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Highlights from the article: Keywords: Fluorescence; Light; Nitric oxide; Photochemistry B Photoactivation of two novel b BODIPY and Rhodamine-based molecular hybrids with the highly biocompatible green light triggers the NO release from the nitroso aniline-derivative appendages without precluding the typical green and orange-green fluorescence emission of the antennae units, making them intriguing systems for image-guided phototherapeutic applications where the controlled delivery of NO is required.

An organic field‐effect transistor based on a squaraine fiber is studied, where the electric conductance values of the bulk and accumulation channel are comparable. The measured current–voltage characteristics are decomposed into two components, one representing the bulk and the other the accumulation channel. For small gate voltage (Vg), the output characteristics of the channel are described as a superposition of the Ohmic, space‐charge‐limited current, and trap‐filled‐limited (TFL) conduction mechanisms. The traps near the source are filled with electrons injected from source via the source‐gate electric field, but the traps near the drain could be filled only with the source‐drain electric field (Vd). The higher the gate voltage, the larger is the density of electrons injected from the source into the accumulation channel, the larger the density of free electrons, the larger the density of the trapped electrons, and the larger the drain voltage Vd=VTFL up to which the modified Child's law (Id≈θVd2) exists. θ is the fraction of the free electrons. For large voltage Vg, all traps are filled with the source‐gate electric field, and, as a result, only Ohm's and Child's laws (Id≈Vd2) are observed. The electron mobility in the accumulation channel features a linear dependence on the gate voltage. [ABSTRACT FROM AUTHOR]

An editorial on mucosal damage in celiac disease and the risk of neurological and psychiatric conditions is presented. Topics discussed include T-cell activation against gluten's immunogenic fraction gliadin; neurological and psychiatric disorders; and the prenatal development, intestinal barrier maturation in preterm infants dependency on gestational age and post-natal age.

Introduction: Mitral valve prolapse (MVP) is a common clinical condition in the general population. A subgroup of patients with MVP may experience ventricular arrhythmias and sudden cardiac death ("arrhythmic mitral valve prolapse" [AMVP]) but how to stratify arrhythmic risk is still unclear. Our meta‐analysis aims to identify predictive factors for arrhythmic risk in patients with MVP. Methods: We systematically searched Medline, Cochrane, Journals@Ovid, Scopus electronic databases for studies published up to December 28, 2022 and comparing AMVP and nonarrhythmic mitral valve prolapse (NAMVP) for what concerns history, electrocardiographic, echocardiographic and cardiac magnetic resonance features. The effect size was estimated using a random‐effect model as odds ratio (OR) and mean difference (MD). Results: A total of 10 studies enrolling 1715 patients were included. Late gadolinium enhancement (LGE) (OR: 16.67; p =.005), T‐wave inversion (TWI) (OR: 2.63; p <.0001), bileaflet MVP (OR: 1.92; p <.0001) and mitral anulus disjunction (MAD) (OR: 2.60; p <.0001) were more represented among patients with AMVP than in NAMVP. Patients with AMVP were shown to have longer anterior mitral leaflet (AML) (MD: 2.63 mm; p <.0001), posterior mitral leaflet (MD: 2.96 mm; p <.0001), thicker AML (MD: 0.49 mm; p <.0001), longer MAD length (MD: 1.24 mm; p <.0001) and higher amount of LGE (MD: 1.41%; p <.0001) than NAMVP. AMVP showed increased mechanical dispersion (MD: 8.04 ms; 95% confidence interval: 5.13–10.96; p <.0001) compared with NAMVP. Conclusions: Our meta‐analysis proved that LGE, TWI, bileaflet MVP, and MAD are predictive factors for arrhythmic risk in MVP patients. [ABSTRACT FROM AUTHOR]

Background: Managing SARS‐CoV‐2 infection in frail and immunosuppressed patients still represents an open challenge, but, starting from the phase 3 PROVENT study, prophylaxis with tixagevimab‐cilgavimab has improved the approach in this category of patients, guaranteeing a better outcome and inferior mortality. Real‐life data in a heterogeneous cohort are few. Methods: The aim of this study is to evaluate the benefit of prophylaxis with tixagevimab‐cilgavimab in a cohort of 202 patients affected by different hematological diseases (lymphoproliferative, myeloproliferative, autoimmune, patients recently receiving a bone marrow transplant), active (with ongoing treatment), or in watch‐and‐wait strategy, followed in our center, during a median follow‐up of 249 (45‐325) days. Results: An incidence of 44 breakthrough infections (21.8%) is reported, with no treatment‐related adverse effects. Age ≥70 years, ongoing treatment (above all with monoclonal antibodies), baseline lymphoproliferative disorders, and prior virus exposure are identified as risk factors related to subsequent infection (p < 0.05). Moreover, the incidence is higher in low/nonresponse to prior vaccination (p =.002). Patients treated with tixagevimab‐cilgavimab had a mild course of the infection and a reduction of the duration compared with preprophylaxis infection (11 vs. 15 days, p <.001). The concurrent treatment with anti‐CD20 monoclonal antibodies and B–non‐Hodgkin lymphoma still confers a higher duration of infection despite prophylaxis. No deaths attributable to the infection occurred. Conclusion: Prophylaxis treatment seems to be a valid and safe strategy, although not preventing breakthrough infection, but the severe complications associated with the infection and the possible delays in administering lifesaving therapies from long positivity. The use of tixagevimab‐cilgavimab improved the management of immunocompromised patients with a high risk of severe SARS‐CoV‐2 disease. In a real‐world setting, it confirmed its role not only in preventing the occurrence of breakthrough infection, but also, above all, avoiding the severe complications associated and reducing the total days of positivity. [ABSTRACT FROM AUTHOR]

Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user‐friendly platform to complete patient‐reported outcome measures (PROMs) on their mobile devices. CRUSE®, the Chronic Urticaria Self Evaluation app, aims to address this unmet need. Methods: CRUSE® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real‐time insights. Additionally, CRUSE® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. Results: CRUSE® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country‐specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second‐generation antihistamines were used in 74.0% of days. Conclusions: The initial data from CRUSE® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management. [ABSTRACT FROM AUTHOR]

