Search

Recent research syntheses have identified several potentially high-leverage teaching strategies for improving low-attaining secondary school students' learning of mathematics. These strategies include the structured use of representations and manipulatives and an emphasis on derived facts and estimation. This paper reports on 70 semi-structured interviews conducted with low-attaining students in Years 9-10 (ages 13-15) in England. The interviews addressed the students' perceptions of learning mathematics and the teaching strategies that they experienced and believed were most helpful. Many students reported rarely using number lines, not spontaneously estimating answers and being unfamiliar with derived facts. During the interviews, with minimal direction, students often showed that they were well able to make use of these strategies; however, they did not report making spontaneous use of them independently. We conclude that many of the most well-evidenced and recommended strategies to support low-attaining students in mathematics appear to be unfamiliar and unvalued, and we discuss how this might be addressed.

Abstract The burgeoning realm of Machine Type Communications (MTC) has ushered in a paradigm shift in wireless communication, necessitating innovative strategies to efficiently manage diverse application requirements. This paper presents a pioneering Dynamic Priority-based Bandwidth Allocation (DPBA) scheme tailored specifically for MTC scenarios, encompassing both MTC and Human Type Communications (HTC) coexistence. DPBA employs an adaptive framework addressing dynamic MTC traffic, optimizing resource use while meeting latency constraints and sporadic data patterns. By dynamically prioritizing MTC applications based on requirements, the scheme allocates bandwidth for reliable data delivery. DPBA extends to MTC and HTC coexistence, managing diverse quality demands. This underlines its versatility and capacity to serve distinct needs in a shared spectrum. To substantiate its performance, the DPBA scheme is rigorously evaluated against a spectrum of related allocation methods like Proportional Fairness (PF), Static Priority Scheduling (SPS), and the Machine Learning-based Scheme (MLS), DPBA excels in simulations, minimizing packet loss, latency, enhancing throughput and ensuring fairness, surpassing benchmarks. This research underscores the critical importance of tailored bandwidth allocation strategies in advancing MTC and HTC coexistent environments. With its adaptability, efficiency, and remarkable performance, the DPBA scheme emerges as a cornerstone in the trajectory of wireless communication networks, catering to the distinct requirements of both MTC and HTC applications.

The cement industry contributes around 7% of global anthropogenic carbon dioxide emissions, mainly from the combustion of fuels and limestone decomposition during clinker production. Using alternative fuels derived from wastes is a key strategy to reduce these emissions. However, alternative fuels vary in composition and heating value, so selecting appropriate ones is crucial to maintain clinker quality and manufacturing processes while minimizing environmental impact. This study evaluated various biomass and industrial wastes as potential alternative fuels, characterizing them based on proximate analysis, elemental and oxide composition, lower heating value, and bulk density. Sawdust, pecan nutshell, industrial hose waste, and plastic waste emerged as viable options as they met the suggested thresholds for heating value, chloride, moisture, and ash content. Industrial hose waste and plastic waste were most favorable with the highest heating values while meeting all the criteria. Conversely, wind blade waste, tire-derived fuel, and automotive shredder residue did not meet all the recommended criteria. Therefore, blending them with alternative and fossil fuels is necessary to preserve clinker quality and facilitate combustion. The findings of this research will serve as the basis for developing a computational model to optimize the blending of alternative fuels with fossil fuels for cement production.

Abstract Kidney transplantation (KT) is associated with a substantial risk of postoperative complications (POC) for which performant predictors are lacking. Data showed that a perioperative gain of weight (ΔWeight) was associated with higher risk of POC, but it remains unexplored in KT. This retrospective study aimed to investigate the association between ΔWeight and POC after KT. ΔWeight was calculated on postoperative day (POD) 2. POC were graded according to the Dindo-Clavien classification. Primary endpoint was overall POC. A total of 242 patients were included and 174 (71.9%) complications were reported. Patients showed a rapid gain of weight after KT. Mean ΔWeight was 7.83 kg (± 3.20) compared to 5.3 kg (± 3.56) in patients with and without complication, respectively (p = 0.0005). ΔWeight showed an accuracy of 0.74 for overall POC. A cut-off of 8.5 kg was determined. ΔWeight ≥ 8.5 kg was identified as an independent predictor of overall POC on multivariable analysis (OR 2.04; 95% CI 1.08–3.84; p = 0.025). ΔWeight ≥ 8.5 kg appeared as an independent predictor of POC after KT. These results stress the need to monitor weight in KT and to further investigate this surrogate with future studies assessing its clinical relevance.

