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The purpose of this pilot study was to determine whether positive results from a word-problem intervention implemented one-to-one contributed to similar outcomes when implemented in small groups of three to four students. Third-grade students experiencing mathematics difficulty (N = 76) were randomly assigned to word-problem intervention (n = 56) or business-as-usual comparison (n = 20). Intervention occurred for 13 weeks, 3 times per week, 30 min per session. Multilevel models revealed the intervention condition significantly outperformed the BaU on a proximal word-problem outcome, corroborating results from our prior individual intervention. When comparing student performance in the individual versus small-group intervention, findings suggest students received added benefit from the individual intervention. The word-problem intervention successfully translated to a small-group setting, which holds important implications for educators working with students in supplemental, targeted, or Tier 2 mathematics intervention settings.

IntroductionPatients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience cognitive problems with attention, information processing speed, working memory, learning efficiency, and executive function. Commonly, patients report worsening of cognitive symptoms over time after physical and/or cognitive challenges. To determine, monitor, and manage longitudinal decrements in cognitive function after such exposures, it is important to be able to screen for cognitive dysfunction and changes over time in clinic and also remotely at home. The primary objectives of this paper were: (1) to determine whether a brief computerized cognitive screening battery will detect differences in cognitive function between ME/CFS and Healthy Controls (HC), (2) to monitor the impact of a full-day study visit on cognitive function over time, and (3) to evaluate the impact of exercise testing on cognitive dysfunction.MethodsThis cognitive sub-study was conducted between 2013 and 2019 across seven U.S. ME/CFS clinics as part of the Multi-Site Clinical Assessment of ME/CFS (MCAM) study. The analysis included 426 participants (261 ME/CFS and 165 HC), who completed cognitive assessments including a computerized CogState Brief Screening Battery (CBSB) administered across five timepoints (T0-T4) at the start of and following a full day in-clinic visit that included exercise testing for a subset of participants (182 ME/CFS and 160 HC). Exercise testing consisted of ramped cycle ergometry to volitional exhaustion. The primary outcomes are performance accuracy and latency (performance speed) on the computerized CBSB administered online in clinic (T0 and T1) and at home (T2-T4).ResultsNo difference was found in performance accuracy between ME/CFS and HCs whereas information processing speed was significantly slower for ME/CFS at most timepoints with Cohen’s d effect sizes ranging from 0.3–0.5 (p < 0.01). The cognitive decline over time on all CBSB tasks was similar for patients with ME/CFS independent of whether exercise testing was included in the clinic visit.ConclusionThe challenges of a clinic visit (including cognitive testing) can lead to further cognitive deficits. A single short session of intense exercise does not further reduce speed of performance on any CBSB tasks.

Background: Despite the widespread prevalence and substantial burden of mental disorders, they remain significantly underdiagnosed and undertreated. In low- and middle-income countries like Senegal, integrating mental health services into primary care represents the most feasible strategy to bridge the treatment gap. This study aimed to assess the effects of a mental health e-learning program on the knowledge, attitudes, and practices of allied and healthcare professionals in Senegal. Methods: An e-learning platform including 12 interactive modules was used to train 322 allied and healthcare professionals. We evaluated changes in knowledge, attitudes, and practices, as well as in satisfaction with knowledge and in self-assessed ability to diagnose and manage patients, by comparing data collected before and after the e-learning modules. Qualitative feedback on the satisfaction with the various components of the program was also collected via a post-training survey. Outcomes: Knowledge, attitudes and practices scores increased significantly for all modules. Additionally, scores related to satisfaction with knowledge and ability to diagnose and manage patients showed significant improvements (+77.0 % and +75.0 %, respectively), surpassing the gains observed in knowledge, attitudes, and practices scores (+19.2 %, +11.1 % and +15.0 %, respectively). Mean scores regarding participants' satisfaction with the various elements of the program ranged from 8.1 to 9.1, out of a maximum of 10. Conclusion: Although only a limited number of participants completed all 12 modules, the mental health e-learning program showed positive results on the knowledge, attitudes, and practices of participants. It also increased their confidence and was perceived as a very positive experience by learners.

