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The study of the behavior of magnetic skyrmions in local magnetic fields' nanometric length-scale has gained increasing interest in recent years due to the theoretical proposal of magnetic skyrmion–superconducting vortex pairs as potential hosts for topologically protected bound states, which hold high promise for applications in quantum computing. From a magnetic interaction point-of-view, the key interest lies in understanding the skyrmion dynamics triggered by the magnetic energy landscape generated by the superconducting vortex. Here, we present a micromagnetic study of the dynamics of nanometric skyrmions inside a Gaussian magnetic field profile, which is used as a simplified version of the vortex magnetic flux. On the one hand, our calculations show that local non-linear magnetic fields can be very effective in controlling the dynamics of magnetic skyrmions; in particular, they offer the appealing possibility to manipulate skyrmions in a two dimensional space. On the other hand, they also show that the dynamics of a skyrmion in a local magnetic field can be manipulated via a uniform external magnetic field without any change in the magnetic field gradient. An analytical expression for the skyrmion velocity is given, and the corresponding microscopic dynamics are confirmed by the micromagnetic simulations. This work is expected to motivate more theoretical and experimental studies of the behavior of magnetic skyrmions in proximity to superconducting vortices. [ABSTRACT FROM AUTHOR]

In the last two decades, librarians and LIS scholars have turned to critical race theory (CRT) for new insights about their field and its relationship to race and racism in the United States. Yet law librarians have been engaging CRT since the 1980s. In fact, founding critical race theorists Richard Delgado and Jean Stefancic wrote about law libraries and legal information—just as several law librarians and legal information scholars were writing about critical legal theory—in the earliest days of the movement. This paper surveys these works and assesses the impact they have had on law librarianship in the hope of encouraging CRT-aligned LIS scholars and librarians in other subfiels to discover this previously overlooked foundation of CRT in LIS. [ABSTRACT FROM AUTHOR]

Mindfulness-based interventions have gained popularity among elite athletes, but their effectiveness in enhancing archery performance has been inconsistent. This study examined the feasibility of a 12-week mindfulness flow program (MFP) specifically designed for the archers and assessed the effect of the MFP on shooting performance. Twelve members of the Hong Kong Archery Team voluntarily participated in the present study. Their shooting performance, anxiety, mindfulness, and flow state were assessed before and after the MFP intervention. The results showed that the MFP was highly feasible, with 100% attendance. The athletes highly enjoyed the MFP sessions (mean rating: 7.9/10). Improved shooting performance, increased mindfulness, and flow state levels, and reduced anxiety were also observed after the intervention. These findings suggest a positive reception from and potential benefits for athletes. However, it is suggested to conduct additional research using randomized controlled trials to explore the program's effects and applicability in enhancing sports performance. [ABSTRACT FROM AUTHOR]

Structure determination is necessary to identify unknown organic molecules, such as those in natural products, forensic samples, the interstellar medium, and laboratory syntheses. Rotational spectroscopy enables structure determination by providing accurate 3D information about small organic molecules via their moments of inertia. Using these moments, Kraitchman analysis determines isotopic substitution coordinates, which are the unsigned |x|, |y|, |z| coordinates of all atoms with natural isotopic abundance, including carbon, nitrogen, and oxygen. While unsigned substitution coordinates can verify guesses of structures, the missing +/− signs make it challenging to determine the actual structure from the substitution coordinates alone. To tackle this inverse problem, we develop Kreed (Kraitchman REflection-Equivariant Diffusion), a generative diffusion model that infers a molecule's complete 3D structure from only its molecular formula, moments of inertia, and unsigned substitution coordinates of heavy atoms. Kreed's top-1 predictions identify the correct 3D structure with near-perfect accuracy on large simulated datasets when provided with substitution coordinates of all heavy atoms with natural isotopic abundance. Accuracy decreases as fewer substitution coordinates are provided, but is retained for smaller molecules. On a test set of experimentally measured substitution coordinates gathered from the literature, Kreed predicts the correct all-atom 3D structure in 25 of 33 cases, demonstrating experimental potential for de novo 3D structure determination with rotational spectroscopy. [ABSTRACT FROM AUTHOR]

How does the viability of a product category shift over time? Studies abound on how categories emerge and become established, or fall out of use. Yet, extant research has often examined the evolution of categories one at a time, leaving open the question of how related categories affect a focal category's viability. In contrast, we consider both intra- and inter-category dynamics. Viewing categories as continuously shaped by actors' efforts to position their products, we argue that these efforts alter the coherence that products exhibit not only within a category (a category's heterogeneity), but also across related categories (a category's distinctiveness). We theorize how the interaction between a category's heterogeneity and distinctiveness shapes its subsequent viability. When a focal category's distinctiveness is low, the heterogeneity–viability relationship takes an inverted U-shape. However, as distinctiveness grows, the relationship flattens and eventually flips to a U-shape. We explain this by considering the trade-off between the "classification" and "valuation" benefits that a category affords. We find support for our argument by tracking 170 categories over an 11-year period on Kickstarter, one of the largest crowdfunding platforms. By providing a nuanced understanding of category dynamics, we shed new light onto the fluctuating viability of categories. [ABSTRACT FROM AUTHOR]

The effect of the GaAsP strain-compensating layer on type-II GaAs1−xSbx/InyGa1−yAs was investigated. GaAsSb/InGaAs multiple quantum wells (MQWs) without and with GaAsP strain-compensating layers were grown by molecular beam epitaxy. Increasing Sb or In compositions can extend photoluminescence (PL) emission at longer wavelength along with the highly induced compressive strain in the QWs. The power-dependent PL measured at low temperature reveals the type-II band characteristics of the GaAs1−xSbx/InyGa1−yAs system. A detailed analysis of the experimental data reveals that the GaAsP layers compensate the compressive strain of GaAsSb/InGaAs. The type-II QWs with GaAsP layers, (8 nm) GaAs0.84Sb0.16/(2.5 nm) In0.3Ga0.7As/(10 nm) GaAs0.85P0.15, emits PL at ∼1.1 μm, up to 210 K, while the PL of those strained sample without GaAsP vanishes at lower temperature. In view of the described sample, x-ray diffraction (XRD) analysis along with the simulation shows the validity of the procedure, resulting in nearly matched parameters of QW thicknesses and material compositions—(8.9 nm) GaAs0.835Sb0.165/(2.3 nm) In0.3Ga0.7As/(10.3 nm) GaAs0.85P0.15, with those of the designed QW. The thicknesses of QW from the TEM image, (8.6 nm) GaAsSb/(3.1 nm) InGaAs/(10.1 nm) GaAsP, agree well with the XRD results. [ABSTRACT FROM AUTHOR]

