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Metrics derived from continuous glucose monitoring (CGM) systems are often discordant between systems. A major cause is that CGM systems are not standardized; they use various algorithms and calibration methods, leading to discordant CGM readings across systems. This discordance can be addressed by standardizing CGM performance assessments: If manufacturers aim their CGM systems at the same target, then CGM readings will align across systems. This standardization should include the comparator device, sample origin, and study procedures. With better aligned CGM readings, CGM-derived metrics will subsequently also align better between systems.

Comparing the performance of different continuous glucose monitoring (CGM) systems is challenging due to the lack of comprehensive guidelines for clinical study design. In particular, the absence of concise requirements for the distribution of comparator (reference) blood glucose (BG) concentrations and their rate of change (RoC) that are used to evaluate CGM performance, impairs comparability. For this article, several experts in the field of CGM performance testing have collaborated to propose characteristics of the distribution of comparator measurements that should be collected during CGM performance testing. Specifically, it is proposed that at least 7.5% of comparator BG concentrations are 300 mg/dL (16.7 mmol/L), respectively, and that at least 7.5% of BG-RoC combinations indicate fast BG changes with impending hypo- or hyperglycemia, respectively. These proposed characteristics of the comparator data can facilitate the harmonization of testing conditions across different studies and CGM systems and ensure that the most relevant scenarios representing real-life situations are established during performance testing. In addition, a study protocol and testing procedure for the manipulation of glucose levels are suggested that enable the collection of comparator data with these characteristics. This work is an important step toward establishing a future standard for the performance evaluation of CGM systems.

This article details a pedagogical inquiry research project, "Crafting Pedagogies with(in) Suspension: Viral Pedagogies in COVID times in Early Childhood Education," where educator co-researchers collaborated with a pedagogist-researcher to explore how we might craft early childhood education pedagogies relevant to pandemic times. In particular, we trace how questions of community-making emerged as quotidian conceptions of community failed in the conditions of the pandemic. Thinking with the question "how much snot is too much snot?"--a question educators were asked to assess as a marker of community participation--we share three tensions of community-making: policing bodies, normalcy, and community-making as an ongoing process. Importantly, we work to share our pedagogical thinking with these tensions, asking how they create different possibilities for making community with children and families in educational contexts.

Purpose: The first-aid courses organized by the Youth Red Cross Carinthia (Austria) had a quality problem, necessitating a professionalization in teaching and time structure. This research aimed to enhance the quality and effectiveness of these courses by implementing modified lesson studies with non-professional trainers. The paper presents the realization process, empirical research and results obtained by applying the first-aid curriculum. Design/methodology/approach: Around 22 lesson study first-aid courses (14 classes with 2 cycles, 8 with 3 cycles) were conducted and evaluated in different Austrian school types. An observation sheet was created to evaluate attention and competencies. Interviews were conducted with both teachers and students to validate the results. Findings: The research findings demonstrate that lesson studies can significantly enhance the quality and effectiveness of first-aid courses. Inexperienced and experienced first-aid teachers significantly improved their teaching skills. Newly educated first-aid teachers showed substantial improvement, leading to the introduction of an induction period and coaching opportunity within the Youth Red Cross Carinthia. Originality/value: This is the first lesson study conducted in a non-academic context. It highlights the adaptation process of Carinthian first-aid courses. It illustrates how lesson studies impact lesson clarity, instructional variety, student engagement in the learning process, student outcome, student feedback and teaching effectiveness in a non-academic context. It contributes to the literature on the application of lesson study in first-aid education and provides insight into the benefits of this approach in enhancing the quality of first-aid training.