Background: Hydro-electrolyte balance is necessary to maintain body homeostasis and blood pressure values within narrow limits. This is accomplished, in part, by renal responses. We conducted this study to determine the effects of Combretum micranthum on hydro-electrolyte metabolism, renal function and arterial blood pressure. Subjects and methods: We conducted a pilot study including 40 subjects: 10 control subjects, 10 subjects under Combretum micranthum G. Don (400 mg/day), 10 subjects under furosemide (120 mg/day), and 10 subjects under spironolactone (50 mg/day).Anthropobiometric, cardiovascular parameters and the body composition were collected from each subject. Blood and 24-hour urine samples were collected for biological tests. Results: At baseline, clinical and biological parameters were comparable for all groups. Consumers of combretum micranthum had a significant decrease in global body fat percentage (−1.63 %; p = 0.045). In the group of combretum micranthum consumers, the body water mass (BWM) is significantly evolved in the direction of an increase (4.37; p = 0.023) and similar to what was observed in the group of subjects treated with spironolactone (0.67; p = 0.042). Consumption of combretum micranthum showed a marked reduction in hypertension indices (systolic blood pressure, diastolic blood pressure and heart rate) identical to that induced by consumption of furosemide or spironolactone. The consumption of combretum micranthum resulted in a significant reduction in kaliemia (−1.07; p

ABSTRACT Respiratory disease, attributed to influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, was reported nationally during the 2023/2024 respiratory viral season. The emergence of novel SARS-CoV-2 variants was considered a significant factor contributing to the rise in COVID-19 cases. Data from the Johns Hopkins Hospital System (JHHS) showed that enterovirus/rhinovirus had also been circulating at high rates. Analyzing clinical outcomes of the most prevalent respiratory viruses is crucial for understanding the role of circulating viral genotypes. A retrospective cohort of patients who tested positive for SARS-CoV-2, influenza, RSV, or enterovirus/rhinovirus between 1 June and 31 December 2023 was included in the study. Remnant clinical samples were utilized for targeted viral whole-genome sequencing and genotyping. Patients’ metadata and outcomes following infection were studied, stratified by viral variants and genotypes. The increase of SARS-CoV-2 positivity in December was associated with the predominance of JN.1. Admissions for patients under 18 years old were primarily associated with enterovirus/rhinovirus and RSV, while older age groups were mainly linked to SARS-CoV-2 and influenza infections. SARS-CoV-2-related admissions increased with the predominance of the JN.1 variant in December. No significant difference in admissions for influenza subtypes, rhinovirus species, or SARS-CoV-2 variants was observed. RSV A was associated with slightly higher odds of admission compared with RSV B. Our data highlight the importance of systematically analyzing respiratory viral infections to inform public health strategies and clinical management, especially as SARS-CoV-2 becomes endemic. The findings highlight the value of expanded genomic surveillance in elucidating the clinical significance of viral evolution.IMPORTANCEThe analysis of the epidemiology and clinical outcomes of multiple co-circulating respiratory viruses in the early 2023/2024 respiratory virus season highlights the emergence of the SARS-CoV-2 JN.1 variant as well as underscores the importance of enterovirus/rhinovirus in respiratory infections. Understanding these dynamics is essential for refining public health strategies and clinical management, especially as SARS-CoV-2 transitions to an endemic status. This work emphasizes the need for ongoing surveillance, robust diagnostic algorithms, and detailed genomic analyses to anticipate and mitigate the burden of respiratory viral infections, ultimately contributing to more informed decision-making in healthcare settings and better patient outcomes.

Background: Clinical and translational research has identified deficits in the dopaminergic neurotransmission in the striatum in Alzheimer's disease (AD) and this could be related to the pathophysiology of psychiatric symptoms appearing even at early stages of the pathology. Hypothesis: We hypothesized that AD pathology in the hippocampus may influence dopaminergic neurotransmission even in the absence of AD-related lesion in the mesostriatal circuit. Methods: We chemogenetically manipulated the activity of hippocampal neurons and astrocytes in wild-type and hemizygous TgF344-AD (Tg) rats, an animal model of AD pathology. We assessed the brain-wide functional output of this manipulation using in vivo Single Photon Emission Computed Tomography to measure cerebral blood flow and D2/3 receptor binding, in response to acute (3 mg kg-1 i.p.) and chronic (0.015 mg/ml in drinking water, 28 days) stimulation of neurons or astrocytes with clozapine N-oxide. We also assessed the effects of the chronic chemogenetic manipulations on D2 receptor density, low or high aggregated forms of amyloid Aβ40 and Aβ42, astrocytes and microglial reactivity, and the capacity of astrocytes and microglia to surround and phagocytize Aβ both locally and in the striatum. Results: We showed that acute and chronic neuronal and astrocytic stimulation induces widespread effects on the brain regional activation pattern, notably with an inhibition of striatal activation. In the Tg rats, both these effects were blunted. Chemogenetic stimulation in the hippocampus increased microglial density and its capacity to limit AD pathology, whereas these effects were absent in the striatum perhaps as a consequence of the altered connectivity between the hippocampus and the striatum. Conclusions: Our work suggests that hippocampal AD pathology may alter mesostriatal signalling and induce widespread alterations of brain activity. Neuronal and astrocytic activation may induce a protective, Aβ-limiting phenotype of microglia, which surrounds Aβ plaques and limits Αβ concentration more efficiently.