Background: Helicobacter species (spp.) have been detected in human bile and hepatobiliary tissue Helicobacter spp. promote gallstone formation and hepatobiliary tumors in laboratory studies, though it remains unclear whether Helicobacter spp. contribute to these cancers in humans. We used a multiplex panel to assess whether seropositivity to Helicobacter (H.) hepaticus or H. bilis proteins was associated with the development of hepatobiliary cancers in the Finnish Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention (ATBC) Study, and US‐based Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Methods: We included 62 biliary and 121 liver cancers, and 190 age‐matched controls from ATBC and 74 biliary and 105 liver cancers, and 364 age‐ and sex‐matched controls from PLCO. Seropositivity to 14 H. hepaticus and H. bilis antigens was measured using a multiplex assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for major hepatobiliary cancer risk factors and Helicobacter pylori serostatus. Results: Seropositivity to the H. bilis antigen, P167D, was associated with more than a twofold higher risk of liver cancer (OR: 2.38; 95% CI: 1.06, 5.36) and seropositivity to the H. hepaticus antigens HH0407 or HH1201, or H. bilis antigen, HRAG 01470 were associated with higher risk of biliary cancer (OR: 5.01; 95% CI: 1.53, 16.40; OR: 2.40; 95% CI: 1.00, 5.76; OR: 3.27; 95% CI: 1.14, 9.34, respectively) within PLCO. No associations for any of the H. hepaticus or H. bilis antigens were noted for liver or biliary cancers within ATBC. Conclusions: Further investigations in cohort studies should examine the role of Helicobacter spp. in the etiology of liver and biliary cancers. [ABSTRACT FROM AUTHOR]

Background: Current pregnancy weight gain guidelines were developed based on implicit assumptions of a small group of experts about the relative seriousness of adverse health outcomes. Therefore, they will not necessarily reflect the values of women. Objective: To estimate the seriousness of 11 maternal and child health outcomes that have been consistently associated with pregnancy weight gain by engaging patients and health professionals. Methods: We collected data using an online panel approach with a modified Delphi structure. We selected a purposeful sample of maternal and child health professionals (n = 84) and women who were pregnant or recently postpartum (patients) (n = 82) in the United States as panellists. We conducted three concurrent panels: professionals only, patients only, and patients and professionals. During a 3‐round online modified Delphi process, participants rated the seriousness of health outcomes (Round 1), reviewed and discussed the initial results (Round 2), and revised their original ratings (Round 3). Panellists assigned seriousness ratings (0, [not serious] to 100 [most serious]) for infant death, stillbirth, preterm birth, gestational diabetes, preeclampsia, small‐for‐gestational‐age (SGA) birth, large‐for‐gestational‐age (LGA) birth, unplanned caesarean delivery, maternal obesity, childhood obesity, and maternal metabolic syndrome. Results: Each panel individually came to a consensus on all seriousness ratings. The final median seriousness ratings combined across all panels were highest for infant death (100), stillbirth (95), preterm birth (80), and preeclampsia (80). Obesity in children, metabolic syndrome in women, obesity in women, and gestational diabetes had median seriousness ratings ranging from 55 to 65. The lowest seriousness ratings were for SGA birth, LGA birth, and unplanned caesarean delivery (30‐40). Conclusion: Professionals and women rate some adverse outcomes as being more serious than others. These ratings can be used to establish the range of pregnancy weight gain associated with the lowest risk of a broad range of maternal and child health outcomes. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including ictal epileptic headache (IEH), migraine, and epilepsy.

A letter to the editor is presented regarding the bilateral anomalous choroidal vessels observed in patients with neurofibromatosis type 1 using the near infrared reflectance (NIR) and enhanced depth imaging-spectral domain optical coherence tomography (EDI-SDOCT).

This research compared personal sunlight exposure times monitored electronically within suburban Australian environments against self‐report paper journals for determining the timing and total duration of individual exposure to daily solar radiation. A total of 90 Electronic Sun Journal (ESJ) daily readings and self‐report timing and duration estimates of exposure for weekend and weekdays were compared. A Wilcoxon ranked sign test showed a significant difference (V = 157, P < 0.001) between the duration of exposure recorded electronically and the duration of exposure that was self‐reported in a diary. There was also found to be a statistically significant difference between total exposure time measured using both methods for weekends (V = 10, P < 0.001) and weekdays (V = 87, P < 0.001). General trends in outdoor exposure timing confirmed that the most frequent daily exposures received over the weekend occurred between 1 and 2 h earlier than the most frequent exposures received on weekdays. This preliminary research found that exposure durations as recorded by the ESJ were longer on the weekends compared to weekdays (W = 402, P < 0.001) and confirmed that the ESJ is a viable alternative to self‐reporting diaries. [ABSTRACT FROM AUTHOR]

Background: The down‐regulation of Connexin 43 (CX43) hemichannels (HCs) function in soft tissue cells promotes the up‐regulation of numerous pro‐healing genes, as the down‐regulation of pro‐fibrotic ones, leading to its identification as a potential target for the modulation of wound healing. On the other hand, titanium is commonly used as a transmucosal material, both for dental implants and abutments, and its surface micro‐topography is known to affect cell responses. Aim/Hypothesis: To investigate whether threaded titanium surfaces with different groove characteristics modulate CX43 expression and its organization in HCs rather than in gap junction (GJs) in an immortalized mouse myoblast cell line. In addition, to verify if the growth pattern and arrangement of cells on the grooves. Material and Methods: Murine myoblasts C2C12 were seeded on discs with grooved titanium surfaces with different patterns‐ UTM (Ultrathin Threaded Microsurface) and XA microgrooved surface. A machined surface was used as control (MA). Titanium surface specimens were kindly provided by Sweden & Martina (Padova, Italy). Cells were cultured up to 7 days and daily monitored for viability through chemiluminescence (cell proliferation). Gene expression analysis for CX43, alkaline phosphatase (ALP) and collagen 1 (COL1a) was performed+ after 3 days of culture total RNA was purified, retro‐transcribed to cDNA and amplified through quantitative RT‐PCR. To localize the expression of CX43 and thus to identify its organization as HCs or as GJs, cells were observed under fluorescence after actin, CX43 and nuclei labeling. Differences among the groups were evaluated through Two‐Way ANOVA statistical test. Results: Very weak signal for CX43 was observed on UTM surface (mRNA 6.12‐fold less than XA and 2.58‐fold less than MA). CX43 expression was extremely up‐regulated on XA surface after 3 days, when compared to UTM and MA surface (_I_P_i_ < 0.0001). Conversely, cell proliferation was significantly reduced (_I_P_i_ < 0.0001). On the XA surface, CX43 expression was labelled in the peri‐nuclear area, indicating its organization in HCs. MA showed a slightly enhanced level of CX43 (2.37‐fold less than XA) and, where cells were confluent, CX43 signal was marked around cell nuclei (HCs) and at the edges of cell profile, indicating GJs with other cells. Noteworthy, the disposition of cells on XA and UTM surfaces followed the grid of the grooved surface topography, with cells laying on the grid hollows and elongated to colonize the surface. Furthermore, gene expression analysis revealed that MA control surface induced a commitment of C2C12 towards an osteoblastic phenotype, showing greater levels of ALP and COL1a. Conclusions and Clinical Implications: The microgrooved titanium surfaces showed a modulatory role on myoblasts, promoting an evident cell arrangement along the surface grooves on UTM and XA surfaces. This may lead in vivo to the deposition of an oriented extracellular matrix. Additionally, UTM surface caused CX43 down‐regulation, leading to the hypothesis of a more favorable in vivo soft tissues wound healing. [ABSTRACT FROM AUTHOR]