Abstract Background The selection of data elements is a decisive task within the development of a health registry. Having the right metadata is crucial for answering the particular research questions. Furthermore, the set of data elements determines the registries’ readiness of interoperability and data reusability to a major extent. Six health registries shared and published their metadata within a German funding initiative. As one step in the direction of a common set of data elements, a selection of those metadata was evaluated with regard to their appropriateness for a broader usage. Methods Each registry was asked to contribute a 10%-selection of their data elements to an evaluation sample. The survey was set up with the online survey tool „LimeSurvey Cloud”. The registries and an accompanying project participated in the survey with one vote for each project. The data elements were offered in content groups along with the question of whether the data element is appropriate for health registries on a broader scale. The question could be answered using a Likert scale with five options. Furthermore, “no answer” was allowed. The level of agreement was assessed using weighted Cohen’s kappa and Kendall’s coefficient of concordance. Results The evaluation sample consisted of 269 data elements. With a grade of “perhaps recommendable” or higher in the mean, 169 data elements were selected. These data elements belong preferably to groups’ demography, education/occupation, medication, and nutrition. Half of the registries lost significance compared with their percentage of data elements in the evaluation sample, one remained stable. The level of concordance was adequate. Conclusions The survey revealed a set of 169 data elements recommended for health registries. When developing a registry, this set could be valuable help in selecting the metadata appropriate to answer the registry’s research questions. However, due to the high specificity of research questions, data elements beyond this set will be needed to cover the whole range of interests of a register. A broader discussion and subsequent surveys are needed to establish a common set of data elements on an international scale.

This article summarizes the 2023 International Continence Society (ICS) Workshop 5 focused on neurologically mediated chronic pelvic pain (CPP) (Workshop 5). A team of experts share practical advice and tools for assessment, diagnosis and management relevant to pudendal neuropathy or other nerve entrapment, central nervous system diagnoses such as herniated disc, radiculopathy, Tarlov cyst, tethered cord, hip confounders, and systemic neuropathy such as small fiber neuropathy, neuroinflammatory disease (e.g. Lyme, Multiple Sclerosis) and central sensitization.

Abstract Muscle function is compromised by gravitational unloading in space affecting overall musculoskeletal health. Astronauts perform daily exercise programmes to mitigate these effects but knowing which muscles to target would optimise effectiveness. Accurate inflight assessment to inform exercise programmes is critical due to lack of technologies suitable for spaceflight. Changes in mechanical properties indicate muscle health status and can be measured rapidly and non-invasively using novel technology. A hand-held MyotonPRO device enabled monitoring of muscle health for the first time in spaceflight (> 180 days). Greater/maintained stiffness indicated countermeasures were effective. Tissue stiffness was preserved in the majority of muscles (neck, shoulder, back, thigh) but Tibialis Anterior (foot lever muscle) stiffness decreased inflight vs. preflight (p

IntroductionPositive Youth Development (PYD) is a strength-based perspective that focuses on the resources to promote a successful transition to adulthood, derived from the Relational Developmental Systems theory. In this line, the Developmental Assets (DA) model focuses on describing the personal resources (Internal Assets) and contextual resources (External Assets) that help to reach PYD. Most research from this approach has been carried out in United States and, to a lesser extent, in the European continent. The aim of this scoping review was to examine the evidence collected for the DA model in Europe.MethodsWeb of Science database was used to search for articles published between 2013 and February 2024. Initially, there were 55 possible articles to be included, but after applying the exclusion criteria, this number was reduced to 11.ResultsThe findings suggested that the evidence for DA in Europe was in line with North American research, so that a higher presence of DA was related to higher well-being, better psychological adjustment, and lower risk behaviors. Internal Assets were the most influential assets, with the Positive Identity category being especially remarkable. Commitment to Learning and Social Competencies were also highlighted in the studies included in the review. Concerning External Assets, Positive Boundaries-expectations and Empowerment were emphasized as protective factors in youth development. These assets were found to present a protective effect against risk behaviors and were positively associated with PYD and socioemotional skills.DiscussionThus, these findings support the applicability of the DA framework in promoting PYD in European context, and some intervention strategies are discussed considering cultural diversity.

