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Objective: To evaluate the effectiveness of a sexual rehabilitation program, SEXHAB, in improving sexual functioning, reducing sexual distress, and enhancing marital satisfaction for women after gynecological cancer treatment. Methods: This is a randomized controlled trial that included 150 women newly diagnosed with gynecological cancer from three public hospitals in Hong Kong. Participants were randomly assigned to the intervention group (n = 78) to receive the SEXHAB or to an attention control group (n = 72) to receive attention. The SEXHAB comprises four individual‐ or couple‐based sessions with three major components: information provision, cognitive‐behavioral therapy and counseling using motivational interviewing skills. The outcomes were measured at baseline (T0), upon completion of the program (T1) and 12‐month post‐treatment (T2). Semi‐structured interviews were also conducted with the SEXHAB group participants to explore their experiences with and opinions toward the program. Results: At both follow‐ups, there were no statistically significant differences between groups in improving sexual functioning, sexual distress and marital satisfaction. Nevertheless, participants in the SEXHAB group reported their partners having significantly greater sexual interest at T1 (76% vs. 52%, rate ratio: 1.46, 95% CI: 1.07 to 1.99, p = 0.024) and T2 (74% vs. 48%, rate ratio: 1.55, 95% CI: 1.11 to 2.10, p = 0.014). From the qualitative interviews, the interviewees who resumed sexual activity reported positive experiences in rebuilding sexuality and intimacy. Conclusions: Despite the quantitative results are negative, the qualitative findings suggest potential benefits of the SEXHAB for women resuming sexual activities after treatment for gynecological cancer. Further studies with longer intervention period and follow‐ups are needed to confirm the intervention effects. [ABSTRACT FROM AUTHOR]

Objectives: There is relatively scarce data regarding the association between primary hyperparathyroidism (PHPT) and incident diabetes in large population‐based longitudinal studies. We aimed to evaluate the risk of incident diabetes in individuals with and without PHPT and investigate the association between serum calcium concentrations and the risk of incident diabetes in patients with PHPT. Methods: We included 2749 PHPT patients and 13,745 age, sex and index year matched non‐PHPT individuals during 2000–2019. We used Cox regression models to compare the risk of incident diabetes in individuals with and without PHPT, and the risk of incident diabetes in PHPT patients with serum calcium concentration above and below the median value. The association between serum calcium concentrations and the risk of incident diabetes was examined by restricted cubic spline analyses in patients with PHPT. Results: During a median follow‐up time of 5.17 years (IQR 2.17, 9.58), 433 patients (15.75%) with PHPT and 2110 individuals (15.35%) without PHPT developed diabetes, respectively. Patients with PHPT had a higher incidence rate of diabetes compared to non‐PHPT individuals (27.60 [95% CI 25.00, 30.30] vs. 23.90 [95% CI 22.80, 24.90] per 1000 person‐years, log‐rank test p =.007]. Crude Cox regression model showed PHPT was associated with a 15% higher risk of incident diabetes (HR 1.15, 95%CI 1.04, 1.28). In patients with PHPT, a 44% higher risk of incident diabetes was found in patients with serum calcium concentrations above the median value (2.63 mmol/L), compared to those below the median value (HR 1.44, 95%CI 1.08, 1.90). Restricted cubic spline analyses confirmed a positive linear association between serum calcium concentrations and the risk of incident diabetes in those with PHPT (p‐value for nonlinear =.751) Conclusions: Patients with PHPT had a higher risk of incident diabetes compared to non‐PHPT individuals. A positive linear association was found between serum calcium concentrations and the risk of incident diabetes in patients with PHPT. [ABSTRACT FROM AUTHOR]

The article discusses a new antibody called SM17 that targets IL-17RB and its potential in treating atopic dermatitis (AD). The study found that SM17 could inhibit the release of Th2 cytokines and suppress the proliferation of ILC2 and Th2 cells. In a mouse model of AD, SM17 demonstrated beneficial effects in reducing skin inflammation, epidermal hyperplasia, and eosinophil infiltration. The study suggests that SM17 may be a promising treatment option for AD with enhanced therapeutic effects and a superior safety profile compared to current treatments. [Extracted from the article]

Background Methods Results Conclusion Current guidelines recommend adrenal venous sampling (AVS) for subtyping primary aldosteronism (PA). However, bilateral adrenal cannulation failure is common especially at low‐volume centers. The role of unilateral‐cannulating AVS in selecting patients for unilateral adrenalectomy is unclear.Fifty consecutive patients underwent AVS between 2009 and 2023 and thirty‐three (66%) underwent unilateral adrenalectomy. We defined unilateral PA (uPA) by the normalized plasma aldosterone and the aldosterone–renin ratio following unilateral adrenalectomy. We examined the effectiveness of unilateral‐cannulating AVS in identifying uPA.88%, 50%, and 48% of patients had the left, right, and bilateral adrenal veins successfully cannulated, respectively. Among patients with bilateral successful cannulation, a lateralization index (LI) > 4 provided a sensitivity of 100% and a positive predictive value (PPV) of 86.7% for uPA. Thresholds for the contralateral suppression index (CSI) and relative aldosterone secretion index (RASI) were derived from this subgroup and applied to the entire cohort. CSI <0.5 demonstrated a sensitivity of 76.5% and PPV of 92.9% for uPA, whereas RASI >2.4 showed a sensitivity of 85.0% and PPV of 94.4% for uPA. With CSI <0.5 or RASI >2.4 combined, a higher PPV (95.5%) was achieved when compared to computed tomography and iodocholesterol scintigraphy (86.2% and 62.5%, respectively).Despite unsuccessful bilateral cannulation, our study confirms that unilateral‐cannulating AVS can effectively select patients for unilateral adrenalectomy based on a combination of CSI or RASI criteria. [ABSTRACT FROM AUTHOR]

The large scale deployment of modern wind turbines and the yearly increase of installed capacity have drawn attention to their operation and maintenance issues. The development of highly reliable and low‐maintenance wind turbines is an urgent demand in order to achieve the low‐carbon goals, and the arrival of fault diagnosis provides assurance for its satisfactory operation and maintenance. Numerous statistical studies have pointed out that generator failures are a main cause of wind turbine system downtime. The generator, as one of the core components, converts rotating mechanical energy into electrical energy. However, the generators can hardly operate reliably towards the end of the turbine life owing to the variable‐speed conditions and harsh electromagnetic environments. This article first provides a comprehensive and up‐to‐date review of the electrical and mechanical failures of various parts (stator, rotor, air gap and bearings) of the generator. Then the fault characteristics and diagnostic processes of generators are investigated, and the principles and processes of fault diagnosis are discussed. Finally, the application of four categories of model‐based, signal‐based, knowledge‐based and hybrid approaches to wind turbine generator fault diagnosis is summarized. The comprehensive review shows that the hybrid approach is now the leading and most accurate tool for real‐time fault diagnosis for wind turbine generators. A qualitative and quantitative assessment of algorithm performance using false alarm rates is proposed. The methodology can subsequently be applied to the wind industry. [ABSTRACT FROM AUTHOR]