Background: Botulism is a rare and life-threatening disease caused by the potent botulinum neurotoxin (BoNT), which can be produced by Clostridium botulinum (C. botulinum) and related bacteria. Clinical manifestations, which include a symmetrical, descending muscular paralysis, generalized hypotonia, and potentially respiratory failure, are non-specific and diagnosis is challenging, especially when anamnesis does not reveal any typical risk factor, like honey consumption. Case Presentation: We present what is, to the best of our knowledge, the first documented case of infant botulism (IB) in Sicily and discuss its peculiarities and the challenges faced in the diagnostic-therapeutic process. The infant was exclusively breastfed and no history of consumption of possibly contaminated foods, like honey, was found. The signs observed at presentation included poor suction, hypotonia, and hyporeactivity. A detailed anamnesis motivated the suspicion of botulism, due to the occurrence of constipation and exposure to dust from home renovation works during the days before the onset of symptoms. The botulinum antitoxin was administered and the diagnosis was confirmed through fecal examination, detecting toxin-producing C. botulinum. Conclusion: IB should be considered in every infant with rapidly progressing hypotonia and a history of constipation. However rarely, transmission could occur through inhalation of dust particles containing the toxin, therefore it is important to explore all possible sources of exposure. In the case described, timely diagnosis and treatment determined the successful outcome, which highlights the importance of early intervention in managing IB. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of a mindfulness-based family psychoeducation (MBFPE) intervention on caregivers and the young adults with first-episode psychosis in mental health care. Methods: Sixty-five caregivers were randomly assigned to the MBFPE program (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32). Eighteen young adults in recovery (YAIR) also participated in the study. All of the participants completed the assessments before participating in the intervention (T1), after the intervention (T2), and at 9-month follow-up (T3). Results: Intention-to-treat analyses were conducted. The caregivers reported a significant and large effect size on positive caregiving experiences based on a Time × Group analysis (g = 0.862, p = 0.006). Among the YAIR participants, between-group differences were significant in their perceptions of caregivers' expressed emotions, including large effect sizes of perceived criticism (g = 1.396, p = 0.049) and hostility (g = 1.444, p = 0.043). Caregiver demographics, including age, education level, socioeconomic status, and number of family members, were found to moderate the effect sizes of the variables studied. Conclusion: This study provides evidence of the effects of MBFPE programs on the outcomes of caregivers and the young adults with first-episode psychosis in their care. Specifically, the MBFPE program in this study played a greater role in promoting positive caregiving experiences and changing caregivers' expressed emotions, especially their expressed criticism of YAIR, compared with the regular FPE program. Therefore, the application of mindfulness training to promote family care and YAIR recovery should be encouraged. [ABSTRACT FROM AUTHOR]

Endometriosis is a chronic inflammatory disease that affects about 10% of women, and it is characterized by the presence of endometrial tissue outside the uterine cavity. Associated symptoms are dyspareunia, chronic pelvic pain, and infertility. The diagnosis of endometriosis can be challenging due to various clinical and imaging presentations. Laparoscopy is the gold standard for the diagnosis, but it is an invasive procedure. The literature has increasingly promoted a switch to less invasive imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). The latter, also in relation to the latest technological advances, allows a comprehensive and accurate assessment of the pelvis and it can also identify sites of endometriosis that escape laparoscopic evaluation. Furthermore, MRI has been found to be more accurate than other imaging techniques in relation to its improved sensitivity and specificity in identifying disease sites, also due to the role of new emerging sequences. This article aims to review the current role of advanced MRI applications in the assessment of endometriosis. [ABSTRACT FROM AUTHOR]

Multidrug resistant (MDR) bacteria are recognized to be one of the most important problems in public health. The outer membrane permeability is a critical intrinsic mechanism of bacterial resistance. In addition, bacteria produce a small number of dormant persister cells causing multidrug tolerance that reduces antimicrobial efficacy. This study aimed to evaluate the inhibitory effects of the combination of aromatic isothiocyanates (ITCs) with membrane-active agents on bacterial persisters and MDR Gram-negative bacteria. Our study demonstrated that membrane-active agents, particularly ethylenediaminetetraacetic acid (EDTA) synergistically enhanced the inhibitory activity of aromatic benzyl ITC and phenethyl ITC against most Gram-negative bacteria strains with fractional inhibitory concentration index values ranging from 0.18 to 0.5 and 0.16 to 0.5, respectively, and contributed to an 8- to 64-fold minimal inhibitory concentration reduction compared with those of aromatic ITCs alone. The EDTA-aromatic ITCs combination effectively reduced the survival rates of tested bacteria and significantly eradicated bacterial persisters (p = 0.033 and 0.037, respectively). The growth kinetics analysis also supported the enhanced inhibitory effect of EDTA-aromatic ITCs combination against tested bacteria. Our results suggested an alternate treatment strategy against Gram-negative bacteria, promoting the entry of aromatic ITCs into bacterial cytoplasm to facilitate bacterial clearance and thus preventing the development of bacterial resistance. [ABSTRACT FROM AUTHOR]

(1) Background: Head and neck cancer (HNC) is a major public health challenge worldwide, with oral squamous cell carcinoma (OSCC) being the predominant form. Despite advances in treatment, OSCC remains a major cause of morbidity and mortality due to delayed diagnosis and limited therapeutic efficacy. This study reviews omics technologies to assess new salivary biomarkers for the early detection of OSCC. (2) Methods: A comprehensive literature search in the last 20 years identified four relevant studies focusing on salivary biomarkers in OSCC. (3) Results: Proteomic and genomic analyses revealed significant changes in salivary composition between OSCC patients and healthy controls, suggesting promising diagnostic and prognostic biomarkers. However, studies showed varying degrees of bias, indicating the need for further research and improved standardization. (4) Conclusions: Saliva, with its advantages of ease of collection, minimal invasiveness, and potential for large-scale screening, is an emerging promising substrate for non-invasive biomarker research. Nonetheless, there is a need for improved biomarker sensitivity and specificity; currently, histological examination remains the golden standard. [ABSTRACT FROM AUTHOR]

Purpose: Heterozygous STAT1 Gain-of-Function (GOF) mutations are the most common cause of chronic mucocutaneous candidiasis (CMC) among Inborn Errors of Immunity. Clinically, these mutations manifest as a broad spectrum of immune dysregulation, including autoimmune diseases, vascular disorders, and malignancies. The pathogenic mechanisms of immune dysregulation and its impact on immune cells are not yet fully understood. In treatment, JAK inhibitors have shown therapeutic effectiveness in some patients. Methods: We analyzed clinical presentations, cellular phenotypes, and functional impacts in five Taiwanese patients with STAT1 GOF. Results: We identified two novel GOF mutations in 5 patients from 2 Taiwanese families, presenting with symptoms of CMC, late-onset rosacea, and autoimmunity. The enhanced phosphorylation and delayed dephosphorylation were displayed by the patients' cells. There are alterations in both innate and adaptive immune cells, including expansion of CD38+HLADR +CD8+ T cells, a skewed activated Tfh cells toward Th1, reduction of memory, marginal zone and anergic B cells, all main functional dendritic cell lineages, and a reduction in classical monocyte. Baricitinib showed therapeutic effectiveness without side effects. Conclusion: Our study provides the first comprehensive clinical and molecular characteristics in STAT1 GOF patient in Taiwan and highlights the dysregulated T and B cells subsets which may hinge the autoimmunity in STAT1 GOF patients. It also demonstrated the therapeutic safety and efficacy of baricitinib in pediatric patient. Further research is needed to delineate how the aberrant STAT1 signaling lead to the changes in cellular populations as well as to better link to the clinical manifestations of the disease. [ABSTRACT FROM AUTHOR]

