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Abstract Background Breast cancer incidence has been on the rise significantly in the Asian population, occurring at an earlier age and a later stage. The potential predictive value of molecular subtypes, biomarkers, and genetic variations has not been deeply explored in the Asian population. This study evaluated the effect of molecular subtype classification and the presence or absence of biomarkers and genetic variations on pathological complete response (pCR) after neoadjuvant treatment in Asian breast cancer patients. Methods A systematic search was conducted in MEDLINE (PubMed), Science Direct, Scopus, and Cochrane Library databases. Studies were selected if they included Asian breast cancer patients treated with neoadjuvant chemotherapy and contained data for qualitative or quantitative analyses. The quality of the included studies was assessed using the Newcastle Ottawa Scale. Following the random effects model, pooled odds ratios or hazard ratios with 95% confidence intervals for pCR were analysed using Review Manager Software. Heterogeneity between studies was assessed using Cochran’s Q-test and I 2 test statistics. Results In total, 19,708 Asian breast cancer patients were pooled from 101 studies. In the neoadjuvant setting, taxane-anthracycline (TA) chemotherapy showed better pCR outcomes in triple-negative breast cancer (TNBC) (p

Purpose: Bullying in elementary schools is a serious problem that can affect children's social and emotional well-being. This research aims to analyze the character-building capital applied in homeschooling and how this influences the social behavior of elementary school children in the context of bullying prevention. Design/methodology/approach: This study uses a qualitative approach with in-depth interview methods and observations of parents and children participating in homeschooling. Findings: The research results show that homeschooling provides flexibility in the application of character values that can be adapted according to the child's individual needs. Character education methods applied in homeschooling, such as a values-based approach and direct parental involvement, have proven effective in increasing children's empathy, responsibility and social skills. This research provides new insight into the role of homeschooling in character formation and bullying prevention, and offers recommendations for developing more effective character education strategies in the homeschooling context. It is hoped that these findings will contribute to parents, educators and policy makers in creating a safer and more supportive educational environment for these children. Paper type: Research paper

With the rapid development of science and technology, all types of mixed media contain large amounts of data. Traditional single multimedia data can no longer satisfy daily requirements. Therefore, the cross-modal retrieval technology has become an urgent requirement. Consequently, there is a pressing need for cross-modal retrieval technology. Its purpose is to mine the connection between different modal samples, that is, to retrieve another modal sample with approximate semantics through one modal sample. For example, users can retrieve multimedia data such as images or videos with text. However, there are differences in the modal representation of different types of multimedia data, and measuring the correlation between different modes is the main problem of cross-modal retrieval. Currently, the most popular deep learning methods have achieved remarkable results in the field of data processing and graphics. Many researchers have applied deep learning methods to cross-modal retrieval to solve the problem of similarity measurement between different multimedia data. By summarizing the relevant paper methods of cross-modal retrieval, this paper provides a definition of cross-modal retrieval problems, reviews the core ideas of the current mainstream cross-modal retrieval methods in the form of three main methods, lists the commonly used data sets and evaluation methods, and finally analyzes the problems and future research trends of cross-modal retrieval.

With the development of intelligent collection technology and popularization of intelligent terminals, multi-source heterogeneous data are growing rapidly. The effective utilization of rich semantic information contained in massive amounts of multi-source heterogeneous data to provide users with high-quality cross-modal information retrieval services has become an urgent problem to be solved in the current field of information retrieval. In this paper, we propose a novel cross-modal retrieval method, named MGSGH, which deeply explores the internal correlation between data of different granularities by integrating coarse-grained global semantic information and fine-grained scene graph information to model global semantic concepts and local semantic relationship graphs within a modality respectively. By enforcing cross-modal consistency constraints and intra-modal similarity preservation, we effectively integrate the visual features of image data and semantic information of text data to overcome the heterogeneity between the two types of data. Furthermore, we propose a new method for learning hash codes directly, thereby reducing the impact of quantization loss. Our comprehensive experimental evaluation demonstrated the effectiveness and superiority of the proposed model in achieving accurate and efficient cross-modal retrieval.