The article discusses the establishment of the Cardiovascular Health Leadership Research Forum (CV HLRF) in Australia to address the high burden of cardiovascular disease (CVD) and stroke. The forum aims to connect health leaders, clinicians, researchers, and industry partners to drive new preventive and therapeutic strategies. By harmonizing data and clinical quality indicators, the CV HLRF seeks to identify and address health challenges, particularly focusing on improving outcomes for diverse populations. The forum also aims to influence policy, practice, and resource allocation by aligning research priorities with national health challenges and leveraging partnerships for impactful research and innovation. [Extracted from the article]

Background: Promoting options for aging in place (AIP) has broad appeal to policymakers and professionals providing services to persons living with dementia (PWD). However, the benefits or burdens of AIP likely vary among individuals and families. We sought to describe factors influencing decision‐making to age in place versus seek a higher level of residential care for PWD. Methods: A qualitative study was undertaken as part of a larger mixed‐methods study utilizing semi‐structured interviews with PWD, family care partners, and dementia clinicians. Interview transcripts were analyzed using qualitative content analysis with constant comparison. Sample size was determined by thematic saturation within subgroups. Results: We conducted 74 interviews among 14 PWD, 36 care partners, and 24 clinicians. Preferences for AIP were driven by (1) desire to preserve independence, (2) a sense that the "best care" is delivered by loved ones and in a familiar environment, (3) distrust and fear of care facilities, and (4) caregiver guilt. PWD and care partners frequently considered moving from home as a "last resort" and wanted to avoid planning for future care needs. Many decisions to move were reactive and triggered by patient safety events, physical dependency, or the loss of caregiver. Proactive decision‐making was facilitated by (1) prior experience witnessing the challenges of caring for a person with advanced dementia in the home; and (2) having substantial financial resources such that participants could seek major home adaptations or avoid "lower quality" institutions. Conclusions: Decisions regarding care setting for PWD frequently do not feel like a choice and are made under imperfect conditions. Programs using AIP as an outcome measure should recognize the various patient‐centered and non‐patient‐centered factors that influence such choices, and interventions should be designed to promote more informed and equitable decision‐making for care setting in dementia. [ABSTRACT FROM AUTHOR]

Chronic pelvic pain (CPP) is the primary symptom of endometriosis patients, but adequate treatments are lacking. Modulation of ion channels expressed by sensory nerves innervating the viscera has shown promise for the treatment of irritable bowel syndrome and overactive bladder. However, similar approaches for endometriosis‐associated CPP remain underdeveloped. Here, we examined the role of the voltage‐gated sodium (NaV) channel NaV1.7 in (i) the sensitivity of vagina‐innervating sensory afferents and investigated whether (ii) NaV1.7 inhibition reduces nociceptive signals from the vagina and (iii) ameliorates endometriosis‐associated CPP. The mechanical responsiveness of vagina‐innervating sensory afferents was assessed with ex vivo single‐unit recording preparations. Pain evoked by vaginal distension (VD) was quantified by the visceromotor response (VMR) in vivo. In control mice, pharmacological activation of NaV1.7 with OD1 sensitised vagina‐innervating pelvic afferents to mechanical stimuli. Using a syngeneic mouse model of endometriosis, we established that endometriosis sensitised vagina‐innervating pelvic afferents to mechanical stimuli. The highly selective NaV1.7 inhibitor Tsp1a revealed that this afferent hypersensitivity occurred in a NaV1.7‐dependent manner. Moreover, in vivo intra‐vaginal treatment with Tsp1a reduced the exaggerated VMRs to VD which is characteristic of mice with endometriosis. Conversely, Tsp1a did not alter ex vivo afferent mechanosensitivity nor in vivo VMRs to VD in Sham control mice. Collectively, these findings suggest that NaV1.7 plays a crucial role in endometriosis‐induced vaginal hyperalgesia. Importantly, NaV1.7 inhibition selectively alleviated endometriosis‐associated CPP without the loss of normal sensation, suggesting that selective targeting of NaV1.7 could improve the quality of life of women with endometriosis. [ABSTRACT FROM AUTHOR]

Respirable crystalline silica (RCS) poses significant health risks in workplaces, including underground coal mines, metal and nonmetal mining, construction sites, fire suppression, and oil and gas industries. Raman spectroscopy offers a promising avenue for direct analysis of RCS on sample filters with minimal pretreatment. However, the presence of organic compounds (OC) in the samples can generate fluorescence signals that interfere with RCS measurements, potentially saturating the detector even at short integration times, particularly when using portable Raman instruments. This study explores a novel approach to address these challenges by functionalizing filters with a hydroxyapatite/silver bromide/titanium dioxide (HAT) photocatalyst, facilitating the oxidation and removal of OC using the Raman excitation laser. Photocatalytic degradation experiments conducted on polyvinyl chloride (PVC) filters preloaded with HAT and anatase titanium dioxide (TiO2) particles demonstrated that HAT significantly enhances the degradation of OC, such as oxalic acid, under visible light irradiation compared to TiO2. Additionally, fluorescence interferences were reduced for coal dust samples analyzed on functionalized silver filters using a portable Raman instrument. The efficacy of HAT in OC photocatalytic degradation on silver filters was further confirmed using a benchtop micro‐Raman system. Filter functionalization had minimal impact on filtration efficiencies and pressure drops, indicating the feasibility of this approach for improving RCS analysis while maintaining filter performance. [ABSTRACT FROM AUTHOR]

Objective: The objective was to develop consensus treatment plans (CTPs) for patients with refractory moderately severe juvenile dermatomyositis (JDM) treated with biologic disease‐modifying antirheumatic drugs (bDMARDs). Methods: The Biologics Workgroup of the Childhood Arthritis and Rheumatology Research Alliance JDM Research Committee used case‐based surveys, consensus framework, and nominal group technique to produce bDMARD CTPs for patients with refractory moderately severe JDM. Results: Four bDMARD CTPs were proposed: tumor necrosis factor α (TNFα) inhibitor (adalimumab or infliximab), abatacept, rituximab, and tocilizumab. Each CTP has different options for dosing and/or route. Among 76 respondents, consensus was achieved for the proposed CTPs (93% [67 of 72]) as well as for patient characteristics, assessments, outcome measures, and follow‐up. By weighted average, respondents indicated that they would most likely administer rituximab, followed by abatacept, TNFα inhibitor, and tocilizumab. Conclusion: CTPs for the administration of bDMARDs in refractory moderately severe JDM were developed using consensus methodology. The implementation of the bDMARD CTPs will lay the groundwork for registry‐based prospective comparative effectiveness studies. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion Residency programmes are in transition to a framework for competency‐based medical education (CBME). The intersection of CBME with transformational learning (TL) experiences and professional identity formation (PIF) — particularly within senior learners in transitional states — is unknown but important to understand in order to develop and implement strategies to support trainees' professional development.Through inductive qualitative methods, we conducted semi‐structured interviews (n = 22) of current trainees and recent graduates from adult cardiology residency training programmes within Canada to explore the impact of TL experiences on residents' professional growth and identity formation. Interviews were analysed using thematic analysis informed by TL theory.CBME did not appear to influence trainees' experiences of disorienting dilemmas and TL. Important clinical encounters and interpersonal relationships — in particular, those between mentor and mentee — shaped trainees' professional development as cardiologists (‘enabling factors’ for TL and PIF). ‘Imposter phenomenon’ was widely prevalent in our sample study population even among graduates who had already completed their training. Requisite elements for transformation (disorienting dilemmas, critical reflection, discourse and action) also contributed to PIF.TL experiences influenced PIF in senior learners but infrequently intersected with CBME; these experiences were more commonly prompted by disorienting dilemmas relating to clinical outcomes or interpersonal interactions independent of CBME‐specific architecture. [ABSTRACT FROM AUTHOR]

