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Objective: Child sleep problems are commonly reported by parents of children aged 6--18 years, with a growing body of evidence describing the link between children's screen time and parental perceived child sleep problems. Using cross-sectional data, representative of the Victorian population, this study explored whether the relationship between screen time and parental perceived sleep problems differed across child age groups. It also examined whether parental rules moderated this relationship differentially between primary school-aged children and adolescents. Method: Participants were 1699 parents living in Victoria with children aged 6 to 18 years who were recruited to complete a computer assisted personal communication through random dialling of mobile and landline numbers. Results: Results indicated that more screen time was associated with more parental perceived sleep problems, with parental rules moderating this relationship for primary school-aged children but not for adolescents. Contrary to expectations, the relationship between screen time and parental perceived sleep problems did not differ across child age groups. Conclusions: Results suggest that parental rules on media device use may be an instrumental factor in the development of successful intervention programmes for primary school-aged children. Further implications of these findings and suggestions for future research are discussed.

Ice shelf calving constitutes roughly half of the total mass loss from the Antarctic ice sheet. Although much attention is paid to calving of giant tabular icebergs, these events are relatively rare. Here, we investigate the role of frontal melting and stresses at the ice shelf front in driving bending and calving on the scale of ∼100 m, perpendicular to the ice edge. We focus in particular on how buoyant underwater “feet” that protrude beyond the above-water ice cliff may cause tensile stresses at the base of the ice. Indirect and anecdotal observations of such feet at the Ross Ice Shelf front suggest that the resulting bending may be widespread and can trigger calving. We consider satellite observations together with an elastic beam model and a parameterization of wave erosion to better understand the dynamics at the ice shelf front. Our results suggest that on average frontal ablation rather consistently accounts for 20±5 m yr−1 of ice loss at Ross Ice Shelf, likely mostly due to wave erosion and smaller-scale, 𝒪(100 m), foot-induced calving. This constitutes only ∼2 % of the total frontal mass loss (since near-front ice velocities are ∼1000 m yr−1). Observational evidence suggests that sporadic larger events can skew this rate (we document one foot-induced calving event of size ∼1 km). Stresses from foot-induced bending are likely not sufficient to initiate crevassing but rather act to propagate existing crevasses. In addition, our results support recent findings by Buck (2024) that additional bending moments, likely due to temperature gradients in the ice, may play a role in driving frontal deflections. The highly variable environment, irregularity of pre-existing crevasse spacing, and complex rheology of the ice continue to pose challenges in better constraining the drivers behind the observed deformations and resulting calving rates.

The recent rediscovering of the Millefiori Piemontese breed, previously considered as extinct, has led to its genetic characterisation: establishing the basis for its recovery and preservation. This study describes the morpho-biometric traits and compares the genetic variability of the Millefiori Piemontese breed with that of other local chicken breeds using 26 microsatellite markers. A subset of 14 markers was used to compare the genetic variation of the Millefiori Piemontese breed with that of two other Piedmontese chicken breeds (Bionda Piemontese and Bianca di Saluzzo) as well as 17 Italian and 2 commercial hybrids, whose genetic variability has already been investigated. The present study confirmed the sexual dimorphism and assessed the genetic variability of the Millefiori Piemontese in terms of number of alleles/locus (Na = 4), the effective number of alleles (Nea = 3), observed (Ho = 0.56) and expected heterozygosity (He = 0.53), self-coancestry (IB = 0.65), potential extinction risk (ERI = 2), and its contribution to the Italian poultry biodiversity (GDT = −0.60). The results indicate that, despite its small population size (Ne = 56), the Millefiori Piemontese population exhibits significant genetic diversity, making it a valuable resource for breeding programs focused on preserving the breed and safeguarding its biodiversity. This study is the first to investigate the genetic variability of the Millefiori Piemontese breed and compare it with other local poultry breeds. The findings highlight the genetic uniqueness of the Millefiori breed and its significant contribution to the biodiversity of chickens in Piedmont and Italy, emphasising the importance of its conservation.

Outliers are typically identified using frequentist methods. The data are classified as “outliers” or “not outliers” based on a test statistic that measures the magnitude of the difference between a value and the majority part of the data. The threshold for a data value to be an outlier is typically defined by the user. However, a subjective choice of the threshold increases the uncertainty associated with outlier status for each data value. A cellwise outlier detection algorithm named FuzzyHRT is used to automate the editing process in repeated surveys. This algorithm uses Bienaymé–Chebyshev’s inequality and fuzzy logic to detect four different types of outliers resulting from format inconsistencies, historical, tail, and relational anomalies. However, fuzzy logic is not suited for probabilistic reasoning behind the identification of anomalous cells. Bayesian methods are well suited for quantifying the uncertainty associated with the identification of outliers. Although, as suggested by the literature, there exist well-developed Bayesian methods for record-level outlier detection, Bayesian methods for identifying outliers within individual records (i.e., at the cell level) remain unexplored. This paper presents two approaches from the Bayesian perspective to study the uncertainty associated with identifying outliers. A Bayesian bootstrap approach is explored to study the uncertainty associated with the output scores from the FuzzyHRT algorithm. Empirical likelihoods in a Bayesian setting are also considered for probabilistic reasoning behind the identification of anomalous cells. NASS survey data for livestock and major crop yield (such as corn) are considered for comparing the performances of the two proposed approaches with recent cellwise outlier methods.

