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Background: Antimicrobial stewardship programs (ASP) often function naturally as facilitators within clinical hospital settings, by working with individuals and teams to reduce unnecessary antibiotics. Within implementation science, facilitation has been studied and evaluated as an implementation strategy that can accelerate and improve fidelity to implementation efforts. This study describes a novel, virtual facilitation strategy developed and served as an intervention within the optimizing perioperative antibiotics for children trial (OPERATIC trial). This paper: (1) describes ASP team's preferences for and use of a facilitation workshop and (2) describes sustained use of facilitation skills throughout the study period. Methods: Study participants included antimicrobial stewardship team members from the nine children's hospitals that participated in this study and completed facilitation training. All individuals who completed facilitation training were asked to evaluate the training through an online survey. Additionally, site leads were interviewed by the site coordinator every other month and asked about their team's use of facilitation skills throughout the rest of the study period. Survey data were managed and coded in R, and qualitative interview data were analyzed using rapid methodology. Results: 30 individuals, including both physicians and pharmacists, completed the evaluation. Individuals largely rated themselves as novice facilitators (53%). Individuals reported satisfaction with virtual facilitation and identified different components of the workshops as valuable. An additional 108 interviews were performed throughout the study period. These interviews found that facilitators reported using all skills throughout the study period and described varied use of skills over time. All nine sites applied facilitation strategies, team building techniques, and communication/conflict skills at some point during the intervention phase. Conclusion: We describe the use of virtual facilitation as an acceptable and appropriate strategy to enhance facilitation skills for ASP teams working to reduce unnecessary postoperative antibiotics. Participants reported different useful components of facilitation training and described using differing facilitation skills throughout the trial. Overall, the use of facilitation skills continued throughout the duration of the study period. This paper outlines how facilitation training can be conducted virtually in a way that is feasible and acceptable to clinicians. Trial registration: NCT04366440, April 24, 2020. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial stewardship programs (ASP) often function naturally as facilitators within clinical hospital settings, by working with individuals and teams to reduce unnecessary antibiotics. Within implementation science, facilitation has been studied and evaluated as an implementation strategy that can accelerate and improve fidelity to implementation efforts. This study describes a novel, virtual facilitation strategy developed and served as an intervention within the optimizing perioperative antibiotics for children trial (OPERATIC trial). This paper: (1) describes ASP team's preferences for and use of a facilitation workshop and (2) describes sustained use of facilitation skills throughout the study period. Methods: Study participants included antimicrobial stewardship team members from the nine children's hospitals that participated in this study and completed facilitation training. All individuals who completed facilitation training were asked to evaluate the training through an online survey. Additionally, site leads were interviewed by the site coordinator every other month and asked about their team's use of facilitation skills throughout the rest of the study period. Survey data were managed and coded in R, and qualitative interview data were analyzed using rapid methodology. Results: 30 individuals, including both physicians and pharmacists, completed the evaluation. Individuals largely rated themselves as novice facilitators (53%). Individuals reported satisfaction with virtual facilitation and identified different components of the workshops as valuable. An additional 108 interviews were performed throughout the study period. These interviews found that facilitators reported using all skills throughout the study period and described varied use of skills over time. All nine sites applied facilitation strategies, team building techniques, and communication/conflict skills at some point during the intervention phase. Conclusion: We describe the use of virtual facilitation as an acceptable and appropriate strategy to enhance facilitation skills for ASP teams working to reduce unnecessary postoperative antibiotics. Participants reported different useful components of facilitation training and described using differing facilitation skills throughout the trial. Overall, the use of facilitation skills continued throughout the duration of the study period. This paper outlines how facilitation training can be conducted virtually in a way that is feasible and acceptable to clinicians. Trial registration: NCT04366440, April 24, 2020. [ABSTRACT FROM AUTHOR]

Snap-through is a nonlinear jump phenomenon that is increasingly being designed into engineering structures. The rich and varied dynamics of snap-through present a significant bottleneck in the design process as costly dynamic simulations are required to ensure predictable behaviour. The purpose of this research is to investigate the use of a recent projection-based, reduced-order modelling technique, namely, implicit condensation and expansion with inertial compensation, to reproduce the snap-through behaviours found in bistable finite element systems in analogous models with minimal degrees of freedom. In this work, the free response of a simple mass-spring oscillator is used to differentiate different types of snap-through. This provides a framework for discussing the dynamics of a family of buckled beams. The ability of the reduced-order models to faithfully reproduce these dynamics is investigated by testing the existence and stability of predicted periodic orbits. It is shown that the minimum projection basis required to capture snap-through accurately can be found through considering the minimum energy required for different types of snap-through. For bistable beams, this can be further simplified to just requiring an eigenvalue analysis at the most unstable equilibrium. [ABSTRACT FROM AUTHOR]

AbstractImmune checkpoint inhibitors (ICIs) have revolutionised the treatment of metastatic NSCLC and have become standard first-line therapy both as monotherapy, for patients with PD-L1 expression ≥50%, and in combination with chemotherapy (CT), regardless of PD-L1 expression. This study used an artificial intelligence technique, the IPDfromKM method, to reconstruct individual patient data from Kaplan-Meier curves of phase III randomised clinical trial results to provide a comparative overview of different first-line chemo-immunotherapy options. Overall survival (OS) was estimated using hazard ratios and restricted mean survival time (RMST). Ten clinical trials were included in the analysis. In the squamous population, combinations of cemiplimab + CT (HR = 0.56), pembrolizumab + CT (HR = 0.67), and nivolumab + ipilimumab + CT (HR = 0.71) significantly improved OS compared with CT alone, with no difference between treatments. At longer follow-up, nivolumab + ipilimumab + CT showed longer RMST compared to pembrolizumab + CT in the PD-L1 < 1% subgroup (24.9 months vs. 22.8 months). In non-squamous NSCLC, the survival benefit of ICIs + CT was much more homogeneous, with similar results across the different options. Overall, pembrolizumab + CT showed the best results both in terms of HR (0.68, 95%CI 0.60-0.77) and RMST at long follow-up (30.4 months in the PDL-1 ≥ 1% subgroup and 24 months in the PDL-1 < 1% population). In conclusion, there are some differences between frontline options for treating metastatic NSCLC based on tumour histology and PD-L1 expression. However, further head-to-head trials and longer follow-up are needed to clarify the clinical impact of these differences. [ABSTRACT FROM AUTHOR]

