson's disease treatment is dopamine replacement therapy, which can reduce some of the motor signs. There is a need for additional treatment options to supplement available medications. Photobiomodulation (PBM) is a form of light therapy that has been shown to have multiple clinical benefits due to its enhancement of the mitochondrial electron transport chain and the subsequent increase in mitochondrial membrane potential and ATP production. PBM also modulates cellular signalling and has been shown to reduce inflammation. Clinically, PBM has been used for decades to improve wound healing, treat pain, reduce swelling and heal deep tissues. Pre-clinical experiments have indicated that PBM has the potential to improve the clinical signs of Parkinson's disease and to provide neuroprotection. This effect is seen whether the PBM is directed to the head of the animal or to other parts of the body (remotely). A small number of clinical trials has given weight to the possibility that using PBM can improve both motor and non-motor clinical signs and symptoms of Parkinson's disease and may potentially slow its progression. [ABSTRACT FROM AUTHOR]

This article presents the case of a 65-year-old man who was admitted to hospital due to persistent diarrhoea and unintentional weight loss. During the initial diagnosis, ultrasound examination revealed numerous liver metastases, the most common causes of which are colon, lung, and breast cancers. However, in the presented case, further diagnostics revealed a highly malignant duodenal neuroendocrine tumour. Two years earlier, primary hyperparathyroidism was diagnosed, but this problem was neglected by the patient. The mentioned diseases can be a clinical manifestation of multiple endocrine neoplasia type 1 syndrome. Unfortunately, the patient died before the final diagnosis. The daughter of the patient was also encouraged to check for the disease. Extraordinarily, she was totally uninterested. Denial about terminal cancer and disregard of its consequences is a palliative issue affecting not only patients but also their families. [ABSTRACT FROM AUTHOR]

Background: Despite multiple studies on the embolization of the middle meningeal artery, there is limited data on the treatment response of recurrent chronic subdural hematomas (CSDH) to embolization and on the volume change. Methods: We retrospectively compared the treatment response and volume change of recurrent CSDHs in a conventional group (second surgery) with an embolization group (embolization as stand-alone treatment) during the time-period from August 2019 until June 2022. Different clinical and radiological factors were assessed. Treatment failure was defined as necessity of treatment for second recurrence. Hematoma volumes were determined in the initial CT scan before first surgery, after the first surgery, before retreatment as well as in an early (1 day–2 weeks) and in a late follow-up CT scan (2–8 weeks). Results: Fifty recurrent hematomas after initial surgery were treated either by second surgery (n = 27) or by embolization (n = 23). 8/27 (26,6%) surgically treated and 3/23 (13%) of the hematomas treated by embolization needed to be treated again. This leads to an efficacy in recurrent hematomas of 73,4% in surgically treated and of 87% in embolized hematomas (p = 0.189). In the conventional group, mean volume decreased significantly already in the first follow-up CT scan from 101.7 ml (SD 53.7) to 60.7 ml (SD 40.3) (p = 0.001) and dropped further in the later follow-up scan to 46.6 ml (SD 37.1) (p = 0.001). In the embolization group, the mean volume did decrease insignificantly from 75.1 ml (SD 27.3) to 68 ml (SD 31.4) in the first scan (p = 0.062). However, in the late scan significant volume reduction to 30.8 ml (SD 17.1) could be observed (p = 0.002). Conclusions: Embolization of the middle meningeal artery is an effective treatment option for recurrent CSDH. Patients with mild symptoms who can tolerate slow volume reduction are suitable for embolization, whereas patients with severe symptoms should be reserved for surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: To address the global need for accessible evidence-based tools for competency-based education, we developed ENTRUST, an innovative online virtual patient simulation platform to author and securely deploy case scenarios to assess surgical decision-making competence. STUDY DESIGN: In partnership with the College of Surgeons of East, Central, and Southern Africa, ENTRUST was piloted during the Membership of the College of Surgeons (MCS) 2021 examination. Examinees (n = 110) completed the traditional 11-station oral objective structured clinical examinations (OSCEs), followed by 3 ENTRUST cases, authored to query similar clinical content of 3 corresponding OSCE cases. ENTRUST scores were analyzed for associations with MCS Examination outcome using independent sample t tests. Correlation of ENTRUST scores to MCS Examination Percentage and OSCE station scores was calculated with Pearson correlations. Bivariate and multivariate analyses were performed to evaluate predictors of performance. RESULTS: ENTRUST performance was significantly higher in examinees who passed the MCS examination compared with those who failed (p < 0.001). The ENTRUST score was positively correlated with MCS Examination Percentage (p < 0.001) and combined OSCE station scores (p < 0.001). On multivariate analysis, there was a strong association between MCS Examination Percentage and ENTRUST Grand Total Score (p < 0.001), Simulation Total Score (p = 0.018), and Question Total Score (p < 0.001). Age was a negative predictor for ENTRUST Grand Total and Simulation Total Score, but not for Question Total Score. Sex, native language status, and intended specialty were not associated with performance on ENTRUST. CONCLUSIONS: This study demonstrates feasibility and initial validity evidence for the use of ENTRUST in a high-stakes examination context for assessment of surgical decision-making. ENTRUST holds potential as an accessible learning and assessment platform for surgical trainees worldwide. [ABSTRACT FROM AUTHOR]

The human gut microbiome contains the largest number of bacteria in the body and has the potential to greatly influence metabolism, not only locally but also systemically. There is an established link between a healthy, balanced, and diverse microbiome and overall health. When the gut microbiome becomes unbalanced (dysbiosis) through dietary changes, medication use, lifestyle choices, environmental factors, and ageing, this has a profound effect on our health and is linked to many diseases, including lifestyle diseases, metabolic diseases, inflammatory diseases, and neurological diseases. While this link in humans is largely an association of dysbiosis with disease, in animal models, a causative link can be demonstrated. The link between the gut and the brain is particularly important in maintaining brain health, with a strong association between dysbiosis in the gut and neurodegenerative and neurodevelopmental diseases. This link suggests not only that the gut microbiota composition can be used to make an early diagnosis of neurodegenerative and neurodevelopmental diseases but also that modifying the gut microbiome to influence the microbiome–gut–brain axis might present a therapeutic target for diseases that have proved intractable, with the aim of altering the trajectory of neurodegenerative and neurodevelopmental diseases such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, autism spectrum disorder, and attention-deficit hyperactivity disorder, among others. There is also a microbiome–gut–brain link to other potentially reversible neurological diseases, such as migraine, post-operative cognitive dysfunction, and long COVID, which might be considered models of therapy for neurodegenerative disease. The role of traditional methods in altering the microbiome, as well as newer, more novel treatments such as faecal microbiome transplants and photobiomodulation, are discussed. [ABSTRACT FROM AUTHOR]