This study examined the influence of addition and subtraction practice embedded within a word-problem intervention for Grade 3 students experiencing word-problem difficulty. Students (N = 448) were randomly assigned to one of two variants of a word-problem intervention or a business-as-usual comparison condition. Within the word-problem interventions, students participated in targeted addition and subtraction fact and computation practice for approximately 3 minutes of each 30-minute session across 47 intervention sessions, but also continually practiced addition and subtraction through word-problem solving. At posttest, students who participated in the intervention demonstrated improved single-digit addition and subtraction performance as well as improved double-digit addition and subtraction performance. At follow-up in Grade 4, persistence of effects was only identified for double-digit addition. Considering addition and subtraction are foundational to many other mathematics skills, addition and subtraction practice serves as an important component of mathematics intervention.

Peanut is a worldwide oilseed crop and the need to assess germplasm in a non-destructive manner is important for seed nutritional breeding. In this study, Near Infrared Spectroscopy (NIRS) was applied to rapidly assess germplasm variability from whole seed of 699 samples, field-collected and assembled in four genetic and environment-based sets: one set of 300 varieties of a core-collection and three sets of 133 genotypes of an interspecific population, evaluated in three environments in a large spatial scale of two countries, Mbalmayo and Bafia in Cameroon and Nioro in Senegal, under rainfed conditions. NIR elemental spectra were gathered on six subsets of seeds of each sample, after three rotation scans, with a spectral resolution of 16 cm-1 over the spectral range of 867 nm to 2530 ​nm. Spectra were then processed by principal component analysis (PCA) coupled with Partial least squares-discriminant analysis (PLS-DA). As results, a huge variability was found between varieties and genotypes for all NIR wavelength within and between environments. The magnitude of genetic variation was particularly observed at 11 relevant wavelengths such as 1723 ​nm, usually related to oil content and fatty acid composition. PCA yielded the most chemical attributes in three significant PCs (i.e., eigenvalues >10), which together captured 93% of the total variation, revealing genetic and environment structure of varieties and genotypes into four clusters, corresponding to the four samples sets. The pattern of genetic variability of the interspecific population covers, remarkably half of spectrum of the core-collection, turning out to be the largest. Interestingly, a PLS-DA model was developed and a strong accuracy of 99.6% was achieved for the four sets, aiming to classify each seed sample according to environment origin. The confusion matrix achieved for the two sets of Bafia and Nioro showed 100% of instances classified correctly with 100% at both sensitivity and specificity, confirming that their seed quality was different from each other and all other samples. Overall, NIRS chemometrics is useful to assess and distinguish seeds from different environments and highlights the value of the interspecific population and core-collection, as a source of nutritional diversity, to support the breeding efforts.

This paper examines the influence of various factors, including the addition of nano-calcium carbonate particles (chemical processes, C) to CPBs, non-isothermal field curing temperatures (thermal factor, T), and field vertical curing stress (mechanical factor, M), on the self-desiccation capacity of CPB plugs. The assessment of self-desiccation involves the determination of pore water pressure (PWP) and volumetric water content (VWC) in the examined CPBs. Thermo-mechanical-chemical (TMC) column experiments were conducted to investigate the interaction among these factors and their collective impact on the evolution of PWP and VWC within the CPB plug. The findings underscore that each factor, both individually and in combination, significantly affects the magnitude and progression of self-desiccation in CPB plugs. Notably, the factors of elevated field temperature and the introduction of nano-calcium carbonate (NC) to the CPB exert the most substantial influence on the extent and enhancement of self-desiccation, whereas the impact of field curing stress in isolation is comparatively much weaker. The integration of nano-calcium carbonate, especially under non-isothermal conditions and concurrent field stress, emerges as a key contributor to enhanced PWP and VWC dissipation rates. The role of non-isothermal field curing temperature is underscored as a significant contributing factor in the self-desiccation of CPB plugs. The results presented in this paper will contribute to a more cost-effective design of CPB plugs and the improved optimization of CPB mixtures with nano-calcium carbonate particles.