Background: [177Lu]Lu–PSMA‐617 (177Lu‐PSMA‐617) plus protocol‐permitted standard of care (SOC) prolonged overall survival (OS) and radiographic progression‐free survival (rPFS) versus SOC in patients with prostate‐specific membrane antigen (PSMA)–positive metastatic castration‐resistant prostate cancer (mCRPC) in the phase 3 VISION study, in addition to beneficial effects on symptomatic skeletal events (SSEs) and health‐related quality of life (HRQOL). Methods: Post hoc analyses used the full analysis set from the VISION study (N = 831) overall and by randomized treatment arm (177Lu‐PSMA‐617 plus SOC, n = 551; SOC, n = 280). Correlations were determined between OS and rPFS and between rPFS or OS and time to SSE or to worsening HRQOL (Functional Assessment of Cancer Therapy–Prostate [FACT‐P] and 5‐level EQ‐5D [EQ‐5D‐5L]). Correlation analyses used an iterative multiple imputation copula‐based approach (correlation coefficients [rho] of <0.3 were defined as weak, ≥0.3 and <0.5 as mild, ≥0.5 and <0.7 as moderate, and ≥0.7 as strong). Results: In the overall population, rPFS correlated strongly with OS (rho, ≥0.7). Correlations between rPFS or OS and time to SSE without death were weak or mild. Time to worsening in the FACT‐P total score and emotional and physical well‐being domains correlated mildly or moderately with rPFS and moderately with OS. Correlation coefficients for time‐to‐worsening EQ‐5D‐5L scores were mild to moderate for both rPFS and OS. Correlation coefficients were similar between treatment arms. Conclusions: In this analysis of the VISION study, rPFS correlated strongly with OS but not with time to SSE or worsening HRQOL. These findings require further investigation. In patients with metastatic castration‐resistant prostate cancer participating in the VISION randomized phase 3 trial, radiographic progression‐free survival correlated strongly with overall survival but not with time to a first symptomatic skeletal event or worsening health‐related quality of life or pain. There were no clear or consistent differences in the strengths of correlation between the two treatment groups ([177Lu]Lu‐PSMA‐617 plus protocol‐permitted standard of care vs. standard of care alone). [ABSTRACT FROM AUTHOR]

Purpose: Cancer care for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexuality and gender diverse (LGBTQIA +) individuals is marked by disparities stemming from a history of discrimination, stigma, and systemic inequities. For LGBTQIA + individuals seeking cancer care, cancer center websites may be a first point of contact with healthcare. Two complementary studies sought to evaluate the LGBTQIA + inclusivity of cancer centers’ websites. Methods: The authors conducted two studies in 2022–2023, reviewing the websites of National Cancer Institute (NCI)-designated cancer centers and Children’s Oncology Group (COG)-designated health systems and cancer centers. Reviewers manually searched websites and coded several Yes/No criteria for LGBTQIA + inclusivity. Results: Among the 65 NCI cancer centers’ websites in 2023, 66% included a nondiscrimination statement, 71% mentioned LGBTQIA + health disparities, 65% included LGBTQIA + tailored resources, and 66% had articles about LGBTQIA + health. There was a trend of increased inclusivity across categories from 2022 to 2023. Among the 204 COG-designated health system websites in 2023, there were 60 pediatric care websites and 144 lifespan care websites. A total of 79.9% of COG health system websites referenced LGBTQIA + patients (80.0% of pediatric and 79.9% of lifespan sites), 16.7% of COG cancer center websites referenced LGBTQIA + patients in the context of cancer care (6.7% of pediatric and 20.8% of lifespan sites), and 82.4% yielded results when search terms were input (83.3% of pediatric and 81.9% of lifespan sites). Conclusions: Adult and pediatric cancer centers’ websites have varying levels of LGBTQIA + inclusivity based on nondiscrimination statements, articles, and the availability of LGBTQIA + resources. While there have been some improvements in inclusivity on the NCI-designated cancer centers’ websites between 2022 and 2023, there is a need for further improvement. [ABSTRACT FROM AUTHOR]

κ‐carrageenan, an algae‐extracted polysaccharide known for its emulsifying properties, is widely used in food and beauty products. Because of its abundance in nature, similarity to natural glycosaminoglycans, and biocompatibility, it is a promising alternative to animal gelatin for tissue engineering. Key to the more widespread use of κ‐carrageenan for biomedical applications is its processability, which is hampered by its temperature‐dependent rheological properties. Here, a κ‐carrageenan‐based ink is introduced that can be 3D printed at room temperature through direct ink writing (DIW). This is achieved by formulating κ‐carrageenan as microgels that are covalently crosslinked through a second network, resulting in double network granular hydrogels (DNGHs). These DNGHs can be stiffened to reach stiffnesses up to 0.9 MPa under tension and 1.1 MPa under compression through the addition of metal ions and glucose. The metal/glucose reinforcement also increases the work of fracture up to 1.1 MJ m−3, exceeding that of unmodified κ‐carrageenan DNGHs 50‐fold. The potential of the ink by room temperature 3D printing cm‐sized free‐standing load‐bearing structures is demonstrated. This ink is envisaged to be a well‐suited algae‐derived alternative for the animal‐based gelatin for tissue engineering and in food applications for example as soft confectionery products. [ABSTRACT FROM AUTHOR]

This study investigates a novel microfluidic mixing technique that uses the resonant oscillation of coalescent droplets. During the vertical contact-separation process, solutes are initially separated as a result of the combined effects of diffusion and gravity. We show that the application of alternating current (AC) voltage to microelectrodes below the droplets causes a resonant oscillation, which enhances the even distribution of the solute. The difference in concentration between the top and bottom droplets exhibits frequency dependence and indicates the existence of a particular AC frequency that results in a homogeneous concentration. This frequency corresponds to the resonance frequency of the droplet oscillation that is determined using particle tracking velocimetry. To understand the mixing process, a phenomenological model based on the equilibrium between surface tension, viscosity, and electrostatic force was developed. This model accurately predicted the resonance frequency of droplet flow and was consistent with the experimental results. These results suggest that the resonant oscillation of droplets driven by AC voltage significantly enhances the diffusion of solutes, which is an effective approach to microfluid mixing. [ABSTRACT FROM AUTHOR]

High-density lipoprotein (HDL) cholesterol is traditionally viewed as protective against cardiovascular disease (CVD). However, emerging evidence reveals that dysfunctional HDL, characterized by impaired reverse cholesterol transport (RCT), reduced anti-inflammatory and antioxidant activities and increased endothelial dysfunction, which can contribute to coronary artery disease (CAD). Dysfunctional HDL, resulting from oxidative modifications of Apolipoprotein A-1 (Apo A-1) and enzyme inactivation, fails to effectively remove cholesterol from peripheral tissues and may promote inflammation and atherosclerosis. Genetic mutations affecting HDL metabolism further complicate its role in cardiovascular health. Studies have shown that conventional therapies aimed at raising HDL-C levels do not necessarily reduce cardiovascular events, highlighting the need for new approaches that improve HDL functionality. Therapeutic strategies such as Apo A-1 mimetic peptides, reconstituted HDL infusions, and drugs targeting specific HDL metabolic pathways are being explored. Additionally, weight loss, statin therapy, and niacin have shown potential in enhancing HDL function. The pathophysiology of dysfunctional HDL involves complex mechanisms, including oxidative stress, inflammation, and genetic mutations, which alter its structure and function, diminishing its cardioprotective effects. New functional assays, such as the cholesterol efflux capacity (CEC) and HDL inflammatory index, provide more accurate predictions of cardiovascular risk by assessing HDL quality rather than quantity. As research progresses, the focus is shifting towards therapeutic strategies that enhance HDL function and address the root causes of its dysfunction, offering a more effective approach to reducing cardiovascular risk and preventing CAD. [ABSTRACT FROM AUTHOR]