Emerging evidence is increasingly supporting the use of transcranial photobiomodulation (tPBM) to improve symptoms of neurodegenerative diseases, including Parkinson's disease (PD). The objective of this study was to analyse the safety and efficacy of tPBM for PD motor symptoms. The study was a triple blind, randomized placebo-controlled trial with 40 idiopathic PD patients receiving either active tPBM (635 nm plus 810 nm LEDs) or sham tPBM for 24 min per day (56.88J), six days per week, for 12 weeks. The primary outcome measures were treatment safety and a 37-item MDS-UPDRS-III (motor domain) assessed at baseline and 12 weeks. Individual MDS-UPDRS-III items were clustered into sub-score domains (facial, upper-limb, lower-limb, gait, and tremor). The treatment produced no safety concerns or adverse events, apart from occasional temporary and minor dizziness. There was no significant difference in total MDS-UPDRS-III scores between groups, presumably due to the placebo effect. Additional analyses demonstrated that facial and lower-limb sub-scores significantly improved with active treatment, while gait and lower-limb sub-scores significantly improved with sham treatment. Approximately 70% of participants responded to active treatment (≥5 decrease in MDS-UPDRS-III score) and improved in all sub-scores, while sham responders improved in lower-limb sub-scores only. tPBM appears to be a safe treatment and improved several PD motor symptoms in patients that responded to treatment. tPBM is proving to be increasingly attractive as a possible non-pharmaceutical adjunct therapy. [ABSTRACT FROM AUTHOR]

In the pages of this journal, Damon Coletta and Tom Crosbie published a response to our article entitled, "The Continuing Relevance of Morris Janowitz's The Professional Soldier for the Education of Officers." In that article, we argued that Janowitz's emphasis on the need for political awareness in the U.S. military should receive greater attention in the education of today's officer corps. Coletta and Crosbie suggest that we are too ready to abandon Samuel Huntington's classic work, The Soldier and the State. In this continuation of that dialogue, we respond with three clarifications and three substantive disagreements. Huntington and Janowitz offer divergent perspectives on the issues of officer education and "political virtue," we suggest, and Janowitz's perspective deserves greater weight that it has traditionally received. Coletta and Crosbie also place greater emphasis on the separability of political and military affairs than is warranted, and Janowitz is more helpful here as well. [ABSTRACT FROM AUTHOR]

Objective: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research.Materials and methods: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research.Results: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research.Conclusion: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research.Key Points: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research.Graphical Abstract: To investigate how different combinations of T1-weighted (T1w), T2-weighted (T2w), and diffusion-weighted imaging (DWI) impact the performance of virtual contrast-enhanced (vCE) breast MRI.The IRB-approved, retrospective study included 1064 multiparametric breast MRI scans (age: 52 ± 12 years) obtained from 2017 to 2020 (single site, two 3-T MRI). Eleven independent neural networks were trained to derive vCE images from varying input combinations of T1w, T2w, and multi-b-value DWI sequences (b-value = 50–1500 s/mm2). Three readers evaluated the vCE images with regard to qualitative scores of diagnostic image quality, image sharpness, satisfaction with contrast/signal-to-noise ratio, and lesion/non-mass enhancement conspicuity. Quantitative metrics (SSIM, PSNR, NRMSE, and median symmetrical accuracy) were analyzed and statistically compared between the input combinations for the full breast volume and both enhancing and non-enhancing target findings.The independent test set consisted of 187 cases. The quantitative metrics significantly improved in target findings when multi-b-value DWI sequences were included during vCE training (p < 0.05). Non-significant effects (p > 0.05) were observed for the quantitative metrics on the full breast volume when comparing input combinations including T1w. Using T1w and DWI acquisitions during vCE training is necessary to achieve high satisfaction with contrast/SNR and good conspicuity of the enhancing findings. The input combination of T1w, T2w, and DWI sequences with three b-values showed the best qualitative performance.vCE breast MRI performance is significantly influenced by input sequences. Quantitative metrics and visual quality of vCE images significantly benefit when multi b-value DWI is added to morphologic T1w-/T2w sequences as input for model training.QuestionHow do different MRI sequences impact the performance of virtual contrast-enhanced (vCE) breast MRI?FindingsThe input combination of T1-weighted, T2-weighted, and diffusion-weighted imaging sequences with three b-values showed the best qualitative performance.Clinical relevanceWhile in the future neural networks providing virtual contrast-enhanced images might further improve accessibility to breast MRI, the significant influence of input data needs to be considered during translational research. [ABSTRACT FROM AUTHOR]