INTRODUCTION: Many studies have reported the association of SARS-CoV-2 with benign and malignant hemopathies. Data from African series are scarce. This work was conducted in sub-Saharan Africa and aimed to study the clinical, biological, and evolutionary features of hemopathies associated with this infection. MATERIALS AND METHODS: It was a retrospective, cross-sectional study carried out over 32 months including 86 patients with benign or malignant hemopathies who underwent coronavirus disease-2019 (COVID-19) confirmed by the real-time reverse transcriptase-polymerase chain reaction or presenting with atypical clinical signs associated with highly suggestive computed tomography (CT) scan signs. RESULTS: The mean age of patients was 48.3 ± 18.7 years with a sex ratio of 0.75. The main benign hemopathies were sickle cell trait (SCT) (n = 51), sickle cell disease SS (n = 8), and sickle cell disease SC (n = 1), while malignant hemopathies were represented by multiple myeloma (n = 5), non-Hodgkin lymphoma (n = 5), and chronic lymphocytic leukemia (n = 4). The clinical symptoms mainly featured anemic syndrome (16.3%) and a vaso-occlusive crisis was found in 9.3% of homozygous sickle-cell patients. The infection was moderate in 48% of cases and severe in 19.7%. The severe forms were commonly found in patients with malignant hemopathies (47.6%) and the benign forms were noted in benign hemopathies (38.4%). Full blood count outlined anemia in 32.5% and lymphopenia in 23.2% of cases. On imaging, the CT scan reported severe lesions in 41.3% of cases. The outcome resulted in full recovery in 76.7% of cases, and mortality occurred in 23.3%. In univariate analysis, death was mainly noted in patients with lymphoid hemopathies (15%). Comorbidities (P < 0.0001), lymphoid hemopathies (P < 0.0001), and the severity of COVID-19 (P < 0.0001) had a positive impact on death occurrence in univariate analysis. CONCLUSION: The association between SARS-CoV-2 and hemopathy is not uncommon and is dominated by benign hemopathies. Malignant hemopathies are at-risk underlying conditions justifying a hospital follow-up of mild forms, allowing better survival. Particular attention must be paid to SCT with comorbidities and those with sickle cell disease of disease.

Abstract Plasma metabolomics holds potential for precision medicine, but limited information is available to compare the performance of such methods across multiple cohorts. We compared plasma metabolite profiles after an overnight fast in 11,309 participants of five population-based Swedish cohorts (50–80 years, 52% women). Metabolite profiles were uniformly generated at a core laboratory (Metabolon Inc.) with untargeted liquid chromatography mass spectrometry and a comprehensive reference library. Analysis of a second sample obtained one year later was conducted in a subset. Of 1629 detected metabolites, 1074 (66%) were detected in all cohorts while only 10% were unique to one cohort, most of which were xenobiotics or uncharacterized. The major classes were lipids (28%), xenobiotics (22%), amino acids (14%), and uncharacterized (19%). The most abundant plasma metabolome components were the major dietary fatty acids and amino acids, glucose, lactate and creatinine. Most metabolites displayed a log-normal distribution. Temporal variability was generally similar to clinical chemistry analytes but more pronounced for xenobiotics. Extensive metabolite-metabolite correlations were observed but mainly restricted to within each class. Metabolites were broadly associated with clinical factors, particularly body mass index, sex and renal function. Collectively, our findings inform the conduct and interpretation of metabolite association and precision medicine studies.

In 2020, a sylvatic dengue virus serotype 2 infection outbreak resulted in 59 confirmed dengue cases in Kedougou, Senegal, suggesting those strains might not require adaptation to reemerge into urban transmission cycles. Large-scale genomic surveillance and updated molecular diagnostic tools are needed to effectively prevent dengue virus infections in Senegal.

Abstract Background Following WHO guidelines, microscopy is the gold standard for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this context, we assessed the performance of the laboratory by confirming the reliability and the accuracy of results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal. Methods This is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin blood smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess microscopists’ ability to determine PD and fourteen (14) slides were used for detection (positive vs negative) and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software. Results A minimum threshold of 50% concordance was used for comparison. Of the twenty (20) slides read, 100% concordance was obtained on eight (8) detection (positive vs negative) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the microscopists. For species identification a concordance greater than 80% was noted and the microscopists obtained scores between 0.20 and 0.4 on a scale of 0 to 1 for parasite density reading. The microscopists obtained 100% precision, sensitivity, specificity and both negative and positive predictive values. Conclusion This work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD is in accordance with the requirements of WHO and ISO 15189. Further training of microscopists may be needed to maintain competency.