Simple Summary: Non-human primates, due to their close taxonomic relationship with humans, host the highest diversity of parasites with zoonotic potential. In zoological gardens, the presence of helminths and protist parasites with a direct lifecycle is virtually unavoidable; biosecurity measures are of the utmost importance to control their spread and environmental load and avoid transmission to staff and visitors. In this study, we investigated the population of non-human primates in two zoos in Northern Italy to evaluate gastrointestinal parasite diversity and their zoonotic potential. The highest prevalence was registered for protist taxa, i.e., Giardia and Blastocystis. Proof for the transmission of parasites from synanthropic rats to the animals in the collection was also provided. Non-human primates (NHPs) host a variety of helminth and protist parasites that are able to cause infection in humans. Gastrointestinal parasites in NHPs living in two zoological gardens of Northern Italy were studied. An total of 96 faecal pools were collected from 26 groups of NHPs. The mini-Flotac method was applied to fecal samples to detect gastrointestinal helminthiases, while the detection of the protists Cryptosporidium spp., Blastocystis sp. and Giardia duodenalis was performed by targeting SSU rRNA through nested PCR and real-time PCR; they were further studied by sequencing the same gene for Blastocystis and βgiardine and triosephosphate isomerase (TPI) genes for Giardia. Twenty-two out of the 96 examined fecal pools (22.9%) were positive for one or more helminth species, including Hymenolepis diminuta, Trichurid, Capillariid and Strongylid eggs. All samples were negative for Cryptosporidium spp., while 16/26 (61.5%) animals were positive for G. duodenalis in the real-time PCR; the sequences obtained assigned them all to sub-assemblage BIV. Blastocystis sp. was detected in 22/26 of the NHPs (84.6%); molecular analyses attributed the isolates to ST 4, allele 92. Analyses of the feces of sympatric rats revealed the presence of the same allele, as well as of Hymenolepis diminuta eggs, raising concern about their role as parasite reservoirs in the facilities. [ABSTRACT FROM AUTHOR]

Enriching methane from sources such as natural gas, biogas, and coalbed methane is a valuable gas separation endeavor, given methane as a cleaner and more sustainable fuel resource. Pressure swing adsorption (PSA) is widely regarded as a mature technology for this purpose. The essence of the mathematical model is to capture the fundamental aspects of the problem, enabling an accurate description of the system. This review summarizes recent trends in the mathematical modelling of PSA for methane enrichment. It provides a comprehensive compilation of numerical modelling and simulation studies, with a critical emphasis on methane enrichment applications. A rigorous mathematical model describing the adsorption phenomenology in a packed bed column is presented, incorporating mass, momentum, and energy balances, which serve as the fundamental framework for the cyclic adsorption process. Key analyses and performance metrics of PSA systems are detailed through examples from the literature. A case study based on a single column is presented to exemplify the mathematical modelling pathway and serve as a basis for model validation. The paper concludes by highlighting instructive avenues for future research directions and development in this area. [ABSTRACT FROM AUTHOR]

Gliomas present a complex challenge in neuro-oncology, often accompanied by the debilitating complication of epilepsy. Understanding the biological interaction and common pathways between gliomagenesis and epileptogenesis is crucial for improving the current understanding of tumorigenesis and also for developing effective management strategies. Shared genetic and molecular mechanisms, such as IDH mutations and dysregulated glutamate signaling, contribute to both tumor progression and seizure development. Targeting these pathways, such as through direct inhibition of mutant IDH enzymes or modulation of glutamate receptors, holds promise for improving patient outcomes. Additionally, advancements in surgical techniques, like supratotal resection guided by connectomics, offer opportunities for maximally safe tumor resection and enhanced seizure control. Advanced imaging modalities further aid in identifying epileptogenic foci and tailoring treatment approaches based on the tumor's metabolic characteristics. This review aims to explore the complex interplay between gliomagenesis, epileptogenesis, and neural circuit remodeling, offering insights into shared molecular pathways and innovative treatment strategies to improve outcomes for patients with gliomas and associated epilepsy. [ABSTRACT FROM AUTHOR]

Purpose Herpes Simplex Virus type 1 (HSV-1) is a highly contagious virus that manifests as a painful lesion and recurrences can be distressing to patients. The purpose of this pilot study was to determine if the use of a 70% ethanol alcohol hand sanitizer alters the duration, size of the lesion, level of pain upon administering treatment, and overall daily discomfort during outbreak. Methods This study was a double-blind randomized controlled trial (RCT) using 70% ethanol alcohol hand sanitizer for the experiment and medical grade mineral oil for the control group. The treatment and the control were dispensed in lip gloss applicators for applying medicament. Data was collected through the initial examination, a daily journal, photographs, and a reexamination day. Descriptive statistics and the independent sample t-test were used to analyze data (p=0.05). Results A total of 20 individuals completed the research study: ten in the experimental group and ten in the control group. The mean duration of HSV-1 lesions for the control group was 10.3 days while the mean duration of the HSV-1 lesions for the experimental group was 7.6 days. The mean size of lesions for the control group was 4.87 mm; the mean size for the experimental group was 4.25 mm. The mean pain score for the control group was 1.08 and the mean pain score for the experimental group was 2.74. The mean discomfort score for the control group was 1.33 while the mean discomfort score for the experimental group was 1.72. There was no statistically significant difference between the experimental and control groups in terms of duration, size of lesions, pain, and discomfort. Conclusion Based on the results of this pilot study, 70% ethanol alcohol hand sanitizer did not demonstrate statistical significance in the treatment and management of HSV-1 lesions. Additional research is needed with a larger sample size to determine if statistical differences can be measured. [ABSTRACT FROM AUTHOR]

Purpose Many adults in the United States struggle with mild, moderate, or severe dental anxiety (DA). Understanding the perspectives of patients with DA may help oral health professionals gain greater insight into their needs and learn how to provide an improved experience for these patients. The purpose of this study was to identify patients' perspectives on factors that impact anxiety in a dental practice setting. Methods A qualitative, descriptive case study design was used to identify patients' perspectives on factors impacting anxiety in a dental practice setting. Potential participants were screened using the Modified Dental Anxiety Scale (MDAS) and needed a moderate DA score to qualify for the study. An interview guide focused on obtaining information about the etiology, contributing factors, management strategies, and participant experiences of DA was used for the semi-structured virtual interviews. Responses were coded using a qualitative research analytic platform (Dedoose; Los Angeles, CA, USA). The co-investigators systematically reviewed the codes using the classic qualitative analysis strategies and journal notes to identify themes and subthemes. Results Twenty-two individuals qualified for participation in this study. Most participants reported having DA beginning in early childhood and throughout their adult life. Seven themes, including Avoidance, Supportive Behaviors, Confidence in Provider, Diversion, Enduring, Adaptations, and Benevolence emerged. Participants reported their primary method for managing DA was to avoid attending their dental appointments. Conclusion Participants in this study expressed various coping mechanisms and management strategies to alleviate the symptoms of DA. Multiple opportunities exist for increasing patient-provider trust and patient comfort to reduce DA, and ultimately improve the oral health status of individuals with DA. Keywords dental anxiety, coping mechanisms, triggers, dental practice setting, communication, patient-provider relationship [ABSTRACT FROM AUTHOR]