Mesenchymal stem cells (MSCs) under hypoxic conditions can produce secretomes containing growth factors such as vascular endothelial growth factor (VEGF), accelerating angiogenesis in wound healing disorders in diabetic ulcers. This study aimed to prove the influence of gel secretome MSC hypoxia administration on increasing VEGF and P38 gene expression in rats’ diabetic wounds. An in vivo study was conducted on 25 male Rattus norvegicus, randomly divided into four groups: base gel as a negative control, Gentamycin as a positive control, and gel secretome at a dose of 100 µL, and 200 µL/kg body weight. The differences in P38 and VEGF gene expression were tested using quantitative real-time polymerase chain reaction (qRT-PCR). Wound closure appeared to be fastest in treatment groups at a dose of 100 µL/kg body weight, followed by a dose of 200 µL/kg body weight, followed by Gentamycin and base gel group. The wound closure rate percentage was significantly different in the intervention group compared to the control group (p = 0.000). The results showed a significant difference in P38 and VEGF gene expression between the treatment and control groups (p = 0.000). This study demonstrates the administration of gel secretome hypoxia mesenchymal stem cells increases P38 and VEGF expression in rats’ diabetic wounds.

This research aims to evaluate regional innovations in implementing Surabaya City government policies to reduce stunting rates and improve the quality of public health services. A qualitative descriptive method was used with a case study approach involving field observations and structured interviews. The research results show the success of Posyandu Prima in reducing stunting rates significantly in the last two years. The Surabaya City Government has proven effective in managing this program's human resources and budget. The active involvement of Great Surabaya Cadres (KSH) and non-governmental organizations also contributed greatly to the program's success. Cross-sector collaboration plays an important role in supporting implementation. Institutional characteristics, such as commitment to public health and ability to collaborate, also matter. Theoretically, this research shows that synergy between the parties involved and government commitment can achieve significant results in handling the stunting problem. In conclusion, the Prima Posyandu Program has proven successful in reducing stunting rates and improving the quality of public health services in Surabaya. Additionally, the collaborative efforts between community stakeholders, healthcare providers, and governmental bodies underscore the crucial role of multi-sectoral partnerships in addressing complex public health issues like stunting. This synergy fosters comprehensive approaches that combine local knowledge, resources, and policy support to effectively combat stunting and enhance the well-being of communities. Thus, the Prima Posyandu Program's success is a compelling example of how concerted action and sustained commitment can yield tangible improvements in population health outcomes.

Patients with Type 2 diabetes mellitus (T2DM) and Chronic Kidney Disease (CKD) face an increased risk of morbidity and mortality after influenza infection. Several studies have shown that the influenza vaccine effectively prevents morbidity and mortality in T2DM patients. However, there has been limited research aimed at assessing the effectiveness of the trivalent influenza vaccine in T2DM–CKD patients. This study aimed to identify Geometric Mean Titers (GMTs), seroprotection, seroconversion, safety, and efficacy. This open-label clinical trial was conducted at AMC Hospital in Bandung, West Java, Indonesia between June 2021 and July 2022. The study subjects consisted of 41 T2DM and 26 T2DM–CKD patients who were administered the trivalent influenza vaccine. There was a significant difference in the average age, with the T2DM–CKD patients being older. Median titers post-vaccination for the B/Washington virus were higher in the T2DM patients compared to the T2DM–CKD patients, and this difference was statistically significant. A majority, comprising 75.6% of the T2DM and 80.8% of the T2DM–CKD patients monitored post-influenza-vaccination, did not experience any adverse reactions. The most common reaction was the sensation of fever, with incidence rates of 12.2% in the T2DM patients and 15.4% in the T2DM–CKD patients. Furthermore, we observed that the incidence of Influenza-like Illness was highest at 7.3% in the T2DM patients and 7.7% in the T2DM–CKD patients. The trivalent influenza vaccine demonstrated equivalent safety and effectiveness in both groups.