Acquired hemophilia should be evaluated in pediatric patients with bleeding and isolated prolonged aPTT. Immunosuppressive treatment should be initiated even in minor bleedings. Bypassing agents like rFVIIa can be used in children with success. [ABSTRACT FROM AUTHOR]

This research presents a novel methodology for deriving the total daily broadband solar UVA (320–400 nm) received by school teachers during their working day from Ozone Monitoring Instrument (OMI) satellite solar noon UVA irradiance measurements for a Queensland subtropical site (27.5°S, 152°E). Daily UVA exposures are weighted to the anatomical human cheek (anterior infra‐orbital region) for teachers wearing and not wearing broad‐brimmed hats. The method utilizes the OMI UVA irradiance data collected daily at high temporal resolution over 2005 to 2016 to derive the total daily UVA exposure to a horizontal plane. These horizontal plane exposures are scaled by factors to take into account the timing of outdoor activity. The relationship between exposures to a horizontal plane and those to a vertical plane and the protection provided by a broad‐brimmed hat was assessed to evaluate the total daily UVA exposures to the cheek for classroom and physical education teaching staff expected to be outside at different periods of the day. The developed method enables the total daily UVA exposure to specific anatomical sites to be evaluated from the satellite solar noon irradiance at locations that do not have access to surface‐based instrumentation capable of recording in the solar UVA waveband. [ABSTRACT FROM AUTHOR]

Most of the Italian infrastructures have been built since the mid‐twentieth century. Prestressed concrete (PC) has been widely used, especially for bridges and viaducts. These structures have proved effective over time, but their performance could be affected by degradation phenomena (i.e., corrosion of the tendons and residual prestressing) or construction defects (i.e., grouting of the ducts), which need to be accurately modeled. This paper focuses on the flexural response of two reduced‐scale, posttensioned, PC bridge girders, prestressed with two different jacking forces and tested under four‐point bending configuration. Four multidimensional numerical models were developed to simulate the experimental behaviors of the selected specimens, using two alternative computational strategies, namely, the finite element method (FEM) and applied element method (AEM). Three FEM modeling were considered, ranging from one‐dimensional lumped‐plasticity models to two‐dimensional and three‐dimensional (3D) spread‐plasticity models. Besides, 3D AEM models were developed into another software package. The accuracy and the computational costs of the two numerical strategies are discussed in this paper. Also, the main features of each numerical modeling technique are addressed, including comparisons between numerical and experimental global response data as well as the statistical characterization of the model error. Based on these different features, the authors also suggest the most suitable numerical strategy for future studies on PC girders. [ABSTRACT FROM AUTHOR]

Background: Kilo‐voltage cone‐beam computed tomography (CBCT) is a prevalent modality used for adaptive radiotherapy (ART) due to its compatibility with linear accelerators and ability to provide online imaging. However, the widely‐used Feldkamp‐Davis‐Kress (FDK) reconstruction algorithm has several limitations, including potential streak aliasing artifacts and elevated noise levels. Iterative reconstruction (IR) techniques, such as total variation (TV) minimization, dictionary‐based methods, and prior information‐based methods, have emerged as viable solutions to address these limitations and improve the quality and applicability of CBCT in ART. Purpose: One of the primary challenges in IR‐based techniques is finding the right balance between minimizing image noise and preserving image resolution. To overcome this challenge, we have developed a new reconstruction technique called high‐resolution CBCT (HRCBCT) that specifically focuses on improving image resolution while reducing noise levels. Methods: The HRCBCT reconstruction technique builds upon the conventional IR approach, incorporating three components: the data fidelity term, the resolution preservation term, and the regularization term. The data fidelity term ensures alignment between reconstructed values and measured projection data, while the resolution preservation term exploits the high resolution of the initial Feldkamp‐Davis‐Kress (FDK) algorithm. The regularization term mitigates noise during the IR process. To enhance convergence and resolution at each iterative stage, we applied Iterative Filtered Backprojection (IFBP) to the data fidelity minimization process. Results: We evaluated the performance of the proposed HRCBCT algorithm using data from two physical phantoms and one head and neck patient. The HRCBCT algorithm outperformed all four different algorithms; FDK, Iterative Filtered Back Projection (IFBP), Compressed Sensing based Iterative Reconstruction (CSIR), and Prior Image Constrained Compressed Sensing (PICCS) methods in terms of resolution and noise reduction for all data sets. Line profiles across three line pairs of resolution revealed that the HRCBCT algorithm delivered the highest distinguishable line pairs compared to the other algorithms. Similarly, the Modulation Transfer Function (MTF) measurements, obtained from the tungsten wire insert on the CatPhan 600 physical phantom, showed a significant improvement with HRCBCT over traditional algorithms. Conclusion: The proposed HRCBCT algorithm offers a promising solution for enhancing CBCT image quality in adaptive radiotherapy settings. By addressing the challenges inherent in traditional IR methods, the algorithm delivers high‐definition CBCT images with improved resolution and reduced noise throughout each iterative step. Implementing the HR CBCT algorithm could significantly impact the accuracy of treatment planning during online adaptive therapy. [ABSTRACT FROM AUTHOR]