The effects of three medicinal plants in the feeds of juvenile Nile tilapia (Oreochromis niloticus) were investigated on growth, survival, immunity, and digestive histology at various inclusion levels: (A) Guiera senegalensis at 0, 1, 2, 4, and 8%; (B) Pluchea odorata at 0, 0.5, 1, 2, and 4%; (C) Piliostigma reticulatum at 0, 1, and 2%; and (D) a mixture of the three at 0, 1, and 2%. After 28 days of feeding, fish were infected with Aeromonas hydrophila for 12 days. The results showed that, except for G. senegalensis, the inclusion of the medicinal plants, alone or combined, enhanced the immune response. The diet with 4% P. odorata significantly increased plasma lysozyme and bactericidal activities without affecting feed conversion efficiency or growth. Despite improved immunity, none of the treatments enhanced post-infection survival rates. However, fish fed the 1% mixture showed healthier livers and intestines, with reduced cell swelling and normal lipid deposits, followed by the 2% mixture and the control. These results highlight the potential benefits of incorporating P. odorata and the plant mixture into the diets of Nile tilapia juveniles for enhancing their immune response against A. hydrophila.

This study examined the differential effects of Strategies for Reading Informational Text and Vocabulary Effectively (STRIVE) on the vocabulary, reading comprehension, and content learning among 4,757 fourth-grade students with and without disabilities. Schools were assigned to one of three conditions: researcher-supported professional development (RPD), school-supported professional development (SPD), or business as usual (BAU). Treatment teachers received 12 hr of professional development distributed over time and delivered a set of instructional practices for teaching vocabulary and comprehension embedded within 36 social studies lessons (45 min per lesson). Findings revealed that students with and without disabilities in classes assigned to STRIVE treatment (SPD and RPD) outperformed their peers in classes assigned to the BAU condition at a statistically significant level on measures of content knowledge and content vocabulary and a distal measure of vocabulary. STRIVE did not affect students with disabilities (SWDs) and without disabilities differentially on the measures of content knowledge and distal vocabulary, though effects sizes for non-SWDs in SPD and RPD were larger than those for SWDs. [For the corresponding grantee submission, see ED612377.]

Chikungunya virus has caused millions of cases worldwide over the past 20 years, with recent outbreaks in Kedougou region in the southeastern Senegal, West Africa. Genomic characterization highlights that an ongoing epidemic in Kedougou in 2023 is not due to an introduction event but caused by the re-emergence of an endemic strain evolving linearly in a sylvatic context.

In the petroleum sector, electrical submersible pumps (ESP) face numerous challenges when handling multiphase flow of gas and liquid. The primary challenge is from the build-up of the gas-bubbles within the impellers of ESPs, leading from moderate to severe deterioration in pump efficiency. Consequently, a comprehensive investigation is conducted, involving a combination of experimental and numerical analyses, to thoroughly explore the effects of gas entrainment on the performance and intricate internal flow mechanisms of a five-stage mixed-flow ESP. All these analysis was carried out under both design (Qd) and off-design conditions (0.8Qd, and 1.2Qd). For unsteady numerical calculations, two widely used multiphase-models: The volume of fluid (VOF) and The Euler-Euler model are employed and compared to investigate the versatility/validity of these models in predicting multiphase performance of ESP. The comparison between tests, Eulerian, and VOF models demonstrated that the Eulerian model aligns well with the experimental results. and shows higher-adaptability pattern with the test results. This reveals its best capability/versatility in predicting two-phase performance and internal-flow results for ESP. Moreover, it can more accurately capture the phase slippage inside ESP under two-phase flow. Additionally, this work provides a vision to the broad-applicability of Eulerian-model for complicated machinery such as ESP.

PurposeOur purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors.MethodsWe used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors.ResultsFactor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality.ConclusionNearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function.Implications for cancer survivorsImproving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors' HRQOL.

Due to observed impacts of sea level rise, many sediment management strategies in coastal settings are seeking ways to beneficially use locally dredged sediment in restoration, nourishment, and construction projects. The placement of sediment in shallow, near-marsh areas is a promising application of dredged material to both increase accretion and provide protection to marshes and intertidal flats in back bay areas. However, dredged material in these areas often include fine-grained (

Samarium diiodide (SmI2) is a single electron reductant and versatile synthetic tool that can be used to create carbon- carbon bonds or other synthetic transformations. SmI2 is typically used with an Argon atmosphere glovebox and anhydrous solvents from a solvent purification system; however, not all labs have access to these equipment. A more accessible air-free option is Schlenk line glassware. Here in reports an optimized method for the synthesis and use of SmI2 on a Schlenk line. During optimization of the system, it was found that the largest impact on the success of SmI2 was the THF solvent. Anhydrous solvent was achieved though distillation, but after storage of the solvent over two weeks enough moisture/air was accumulated to significantly impact the concentration of the SmI2 formed in solution. The use of molecular sieves further indicates that the impact of water accumulation in the solvent compared to oxygen has the most significant factor on the success of synthesizing SmI2. These observations of THF storage overtime are important to account for when carrying out SmI2 reactions and other air-sensitive reactions on the Schlenk line.