Autism is a neurodevelopmental condition that starts in childhood and continues into adulthood. The core characteristics include difficulties with social interaction and communication, together with restricted and repetitive behaviours. There are a number of key abnormalities of brain structure and function that trigger these behavioural patterns, including an imbalance of functional connectivity and synaptic transmission, neuronal death, gliosis and inflammation. In addition, autism has been linked to alterations in the gut microbiome. Unfortunately, as it stands, there are few treatment options available for patients. In this mini-review, we consider the effectiveness of a potential new treatment for autism, known as photobiomodulation, the therapeutic use of red to near infrared light on body tissues. This treatment has been shown in a range of pathological conditions-to improve the key changes that characterise autism, including the functional connectivity and survival patterns of neurones, the patterns of gliosis and inflammation and the composition of the microbiome. We highlight the idea that photobiomodulation may form an ideal treatment option for autism, one that is certainly worthy of further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with obesity are vulnerable to low rates of preventive health screening. Veterans with obesity seeking bariatric surgery are also hypothesized to have gaps in preventive health screening. Evaluation in a multidisciplinary bariatric surgery clinic is a point of interaction with the healthcare system that could facilitate improvements in screening.Methods: This is a retrospective cohort study of 381 consecutive patients undergoing bariatric surgery at a Veterans Affairs Hospital from January 2010 to October 2021. Age- and sex-appropriate health screening rates were determined at initial referral to a multidisciplinary bariatric surgery clinic and at the time of surgery. Rates of guideline concordance at both time points were compared using McNemar's test. Univariate and multivariate analyses were performed to identify the risk factors for nonconcordance.Results: Concordance with all recommended screening was low at initial referral and significantly improved by time of surgery (39.1%‒63.8%; p<0.001). Screening rates significantly improved for HIV (p<0.001), cervical cancer (p=0.03), and colon cancer (p<0.001). Increases in BMI (p=0.005) and the number of indicated screening tests (p=0.029) were associated with reduced odds of concordance at initial referral. Smoking history (p=0.012) and increasing distance to the nearest Veterans Affairs Medical Center (p=0.039) were associated with reduced odds of change from nonconcordance at initial referral to concordance at the time of surgery.Conclusions: Rates of preventive health screening in Veterans with obesity are low. A multidisciplinary bariatric surgery clinic is an opportunity to improve preventive health screening in Veterans referred for bariatric surgery. [ABSTRACT FROM AUTHOR]

Objective: Cytomegalovirus (CMV) infection is associated with age‐related chronic disease, and co‐infection with Epstein‐Barr virus (EBV) may compound disease risk. We aimed to assess the frequency of CMV infection and its relationship with age among EBV seropositive individuals in an Indigenous Amazonian population. Methods: We report concentrations of CMV and EBV antibodies in dried blood spot samples collected from 157 EBV positive Shuar participants aged 15–86 years (60.5% female) to assess CMV infection rate. We used logistic and linear regression models to examine associations among CMV, EBV, and age, adjusting for sex, geographic region, and body mass index. Results: Nearly two‐thirds (63.1%) of EBV seropositive participants were also CMV seropositive. A 1‐year increase in age was associated with 3.4% higher odds of CMV infection (OR [95% CI]: 1.034 [1.009–1.064], p =.012), but CMV antibody concentration was not significantly associated with age or EBV antibody concentration among co‐infected individuals. Conclusions: Herpesvirus‐related immunosenescence may be important to understanding chronic disease risk among Shuar. Future studies should further explore the role of co‐infection in shaping age‐related changes in immune function. [ABSTRACT FROM AUTHOR]

The article examines the dynamics described in that paradigmatic discernment prayer process and comment on its adaptation in contemporary settings. Topics discussed include process of formulating the question, or of gathering relevant data, background for communal discernment and process of developing a charism, vision or mission statement.

Chronic kidney disease (CKD) is a growing global public health problem. The implementation of evidence-based clinical practices only defers the development of kidney failure. Death, transplantation, or dialysis are the consequences of kidney failure, resulting in a significant burden on the health system. Hence, innovative therapeutic strategies are urgently needed due to the limitations of current interventions. Photobiomodulation (PBM), a form of non-thermal light therapy, effectively mitigates mitochondrial dysfunction, reactive oxidative stress, inflammation, and gut microbiota dysbiosis, all of which are inherent in CKD. Preliminary studies suggest the benefits of PBM in multiple diseases, including CKD. Hence, this review will provide a concise summary of the underlying action mechanisms of PBM and its potential therapeutic effects on CKD. Based on the findings, PBM may represent a novel, non-invasive and non-pharmacological therapy for CKD, although more studies are necessary before PBM can be widely recommended. [ABSTRACT FROM AUTHOR]

Purpose: Homeless opioid treatment clients who transition into housing generally demonstrate better outcomes, but housing environments vary widely and may not benefit racial/ethnic minority populations equally. We sought to identify how race/ethnicity moderates the association between positive opioid treatment response and moving into dependent or independent living environments. Methods: We used the Treatment Episode Dataset-Discharges (2018–2019) to identify outpatient treatment clients who were homeless at admission and indicated heroin or other opioids as their primary drug of choice (n = 20,021). We defined positive treatment response as a reduction in opioid use between admission and discharge. We used multivariable logistic regression to model treatment response. We included an interaction between housing at discharge (remained homeless [reference], dependent living, or independent living) and race/ethnicity, and adjusted for relevant confounders. Results: Transitioning from homeless to dependent living was positively associated with treatment response among White (aOR = 3.57, 95% CI = 3.15-4.06), Hispanic (aOR = 2.11, 95% CI = 1.55-2.86), and Black clients (aOR = 1.79, 95% CI = 1.41-2.27), but no association was observed for homeless American Indian/Alaska Native clients. Transitioning from homeless to independent living was strongly associated with treatment response among all groups with the strongest association observed among White clients (aOR = 4.70, 95% CI = 4.26-5.19). Conclusions: Interventions aimed at improving OUD treatment outcomes among homeless clients should identify individual and structural factors that support moving into fully housed and independent living environments. Dependent living offers needed support during crises, but should be temporary and priority should be placed on independent, permanent, and autonomous living environments. [ABSTRACT FROM AUTHOR]

The article presents the author's experience of teaching discernment to individuals and groups, which enabled him to appreciate the significance of context and how it affects the choice and the dynamics of Election as presented in the Spiritual Exercises. He mentions that Saint Ignatius of Loyola's wisdom on the discernment of spirits and the Election helped in grounding his perspective, and he considers decision-making a complex process.