Dyskeratosis congenita (DC) is a rare inherited bone marrow failure syndrome, caused by genetic mutations that principally affect telomere biology. Approximately 35% of cases remain uncharacterised at the genetic level. To explore the genetic landscape, we conducted genetic studies on a large collection of clinically diagnosed cases of DC as well as cases exhibiting features resembling DC, referred to as 'DC-like' (DCL). This led us to identify several novel pathogenic variants within known genetic loci and in the novel X-linked gene, POLA1. In addition, we have also identified several novel variants in POT1 and ZCCHC8 in multiple cases from different families expanding the allelic series of DC and DCL phenotypes. Functional characterisation of novel POLA1 and POT1 variants, revealed pathogenic effects on protein-protein interactions with primase, CTC1-STN1-TEN1 (CST) and shelterin subunit complexes, that are critical for telomere maintenance. ZCCHC8 variants demonstrated ZCCHC8 deficiency and signs of pervasive transcription, triggering inflammation in patients' blood. In conclusion, our studies expand the current genetic architecture and broaden our understanding of disease mechanisms underlying DC and DCL disorders. Synopsis: The evolving genetic landscape of inherited bone marrow failure syndrome dyskeratosis congenita reveals new pathogenic variants that broadens our understanding of current genetic and molecular mechanisms underlying this disorder. Several novel pathogenic variants within known susceptibility loci, as well as in the novel X-linked locus POLA1, are part of the evolving DC and DCL genetic landscape. Telomere maintenance is impacted by novel variants in POLA1 and POT1, while pervasive transcription and inflammation are caused by ZCCHC8 variants. Current knowledge on disease mechanisms beyond the regulation of long non-coding RNA TERC is extended by the clinical, genetic, and molecular similarity between DC and DCL cases. The evolving genetic landscape of inherited bone marrow failure syndrome dyskeratosis congenita reveals new pathogenic variants that broadens our understanding of current genetic and molecular mechanisms underlying this disorder. [ABSTRACT FROM AUTHOR]

Aims: Molecular classification according to The Cancer Genome Atlas (TCGA) improves endometrial endometrioid carcinoma (EEC) prognostication and has specific treatment implications; however, original data were skewed towards low‐grade and low‐stage tumours. Herein, we molecularly classify EECs metastatic at the time of diagnosis or with subsequently documented recurrent/metastatic disease to examine correlation with clinical outcomes. Methods: TCGA categories include POLE‐mutated, microsatellite instability (MSI), p53 abnormal (p53 abnl) and no specific molecular profile (NSMP). POLE targeted sequencing at exons 9, 11, 13 and 14 and immunohistochemistry (IHC) for PMS2, MSH6 and p53 were performed to establish molecular classification. Results: The distribution in our cohort of 141 EECs was similar to that generally reported in EEC, with nine POLE‐mutated (6%), 45 MSI (32%), 16 p53 abnl (11%) and 71 NSMP (50%), with similar distributions between low‐ and high‐stage cohorts. We demonstrate that when stratified by molecular subtype, disease‐specific survival from the time of high‐stage (stages III–IV) presentation or time of recurrence in low‐stage (stages I–II) disease among metastatic and/or recurrent EEC is strongly associated with TCGA classification (high‐stage P = 0.02, low‐stage P = 0.017). Discordant molecular classification between primary and metastatic/recurrent tumours occurred in four of 105 (3.8%) patients, two related to PMS2/MSH6 IHC and two related to p53 IHC. Conclusions: We demonstrate that molecular classification is prognostically relevant not only at the time of diagnosis, but also at the time of recurrence and in the metastatic setting. Rare subclonal alterations occur and suggest a role for confirming TCGA classification in recurrent/metastatic tumours. [ABSTRACT FROM AUTHOR]

Objectives: Post‐cardiac and aortic surgery stroke is often underreported. We detail our single‐centre experience the following introduction of comprehensive consultant‐led daily stroke service, to demonstrate the efficacy of a stroke team in recovery from stroke following cardiac and aortic surgeries. Methods: This retrospective, single‐centre observational cohort study analysed consecutive patients undergoing cardiac and aortic surgery at our institution from August 2014 to December 2020. Main outcomes included stroke rate, predictors of stroke, and neurological deficit resolution or persistence at discharge and clinic follow‐up. Results: A total of 12,135 procedures were carried out in the reference period. Among these, 436 (3.6%) suffered a stroke. Overall survival to discharge and follow‐up were 86.0% and 84.0% respectively. Independent risk factors for post‐operative stroke included advanced age (OR 1.033, 95% CI [1.023, 1.044], p <.001), female sex (OR 1.491, 95% [1.212, 1.827], p <.001), history of previous cardiac surgeries (OR 1.670, 95% CI [1.239, 2.218], p <.001), simultaneous coronary artery bypass graft + valve procedures (OR 1.825, 95% CI [1.382, 2.382], p <.001) and CPB time longer than 240 min (OR 3.384, 95% CI [2.413, 4.705], p <.001). Stroke patients managed by the multidisciplinary team demonstrated significantly higher rates of survival at discharge (87.3% vs. 61.9%, p =.001). Conclusions: Perioperative stroke can be debilitating immediately long term. The involvement of specialist stroke teams plays a key role in reducing the long‐term burden and mortality of this condition. [ABSTRACT FROM AUTHOR]

To help with preparedness efforts of Canadian public health and safety systems for adaptation to climate change, the humidity index (humidex) and three threshold‐based humidex indices (annual number of days with humidex greater than 30, 35 and 40) were computed for a multi‐model ensemble of climate change projections, over Canada. The ensemble consists of one run from each 19 Coupled Model Intercomparison Project Phase 6 (CMIP6) global climate models and offers historical simulations starting in 1950 and future projections out to 2100 following Shared Socioeconomic Pathways (SSPs): SSP1‐2.6, SSP2‐4.5 and SSP5‐8.5. Each ensemble member was bias‐adjusted and statistically downscaled using the Multivariate bias correction—N‐dimensional probability density function transform (MBCn) with hourly data from ERA5‐Land as the target dataset and following a method proposed by Diaconescu et al. (2023; International Journal of Climatology, 43, 837) to calculate humidex from daily climate model outputs. This paper details the steps for data production including evaluation of the target historical gridded data and selection of downscaling method and presents some of the resulting humidex projections at the end of the century. [ABSTRACT FROM AUTHOR]