ProposeThis study aimed to propose an innovative, open, and circular program that combines acceptance and commitment therapy (ACT) and mindfulness practices. We assessed its feasibility, acceptability, and first signs of its effect on psychological wellbeing in cancer support treatment.MethodsA single-center, single-arm, uncontrolled study was performed. Forty adult patients with non-metastatic prostate or breast cancer, newly diagnosed or undergoing treatment (chemotherapy, radiotherapy, hormone therapy), were recruited. Three cycles of three MAEva program sessions (MAEva: Mindfulness meditation, Acceptance, and Commitment to values program) over nine consecutive weeks were proposed. During the total of 12 weeks of follow-up, after attending the first session, patients were free to attend subsequent sessions.ResultsAdherence to the study was high, with participation in an average of 6.8 out of nine sessions. A total of eight patients attended all sessions over the three cycles, and 90% participated in at least one cycle. Furthermore, attendance was associated with a statistically significant improvement in Quality of Life (QoL). Each additional session was associated with a mean increase in overall QoL score of more than one point (β = 1.09 [0.13; 2.04], p = 0.02). The fatigue dimensions decreased with session attendance: physical (β = −2.24 [−3.63; −0.85]), emotional (β = −2.60 [−4.11; −1.09]), and interference with daily life (β = −2.33 [−3.95; −0.72]). The qualitative section demonstrated that patients learned skills and shared their ability to “let go”. Patients rated the degree of importance of the program at 8.36/10 (SD ± 1.64).ConclusionThis study highlights the feasibility and acceptability of an original program that combines ACT and mindfulness practices in cancer patients. Future studies are required to demonstrate the efficacy of the MAEVA program. The MAEva pilot study is registered with ClinicalTrials.gov under the identifier NCT04751201.Clinical trial registrationhttps://classic.clinicaltrials.gov/ct2/show/NCT04751201, identifier [NCT04751201].

Objectives We aimed to evaluate the risk of colorectal adenocarcinoma (CRA) associated with long-term use of proton pump inhibitors (PPIs) in a large nationwide cohort.Design Retrospective cohort study.Setting This research was conducted at the national level, encompassing the entire population of Sweden.Participants This study utilised Swedish national registries to identify all adults who had ≥180 days of cumulative PPI use between July 2005 and December 2012, excluding participants who were followed up for less than 1 year. A total of 754 118 maintenance PPI users were included, with a maximum follow-up of 7.5 years.Interventions Maintenance PPI use (cumulative≥180 days), with a comparator of maintenance histamine-2 receptor antagonist (H2RA) use.Primary and secondary outcome measures The primary outcome measure was the risk of CRA, presented as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs). Subgroup analyses were performed to explore the impact of indications, tumour locations, tumour stages and the duration of follow-up. A multivariable Poisson regression model was fitted to estimate the incidence rate ratios (IRRs) and 95% CIs of PPI versus H2RA use.Results Maintenance PPI users exhibited a slightly elevated risk of CRA compared to the general population (SIR 1.10, 95% CI=1.06 to 1.13) for both men and women. Individuals aged 18–39 (SIR 2.79, 95% CI=1.62 to 4.47) and 40–49 (SIR 2.02, 95% CI=1.65 to 2.45) had significantly higher risks than the general population. Right-sided CRA showed a higher risk compared to the general population (SIR 1.26, 95% CI=1.20 to 1.32). There was no significant difference in the risk of CRA between maintenance PPI users and maintenance H2RA users (IRR 1.05, 95% CI=0.87 to 1.27, p

Gossypiboma is a dreaded complication following mainly abdomino-pelvic surgeries. The clinical presentation varies widely and is strongly associated with two factors: localization of the textiloma and type of the tissue reaction. Intravesical gossypiboma migration is rare and usually presents as recurrent urinary tract infections. We report a case of gossypiboma migration into the bladder that was treated by endoscopic extraction. The purpose of this report is to remind the importance of the prevention which must be the challenge rather than the treatment modalities.

Summary: Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022–July 2023). The first phase involved a survey to MASCC-MSG members (January 2022–May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023–May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received.