Introduction: European mistletoe (Viscum album L.) has been gaining increasing interest in the field of oncology as a clinically relevant adjunctive treatment in many forms of cancer. In the field of phytopharmacology, harvesting time is pivotal. In the last century, a form of metabolomic fingerprinting based on pattern formation was proposed as a way to determine optimal harvesting times to ensure high quality of mistletoe as raw material for pharmaceutical use. In order to further evaluate the information obtained with this metabolomic fingerprinting method, we analysed a large time series of previously undigitised daily mistletoe chromatograms dating back to the 1950s.Methods: These chromatograms were scanned and evaluated using computerized image analysis, resulting in 12 descriptors for each individual chromatogram. We performed a statistical analysis of the data obtained, investigating statistical distributions, cross-correlations and time self-correlations.Results: The analysed dataset spanning about 27 years, contains 19,037 evaluable chromatograms in daily resolution. Based on the distribution and cross-correlation analyses, the 12 descriptors could be clustered into six independent groups describing different aspects of the chromatograms. One descriptor was found to mirror the annual rhythm being well correlated with temperature and a phase shift of 10 days. The time self-correlation analysis showed that most other descriptors had a characteristic self-correlation of ∼50 days, which points to further infradian rhythms (i.e., more than 24 h).Discussion: To our knowledge, this dataset is the largest of its type. The combination of this form of metabolomic fingerprinting with the proposed computer analysis seems to be a promising tool to characterise biological variations of mistletoe. Additional research is underway to further analyse the different rhythms present in this dataset.

Background Trauma plays an important role in the development of psychosis, but no studies have investigated whether a trauma-focused therapy could prevent psychosis. Aims This study aimed to establish whether it would be feasible to conduct a multicentre randomised controlled trial (RCT) to prevent psychosis in people with an at-risk mental state (ARMS), using eye-movement desensitisation and reprocessing therapy (EMDR). Method This started as a mixed-method randomised study comparing EMDR to treatment as usual but, as a result of low participant recruitment, was changed to a single-arm feasibility study. The proposed primary outcome for an RCT was transition to psychosis at 12-month follow-up. Data on secondary outcomes were also collected. Qualitative interviews were conducted with patients and therapists. Results Fourteen participants were recruited from the Early Intervention teams. Most people who expressed an interest in taking part attended an assessment to determine eligibility. All those eligible consented to take part. A total of 64% (7 of 11) of participants who were offered EMDR were followed up at 12 months. Of the 11 participants offered EMDR, one (11%, 95% CI: 0.2%, 48%) transitioned to psychosis. Nine patients and three therapists were interviewed. Participants who completed therapy (n = 4; mean 10.5 sessions) found EMDR helpful, but those who discontinued (n = 6; mean 5.2 sessions) said it had not benefitted them overall. Therapists said EMDR could be effective, although not for all patients. Conclusions Future studies recruiting people with an ARMS to an RCT may need to extend recruitment beyond Early Intervention teams. Although some individuals found EMDR helpful, reasons for discontinuing need to be addressed in future studies.

There is evidence that a user’s subjective confidence in an Artificial Intelligence (AI)-based system is crucial in its use, even more decisive than the objective effectiveness and efficiency of the system. Therefore, different methods have been proposed for analyzing confidence in AI. In our research, we set out to evaluate how the degree of perceived trust in an AI system could affect a user’s final decision to follow AI recommendations. To this end, we established trustworthy criteria that such an evaluation should meet by following a co-creation approach with a multidisciplinary group of 10 experts. After a systematic review of 3,204 articles, we found that none of the tools met the inclusion criteria. Thus, we introduce the so-called “Perceived Operational Trust Degree in AI” (POTDAI) tool that is based on the findings from the expert group and the literature analysis, with a methodology that adds rigor to that employed previously to create similar evaluation tools. We propose a short questionnaire for quick and easy application, inspired by the original version of the Technology Acceptance Model (TAM) with six Likert-type items. In this way, we also respond to the need pointed out by authors such as Vorm and Combs to extend the TAM to address questions related to user perception in systems with an AI component. Thus, POTDAI can be used alone or in combination with TAM to obtain additional information on its usefulness and ease of use.