Background: Interest in the role of employability in student–dietitian transitions is increasing. However, little is known about the cross‐cultural transition‐to‐work experience of Australian‐trained dietetic graduates of international backgrounds, as well as strategies to optimise work‐readiness. The present study aimed to explore graduates' career narratives and identify employability capitals that enabled successful transitions to work. Methods: A qualitative interpretive approach was employed via a cultural lens. Eighteen participants from five Asian countries who had graduated from an Australian university within 3–15 years, with work experience in Australia or in their respective home countries, took part in in‐depth interviews. Thematic analysis was performed, guided by the graduate capitals based approach. Results: Transition‐to‐work was dynamic and non‐linear; four themes and 12 subthemes identified: (1) upon graduation, participants felt ambivalent about their decision to either stay in Australia or return home, influenced by graduate visa restrictions, and individual perceptions of their ability to mobilise cultural strengths to gain employment; (2) to get a foot in the door, participants demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities in Australia and their home countries; (3) regardless of which country they worked, graduates reported struggling with their cross‐cultural identities in the workplace; and (4) eventually, these graduates appreciated their ethnic capital, thrived in their work and extended a helping hand to their junior cross‐cultural dietitians. Conclusions: Initiatives facilitating connections to the host country and supporting cultural and ethnic capital development, along with ongoing research reviewing employability capital applications, will benefit cross‐cultural dietetic graduates and the communities they potentially will serve. Key points: International student dietitians graduated in Australia often faced additional barriers in seeking employment compared to their domestic counterparts.International dietetic graduates had to choose to return to home country or stay for employment in Australia but their option was limited by residency rights and connections to the communities.For those who stayed, they demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities.For graduates who went home, they experienced back‐transition and translation of Australian dietetics knowledge in the Asian communities.Despite difficult circumstances, international dietetic graduates mobilised graduate capitals to optimise their transition‐to‐work journey and eventually found their cross‐cultural identity in the workplace. [ABSTRACT FROM AUTHOR]

We examine the ability of two dynamic turbulence closure models to simulate the diurnal development of convection and the transition from dry to shallow cumuli and then to deep convection. The dynamic models are compared with the conventional Smagorinsky scheme at a range of cloud‐resolving and grey‐zone resolutions. The dynamic schemes include the Lagrangian‐averaged, scale‐dependent dynamic Smagorinsky model and a Lagrangian‐averaged, dynamic mixed model. The conventional Smagorinsky model fails to reproduce the shallow convection stage beyond the large‐eddy simulation regime, continuously building up the convective available potential energy that eventually leads to an unrealistic deep convection phase. The dynamic Smagorinsky model significantly improves the representation of shallow and deep convection; however, it exhibits issues similar to the conventional scheme at coarser resolutions. In contrast, the dynamic mixed model closely follows the large‐eddy simulation results across the range of sub‐kilometre simulations. This is achieved by the combined effect of an adaptive length scale and the inclusion of the Leonard terms, which can produce counter‐gradient fluxes through the backscatter of energy from the subgrid to the resolved scales and enable appropriate non‐local contributions. A further sensitivity test on the inclusion of the Leonard terms on all hydrometeor fluxes reveals the strong interaction between turbulent transport and microphysics and the possible need for further optimisation of the dynamic mixed model coefficients together with the microphysical representation. [ABSTRACT FROM AUTHOR]

Low‐grade serous ovarian carcinoma (LGSC) is a rare and lethal subtype of ovarian cancer. LGSC is pathologically, biologically, and clinically distinct from the more common high‐grade serous ovarian carcinoma (HGSC). LGSC arises from serous borderline ovarian tumours (SBTs). The mechanism of transformation for SBTs to LGSC remains poorly understood. To better understand the biology of LGSC, we performed whole proteome profiling of formalin‐fixed, paraffin‐embedded tissue blocks of LGSC (n = 11), HGSC (n = 19), and SBTs (n = 26). We identified that the whole proteome is able to distinguish between histotypes of the ovarian epithelial tumours. Proteins associated with the tumour microenvironment were differentially expressed between LGSC and SBTs. Fibroblast activation protein (FAP), a protein expressed in cancer‐associated fibroblasts, is the most differentially abundant protein in LGSC compared with SBT. Multiplex immunohistochemistry (IHC) for immune markers (CD20, CD79a, CD3, CD8, and CD68) was performed to determine the presence of B cells, T cells, and macrophages. The LGSC FAP+ stroma was associated with greater abundance of Tregs and M2 macrophages, features not present in SBTs. Our proteomics cohort reveals that there are changes in the tumour microenvironment in LGSC compared with its putative precursor lesion, SBT. These changes suggest that the tumour microenvironment provides a supportive environment for LGSC tumourigenesis and progression. Thus, targeting the tumour microenvironment of LGSC may be a viable therapeutic strategy. © 2024 The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Understanding wood combustion has become increasingly critical as fire safety engineering moves toward a performance‐based approach to building design. Although different kinetic models have been developed for wood burning, chemical kinetics remains a significant challenge for accurate prediction. This work has developed a novel multiscale model by implementing kinetic parameters calculated from molecular dynamics simulations using reactive forcefield into a kinetic model of wood burning. The calculated kinetic parameters of the main components in wood, namely, cellulose, hemicellulose, and lignin, are first utilized to model microscale thermogravimetric experiments for validation. Subsequently, the mesoscale and full‐scale fire tests have been simulated by the multiscale model. Furthermore, the fire properties of various wood species at different heat fluxes have been predicted and compared with results from the cone calorimeter test. Our multiscale model outperforms existing kinetic models in predicting wood combustion and can effectively discern the influence of chemical components on fire properties. [ABSTRACT FROM AUTHOR]

Objectives: To assess navigation accuracy for complete‐arch implant placement with immediate loading of digitally prefabricated provisional. Materials and Methods: Consecutive edentulous and terminal dentition patients requiring at least one complete‐arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre‐operative and post‐operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T‐tests were performed to investigate the potential effect of the registration algorithm (fiducial‐based vs. fiducial‐free), type of references for the fiducial‐free algorithm (teeth vs. bone screws), site characteristic (healed vs. post‐extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p‐value <0.05. Results: Twenty‐five patients, 36 complete‐arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post‐extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single‐axis deviations were reported for the type of jaw (y‐axis at implant platform and apex), registration algorithm (y‐axis platform and z‐axis deviations), and type of references for the fiducial‐free algorithm. No statistically significant differences were found in relation to implant angulation. Conclusions: Within the study limitations navigation was reliable for complete‐arch implant placement with immediate loading digitally pre‐fabricated FDP. AI‐driven surface anatomy identification and calibration protocol made fiducial‐free registration as accurate as fiducial‐based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post‐extractive. Live‐tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered. [ABSTRACT FROM AUTHOR]

Aims: Many transgender and gender diverse (TGD) individuals have expressed concerns about the potential for oral pre‐exposure prophylaxis to affect hormonal concentrations achieved from taking gender‐affirming hormone therapy (GAHT). The purpose of this study was to understand the bidirectional effects between hormone and intraerythrocytic tenofovir diphosphate concentrations when switching from tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) to tenofovir alafenamide/emtricitabine (TAF/FTC) in TGD users/nonusers of GAHT. Methods: The study evaluated stored blood samples and dried blood spot cards from TGD adults without HIV who took ≥12 weeks of TDF/FTC and then switched to ≥12 weeks of TAF/FTC for pre‐exposure prophylaxis. Results: Thirty‐nine individuals met the study inclusion criteria. Regardless of sex assigned at birth and the use of GAHT, there were no significant differences in hormone concentrations when individuals taking GAHT were taking TDF/FTC and then switched to TAF/FTC. Further, there was no significant difference in intraerythrocytic tenofovir diphosphate concentrations between users and nonusers of GAHT. Conclusion: There are no bidirectional effects between hormone and intraerythocytic tenofovir diphosphate concentrations when switching from TDF/FTC to TAF/FTC in TGD users/nonusers of GAHT. [ABSTRACT FROM AUTHOR]