The effects of different dietary EPA/DHA ratios (2.19, 1.59, 0.98, 0.55 and 0.38, respectively) on the growth performance, intestinal microbiota, immunity and resistance to heat stress in abalone Haliotis discus hannai Ino was evaluated after a 93-day feeding trial. Five isonitrogenous and isolipic (about 33% crude protein and 3% crude lipid) practical diets were formulated to fed abalones (initial body weight: 25.82 ± 0.51 g; initial mean shell length: 59.57 ± 0.40 mm). Results showed that 0.98–2.19 dietary EPA/DHA ratio significantly increased abalone’s weight gain rate (WGR) and daily increment in shell length (DISL). As for the intestine enzyme activity, trypsin activity was significantly higher when 0.55 EPA/DHA ratio was applied to the diet. The lipase activity in the groups with 0.98 and 0.55 dietary EPA/DHA ratio was significantly higher than those in other groups. And 1.59 dietary EPA/DHA ratio significantly increased α-amylase activity. In regard to the intestinal microbiota, the 0.98 dietary EPA/DHA ratio significantly increased the diversity indices and number of OTUs in the intestine, followed by the 2.19 dietary EPA/DHA ratio. At the phyla level, Firmicutes, Proteobacteria, Bacterioidota and Actinobacteria were dominant in all groups. The Mycoplasma was the most prevalent genus among all the groups. The highest abundance of Clostridium_sensu_stricto_11, Mycobacterium and Bacteroides belonged to the group with the 0.38 dietary EPA/DHA ratio. The abundance of Bacilli, Terasakiellacease and Ahrensia in 0.38 group were higher than that in the group with 0.98 and 2.19 dietary EPA/DHA ratio. Moreover, 1.59 dietary EPA/DHA ratio significantly reduced the falling rate of abalone after heat stress. And the hsp70 and hsp90 mRNA expression levels in the digestive gland were up-regulated significantly in the group with the 2.19 dietary EPA/DHA ratio. The 0.98 dietary EPA/DHA ratio could increase the content of malondialdehyde in cell-free hemolymph and the expressions of tnfa and nrf2 in digestive gland. In conclusion, the optimal dietary EPA/DHA ratio for abalone was estimated to be 1.63 using a second-order quadratic regression based on WGR. The 1.59–2.19 dietary EPA/DHA ratio could increase the immunity and resistance of abalone against heat stress.

This study examines the effects of water vapor on the performance and stability of a Roots-type hydrogen circulation pump. The accuracy of the numerical model was initially confirmed using air as the experimental medium, and subsequent simulations were conducted with pure hydrogen or mixed media containing water vapor. Analysis of pressure and velocity distribution within the pump revealed that water vapor does not significantly impact these factors. However, the interaction between hydrogen and water vapor results in the formation of larger hydrogen clusters, reducing internal leakage flow and leading to a slight increase in inlet and outlet flow rates. The presence of water vapor in the suction chamber increases turbulence energy in the root region of the rotor, influencing flow patterns and creating multi-scale vortex structures. In the exhaust chamber, the turbulence energy is lower and there are fewer vortices, but high-energy vortices may occur at the connection to the exhaust pipe, affecting the outlet flow rate.

BackgroundThe WHO Emergency Medical Teams (EMT) Initiative coordinates the deployment of qualified medical teams who promptly respond to public health emergencies (PHEs) and provide quality service during emergencies whilst strengthening capacity. Globally, 40 EMTs have been classified between 2016 and the present (as of the writing of this article in December 2023) and are from across all the WHO regions except the WHO Africa Region (AFRO). However, WHO Africa has prioritised the implementation of EMTs in 10 priority countries to address the public health emergencies (PHEs) affecting the region.ObjectiveThis article describes the development and progress of national EMTs in the WHO African Region over the past 7 years and elucidates the main lessons learned and the complexity and challenges in the process.MethodsThis study employed a case study approach because of its appropriateness in examining a complex social phenomenon in a socio-political context in depth, using multiple lenses simultaneously. Data and information were obtained through document reviews and key informant interviews (KIIs) (n = 5) with the members of the EMT Initiative on shared field experiences. Data were systematically analysed using the Stages of Implementation Completion (SIC) framework, and the lessons learnt were presented using components of a framework from Adini et al.ResultsThe Initiative commenced in the WHO African Region following its launch in December 2017 in Senegal. The assessments of the concept’s engagement (involved learning and deciding), feasibility (reviewing expectation and capacity), and readiness planning (collaborating and preparing) showed that the context-specific (African context) challenges, lessons from different emergency response actions mainly guided the Initiative’s pre-implementation phase in the region and prompted the WHO emergency leadership on the urgency and need for the EMT concept in the region. The assessment of the implementation processes showed progress in key areas, with staff demonstrating improved competency, EMT services maintaining high fidelity, effective consultation launching critical components, and ongoing services providing successful support and monitoring. Creating the N-EMTs and revitalising the EMT concept required an aligned strategy with other regional emergency programmes and a futuristic vision. Proposed sustainability and governance components include creating N-EMT, developing a coordination structure, collaborating with partners, and finalising the N-EMT.ConclusionThe Initiative is an imperative component that would allow better-targeted management of health emergencies in the region. The continuous refinement of the EMT initiative is crucial. There is a need to work on additional components, such as a context-specific framework for collaborations and partnerships that would enhance deployment and procurement modalities and the complementarity between other regional initiatives to improve the work. Emphasis should be placed on strengthening local health systems, enhancing training and capacity-building programmes, and fostering regional and international collaborations. Additionally, sustainable funding and resource allocation are essential to ensure the resilience of EMTs in the African region and their long-term success.