Traditional frame-based cameras, despite their effectiveness and usage in computer vision, exhibit limitations such as high latency, low dynamic range, high power consumption, and motion blur. For two decades, researchers have explored neuromorphic cameras, which operate differently from traditional frame-based types, mimicking biological vision systems for enhanced data acquisition and spatio-temporal resolution. Each pixel asynchronously captures intensity changes in the scene above certain user-defined thresholds, and streams of events are captured. However, the distinct characteristics of these sensors mean that traditional computer vision methods are not directly applicable, necessitating the investigation of new approaches before being applied in real applications. This work aims to fill existing gaps in the literature by providing a survey and a discussion centered on the different application domains, differentiating between computer vision problems and whether solutions are better suited for or have been applied to a specific field. Moreover, an extensive discussion highlights the major achievements and challenges, in addition to the unique characteristics, of each application field. [ABSTRACT FROM AUTHOR]

Residential real estate transaction data from Savannah, Georgia, from 2008 to 2021 was used to explore the connection between the volume of competing homes for sale at the time of listing and the effort level of the listing agent. Five proxies for agent effort were identified and, controlling for price, characteristics of the house, timing of the sale, and agent, results suggest that a greater volume of competing homes led to increased agent effort. A 1 standard deviation increase in the number of similarly priced concurrently listed homes resulted in a 3.7 to 12% increase in agent effort, as measured by proxy variables at their means. This result was robust over all five proxies for agent effort and the effect was noticeably larger for competing homes in a similar price range as compared to those in different pricing segments. Sentiment analysis was also conducted on publicly displayed agent property descriptions and indicated that public descriptions became more positive in tone as the volume of competing listings increased. [ABSTRACT FROM AUTHOR]

Both Karol Wojtyła and Edith Stein were philosophers who wrote plays. The metaphor of the islands that complement a continent, used by Gabriel Marcel to refer to his own plays in relation to his philosophical works, is most suitable for organizing and understanding the dramatic compositions of Wojtyła and Stein. Three continents can be identified, namely, the intellectual, the vital, and the vocational continent in their plays. This paper analyzes six of those plays in terms of the three different but interrelated continents, shedding light on a progression from the thesis play to the theater of commitment. The vocational continent, aided by its political commentary, is the one that best illustrates the vocation of service to the community through the call to mediate between God and humankind. [ABSTRACT FROM AUTHOR]

Simple Summary: Recently, numerous treatments have been approved for patients with previously untreated locally advanced or metastatic urothelial cancer. These combinations prolong survival compared to chemotherapy, which is generally considered the standard of care. Since direct head-to-head comparisons between these innovative treatments are not available, our analysis was aimed at performing indirect comparisons among these agents, including chemotherapy as a common comparator. In handling these indirect comparisons, our study used an innovative evidence-based method (the IPDfromKM technique) that reconstructs individual patient data from published clinical trials. Overall survival was the endpoint of our analysis. Our results showed that enfortumab vedotin plus pembrolizumab was the most effective treatment at levels of statistical significance. The combinations of a PD(L)-1 inhibitor plus chemotherapy ranked second, while monotherapies with a PD(L)-1 inhibitor ranked third. One strength of this analysis is represented by the large number of different treatments that were evaluated and compared to each other. Background: Patients with locally advanced/metastatic urothelial cancer have been conventionally treated with platinum-based chemotherapy. Recently, numerous new treatments have been proposed to improve overall survival (OS) and reduce adverse effects, but no direct head-to-head comparisons among these agents are available. Methods: The treatments evaluated in our analyses included (a) monotherapy with immune checkpoint inhibitors (ICI); (b) combinations of an ICI with chemotherapy; and (c) combinations of an ICI with other drugs. Using OS as the endpoint, a series of indirect comparisons were performed to rank the most effective regimens against both chemotherapy and each other. Our analysis was based on the application of an artificial intelligence software program (IPDfromKM method) that reconstructs individual patient data from the information reported in the graphs of Kaplan–Meier curves. Results: A total of five studies published in six articles were included. In our main analysis, nivolumab plus chemotherapy showed better OS compared to chemotherapy (HR = 0.70, 95% CI: 0.59–0.82), while durvalumab plus tremelimumab showed no OS benefit (HR = 0.95, 95% CI 0.82–1.11). More interestingly, enfortumab vedotin plus pembrolizumab significantly prolonged OS compared to both chemotherapy alone (HR = 0.53, 95% CI 0.45–0.63) and nivolumab plus chemotherapy (HR = 0.76, 95% CI 0.60–0.97). Discussion and conclusion: Among new treatments for locally advanced and metastatic urothelial cancer, enfortumab vedotin plus pembrolizumab showed the best efficacy in terms of OS. Our results support the use of this combination as a first-line treatment in this setting. [ABSTRACT FROM AUTHOR]

This paper experimentally assesses the efficacy of the indirect Structural Health Monitoring (iSHM) framework on a full‐scale short‐span bridge of nine meters long, using an instrumented vehicle with non‐negligible mass with respect to the mass of the bridge. Emphasis is given to the dynamic identification of the two mechanical systems through Experimental Modal Analysis (EMA) on both the vehicle and the bridge. The EMA vehicle testing is among the main contributions of this paper, as such data become available in experimental iSHM implementations for the first time in the literature. Thus, new insights are brought on the vehicle's dual role as a roving sensing unit and a vibrating mechanical system. A wireless sensor network is adopted that supports a dual monitoring system, i.e., an indirect system with accelerometers on the vehicle and a conventional system with fixed sensors on the bridge. Under a stationary vehicle's position on the bridge, it is shown that a strong dynamic coupling occurs between the two systems due to their high mass ratio and the vehicle's function as a Spring Mass Damper (SMD). In vehicle's moving state, it is demonstrated that transfer of energy occurs between the vehicle and the bridge, which both oscillate under multiple modes of vibration that change over time. It is identified that four main parameters influence the quality of the extracted bridge natural frequencies from the vehicle‐acquired data, i.e., (i) the filtering properties of the vehicle, (ii) the effective signals length in the presence of road discontinuities, (iii) the speed trade‐offs, and (iv) the level of vehicle‐induced bridge excitation and its transmissibility level. The careful consideration of those parameters determines the effectiveness of iSHM implementations in short‐span bridges. [ABSTRACT FROM AUTHOR]