Purpose: Anti-granulocyte-macrophage colony-stimulating factor autoantibodies (anti-GM-CSF Abs) are implicated in the pathogenesis of Cryptococcus gattii (C. gattii) infection and pulmonary alveolar proteinosis (PAP). Their presence has also been noted in nocardiosis cases, particularly those with disseminated disease. This study delineates a case series characterizing clinical features and specificity of anti-GM-CSF Abs in nocardiosis patients. Methods: In this study, eight patients were recruited to determine the presence or absence of anti-GM-CSF Abs. In addition to the detailed description of the clinical course, we thoroughly investigated the autoantibodies regarding the characteristics, isotypes, subclasses, titers, and neutralizing capacities by utilizing the plasma samples from patients. Results: Of eight patients, five tested positive for anti-GM-CSF Abs, all with central nervous system (CNS) involvement; patients negative for these antibodies did not develop CNS nocardiosis. Distinct from previously documented cases, none of our patients with anti-GM-CSF Abs exhibited PAP symptoms. The titer and neutralizing activity of anti-GM-CSF Abs in our cohort did not significantly deviate from those found in C. gattii cryptococcosis and PAP patients. Uniquely, one individual (Patient 3) showed a minimal titer and neutralizing action of anti-GM-CSF Abs, with no relation to disease severity. Moreover, IgM autoantibodies were notably present in all CNS nocardiosis cases investigated. Conclusion: The presence of anti-GM-CSF Abs suggests an intrinsic immunodeficiency predisposing individuals toward CNS nocardiosis. The presence of anti-GM-CSF Abs helps to elucidate vulnerability to CNS nocardiosis, even with low titer of autoantibodies. Consequently, systematic screening for anti-GM-CSF Abs should be considered a crucial diagnostic step for nocardiosis patients. [ABSTRACT FROM AUTHOR]

Metastatic renal cell carcinoma (RCC) can present with oligometastatic disease and/or develop oligoprogression following systemic therapy. Cytoreductive and focal metastasis-directed therapy options include resection, stereotactic ablative radiation and thermal ablation. Aggressive focal therapy may allow delay in initiation of or modification to systemic therapy and improve clinical outcomes. In this narrative review we synthesize current practice guidelines and prospective data on focal therapy management options and highlight future research. Patient selection and the choice of focal treatment techniques are controversial due to limited and heterogeneous data and patients may benefit from multidisciplinary evaluation. Prospective comparative trials with clearly defined inclusion criteria and relevant end points are needed to clarify the risks and benefits of different approaches. Article highlights Evaluation Oligometastatic and oligoprogressive renal cell carcinoma (RCC) should be evaluated with contrast-enhanced body CT and brain MRI, with additional imaging based on symptoms or as needed for planning of future focal treatments. Guidelines stratify patients by International Metastatic RCC Database Consortium (IMDC) prognostic risk groups (section 4). Management While the quality of the data is mixed, there are myriad options for treating oligometastatic and oligoprogressive RCC, including active surveillance, systemic therapy, focal cytoreductive treatment of the primary and focal metastasis-directed therapy. Optimal patient selection, timing and choice of focal therapy in contemporary clinical practice remains unclear. Discussion of management options for metastasis-directed therapy including surgery, stereotactic ablative radiotherapy and thermal ablation should be discussed in a multidisciplinary setting (section 7). Follow-up after focal therapy After focal treatment of metastatic disease, current guidelines recommend CT body imaging every 1–6 months with annual history and physical for 5 years. There are no high-quality data on the benefits of systemic therapy after focal treatment of all sites of metastatic disease (section 8). Future directions Multiple ongoing trials are investigating the optimal choice, timing and combination of focal treatment techniques with immunotherapy for oligometastatic and oligoprogressive RCC (section 9). [ABSTRACT FROM AUTHOR]

The development of composite materials with fewer interface problems always helps to obtaining good properties. Two types of insulating biopolymers (7% w/w) were incorporated into a conductive matrix (polyaniline) during polymerization. The synthesis method, inspired by the synthesis of polyaniline and the coating of chitosan for the development of flexible electrodes, produces thermosets that are more thermally stable than the matrix until 350 °C. While one (gum) reduces the electrical conductivity, the other (lignin) increases the basic value of the raw material (~ 0.72 S Cm–1) by a factor of 10. The physicochemical and morphological analyses show the formation of the polymer on the surface of the biopolymer with the appearance of new chemical bonds by interactions between hydroxyls of the biopolymer and the nitrogen of amine function from the polyaniline. [ABSTRACT FROM AUTHOR]

Background: Vitamin D is critical to bone health by regulating intestinal absorption of calcium, whereas proinflammatory cytokines, including IL-1, IL-6, IL-12, and TNF-α, are known to increase bone resorption. We hypothesized that vitamin D and these cytokines at the time of breast cancer diagnosis were predictive for fragility fractures in women receiving aromatase inhibitors (AIs). Methods: In a prospective cohort of 1,709 breast cancer patients treated with AIs, we measured the levels of 25-hydroxyvitamin D (25OHD), IL-1β, IL-6, IL-12, and TNF-α from baseline blood samples. The associations of these biomarkers were analyzed with bone turnover markers (BALP and TRACP), bone regulatory markers (OPG and RANKL), bone mineral density (BMD) close to cancer diagnosis, and risk of fragility fractures during a median of 7.5 years of follow up. Results: Compared to patients with vitamin D deficiency, patients with sufficient levels had higher bone turnover, lower BMD, and higher fracture risk; the latter became non-significant after controlling for covariates including BMD and no longer existed when patients taking vitamin D supplement or bisphosphonates or with history of fracture or osteoporosis were excluded. There was a non-significant trend of higher levels of IL-1β and TNF-α associated with higher risk of fracture (highest vs. lowest tertile, IL-1β: adjusted HR=1.37, 95% CI=0.94-1.99; TNF-α: adjusted HR=1.38, 95% CI=0.96-1.98). Conclusions: Our results do not support proinflammatory cytokines or vitamin D levels as predictors for risk of fragility fractures in women receiving AIs for breast cancer. [ABSTRACT FROM AUTHOR]

Autonomic symptoms may be local and general clinical manifestations of both epilepsy and migraine caused by the dysfunction of brain areas best known as the central autonomic network. Despite their prevalence, autonomic signs are often misdiagnosed and their treatment is undervalued. This review aims to describe the autonomic manifestations reported during seizures and migraineur attacks according to their presentation, focusing on the role of the central autonomic network (CAN) and on the parasympathetic outflow that often-induced cranial autonomic symptoms (CAS) during migraineur attacks. Further, our purpose is to analyze the pathophysiological meanings and whether their presence influences the prognosis and therapy of these disorders. [ABSTRACT FROM AUTHOR]

Total alkalinity (A T) and dissolved inorganic carbon (C T) in the oceans are important properties to understand the ocean carbon cycle and its link with global change (ocean carbon sinks and sources, ocean acidification) and ultimately find carbon based solutions or mitigation procedures (marine carbon removal). We present an extended database (SNAPO-CO2, Metzl et al, 2024d) with 24700 new additional data for the period 2002 to 2023. The full database now includes more than 67000 A T and C T observations along with basic ancillary data (time and space location, depth, temperature and salinity) in various oceanic regions obtained since 1993 mainly in the frame of French research projects. This includes both surface and water columns data acquired in open oceans, coastal zones, rivers and in the Mediterranean Sea and either from time-series or punctual cruises. Most A T and C T data in this synthesis were measured from discrete samples using the same closed-cell potentiometric titration calibrated with Certified Reference Material, with an overall accuracy of ± 4 µmol kg-1 for both A T and C T. The same technique was used onboard for underway measurements during cruises conducted in the Southern Indian and Southern Oceans. The A T and C T data from these cruises are also added in this synthesis. The data are provided in one dataset for the global ocean (https://doi.org/10.17882/102337) that offers a direct use for regional or global purposes, e.g. A T/Salinity relationships, long-term C T estimates, constraint and validation of diagnostics C T and A T reconstructed fields or ocean carbon and coupled climate/carbon models simulations, as well as data derived from Biogeochemical-Argo (BGC-Argo) floats. These data can also be used to calculate pH, fugacity of CO2 (f CO2) and other carbon system properties to derive ocean acidification rates or air-sea CO2 fluxes. [ABSTRACT FROM AUTHOR]