Background: Hepatitis B virus (HBV) infection is a particular concern in human immunodeficiency virus (HIV) infected individuals. In Ethiopia, detailed clinical and virological descriptions of HBV prevailing during HIV co-infection and symptomatic liver disease patients are lacking. The aim of this study was to investigate HBV virological characteristics from Ethiopian HBV/HIV co-infected and HBV mono-infected individuals. Methods: A total of 4105 sera from HIV positive individuals, liver disease patients, and blood donors were screened serologically for HBV. The overlapping polymerase/surface genome region of HBV from 180 infected individuals was extracted, amplified, and sequenced for genotypic analysis. Results: The HBsAg seroprevalence was detected 43% in liver disease patients, 8.4% in blood donors, and 6.7% in HIV/HBV co-infected individuals. The occult HBV prevalence was 3.7% in HIV/HBV co-infected individuals and 2.8% in blood donors with an overall prevalence rate of 3.4%. A phylogenetic analysis showed three HBV genotypes; A (61.1%), D (38.3%) and E (0.6%). Genotype A belongs to subtypes A1 (99.1%) and A9 (0.9%), but genotype D showed heterogeneous subtypes; D2 (63.8%) followed by D4 (21.7%), D1 (8.7%), D3 (4.3%), and D10 (1.4%). Conclusions: The HIV/HBV co-infected individuals and blood donors showed lower HBsAg seroprevalence compared to liver diseases patients. Occult HBV prevalence showed no difference between HIV/HBV co-infected and blood donor groups. This study demonstrated predominance distribution of HBV subtypes A1 and D2 in northwest Ethiopia. The observed virological characteristics could contribute for evidence-based management of viral hepatitis in Ethiopia where antiretroviral therapy guidelines do not cater for viral hepatitis screening during HIV co-infection. [ABSTRACT FROM AUTHOR]

The properties of composite materials are highly dependent on the fiber and matrix fraction and on the porosity resulting from micro voids. This paper addresses void content characterization and the constituent content of composite materials by resorting to a comparison of destructive and non-destructive methods. The work presents the detailed procedures of two destructive methods, using acid digestion of epoxy resins matrices, and compares their processes. It also presents the results of a non-destructive method, by means of Micro Computed Tomography (MicroCT). The results of both destructive and non-destructive methods are compared, and a recommendation is made based on the application and the type of composite being analyzed. The MicroCT showed better and more consistent results in detecting voids in the material, while the acid digestion tests provided better results about the fiber and matrix percentage. Exported results from the MicroCT scanning with actual locations of voids were used in numerical analysis, to examine the feasibility of using them, whether by developing models that map damage in the proximity of the void, or by developing models that predict the properties of the entire material with respect to the content, shape, and distribution in the material. [ABSTRACT FROM AUTHOR]

Objective: To investigate the potential relationship between opsins and photobiomodulation. Background: Opsins and other photoreceptors occur in all phyla and are important in light-activated signaling and organism homeostasis. In addition to the visual opsin systems of the retina (OPN1 and OPN2), there are several non-visual opsins found throughout the body tissues, including encephalopsin/panopsin (OPN3), melanopsin (OPN4), and neuropsin (OPN5), as well as other structures that have light-sensitive properties, such as enzymes, ion channels, particularly those located in cell membranes, lysosomes, and neuronal structures such as the nodes of Ranvier. The influence of these structures on exposure to light, including self-generated light within the body (autofluorescence), on circadian oscillators, and circadian and ultradian rhythms have become increasingly reported. The visual and non-visual phototransduction cascade originating from opsins and other structures has potential significant mechanistic effects on tissues and health. Methods: A PubMed and Google Scholar search was made using the search terms ''photobiomodulation'', ''light'', ''neuron'', ''opsins'', ''neuropsin'', ''melanopsin'', ''encephalopsin'', ''rhodopsin'', and ''chromophore''. Results: This review was examined the influence of neuropsin (also known as kallikrein 8), encephalopsin, and melanopsin specifically on ion channel function, and more broadly on the central and peripheral nervous systems. The relationship between opsins 3, 4, and 5 and photobiomodulation mechanisms was evaluated, along with a proposed role of photobiomodulation through opsins and light-sensitive organelles as potential alleviators of symptoms and accelerators of beneficial regenerative processes. The potential clinical implications of this in musculoskeletal conditions, wounds, and in the symptomatic management of neurodegenerative disease was also examined. Conclusions: Systematic research into the pleotropic therapeutic role of photobiomodulation, mediated through its action on opsins and other light-sensitive organelles may assist in the future execution of safe, low-risk precision medicine for a variety of chronic and complex disease conditions, and for health maintenance in aging. [ABSTRACT FROM AUTHOR]

Objective: The beneficial effects of photobiomodulation (PBM) on cellular function are well characterized, principally deriving from the absorption of red to near-infrared radiation by chromophores such as cytochrome-coxidase. However, the effects and underlying mechanisms of PBM on non-mitochondria containing cells, such as red blood cells (RBCs), are relatively unknown. In this review, we evaluate studies that investigated the effects of PBM on RBCs in the peripheral circulation, with particular attention on changes in the structural and functional features of RBC membrane dynamics, as well as the potential implications of PBM as an intervention for pathologies related to RBC dysfunction. Methods: A literature review was performed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, using the following databases: PubMed; Ovid (OvidMedline); Scopus; Web of Science; Google Scholar; Scholar.ru; eLIBRARY.ru; Digital Library: Dissertation; and Russian State Library. Search results included publications in Russian, Ukrainian, and English languages after 1995. Eligible articles included the effects of PBM on RBC membrane morphology and function in the peripheral circulation, used either in isolation or alongside other interventions. Results: The majority of articles indicated beneficial changes in RBC structure and function following exposure to PBM, including increased osmotic resistance, normalization of membrane permeability, decreased free radical oxidation and concentration of intermediate products of lipid peroxidation, reduced phospholipase A2 membrane activity, and normalization of the viscoelastic properties of RBCs and erythrocyte deformability index. Most trials had small patient numbers with no long-term follow-up. Conclusions: The importance of RBC membrane dysfunction as a potential marker and mechanism for RBC pathologies was highlighted. PBM has shown to have membrane protective effects. Further clinical trials are recommended to provide more evidence PBM therapy to treat RBC-related diseases, which may, at the correct dose, improve RBC stability and deformability in RBC-related pathologies. [ABSTRACT FROM AUTHOR]