Glucagon was discovered about a hundred years ago and its role in health and disease is under continuous investigation. Glucagon is a counter regulatory hormone secreted by alpha cells of the pancreas in response to multiple stimuli. Although some of glucagon's actions and its clinical application have been described, clinical experience with glucagon has been historically overshadowed by that of insulin. To date, the role of glucagon's actions in pharmacotherapy has been under explored. Glucagon plays a considerable role as a hormonal regulator via its known actions on the liver. The rise in obesity and diabetes mellitus prevalence is bringing focus to glucagon's known physiological roles and possible clinical applications. Six glucagon products and a glucagon analog are approved for use in the United States. Clinical pharmacology studies provide crucial support of glucagon's actions as evident from comprehensive pharmacokinetics and pharmacodynamics evaluations in humans. Here, we briefly describe the established physiological role of glucagon in humans and its known relationship with disease. We later summarize the clinical pharmacology of available glucagon products with different routes of administration. [ABSTRACT FROM AUTHOR]

Aims: To compare four a priori rival mediated pathways of frequent social media use, electronic nicotine delivery systems (ENDS) use and internalizing mental health (MH) problems across five waves of nationally representative data. Design, setting and participants: This was a longitudinal study using data drawn from waves 2–5 (October 2014–November 2019) of the Population Assessment of Tobacco and Health Study, a nationally representative cohort study spanning approximately 5 years, conducted in the United States. The analytical sample of participants included those who were aged 12–14 years at wave 2 and who provided data in subsequent waves until wave 4.5 (n = 4627, 69.7% were White and 51.4% were male). Measurements: Frequent social media use (several times a day), ENDS use (past 30‐day use) and internalizing MH problems (endorsed symptoms on four items in the past year) were dichotomized for analysis. Findings The weighted proportions of the three key variables increased over time. From wave 2 to wave 5, frequent social media use grew from 56.9 to 77.2%; internalizing MH problems from 18.9 to 29.0%; and ENDS use from 1.4 to 11.4%. In weighted logistic regressions using generalized linear mixed models with random effects, there was a significant within‐person association between frequent social media use at time t and greater ENDS use at t + 1 [adjusted odds ratio (aOR) = 1.87; 95% confidence interval (CI) = 1.47, 2.37] and worsened internalizing MH problems at t + 1 (aOR = 1.19; 95% CI = 1.04, 1.37). A model‐based causal mediation analysis and marginal structural models were fitted to estimate the average causal mediation effect. Among all four examined mediation pathways throughout the three constructs, partial mediation was observed, and all the pathways were significant for both boys and girls. Sex differences did not emerge in the examined prospective mediated pathways. Conclusions: Among youth in the United States, frequent social media use appears to mediate the prospective association between experiencing internalizing mental health problems and using electronic nicotine delivery systems. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Epidural steroid injections (ESIs) are commonly used as a treatment for lumbar radiculopathy. Currently, most research on comparative efficacy of various steroids in epidural steroid injections is focused on transforaminal ESIs (TFESIs). Through this study, we aimed to compare various steroid doses with or without local anesthetic in interlaminar ESIs (ILESIs).We reviewed charts for all adult patients who received ILESIs identified by CPT code 62323 between January 2017 to April 2021. Baseline demographic data including age, sex, BMI, and smoking status were recorded. NRS pain scores before the injection and percentage of pain relief at 1‐month follow‐up were recorded. We compared percentage of patients reporting pain relief at 1 month follow‐up of low‐dose dexamethasone alone (5 mg), to low‐dose dexamethasone mixed with local anesthetic, and to high‐dose dexamethasone (10 mg) mixed with local anesthetic, specifically for ILESIs.Data were available for 311 patients. There was no significant difference in pain relief between the 3 groups at 1 month follow‐up. The majority of patients had moderate to significant improvement in pain, supporting the use of ILESIs. Moreover, low‐dose steroid with local anesthetic was found to be as efficacious as high‐dose steroid alone. Although not statistically significant, the addition of local anesthetic to low‐dose or high‐dose steroid increased the percentage of patients reporting moderate to significant pain relief.ILESIs with non‐particulate steroids provide moderate to significant pain improvement in the short term, with low‐dose steroid mixed with local anesthetic being as efficacious as a high‐dose steroid. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) utilizes reactive oxygen species (ROS) for eradication of cancer cells. Its effectiveness is governed by the oxygen content, which is scarce in the hypoxic tumor microenvironment. We report herein two zinc(II) phthalocyanines substituted with two or four nitric oxide (NO)‐releasing moieties, namely ZnPc‐2NO and ZnPc‐4NO, which can suppress the mitochondrial respiration, thereby sparing more intracellular oxygen for PDT. Using HT29 human colorectal adenocarcinoma cells and A549 human lung carcinoma cells, we have demonstrated that both conjugates release NO upon interaction with the intracellular glutathione, which can reduce the cellular oxygen consumption rate and adenosine triphosphate generation and alter the mitochondrial membrane potential. They can also relieve the hypoxic status of cancer cells and decrease the expression of hypoxia‐inducible factor protein HIF‐1α. Upon light irradiation, both conjugates can generate ROS and induce cytotoxicity even under a hypoxic condition, overcoming the oxygen‐dependent nature of PDT. Interestingly, the photodynamic action of ZnPc‐2NO elicits the release of damage‐associated molecular patterns, inducing the maturation of dendritic cells and triggering an antitumor immune response. The immunogenic cell death caused by this oxygen‐economized PDT has been demonstrated through a series of in vitro and in vivo experiments. [ABSTRACT FROM AUTHOR]

Summary: Systemic mastocytosis (SM) is a rare haematological neoplasm associated with the gain of function mutation KIT D816V in 90% of adult patients. Classically, cytogenetic aberrations are not common except in cases of SM associated with another haematological neoplasm. We highlight here an unusual clinical presentation of SM and demonstrate the utility of advanced cytogenetic analysis (optical genome mapping, OGM) in detecting a novel cytogenetic abnormality resulting in an unusual mechanism of DNMT3A and TET2 loss of function. [ABSTRACT FROM AUTHOR]

Clusterwise linear regression (CLR) is a powerful extension of the conventional linear regression framework when the data complexity exceeds the capability of a single linear model. This article presents the first examination of CLR algorithms developed over the past two decades through randomized large‐sample testing. Using a unified framework and carefully controlled data characteristics, a comprehensive and systematic assessment of CLR algorithms were performed. The findings of this study provide potential users with a clear understanding of the various benefits and limitations of selecting the appropriate CLR algorithms for their data. Furthermore, this study has disproved past claims which were concluded based on limited samples, and provides insights to better understand the CLR challenges. Finally, this article identifies areas for improvement that could provide crucial performance and reliability improvement of CLR algorithms. [ABSTRACT FROM AUTHOR]