The properties of β- and γ-bands are analyzed in the framework of the IBM. It is shown that the general features of the observed excitation energies and the transition probabilities to the ground state band can be explained simply in terms of the intrinsic states of the IBM.

Aims: Diagnosing acute heart failure (AHF) remains particularly challenging in older patients. Natriuretic peptides are recommended as valuable diagnostic tools in this context. This study aims to establish the diagnostic thresholds of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for AHF in patients aged over 75 years, both with and without co-morbidities., Methods and Results: In this retrospective longitudinal multicentre cohort study, data were gathered from 12 071 hospitalized patients aged 75 years or older, presenting with acute dyspnoea and undergoing BNP or NT-proBNP measurement within 48 h of admission across 10 Assistance Publique-Hôpitaux de Paris facilities between 2011 and 2022, encompassing geriatrics, cardiology, and pulmonology departments. Final diagnoses were categorized using ICD-10 criteria as either AHF or other acute respiratory conditions such as COPD exacerbation, pulmonary embolism, and pneumonia. The mean (SD) age of the population was 84.0 (80.0, 89.0) years, with 52.7% being female. Out of these, 7946 (65.8%) were diagnosed with AHF upon discharge. For NT-proBNP, the identified 'optimal' threshold for diagnosing AHF was 1748 ng/L, with a positive predictive value (PPV) of 84%. Among patients aged over 85 years, a threshold of 2235 pg/mL for NT-proBNP was associated with an 84% PPV. In patients with atrial fibrillation (AF), a threshold of 2332 pg/mL for NT-proBNP demonstrated a PPV of 90% for AHF diagnosis. Additionally, in patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min, a threshold of 3474 pg/mL for NT-proBNP yielded a 90% PPV for AHF diagnosis. In male patients, a threshold of 1800 pg/mL showed an 85% PPV for AHF diagnosis, while in patients with obesity, a threshold of 1375 pg/mL demonstrated an 85% PPV for AHF diagnosis., Conclusions: In older patients, we found significant effects of co-morbidities on natriuretic peptides results, particularly in patients over 85 years old, older patients with abnormal renal function, obesity, and atrial fibrillation. Despite the consideration of those co-morbid conditions, NT-proBNP and BNP level continue to demonstrate utility in the diagnosis of AHF in older patients., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Despite advances in diagnosis of erythrocytosis and thrombocytosis due to driver mutation testing, many cases remain classified as "idiopathic". This can be explained by the absence of an evident secondary cause, inconclusive bone marrow biopsy or neglection of family history. Analysis of a broad panel of genes through next-generation sequencing (NGS) could improve diagnostic work-up identifying underlying genetic causes. We reviewed the results of NGS performed in our laboratory and its diagnostic impact on 117 patients with unexplained erythrocytosis and 58 with unexplained thrombocytosis; six patients (5.1%) were diagnosed with polycythaemia vera (PV) and 8 (6.8%) with familial erythrocytosis after NGS testing. Low EPO and a family history seemed to predict a positive result, respectively. However, a greater percentage of patients were ultimately diagnosed with secondary erythrocytosis (36%), remained as idiopathic (28.2%) or were self-limited (15%). The yield of NGS was shown to be slightly higher in patients with thrombocytosis, as 15 (25.9%) were diagnosed with essential thrombocythemia (ET) or familial thrombocytosis after variant detection; previous research has shown similar results, but most of them carried out NGS retrospectively, while the present study exhibits the performance of this test in a real-world setting. Overall, the low rate of variant detection and its poor impact on diagnostic work-up highlights the need for a thorough screening prior to NGS, in order to improve its yield.