Objective: The aim of this study was to identify whether the coping strategy of active self-care, and the coping resource of employment flexibility were moderators of the relationships between parental distress and parenting practices, and parental experience and parenting practices, in parents of adolescents. Method: This research was part of a larger study conducted by the Parenting Research Centre who surveyed a representative sample of 2600 Victorian parents on their parental concerns, approaches, and experiences using computer-assisted telephone interviews. Results: Results demonstrated that employment flexibility and active self-care significantly moderated the relationship between a demanding parental experience and autonomy-supportive parent-child communication, and that active self-care moderated the relationship between the belief parenting comes naturally and negative parenting. It was concluded that both coping indicators had protective effects on parenting practices, through interacting with parental experience. Conclusions: Practical implications of this research include enhancement of parental interventions by lending evidence that both self-care and employment flexibility promote parent-child communication and protect against more aversive parenting behaviours.

Objective: To investigate the physical activity levels of students enrolled in a standard fitness walking class versus a service-learning dog walking class. Participants: College students (N = 65) from a university in the Southeastern United States (71% female; 85% White; 72% seniors). Methods: Students wore NL-1000 pedometers twice a week for 50 minutes for a full academic year. Service-learning students also completed reflection papers. Pedometer data was analyzed using SPSS and papers were analyzed through inductive coding. Results: Significant differences were found in each quantitative measure collected between classes. Students in the service-learning fitness walking class took more steps, walked further, and obtained more minutes of moderate to vigorous physical activity than the students in the standard fitness walking class. Results from student reflections provided insight into why these differences occurred as well as additional student experiences. Conclusions: Incorporating a service component into a physical activity course can be beneficial.

The prolongation of survival along with the preservation of quality of life, possibly avoiding harmful cumulative toxicities, is the primary therapeutic aim for patients with metastatic colorectal cancer (mCRC) in the third-line setting. Several therapeutic options are now available, although some differences across countries in drug approval and the optimal therapeutic sequencing associated with each peculiar patient subgroup represent a clinical challenge for oncologists. Among various options, the SUNLIGHT trial showed how the combination of trifluridine/tipiracil (FTD/TPI) with bevacizumab is effective with an easily manageable toxicity profile compared to FTD/TPI alone. Of note, the efficacy is confirmed independently from KRAS mutational status and also for patients who had breaks in anti-vascular endothelial growth factor (anti-VEGF) therapy. Herein, we describe the current state of the art in the landscape of treatments after the second progression in mCRC. Based on a critical review of the literature aimed to guide clinicians in their daily decision-making, we point out that the combination of FTD/TPI with bevacizumab produces a clinical benefit in unselected mCRC patients. Therefore, the FTD/TPI plus bevacizumab regimen can represent a new standard of care for the treatment of patients with refractory mCRC who have progressed after two lines of therapy.

BackgroundElectrical remodeling has been linked to the progression and recurrence of atrial fibrillation (AF) after catheter ablation (CA). Substrate mapping based solely on a voltage amplitude electrogram (EGM) does not provide a comprehensive understanding of the left atrial (LA) disease. The aim of this study is to assess left atrial spatial entropy (LASE) from voltage maps routinely obtained during AF ablation to further characterize the LA substrate.Materials and MethodsHigh-density electroanatomic maps (EAMs) of 27 patients with paroxysmal or persistent AF undergoing routine CA were prospectively collected. Computational post-processing was performed on the voltage maps. Using the Shannon entropy model, the probability distribution of the amplitude range values associated with each point of the map was used to measure LASE. Finally, correlations between LASE and clinical and electrophysiological characteristics of AF were explored.ResultsLASE differentiated between patients with paroxysmal and persistent AF (6.45 ± 0.41 vs. 5.87 ± 0.53; p = 0.028) and patients with normal and abnormal LA substrate (6.42 ± 0.42 vs. 5.87 ± 0.56; p = 0.043), independent of the basal rhythm during EM acquisition (6.33 ± 0.41 vs. 6.11 ± 0.63; p = 0.619). Accordance between LASE and EAMs was assessed by ROC analysis (AUC: 0.81; C.I.: 0.62–0.99; Youden index: 6.06; sensitivity: 80%; and specificity: 80%). Patients with the lowest LASE reported AF recurrence at the follow-up.ConclusionLASE may play a role in the further characterization of the LA substrate and the type of AF, independent of basal rhythm.

