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BACKGROUND: Cross-neurotype differences in social communication patterns contribute to high unemployment rates among adults with autism. Adults with autism can be unsuccessful in job searches or terminated from employment due to mismatches between their social attention behaviors and societys expectations on workplace communication. OBJECTIVE: We propose a behavioral intervention concerning distribution of attention in triadic (three-way) conversations. Specifically, the objective is to determine whether providing personalized feedback to each individual with autism based on an analysis of their attention distribution behavior during an initial conversation session would cause them to modify their orientation behavior in a subsequent conversation session. METHODS: Our system uses an unobtrusive head orientation estimation model to track the focus of attention of each individual. Head orientation sequences from a conversation session are analyzed based on five statistical domains (eg, maximum exclusion duration and average contact duration) representing different types of attention distribution behavior. An intervention is provided to a participant if they exceeded the nonautistic average for that behavior by at least 2 SDs. The intervention uses data analysis and video modeling along with a constructive discussion about the targeted behaviors. Twenty-four individuals with autism with no intellectual disabilities participated in the study. The participants were divided into test and control groups of 12 participants each. RESULTS: Based on their attention distribution behavior in the initial conversation session, 11 of the 12 participants in the test group received an intervention in at least one domain. Of the 11 participants who received the intervention, 10 showed improvement in at least one domain on which they received feedback. Independent t tests for larger test groups (df>15) confirmed that the group improvements are statistically significant compared with the corresponding controls (P

ABSTRACT: The advent of immunological therapies has revolutionized the treatment of solid and haematological cancers over the last decade. Licensed therapies which activate the immune system to target cancer cells can be broadly divided into two classes. The first class are antibodies that inhibit immune checkpoint signalling, known as immune checkpoint inhibitors (ICIs). The second class are cell‐based immune therapies including chimeric antigen receptor T lymphocyte (CAR‐T) cell therapies, natural killer (NK) cell therapies, and tumour infiltrating lymphocyte (TIL) therapies. The clinical efficacy of all these treatments generally outweighs the risks, but there is a high rate of immune‐related adverse events (irAEs), which are often unpredictable in timing with clinical sequalae ranging from mild (e.g. rash) to severe or even fatal (e.g. myocarditis, cytokine release syndrome) and reversible to permanent (e.g. endocrinopathies).The mechanisms underpinning irAE pathology vary across different irAE complications and syndromes, reflecting the broad clinical phenotypes observed and the variability of different individual immune responses, and are poorly understood overall. Immune‐related cardiovascular toxicities have emerged, and our understanding has evolved from focussing initially on rare but fatal ICI‐related myocarditis with cardiogenic shock to more common complications including less severe ICI‐related myocarditis, pericarditis, arrhythmias, including conduction system disease and heart block, non‐inflammatory heart failure, takotsubo syndrome and coronary artery disease. In this scientific statement on the cardiovascular toxicities of immune therapies for cancer, we summarize the pathophysiology, epidemiology, diagnosis, and management of ICI, CAR‐T, NK, and TIL therapies. We also highlight gaps in the literature and where future research should focus.

Abstract Background Poor hand hygiene (HH) among health care workers (HCWs) in low-resource healthcare settings has continued to increase the spread of infectious diseases, including COVID-19. The present study aimed to assess the knowledge, attitude, adherence, and barriers to HH practices among HCWs during the COVID-19 pandemic in Nigeria. Methods The study was an online cross-sectional survey using a tailored questionnaire distributed through chain referral sampling among southern Nigerian HCWs during the first wave of the COVID-19 pandemic (February to August 2020). The primary outcomes were knowledge, attitude, adherence to HH guidelines, and the barriers limiting compliance with the guidelines. Data were analysed using percentage, frequency, mean, standard deviation, one-way ANOVA, and multiple linear regression. The study timeline was from 15 April to 31 July 2020. Results Four hundred and fifty-four HCWs (236 males and 218 females) participated in the study. The participants had a moderate knowledge of standard HH protocol (mean ± SD) 62.45 ± 10.82%, positive attitude 84.34 ± 11.32%, and high adherence to the standard guidelines 81.21 ± 9.49%. There was no significant difference in knowledge, attitude, and adherence across the healthcare professions. Increasing age (β = 0.186, p