Sore throat represents one of the main causes of antibiotic overprescription in children. Its management is still a matter of debate, with countries considering streptococcal pharyngotonsillitis a benign and self-limiting condition and others advocating for its antibiotic treatment to prevent suppurative complications and acute rheumatic fever. Italian paediatricians frequently prescribe antibiotics on a clinical basis regardless of microbiological results. Moreover, broad-spectrum antibiotics are inappropriately prescribed for this condition. In this regard, an intersociety consensus conference was issued to promote the judicious use of antibiotic therapy in paediatric outpatient settings. A systematic review of the literature was performed, and updated recommendations were developed according to the GRADE methodology. Antibiotic treatment with amoxicillin (50 mg/kg/day) for 10 days is recommended in all children with proven streptococcal pharyngitis. Benzathine-penicillin could be prescribed in children with impaired intestinal absorption or inability to tolerate enteral intake and in those at high risk of suppurative complications with low compliance to oral therapy. In children with suspected amoxicillin allergy, third-generation cefalosporins for five days are recommended in low-risk patients, and macrolides are recommended in high-risk ones. Candidates for tonsillectomy due to recurrent pharyngitis could be treated with amoxicillin-clavulanic acid, clindamycin, or combined therapy with amoxicillin plus rifampicin for four days, in an attempt to avoid surgery. [ABSTRACT FROM AUTHOR]

This paper presents the detailed design configuration and investigation of a small-scale dual-band metamaterial absorber (MTMA) for solid and liquid sensing applications. The overall dimension of the MTMA unit cell is 10 × 10 × 1.57 mm3 and constitutes an affordable FR-4 substrate. The absorber exhibits dual absorption peaks at 3.470 GHz for the S-band and 7.219 GHz for the C-band, respectively. Both absorption characteristics have been validated through comprehensive simulation and experimental procedures. The dual-band absorption rate exceeded 99% during simulations, and experimental validation showed an absorption rate above 98%. For sensing applications, various solid materials, including different Rogers substrates (RT 5880, RT 5870, RT 4003 and RT 4835) and liquids such as sunflower and crown oil, were utilized. Our findings indicate that the proposed MTMA achieves a maximum Q-factor of 191 and a sensitivity of up to 2.5 for both solid and liquid sensing applications compared to previous studies. The simulation and experimental validation of the result indicate that suggested MTMA can be effectively used in different sensing applications such as the medical and communications industry. [ABSTRACT FROM AUTHOR]

The maintenance of intestinal homeostasis is a fundamental process critical for organismal integrity. Sitting at the interface of the gut microbiome and mucosal immunity, adaptive and innate lymphoid populations regulate the balance between commensal micro-organisms and pathogens. Checkpoint inhibitors, particularly those targeting the CTLA-4 pathway, disrupt this fine balance and can lead to inflammatory bowel disease and immune checkpoint colitis. Here, we show that CTLA-4 is expressed by innate lymphoid cells and that its expression is regulated by ILC subset-specific cytokine cues in a microbiota-dependent manner. Genetic deletion or antibody blockade of CTLA-4 in multiple in vivo models of colitis demonstrates that this pathway plays a key role in intestinal homeostasis. Lastly, we have found that this observation is conserved in human IBD. We propose that this population of CTLA-4-positive ILC may serve as an important target for the treatment of idiopathic and iatrogenic intestinal inflammation. At the mucosal interface of the gut and microbiome immune cells play pivotal roles to regulate between commensalism, colonisation and pathogenic invasion. Here, Lo et al. show CTLA-4 expression in innate lymphoid cells is linked to mucosal homeostasis in a microbiome dependent manner. [ABSTRACT FROM AUTHOR]

An expedient route to 2-aminodihydrothiophenes and their seleno analogues is reported. A three-component photoredox reaction between alkene, thio(seleno)cyanate, and bromomalonate is employed, generating a carbo-thio(seleno)cyanate intermediate that undergoes a domino of reactions mediated by alumina column chromatography, leading to valuable chalcogen pharmacophores. Mechanistic investigations using DFT and control experiments reveals an intramolecular H-bond responsible for driving the domino forward. [ABSTRACT FROM AUTHOR]

Monocyte distribution width (MDW) is a measure of monocyte anisocytosis. In this study, we assessed the role of MDW, in comparison to C-reactive protein (CRP), procalcitonin (PCT), and lactate, as a screening and prognostic biomarker of sepsis in intensive care unit (ICU) by longitudinally measuring it in the first 5 days of hospital stay. We considered all consecutive patients admitted to the ICU. At admission, patients were classified as septic or not according to Sepsis-3 criteria. MDW, CRP, PCT, and lactate were measured daily in the first 5 days of hospitalization. ICU mortality was also recorded. We included 193 patients, 62 with sepsis and 131 without sepsis (controls). 58% and 26 % of the patients, with and without sepsis respectively, died during ICU stay. MDW showed the highest accuracy for sepsis detection, superior to CRP, PCT, and lactate (AUC of 0.840, 0.755, 0.708, 0.622, respectively). At admission, no biomarker predicts ICU mortality in patients with sepsis. The kinetic of all biomarkers during the first 5 days of hospitalization was associated with ICU mortality. Noteworthy, above all, the kinetic of MDW showed the best accuracy. Specifically, an increase or decrease in MDW from day 1–4 and 5 was significantly associated with mortality or survival, respectively. MDW is a reliable diagnostic and prognostic sepsis biomarker, better than traditional biomarkers. [ABSTRACT FROM AUTHOR]

The vehicle routing problem is common for drone delivery in urban areas, and the routing strategies can impact both transport efficiency and community noise. In this article, we propose an optimization method for drone routing to reduce the en route noise impact during the delivery process. A hybrid cost function is adopted to evaluate the quality of the routing strategies, considering both the noise impact and path length. The en route noise is evaluated based on an efficient flight simulation and noise assessment platform, which enables accurate sound source modeling for a practical delivery drone and sound propagation computation in a realistic urban environment. A three-phase heuristic algorithm is employed to optimize the routing strategy. Large-scale simulations conducted in a representative metropolitan area demonstrate significant reductions in both instantaneous and accumulated noise levels. This article highlights the importance of incorporating noise optimization strategies in urban drone delivery systems to improve public acceptance and sustainable air transport. [ABSTRACT FROM AUTHOR]