Summary: Since the nineties, the incidence of sporadic early-onset (EO) cancers has been rising worldwide. The underlying reasons are still unknown. However, identifying them is vital for advancing both prevention and intervention. Here, we exploit available knowledge derived from clinical observations to formulate testable hypotheses aimed at defining the causal factors of this epidemic and discuss how to experimentally test them. We explore the potential impact of exposome changes from the millennials to contemporary young generations, considering both environmental exposures and enhanced susceptibilities to EO-cancer development. We emphasize how establishing the time required for an EO cancer to develop is relevant to defining future screening strategies. Finally, we discuss the importance of integrating multi-dimensional data from international collaborations to generate comprehensive knowledge and translate these findings back into clinical practice.

Background: Reconstruction of mandibular bone defects is a surgical challenge, and microvascular reconstruction is the current gold standard. The field of tissue bioengineering has been providing an increasing number of alternative strategies for bone reconstruction.Methods: In this preclinical study, the performance of two bioengineered scaffolds, a hydrogel made of polyethylene glycol-chitosan (HyCh) and a hybrid core-shell combination of poly (L-lactic acid)/poly (ε-caprolactone) and HyCh (PLA-PCL-HyCh), seeded with different concentrations of human mesenchymal stromal cells (hMSCs), has been explored in non-critical size mandibular defects in a rabbit model. The bone regenerative properties of the bioengineered scaffolds were analyzed by in vivo radiological examinations and ex vivo radiological, histomorphological, and immunohistochemical analyses.Results: The relative density increase (RDI) was significantly more pronounced in defects where a scaffold was placed, particularly if seeded with hMSCs. The immunohistochemical profile showed significantly higher expression of both VEGF-A and osteopontin in defects reconstructed with scaffolds. Native microarchitectural characteristics were not demonstrated in any experimental group.Conclusion: Herein, we demonstrate that bone regeneration can be boosted by scaffold- and seeded scaffold-reconstruction, achieving, respectively, 50% and 70% restoration of presurgical bone density in 120 days, compared to 40% restoration seen in spontaneous regeneration. Although optimization of the regenerative performance is needed, these results will help to establish a baseline reference for future experiments.

Abstract Aims/Introduction Pregnancy complicated by gestational diabetes mellitus (GDM) is characterized by excessive insulin resistance that impairs the metabolism of glucose and lipids. the aim of the study was to examine lipid profiles during pregnancy of women with GDM, and its impact on fetal growth in a multiethnic population. Materials and Methods The study included 322 pregnant women of different ethnicity with GDM attending a clinical unit specializing in metabolic diseases. Results The area under the curve for the 75‐g oral glucose tolerance test and glycated hemoglobin were significantly different among all groups. At the time of being diagnosed with GDM, Asian and African mothers had significantly lower levels of total and low‐density liprotein cholesterol than European mothers (P

PurposeIn GI cancers, anaplastic lymphoma kinase (ALK) rearrangements are extremely less frequent than in non-small-cell lung cancer but may be important to offer personalized strategies of treatment in selected patients. Data about the activity and efficacy of ALK inhibitors (ALKi) in GI cancers are scarce.Materials and methodsWe assembled a clinical and molecular international data set of pretreated patients with metastatic or nonresectable cancers of GI primary tumor origin with documented ALK rearrangement treated with at least one line of ALKi. Measurable disease as per RECIST 1.1 was required for response analysis.ResultsPrimary tumor sites were distributed as follows: 5 (38%) pancreas, 3 (23%) right colon, and 1 (8%) for each one of gastric, duodenal, rectal, left colon, and biliary tract sites. Seven patients (54%) were treated with alectinib, 5 (38%) with crizotinib, and 1 (8%) with entrectinib. After disease progression, five patients (38%) received a subsequent ALKi treatment line, and at the time of data cutoff date, treatment was still ongoing in two patients. Five of 12 evaluable patients (41%) achieved a partial response to first-line ALKi, five patients (41%) had stable disease, and 2 (17%) had progressive disease. No complete responses were registered. At a median follow-up of 39.6 months (interquartile range: 19.8-59.5), the median progression-free survival was 5.0 months (95% CI, 3.68 to no response) and the median overall survival was 9.3 months (95% CI, 5.46 to no response).ConclusionTreatment with ALKi provides remarkable responses and clinical benefit in pretreated patients with ALK fusion-positive GI malignancies. Despite the rarity, ALK rearrangements represent an important therapeutic target in individual pretreated patients with GI solid tumors. Further work providing prospective clinical validation of this target is needed.