Background: The influence of gender is significant in the manifestation and response to many diseases and in the treatment strategy. Photobiomodulation (PBM) therapy, including laser acupuncture, is an evidence-based treatment and disease prevention modality that has shown promising efficacy for a myriad of chronic and acute diseases. Anecdotal experience and limited clinical trials suggest gender differences exist in treatment outcomes to PBM therapy. There is preliminary evidence that gender may be as important as skin color in the individual response to PBM therapy. Purpose: To conduct a literature search of publications addressing the effects of gender differences in PBM therapy, including laser acupuncture, to provide a narrative review of the findings, and to explore potential mechanisms for the influence of gender. Methods: A narrative review of the literature on gender differences in PBM applications was conducted using key words relating to PBM therapy and gender. Results: A total of 13 articles were identified. Of these articles, 11 have direct experimental investigations into the response difference in gender for PBM, including laser acupuncture. A variety of cadaver, human, and experimental studies demonstrated results that gender effects were significant in PBM outcome responses, including differences in tendon structural and mechanical outcomes, and mitochondrial gene expression. One cadaver experiment showed that gender was more important than skin tone. The physiologic mechanisms directing gender differences are explored and postulated. Conclusions: The review suggests that to address the requirements of a proficient precision medicine-based strategy, it is important for PBM therapy to consider gender in its treatment plan and dosing prescription. Further research is warranted to determine the correct dose for optimal gender treatment, including genderspecific treatment plans to improve outcomes, taking into account wavelength, energy exposure, intensity, and parameters related to the deliverance of treatment to each anatomical location. [ABSTRACT FROM AUTHOR]

Objective: To assess whether remote application of photobiomodulation (PBM) is effective in reducing clinical signs of Parkinson's disease (PD). Background: PD is a progressive neurodegenerative disease for which there is no cure and few treatment options. There is a strong link between the microbiome--gut--brain axis and PD. PBM in animal models can reduce the signs of PD and protect the neurons from damage when applied directly to the head or to remote parts of the body. In a clinical study, PBM has been shown to improve clinical signs of PD for up to 1 year. Methods: Seven participants were treated with PBM to the abdomen and neck three times per week for 12 weeks. Participants were assessed for mobility, balance, cognition, fine motor skill, and sense of smell on enrolment, after 12 weeks of treatment in a clinic and after 33 weeks of home treatment. Results: A number of clinical signs of PD were shown to be improved by remote PBM treatment, including mobility, cognition, dynamic balance, spiral test, and sense of smell. Improvements were individual to the participant. Some improvements were lost for certain participants during at-home treatment, which coincided with a number of enforced coronavirus disease 2019 (COVID-19) pandemic lockdown periods. Conclusions: Remote application of PBM was shown to be an effective treatment for a number of clinical signs of PD, with some being maintained for 45 weeks, despite lockdown restrictions. Improvements in clinical signs were similar to those seen with the application of remote plus transcranial PBM treatment in a previous study. Clinical Trial Registration number: U1111-1205-2035. [ABSTRACT FROM AUTHOR]

Objective: Anemia is an important global health challenge. We investigate anemia prevalence among Indigenous Shuar of Ecuador to expand our understanding of population‐level variation, and to test hypotheses about how anemia variation is related to age, sex, and market integration. Methods: Hemoglobin levels were measured in a total sample of 1650 Shuar participants (ages 6 months to 86 years) from 46 communities between 2008 and 2017 to compare anemia prevalence across regions characterized by different levels of market integration. Results: Shuar anemia rates among children under 15 years (12.2%), adult women (10.5%), and adult men (5.3%) were less than half of those previously documented in other neo‐tropical Indigenous populations. Anemia prevalence did not vary between more traditional and market integrated communities (OR = 0.47, p =.52). However, anemia was negatively associated with body mass index (OR = 0.47, p =.002). Conclusions: Compared to other South American Indigenous populations, anemia prevalence is relatively low among Shuar of Ecuador and invariant with market integration. Understanding this pattern can provide valuable insights into anemia prevention among at‐risk populations. [ABSTRACT FROM AUTHOR]

Although imputation of missing SNP results has been widely used in genetic studies, claims about the quality and usefulness of imputation have outnumbered the few studies that have questioned its limitations. But it is becoming clear that these limitations are real—for example, disease association signals can be missed in regions of LD breakdown. Here, as a case study, using the chromosomal region of the well‐known lactase gene, LCT, we address the issue of imputation in the context of variants that have become frequent in a limited number of modern population groups only recently, due to selection. We study SNPs in a 500 bp region covering the enhancer of LCT, and compare imputed genotypes with directly genotyped data. We examine the haplotype pairs of all individuals with discrepant and missing genotypes. We highlight the nonrandom nature of the allelic errors and show that most incorrect imputations and missing data result from long haplotypes that are evolutionarily closely related to those carrying the derived alleles, while some relate to rare and recombinant haplotypes. We conclude that bias of incorrectly imputed and missing genotypes can decrease the accuracy of imputed results substantially. [ABSTRACT FROM AUTHOR]

The practice of agroecology has been promoted as a promising pathway to improve environmental and human well-being. Previous research has shown that farm size is often related to factors that can help or hinder agroecological practice use, but context is key. Here, we examine the relationship between farm size and the use of agroecological practices by assessing 596 management plans for farms associated with the Brazilian participatory agroecology network Rede Ecovida. In contrast to other studies, we found that the probability of using agroecological practices generally did not differ by farm size. We draw on interviews with agroecological actors to contextualize these findings and characterize the relationship between farm size and agroecology, both as a set of practices and a social movement. We suggest that, in this case, the lack of a relationship between farm size and agroecological practices might be explained by Rede Ecovida’s role as a “social carrier” that advances agroecological principles and practices in the pursuit of territorial, or actual, autonomy. This study highlights the importance of the socio-organizational dimensions of agroecological transitions and suggests that increased support should be directed to social networks and participatory certification models to encourage scaling agroecology across diverse farm types and sizes. [ABSTRACT FROM AUTHOR]