Objective: Cranial computed tomography (CT) scan is the most widely used tool to rule out intracranial lesions after pediatric traumatic brain injury (TBI). However, in pediatric population, the radiation exposure can lead to an increased risk of hematological and brain neoplasm. Defined in 2019 National Institute for Health and Care Excellence (NICE) guidelines as "troponins for the brain", serum biomarkers measurements, particularly S100B, have progressively emerged as a supplementary tool in the management of TBI thanks to their capacity to predict intracranial post-traumatic lesions. Methods: This systematic review was conducted following the PRISMA protocol (preferred reporting items for systematic reviews and meta-analyses). No chronological limits of study publications were included. Studies reporting data from children with TBI undergoing serum S100B measurement and computed tomography (CT) scans were included. Results: Of 380 articles screened, 10 studies met the inclusion criteria. Patients admitted with mild-TBI in the Emergency Department (ED) were 1325 (80.25%). The overall pooled sensitivity and specificity were 98% (95% CI, 92–99%) and 45% (95% CI, 29–63%), respectively. The meta-analysis revealed a high negative predictive value (NVP) (99%; 95% CI, 94–100%) and a low positive predictive value (PPV) (41%; 95% CI, 16–79%). Area under the curve (AUC) was 76% (95% CI, 65–85%). The overall pooled negative predictive value (NPV) was 99% (95% CI, 99–100%). Conclusions: The measurement of serum S100B in the diagnostic workflow of mTBI could help informed decision-making in the ED setting, potentially safely reducing the use of CT scan in the pediatric population. The high sensitivity and excellent negative predictive values look promising and seem to be close to the values found in adults. Despite this, it must be pointed out the high heterogeneity (> 90%) found among studies. In order for S100B to be regularly introduced in the pediatric workflow for TBI, it is important to conduct further studies to obtain cut-off levels based on pediatric reference intervals. [ABSTRACT FROM AUTHOR]

Background: Epidermoid cysts are benign, slow growing extra-axial lesions most commonly found in the cerebellopontine angle that have a characteristic imaging pattern of restricted diffusion on diffusion-weighted imaging (DWI). Methods: A 10-year-old male with a history of asthma and diabetes was found to have a lesion within the fourth ventricle on a magnetic resonance imaging (MRI) brain study. MRI showed a well-circumscribed vermian lesion without contrast enhancement or restricted diffusion with mild hydrocephalus. He was referred to the neurosurgical service once he acutely developed symptoms of dizziness. He underwent a gross-total resection of the lesion on which histopathology confirmed an epidermoid cyst. Results: Here, we report a case of an atypical epidermoid cysts found in the midline of the fourth ventricle without restricted diffusion on MRI. Conclusion: Avid restricted-diffusion on DWI is usually pathognomonic for an epidermoid cyst when evaluating an extra-axial lesion, yet we report the second case in the literature of an epidermoid cyst without this classical imaging characteristic. [ABSTRACT FROM AUTHOR]

Introduction and methods: Through years of conversations, three disciplinebased education researchers used a duoethnographic process to interrogate their own discipline-based education research (DBER) identities. We present a description of how these individuals navigate being a "both," gathered through reflections, discussions, and deeper research to explore perspectives of our professional identities and what we perceive those identities look like to our peers, supervisors, and trainees. Results: Our own definitions and eventually realized identities as a "both" emerged through this research process. We envision that science faculty have multiple roles, demands, and identities; at the most basic level, they are "both" an educator and a researcher. In the unique case of discipline-based education research (i.e., scholars studying the teaching and learning of science often in science departments), some faculty find an overlap between complementary yet sometimes competing research agendas (i.e., biology research (BR) and discipline-based education research (DBER)), of which they do "both." Discussion: This article has two key contributions. First, it articulates this sideglancing process of our navigation of being a DBER "both," leveraging each of our unique perspectives and the literature. Second, it represents how such an exploration may be useful to other interdisciplinary researchers in understanding and embracing all parts of their identities. [ABSTRACT FROM AUTHOR]

Catheter ablation for tachyarrhythmia via superior approach has been used in patients without possible inferior vena cava access such as in cases of venous occlusion or complex anomaly. Difficulty in catheter manipulation, instability, number of required vascular access, and radiation exposure of operator had been described in the procedure. Application of three‐dimensional (3‐D) mapping system in catheter ablation via superior approach could navigate the guiding catheter and provide more precise ablation. We reported four cases receiving catheter ablation due to atrioventricular nodal reentry tachycardia, atrial fibrillation, and right ventricular arrhythmia via superior approach facilitated by 3‐D mapping system with fewer vascular access and catheters. [ABSTRACT FROM AUTHOR]

COVID-19 vaccines mitigate severe disease, yet uptake remains low among people experiencing homelessness (PEH) despite the risk of transmission in congregate settings like homeless shelters. This study evaluated retrospective COVID-19 vaccination intent and decision-making between March 2020-October 2021 to identify modifiable factors to improve vaccine acceptance among PEH. We conducted 31 semi-structured interviews and eight focus group discussions across six homeless shelters in Seattle-King County, Washington. Residents and staff aged ≥18 years were recruited through purposive sampling for interviews and convenience sampling for focus groups. Thematic analysis was conducted. Participants reported that too much contradictory and changing information about COVID-19 vaccines led to confusion. Information deemed trustworthy contributed to individual's knowledge and in some cases changed their vaccination intent. While many intended to get vaccinated without external motivators, others were motivated by incentives and requirements. Despite intention to vaccinate, participants reported barriers to COVID-19 vaccine access including availability of vaccine doses, timely eligibility for vaccination, and availability of appointments. Participants presented recommendations to improve COVID-19 information content and dissemination, access, and use of incentives in shelter settings. Future research should test recommended vaccination strategies rooted in the voices and experiences of PEH to determine feasibility and effectiveness in shelter settings. [ABSTRACT FROM AUTHOR]

Introduction: In patients with Hereditary Angioedema (HAE) related to primary C1 inhibitor deficiency (C1INH), the defective clearance of immune complexes and apoptotic materials along with impairment of normal humoral response potentially leads to autoimmunity. Few studies report evidence on autoimmune diseases in C1INH-HAE, but no large population studies focus on rare connective tissue diseases (RCTDs). We aim at evaluating for the first time prevalence and distribution of RCTDs - Systemic Lupus Erytematosus (SLE), primary Sjogren Syndrome (SjS), primary antiphospholipid syndrome (APS), Systemic Sclerosis (SSc), and mixed connective tissue diseases (MCTD) in a large Italian cohort of C1INH-HAE patients. Methods: A multicenter observational study includes C1INH-HAE patients from ITACA Centers throughout Italy (time frame Sept 2023-March 2024). Inclusion criteria are i. a defined diagnosis of type I or type II C1INH-HAE; ii. age =15 years (puberty already occurred); iii. enrollment in the ITACA Registry. The diagnosis of SLE, primary SjS, primary APS, SSc, and MCTD are made in accordance with international classification criteria. Results: Data are collected from a total of 855 C1INH-HAE patients referring to 15 ITACA Centers. Patients with concomitant RCTDs were 18/855 (2.1%) with F:M ratio 3.5 and a prevalent type I C1INH-HAE diagnosis (87.2%). A diagnosis of SLE results in 44.5% of cases (n=8) while the remaining diagnoses are primary SjS (22.2%, n=4), primary APS (16.6%, n=3), SSc (11.2%, n=2), and a single case of MCTD (5.5%). The female gender is prevalent in all the RCTDs. Patients on long term prophylaxis (LTP) are significantly prevalent in RCTDs group than in the whole C1INH-HAE population (p<0.01). Conclusions: A relevant prevalence of RCTDs is documented in C1INH-HAE patients, mainly SLE. Patients with RCTDs are on LTP in a significant proportion supporting the idea of a bidirectional link between C1INH-HAE and autoimmunity. [ABSTRACT FROM AUTHOR]

Introduction: 5p deletion syndrome, also called Cri-du-chat syndrome 5p is a rare genetic syndrome with reports up to 36% of patients are associated with congenital heart defects. We investigated the association between left outflow tract obstruction and Cri-du-chat syndrome. Methods: A retrospective review of the abnormal microarray cases with congenital heart defects in Children's Hospital of Pittsburgh and the Cytogenomics of Cardiovascular Malformations Consortium. Results: A retrospective review at nine pediatric centers identified 4 patients with 5p deletions and left outflow tract obstruction (LVOTO). Three of these patients had additional copy number variants. We present data suggesting an association of LVOTO with 5p deletion with high mortality in the presence of additional copy number variants. Conclusion: A rare combination of 5p deletion and left ventricular outflow obstruction was observed in the registry of copy number variants and congenital heart defects. [ABSTRACT FROM AUTHOR]