Despite the introduction of targeted (BRAFi/MEKi) and immune checkpoint inhibitors (ICIs) has significantly reduced the recurrence rate and improved the overall survival (OS) of patients with Stage III and IV melanoma, only a percentage will benefit of durable disease control. The aim of this study was to examine whether the levels of circulating tumour DNA (ctDNA) in plasma of advanced melanoma patients undergoing BRAFi/MEKi or ICIs vary according to the patients' survival outcomes (i.e. progression‐free survival (PFS) and OS) and disease progression. Plasma samples of Stage III‐IV melanoma patients were collected at baseline (treatment initiation) and thereafter every 3 months. Circulating BRAFV600E/K and NRASQ61R/K mutations were analysed through droplet digital PCR (ddPCR, Bio‐Rad) in a total of 177 plasma samples from 48 melanoma patients (19 Stage III, 29 Stage IV). Baseline ctDNA concentration was significantly associated with OS (HR = 1.003, 95% CI = 1.000–1.006, p = 0.043) and PFS (HR = 1.004, 95% CI = 1.000–1.007, p = 0.029) independent of clinical‐prognostic confounders. For each unit increase in the ∆ctDNA (concentration difference between the last follow‐up and baseline) there was a 24% increased risk of disease progression, irrespective of treatment type and stage at diagnosis (OR = 1.24, 95% CI = 1.03–1.49, p = 0.020, AUC = 0.93). Patients with reduction of ctDNA level from baseline to the last follow‐up had longer OS (HR = 0.14; 95% CI = 0.05–0.44, p = 0.001) and PFS (HR = 0.08; 95% CI = 0.03–0.27, p < 0.0001) compared to patients with increased ctDNA, including adjustment for confounding factors. Our findings suggest that variation of ctDNA over time during melanoma treatment reflects the clinical outcome and tumour response to therapy and might be helpful in clinical monitoring. [ABSTRACT FROM AUTHOR]

The Glossifungites Ichnofacies is a substrate‐controlled ichnofacies that occurs in omission surfaces and has been used in the identification and interpretation of stratigraphic discontinuities. The Early Permian Rio Bonito–Palermo sedimentary succession from the Paraná Basin (southern Brazil) offers an opportunity to discuss the genesis of the omission surfaces demarked by the occurrence of Glossifungites suites. These suites are composed of sharp, unlined burrows with irregular boundaries and passive infill by generally medium‐ to coarse‐grained sandstones. Thalassinoides is the dominant component in the Glossifungites suites in the studied deposits, with local occurrences of Diplocraterion, Gyrolithes, and Skolithos. Based on the ichnological signatures of the distinct Glossifungites suites observed in these deposits and the characteristics of the facies in which they occur, the associated discontinuity surfaces were interpreted as autogenic or allogenic. The morphological distinction between allogenic and autogenic expressions of the Glossifungites Ichnofacies is observed. Glossifungites suites demarking autogenic surfaces are associated with dewatered muddy substrates from the estuarine settings. Glossifungites suites demarking allogenic surfaces are characterized by large vertical burrows and occur in association with a sequence boundary and coplanar surfaces registered in lower shoreface settings. [ABSTRACT FROM AUTHOR]

A case study is presented of a 71-year-old woman presenting with severe lower back pain radiating to her left leg one month after she had undergone surgery to treat colon cancer. It reports that the pain was identified as stemming from metastatic cancer of the bone marrow.

Objective: To evaluate the presence of tau deposition and pathologic features of chronic traumatic encephalopathy (CTE) in young adult patients treated with focal cortical resections for drug‐resistant epilepsy. Methods: Sixty consecutive patients who had undergone surgical treatment for drug‐resistant focal epilepsy between 18 and 45 years of age were identified (2010‐2017). Medical records were reviewed to determine clinical factors, including history of head trauma, age at seizure onset, age at surgical resection, seizure type(s) and frequency, imaging findings, and surgical outcome. All formalin‐fixed, paraffin‐embedded blocks from the surgical specimens from each subject were sectioned and stained with hematoxylin and eosin and antibodies to tau (Thermo Fisher Scientific Clone AT8), and examined blindly for tau pathology, including lesions characteristic of CTE. Results: The median age at resection was 29.5 years (range = 19‐45). A history of head trauma was reported in 19 patients. Although none of the patients had pathological findings characteristic of CTE, 23 patients (38%) demonstrated tau‐immunoreactive lesions, including neurites, neurofibrillary pretangles, neurofibrillary tangles, subpial tau, and/or glial tau. In 4 of the 23 patients (7% of the cohort; 17% of those with tau pathology), substantial tau burden was identified. Three of these 4 patients had no significant history of head trauma; 1 patient had multiple sports‐related concussions. No specific clinical factors correlated with the presence of tau pathology. Significance: Tau‐immunoreactive lesions were found in 38% of 60 patients who underwent a focal cortical resection for drug‐resistant focal epilepsy. Diagnostic features of CTE were not detected in any patient; however, the pathological evaluation for CTE was limited to a surgical specimen. The prominent and excessive tau deposition in 23 patients (38%) is abnormal in this age group and warrants further investigation. [ABSTRACT FROM AUTHOR]

The risk of keratinocyte skin cancer, malignant melanoma and ultraviolet radiation (UVR)‐induced eye disease is disproportionately higher in Australia and New Zealand compared to equivalent northern hemisphere latitudes. While many teachers are aware of the importance of reinforcing sun safety messages to students, many may not be aware of the considerable personal exposure risk while performing outdoor duties in locations experiencing high to extreme ambient UVR year‐round. Personal erythemally effective exposure of classroom teachers in tropical Townsville (19.3°S) was measured to establish seasonal extremes in exposure behavior. Mean daily personal exposure was higher in winter (91.2 J m‐2, 0.91 Standard Erythema Dose [SED]) than summer (63.3 J m−2, 0.63 SED). The range of exposures represents personal exposures that approximate current national guidelines for Australian workers at the study latitude of approximately 1.2 SED (30 J m−2 effective to the International Commission on Non‐Ionizing Radiation Protection). Similar proportions of teachers spent more than 1 h outdoors per day in winter (28.6%) and summer (23.6%) as part of their teaching duties with seasonal differences having little effect on the time of exposure. Personal exposures for teachers peaked during both seasons near school meal break times at 11:00 am and 1:00 pm, respectively. [ABSTRACT FROM AUTHOR]