Background: Non-invasive brain mapping using navigated transcranial magnetic stimulation (nTMS) is a valuable tool prior to resection of malignant brain tumors. With nTMS motor mapping, it is additionally possible to analyze the function of the motor system and to evaluate tumor-induced neuroplasticity. Distinct changes in motor cortex excitability induced by certain malignant brain tumors are a focal point of research. Methods: A retrospective single-center study was conducted involving patients with malignant brain tumors. Clinical data, resting motor threshold (rMT), and nTMS-based tractography were evaluated. The interhemispheric rMT-ratio (rMTTumor/rMTControl) was calculated for each extremity and considered pathological if it was >110% or <90%. Distances between the corticospinal tract and the tumor (lesion-to-tract-distance -- LTD) were measured. Results: 49 patients were evaluated. 16 patients (32.7%) had a preoperative motor deficit. The cohort comprised 22 glioblastomas (44.9%), 5 gliomas of Classification of Tumors of the Central Nervous System (CNS WHO) grade 3 (10.2%), 6 gliomas of CNS WHO grade 2 (12.2%) and 16 cerebral metastases (32.7%). 26 (53.1%) had a pathological rMT-ratio for the upper extremity and 35 (71.4%) for the lower extremity. All patients with tumor-induced motor deficits had pathological interhemispheric rMT-ratios, and presence of tumor-induced motor deficits was associated with infiltration of the tumor to the nTMS-positive cortex (p = 0.04) and shorter LTDs (all p<0.021). Pathological interhemispheric rMT-ratio for the upper extremity was associated with cerebral metastases, but not with gliomas (p = 0.002). Conclusions: Our study underlines the diagnostic potential of nTMS motor mapping to go beyond surgical risk stratification. Pathological alterations in motor cortex excitability can be measured with nTMS mapping. Pathological cortical excitability was more frequent in cerebral metastases than in gliomas. [ABSTRACT FROM AUTHOR]

In the current strategic environment, Morris Janowitz's The Professional Soldier deserves renewed emphasis, especially from the military's senior leaders who are responsible for the education and development of the country's officer corps. Janowitz's work is an especially valuable guide to the education of officers today because of his focus on the need for military officers to understand the political impact of military posture and military operations. The education of U.S. military officers to meet the country's national security needs in the 21st century must go beyond Huntington's formulation of expertise to an appreciation, in Janowitz's terms, of "the political and social impact of the military establishment on international security affairs" across the spectrum of conflict. Janowitz's formulation is the better guide because military means serve political purposes, and ultimately, a country's strategic success will be judged in political terms. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a progressive neurodegenerative disease with no cure and few treatment options. Its incidence is increasing due to aging populations, longer disease duration and potentially as a COVID-19 sequela. Photobiomodulation (PBM) has been successfully used in animal models to reduce the signs of PD and to protect dopaminergic neurons.Objective: To assess the effectiveness of PBM to mitigate clinical signs of PD in a prospective proof-of-concept study, using a combination of transcranial and remote treatment, in order to inform on best practice for a larger randomized placebo-controlled trial (RCT).Methods: Twelve participants with idiopathic PD were recruited. Six were randomly chosen to begin 12 weeks of transcranial, intranasal, neck and abdominal PBM. The remaining 6 were waitlisted for 14 weeks before commencing the same treatment. After the 12-week treatment period, all participants were supplied with PBM devices to continue home treatment. Participants were assessed for mobility, fine motor skills, balance and cognition before treatment began, after 4 weeks of treatment, after 12 weeks of treatment and the end of the home treatment period. A Wilcoxon Signed Ranks test was used to assess treatment effectiveness at a significance level of 5%.Results: Measures of mobility, cognition, dynamic balance and fine motor skill were significantly improved (p < 0.05) with PBM treatment for 12 weeks and up to one year. Many individual improvements were above the minimal clinically important difference, the threshold judged to be meaningful for participants. Individual improvements varied but many continued for up to one year with sustained home treatment. There was a demonstrable Hawthorne Effect that was below the treatment effect. No side effects of the treatment were observed.Conclusions: PBM was shown to be a safe and potentially effective treatment for a range of clinical signs and symptoms of PD. Improvements were maintained for as long as treatment continued, for up to one year in a neurodegenerative disease where decline is typically expected. Home treatment of PD by the person themselves or with the help of a carer might be an effective therapy option. The results of this study indicate that a large RCT is warranted.Trial Registration: Australian New Zealand Clinical Trials Registry, registration number: ACTRN12618000038291p , registered on 12/01/2018. [ABSTRACT FROM AUTHOR]

[Display omitted] • Acute pre-treatment with caffeine has an anti-inflammatory effect characterized by the negative regulation of the expression of the gene encoding the pro-inflammatory cytokine Il-1β in the brain regions of the striatum and hippocampus. • Treatment with caffeine and LPS alters the epigenetic scenario by modifying the expression pattern of DNA-modifying enzymes with a consequent change in the percentages of 5-meC and 5-hmeC marks of the Adora1 and Adora2A genes in the CNS. • The neuroprotective effect of caffeine pretreatment is mediated by the differential modulation of the expression of adenosine receptors in the striatum and hippocampus and has the Adora2B gene as a key point in the connection between the expanded networks of the Adora1 and Adora2A genes. Caffeine has been extensively studied in the context of CNS pathologies as many researchers have shown that consuming it reduces pro-inflammatory biomarkers, potentially delaying the progression of neurodegenerative pathologies. Several lines of evidence suggest that adenosine receptors, especially A 1 and A 2 A receptors, are the main targets of its neuroprotective action. We found that caffeine pretreatment 15 min before LPS administration reduced the expression of Il1b in the hippocampus and striatum. The harmful modulation of caffeine-induced inflammatory response involved the downregulation of the expression of A 2 A receptors, especially in the hippocampus. Caffeine treatment alone promoted the downregulation of the adenosinergic receptor Adora2A; however, this promotion effect was reversed by LPS. Although administering caffeine increased the expression of the enzymes DNA methyltransferases 1 and 3A and decreased the expression of the demethylase enzyme Tet1, this effect was reversed by LPS in the hippocampus of mice that were administered Caffeine + LPS, relative to the basal condition; no significant differences were observed in the methylation status of the promoter regions of adenosine receptors. Finally, the bioinformatics analysis of the expanded network demonstrated the following results: the Adora2B gene connects the extended networks of the adenosine receptors Adora1 and Adora2A; the Mapk3 and Esr1 genes connect the extended Adora1 network; the Mapk4 and Arrb2 genes connect the extended Adora2A network with the extended network of the proinflammatory cytokine Il1β. These results indicated that the anti-inflammatory effects of acute caffeine administration in the hippocampus may be mediated by a complex network of interdependencies between the Adora2B and Adora2A genes. [ABSTRACT FROM AUTHOR]