Diabetes mellitus (DM) is more common among people living with human immunodeficiency virus (PLWH) compared with healthy individuals. In a prospective multicenter study (N = 248), we identified normoglycemic (48.7%), prediabetic (44.4%), and diabetic (6.9%) PLWH. Glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) sensitivity in defining dysglycemia was 96.8%, while addition of oral glucose tolerance test led to reclassification of only 4 patients. Inclusion of 93 additional PLWH with known DM enabled identification of multiple independent predictors of dysglycemia or diabetes: older age, higher body mass index, Ethiopian origin, HIV duration, lower integrase inhibitor exposure, and advanced disease at diagnosis. Shotgun metagenomic microbiome analysis revealed 4 species that were significantly expanded with hyperglycemia/hyperinsulinemia, and 2 species that were differentially more prevalent in prediabetic/diabetic PLWH. Collectively, we uncover multiple potential host and microbiome predictors of altered glycemic status in PLWH, while demonstrating that FBG and HbA1c likely suffice for diabetes screening. These potential diabetic predictors merit future prospective validation., Competing Interests: Potential conflicts of interest. E. E. is a scientific cofounder of DayTwo and BiomX, and an advisor to Purposebio, Aposense, Zoe, and MyGutly in topics unrelated to this work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Flow regulation in gravel-bed rivers impacts the hydrology, sediments and morphology, riparian vegetation, and vertical connectivity with the hyporheic zone. In this context, previous works have suggested that flood events may have riverine morphological and ecological benefits. In a Mediterranean-climate river system, we analyzed the impact of a 18-year return period flood on river morphology, riparian vegetation, fish aquatic habitat quality, and hyporheic exchange in a dam-regulated gravel-bed river, Serpis River (Spain). We collected pre- and post-flood riparian vegetation distributions and bathymetries, which were used to develop two-dimensional surface and three-dimensional subsurface numerical models to map surface and hyporheic hydraulics. Results show that the large flood removed the invasive giant reed from large areas, reshaped the in-channel morphology by forming new bars and pools, and enhanced the complexity of the flow field and the hydro-morphological diversity. The habitat availability for the endemic Eastern Iberian chub (Squalius valentinus) and invasive bleak (Alburnus alburnus) increased. Hyporheic exchange showed limited change under losing conditions, but noticeable under neutral ambient groundwater condition. This study corroborates the beneficial effects that flood events or high flow releases may have on regulated streams and the potential use of high flow pulse as a restoration tool., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: The European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanisation need to be addressed in order to tackle the growing burden of disease and health inequalities in cities. This study, Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project), aims to investigate the complex association between the urban environmental exposures (UrbEEs) and health., Methods and Analysis: DAS-EP is a Spanish multiregional cross-sectional project that combines population health surveys (PHS) and geographical information systems (GIS) allowing to collect rich individual-level data from 17 000 adult citizens participating in the PHS conducted in the autonomous regions of the Basque Country, Andalusia, and the Valencian Community, and the city of Barcelona in the years 2021-2023. This study focuses on the population living in cities or metropolitan areas with more than 100 000 inhabitants. UrbEEs are described by objective estimates at participants' home addresses by GIS, and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders and sleep quality. We aim to further understand the direct and indirect effects between UrbEEs and health, as well as to estimate the impact at the population level, taking respondents' sociodemographic and socioeconomic characteristics, and lifestyle into consideration., Ethics and Dissemination: The study was approved by the regional Research Ethics Committee of the Basque Country (Ethics Committee for Research Involving Medicinal Products in the Basque Country; PI2022138), Andalusia (Biomedical Research Ethics Committee of the Province of Granada; 2078-N-22), Barcelona (CEIC-PSMar; 2022/10667) and the Valencian Community (Ethics Committee for Clinical Research of the Directorate General of Public Health and Center for Advanced Research in Public Health; 20221125/04). The results will be communicated to the general population, health professionals, and institutions through conferences, reports and scientific articles., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)