Introduction: Approximately 5 to 10% of women of reproductive age suffer from the prevalent endocrine illness known as Polycystic Ovarian Syndrome (PCOS). Copeptin, irrespective of age and weight, has been found to have significant associations with cardiometabolic parameters. Studies on the diagnostic and prognostic significance of copeptin and its correlation with components of metabolic syndrome in PCOS are scarce, particularly in the Indian context. Aim: To assess the utility of copeptin as a diagnostic marker of PCOS and to evaluate the correlation of serum copeptin levels with metabolic syndrome components in women with PCOS. Materials and Methods: This cross-sectional analytical study was conducted at Father Muller Medical College Hospital, Mangalore, Karnataka, India, from June 2022 to September 2023. A total of 60 subjects with PCOS were selected through convenient sampling and divided into two groups: Group 1-subjects with PCOS having metabolic syndrome, and Group 2-subjects with PCOS but not having metabolic syndrome. Blood samples for serum copeptin were taken under aseptic precautions, and levels were analysed using a commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit (Biovendor, USA) following the manufacturers’ instructions. The copeptin ELISA kit had an assay range of 0-100 pmol/L and results were expressed in ng/mL. Serum insulin levels were measured using specific Electro-chemiluminescence immunoassays. Levels of total cholesterol, High-Density Lipoprotein Cholesterol (HDL-C), and Triglycerides (TG) were determined with enzymatic colorimetric assays by spectrophotometry. Low-Density Lipoprotein Cholesterol (LDL-C) was calculated using the Friedewald formula. Insulin resistance was calculated using the Homeostasis Model Assessment Insulin Resistance Index (HOMA-IR). Statistical analysis was done by using descriptive statistics. A comparison was done by student’s unpaired t-test. The chi-square test and Pearson correlation test were used for categorical data. The Statistical Package for Social Sciences (SPSS) version 24.0 was used for analysis. Results: The mean age of the study participants was 24.24±4.721 years, ranging from 15 to 43 years. The mean age of patients with metabolic syndrome was 23.96±6.3 years, while those without metabolic syndrome was 24.40±3.52 years. The mean Body Mass Index (BMI) was 31.17±5.38 in those with metabolic syndrome and 23.2±4.7 in those without (p=0.0001). The Waist-to-Hip Ratio (WHR) of Group 1 was significantly higher than Group 2 (p=0.001). The two groups did not differ significantly with regard to serum copeptin level, i.e., 7.386±4.58 in Group 1 and 8.66±6.03 in Group 2 (p=0.736). Serum copeptin levels showed a significant correlation with fasting serum insulin (0.006) and Homeostatic Model Assessment - Insulin Resistance (HOMA-IR) (0.012). Conclusion: Serum copeptin cannot be used as an independent marker for the diagnosis of metabolic syndrome in PCOS patients but may indicate other prognostic factors.

Tenebrio molitor larvae are the first insect species to be given a favorable assessment by the European Food Safety Authority (EFSA) as a novel food source, enabling consumption of whole insect larvae or larvae that have been powdered and processed into a variety of food products. Pressure from economic hardships and increase in population growth have paved a way for the realization of an alternative food source in Zimbabwe. This study focused on determining the potential toxicity of Tenebrio molitor larvae powder as an alternative food source for humans. To determine the sub-chronic toxicity of Tenebrio molitor, the powder was administered daily by oral gavage to Sprague-Dawley rats at dose levels of 0, 300, 1000 and 3000 mg/kg for 70 days. A toxicological assessment which included mortality, appearance of clinical symptoms, food consumption, organ and body weight changes were performed. There were no treatment-related mortalities, clinical signs, changes in food consumption, body and organ weights observed during the treatment period. The study's findings suggest Tenebrio molitor larvae to be a good alternative as it did not appear to affect the rats' normal physiological and metabolic processes hence can be considered safe for human consumption. However, further studies on hematological, histological and biochemical markers may be necessary for confirmation of these current results.

# Background Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS. # Methods This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate. # Results Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group (*p* = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval \[CI\] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days (*p* = 0.050) but was statistically significant at 60 days (*p* = 0.043). # Conclusions Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission.