Skin cancer, the most prevalent cancer in Caucasians residing at low latitudes, can primarily be prevented by avoiding overexposure to sunlight. Serial cross‐sectional observations were conducted at an outdoor motorsport event held in Townsville, Queensland each July (Southern winter) to determine whether sun‐protection habits changed over time. Most (71.1%) of the 1337 attendees observed (97.6% lightly pigmented skin, 64.0% male) wore a hat (any style shading the face), while few (18.5%) wore three‐quarter or full‐length sleeves. While hat‐wearing rates (any style) were similar in 2009 (326, 72.6%) and 2013 (625, 70.4%), the use of sun‐protective styles (wide‐brimmed/bucket/legionnaires) decreased from 29.2% to 18.6% over the same period, primarily because the use of sun‐protective hats halved (from 28.7% to 14.0%) among females, while decreasing from 29.4% to 21.1% in males. Although relatively few individuals wore sun‐protective (three‐quarter‐length or full‐length) sleeves regardless of year (OR = 0.117, P < 0.0001), encouragingly, the use of sun‐protective sleeves more than doubled between 2009 (10.5%) and 2013 (22.5%). Interestingly females, albeit the minority, at this sporting event were less likely to wear a hat (OR = 0.473, P < 0.0001) than males. These findings highlight the need for continued momentum toward skin cancer primary prevention through sun protection with a dedicated focus on outdoor sporting settings. [ABSTRACT FROM AUTHOR]

Copper indium disulfide nanoparticles continue attracting attention as absorber material in light harvesting devices. The preparation of thin films by deposition of this material from colloidal solution remains challenging. Typically, colloidal semiconductor nanoparticles are surrounded by long organic ligand molecules which are required to stabilize the particles during synthesis. A common way to obtain conductive thin films is the development of ligand exchange procedures that need to be applied prior to film deposition. However, in the case of copper indium disulfide nanoparticles, appropriate procedures are still missing. Therefore, an alternative approach is investigated herein. Colloidal copper indium disulfide nanoparticles are synthesized and deposited on substrates. Instead of applying a ligand exchange procedure, thermal removal of the ligands and sintering of the inorganic film are explored. Results on the preparation of the nanoparticle films, their structural investigation, and conductivity measurements are reported. [ABSTRACT FROM AUTHOR]

Background: Survivors of primary malignant musculoskeletal tumors often face long‐term disability. Clinicians at present are unable to provide evidence‐based advice about returning to sports, which is important for active patients. Purposes: Identify patients returning to sports.Describe the sporting activities in which patients participate.Identify the outcome measures used to assess return to sport.Identify barriers preventing return to sports. Study design: Systematic review. Methods: A comprehensive search strategy was used to identify relevant studies combining the following concepts: (1) Bone/Soft tissue tumor, (2) Lower limb, (3) Surgical interventions, and (4) Sports. Studies were selected according to eligibility criteria with the consensus of three authors (MTB, FS, and CG). Results: Twenty‐two studies were selected, published between 1985 and 2020, including 1005 patients. Fifteen of the 22 studies had valid data on return to sports, with 705 participants, of which 412 (58.4%) returned to some form of sport such as swimming and cycling, at a mean follow‐up period of 7.6 years. Four studies directly compared limb sparing surgery and amputation; none of these were able to identify a difference in sports participation or ability. Conclusion: There is insufficient published research to provide guidance for patients with respect to return to sports following musculoskeletal tumors. Future prospective studies are needed to collect better pre‐ and post‐treatment data at multiple time intervals. Validated clinical and patient sports participation outcomes such as type of sports, level, frequency, and validated sports‐specific outcome scores should be recorded. In particular, more comparison between limb sparing surgery and amputation would be welcome. [ABSTRACT FROM AUTHOR]

Aggressive SM + AML has limited therapeutic options. Even a strong combination of decitabine–venetoclax–midostaurin has a transient effect on AML and a mitigated effect on SM. Larger series are required to identify the best therapeutic strategy. [ABSTRACT FROM AUTHOR]

Objectives: Polyethylene glycol (PEG) split‐dose regimen is recommended as the option of choice for colon preparation before colonoscopy in children and adults. Sodium picosulfate plus magnesium citrate (SPMC) is equally effective but better tolerated than PEG for bowel preparation before colonoscopy in children. The aim of this study was to assess the superiority of SPMC split‐dose regimen compared with SPMC day‐before regimen for bowel cleansing before colonoscopy in children. Methods: This was a multicenter, randomized, single‐blind study. Pediatric inpatients undergoing colonoscopy received SPMC either in the day‐before dosing or in split dosing. Overall bowel cleansing was assessed using the Boston Bowel Preparation Scale (BBPS) and was rated as successful when BBPS was ≥6. Patient tolerability, acceptability, and compliance were recorded. Results: The rate of successful cleansing level was significantly higher in the split‐dose group than in the day‐before group (P < 0.001). The BBPS scores were significantly higher in the split‐dose group than in the day‐before group for the whole colon (P < 0.001), the right colon (P < 0.001) and transverse colon (P < 0.001). Patient acceptability was better in the split‐dose group (P = 0.0003; P = 0.005). The percentage of children needing nasogastric tube placement was better in the split‐dose group (P = 0.007). Conclusions: The split‐dose regimen of SPMC was superior to the day‐before regimen in terms of successful colon cleansing and acceptability. [ABSTRACT FROM AUTHOR]