In-stent restenosis (ISR) remains the predominant cause of stent failure and the most common indication for repeat revascularization. Despite technological advances in stent design, ISR continues to pose significant challenges, contributing to increased morbidity and mortality among patients undergoing percutaneous coronary interventions. In the last decade, intravascular imaging has emerged as an important method for identifying the mechanisms behind ISR and guiding its treatment. Treatment options for ISR have expanded to include balloon angioplasty, cutting or scoring balloons, intravascular lithotripsy, atheroablative devices, drug-eluting stents, drug-coated balloons, surgical revascularization, and intravascular brachytherapy. The aim of the current review is to describe the classification and mechanisms of ISR, provide a comprehensive and updated overview of the evidence supporting different treatment strategies, suggest a management algorithm, and present insights into future developments in the field.

Background: O-6-methylguanine-DNA methyltransferase is responsible for the direct repair of O6-methylguanine lesions induced by alkylating agents, including temozolomide. O-6-methylguanine-DNA methyltransferase promoter hypermethylation is a well-established biomarker for temozolomide response in glioblastoma patients, also correlated with therapeutic response in colorectal cancer. Objectives: The ARETHUSA clinical trial aims to stratify colorectal cancer patients based on their mismatch repair status. Mismatch repair-deficient patients are eligible for treatment with immune checkpoint inhibitors (anti-PDL-1), whereas mismatch repair-proficient samples are screened for O-6-methylguanine-DNA methyltransferase promoter methylation to identify those suitable for temozolomide treatment. Methods: In this context, a subset of ARETHUSA metastatic colorectal cancer samples was used to compare two different techniques for assessing O-6-methylguanine-DNA methyltransferase hypermethylation: Methyl-BEAMing, a highly sensitive digital PCR approach that combines emulsion PCR and flow cytometry, and droplet digital PCR, a more automated procedure that enables the rapid, operator-independent analysis of a large number of samples. Results: Our study clearly demonstrates that the results obtained using Methyl-BEAMing and droplet digital PCR are comparable, with both techniques showing similar accuracy, sensitivity, and reproducibility. Conclusions: Digital droplet PCR proved to be an efficient method for detecting gene promoter methylation. However, the Methyl-BEAMing method has proved more sensitive for detecting low quantities of DNA.

Background: Diabetes, particularly type 2 diabetes (T2D), is linked with an increased risk of developing coronary heart disease (CHD). The present study aimed to evaluate potential circulating biomarkers of CHD by adopting a targeted proteomic approach based on proximity extension assays (PEA). Methods: The study was based on 30 patients with both T2D and CHD (group DC), 30 patients with T2D without CHD (group DN) and 29 patients without diabetes but with a diagnosis of CHD (group NC). Plasma samples were analyzed using PEA, with an Olink Target 96 cardiometabolic panel expressed as normalized protein expression (NPX) units. Results: Lysosomal Pro-X carboxypeptidase (PRCP), Liver carboxylesterase 1 (CES1), Complement C2 (C2), and Intercellular adhesion molecule 3 (ICAM3) were lower in the DC and NC groups compared with the DN groups. Lithostathine-1-alpha (REG1A) and Immunoglobulin lambda constant 2 (IGLC2) were found higher in the DC group compared to DN and NC groups. ROC analysis suggested a significant ability of the six proteins to distinguish among the three groups (whole model test p < 0.0001, AUC 0.83–0.88), with a satisfactory discriminating performance in terms of sensitivity (77–90%) and specificity (70–90%). A possible role of IGLC2, PRCP, and REG1A in indicating kidney impairment was found, with a sensitivity of 92% and specificity of 83%. Conclusions: The identified panel of six plasma proteins, using a targeted proteomic approach, provided evidence that these parameters could be considered in the chronic evolution of T2D and its complications.

In the Japanese philosophy of life, ‘ikigai’ broadly refers to having a ‘reason for living’, or a purpose in life. From a phenomenological and empirical viewpoint, ikigai is reported to increase human well-being and even life expectancy. However, it remains difficult to translate, define and formalize with regard to contemporary psychological theories. In this respect, the aim of this paper is twofold: to capture as accurately as possible what ikigai is, and to examine whether the concept applies to a professional context. We first offer a comprehensive overview of ikigai, bridge the gap between this specific body of literature and related psychological theoretical frameworks, such as those addressing motivation, well-being, and attention. On this basis, we conceptualize an integrated cognitive-motivational model of ikigai using an IPO (Input-Process-Output) framework: we organize dispositional or situational factors supposedly supporting ikigai as inputs, fueling the core process of ikigai (mainly built from motivational and attentional mechanisms), which produce outcomes (including well-being). A feedback loop completes the model and allows the process to maintain over time. This conceptual proposal is a first step towards applying and testing the model in professional contexts, in order to renew our approach of engagement, well-being, and performance at work as well as inspire workplace evolution.