This paper explores the potential of applying Zero Forcing (ZF) and Block Diagonalization (BD), two linear precoding techniques commonly utilized in communications, to a Multi-User Multiple Input Multiple Output (MU-MIMO) Integrated Sensing and Communications (ISAC) setup. The parallels between communications and sensing are highlighted to show the feasibility of extending ZF and BD to ISAC. To enable the implementation of these techniques, the concept of sensing channel is exploited, enabling the treatment of the sensing receiver as an additional user. Furthermore, two user selection strategies extend existing communication-only algorithms to accommodate sensing requirements. The efficacy of the proposed techniques is substantiated through comprehensive simulations. With the proposed solution, a high beampattern gain is maintained for the sensing while keeping good communication performance, only limited by the power allocation between the two functionalities.

The concept of sustainability has been recently extended to cover economic and social factors besides the traditional environmental ones. This paper reflects on the potential of mobile communication standards towards achieving sustainable mobility, with focus on vehicular communications and use cases in smart cities scenarios. In this context, intelligent transportation systems, including connected and autonomous vehicles, will be key for developing affordable and sustainable infrastructures and services. We start by identifying three current technology trends, namely, towards climate neutral; cloudification and edge computing; and Big Data and artificial intelligence, and then we examine their capability to enable sustainable Vehicle-to-Everything (V2X) communication systems in beyond 5G and 6G networks. In the second part of the paper, a set of selected use case categories involving connected and autonomous vehicles is presented, showcasing the potential impact of the selected technology trends. Finally, a review of the estimates of the quantitative savings that could be achieved in environmental-related parameters such as energy/fuel consumption and greenhouse gas emissions is provided.

In the last 20 years, evidence has been found that supports the “5Cs” of the Positive Youth Development (PYD) model developed by Lerner and his colleagues in the United States. This model considers adolescents as active elements who may acquire the resources and strengths to develop positive relationships with others. However, few studies have focused on its generalization to other contexts. Therefore, the aim of the present scoping review is to examine the evidence of the 5Cs model (Confidence, Competence, Caring, Connection and Character) in Europe. A search was carried out in the international Web of Science database for articles published in Europe between 2013 and June 2023, obtaining 123 articles. Subsequently, after applying the inclusion criteria, 23 articles were included. The findings agreed that men have higher levels of Competence and Confidence, while women scored higher in Connection, Caring and Character. Furthermore, many studies stated that higher scores in Connection, Competence, Character and Confidence are related to better mental health, higher academic performance and greater social and environmental contribution. Consequently, it is crucial to increase the number of interventions based on this model to result in future adults who are healthy, happy and engaged with society. Finally, future lines of research are discussed, as well as the importance of researchers carrying out more intervention programs.

Abstract Background This study of nutritional patterns in relation to cancers among pediatric oncology population in Tanzania was motivated by the lack of up-to-date information about the nutritional practices, the controversy around the importance of nutritional support and the lack of consistent nutritional criteria among pediatric oncology populations. Methods A survey study in two cancer referral hospitals of children diagnosed with any cancers, aged between 1 and 17 years inclusive and being eligible for enteral feeding included 131 children. Their demographic, nutritional, feeding and cancer profiles were analyzed descriptively through mapping and other approaches as well as inferentially using multinomial regression models to understand different aspects of nutrition for children suffering from cancers. Results The majority (15% or higher) of pediatric oncology population originated from the lake zone. Between 7 and 12% of pediatric oncology population originated from the Western zone. The top-three cancers with their percentages in the brackets were: Wilms Tumor (32%), Acute Lymphoblastic Leukemia (26%) and Retinoblastoma (13%). About 69% of the pediatric oncology population ate foods that are rich in energy but poor in protein such as rice (21.5%), porridge (19.3%), banana (11.7%) and potatoes (10.2%). On the other hand, only 17.5% ate foods that are generally protein-rich such as meat (8.0%), fish (5.3%) and chicken (4.2%); and 12.7% ate milk (4.2%), beans (3.4%), vegetables (2.7%), eggs (1.9%) and fruits (1.5%). Cancers impacted food intake in about 60% of all children with cancers and affected appetite in 18.3% of them. Cancers caused vomiting in 16% and diarrhea in 6.1% of children. The majority of children with cancers (61.8%) took at least one meal while 34.4% took just snacks (p