Current shading strategies used to protect outdoor playgrounds from harmful solar radiation include the placement of artificial cloth weaves or permanent roofing over a playground site, planting trees in proximity to playground equipment, and using vegetation or surface texture variations to cool playground surfaces. How and where an artificial shade structure is placed or a tree is planted to maximize the shade protection over specific playground areas, requires careful assessment of local seasonal sun exposure patterns. The Playground Shade Index (PSI) is introduced here as a design metric to enable shade and solar ultraviolet exposure patterns to be derived in an outdoor space using conventional aerial views of suburban park maps. The implementation of the PSI is demonstrated by incorporating a machine learning design tool to classify the position of trees from an aerial image, thus enabling the mapping of seasonal shade and ultraviolet exposure patterns within an existing 7180 m2 parkland. This is achieved by modeling the relative position of the sun with respect to nearby buildings, shade structures, and the identified evergreen and deciduous tree species surrounding an outdoor playground. [ABSTRACT FROM AUTHOR]

Riboflavin (Rf) is an endogenous photosensitizer, which can participate in Type I and Type II processes. We have recently shown that the yield of the triplet excited states of Rf is enhanced in the presence of pectin‐coated silver nanoparticles (Pec@AgNP) due to formation of a complex between Rf and Pec@AgNP (Rf‐Pec@AgNP). Consequently, under aerobic conditions, the amounts of singlet molecular oxygen and superoxide radical anion generated are also larger in the presence of the nanoparticles. This result made us suspect that the nanoparticles could have a beneficial effect in Rf‐based PDT. To prove this hypothesis, we here compared the photodamage in HeLa cells incubated with Rf in the presence and in the absence of Pec@AgNP applying several optical assays. We used fluorescence imaging of irradiated HeLa cells incubated with Annexin V and propidium iodide to evaluate the occurrence of apoptosis/necrosis, the reduction of the tetrazolium dye MTT to formazan and neutral red uptake to prove cell viability, as well as synchrotron infrared microscopy of single cells to evaluate possible structural changes of DNA and nuclear proteins. The enhanced photodamage observed in the presence of Pec@AgNP seems to indicate that Rf enters into the cells complexed with the nanoparticles. Here, we employ pectin‐coated silver nanoparticles to enhance the photodamage produced by Riboflavin in HeLa cells. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article related to ictal epileptic tachycardia and bradycardia by Pasquale Parisi in a previous issue.

A letter to the editor is presented in response to the article "Migralepsy: A call for revision of the definition."

A letter to the editor is presented in response to an article related to interictal epileptic discharges by C. A. Tassinari and colleagues.

A letter to the editor is presented in response to the article "Vigabatrin and epilepsy: lesson learned," by J.M. Wild and colleagues that was published in an issue of the "Epilepsia" periodical in 2007.

Discusses emerging trends in connectionist models of development. Reliance of the modelson the backpropagation-of-error learning algorithm; Reasons behind the success of backprop nets.

We present observations of Uranus in northern spring with the Very Large Array from 0.7 to 5 cm. These observations reveal details in thermal emission from Uranus' north pole at 10s of bars, including a dark collar near 80°N and a bright spot at the polar center. The bright central spot resembles observations of polar emission on Saturn and Neptune at shallower pressures. We constrain the variations in temperature and NH3/H2S abundances which could explain these features. We find that the brightness temperature of the polar spot can be recreated through 5 K temperature gradients and/or 10× depletion of NH3 or H2S vapor between 10 and 20 bars, both consistent with the presence of a cyclonic polar vortex. The contrast of the polar spot may have increased since 2015, which would suggest seasonal evolution of Uranus' polar circulation at depth. Plain Language Summary: New radio telescope observations of Uranus several interesting features, including a compact feature at the center of the North Pole which appears warmer than its surroundings. This feature likely indicates the presence of a polar cyclone and shows similarities to polar features observed on other giant planets in the solar system. Key Points: Very Large Array observations in 2021 and 2022 reveal a bright, compact spot centered at Uranus' pole at several wavelengthsConstraints on horizontal temperature and composition gradients necessary to explain the polar emission structure are derivedInferred patterns in temperature, zonal wind speed and trace gas variations are consistent with the presence of a compact cyclonic vortex [ABSTRACT FROM AUTHOR]

Background: In older patients with acute myeloid leukemia (AML), the definition of fitness, prognosis, and risk of death represents an open question. Methods: In the present study, we tested the impact on survival of disease-and patient-related parameters in a large cohort of elderly AML patients homogeneously assigned to treatment with hypomethylating agents (HMAs). Results: In 131 patients with a median age of 76 years, we confirmed that early response (<0.001) and biology-based risk classification (p = 0.003) can select patients with better-predicted survival. However, a full disease-oriented model had limitations in stratifying our patients, prompting us to investigate the impact of baseline comorbidities on overall survival basing on a comorbidity score. The albumin level (p = 0.001) and the presence of lung disease (p = 0.013) had a single-variable impact on prognosis. The baseline comorbidity burden was a powerful predictor of patients' frailty, correlating with increased incidence of adverse events, especially infections, and predicted overall survival (p < 0.001). Conclusion: The comorbidity burden may contribute to impact prognosis in addition to disease biology. While the therapeutic armamentarium of elderly AML is improving, a comprehensive approach that combines AML biology with tailored interventions to patients' frailty is likely to fully exploit the anti-leukemia potential of novel drugs. [ABSTRACT FROM AUTHOR]