This paper reports on the growing issues experienced when conducting web-based–based research. Nongenuine participants, repeat responders, and misrepresentation are common issues in health research posing significant challenges to data integrity. A summary of existing data on the topic and the different impacts on studies is presented. Seven case studies experienced by different teams within our institutions are then reported, primarily focused on mental health research. Finally, strategies to combat these challenges are presented, including protocol development, transparent recruitment practices, and continuous data monitoring. These strategies and challenges impact the entire research cycle and need to be considered prior to, during, and post data collection. With a lack of current clear guidelines on this topic, this report attempts to highlight considerations to be taken to minimize the impact of such challenges on researchers, studies, and wider research. Researchers conducting web-based research must put mitigating strategies in place, and reporting on mitigation efforts should be mandatory in grant applications and publications to uphold the credibility of web-based research.

Abstract Background The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture. Case presentation We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability. Conclusion Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.

BackgroundCross-neurotype differences in social communication patterns contribute to high unemployment rates among adults with autism. Adults with autism can be unsuccessful in job searches or terminated from employment due to mismatches between their social attention behaviors and society’s expectations on workplace communication. ObjectiveWe propose a behavioral intervention concerning distribution of attention in triadic (three-way) conversations. Specifically, the objective is to determine whether providing personalized feedback to each individual with autism based on an analysis of their attention distribution behavior during an initial conversation session would cause them to modify their orientation behavior in a subsequent conversation session. MethodsOur system uses an unobtrusive head orientation estimation model to track the focus of attention of each individual. Head orientation sequences from a conversation session are analyzed based on five statistical domains (eg, maximum exclusion duration and average contact duration) representing different types of attention distribution behavior. An intervention is provided to a participant if they exceeded the nonautistic average for that behavior by at least 2 SDs. The intervention uses data analysis and video modeling along with a constructive discussion about the targeted behaviors. Twenty-four individuals with autism with no intellectual disabilities participated in the study. The participants were divided into test and control groups of 12 participants each. ResultsBased on their attention distribution behavior in the initial conversation session, 11 of the 12 participants in the test group received an intervention in at least one domain. Of the 11 participants who received the intervention, 10 showed improvement in at least one domain on which they received feedback. Independent t tests for larger test groups (df>15) confirmed that the group improvements are statistically significant compared with the corresponding controls (P

In this work, epoxy resin-based composites reinforced with nanoclays, nanoalumina, carbon nanotubes (CNTs) (0.15, 0.50, and 1.50% vol were submitted to morphological characterization by scanning (SEM) and transmission (TEM) electron microscopies, electrical tests through electrical impedance spectroscopy, and electromagnetic analyses (scattering parameters), in the frequency range of 8.2 to 12.4 GHz. SEM images of the CNT composite revealed nanotube clusters in the matrix. The proximity between the CNTs is corroborated by the increase in the electrical conductivity of the composite due to the formation of a long-range electron transport network, which favored the polarization effect, absorption losses (SEA = 1.33 dB), reflection (SER = 3.38 dB) and reflection loss (RL = -6.61 dB at 10.8 GHz). Composites with nanoclays and nanoalumina showed no significant electrical and electromagnetic results.

Summary: Background: Autistic people are a high-risk group for self-harm and suicide. There are no evidence-based suicide prevention interventions developed specifically for autistic people. We undertook a pilot feasibility randomised controlled trial of autism adapted safety plans (AASP) to reduce self-harm and suicide for autistic people. Methods: This study took place in the United Kingdom and followed a randomised, two-arm, controlled design. Autistic adults (n = 53, mean age = 39, gender = 49% female, 29% not male or female) were recruited via third sector organisations and self-referral between 11.8.21 and 19.10.22. Participants were randomised without stratification to usual care with or without AASP. The AASP was completed by the autistic adults together with someone trained to support them. Research staff who completed follow-up assessments were blind to participant allocation. Primary outcomes were feasibility and acceptability. Participants were assessed at baseline, 1 and 6 months. Primary data were analysed under the intention to treat principle. Study protocol is published. The trial is closed to new participants. This study is registered with the ISRCTN registry, ISRCTN70594445. Findings: 53 participants consented, 49 were randomised to either AASP with usual care (n = 25) or usual care (n = 24). 68% of participants in the AASP arm were satisfied with the AASP and 41% rated it as useable. Feedback on the AASP and research methods were positive with suggested adaptations to some outcome measures. Retention and completion of outcomes measures in both arms was excellent, as was fidelity of delivery of the AASP. Interpretation: Study progression criteria were met, suggesting that the parameters of a future definitive trial of clinical and cost effectiveness of AASP to reduce self-harm and suicide in autistic adults are achievable, with minor recommended adaptions to outcome measures and AASP. Future research should explore the use of AASP in routine clinical practice. Funding: This study is funded by the NIHR [Public Health Research Programme (NIHR129196)].