Introduction: Social network‐based testing approaches (SNAs) encourage individuals ("test promoters") to motivate sexual partners and/or those in their social networks to test for HIV. We conducted a systematic review to examine the effectiveness, acceptability and cost‐effectiveness of SNA. Methods: We searched five databases from January 2010 to May 2023, and included studies that compared SNA with non‐SNA. We used random‐effects meta‐analysis to combine effect estimates. Certainty was assessed using the GRADE approach. Results: We identified 47 studies. SNA may increase uptake of HIV testing compared to non‐SNA (RR 2.04, 95% CI: 1.06–3.95, Low certainty). The proportion of first‐time testers was probably higher among partners or social contacts of test promoters using SNA compared to non‐SNA (RR 1.49, 95% CI: 1.22–1.81, Moderate certainty). The proportion of people who tested positive for HIV may be higher among partners or social contacts of test promoters using SNA compared to non‐SNA (RR 1.84, 95% CI: 1.01–3.35, Low certainty). There were no reports of any adverse events or harms associated with SNA. Based on six cost‐effectiveness studies, SNA was generally cheaper per person tested and per person diagnosed compared to non‐SNA. Based on 23 qualitative studies, SNA is likely to be acceptable to a variety of populations. Discussion: Our review collated evidence for SNA to HIV testing covering the key populations and the general population who may benefit from HIV testing. We summarized evidence for the effectiveness, acceptability and cost‐effectiveness of different models of SNA. While we did not identify an ideal model of SNA that could be immediately scaled up, for each setting and population targeted, we recommend various implementation considerations as our meta‐analysis showed the effectiveness might differ due to factors which include the testing modality (i.e. use of HIV self‐testing), type of test promoters, long or short duration of recruitment and use of financial incentives. Conclusions: Social network‐based approaches may enhance HIV testing uptake, increase the proportion of first‐time testers and those testing positive for HIV. Heterogeneity among studies highlights the need for context‐specific adaptations, but the overall positive impact of SNA on HIV testing outcomes could support its integration into existing HIV testing services. [ABSTRACT FROM AUTHOR]

Background: Tailored sexuality education for adolescents with intellectual and developmental disabilities is a crucial, yet unmet, need as this population is particularly at risk for sexual abuse and victimisation. However, there are no evidence‐based interventions to specifically address this need. This paper presents the development of an intervention framework to address equity in sexuality education and support adolescents with intellectual and developmental disabilities to understand and provide sexual consent, a foundational aspect of sexuality education and sexual health. Methods: The Sexual Health Equity Project team used a Community‐Based Participatory Research approach to develop a four‐module sexual consent intervention for adolescents with intellectual and developmental disabilities. We leveraged a diverse, interdisciplinary team in a suburban Midwestern school district, and used Backward Design to create objectives and assessments which were rooted in findings from qualitative data by special education teachers. Results: The resulting sexual consent intervention, Ask Me First—Choices, is comprised of four modules covering topics including definition of sexual consent; decision‐making strategies and practice; communicating consent and refusal, identifying situations of consent and non‐consent; and legal issues surrounding consent. Each module is divided into five components for content delivery: (1) introduction, (2) lecture, (3) supplemental activity, (4) assessment, and (5) conclusion. We detail the intervention's unique aspects, emphasising areas where we used Universal Design for Learning principles to support teachers' instruction and students' learning. Conclusion: Our efforts to create a sexual consent intervention directly address sexuality education equity issues. We offer commentary on our design process and decisions, as well as recommendations for future groups who want to develop sexual health interventions in similar contexts for students with intellectual and developmental disabilities. Next steps include further testing and validation of the sexual consent intervention to build the evidence‐base of sexuality education for adolescents with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

The biochemical and physical properties of a scaffold can be tailored to elicit specific cellular responses. However, it is challenging to decouple their individual effects on cell‐material interactions. Here, we solvent‐cast 3D printed different ratios of high and low molecular weight (MW) poly(caprolactone) (PCL) to fabricate scaffolds with significantly different stiffnesses without affecting other properties. Ink viscosity was used to match processing conditions between inks and generate scaffolds with the same surface chemistry, crystallinity, filament diameter, and architecture. Increasing the ratio of low MW PCL resulted in a significant decrease in modulus. Scaffold modulus did not affect human mesenchymal stromal cell (hMSC) differentiation under osteogenic conditions. However, hMSC response was significantly affected by scaffold stiffness in chondrogenic media. Low stiffness promoted more stable chondrogenesis whereas high stiffness drove hMSC progression toward hypertrophy. These data illustrate how this versatile platform can be used to independently modify biochemical and physical cues in a single scaffold to synergistically enhance desired cellular response. [ABSTRACT FROM AUTHOR]

This study examined whether mentorship could promote young gay men's identities and well‐being, and whether a mentor's sexual orientation matters. A randomized control trial compared outcomes across three conditions: Arm A (a mentee matched with a sexual minority mentor), Arm B (a mentee matched with a heterosexual mentor), and a control arm receiving psychoeducation only. A community sample of 60 mentees aged 18–25 years was randomly allocated to the three arms and completed questionnaires at baseline, 3 months into the intervention, and at the end of the 6‐month program. Fifteen mentees recounted their mentoring experiences through in‐depth interviews. Linear mixed effects models showed that for both intervention and control conditions, internalized homonegativity declined while resilience, loneliness, and body acceptance improved over time. No time and group interactions were found. Meanwhile, a mentor's sexual orientation did not drive differential quality and outcomes of mentorship. Interviewees cited various benefits of mentorship, including providing companionship, enriching connection with lesbian, gay, bisexual (LGB) communities, and adding knowledge and perspectives of LGB lives and identities. Although quantitative data did not support any exclusive benefits of mentorship, most mentees recognized mentorship as a vital source of affirmation and companionship. Implications for research and mentoring programs are discussed. Highlights: Mentorship has been suggested as a community‐based program to improve LGB people's mental health.This study found equivocal quantitative evidence for short‐term effects of a mentorship.Qualitative interviews reveal potential benefits of mentorship for young gay mentees.Mentors' sexual orientations did not play a major part in the quality and outcomes of mentorship. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis units are now managing an increasing number of patients with varying needs and levels of acuity. To maintain safety, haemodialysis patients must be placed in the most appropriate dialysis unit that has the required human and physical resources to care for them. The first step towards achieving these goals is to develop a tool specific to haemodialysis units to effectively measure patient acuity. Objective: To develop a haemodialysis acuity tool, utilising a focus group approach, in assessing patient's suitability for a specific dialysis location thus ensuring patient safety. Design: This is a cross‐sectional qualitative study via a focus group approach. Participants: Participants were nurse unit managers and team leaders of a District Renal Service. Approach: Participants were interviewed to explore their views on the elements and measures identified in the research aims. Themes for interviews were informed by current literature on acuity tools for haemodialysis patients' admission to the dialysis units. Interviews were recorded and transcribed verbatim and progressively analysed using a thematic analysis approach. Results: Ten nurse unit managers/team leaders (100%) were interviewed and thematic analysis of the transcripts was conducted utilising the deductive approach. Five themes were identified which will form the main categories in the development of the tool, namely: Age/frailty; co‐morbidity; physical; dialysis; and psychosocial. Conclusion: This study is instrumental in the development of the haemodialysis acuity tool which can be used in allocating dialysis location specific to patient's needs and available resources. The tool can also be used in analysing patient care processes and resource requirements based on the patients' and unit's profile. [ABSTRACT FROM AUTHOR]