Background: Carbon (C) sink and stock are among the most important ecosystem services provided by forests in climate change mitigation policies. In this context, old-growth forests constitute an essential reference point for the development of close-to-nature silviculture, including C management techniques. Despite their small extent in Europe, temperate old-growth forests are assumed to be among the most prominent in terms of biomass and C stored. However, monitoring and reporting of C stocks is still poorly understood. To better understand the C stock amount and distribution in temperate old-growth forests, we estimated the C stock of two old-growth stands in the Dinaric Alps applying different assessment methods, including direct and indirect approaches (e.g., field measurements and allometric equations vs. IPCC standard methods). This paper presents the quantification and the distribution of C across the five main forest C pools (i.e., aboveground, belowground, deadwood, litter and soil) in the study areas and the differences between the applied methods. Results: We report a very prominent C stock in both study areas (507 Mg C ha− 1), concentrated in a few large trees (36% of C in 5% of trees). Moreover, we found significant differences in C stock estimation between direct and indirect methods. Indeed, the latter tended to underestimate or overestimate depending on the pool considered. Conclusions: Comparison of our results with previous studies and data collected in European forests highlights the prominence of temperate forests, among which the Dinaric Alps old-growth forests are the largest. These findings provide an important benchmark for the development of future approaches to the management of the European temperate forests. However, further and deeper research on C stock and fluxes in old-growth stands is of prime importance to understand the potential and limits of the climate mitigation role of forests. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has greatly affected adolescents, including their social media use and mental well-being. Ongoing research is needed to better understand how social media use relates to mental health and well-being in this challenging time. This qualitative study explored the role of social media in addressing the mental health problems faced by adolescents during the pandemic. Materials and methods: A total of 41 adolescents aged 13 to 17 in West Malaysia participated in this one-on-one interview. Results: The thematic analysis suggests three themes emerged, namely: (1) the importance of social media in addressing mental health issues; (2) the effects of social media on one’s mental health; and (3) coping strategies for dealing with stress experienced on social media. The adolescents faced positive effects (e.g., socialising, an easy source of information, a form of entertainment, exposure to world news, and ways of dealing with mental health issues by releasing their emotions and feelings) and negative effects of social media, such as cyberbullying, internet addiction, bad influence, a breakdown in family physical contacts and relationships, misinformation, and disinformation). The coping strategies include avoiding social media, ignoring negative comments, helping those in need, referral to school counsellors, trusted friends or family members, and indulging in physical activities to relieve stress. Conclusion: The importance of social media in addressing mental health issues cannot be underestimated. The results’ implications and the need for additional research on the relationship between adolescent mental health and social media use are highlighted. [ABSTRACT FROM AUTHOR]

Background: Pediatric cancer patients' oncology teams regularly take on a primary care role, but due to the urgent nature of cancer treatment, developmental screenings may be deprioritized. This leaves patients at risk of developmental diagnoses and referrals being delayed. Aims: Clarify the current developmental surveillance and screening practices of one pediatric oncology team. Materials and methods: Researchers reviewed charts for patients (n = 66) seen at a pediatric oncology clinic in a suburban academic medical center to determine engagement in developmental screening (including functioning around related areas such as speech, neurocognition, etc.) and referrals for care in these areas. Results: Developmental histories were collected from all patients through admission history and physical examination (H&P), but there was no routinized follow‐up. Physicians did not conduct regular developmental screening per American Academy of Pediatrics guidelines for any patients but identified n = 3 patients with needs while the psychology team routinely surveilled all patients seen during this time (n = 41) and identified n = 18 patients as having delays. Discussion: Physicians did not routinely screen for development needs beyond H&P and were inconsistent in developmental follow‐up/referrals. Integrated psychologists were key in generating referrals for developmental‐based care. However, many oncology patients were not seen by psychologists quickly or at all, creating a significant gap in care during a crucial developmental period. Conclusion: The case is made for further routinization of ongoing developmental screening in pediatric oncology care. Key points: For pediatric oncology patients, oncology providers may take on a primary care role to surveil, screen, and refer for developmental concerns per guidelines issued by the American Academy of Pediatrics.This quality improvement study sought to explore the developmental monitoring practices of one pediatric oncology clinic.Only a portion of pediatric oncology patients diagnosed with cancer between 6 months and 5 years 11 months received developmental surveillance, screenings, and/or referrals from the oncology team beyond patients' initial history and physical.Patients who were seen by the integrated psycho‐oncology team were the most likely to have received developmental surveillance, screening, and referrals. Integrated psycho‐oncology providers may serve to address gaps in developmental monitoring practices in pediatric oncology clinics. [ABSTRACT FROM AUTHOR]

We propose a novel mechanism for visualizing the chirality of compounds in solution using a vertical contact‐separation process (VCSP) of liquid crystal micro‐droplets (LCμDs). By employing the VCSP between target micro‐droplets and sensor LCμDs, the chiral compounds initially introduced in the target micro‐droplets diffuse into coalescent micro‐droplets. After the VCSP, we observed a wavelength shift in the selective reflection from the sensor LCμDs, allowing us to visualize the chirality present in the target micro‐droplets. To quantitatively analyze the wavelength shift of the selective reflection, we utilized reflective spectroscopic techniques. Our findings demonstrate that the chirality sensing mechanism achieves a detection accuracy of 10 μg. Moreover, this chiral sensing mechanism can be effectively applied to two‐dimensional micro‐droplet array systems. © 2023 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Refractory acute myeloid leukaemia is very difficult to treat and represents an unmet clinical need. In recent years, new drugs and combinations of drugs have been tested in this category, with encouraging results. However, all treated patients relapsed and died from the disease. The only curative option is allogeneic transplantation through a graft from a healthy donor immune system. Using myeloablative conditioning regimens, the median overall survival regimens is 19%. Several so-called sequential induction chemotherapies followed by allogeneic transplantation conditioned by reduced intensity regimens have been developed, improving the overall survival to 25–57%. In the allogeneic transplantation field, continuous improvements in practices, particularly regarding graft versus host disease prevention, infection prevention, and treatment, have allowed us to observe improvements in survival rates. This is true mainly for patients in complete remission before transplantation and less so for refractory patients. However, full myeloablative regimens are toxic and carry a high risk of treatment-related mortality. In this review, we describe the results obtained with the different modalities used in more recent retrospective and prospective studies. Based on these findings, we speculate how allogeneic stem cell transplantation could be modified to maximise its therapeutic effect on refractory acute myeloid leukaemia. [ABSTRACT FROM AUTHOR]

This paper demonstrates the latest developments in particle-scale modelling of a clay. It shows that by creating an initial sample of platelets featuring aggregated stacks, excellent macroscopic behaviour is achieved. This approach is justified by examining SEM images of clay slurries, and is consistent with the behaviour of real clays. The use of aggregated stacks allows a wider range of platelet interactions and micro properties to be simulated and investigated, and significantly, enables interactions to be modelled that are based on a range of real measurements obtained from surface force experiments. [ABSTRACT FROM AUTHOR]

We review the phenomenology of classical Cepheids (CCs), Anomalous Cepheids (ACs) and type II Cepheids (TIICs) in the Milky Way (MW) and in the Magellanic Clouds (MCs). We also examine the Hertzsprung progression in different stellar systems by using the shape of I-band light curves (Fourier parameters) and observables based on the difference in magnitude and in phase between the bump and the minimum in luminosity. The distribution of Cepheids in optical and in optical–near infrared (NIR) color–magnitude diagrams is investigated to constrain the topology of the instability strip. The use of Cepheids as tracers of young (CCs), intermediate (ACs) and old (TIICs) stellar populations are brought forward by the comparison between observations (MCs) and cluster isochrones covering a broad range in stellar ages and in chemical compositions. The different diagnostics adopted to estimate individual distances (period–luminosity, period–Wesenheit, period–luminosity–color relations) are reviewed together with pros and cons in the use of fundamental and overtones, optical and NIR photometric bands, and reddening free pseudo magnitudes (Wesenheit). We also discuss the use of CCs as stellar tracers and the radial gradients among the different groups of elements (iron, α , neutron-capture) together with their age-dependence. Finally, we briefly outline the role that near-future space and ground-based facilities will play in the astrophysical and cosmological use of Cepheids. [ABSTRACT FROM AUTHOR]