Accurate classification of transients obtained from spectroscopic data are important to understand their nature and discover new classes of astronomical objects. For supernovae (SNe), SNID, NGSF (a Python version of SUPERFIT), and DASH are widely used in the community. Each tool provides its own metric to help determine classification, such as rlap of SNID, chi2/dof of NGSF, and Probability of DASH. However, we do not know how accurate these tools are, and they have not been tested with a large homogeneous data set. Thus, in this work, we study the accuracy of these spectral classification tools using 4646 SEDMachine spectra, which have accurate classifications obtained from the Zwicky Transient Facility Bright Transient Survey (BTS). Comparing our classifications with those from BTS, we have tested the classification accuracy in various ways. We find that NGSF has the best performance (overall Accuracy 87.6% when samples are split into SNe Ia and Non-Ia types), while SNID and DASH have similar performance with overall Accuracy of 79.3% and 76.2%, respectively. Specifically for SNe Ia, SNID can accurately classify them when rlap > 15 without contamination from other types, such as Ibc, II, SLSN, and other objects that are not SNe (Purity > 98%). For other types, determining their classification is often uncertain. We conclude that it is difficult to obtain an accurate classification from these tools alone. This results in additional human visual inspection effort being required in order to confirm the classification. To reduce this human visual inspection and to support the classification process for future large-scale surveys, this work provides supporting information, such as the accuracy of each tool as a function of its metric. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the rate of hyperechoic liver lesions that are clinically actionable and evaluate imaging and clinical factors associated with these to determine the need for follow-up. Materials and methods: This retrospective study included 228 hyperechoic hepatic lesions on ultrasound in 228 patients. Reference standards included either dynamic contrast enhanced MRI (n = 130) or CT (n = 46), follow-up ultrasound performed at least 2 years from baseline (n = 50), or histopathology (n = 2). Three radiologists independently assessed imaging features including lesion orientation, degree of hyper-echogenicity, lesion heterogeneity, and background liver echotexture. Univariable and multivariable logistic regression was used to determine features associated with an actionable hyperechoic lesion. Results: Of the 228 hyperechoic lesions, 14 (6.1%) lesions were clinically actionable (or requiring follow-up), and 214 (93.9%) were clinically insignificant. Features that differed between patients with clinically insignificant vs. actionable lesions included: age (52.9 ± 15.1 vs. 63.9 ± 15.8 years, p = 0.004), male sex (43.9% vs 71.4%, p = 0.045), history of cirrhosis (6.5% vs 50%, p < 0.001), lesion size (1.9 ± 1.4 cm vs. 3.5 ± 2.8 cm, p = 0.003), heterogeneous lesion echogenicity (16.4% vs. 50%, p = 0.006), and cirrhotic/coarsened background liver (7.5% vs. 35.7%, p = 0.005). Stepwise logistic regression and multivariable analysis identified age, presence of cirrhosis, and lesion size as features most predictive of an actionable lesion (OR 1.04, 24.3, 1.77 respectively). Reader agreement for imaging features was fair to moderate (k = 0.29–0.53). 100%(168/168) of hyperechoic liver lesions measuring ≤ 3 cm in patients without a history of malignancy or underlying liver disease were clinically insignificant. Conclusion: Our study findings support the overall favorable diagnoses of hyperechoic liver lesions ≤ 3 cm in patients without underlying risk factors. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Although the benefits of sodium–glucose cotransporter 2 inhibitor (SGLT2i) use in chronic kidney disease (CKD) are well established, the effects of these therapeutic agents in patients with advanced CKD are less certain. We hypothesised that the continued use of these drugs, even when renal function deteriorates to stage 4 CKD or worse, is safe and associated with improved cardiorenal survival. Methods: This is a retrospective cohort study utilising data from medical records from two institutions. All patients with type 2 diabetes mellitus who were prescribed an SGLT2i between 1 January 2016 and 31 December 2021, who subsequently had eGFR <30 ml/min per 1.73 m2 recorded on two occasions at least 90 days apart, were identified. The date on which the eGFR first reached any level less than 30 ml/min per 1.73 m2 was defined as the index date. Individuals were then categorised into the SGLT2i continuation group or the discontinuation group according to the use of SGLT2i after the index date. Inverse probability of treatment weighting (IPTW) was performed to minimise confounding. Outcomes of interest included heart failure outcomes, cardiovascular outcomes, renal outcomes and safety outcomes. Results: According to the eligibility criteria, 337 patients in the continuation group and 358 in the discontinuation group were identified. After IPTW, continuation of SGLT2i use was associated with significantly lower risks of the composite of major adverse cardiovascular events compared with discontinuation of SGLT2i use (HR 0.65 [95% CI 0.43, 0.99]), largely driven by reduced risk of myocardial infarction during follow-up (subdistribution HR [SHR] 0.43 [95% CI 0.21, 0.89]). The incidences of an eGFR decline of 50% or more (SHR 0.58 [95% CI 0.42, 0.81]) and all-cause hospital admission (SHR 0.77 [95% CI 0.64, 0.94]) were also significantly lower in the continuation group. None of the studied safety outcomes were significantly different when comparing the two groups. Blood haemoglobin levels were significantly higher in the continuation group at the end of follow-up (114.6 g/l vs 110.4 g/l, with a difference of 4.12 g/l; p=0.047). Conclusions/interpretation: In patients with CKD who were treated with an SGLT2i, continuation of SGLT2i use after eGFR declined to 30 ml/min per 1.73 m2 or less was associated with lower risks of cardiovascular and renal events compared with discontinuation of SGLT2i use. Continued use of SGLT2i throughout the course of CKD should be considered to optimise patient outcomes. [ABSTRACT FROM AUTHOR]

Zirconium-89 radiolabeled immuno-positron emission tomography (89Zr-iPET) has become a critical tool for patient stratification before and after immunotherapies for therapeutic evaluation. In this study, random and site-specific radiolabeling of 89Zr-iPET tracers were investigated. Traditional lysine-based conjugation and enzyme-based GlyCLICK® kit method were used to prepare DFO-anti-PD-L1-mAb conjugates with a chelator-to-antibody ratio (CAR) of 0–7 and 2.0, respectively. Then, conjugates with different CAR levels were radiolabeled with 89Zr to obtain randomly or site-specifically radiolabeled 89Zr-iPET tracer. [ABSTRACT FROM AUTHOR]

This research examines the effects of information disclosure ratings (IDR) on firm-specific stock price crash risk. We present evidence that there is a statistically significant negative relationship between stock price crash risk and IDR. Specifically, effective information disclosure attracts greater investor attention and leads to more liquidity, which mitigates the stock price crash risk. Our findings remain robust after controlling for relevant variables and addressing the issue of endogeneity. This research proves that high IDR mitigates the stock price crash risk by eliciting market reaction, which not only introduces a novel perspective for investors in their analysis of corporate risks but also offers valuable directions for policy formulation to guide the market. [ABSTRACT FROM AUTHOR]