Abstract Compression sonography has been proposed as a method for non‐invasive measurement of venous pressures during spaceflight, but initial reports of venous pressure measured by compression ultrasound conflict with prior reports of invasively measured central venous pressure (CVP). The aim of this study is to determine the agreement of compression sonography of the internal jugular vein (IJVP) with invasive measures of CVP over a range of pressures relevant to microgravity exposure. Ten healthy volunteers (18–55 years, five female) completed two 3‐day sessions of supine bed rest to simulate microgravity. IJVP and CVP were measured in the seated position, and in the supine position throughout 3 days of bed rest. The range of CVP recorded was in line with previous reports of CVP during changes in posture on Earth and in microgravity. The correlation between IJVP and CVP was poor when measured during spontaneous breathing (r = 0.29; R2 = 0.09; P = 0.0002; standard error of the estimate (SEE) = 3.0 mmHg) or end‐expiration CVP (CVPEE; r = 0.19; R2 = 0.04; P = 0.121; SEE = 3.0 mmHg). There was a modest correlation between the change in CVP and the change in IJVP for both spontaneous ΔCVP (r = 0.49; R2 = 0.24; P

Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5Cs) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the overall PYD factor, the 5Cs, and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men’s sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors. Concerning gender differences, men showed more risky behaviors than women. A partial mediation model pointed out that lower character and higher perceived competence in men partly explained the higher presence of risky behavior compared to women. These results underline the need to promote PYD within the university context to prevent risky behaviors by addressing gender differences and the separate role of the 5Cs.

Pancreatic neuroendocrine neoplasms are a rare and complex group of neoplastic lesions that develop from pancreatic islet cells. Their incidence has dramatically increased during the last two decades. Due to its complex nature and pathophysiological behaviour, surgical management continues to evolve. Surgery remains the cornerstone of treatment for most non-functional and functional pancreatic neuroendocrine tumours, while lymphadenectomy remains a controversial subject. Different techniques, such as pancreas-preserving and minimally invasive approaches, continue to evolve and offer the same overall outcomes as open surgery. This comprehensive review describes in detail the current and most up-to-date classification and staging of pancreatic neuroendocrine tumours, explores the rationale for non-surgical and surgical management, and focuses on surgical treatment and more specifically, on minimally invasive approaches.

Equipping autonomous agents for dynamic interaction and navigation is a significant challenge in intelligent transportation systems. This study aims to address this by implementing a brain-inspired model for decision making in autonomous vehicles. We employ active inference, a Bayesian approach that models decision-making processes similar to the human brain, focusing on the agent’s preferences and the principle of free energy. This approach is combined with imitation learning to enhance the vehicle’s ability to adapt to new observations and make human-like decisions. The research involved developing a multi-modal self-awareness architecture for autonomous driving systems and testing this model in driving scenarios, including abnormal observations. The results demonstrated the model’s effectiveness in enabling the vehicle to make safe decisions, particularly in unobserved or dynamic environments. The study concludes that the integration of active inference with imitation learning significantly improves the performance of autonomous vehicles, offering a promising direction for future developments in intelligent transportation systems.

Objective Traumatic experiences and post‐traumatic stress disorder (PTSD) are common in schizophrenia. However, few studies screening for PTSD have established the temporality of PTSD‐related traumatic events to psychosis onset. Furthermore, it is unclear how many patients attribute a trauma‐based contribution to their psychosis or would find trauma‐focused therapy acceptable. We examine the prevalence and timing of trauma in psychosis, as well as patient views on the relationship between their trauma experiences and mental health difficulties, and on receiving trauma‐focused therapy. Methods Sixty‐eight patients with an at‐risk mental state (ARMS) or psychotic disorder in a UK secondary‐care setting completed self‐report measures of trauma and PTSD, and undertook research interviews. Proportions and odds ratios were derived with 95% confidence intervals. Results We recruited 68 participants (estimated response rate 62%; psychotic disorder n = 61, ARMS n = 7). Sixty three (95%) reported traumatic events and 32 (47%) reported childhood abuse. Twenty‐six individuals (38%) met criteria for PTSD, though for >95% this was not recorded in their notes, and 25 (37%) had sub‐threshold PTSD. For 69% of participants, their worst trauma occurred before the onset of their psychosis symptoms. Most (65%) believed their psychosis symptoms were related to past traumas and 82% of these were interested in receiving trauma‐focused therapy. Conclusions PTSD is common in and often pre‐dates onset of psychosis. Most patients believe their symptoms and traumas are related and would be interested in trauma‐focused therapy if available. Studies evaluating the effectiveness of trauma‐focused therapies for those with or at high‐risk of psychosis are required.