Background: Petroclival meningiomas are challenging tumors. Several skull base approaches have been proposed in the last decades, with variable rates of postoperative morbidity and extent of resection. Methods: We herein reported the step-by-step microsurgical resection of a large petroclival meningioma through an extended retrosigmoid approach. Detailed surgical technique has been accompanied by a 2D operative video. Conclusion: The extended retrosigmoid approach allowed for a safe gross total resection of the tumor, as confirmed by the postoperative MRI. The patient did not experience any new postoperative deficit, despite a transient diplopia, and was discharged on postoperative day 7. [ABSTRACT FROM AUTHOR]

Purpose The relative newness of Post-COVID Conditions (PCC) has revealed a void in assessment protocols and treatment guidelines for dental settings. Providing oral health care practitioners with an assessment and treatment protocol could facilitate the delivery of comprehensive oral health care. The purpose of this study was to test a protocol for assessing and treating patients with PCC in dental practice settings. Methods A qualitative exploratory research design was used to conduct the study. A PCC assessment and treatment protocol (ATP) was developed and was used by dental hygienists in clinical practice in California for a period of 6 weeks. Following the use of the PCC ATP practitioners were invited to participate in individual interviews. Online individual interviews were comprised of 20 dental hygienists recruited via purposive sampling. Participant anonymity was preserved using pseudonyms. A qualitative analysis software program was used to identify codes and themes. Investigator triangulation, member checks, and saturation were used to validate responses. Results Fifty-six participants completed the six-week PCC ATP and twenty participants took part in the interview session. Four themes were identified: awareness, accessibility, resources, and complications. Within the accessibility theme, subthemes of ease of use and guidance emerged. The complications theme yielded three subthemes: time, clinician hesitation, and patient lack of cooperation. Conclusion This study demonstrated that a PCC ATP created awareness of the varied symptoms of PCC and is a useful resource for clinical practitioners. Providing dental hygienists with a treatment protocol supports efforts to provide person-centered evidence-based care. [ABSTRACT FROM AUTHOR]

The failure strain of a tube is a function of the biaxial strain ratio (axial strain/hoop strain) to which it is subjected. The relationship between failure strain and the strain ratio can be determined experimentally using expansion due to compression tests with a tensile load (EDCT), in which a ductile pellet placed inside the tube is compressed axially so it expands in diameter and imposes a hoop strain on the tube. At the same time, a tensile load on the ends of the tube creates an axial strain. This study investigates the capabilities and limitations of EDCT tests using two devices that allow experiments to be performed on a standard tensile testing machine. The first device applies an axial force on the ends of the sample, and the second device applies an axial displacement. Tests on zirconium alloy tubes confirmed that the failure strain is dependent on the strain ratio and the metallurgical state of the material. EDCT tests can produce a range of strain ratios, but there is an upper limit on the strain ratio that can be obtained, and it is dependent on the plastic behaviour of the sample and the friction conditions between the components. [ABSTRACT FROM AUTHOR]

Broad-spectrum empiric antibiotics are routinely administered to hospitalized patients with potential infections. These antibiotics provide protection; however, they come with their own negative effects. The utility of Methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) nasal screening to steward anti-MRSA empiric antibiotics in hospitalized patients is established. With this current study, we look to determine the optimal frequency of MRSA nasal testing to help limit unnecessary testing consistent with the efforts of Choosing Wisely. We hypothesize that MRSA PCR nasal swab conversion will be low within the first 2 wk after index swab collection. We performed a single-center retrospective chart review of all adult patient encounters from October 2019-July 2021 with MRSA PCR nasal testing. We excluded duplicate patient encounters. Further exclusion criteria included patients with a single MRSA PCR swab and those who tested positive for MRSA colonization on their index swab. We evaluated how many conversions from negative to positive there were, and the timing of those relative to those that did not develop colonization while in the hospital. 263 patients had multiple MRSA nares screening. 215 patients had 2 swab collections, 35 patients had 3 swab collections, 9 patients had 4 swab collections, and 4 patients had 5 swab collections. 14 converted from negative to positive. The time of conversions ranged from within 0-36 d, with an overall cumulative conversion of 5%. The rate of cumulative conversion from one week was 1.9%, for 2 wk it was 3.4%. Findings suggest that MRSA PCR nasal swab conversion is unlikely to occur within 2 wk. Therefore, to optimize resources, further investigation should be conducted to target guidelines as well as systems to limit repeat swab testing. We will investigate the utility of this after implementation. [ABSTRACT FROM AUTHOR]

This paper investigates whether the availability of breastfeeding facilities at the workplace helps to reconcile breastfeeding and work commitments, and whether it has beneficial effects for the health of the child. Using data from the UK Infant Feeding Survey, we find that the availability of breastfeeding facilities at work is associated with longer breastfeeding durations for all women and shorter maternity leave spells for higher educated women. We also find that children born to mothers whose employer offers breastfeeding facilities experience significantly fewer sickness in the first 6 months of life. [ABSTRACT FROM AUTHOR]

We examine whether cigarettes serve as substitutes for electronic nicotine delivery systems (ENDS) among ENDS users and demonstrate methodological extensions of data from a cross‐price purchase task to inform policies and interventions. During a clinical laboratory study, n = 19 exclusive ENDS users and n = 17 dual cigarette/ENDS users completed a cross‐price purchase task with cigarettes available at a fixed price while prices of own‐brand ENDS increased. We estimated cross‐price elasticity using linear models to examine substitutability. We defined five additional outcomes: nonzero cross‐price intensity (purchasing cigarettes if ENDS were free), constant null demand (not purchasing cigarettes at any ENDS price), cross‐product crossover point (first price where participants purchased more cigarettes than ENDS), dual‐demand score (percentage of prices where both products were purchased), and dual‐use break point (minimum relative price to force complete substitution). The cross‐price elasticity results indicated that cigarettes could serve as substitutes for ENDS among ENDS users on average, but this average effect masked substantial heterogeneity in profiles of demand (here, a measure of the drug's reinforcement potential). Policies and regulations that increase ENDS prices appear unlikely to steer most exclusive ENDS users toward cigarette use, as most would not purchase cigarettes at any ENDS price, but they could prompt some dual users to substitute cigarettes completely while others remain dual users. This heterogeneity in consumer responses suggests additional indices of cross‐product demand are useful to characterize the anticipated and unanticipated effects of tobacco price policies more fully. [ABSTRACT FROM AUTHOR]

This brief historical review presents the pioneering work of Franco Basaglia and Franco Rotelli that revolutionized community care in the 1970s in Trieste, Italy. Based on archival records of Micro-areas in Trieste at the social cooperative La Collina, this article addresses the chronology of key moments and components of that innovative community perspective. Trieste's mental health service, considered one of the best in the world, is a reference for deinstitutionalized care in social housing within territories that contributes to healing. Trieste has demonstrated that by adopting a "social enterprise perspective," it reaches targets of sustainable, intersectoral, local networks with responsiveness, agility, and efficiency. The program has demonstrated that it can create substantial gains in terms of inclusion, empowerment, and social economy by working from a rights-based, person-centred approach, thus contributing to social justice. [ABSTRACT FROM AUTHOR]