Purpose: To develop a reconstruction method for highly accelerated cardiac cine MRI with high spatiotemporal resolution and low temporal blurring, and to demonstrate accurate estimation of ventricular volumes and myocardial strain in healthy subjects and in patients. Methods: The proposed method, called CineVN, employs a spatiotemporal Variational Network combined with conjugate gradient descent for optimized data consistency and improved image quality. The method is first evaluated on retrospectively undersampled cine MRI data in terms of image quality. Then, prospectively accelerated data are acquired in 18 healthy subjects both segmented over two heartbeats per slice as well as in real time with 1.6 mm isotropic resolution. Ventricular volumes and strain parameters are computed and compared to a compressed sensing reconstruction and to a conventional reference cine MRI acquisition. Lastly, the method is demonstrated in 46 patients and ventricular volumes and strain parameters are evaluated. Results: CineVN outperformed compressed sensing in image quality metrics on retrospectively undersampled data. Functional parameters and myocardial strain were the most accurate for CineVN compared to two state‐of‐the‐art compressed sensing methods. Conclusion: Deep learning‐based reconstruction using our proposed method enables accurate evaluation of cardiac function in real‐time cine MRI with high spatiotemporal resolution. This has the potential to improve cardiac imaging particularly for patients with arrhythmia or impaired breath‐hold capability. [ABSTRACT FROM AUTHOR]

The existing paradigm on recovery in mental health prioritises self‐empowerment and person‐centred, community‐based care, which necessitates family caregivers' collaboration to support individuals with schizophrenia in the community. However, the role of family caregivers is often under‐recognised and hence insufficiently supported. This consequently compromises caregivers' well‐being and, ultimately, the recovery of individuals with schizophrenia. Although caregiver‐targeted psychoeducation may offer practical support, its effectiveness lacks conclusive evidence. This review aimed to evaluate the impacts of psychoeducation on caregiver‐related outcomes (caregiver burden, quality of life and expressed emotion). Eight electronic databases were searched from inception to September 2023, supplemented by hand searching of end‐reference lists. Two reviewers independently conducted title and abstract screening with predetermined eligibility criteria. A third reviewer was consulted to resolve any discrepancies. A random‐effects meta‐analysis was performed to estimate pooled effect sizes alongside subgroup and sensitivity analyses where appropriate. Twenty‐one studies (totalling 1639 caregivers) were included, based on which psychoeducation contributed to a statistically significant improvement in caregiver‐related outcomes. Given substantial heterogeneity, subgroup and sensitivity analyses were done for the durations and the evaluative scales for psychoeducation. Quality appraisal revealed unclear or high bias in most studies. Notwithstanding the heterogeneity, the directions of the effect sizes consistently indicated the effectiveness of psychoeducation across all outcomes. This finding aligned with Lazarus' stress appraisal and coping theory, which states that psychoeducation improves caregivers' knowledge, coping mechanisms and situation appraisal. Our findings offer encouraging evidence to advocate the integration of psychoeducation into healthcare services, but policy‐based support is warranted for sustained implementation. Further research is merited to optimise its duration and content and appraise its long‐term impacts through disease‐specific scales for objective and subjective outcomes. [ABSTRACT FROM AUTHOR]

According to the Work/Family Border Theory, the pandemic‐induced disruptions, such as widespread teleworking adoption, have blurred work and family boundaries. Meanwhile, the Work–Home Resources Model posited that the impact of such disruptions on work–family conflicts and mental health depends on individual resources. Building on previous research, this study hypothesised that self‐compassion and self‐control mitigate pandemic burnout by reducing work–family conflicts during pandemic. In particular, we proposed that the proactive nature of self‐compassion motivates individuals to seek resources for managing work–family conflicts, while self‐control translates this motivation into action through behavioural regulation and adaptive coping. Using a three‐wave longitudinal design with 568 participants in China during heightened pandemic severity, the study revealed that both self‐compassion and self‐control were associated with lower pandemic burnout, mediated through reduced work–family conflict. The indirect effect of self‐compassion on pandemic burnout via work–family conflicts was significant only for individuals with high or average self‐control, emphasising the complementary role of both factors. Our findings underscore the protective value of self‐compassion and self‐control in navigating work–family conflicts during collective adversities, advocating for their incorporation in theoretical frameworks and practical intervention. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the real‐world treatment patterns and outcomes for patients with pleural mesothelioma (PM) in the era of immunotherapy. Methods: This retrospective audit included patients with PM diagnosed within three tertiary referral centers in Queensland, Australia from January 2017 to July 2023. Patient and treatment characteristics and outcomes were recorded. Data was analyzed using descriptive statistics and the Kaplan‐Meier survival method. Results: A total of 90 patients were included: 84% were male, the median age was 75 years (range 70–79) and 85% had baseline Eastern Group Cooperative Group of 0–1. Subtypes included 54% epithelioid, 17% biphasic, 12% sarcomatoid, and 17% unspecified/unknown. First‐line treatment was received by 57/90 patients (63%) and 33/90 patients (37%) received the best supportive care (BSC). Chemotherapy was most used (63%) overall, but first‐line immunotherapy was more commonly used since ipilimumab/nivolumab was reimbursed by the Australian Pharmaceutical Benefits Scheme in July 2021. After first‐line treatment, only 40% received second‐line treatment and 60% received BSC. 12‐month overall survival (OS) and progression‐free survival for all patients were 53% (95% confidence interval [CI]: 43–65) and 25% (95% CI 15–40) respectively. 12‐month OS was 72%, 64%, and 29% for immunotherapy, chemotherapy, and BSC, respectively. There was no significant difference in survival between chemotherapy and immunotherapy (hazard ratio 1.28, 95% CI: 0.65–2.5, p = 0.5). Conclusion: In our unselected real‐world cohort, both chemotherapy and immunotherapy are active against PM, but the prognosis remains guarded. There remains a need for better treatment options, especially in the first‐line setting. Enrolment in clinical trials is crucial to improving outcomes in this debilitating disease. [ABSTRACT FROM AUTHOR]

This study used data from 435 teacher‐child dyads in early childhood classrooms to examine the extent to which teachers' use of behavior specific praise (BSP) with children screened for elevated rates of externalizing behaviors was influenced by the intensity of child challenging behavior and gender. Observational assessments indicated that teachers used BSP infrequently. A multiple regression model revealed a significant association between the interaction of child challenging behavior and gender and teachers' delivery of BSP. An examination of the simple slopes revealed a disordinal interaction where the relation between challenging behavior and teachers' delivery of BSP differed as a function of child gender. These findings point to an increased need for training to support teachers' use of BSP and understanding of the influence of child gender and behavior on the use of BSP. Practitioner points: Teachers delivered low rates of behavior specific praise to children with high rates of challenging behavior.The relation between child challenging behavior and teachers' delivery of behavior specific praise varied by child gender.For boys, as externalizing child behavior increased there was an increased likelihood of BSP. For girls as externalizing child behavior increased, the likelihood of BSP decreased. [ABSTRACT FROM AUTHOR]