James Burk’s “Theories of Democratic Civil-Military Relations” stands out for the theoretical insights and bold vision that underpin his critique of Samuel Huntington’s The Soldier and the State and Morris Janowitz’s The Professional Soldier. Burk situates these authors within long-standing traditions of political thought to clarify the need for a new normative theory of civil–military relations for mature democracies. A new normative theory, Burk says, will build on the idea of the “citizen-soldier” to explain how good civil–military relations sustain liberal democratic values. More than 20 years after Burk’s article appeared, the theoretical work he called for remains to be done. However, Burk’s intuition that the citizen-soldier ideal offers the most promising foundation for understanding how civil–military relations sustain liberal democratic values is sound. The political education the citizen-soldier ideal requires contributes to both sustaining liberal democratic values at home and to protecting democracies from external threats. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory bowel disease (IBD) is a group of chronic gastrointestinal diseases with frequent systemic complications that are incurable according to current knowledge. These diseases adversely affect various areas of life, lowering patients’ quality of life. One of the most frequently reported symptoms is fatigue. Aim: Translation and validation of the IBD-F patient self-assessment scale with a Polish IBD population. Material and methods: After consent from the author of the questionnaire had been obtained, the questionnaire was translated using the forward- and back-translation method. After arriving at the final Polish version of the questionnaire and ensuring that the questions and statements were comprehensible, the questionnaire was validated with a group of 129 IBD patients. Results: High values of intraclass correlation coefficient (ICC) were achieved for overall results in both parts of the IBD-F questionnaire between test and retest (values exceeding 0.75). A high Cronbach’s α consistency coefficient was achieved for the entire IBD-F questionnaire, both in the test and in the retest (0.968 and 0.975, respectively). Broken down into parts, Cronbach’s α coefficient for Section I (presence and severity of fatigue) of the IBD-F questionnaire was 0.883, and for Section II (impact of fatigue on the person’s life) it was 0.966. All patients evaluating the Polish version of the IBD-F questionnaire deemed the content of the questions comprehensible. Conclusions: The analysis of the results obtained, the Polish version of the IBD-F questionnaire was considered valid, reliable, and clinically useful. [ABSTRACT FROM AUTHOR]

Objective: The objective of this narrative review was to investigate the history of light therapy in hospital settings, with reference to physiotherapy and particularly in an Australian context.Types of articles and search method:a review of available literature was conducted on PubMed, Medline and Google Scholar using keywords light therapy, photobiomodulation, physiotherapy, low-level laser, heliotherapy. Physiotherapy textbooks from Sydney University Library were searched. Historical records were accessed from the San Hospital library. Interviews were conducted with the San Hospital Chief Librarian and a retired former Head Physiotherapist from Royal Prince Alfred Hospital.Summary: Historically, light treatment has been used in both medical and physiotherapy practice. From its roots in ancient Egypt, India, and Greece, through to medieval times, the modern renaissance in 'light as therapy ' was begun by Florence Nightingale who, in the 1850s, advocated the use of clean air and an abundance of sunlight to restore health. Modern light therapy (phototherapy) had a marked uptake in use in medicine in Scandinavia, America, and Australia from 1903, following the pioneering work of Niels Finsen in the late 19th century, which culminated in Dr Finsen receiving the Nobel Prize for Medicine for the treatment of tuberculosis scarring with ultraviolet (UV) light, and treatment of smallpox scarring with red light. Treatment with light, especially UVB light, has been widely applied by physiotherapists in hospitals for dermatological conditions since the 1950s, particularly in Australia, Scandinavia, USA, England and Canada. In parallel, light treatment in hospitals for hyperbilirubinemia was used for neonatal jaundice. Since the 1980s light was also used in the medical specialties of ophthalmology, dermatology, and cardiology. In more recent years in physiotherapy, light was mostly used as an adjunct to the management of orthopedic/rheumatological conditions. Since the 1990s, there has been global use of light, in the form of photobiomodulation for the management of lymphedema, including in supportive cancer care. Photobiomodulation in the form of low-level laser has been used by physiotherapists and pain doctors since the 1990s in the management of chronic pain. The use of light as therapy is exemplified by its use in the San Hospital in Sydney, where light therapy was introduced in 1903 (after Dr. John Harvey Kellogg visited Niels Finsen in Denmark) and is practiced by nurses, physiotherapists and doctors until the present day. The use of light has expanded into new and exciting practices including supportive cancer care, and treatment of depression, oral mucositis, retinopathy of prematurity, and cardiac surgery complications. Light is also being used in the treatment of neurological diseases, such as Parkinson's disease, traumatic brain injury, and multiple sclerosis. The innovative uses of light in physiotherapy treatment would not be possible without the previous experience of successful application of light treatment.Conclusion: Light therapy has had a long tradition in medicine and physiotherapy. Although it has fallen somewhat out of favour over the past decades, there has been a renewed interest using modern techniques in recent times. There has been continuous use of light as a therapy in hospitals in Australia, most particularly the San Hospital in Sydney where it has been in use for almost 120 years. [ABSTRACT FROM AUTHOR]

This narrative review analyses the Australian Guideline (2018) for the treatment of knee osteoarthritis (KOA) developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The Guideline recommended against the use low-level laser therapy (LLLT). Why this conclusion was reached is discussed in this review in the context of evidence provided in other systematic reviews, the latest of which was published in 2019 and which provided strong support for LLLT for knee OA. We evaluated the reference list cited for the recommendation "against" LLLT and compared this with reference lists of systematic reviews and studies published before and after the publication date of the Guideline. Eight randomised controlled trials (RCTs) of LLLT were cited in the Guideline the latest of which was published in 2012. There were seventeen additional RCTs, five of which together with one systematic review were located in the year of publication, 2018. The most recent systematic review in 2019 included 22 RCTs in its analysis. Discordance with the levels of evidence and recommendations was identified. Although GRADE methodology is said to be robust for systematically evaluating evidence and developing recommendations, many studies were not identified in the Guideline. In contrast, the latest systematic review and meta-analysis provides robust evidence for supporting the use of LLLT in knee OA. The conflict between guidelines based on opinion and evidence based on meta-analysis is highlighted. Given the totality of the evidence, we recommend that the Australian Guideline should be updated immediately to reflect a "for" recommendation. [ABSTRACT FROM AUTHOR]