IntroductionStereotactic radiotherapy (SBRT) potentially has a role in the management of oligometastatic melanoma. However, literature with data specific to this management is very limited. The objectives of this study were to evaluate the time to local control (LC) of extra-cranial melanoma metastases after SBRT treatment and to help establish if SBRT is a useful therapy for oligometastatic melanoma.MethodsA retrospective study was conducted with data collected from two referral centers in France between 2007 and 2020. The oligometastatic status of patients was reported based on the latest recommendations with a maximum of three lesions prior to treatment.ResultsA total of 69 patients receiving SBRT for 88 oligometastatic melanoma metastases were included. The median follow-up time was 42.6 months. Most patients were treated for metachronous oligometastatic lesions. Occurrence of oligoprogression, oligorecurrence, and oligopersistence was reported in 42.0%, 39.1%, and 17.4% of cases, respectively. Treated lesions were mostly pulmonary (40.6%), followed by lymph node (34.8%) and hepatic sites (24.6%). Progression-free survival at 1, 2, and 3 years were 47.0% (35-59), 27.0% (16-39), and 25.0% (15.0-37.0), respectively. Time to LC rates at 1, 2, and 3 years were 94.2% (87.0-98.1), 90.3% (81.3-96.1), and 90.3% (81.3-96.1), respectively. Overall survival at 1, 2, and 3 years were 87% (76.0-93.0), 74.0% (76.0-93.0), and 61.0% (47.0-73.0), respectively. Only 17.4% of patients experienced acute, grade 1 or grade 2 toxicities with no reports of grade 3 or higher toxicities.ConclusionSBRT demonstrated efficacy in managing melanoma patients with extracranial oligometastases and showed an overall low toxicity profile. Future randomized studies are needed to establish the role of SBRT in therapeutic approaches for patients with oligometastatic melanoma.

Abstract Rising atmospheric vapour pressure deficit (VPD) associated with climate change affects boreal forest growth via stomatal closure and soil dryness. However, the relationship between VPD and forest growth depends on the climatic context. Here we assess Canadian boreal forest responses to VPD changes from 1951-2018 using a well-replicated tree-growth increment network with approximately 5,000 species-site combinations. Of the 3,559 successful growth models, we observed a relationship between growth and concurrent summer VPD in one-third of the species-site combinations, and between growth and prior summer VPD in almost half of those combinations. The relationship between previous year VPD and current year growth was almost exclusively negative, while current year VPD also tended to reduce growth. Tree species, age, annual temperature, and soil moisture primarily determined tree VPD responses. Younger trees and species like white spruce and Douglas fir exhibited higher VPD sensitivity, as did areas with high annual temperature and low soil moisture. Since 1951, summer VPD increases in Canada have paralleled tree growth decreases, particularly in spruce species. Accelerating atmospheric dryness in the decades ahead will impair carbon storage and societal-economic services.

Abstract Background In case of locally advanced and/or non-metastatic unresectable esophageal cancer, definitive chemoradiotherapy (CRT) delivering 50 Gy in 25 daily fractions in combination with platinum-based regimen remains the standard of care resulting in a 2-year disease-free survival of 25% which deserves to be associated with new systemic strategies. In recent years, several immune checkpoint inhibitors (anti-PD1/anti-PD-L1, anti-Program-Death 1/anti-Program-Death ligand 1) have been approved for the treatment of various solid malignancies including metastatic esophageal cancer. As such, we hypothesized that the addition of an anti-PD-L1 to CRT would provide clinical benefit for patients with locally advanced oesophageal cancer. To assess the efficacy of the anti-PD-L1 durvalumab in combination with CRT and then as maintenance therapy we designed the randomized phase II ARION (Association of Radiochemotherapy with Immunotherapy in unresectable Oesophageal carciNoma- UCGI 33/PRODIGE 67). Methods ARION is a multicenter, open-label, randomized, comparative phase II trial. Patients are randomly assigned in a 1:1 ratio in each arm with a stratification according to tumor stage, histology and centre. Experimental arm relies on CRT with 50 Gy in 25 daily fractions in combination with FOLFOX regimen administrated during and after radiotherapy every two weeks for a total of 6 cycles and durvalumab starting with CRT for a total of 12 infusions. Standard arm is CRT alone. Use of Intensity Modulated radiotherapy is mandatory. The primary endpoint is to increase progression-free survival at 12 months from 50 to 68% (HR = 0.55) (power 90%; one-sided alpha-risk, 10%). Progression will be defined with central external review of imaging. Ancillary studies are planned PD-L1 Combined Positivity Score on carcinoma cells and stromal immune cells of diagnostic biopsy specimen will be correlated to disease free survival. The study of gut microbiota will aim to determine if baseline intestinal bacteria correlates with tumor response. Proteomic analysis on blood samples will compare long-term responder after CRT with durvalumab to non-responder to identify biomarkers. Conclusion Results of the present study will be of great importance to evaluate the impact of immunotherapy in combination with CRT and decipher immune response in this unmet need clinical situation. Trial registration ClinicalTrials.gov, NCT: 03777813.Trial registration date: 5th December 2018.