Approximately 5%–10% of fractures go on to delayed healing and nonunion, posing significant clinical, economic, and social challenges. Current treatment methods involving open bone harvesting and grafting are associated with considerable pain and potential morbidity at the donor site. Hence, there is growing interest in minimally invasive approaches such as bone marrow aspirate concentrate (BMAC), which contains mesenchymal stromal cells (MSCs), macrophages (Mφ), and T cells. However, the use of cultured or activated cells for treatment is not yet FDA‐approved in the United States, necessitating further exploration of optimal cell types and proportions for effective bone formation. As our understanding of osteoimmunology advances, it has become apparent that factors from anti‐inflammatory Mφ (M2) promote bone formation by MSCs. Additionally, M2 Mφ promote T helper 2 (Th2) cells and Treg cells, both of which enhance bone formation. In this study, we investigated the interactions among MSCs, Mφ, and T cells in bone formation and explored the potential of subsets of BMAC. Coculture experiments were conducted using primary MSCs, Mφ, and CD4+ T cells at specific ratios. Our results indicate that nonactivated T cells had no direct influence on osteogenesis by MSCs, while coculturing MSCs with Mφ and T cells at a ratio of 1:5:10 positively impacted bone formation. Furthermore, higher numbers of T cells led to increased M2 polarization and a higher proportion of Th2 cells in the early stages of coculture. These findings suggest the potential for enhancing bone formation by adjusting immune and mesenchymal cell ratios in BMAC. By understanding the interactions and effects of immune cells on bone formation, we can develop more effective strategies and protocols for treating bone defects and nonunions. Further studies are needed to investigate these interactions in vivo and explore additional factors influencing MSC‐based therapies. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to (1) critically evaluate the outcomes measures used to assess the accuracy of implant placement with Computer Assisted Implant Surgery (CAIS) and (2) review the evidence supporting the efficient implementation of CAIS in training and education of clinicians. Methods: A scoping literature review was conducted aiming to identify (a) clinical trials assessing accuracy of implant placement with CAIS, and (b) clinical trials or simulation/cadaver studies where CAIS was utilised and assessed for the training/education of clinicians. Studies since 1995 were assessed for suitability and data related to the outcomes measures of accuracy and educational efficacy were extracted and synthesised. Results: Accuracy of CAIS has been mainly assessed through surrogate measures. Individual clinical trials have not shown any difference between static and dynamic CAIS, but recent meta‐analyses suggest an advantage of dynamic CAIS in reducing angular deviation. The combination of static and dynamic CAIS might offer higher accuracy than each of the two used alone. Dynamic CAIS is suitable for novice surgeons and might even have added value as an education tool for implant surgery, although mastering the technique requires longer training than static. Conclusion: Meta‐analyses of large samples, new and diverse outcomes measures, as well as benchmarking of levels of accuracy with specific clinical outcomes will help to better understand the potential and limitations of CAIS. Dynamic CAIS is suitable for novice operators, but educational interventions distributed over longer periods of time will be required for mastery of the process. [ABSTRACT FROM AUTHOR]

The transition from primary to permanent dentition is an important phase in children's oral development, yet its impact on texture perception and food acceptance are less explored. This study aimed to investigate how changing dentition and tooth loss influence texture preferences and perception of eating difficulty among children aged 5 to 12 years. Children (n = 475) completed a forced‐choice questionnaire featuring drawings of six food pairs, each available in hard or soft texture, and reported whether they had started losing primary teeth and the number of tooth gaps present. They also tasted four samples: chocolate snacks (cake and biscuits) and cheddar cheese (grated and cubes), evaluating their perceived eating difficulty and liking for each sample. Analysis of questionnaire responses showed a general preference for softer food textures among children, with a 36% probability of choosing hard foods. Preferences were not related to child's dental state, including primary teeth loss (p =.13) or number of tooth gaps (p =.45). In the taste test, chocolate biscuits and cheese cubes were perceived as significantly more difficult to eat than chocolate cake and grated cheese, respectively (both p <.0001). Children with more than two tooth gaps reported greater eating difficulty for chocolate biscuits and cheese cubes compared to children with fewer or no tooth gaps. This study demonstrated that children's texture preferences for hardness of foods remained consistent during dentition change, while their perception of eating difficulty could vary based on their dental state at specific points in time. [ABSTRACT FROM AUTHOR]

Foods containing bits and pieces are often less liked by children; however, there is a limited understanding of how perceptions and preferences for foods with particles change during childhood. This study aimed to investigate preferences and perceptions of particle‐containing foods in children aged 5–12 years. Children (n = 485) completed a forced‐choice questionnaire on drawings of six pairs of foods, each available with or without particles. Additionally, children tasted yogurts added with muesli differing in particle size (median diameter: 3.9 or 7.5 mm) and evaluated their perception of particle size in mouth and their liking. The questionnaire results showed that children had a clear preference for foods without particles. The average probability of choosing the 'with‐particle' foods was 28%, significantly below the midpoint of 50% (p <.0001). Preferences for particle‐containing foods were lowest at age six and increased significantly with age (p =.0007). In the taste test, muesli particle size affected oral size perception (p <.0001) but not liking (p =.60). Older children were better able to differentiate particle size than younger children. However, there was no relationship between individual preferences for particle‐containing foods and oral size perception of muesli particles. The observation that children's texture preferences changed with age highlights the role of increased experience in shaping preferences for foods with particles. [ABSTRACT FROM AUTHOR]

Urban areas are expanding exponentially, leading more species of wildlife living in urban environments. Urban environmental characteristics, such as human disturbance, induce stress for many wildlife and have been shown to affect some cognitive traits, such as innovative problem‐solving performance. However, because different cognitive traits have common cognitive processes, it is possible that urban environmental characteristics may directly and indirectly affect related cognitive traits (the ripple effect hypothesis).We tested the ripple effect hypothesis in urban Eurasian red squirrels residing in 11 urban areas that had different urban environmental characteristics (direct human disturbance, indirect human disturbance, areas of green coverage and squirrel population size). These squirrels were innovators who had previously repeatedly solved a food extraction task (the original task). Here, we examined whether and how urban environmental characteristics would directly and indirectly influence performance in two related cognitive traits, generalisation and (long‐term) memory. The generalisation task required the innovators to apply the learned successful solutions when solving a similar but novel problem. The memory task required them to recall the learned solution of the original task after an extended period of time.Some of the selected urban environmental characteristics directly influenced the task performance, both at the population level (site) and at individual levels. Urban environmental characteristics, such as increased direct and indirect human disturbance, decreased the proportion of success in solving the generalisation task or the memory task at the population (site) level. Increased direct human disturbance and less green coverage increased the solving efficiency at individual levels.We also found an indirect effect in one of the urban environmental characteristics, indirect human disturbance, in the generalisation task, but not the memory task. Such an effect was only seen at the individual level but not at the population level; indirect human disturbance decreased the first original latency, which then decreased the generalisation latency across successes.Our results partially support the ripple effect hypothesis, suggesting that urban environmental characteristics are stressors for squirrels and have a greater impact on shaping cognitive performance than previously shown. Together, these results provide a better understanding of cognitive traits that support wildlife in adapting to urban environments. [ABSTRACT FROM AUTHOR]