Aims: Fire regimes are key drivers of ecosystem dynamics and are changing worldwide. Uncertainty about how fire history affects responses to individual fires hampers predictions of fire impacts on important ecosystem functions such as C cycling. Thus, we assessed how fire and fire history affect soil CO2 flux and aboveground net primary production (ANPP). Methods: We utilized a 35-year fire frequency experiment in a mesic grassland to quantify how two aspects of fire history, long-term fire frequency (fire every one, two, or four years, or no fire) and number of years elapsed since the most recent fire, affect soil CO2 flux. We used long-term annual records from the same grassland to compare this to the effect of fire history on ANPP. Results: Historic fire frequency altered the soil CO2 flux response to fire, with greater post-fire stimulation in grassland burned annually than in grassland burned less frequently (~100% vs. ~44% increase over long-term unburned grassland). The flux increase persisted for up to two years after fire. Though fire also stimulated ANPP, this increase did not vary by long-term fire frequency and did not persist into later years. Conclusions: Fire history modifies the soil CO2 flux response to individual fires in this grassland. Predicting the dynamics of this important C flux will require considering not only the presence vs. absence of fire, but also fire history. [ABSTRACT FROM AUTHOR]

One of the major underlying principles of the career civil service in the United States is neutral competence. REFORMING THE POLICE FORCE IN THE REPUBLIC OF GEORGIA The Republic of Georgia is a small country that became independent upon the collapse of the Soviet Union in 1991. Transparency International, an international corruption watchdog, concluded in 2010 that Georgia had one of the world's cleanest police forces, second only to Finland. [Extracted from the article]

Minimally invasive sacroiliac joint fusion has become increasingly prevalent and is described to reduce pain and improve function. In some patients, pain can recur several months after primary surgery. Lack of early implant osseointegration might be a cause of pain and hence an indication for revision surgery. Triangular titanium implants are the most documented implant for minimally invasive sacroiliac joint fusion. There is, however, no knowledge of how triangular titanium implants osseointegrate in humans and whether fusion is induced over the sacroiliac joint. During planned revision surgery due to recurrent pain, six triangular titanium implants were retrieved from six different patients at median 9 months from primary surgery. All six implants were scanned using microcomputed tomography. The presence or absence of bone in‐growth, on‐growth, and through‐growth of the implants was evaluated as an indication of implant osseointegration. Three of six implants showed no or minor signs of osseointegration. Of the three remaining implants, one showed partial osseointegration and two implants showed high degrees of osseointegration. This study showed that triangular titanium implants can osseointegrate into host bone in humans. When osseointegration occurs, triangular titanium implants can give fusion across the sacroiliac joint. [ABSTRACT FROM AUTHOR]

An editorial is presented on photobiomodulation therapy (PBMT) not becoming a mainstream medical therapy. Topics include hundreds of successful clinical studies and widespread use as an alternative and complementary medicine treatment; and Mitochondria containing a variety of different cytochromes either as part of functional proteins or as electron transport shuttles (cytochrome c).

COVID-19 is an evolving pandemic that has far reaching global effects, with a combination of factors that makes the virus difficult to contain. The symptoms of infection can be devastating or at the least very debilitating for vulnerable individuals. It is clear that the elderly are at most risk of the adverse impacts of the virus, including hospitalization and death. Others at risk are those with comorbidities such as cardiovascular disease and metabolic conditions and those with a hyper-excitable immune response. Treatment options for those with acute responses to the virus are limited and there is an urgent need for potential strategies that can mitigate these severe effects. One potential avenue for treatment that has not been explored is the microbiome gut/lung axis. In addition to those severely affected by their acute reaction to the virus, there is also a need for treatment options for those that are slow to recover from the effects of the infection and also those who have been adversely affected by the measures put in place to arrest the spread of the virus. One potential treatment option is photobiomodulation (PBM) therapy. PBM has been shown over many years to be a safe, effective, non-invasive and easily deployed adjunctive treatment option for inflammatory conditions, pain, tissue healing and cellular energy. We have also recently demonstrated the effectiveness of PBM to alter the gut microbiome. PBM therapy is worthy of consideration as a potential treatment for those most vulnerable to COVID-19, such as the elderly and those with comorbidities. The treatment may potentially be advantageous for those infected with the virus, those who have a slow recovery from the effects of the virus and those who have been denied their normal exercise/rehabilitation programs due to the isolation restrictions that have been imposed to control the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To date, there is a paucity of research that examines differences between charter schools that operate in suburban and nonsuburban contexts. This article examines whether students in suburban charter schools perform better or worse than their counterparts in traditional public schools or students in urban charter schools. Boasting the largest and most diverse charter school population in the United States, California offers a fertile urban-suburban context for the study of geographically differentiated charter school impacts and, thus, serves as the focus of our study. The student achievement data (2009–2010, 2010–2011 and 2011–2012 school years) for this study come from the California Department of Education. Using propensity score matching and virtual control records, our findings show that suburban charter schools do not improve academic achievement relative to the matched comparison group of traditional public schools. Suburban charter schools (namely, charters in high-income areas) are largely ineffective and appear to leave their students' achievement unchanged or diminished. This study adds to the existing literature by examining the effects of charter schools on the neighborhoods in which they operate. Methodologically, another important contribution of this study is that it supplements traditional selection criteria for suburban charters (NCES classification) with census-based neighborhood factors. Finally, this study provides evidence of the broader implications of school choice policies in a suburban setting. [ABSTRACT FROM AUTHOR]

Plato's Phaedo has long captivated readers with its moving portrayal of the death of Socrates. But the philosophic significance of the dialogue's emotional power is rarely considered. In this article, I approach the dialogue as a work of tragic philosophy that reveals legitimate grounds for grief in the moral universe of Socrates' circle. I propose that the dialogue is a deliberately failed attempt to depict a non-tragic hero and a non-tragic death, and in depicting philosophy's failure to eliminate tragedy from the contemplative life, the dialogue itself becomes a form of tragic representation. [ABSTRACT FROM AUTHOR]