BackgroundThere are no uniform regulations for the osteopathic profession in Europe. It is subject to country-specific regulations defining who shall be allowed to practice osteopathy and which qualification shall be required. In recent years, legal regulations have been established in several European countries for the profession of osteopathy; however, these are also still pending for Austria. Currently, physiotherapists and physicians with osteopathic training are practicing osteopathy in Austria. ObjectiveThis study aims to examine the characteristics, challenges, and opportunities of osteopaths in Austria. MethodsGuideline-based interviews with osteopaths (N=10) were conducted. The different research questions were examined using a qualitative content analysis. ResultsThe study provided a differentiated insight into the professional situation of osteopaths in Austria. The most important result was that all interviewees unanimously supported a legal regulation of their profession. However, owing to their different professional self-image—on the one hand, individuals working on a structural basis, and, on the other hand, individuals working on a cranial or biodynamic basis—they were able to imagine a uniform professional regulation only to a limited extent. Additional topics for the interviewed osteopaths in Austria were the quality assurance of training and the urgent need for scientific research. Furthermore, the study also dealt with the influence of the COVID-19 pandemic on daily practice and on education and training in osteopathy. ConclusionsThis study is a pioneering study with regard to systematic basic research on osteopathy in Austria. The obtained results and the newly acquired research questions not only have the potential to serve as a basis for further studies but also provide insight into the working and professional situation of osteopaths in Austria for universities, schools, professional associations, politics, and—last but not least—all interested parties. International Registered Report Identifier (IRRID)RR2-10.2196/15399

Background: Atrial fibrillation (AF) catheter ablation has become an increasingly effective and safe strategy for the management of AF. With increased safety of catheter ablation, same-day discharge (SDD) is a potential way to minimize health care resource utilization and improve patient experience. Objective: To evaluate the safety and patient satisfaction of SDD after contemporary AF ablation. Methods: Consecutive patient undergoing AF ablation at our institution between 1/2020 and 10/2021 were enrolled in registry for clinical, quality, procedural and outcomes data. Patients were considered for SDD per physician discretion and patients’ preference based upon clinical evaluation. Adjudicated ninety-day major complications, thirty-day adverse events, and thirty-day re-admissions were collected in a prospective registry for all patients. Results: A total of 2142 consecutive patients underwent elective AF ablation during the study period. After excluding cases with missing data, 1830 patients were included in the analysis. Of those, 350 (19 %) patients were discharged the same day (SDD group) and 1480 (81 %) stayed overnight. Patients in the SDD group compared to overnight stay group were younger, more likely to be male, White patients, lower CHA2DS2-VASc score and to be on lower rates of warfarin as an anticoagulation strategy. After propensity score matching, SDD was associated with lower rate of major complications and higher patient satisfaction. The majority of life-treating complications occurred interprocedurally or within 6 h of procedure termination. Conclusion: The present study demonstrated that SDD after contemporary AF ablation is feasible, safe and associated with higher patient satisfaction using a proposed SDD pathway and criteria.