Summary: While US Asian and Pacific Islander adults have lower 25-hydroxyvitamin D (25(OH)D) levels than White adults, ethnic subgroup data remain limited. In a large California population, the adjusted prevalence of 25(OH)D < 20 ng/mL (50 nmol/L) was 1.5- to 2.7-fold higher for Asian/Pacific Islander compared to White adults, with substantial variation by ethnicity. Purpose: US Asian and Pacific Islander (PI) adults generally have lower 25-hydroxyvitamin D [25(OH)D] levels than non-Hispanic White (NHW) adults, but subgroup data remain limited. We compared sex- and ethnicity-specific prevalence of low 25(OH)D among older Asian/PI and NHW adults. Methods: Data from 102,556 Asian/PI and 381,724 NHW adults aged 50–89 years with measured 25(OH)D in 2012–2019 and body mass index (BMI, within ± 1 year) were examined in a California healthcare system. Low 25(OH)D < 20 ng/mL (50 nmol/L) was examined by race and ethnicity. Covariates included age, smoking, BMI, and season of measurement. Modified Poisson regression was used to estimate prevalence ratios (aPR), adjusting for covariates. Results: Among 31,287 Asian/PI men and 71,269 Asian/PI women, the prevalence of low 25(OH)D was 22.6% and 14.7%, respectively, significantly higher than observed for 122,162 NHW men (12.3%) and 259,562 NHW women (9.9%). Within Asian/PI subgroups, low 25(OH)D prevalence ranged from 17 to 18% (Korean, Japanese, Filipino), 22 to 24% (Chinese, Vietnamese), 28% (South Asian), and 35% (Native Hawaiian/PI) among men and 11 to 14% (Japanese, Filipina, Chinese, Korean), 17 to 18% (South Asian, Vietnamese), and 26% (Native Hawaiian/PI) among women. The corresponding aPRs (NHW reference) for men and women were as follows: Native Hawaiian/PI, 2.70 and 2.34; South Asian, 2.56 and 2.07; Vietnamese, 2.17 and 2.31; Chinese, 2.04 and 1.89; Korean, 1.60 and 1.85; Filipino, 1.58 and 1.52; and Japanese, 1.58 and 1.49 (p < 0.001). Conclusion: In a large US healthcare population of older Asian/PI adults, low 25(OH)D prevalence was 1.5- to 2.7-fold higher for Asian/PI compared to NHW adults, with substantial variation by sex and ethnicity. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) is a prevalent disorder, with oral breathing influencing its severity. Expiratory velopharyngeal obstruction (EVO), observed during drug‐induced sleep endoscopy (DISE), may contribute to oral breathing in OSA patients. EVO results in obstruction between the pharynx and nasal cavity during expiration. This study aims to identify factors associated with positive EVO during DISE. Study Design: Case series. Setting: Tertiary Medical Center. Methods: Seventy‐two OSA patients underwent clinical evaluation, polysomnography, and DISE, utilizing interventions like intraoral negative airway pressure (iNAP), mouth closure, and oral appliances (OAs) in supine positions with head rotation. The findings, classified under velopharynx, oropharynx, tongue base, epiglottis, included the presence of EVO. Results: The results demonstrated that interventions including mouth closure and iNAP were associated with increased observation of EVO (43.1% and 34.7%) compared to OA (20.1%). However, head rotation was associated with decreased presence of EVO during DISE compare to supine (26% vs 35.8%). Noticeably, per 1 year increase of age was associated with an increased odds of EVO (odds ratio: 1.03, 95% confidence interval: 1.01‐1.06). However, no other baseline characteristics were significantly associated the odds of EVO. Conclusion: Our study reveals the effectiveness of head rotation and OA in reducing EVO and improving mouth breathing in OSA patients, offering valuable insights for future treatment strategies. [ABSTRACT FROM AUTHOR]

Aim: The aim was to assess the characteristics of patients who required imaging studies during admission to an acute supportive palliative care unit (ASPCU). Methods: A consecutive number of patients who performed imaging studies during ASPCU admission in a month period were assessed. Epidemiological data, ongoing anticancer treatment, cancer diagnosis, reasons for admission, referral, and type of imaging study were recorded. Indications, findings, consequent actions for treatment, prognosis, and discharge were also collected. Results: Twenty-one of 56 patients admitted to ASPCU in the period taken into consideration were assessed. Pain and deterioration of the general condition were the most frequent indications for admission. Computed tomography (CT) was the most frequent imaging study performed. Indications for performing imaging studies depended on individual clinical needs. Findings suggested different clinical decisions, after a comprehensive oncological and palliative care assessment and family conference, the most frequent of which was to withdraw oncological treatments. The majority of patients underwent transition to palliative care and were discharged home or to hospice. Conclusion: Imaging studies were of paramount importance for clinical treatment and decision-making process in an intensive ASPCU. There is the need to explore the need and the possible outcomes of imaging studies, as well cost-effectiveness in any ASPCU. [ABSTRACT FROM AUTHOR]

In this study, the effect of baffle configuration on the water disinfection efficiency of a planar photoreactor equipped with ultraviolet C light-emitting diodes (UV-C LEDs) was investigated. The results indicated that the configuration of the baffles influenced the hydrodynamics inside the flow channel and thus affected the microbial trajectory, and exposure time. Accordingly, a modified serpentine configuration was developed to enhance the UV light exposure of microbes in water and improve the reactor performance for microbial inactivation. According to the simulation results, the quarter-circle baffles used in the modified serpentine configuration increased the microbial path length along the flow channel. However, because the cross-sectional area of the flow channel decreased, this configuration increased the water velocity. A modified serpentine configuration with a baffle radius of 5 mm achieved the longest microbial exposure time and highest inactivation value for Escherichia coli. At a water flow rate of 160 mL/min, this configuration achieved a UV fluence of 15.2 mJ/cm2 and an inactivation value of 3.8 log, which were approximately 22% and 0.4 log higher than those obtained with the traditional serpentine configuration, respectively. In addition, the maximum water flow rate at which the UV reactor achieved an inactivation value of 4.0 log was 154 mL/min at a baffle radius of 5 mm. This flow rate was 11.5% higher than that obtained with the traditional serpentine configuration. These close agreements between the experimental and simulation results confirmed the strong capability of the proposed modified serpentine configuration to improve reactor performance. [ABSTRACT FROM AUTHOR]

The biosynthesis of nanoparticles is an important research area focused on developing innovative, cost-effective, efficient, and environmentally friendly synthesis techniques with a wide range of applications. This study employs a straightforward and practical method to produce TiO2 nanoparticles (NPs) for use in photocatalysis, antibacterial, antifungal, and antidiabetic applications. It utilizes extract-assisted biosynthesis with Moringa oleifera. To enhance the material and evaluate the impact of bioinspiration on various parameters, the resulting TiO2 NPs undergo calcination at 500 °C. Structural confirmation, bandgap analysis, and functional group studies of MO/TiO2 (Moringa oleifera/TiO2) nanoparticles are conducted using XRD, UV-DRS, FT-IR, and PL analysis. To examine the surface morphological characteristics of the anatase TiO2 nanoparticles, SEM and TEM-EDS electron microscopy analyses were accomplished. The produced TiO2 nanoparticles are also assessed for their photocatalytic and antidiabetic properties. Photocatalytic activity is determined by decolorizing methylene blue dye in the presence of sunlight, revealing that optimal conditions for complete color removal involve using 0.3 g of TiO2 and a concentration of 4 × 10− 5 M at pH 7. A total decolorization efficiency is achieved after 180 min in the presence of MO/TiO2. The biosynthesized Moringa oleifera leaf extracted TiO2 (MO/TiO2) was used for photocatalytic and biomedical applications. MO/TiO2 exhibited the best photocatalytic activity and showed maximum inhibitoin in invitro antidiabetic activity. Invivo antidiabetic activity showed the Moringa oleifera leaf-extracted TiO2 catalyst significantly reduced blood glucose levels. [ABSTRACT FROM AUTHOR]