IntroductionThe learning health system (LHS) aligns science, informatics, incentives, stakeholders, and culture for continuous improvement and innovation. The Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute designed a K12 initiative to grow the number of LHS scientists. We describe approaches developed by 11 funded centers of excellence (COEs) to promote partnerships between scholars and health system leaders and to provide mentored research training.MethodsSince 2018, the COEs have enlisted faculty, secured institutional resources, partnered with health systems, developed and implemented curricula, recruited scholars, and provided mentored training. Program directors for each COE provided descriptive data on program context, scholar characteristics, stakeholder engagement, scholar experiences with health system partnerships, roles following program completion, and key training challenges.ResultsTo date, the 11 COEs have partnered with health systems to train 110 scholars. Nine (82%) programs partner with a Veterans Affairs health system and 9 (82%) partner with safety net providers. Clinically trained scholars (n = 87; 79%) include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians (n = 29; 26%) represent diverse fields, dominated by population health sciences. Stakeholder engagement helps scholars understand health system and patient/family needs and priorities, enabling opportunities to conduct embedded research, improve outcomes, and grow skills in translating research methods and findings into practice. Challenges include supporting scholars through roadblocks that threaten to derail projects during their limited program time, ranging from delays in access to data to COVID-19-related impediments and shifts in organizational priorities.ConclusionsFour years into this novel training program, there is evidence of scholars' accomplishments, both in traditional academic terms and in terms of moving along career trajectories that hold the potential to lead and accelerate transformational health system change. Future LHS training efforts should focus on sustainability, including organizational support for scholar activities.

Abstract Background It has been repeatedly shown that men infected by SARS-CoV-2 face a twofold higher likelihood of dying, being hospitalized or admitted to the intensive care unit compared to women, despite taking into account relevant confounders. It has been hypothesized that these discrepancies are related to sex steroid hormone differences with estrogens being negatively correlated with disease severity. The objective of this study was therefore to evaluate COVID-19-related mortality and morbidity among peri- and postmenopausal women in relation to estrogen-containing menopause hormonal treatments (MHT). Methods This is a national register-based matched cohort study performed in Sweden between January 1 to December 31, 2020. Study participants comprised women over the age of 53 years residing in Sweden. Exposure was defined as prescriptions of local estrogens, systemic estrogens with and without progestogens, progestogens alone, or tibolone. MHT users were then compared with a matched cohort of non-users. The primary outcome consisted of COVID-19 mortality, whereas the secondary outcomes included inpatient hospitalizations/outpatient visits and confirmed SARS-CoV-2 infection. Multivariable adjusted Cox regression-derived hazard ratios (HRs) were calculated. Results Use of systemic estrogens alone is associated with increased COVID-19 mortality among older women (aHR 4.73, 1.22 to 18.32), but the association is no longer significant when discontinuation of estrogen use is accounted for. An increased risk for COVID-19 infection is further observed for women using combined systemic estrogens and progestogens (aHR 1.06, 1.00 to 1.13) or tibolone (aHR 1.21, 1.01 to 1.45). Use of local estrogens is associated with an increased risk for COVID-19-related death (aHR 2.02,1.45 to 2.81) as well as for all secondary outcomes. Conclusions Systemic or local use of estrogens does not decrease COVID-19 morbidity and mortality to premenopausal background levels. Excess risk for COVID-19 morbidity and mortality was noted among older women and those discontinuing systemic estrogens. Higher risk for death was also noted among women using local estrogens, for which non-causal mechanisms such as confounding by comorbidity or frailty seem to be the most plausible underlying explanations. Trial registration details Not applicable.