The purpose of this study was to develop a formulation for a recombinant prefusion spike protein vaccine against SARS-CoV-2. It was found that the spike protein was susceptible to aggregation due to mechanical stress. Therefore, formulation studies were initiated focused on screening pharmaceutical excipients capable of preventing this. The screening of a panel of potential stabilizing conditions found that Tween 20 could inhibit mechanically induced aggregation. A concentration-dependent study indicated that a higher concentration of Tween 20 (0.2% v/v) was required to prevent conformational changes in the trimer. The conformational changes induced by mechanical stress were characterized by size exclusion chromatography (SEC) and hydrogen–deuterium exchange mass spectrometry (HDX-MS), indicating the formation of an extended trimeric conformation that was also unable to bind to antibodies directed to the S2 domain. Long-term stability modeling, using advanced kinetic analysis, indicated that the formulation containing 0.2% (v/v) Tween 20 at a neutral pH was predicted to be stable for at least two years at 2 °C to 8 °C. Additional stabilizer screening conducted by thermal shift assay indicated that sucrose and glycerol were able to significantly increase the spike protein melting temperature (Tm) and improve the overall thermostability of the spike protein in a short-term stability study. Thus, while 0.2% (v/v) Tween 20 was sufficient to prevent aggregation and to maintain spike protein stability under refrigeration, the addition of sucrose further improved vaccine thermostability. Altogether, our study provides a systematic approach to the formulation of protein-based COVID-19 vaccine and highlights the impact of mechanical stress on the conformation of the spike protein and the significance of surfactants and stabilizers in maintaining the structural and functional integrity of the spike protein.

Flatfoot is a common foot deformity, causing foot pain, osteoarthritis of the midfoot, and even knee and hip dysfunction. The elastic modulus of foot soft tissues and its association with gait biomechanics still remain unclear. For this study, we recruited 20 young individuals with flatfoot and 22 age-matched individuals with normal foot arches. The elastic modulus of foot soft tissues (posterior tibial tendon, flexor digitorum brevis, plantar fascia, heel fat pad) was obtained via ultrasound elastography. Gait data were acquired using an optical motion capture system. The association between elastic modulus and gait data was analyzed via correlation analysis. The elastic modulus of the plantar fascia (PF) in individuals with flatfoot was higher than that in individuals with normal foot arches. There was no significant difference in the elastic modulus of the posterior tibial tendon (PTT), the flexor digitorum brevis (FDB), or the heel fat pad (HFD), or the thickness of the PF, PTT, FDB, and HFD. Individuals with flatfoot showed greater motion of the hip and pelvis in the coronal plane, longer double-support phase time, and greater maximum hip adduction moment during walking. The elastic modulus of the PF in individuals with flatfoot was positively correlated with the maximum hip extension angle (r = 0.352, p = 0.033) and the maximum hip adduction moment (r = 0.429, p = 0.039). The plantar fascia is an important plantar structure in flatfoot. The alteration of the plantar fascia’s elastic modulus is likely a significant contributing factor to gait abnormalities in people with flatfoot. More attention should be given to the plantar fascia in the young population with flatfoot.