Background: Petroclival meningiomas are challenging tumors. Several skull base approaches have been proposed in the last decades, with variable rates of postoperative morbidity and extent of resection. Methods: We herein reported the step-by-step microsurgical resection of a large petroclival meningioma through an extended retrosigmoid approach. Detailed surgical technique has been accompanied by a 2D operative video. Conclusion: The extended retrosigmoid approach allowed for a safe gross total resection of the tumor, as confirmed by the postoperative MRI. The patient did not experience any new postoperative deficit, despite a transient diplopia, and was discharged on postoperative day 7. [ABSTRACT FROM AUTHOR]

VPS35 plays a key role in neurodegenerative processes in Alzheimer’s disease and Parkinson’s disease (PD). Many genetic studies have shown a close relationship between autophagy and PD pathophysiology, and specifically, the PD-causing D620N mutation in VPS35 has been shown to impair autophagy. However, the molecular mechanisms underlying neuronal cell death and impaired autophagy in PD are debated. Notably, increasing evidence suggests that Rab9-dependent “alternative” autophagy, which is driven by a different molecular mechanism that driving ATG5-dependent “conventional” autophagy, also contributes to neurodegenerative process. In this study, we investigated the relationship between alternative autophagy and VPS35 D620N mutant-related PD pathogenesis. We isolated iPSCs from the blood mononuclear cell population of two PD patients carrying the VPS35 D620N mutant. In addition, we used CRISPR-Cas9 to generate SH-SY5Y cells carrying the D620N variant of VPS35. We first revealed that the number of autophagic vacuoles was significantly decreased in ATG5-knockout Mouse Embryonic Fibroblast or ATG5-knockdown patient-derived dopaminergic neurons carrying the VPS35 D620N mutant compared with that of the wild type VPS35 control cells. Furthermore, estrogen, which activates alternative autophagy pathways, increased the number of autophagic vacuoles in ATG5-knockdown VPS35 D620N mutant dopaminergic neurons. Estrogen induces Rab9 phosphorylation, mediated through Ulk1 phosphorylation, ultimately regulating alternative autophagy. Moreover, estrogen reduced the apoptosis rate of VPS35 D620N neurons, and this effect of estrogen was diminished under alternative autophagy knockdown conditions. In conclusion, alternative autophagy might be important for maintaining neuronal homeostasis and may be associated with the neuroprotective effect of estrogen in PD with VPS35 D620N. [ABSTRACT FROM AUTHOR]

• Consider cutaneous bacillary angiomatosis in mildly immunocompromised patients. • There are uncertainties about the best antibiotic treatment and its duration. • Validation and use of molecular methods can improve diagnosis and therapy outcomes. Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella henselae or Bartonella quintana that has been mostly described in people living with HIV. Since cBA is considered to be rare in hosts not affected by major immunosuppression, it could be underdiagnosed in this population. Moreover, antimicrobial treatment of cBA has been poorly validated, thus reporting experiences on this clinical entity is important. We reported a challenging and well-characterized case of an Italian 67-year-old gentleman without a history of major immunocompromizing conditions, although he was affected by conditions that can be associated with impaired immune function. The patient reported herein was diagnosed after a long time since the initiation of symptoms and was successfully treated with combined antibiotic therapy including macrolides and quinolones under the guidance of molecular test results. Physicians should consider cBA as a possible manifestation of Bartonella spp. Infection in patients not suffering from major immunocompromizing conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration. [ABSTRACT FROM AUTHOR]

In the United States, people living with HIV (PLWH) in rural areas fare worse along the HIV care continuum than their urban counterparts; this may be due in part to limited geographic access to care. We estimated drive time to care for PLWH, focusing on urban-rural differences. Adult Medicaid enrollees living with HIV and their usual care clinicians were identified using administrative claims data from 14 states (Medicaid Analytic eXtract, 2009–2012). We used geographic network analysis to calculate one-way drive time from the enrollee's ZIP code tabulation area centroid to their clinician's practice address, then examined urban-rural differences using bivariate statistics. Additional analyses included altering the definition of rurality; examining subsamples based on the state of residence, services received, and clinician specialty; and adjusting for individual and county characteristics. Across n = 49,596 PLWH, median drive time to care was 12.8 min (interquartile range 26.3). Median drive time for rural enrollees (43.6 (82.0)) was nearly four times longer than for urban enrollees (11.9 (20.6) minutes, p < 0.0001), and drive times exceeded one hour for 38% of rural enrollees (versus 12% of urban, p < 0.0001). Urban-rural disparities remained in all additional analyses. Sustained efforts to circumvent limited geographic access to care are critical for rural areas. [ABSTRACT FROM AUTHOR]

Mitofusin-2 (MFN2) is an outer mitochondrial membrane protein essential for mitochondrial networking in most cells. Autosomal dominant mutations in the MFN2 gene cause Charcot–Marie–Tooth type 2A disease (CMT2A), a severe and disabling sensory-motor neuropathy that impacts the entire nervous system. Here, we propose a novel therapeutic strategy tailored to correcting the root genetic defect of CMT2A. Though mutant and wild-type MFN2 mRNA are inhibited by RNA interference (RNAi), the wild-type protein is restored by overexpressing cDNA encoding functional MFN2 modified to be resistant to RNAi. We tested this strategy in CMT2A patient-specific human induced pluripotent stem cell (iPSC)-differentiated motor neurons (MNs), demonstrating the correct silencing of endogenous MFN2 and replacement with an exogenous copy of the functional wild-type gene. This approach significantly rescues the CMT2A MN phenotype in vitro, stabilizing the altered axonal mitochondrial distribution and correcting abnormal mitophagic processes. The MFN2 molecular correction was also properly confirmed in vivo in the MitoCharc1 CMT2A transgenic mouse model after cerebrospinal fluid (CSF) delivery of the constructs into newborn mice using adeno-associated virus 9 (AAV9). Altogether, our data support the feasibility of a combined RNAi and gene therapy strategy for treating the broad spectrum of human diseases associated with MFN2 mutations. [ABSTRACT FROM AUTHOR]

Social interactions among viruses occur whenever multiple viral genomes infect the same cells, hosts, or populations of hosts. Viral social interactions range from cooperation to conflict, occur throughout the viral world, and affect every stage of the viral lifecycle. The ubiquity of these social interactions means that they can determine the population dynamics, evolutionary trajectory, and clinical progression of viral infections. At the same time, social interactions in viruses raise new questions for evolutionary theory, providing opportunities to test and extend existing frameworks within social evolution. Many opportunities exist at this interface: Insights into the evolution of viral social interactions have immediate implications for our understanding of the fundamental biology and clinical manifestation of viral diseases. However, these opportunities are currently limited because evolutionary biologists only rarely study social evolution in viruses. Here, we bridge this gap by (1) summarizing the ways in which viruses can interact socially, including consequences for social evolution and evolvability; (2) outlining some open questions raised by viruses that could challenge concepts within social evolution theory; and (3) providing some illustrative examples, data sources, and conceptual questions, for studying the natural history of social viruses. [ABSTRACT FROM AUTHOR]