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With the rise of computer-assisted online learning tools such as the Language Reactor, advanced captioning options such as dual subtitles (i.e. simultaneous display of on-screen texts in the first language and the second/foreign language) have gained much attention. However, little is known about how dual-subtitled viewing may be optimised to foster second/foreign language learning in multimedia learning environments. In this study, I extended Laufer and Hulstijn (Applied Linguistics, 22(1), 1–26, 2001) Involvement Load Hypothesis (ILH) to the context of audiovisual input and examined the effects of dual-subtitled viewing under multiple ILH-based interventions on vocabulary learning. University Chinese-speaking low-intermediate EFL learners (n = 72) were divided into four groups and exposed to dual-subtitled videos with varying ILH-based interventions. Using a counterbalanced 4 × 4 experimental design, I compared learners' immediate vocabulary gains and retention of target words under four different treatments across four experimental sessions, including interventions featuring an involvement load of 4 (moderate need + search + strong evaluation), an involvement load of 3 (moderate need + search + moderate evaluation), an involvement load of 2 (moderate need + search), and an involvement load of 0 (absence of need, search or evaluation). The approach to data analysis was twofold: between-groups and within-groups. ANOVA results revealed that vocabulary gains were the highest when learners viewed dual-subtitled videos under treatments with higher involvement loads. The article ends with a consideration of practical and theoretical implications for language learning through this form of audiovisual multimedia learning condition. [ABSTRACT FROM AUTHOR]

Multisystem inflammatory syndrome is a severe complication of SARS-CoV-2 infection in children (MIS-C). To date, data on long-term sequelae mainly concern cardiac outcomes. All ≤ 18 year olds consecutively admitted to the Buzzi Children's Hospital with a diagnosis of MIS-C between October 1, 2020, and May 31, 2022, were followed up for up to 12 months by a dedicated multidisciplinary team. They underwent laboratory tests, multi-organ clinical and instrumental assessments, and psychosocial evaluation. 56/62 patients, 40 M, mean age 8.7 years (95% CI 7.7, 9.7), completed the follow-up. Cardiological, gastroenterological, pneumological, and neurological evaluations, including IQ and EEG, were normal. Alterations of HOMA-IR index and/or TyG index, observed in almost all patients during hospitalisation, persisted in about a third of the population at 12 months. At 6 and 12 months respectively, impairment of adaptive functions was observed in 38/56 patients (67.9%) and 25/56 (44.6%), emotional and behavioural problems in 10/56 (17.9%) and 9/56 (16.1%), and decline in QoL in 14/56 (25.0%) and 9/56 (16.1%). Psychosocial well-being impairment was significantly more frequent in the subgroup with persistent glycometabolic dysfunction at 12 months (75% vs. 40.9% p < 0.001). Conlusion: The mechanisms that might explain the long-term persistence of both metabolic alterations and neuro-behavioural outcomes and their possible relationship are far from being clarified. Our study points out to the potential long-term effects of pandemics and to the importance of a multidisciplinary follow-up to detect potential negative sequelae in different areas of health, both physical and psychosocial. What is known: • Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. • Few data exist on the medium- and long-term outcomes of MIS-C, mostly focused on cardiac involvement. Emerging evidence shows neurological and psychological sequelae at mid- and long-term follow-up. What is new: • This study reveals that MIS-C may lead to long-term glycometabolic dysfunctions joined to impairment in the realm of general well-being and decline in quality of life, in a subgroup of children. • This study highlights the importance of a long-term multidisciplinary follow-up of children hospitalised with MIS-C, in order to detect the potential long-term sequelae in different areas of health, both physical and psychosocial well-being. [ABSTRACT FROM AUTHOR]

Clinical manifestations of congenital syphilis (CS) include liver disease with/without impaired liver function, identified as syphilitic hepatitis. Hepatic involvement may be dramatic; therefore, early diagnosis is crucial to provide treatment and prevent fatal outcomes. A new resurgence of CS cases has been described in recent years worldwide. We reported our experience with a case series of infants hospitalized for liver disease with a final diagnosis of CS, highlighting the wide spectrum of liver involvement, the rapid progression in cases with late diagnosis, and the pitfalls of the management of this forgotten but reemerging disease. A retrospective analysis of CS patients with hepatic presentation in the period 2008–2023 was conducted. We collected five cases (three female) with a median age of 13.8 days (range 1–84 days). In three cases, mothers were not screened for syphilis during pregnancy, and in two cases, they were seronegative in the first trimester screening. None practiced specific therapy during pregnancy. Hepatic involvement was characterized by hepatosplenomegaly, in four cases associated with cholestatic jaundice and in three cases with liver failure. Rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA) were positive in all cases in mothers and infants. CS presented with multiorgan involvement and was fatal in one case. Conclusions: It is important to consider CS in infants with cholestasis and acute liver failure, but also in sick infants with isolated hepatomegaly. Early recognition of infants with CS is critical to identify missed cases during pregnancy and to start early treatment. What is known: • In recent years, it has been seen an increase of congenital syphilis cases in both low- and middle-income countries. • In most cases, infants born to mothers untreated for syphilis appear normal without signs of infection at birth but may develop manifestations of the disease after months or years if left untreated. • What is new: • Congenital syphilis is an emerging problem that may result in multiorgan involvement with liver disease predominant at onset. • It is important to consider congenital syphilis in infants with cholestasis and liver failure, but also in sick infants with isolated hepatomegaly. [ABSTRACT FROM AUTHOR]

Background: While monoclonal antibodies (mAbs) targeting the CGRP pathway have revolutionized migraine management due to their improved tolerance and adherence, concerns remain about their potential impact on blood pressure (BP), especially in older patients, due to CGRP-mediated vasodilation blockade. Given the growing use of these therapies in older populations, assessing their cardiovascular (CV) safety is of paramount importance. Methods: This multicentric observational prospective study focused on migraine sufferers aged ≥ 60 who began erenumab, galcanezumab, or fremanezumab for prevention. Baseline, three-month, and twelve-month BP measurements were collected. Changes in antihypertensive medication and "Newly or Worsened Hypertensive" patients (NWHP) were assessed. Results: Among 155 patients receiving anti-CGRP mAbs (40 Erenumab, 47 Galcanezumab, 68 Fremanezumab), 42.5% had hypertension history and 39% were on antihypertensive treatment. No significant systolic or diastolic BP changes occurred at any time point compared to baseline (all p > 0.05), with no differences between the three groups. After one year, 20/155 (12.9%) patients were considered NWHP; 11/20 had prior hypertension, and 5/11 adjusted antihypertensive therapy. Among 9/20 newly hypertensive patients, 5/9 had a single measurement above the normal threshold with no requirement for new pharmacological therapy. A higher baseline BP value was associated with increased BP (p = 0.002). Conclusions: The study concludes that treatment with anti-CGRP mAbs over one year does not significantly affect BP in patients aged ≥ 60, nor does it increase the incidence of hypertension compared to general population trends. Nonetheless, continuous monitoring and further long-term studies are necessary to fullya scertain the cardiovascular safety of these medications in the elderly. [ABSTRACT FROM AUTHOR]