The use of different approaches for design and results presentation of studies for the clinical performance evaluation of continuous glucose monitoring (CGM) systems has long been recognized as a major challenge in comparing their results. However, a comprehensive characterization of the variability in study designs is currently unavailable. This article presents a scoping review of clinical CGM performance evaluations published between 2002 and 2022. Specifically, this review quantifies the prevalence of numerous options associated with various aspects of study design, including subject population, comparator (reference) method selection, testing procedures, and statistical accuracy evaluation. We found that there is a large variability in nearly all of those aspects and, in particular, in the characteristics of the comparator measurements. Furthermore, these characteristics as well as other crucial aspects of study design are often not reported in sufficient detail to allow an informed interpretation of study results. We therefore provide recommendations for reporting the general study design, CGM system use, comparator measurement approach, testing procedures, and data analysis/statistical performance evaluation. Additionally, this review aims to serve as a foundation for the development of a standardized CGM performance evaluation procedure, thereby supporting the goals and objectives of the Working Group on CGM established by the Scientific Division of the International Federation of Clinical Chemistry and Laboratory Medicine.

In July 2023, the Center of Excellence in Respiratory Pathogens organized a two-day workshop on infectious diseases modelling and the lessons learnt from the Covid-19 pandemic. This report summarizes the rich discussions that occurred during the workshop.The workshop participants discussed multisource data integration and highlighted the benefits of combining traditional surveillance with more novel data sources like mobility data, social media, and wastewater monitoring. Significant advancements were noted in the development of predictive models, with examples from various countries showcasing the use of machine learning and artificial intelligence in detecting and monitoring disease trends. The role of open collaboration between various stakeholders in modelling was stressed, advocating for the continuation of such partnerships beyond the pandemic. A major gap identified was the absence of a common international framework for data sharing, which is crucial for global pandemic preparedness.Overall, the workshop underscored the need for robust, adaptable modelling frameworks and the integration of different data sources and collaboration across sectors, as key elements in enhancing future pandemic response and preparedness.

This study aimed to explore the factors that influence parental involvement in supporting the education of children with disabilities in Malawi, thereby generating insights into the barriers and facilitators they face. We conducted focus groups and in-depth interviews with 25 participants from Nkhata Bay District: teachers, parents, and children with disabilities. We used the COM-B model to analyse how parents’ capabilities, opportunities, and behaviours influence their involvement in their children’s education. This study revealed that parents of children with disabilities showed willingness, optimism regarding their children’s future, and a strong sense of responsibility for their education. However, factors such as the limited knowledge of children’s learning needs, time, low confidence, and financial challenges have constrained their involvement. Schools and communities frequently limit participation opportunities by not consistently practising or championing parental involvement in policies and actions. This study sheds light on the complex interplay between knowledge, practical constraints, and external support systems that shape parental involvement in the education of children with disabilities. Further research aimed at creating tailored and context-relevant interventions to improve parental involvement in the education of children with disabilities in low-income settings is required.

Human T-cell leukemia virus type 1 (HTLV-1) infects CD4+ T-cells through close cell–cell contacts. The viral Tax-1 (Tax) protein regulates transcription by transactivating the HTLV-1 U3R promoter in the 5′ long terminal repeat of the integrated provirus. Here, we generated a clonal Tax-responsive T-cell line to track HTLV-1 infection at the single-cell level using flow cytometry, bypassing intracellular viral protein staining. Jurkat T-cells stably transduced with the SMPU vector carrying green fluorescent protein (GFP) under control of 18 × 21 bp Tax-responsive element repeats of the U3R were evaluated. Among 40 clones analyzed for Tax responsiveness, the top two were characterized. Upon overexpression of Tax, over 40% of the cells showed GFP positivity, and approximately 90% of the Tax-positive cells were GFP-positive, indicating efficient reporter activity. However, with CREB-deficient Tax mutant M47, both total GFP-positive cell counts and those within the Tax-positive group significantly decreased. Co-culture with chronically HTLV-1-infected MT-2 or C91-PL cells led to an average of 0.9% or 2.4% GFP-positive cells, respectively, confirming the suitability to monitor HTLV-1 transmission and that HTLV-1 infection is very low. Thus, the novel Tax-responsive reporter T-cell line is a suitable tool to monitor infection of HTLV-1 on the single-cell level.