Introduction: The assessment of the ventricular myocardial substrate critically depends on the size of mapping electrodes, their orientation with respect to wavefront propagation, and interelectrode distance. We conducted a dual‐center study to evaluate the impact of microelectrode mapping in patients undergoing catheter ablation (CA) of ventricular tachycardia (VT). Methods: We included 21 consecutive patients (median age, 68 [12], 95% male) with structural heart disease undergoing CA for electrical storm (n = 14) or recurrent VT (n = 7) using the QDOT Micro catheter and a multipolar catheter (PentaRay, n = 9). The associations of peak‐to‐peak maximum standard bipolar (BVc) and minibipolar (PentaRay, BVp) with microbipolar (BVμMax) voltages were respectively tested in sinus rhythm with mixed effect models. Furthermore, we compared the features of standard bipolar (BE) and microbipolar (μBE) electrograms in sinus rhythm at sites of termination with radiofrequency energy. Results: BVμMax was moderately associated with both BVc (β =.85, p <.01) and BVp (β =.56, p <.01). BVμMax was 0.98 (95% CI: 0.93−1.04, p <.01) mV larger than corresponding BVc, and 0.27 (95% CI: 0.16−0.37, p <.01) mV larger than matching BVp in sinus rhythm, with higher percentage differences in low voltage regions, leading to smaller endocardial dense scar (2.3 [2.7] vs. 12.1 [17] cm2, p <.01) and border zone (3.2 [7.4] vs. 4.8 [20.1] cm2, p =.03) regions in microbipolar maps compared to standard bipolar maps. Late potentials areas were nonsignificantly greater in microelectrode maps, compared to standard electrode maps. At sites of VT termination (n = 14), μBE were of higher amplitude (0.9 [0.8] vs. 0.4 [0.2] mV, p <.01), longer duration (117 [66] vs. 74 [38] ms, p <.01), and with greater number of peaks (4 [2] vs. 2 [1], p <.01) in sinus rhythm compared to BE. Conclusion: microelectrode mapping is more sensitive than standard bipolar mapping in the identification of viable myocytes in SR, and may facilitate recognition of targets for CA. [ABSTRACT FROM AUTHOR]

An abstract of the article "Feasibility and sonographic follow-up of barbed suture in laparoscopic myomectomy" by F. Leone and others is presented.

An abstract of the article "Reproducibility of 3D-transvaginal sonography by VCI analysis to differentiate endometrial polyp and hyperplasia in pre-menopausal women" by F. Leone and colleagues is presented.

Heart transplantation on the first day of life, and graft harvesting from anencephalic donors, have been very rare events in the history of transplantation. At Bambino Gesù Hospital (Rome), heart transplantation was performed on a newborn 9 h after birth, using a graft harvested from an anencephalic donor. This graft achieved a good cardiocirculatory function, but the recipient died of necrotizing enterocolitis (NEC) on post‐operative day (POD) 10. Despite failure, this case and other reports support the concept that hearts from anencephalic donors can work normally, and indicate that heart transplantation on the first day of life may have a favorable outcome if postoperative maintenance of multi‐organ balance and function is successful. [ABSTRACT FROM AUTHOR]

Hemoglobinopathies are the most common autosomal recessive disorders and are mostly inherited in a recessive manner. However, certain mutations can affect the globin chain stability, leading to dominant forms of thalassemia. The aim of this work was the molecular and structural characterization of two heterozygous in-frame deletions, leading to ß-globin variants in pediatric patients in Argentina. The HBB gene of the probands and their parents was sequenced, and other markers of globin chain imbalance were analyzed. Several structural analyses were performed, and the effect of the mutations on the globin chain stability was analyzed. In Hb JC-Paz, HBB:c.29_37delCTGCCGTTA (p.Ala10_Thr12del), detected in an Argentinean boy, one α-helix turn is expected to be lost. In Hb Tavapy, HBB:c.182_187delTGAAGG (p.Val60_Lys61del), the deleted residues are close to distal histidine (His63) in the heme pocket. Both mutations are predicted to have a destabilizing effect. The development of computational structural models and bioinformatics algorithms is expected to become a useful tool to understand the impact of the mutations leading to dominant thalassemia. [ABSTRACT FROM AUTHOR]

Abstract: BACKGROUND: Increasing attention is being paid to non‐destructive methods for water status real time monitoring as a potential solution to replace the tedious conventional techniques which are time consuming and not easy to perform directly in the field. The objective of this study was to test the potential effectiveness of two portable optical devices (visible/near infrared (vis/NIR) and near infrared (NIR) spectrophotometers) for the rapid and non‐destructive evaluation of the water status of grapevine leaves. Moreover, a variable selection methodology was proposed to determine a set of candidate variables for the prediction of water potential (Ψ, MPa) related to leaf water status in view of a simplified optical device. RESULTS: The statistics of the partial least square (PLS) models showed in validation R2 between 0.67 and 0.77 for models arising from vis/NIR spectra, and R2 ranged from 0.77 to 0.85 for the NIR region. The overall performance of the multiple linear regression (MLR) models from selected wavelengths was slightly worse than that of the PLS models. Regarding the NIR range, acceptable MLR models were obtained only using 14 effective variables (R2 range 0.63–0.69). CONCLUSION: To address the market demand for portable optical devices and heading towards the trend of miniaturization and low cost of the devices, individual wavelengths could be useful for the design of a simplified and low‐cost handheld system providing useful information for better irrigation scheduling. © 2017 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Abstract: Background: Since 1988, numerous allergen immunotherapy guidelines (AIT‐GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. Objective: To evaluate AIT‐GLs with AGREE‐II, developed in 2010 by McMaster University methodologists to comprehensively evaluate GL quality. Methods: Allergist, from different continents, knowledgeable in AIT and AGREE‐II trained were selected into the project team. The project received methodologists’ guidance. AIT‐GLs in any language were sought from 1980 to 2016; AIT‐GLs were AGREE II‐evaluated by at least 2 team members, independently; discrepancies were resolved in a second round, by team discussion or methodologists’ consulting. Results: We found 31 AIT‐GLs (15 post‐2010), ranging from local consensus reports to international position papers (EAACI, AAAAI‐ACAAI, WAO). Pre‐2010 GLs scored 1.6‐4.6 (23%‐67%) and post‐2010 GLs scored 2.1‐6 (30%‐86%), on a 7‐point Likert scale. The highest scores went to: German‐Austrian‐Swiss (6.0), Mexican (5.1), and the AAAAI/ACAAI AIT‐GL (4.7). These were also the only 3 GLs that received “yes” of both evaluators to the item: “I would recommend this GL for use.” The domains of “Stakeholder involvement” and “Rigor of Development” only scored 3/7, and “Applicability” scored the lowest. Strikingly, newer GLs only scored clearly better in “Editorial independence” and “Global evaluation.” Conclusions: In AIT‐GLs, there is still a lot of room for improvement, especially in domains crucial for the dissemination. For some GLs, the “Scientific rigor” domain flawed. When resources are limited, transculturizing a high‐quality GL might be preferable over developing a GL from zero. Our study and AGREE‐II could help to select the best candidate. Clinical Implications: We here evaluate allergen immunotherapy guideline (AIT‐GL) quality. Only high‐quality AIT‐GLs should be consulted for AIT management decisions. In low‐resource settings, transculturization of these is preferred over developing low‐quality guidelines. [ABSTRACT FROM AUTHOR]