This work aimed at optimizing the preparation of activated carbon (AC) from Kraft lignin for the adsorption of methylene blue (MB) and amoxicillin (AMX) from water. A full factorial design of three factors (precursor:activating agent (H3PO4) ratio, pyrolysis temperature, and residence time) at two levels was used to optimize the AC production. Eight AC products were obtained and evaluated considering the following responses: product yield, specific surface area (SBET), energy consumption, and adsorptive removal of the contaminants under study. The produced AC presented satisfactory SBET, ranging between 750 and 1335 m2 g−1, and efficient adsorption of MB and AMX from water, achieving up to 99% removal under the studied experimental conditions (100 mg L−1 of MB and AMX solution and material dose of 1 g L−1). Statistical analysis showed that product yield and energy consumption for AC production were influenced by temperature and residence time. The determination of a desirability function indicated a precursor/H3PO4 ratio of 1:2, pyrolysis at 700 °C, and residence time of 60 min as the optimal production conditions. The optimized AC presented SBET 1335 m2 g−1 and maximum adsorption capacity of 210 and 280 mg g−1 for MB and AMX, respectively.

Abstract Background Exploration of biomarkers for debilitating diseases such as cervical spondylosis is important to revolutionize clinical diagnosis and management of such conditions. The study aimed to determine the correlation between neck pain and disability and serum levels of interleukin-6 (IL-6), osteoprotegerin (OPG), estradiol (E2), testosterone (TES), calcium (Ca), and magnesium (Mg) among individuals with symptomatic cervical spondylosis. Methods This study was a cohort design. The participants were new referrals to two Nigerian physical therapy clinics. Participants’ neck pain intensity (PI), neck disability index (NDI), IL-6, OPG, E2, TES, Ca, and Mg were measured at baseline and after 13 weeks of follow-up. Data were analyzed using descriptive statistics, independent samples t test, Pearson’s correlation, and multiple linear regression. Results Forty individuals aged 52.40 ± 8.60 years participated in the study. Women had significantly higher levels of IL-6 (t = − 2.392, p = 0.026), OPG (t = − 3.235, p = 0.005), E2 (t = − 6.841, p = 0.001), but lower TES (t = 17.776, p = 0.001). There were no significant sex differences in PI and NDI. There were significant correlations between PI and OPG (r = 0.385, p

Background: Merkel cell carcinoma (MCC) is a rare type of neuroendocrine tumor. Palpebral localization represents 2.5% of MCCs. Surgery is not always possible due to the localization or comorbidities of elderly patients. We hypothesized that radiotherapy (RT) alone could be a curative treatment in patients contraindicated for oncological surgery. Methods: We performed a retrospective monocentric study of patients with localized eyelid MCC treated with curative intent using curative radiotherapy. Results: Overall, 11 patients with histologically confirmed eyelid MCC were treated with curative radiotherapy. The median age was 77 years old (range: 53–94). Curative RT was decided mainly due to difficult localization and significant co-morbidities. The median lesion dose was 57 Gy (range: 47–70). Most patients had adjuvant lymph nodes irradiation with a median dose of 50 Gy (n = 9; 82%). The median follow-up was 62 months (6–152 months). None of the seven deaths were MCC-related. None of our patients relapsed during follow-up. Side effects related to radiotherapy were mild (no grade ≥ 2) and rare (n = 3, 21%). Conclusion: Our data suggest that curative radiotherapy is an effective and safe treatment for Merkel cell carcinoma of the eyelid and periocular region. Radiotherapy alone allows limiting the aesthetic and functional sequelae in elderly and comorbid patients who are contraindicated for oncological surgery.

It is particularly important to investigate the mechanical performance of carbon fiber (CF) reinforced polyamide 6 (PA6) composites used for automotive and aerospace applications, where diffused moisture of the environment may potentially weaken the material over time. In this work, CF/PA6 composites were subjected to two different types of conditioning: distilled water at a temperature of 80 ºC and saline solution for 12 weeks. The volumetric fraction of CF, PA6 matrix, and the voids of the CF/PA6 composites were determined by acid digestion analysis. At the end of the environmental conditionings, the moisture absorption content and the diffusion coefficient (D) were determined. The mechanical performance of CF/PA6 composites unconditioned and conditioned was evaluated through tensile and interlaminar shear strength (ILSS) tests, and morphological characteristics of the fracture surface after the mechanical tensile test. CF/PA6 composites conditioned in saline solution showed a decrease of 53% (tensile sample) and 72% (ILSS sample) in the diffusion coefficient (D) and insignificant losses of mechanical properties when compared to CF/PA6 composites conditioned in distilled water at 80 ºC. This behavior is attributed to the salt molecules blocking the pores and consequently reducing the migration of water into the samples, maintaining the internal integrity of the specimens.