Background Tumor-associated antigens and their derived peptides constitute an opportunity to design off-the-shelf mainline or adjuvant anti-cancer immunotherapies for a broad array of patients. A performant and rational antigen selection pipeline would lay the foundation for immunotherapy trials with the potential to enhance treatment, tremendously benefiting patients suffering from rare, understudied cancers.Methods We present an experimentally validated, data-driven computational pipeline that selects and ranks antigens in a multipronged approach. In addition to minimizing the risk of immune-related adverse events by selecting antigens based on their expression profile in tumor biopsies and healthy tissues, we incorporated a network analysis-derived antigen indispensability index based on computational modeling results, and candidate immunogenicity predictions from a machine learning ensemble model relying on peptide physicochemical characteristics.Results In a model study of uveal melanoma, Human Leukocyte Antigen (HLA) docking simulations and experimental quantification of the peptide–major histocompatibility complex binding affinities confirmed that our approach discriminates between high-binding and low-binding affinity peptides with a performance similar to that of established methodologies. Blinded validation experiments with autologous T-cells yielded peptide stimulation-induced interferon-γ secretion and cytotoxic activity despite high interdonor variability. Dissecting the score contribution of the tested antigens revealed that peptides with the potential to induce cytotoxicity but unsuitable due to potential tissue damage or instability of expression were properly discarded by the computational pipeline.Conclusions In this study, we demonstrate the feasibility of the de novo computational selection of antigens with the capacity to induce an anti-tumor immune response and a predicted low risk of tissue damage. On translation to the clinic, our pipeline supports fast turn-around validation, for example, for adoptive T-cell transfer preparations, in both generalized and personalized antigen-directed immunotherapy settings.

Retention and persistence to graduation have been concerns for colleges and universities across the country. Research has pointed to sociodemographic and economic factors that affect persistence. Our analyses isolate the relationship between advising appointments and the likelihood of persistence controlling for the possibility of an endogenous relationship and while controlling for sociodemographic and academic performance covariates. Using data from one college in a large, public university, we found that students enrolled in Spring 2018 who met with an advisor one or more times in January through August 2018 were 9% more likely to persist and enroll in Fall 2018 than otherwise similar students who did not visit an advisor at all during that period.

Several devices have been developed to assess soil losses by water erosion. However, they rarely assess the combined effects of raindrop impact and surface runoff together with vegetation cover on varying slopes. This study aimed to design and validate an equipment, on laboratory scale, to evaluate the effect of water erosion on undisturbed soil samples with and without plant cover, as well as to assess the kinetic energy of simulated rain and the resultant shear stress at varying runoff intensities. The equipment is composed of a rainfall simulator, an adjustable stand for different slopes and falling heights, and a runoff ramp for testing undisturbed soil samples measuring 15 x 20 x 40 cm (height, width, and length). In this study, the equipment simulated and evaluated the effect of precipitation and runoff on soil losses, allowing to obtain different values of the kinetic energy of precipitation and runoff. For a f low rate of 12 L min-1 and slope of 35%, the shear stress could reach up to 8 Pa. Furthermore, the equipment showed the effect of vegetation cover and slope on soil losses in different granulometric fractions (< 0.106 mm, 0.106 to 0.25 mm, 0.25 to 0.5 mm, 0.5 to 1.0 mm, 1.0 to 2.0 mm, and > 2.0 mm), revealing the potential of its use in several erosion studies on a laboratory scale.

In this paper we continue our investigation of the global categorical symmetries that arise when gauging finite higher groups and their higher subgroups with discrete torsion. The motivation is to provide a common perspective on the construction of non-invertible global symmetries in higher dimensions and a precise description of the associated symmetry categories. We propose that the symmetry categories obtained by gauging higher subgroups may be defined as higher group-theoretical fusion categories, which are built from the projective higher representations of higher groups. As concrete applications we provide a unified description of the symmetry categories of gauge theories in three and four dimensions based on the Lie algebra $\mathfrak{so}(N)$, and a fully categorical description of non-invertible symmetries obtained by gauging a 1-form symmetry with a mixed 't Hooft anomaly. We also discuss the effect of discrete torsion on symmetry categories, based a series of obstructions determined by spectral sequence arguments.