Alopecia areata (AA) is an autoimmune disease that has a complex underlying immunopathogenesis characterized by nonscarring hair loss ranging from small bald patches to complete loss of scalp, face, and/or body hair. Although the etiopathogenesis of AA has not yet been fully characterized, immune privilege collapse at the hair follicle (HF) followed by T-cell receptor recognition of exposed HF autoantigens by autoreactive cytotoxic CD8+ T cells is now understood to play a central role. Few treatment options are available, with the Janus kinase (JAK) 1/2 inhibitor baricitinib (2022) and the selective JAK3/tyrosine kinase expressed in hepatocellular carcinoma (TEC) inhibitor ritlecitinib (2023) being the only US Food and Drug Administration–approved systemic medications thus far for severe AA. Several other treatments are used off-label with limited efficacy and/or suboptimal safety and tolerability. With an increased understanding of the T-cell–mediated autoimmune and inflammatory pathogenesis of AA, additional therapeutic pathways beyond JAK inhibition are currently under investigation for the development of AA therapies. This narrative review presents a detailed overview about the role of T cells and T-cell–signaling pathways in the pathogenesis of AA, with a focus on those pathways targeted by drugs in clinical development for the treatment of AA. A detailed summary of new drugs targeting these pathways with expert commentary on future directions for AA drug development and the importance of targeting multiple T-cell–signaling pathways is also provided in this review.

Abstract The Extremely Brilliant Source (EBS) is the experimental implementation of the novel Hybrid Multi Bend Achromat (HMBA) storage ring magnetic lattice concept, which has been realised at European Synchrotron Radiation Facility. We present its successful commissioning and first operation. We highlight the strengths of the HMBA design and compare them to the previous designs, on which most operational synchrotron X-ray sources are based. We report on the EBS storage ring’s significantly improved horizontal electron beam emittance and other key beam parameters. EBS extends the reach of synchrotron X-ray science confirming the HMBA concept for future facility upgrades and new constructions.

Abstract Background Though the incidence of atrial fibrillation (AF) is increased in patients with cancer, the effectiveness of catheter ablation (CA) for AF in patients with cancer is not well studied. Methods We conducted a retrospective cohort study of patients who underwent CA for AF. Patients with a history of cancer within 5-years prior to, or those with an exposure to anthracyclines and/or thoracic radiation at any time prior to the index ablation were compared to patients without a history of cancer who underwent AF ablation. The primary outcome was freedom from AF [with or without anti-arrhythmic drugs (AADs), or need for repeat CA at 12-months post-ablation]. Secondary endpoints included freedom from AF at 12 months post-ablation with AADs and without AADs. Safety endpoints included bleeding, pulmonary vein stenosis, stroke, and cardiac tamponade. Multivariable regression analysis was performed to identify independent risk predictors of the primary outcome. Results Among 502 patients included in the study, 251 (50%) had a history of cancer. Freedom from AF at 12 months did not differ between patients with and without cancer (83.3% vs 72.5%, p 0.28). The need for repeat ablation was also similar between groups (20.7% vs 27.5%, p 0.29). Multivariable regression analysis did not identify a history of cancer or cancer-related therapy as independent predictors of recurrent AF after ablation. There was no difference in safety endpoints between groups. Conclusion CA is a safe and effective treatment for AF in patients with a history of cancer and those with exposure to potentially cardiotoxic therapy.

IntroductionSweetpotato breeders strive to develop varieties that address productivity challenges farmers face in sub-Saharan Africa (SSA). However, adoption of these varieties is low, partly attributed to limited attention to attributes desired by the end-users.MethodsThis study sought to identify the key traits preferred by eight women processors and 426 consumers (180 male, 246 female) in Manhiça, Marracuene and Maputo districts, Mozambique. Processing diagnostics and consumer studies evaluated two local varieties (‘Lilas’, ‘N’santimuni’) and two improved varieties (‘Alisha’, ‘Irene’). Data from processors were analyzed using content analysis and summary statistics. Consumer hedonic data were analyzed using clustering and regression models, while Penalty analysis and Multiple correspondence analysis were performed for the Just-about-right and Check-all-that-apply tests respectively.ResultsProcessors prioritized mealiness, sweet taste, not fibrous, good sweetpotato smell, ease of peeling, easy to cook and good appearance for the boiled root. ‘N’santimuni’ was the most preferred variety for processing. Consumers preferred ‘N’santimuni’ and ‘Lilas’ because of their high dry matter, pleasant sweetpotato smell, firmness in the hand, smoothness when eating and sweet taste. ‘Alisha’ and ‘Irene’ were the most penalized for low scores on sweetness, mealiness, and firmness. Women consumed sweetpotato more frequently than men and had better discernment of sweet taste, homogeneity and colour. Also, youth and more educated consumers disliked improved varieties more than adults and lower income consumers.DiscussionProcessors and consumers strongly indicated their preference and importance of quality attributes such as mealiness, sweet taste, firmness for boiled sweetpotato. However, such traits are rarely included in breeding designs. Breeding programs can thus be enhanced by studies of biophysical and chemical parameters of sweetpotato. This will enable quantification incorporation of these quality attributes.