BackgroundMost of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs).ObjectiveThe main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs.MethodologyThe present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics.ResultsIn total, 69.2% of PWDs were female individuals. Many PWDs were aged 10–20 years (57% of the sample size). Physical/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (F = 35.11, p

Co(II), Cu(II), and Ni(II) quinolyl Schiff base complexes of (E)-1-(quinolin-2-yl)-N-(quinolin-8yl)methan- imine and (E)-2-((quinolin-8-ylimino)methyl)quinolin-8-ol that were designed here, have been the focus of theoretical simulations based on density functional theory at the ɷB97XD/def2svp level of computation to examine their potential to act effectively as phosgene gas adsorbent materials. According to our findings for electronic properties, surfaces' energy gaps significantly increased during complexation with gas molecules. It was discovered that Ni(II) complexes improved in conductivity and stability on adsorption and Ni_Str01_Cl became more conductive. The variation of the HOMO and LUMO energies was graphically depicted in the density of State (DOS) plots. For all complexes, significant intramolecular interactions between filled and unfilled orbitals were observed. Co_Str02 also exhibited the maximum perturbation energies, which shows that it is stable for the investigated gas adsorption. The active sites realized from the MESP map are clear evidence of the adsorption capacity of the studied complexes Topology analysis suggests both the covalent nature and noncovalent nature of the interaction. Furthermore, the analysis of non-covalent interaction demonstrated weak bonded interaction of vdW type between metal complexes and gas molecule. This suggests good interaction between COCl2 gas molecule and adsorbing complexes. From our calculation, for adsorption energies, Ni-Str01_Cl is observed with negative adsorption energy -6.531 eV and a short distance which shows strong chemisorption with COCl2 gas molecule whereas positive adsorption energies are found for other complexes. Hence, Ni_Str01 is considered a better adsorbent compared to other surfaces. The groundwork for using quinolyl Schiff bases metal complexes to detect COCl2 gas molecules is laid by the current research.

ABSTRACTThe current healthcare system disproportionately affects vulnerable populations, leading to disparities in health outcomes. As a result, medical schools need to equip future physicians with the tools to identify and address healthcare disparities. The University of Nevada, Reno School of Medicine implemented a Scholarly Concentration in Medical Social Justice (SCiMSJ) program to address this issue. Three medical students joined the program and pioneered a project to address the equitable vaccine distribution within the local Hispanic/Latinx community. After identifying the disparity in vaccine uptake and high levels of vaccine hesitancy, they collaborated with local organizations to address vaccine misinformation and accessibility. They organized outreach events, provided vaccine education, and hosted a vaccine clinic at a Catholic church with a high Hispanic/Latinx congregation. Through their efforts, they administered 1,456 vaccines. The estimated economic and societal impacts of their work was 879 COVID-19 cases avoided, 5 deaths avoided, 45 life years saved, and $29,286 in economic value. The project’s success highlights the effectiveness of a student-led approach to promote skill development in social justice training. Leadership skills and coalition building were crucial in overcoming resource limitations and connecting organizations with the necessary volunteer force. Building trust with the Hispanic/Latinx community through outreach efforts and addressing vaccine hesitancy contributed to the well-attended vaccine clinic. The project’s framework and approach can be adopted by other medical students and organizations to address health disparities and improve health outcomes in their communities.

Abstract Prolonged exposure to environmental conditions such as ultraviolet radiation, humidity, and temperature, to which carbon fiber-reinforced thermoplastic polymer components are exposed during their service life, can lead to significant changes in mechanical, physical, and chemicals properties, and can often be irreversible, resulting in premature component failure. This study presents the influence of accelerated weathering exposure times (400 h, 800 h, and 1200 h) on the mechanical, thermal, and structural properties of carbon fiber (CF)/polyamide 6 (PA6) laminates. Analyses of composite surfaces were carried out using microscopy and contact angle measurements, which indicated that the factors of exposure to accelerated only affected the surface of the composites, showing signs of the beginning of degradation. The tensile strength (609 MPa ± 10 MPa) and interlaminar shear strength (27 MPa ± 0.9 MPa) did not present significant changes, showing that the reinforcement, the matrix, and the interface remained stable after exposure to accelerated.