Relative energy deficiency in sport (RED-S) is a condition that arises from persistent low energy availability (LEA), which affects the hypothalamic–pituitary axis and results in alterations of several hormones in both male and female athletes. As frequent blood hormone status determinations using venipuncture are rare in sports practice, microsampling offers promising possibilities for preventing and assessing RED-S. Therefore, this study aimed at developing a liquid chromatography–high-resolution tandem mass spectrometry (LC-HRMS/MS) method for quantifying relevant steroids and thyroid hormones in 30 μL of capillary blood obtained using Mitra® devices with volumetric absorptive microsampling technology (VAMS®). The results of the study showed that all validation criteria were met, including a storage stability of more than 28 days in a frozen state (−18 °C) and 14 days at room temperature (20 °C). The validated assay provided precise (® samples from 50 female and male, healthy, active adults were analyzed. The sensitivity of all analytes was adequate to quantify the decreased hormone concentrations in the RED-S state, as all authentic samples could be measured accordingly. These findings suggest that self-collected VAMS® samples offer a practical opportunity for regular hormone measurements in athletes and can be used for early RED-S assessment and progress monitoring during RED-S recovery.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Caffeine is an ergogenic substance that is consumed globally in many forms. The use of buccally absorbable formulations instead of gastrointestinal uptake has become increasingly popular over the years, especially when accelerated absorption with minimal gastrointestinal stress is desired. This study investigated the impact of five different formulations and administration routes of caffeine on the whole blood concentrations of caffeine, paraxanthine, and theobromine: caffeinated capsules, tablets, shots, pouches, and chewing gums. A uniform dose of caffeine (200 mg) was administered to 16 healthy recreational athletes (26.0 ± 2.1 years) using a randomized crossover design. Samples were taken in the form of dried blood spots at 16 different time points in a 2-hr timeframe after drug administration. The samples were analyzed using a validated liquid chromatography–tandem mass spectrometry method. The results for caffeine showed no significant differences in the overall bioavailability (area under the concentration–time curve), maximal concentration, and time to maximum concentration. However, when analyzing the bioavailability of caffeine in the first 5, 10, and 15 min, the liquid caffeine formulation was superior to other administered forms (p <.05). This indicates that caffeine solubility has a major influence on its absorption rate. In sports, the rate of caffeine absorption must be considered, not only when ingesting anhydrous caffeine, but also when choosing buccal absorption. These findings imply that general guidelines for ergogenic caffeine use should consider the formulation used and, accordingly, the corresponding route of absorption. [ABSTRACT FROM AUTHOR]

The article explores the question whether the way in which Juri Lotman uses the categories of semiotic explosion and unpredictability enables and necessitates the need to give space not only to different descriptions, but also to various self-descriptions (auto-communications) of religion in culture. In other words, the question is posed whether his concept of the semiosphere aids in making sense of the synchronic and diachronic contradictions and controversies in religion – both within what is perceived as a religion and between what are understood to be religions. The focus lies especially on whether Lotman’s semiotic theory of culture has a potential of advancing mutual recognition and supportive respect, that is – solidaristic tolerance between different religious and non-religious ways of being human. The claim is made that this is indeed the case as he models the human situation so that the ‘outside of the system’ is not understood only as a continuation of reality, but visualizes and includes within the system a space for a radical intrusion of possibility – for the truly unpredictable – on the level of culture, humanity, as well as the individual. Therefore, Lotman’s theory of culture could be developed further, in the direction of a translation device between different cultures (of religion), opening up new perspectives for dealing with the challenging semiotic situation in which we all find ourselves living in today.