Despite p-block clusters being known for over a century, their application as catalysts to mediate organic transformations is underexplored. Here, the boron functionalized [P7] cluster [(BBN)P7]2- ([1]²-; BBN = 9-borabicyclo[3.3.1]nonane) is applied in the dearomatized reduction of pyridines, as well as the hydroboration of imines and nitriles. These transformations afford amine products, which are important precursors to pharmaceuticals, agrochemicals, and polymers. Catalyst [1]2- has high stability in these reductions: recycling nine times in quinoline hydroboration led to virtually no loss in catalyst performance. The catalyst can also be recycled between two different organic transformations, again with no loss in catalyst competency. The mechanism for pyridine reduction was probed experimentally using variable time normalization analysis, and computationally using density functional theory. This work demonstrates that Zintl clusters can mediate the reduction of nitrogen containing substrates in a transition metal-free manner. [ABSTRACT FROM AUTHOR]

Numerous riverbeds and floodplains in the Western Mediterranean Area (WMA) have been affected by anthropogenic modifications during the last centuries. In recent decades, an increase in floods in the coastal WMA has been observed. Variations in the rainfall regime and anthropisation have influenced the relevant geomorphological processes. The coastal floodplains analysed include those in Italy, France, and Spain. Geomorphological and land use changes that occurred in the last two centuries were examined using historical and recent maps, historical data, and European big data since the 1800s for 65 basins, for which over 670 flood events and more than 1300 victims were identified. Anthropogenic activities have changed the patterns of floodplains. In most cases, narrowing of the riverbeds, especially in the lower river sections, has been observed. The riverbeds have also changed from braided- to single-channel morphologies. GIS analysis shows reductions in the coastal watercourse widths ranging from 10% to 95%, with an average of 55%. Other changes are related to the deviation in the watercourses, with trends that did not respect the natural river flow. In some cases, the watercourses were covered and have vanished from recent maps. This aspect has reduced or eliminated the perception of the risk not only for the residents but also for land planners. [ABSTRACT FROM AUTHOR]

Treatment gaps in meeting the neuropsychological needs of young adult (YA) cancer survivors can be attributed to several clinical and systemic reasons. Access to neurocognitive care can be increased through the effective integration of neuropsychological monitoring and intervention in survivorship care. In this brief report, we aim to compare the efficacy of a brief neuropsychological screener (DIVERGT) in meeting the assessment and referral needs of pediatric and YA cancer survivors (n = 40) as part of a wellness and survivorship clinic. Participants (n = 40) were patients who presented to a pediatric oncology survivorship clinic over the span of 15 months. [ABSTRACT FROM AUTHOR]

Purpose Professional development is instrumental in the ongoing success of healthcare professionals and students. The purpose of the second year of this two-year study was to continue to apply the results from the CliftonStrengths® assessment to support entry-level dental hygiene students' professional development and to create a conceptual model for professional development in dental hygiene education. Methods CliftonStrengths® were incorporated in didactic and community learning experiences throughout year two of the dental hygiene curriculum. At the end of year two, focus group interviews assessed student perceptions of professional strengths based on these learning experiences. Co-investigators used a qualitative analysis software program to identify codes and themes. Investigator triangulation and member checks were used to validate responses. Results All second-year dental hygiene students (n=32) participated in year two of the study. Two themes were identified: relevance of CliftonStrengths® and professional development. Within the theme of relevance, the subthemes of adaptability, making connections, and teamwork emerged. The theme professional development yielded three subthemes: appreciation, personal and professional identity, and insight. Conclusion This study demonstrated CliftonStrengths® can be used to promote professional development among dental hygiene students. As a result, a conceptual model was developed for professional development in dental hygiene education. This model can be used as a framework for teaching and to improve student learning experiences. [ABSTRACT FROM AUTHOR]

The appropriate time for the administration of P2Y12 inhibitors in patients with non-ST elevation acute coronary syndrome has been the subject of debate for two decades. The current recommendations of the European guidelines suggest administering acetylsalicylic acid and waiting for the coronary angiography and once the anatomy is known, adding a P2Y12 inhibitor only in those cases in which an early interventional strategy is scheduled. However, in the real world, the strategy to perform pretreatment or not is more complex. There is uncertainty regarding whether the patient can access a coronary angiography within 24 hours. In this scenario, pretreatment upon admission of intermediate or high-risk patients could be an option if it is not studied with catheterization within 2 to 4 hours of admission, previously analyzing the patient's ischemic and bleeding risk. Large-scale studies comparing these two options are still lacking. [ABSTRACT FROM AUTHOR]

CDK-1 and PARP-1 play crucial roles in breast cancer progression. Compounds acting as CDK-1 and/or PARP-1 inhibitors can induct cell death in breast cancer with a selective synthetic lethality mechanism. A mixed treatment by means of CDK-1 and PARP-1 inhibitors resulted in radical breast cancer cell growth reduction. Inhibitors with a dual target mechanism of action could arrest cancer progression by simultaneously blocking the DNA repair mechanism and cell cycle, resulting in advantageous monotherapy. To this aim, in the present work, we identified compound 645656 with a significant affinity for both CDK-1 and PARP-1 by a mixed ligand- and structure-based virtual screening protocol. The Biotarget Predictor Tool was used at first in a Multitarget mode to filter the large National Cancer Institute (NCI) database. Then, hierarchical docking studies were performed to further screen the compounds and evaluate the ligands binding mode, whose putative dual-target mechanism of action was investigated through the correlation between the antiproliferative activity data and the target proteins' (CDK-1 and PARP-1) expression pattern. Finally, a Molecular Dynamics Simulation confirmed the high stability of the most effective selected compound 645656 in complex with both PARP-1 and CDK-1. [ABSTRACT FROM AUTHOR]

Background We evaluate the feasibility of a single-stage posterior corpectomy and circumferential arthrodesis with the aid of spinal navigation for the treatment of traumatic thoracolumbar burst fractures. Methods This was a single-center, retrospective study. Demographics, clinical, and radiologic data of 19 patients who underwent surgery at our institution for thoracolumbar burst fractures between 2016 and 2019 were collected. All patients enrolled in the present study underwent surgery by means of posterior fixation and transpedicular corpectomy with the aid of an intraoperative image-guided neuronavigation system. Results Postoperative correction of the vertebral height ratio was achieved in all cases, with an average increase of 23.6% (p = 0.0005). No statistical differences (p = 0.9) were found comparing 1- and 3-month postoperative CT scans, in relation to vertebral height ratio. A statistically significant difference was found between the pre- and postoperative kyphotic angles for the thoracolumbar and lumbar segments (p = 0.0018 and 0.005, respectively), but no difference was found between kyphotic angles at the 3-month follow-up. A unilateral approach was performed on 15 patients (79%), while 4 cases (21%) required a bilateral laminectomy. We did not observe any significant intraoperative complication. Conclusion Single-stage posterior corpectomy and fixation is a safe and effective approach for thoracic and lumbar burst fractures. It provides excellent 360-degree reconstruction in a single surgical stage with satisfactory results in terms of kyphosis reduction, biomechanical stability, and reduced invasiveness. Spinal navigation represents a fundamental tool to overcome some anatomical limits of the presented technique. [ABSTRACT FROM AUTHOR]