The administration of 4-factor prothrombin complex concentrate (4F-PCC) has expanded beyond its Food and Drug Administration (FDA)-approved indication for the emergent reversal of vitamin K antagonists (VKAs). Therefore, this study aimed to evaluate the risks and benefits associated with the expanded use of 4F-PCC. We conducted a single-center retrospective review of 4F-PCC administrations at our university hospital. Of the 159 patients who received 4F-PCC, 76% (n = 121) and 24% (n = 38) received it for the FDA-approved indication in the vitamin K-related coagulopathy (VKA) group and for expanded use in the nonvitamin K-related coagulopathy (nVKA) group, respectively. The expanded use of 4F-PCC was associated with a less robust reduction in the international normalized ratio (INR) (INR of −0.7 ± 1.3 vs INR of −1.6 ± 1.8, P = .002), and fewer patients in the nVKA group achieved a postadministration INR of less than1.5 (11% vs 79%, P = .001) than those in the VKA group. Furthermore, the 30-day mortality rate was significantly higher in the nVKA cohort than in the VKA cohort (42% vs 20%, P = .04). Notably, based on our data, underlying differences in the patient’s comorbidities, particularly advanced liver disease, may have contributed to the observed outcome variations, including mortality rate. Therefore, factors, including comorbidities and the underlying etiology of coagulopathy, should be considered when deciding on the expanded use of 4F-PCC. Further research is needed to better understand the potential risks and benefits of 4F-PCC in expanded use scenarios, and the clinical decision to use 4F-PCC outside its FDA-approved indication should be made carefully, considering this information.

Introduction: Ultrasound-guided nerve blocks are fast becoming a core part of opioid-sparing, multimodal, acute pain management in the emergency department (ED) setting. The ultrasound-guided erector spinae plane block (ESPB) has been shown to be effective in treating a variety of musculoskeletal and neuropathic painful conditions in the ED. Case Series: Here we report the effective use of the ESPB for pain control in four patients who presented with acute abdominal pain related to biliary obstruction in a resource-limited setting. Conclusion: The ESPB may be helpful in treating abdominal pain related to biliary obstruction, which is a novel indication for this well-established technique. This application is particularly relevant in resource-limited settings with significant delay in definitive surgical management. Further research is needed prior to widespread adoption.

Mammalian sperm must undergo capacitation to become fertilization-competent. While working on mice, we recently developed a new methodology for treating sperm in vitro, which results in higher rates of fertilization and embryo development after in vitro fertilization. Sperm incubated in media devoid of nutrients lose motility, although they remain viable. Upon re-adding energy substrates, sperm resume motility and become capacitated with improved functionality. Here, we explore how sperm energy restriction and recovery (SER) treatment affects sperm metabolism and capacitation-associated signaling. Using extracellular flux analysis and metabolite profiling and tracing via nuclear magnetic resonance (NMR) and mass spectrometry (MS), we found that the levels of many metabolites were altered during the starvation phase of SER. Of particular interest, two metabolites, AMP and L-carnitine, were significantly increased in energy-restricted sperm. Upon re-addition of glucose and initiation of capacitation, most metabolite levels recovered and closely mimic the levels observed in capacitating sperm that have not undergone starvation. In both control and SER-treated sperm, incubation under capacitating conditions upregulated glycolysis and oxidative phosphorylation. However, ATP levels were diminished, presumably reflecting the increased energy consumption during capacitation. Flux data following the fate of 13C glucose indicate that, similar to other cells with high glucose consumption rates, pyruvate is converted into 13C-lactate and, with lower efficiency, into 13C-acetate, which are then released into the incubation media. Furthermore, our metabolic flux data show that exogenously supplied glucose is converted into citrate, providing evidence that in sperm cells, as in somatic cells, glycolytic products can be converted into Krebs cycle metabolites.