Introduction: Religion in the semiosphere

Abstract Background CHARGE syndrome (OMIM #214800) is a phenotypically complex genetic condition characterised by multi-system, multi-sensory impairments. Behavioural, psychological, cognitive and sleep difficulties are not well delineated and are likely associated with biopsychosocial factors. Methods This meta-analysis investigated the prevalence of clinical features, physical characteristics and conditions, behavioural, psychological, cognitive and sleep characteristics in CHARGE syndrome, and statistically evaluated directional associations between these characteristics. Pooled prevalence estimates were calculated using reliable, prespecified quality weighting criteria, and meta-regression was conducted to identify associations between characteristics. Results Of the 42 eligible studies, data could be extracted for 1675 participants. Prevalence estimates were highest for developmental delay (84%), intellectual disability (64%), aggressive behaviour (48%), self-injurious behaviour (44%) and sleep difficulties (45%). Meta-regression indicated significant associations between intellectual disability and choanal atresia, intellectual disability and inner ear anomalies, sleep difficulties and growth deficiency, and sleep difficulties and gross motor difficulties. Conclusions Our comprehensive review of clinical features, behavioural, psychological, cognitive and physical characteristics, conditions and comorbidities in CHARGE syndrome provides an empirically based foundation to further research and practice.

Aims: Current evidence of the impact of acute exercise on insulin levels in individuals with type 1 diabetes remains controversial. Therefore, we conducted a systematic review and meta‐analysis to explore exercise‐induced changes in insulin levels. Materials and Methods: We conducted a systematic review (until 05 November 2023) and meta‐analysis exploring the effect of exercise on insulin concentration in individuals with type 1 diabetes. We included randomised cross‐over studies for rapid‐acting insulin and pre‐ and post‐studies for long‐acting insulin in individuals with type 1 diabetes performing any type of acute exercise and had a control condition. The exercise‐induced change in insulin levels was the outcome of interest. When possible, the mean differences (MDs) in insulin levels were pooled using the DerSimonian and Laird random effect method. Risk of bias was assessed for each included study. Results: Seventeen trials, encompassing 186 participants with type 1 diabetes, were included in the systematic review. Twelve out of 17 studies included participants on rapid‐acting insulin regimens and used a cross‐over design, whereas five out of 17 single‐arm studies included participants on (ultra)long‐acting insulin. Seven out of 12 studies on rapid‐acting insulins and all the single‐arm studies were at high risk of bias. Results suggest a statistically significant, small‐to‐moderate increase of rapid‐acting insulin after 30 min of exercise (MD of 18.44 [95% CI 0.02; 36.86; I2 0%] pmol/L); meanwhile, findings on (ultra)long‐acting insulin were inconclusive. Conclusions: A small‐to‐moderate increase of insulin levels in studies including rapid‐acting insulin was found after a bout of physical exercise in individuals with type 1 diabetes. However, current gaps in high‐quality evidence challenge our understanding of insulin kinetics around exercise. [ABSTRACT FROM AUTHOR]

In DWI, multi-exponential signal analysis can be used to determine signal underlying diffusion components. However, the approach is very complex due to the inherent low SNR, the limited number of signal decay data points, and the absence of appropriate acquisition parameters and standardized analysis methods. Within the scope of this work, different methods for multi-exponential analysis of the diffusion signal in the kidney were compared. To assess the impact of fitting parameters, a simulation was conducted comparing the free non-negative (NNLS) and rigid non-linear least square (NLLS) fitting methods. The simulation demonstrated improved accuracy for NNLS in combination with area-under-curve estimation. Furthermore, the accuracy and stability of the results were further enhanced utilizing optimized parameters, namely 350 logarithmically spaced diffusion coefficients within [0.7, 300] × 10−3 mm2/s and a minimal SNR of 100. The NNLS approach shows an improvement over the rigid NLLS method. This becomes apparent not only in terms of accuracy and omitting prior knowledge, but also in better representation of renal tissue physiology. By employing the determined fitting parameters, it is expected that more stable and reliable results for diffusion imaging in the kidney can be achieved. This might enable more accurate DWI results for clinical utilization.