Prompt and efficient responses against natural hazards are needed to build cities capable of withstanding disasters, namely resilient cities. This study aims at presenting and testing synthetic resilience indices over a real urban center threatened by multiple hazards, for which a global overview of city performance is requested. An integrated framework is proposed for quantitative resilience assessment by way of time-independent synthetic indices. The approach proposed is in accordance to the complex network theory and uses a global indicator of the system connectivity to assess the city functioning also in case of network disruption. Resilience is evaluated as a proxy for systemic urban damage by modeling a city ecosystem as a hybrid social-physical network. Seismic and landslide scenario analyses are performed for the city of Sarno, Italy. A probability-based approach is used to compute urban vulnerability. Subsequently, to highlight changes in results according to the type of disaster, a recovery strategy is simulated to assess efficiency and damage states in each recovery stage, and urban resilience. [ABSTRACT FROM AUTHOR]

BACKGROUND: Consumer interest in safeguarding animal welfare and increased demand for fresh aquatic products support the need to understand the effects of stunning methods used in aquaculture on the biochemical process affecting fish fillet quality. The present paper aimed at comparing electrical stunning (ES) and cold shock (ICE) in Salmo carpio, an Italian endemic under‐investigated species. Rigor mortis evolution, fillet adenosine 5′‐triphosphate (ATP), shape, colour, pH and water holding capacity were assessed by integrating chemical and image analyses. RESULTS: Seventy‐two fish (24 fish per treatment) were stunned by ES, ICE or anaesthesia (AN, used as control), then percussively slaughtered. ES and ICE hastened rigor mortis onset and resolution (21 and 28 h post mortem) compared to AN. This was confirmed by the faster ATP degradation in ES and ICE. Fillet shape features varied during rigor mortis, according to the stunning method, with the perimeter showing irreversible variation in ES and ICE groups. Initial circularity was recovered only in AN, while ICE and ES fillets showed significantly different values, between 0 and 192 h. CONCLUSION: ES is a promising stunning technique for S. carpio, but parameters should be optimized, because of the adverse effect on muscle activity which caused a fast pH drop, and the presence of blood spots in the fillets. Further studies are needed to understand whether fillet shape changes can interfere with filleting or fillet processing and consumer appreciation. © 2022 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Thirty-one patients (75%) received anthracycline/etoposide-based therapy (9 out of 31 were I IDH2 i SP I R172 i sp mutated) and 4 of them (4/31, 13%) were consolidated with autologous stem-cell transplantation (ASCT) in first complete remission (CR1); ASCT recipients were all I IDH2 i SP I WT i sp . Patients with I IDH2 i SP I WT i sp AITL achieved CR1 in 14/32 (44%), as opposed to 9/10 (90%) of I IDH2 i SP I R172 i sp patients ( I p i = .018). Thirty-two patients (32/42, 76%) were I IDH2 i SP I WT i sp , and 10 patients (10/42, 24%) were I IDH2 i SP I R172 i sp mutated. [Extracted from the article]

A 5‐year‐old spayed female American Staffordshire was referred for weakness, reluctance to move and distension of the abdomen. Three weeks before, the dog underwent surgery for excision of a nodular mass suspected to be a non‐epitheliotropic cutaneous T‐cell lymphoma (NE‐CTCL). Computed tomography revealed heterogeneous enhancing mesenteric masses and nodular lesions of soft tissue density, and infiltration of the abdominal muscular wall. Moreover, a pattern of diffuse muscle nodules in the skeletal muscles was visible, with lesions showing homogenous, heterogeneous or ring enhancement. Necrosis was histologically observed and these lesions were infiltrated by CD3‐positive and CD20‐, CD79a‐ and Iba1‐negative neoplastic lymphocytes. On the basis of the immunopathological features metastatic NE‐CTCL was suspected. Skeletal muscle metastasis has been rarely reported in small animals and this case report further confirms that this possibility should be considered in dogs with lymphoma. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to explore the gene expression profile of primary central nervous system vasculitis (PCNSV). Methods: Brain specimens of 4 patients with granulomatous vasculitis (GV), 5 with lymphocytic vasculitis (LV), 4 with amyloid β‐related angiitis (ABRA), and 4 normal controls were studied. RNA‐sequencing was performed using the Illumina Hiseq‐4,000 platform and the Illumina TruSeq Total‐RNA library. Student t test and false discovery rate tests were performed for each of the differentially expressed transcripts. Ingenuity Pathway Analysis was used for the pathway expression analysis. CIBERSORT was used to estimate the abundances of different immune cell subsets in the tissues based on gene expression data. Results: Transcripts differentially expressed between PCNSV and normal brain indicated that endosomal, mitochondrial, and ribosome dysfunction, alterations in protein synthesis, and noncoding RNAs might be involved in PCNSV. Pathway analysis revealed the activation of dendritic cell maturation and antigen processing as well as neuroinflammation in PCNSV versus normal brain, whereas oxidative phosphorylation was inhibited. CIBERSORT estimation of immune cell subsets suggested that activated NK cells, M1 macrophages, memory B cells, and follicular helper T cells were likely to be more prevalent in PCNSV samples. Naïve CD4 T cells and monocytes were mainly estimated to be present in GV and ABRA. Plasma cell and γδ T‐cell signatures were mainly found in LV and normal brain. GV showed higher levels of genes associated with macrophage activities and T cells. ABRA showed higher levels of long noncoding RNAs and miR‐616. LV showed higher levels of genes encoding immunoglobulins. Interpretation: RNA sequencing confirmed PCNSV heterogeneity. ANN NEUROL 2023;93:120–130 [ABSTRACT FROM AUTHOR]

The article discusses the Global burdens of disease and health disparities is apparent and has incorporated into medical education through didactics and discussion. The New York Institute of Technology Center for Global Health (NYIT CGH) simulation program is an effective tool for training health care professionals and its aim is to prepare participants for cultural encounters. The 5 sets of competencies program was highlighted.