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Objective, quantitative measures of caregiver-child interaction during play are needed to complement caregiver or examiner ratings for clinical assessment and tracking intervention responses. In this exploratory study, we examined the feasibility of using automated video tracking, Noldus EthoVision XT, to measure 159 2-to-7-year-old autistic children's patterns of movement during play-based, caregiver-child interactions and examined their associations with standard clinical measures and human observational coding of caregiver-child joint engagement. Results revealed that autistic children who exhibited higher durations and velocity of movement were, on average, younger, had lower cognitive abilities, greater autism-related features, spent less time attending to the caregiver, and showed lower levels of joint engagement. After adjusting for age and nonverbal cognitive abilities, we found that children who remained in close proximity to their caregiver were more likely to engage in joint engagement that required support from the caregiver. These findings suggest that video tracking offers promise as a scalable, quantitative, and relevant measure of autism-related behaviors.

Purpose To assess the performance of a local open-source large language model (LLM) in various information extraction tasks from real-life emergency brain MRI reports. Materials and Methods All consecutive emergency brain MRI reports written in 2022 from a French quaternary center were retrospectively reviewed. Two radiologists identified MRI scans that were performed in the emergency department for headaches. Four radiologists scored the reports conclusions as either normal or abnormal. Abnormalities were labeled as either headache-causing or incidental. Vicuna (LMSYS Org), an open-source LLM, performed the same tasks. Vicunas performance metrics were evaluated using the radiologists consensus as the reference standard. Results Among the 2398 reports during the study period, radiologists identified 595 that included headaches in the indication (median age of patients, 35 years [IQR, 26-51 years]; 68% [403 of 595] women). A positive finding was reported in 227 of 595 (38%) cases, 136 of which could explain the headache. The LLM had a sensitivity of 98.0% (95% CI: 96.5, 99.0) and specificity of 99.3% (95% CI: 98.8, 99.7) for detecting the presence of headache in the clinical context, a sensitivity of 99.4% (95% CI: 98.3, 99.9) and specificity of 98.6% (95% CI: 92.2, 100.0) for the use of contrast medium injection, a sensitivity of 96.0% (95% CI: 92.5, 98.2) and specificity of 98.9% (95% CI: 97.2, 99.7) for study categorization as either normal or abnormal, and a sensitivity of 88.2% (95% CI: 81.6, 93.1) and specificity of 73% (95% CI: 62, 81) for causal inference between MRI findings and headache. Conclusion An open-source LLM was able to extract information from free-text radiology reports with excellent accuracy without requiring further training. Keywords: Large Language Model (LLM), Generative Pretrained Transformers (GPT), Open Source, Information Extraction, Report, Brain, MRI Supplemental material is available for this article. Published under a CC BY 4.0 license. See also the commentary by Akinci DAntonoli and Bluethgen in this issue.

OBJECTIVE:  This study aimed to assess factors that influence patients decisions in accepting prenatal diagnostic testing following genetic counseling for increased risk of fetal aneuploidy. METHODS:  This is a retrospective cohort study of women at increased risk of fetal aneuploidy and genetic disorders who had genetic counseling from January 2012 to December 2016 at a single academic center. Demographics, indications for genetic counseling, and rates of diagnostic testing were collected and compared between those who accepted diagnostic testing and those who chose cell free DNA. The variables were analyzed using Chi-square, Fishers exact test, and multiple logistic regression. RESULT:  Of the 2,373 pregnant women who underwent genetic counseling for increased risk of fetal aneuploidy and genetic disorders during the study period, 321 women had diagnostic testing (13.5%). Women at 35 years and older accepted diagnostic testing more than women younger than 35 years (20.7 vs. 11.5%, p

Introduction. This paper presents the novel design and analysis of a hybrid renewable energy system that combines a wave energy converter (WEC) with a floating photovoltaic (FPV) system for offshore installation, with a specific focus on Oran as a case study. The purpose of integrating these two technologies is to harness both wave and solar energy, thereby maximizing energy output and enhancing the reliability of renewable energy sources in offshore environments. The goal of this study is to develop a hybrid system that leverages the complementary nature of WEC and FPV technologies to maximize energy output and improve reliability. By integrating these technologies, the system aims to overcome the limitations of standalone energy systems. The methodology includes selecting suitable WEC and FPV technologies, optimizing their configurations, and analyzing their combined performance under various environmental conditions. To assess the energy production potential, structural stability, and economic feasibility of the hybrid system, computational simulations and data analysis are employed. This comprehensive approach ensures rigorous testing and optimization for real-world applications. The results demonstrate substantial improvements in energy yield and system resilience compared to standalone WEC or FPV systems. The hybrid system shows enhanced performance, particularly in consistent energy output and structural robustness. These findings indicate that combining WEC and FPV technologies can lead to more reliable and efficient offshore renewable energy solutions. The practical values are significant, providing insights into efficient and sustainable offshore renewable energy solutions. By focusing on Oran, it offers a localized perspective that can be adapted to similar coastal areas globally, contributing to the advancement of renewable energy technologies. The hybrid system’s enhanced reliability and efficiency support the broader goal of sustainable energy development in marine environments, highlighting its potential for widespread application and impact. References 23, tables 4, figures 17.

Purpose: A primary goal of the Collaboration and Resources for Encouraging and Supporting Transformations in Education (CREST-Ed) program was to increase the number of highly qualified, minoritized teachers committed to teaching in minority-serving, high-need school districts. This study's purpose was to evaluate the CREST-Ed program's impact on teacher residency outcomes using multiple sources of program evaluation data collected during the five-year grant. Design/methodology/approach: This study of a federal Teacher Quality Partnership (TQP) grant at Georgia State University (GSU), a minority-serving institution (MSI) and research university, shows teacher residency programs can improve the diverse teacher pipeline. The grant, CREST-Ed, provided professional development schools (PDS) support for four urban and 23 rural school districts through partnerships with GSU, Albany State University (ASU) and Columbus State University (CSU). Findings: The study findings suggest that teacher preparation grants can be leveraged to recruit traditionally minoritized teachers of color to increase the diverse teacher pipeline and strengthen PDS partnerships. Originality/value: Both urban and rural PDSs could benefit from teacher residency programs like the CREST-Ed model that catered to the unique needs of each school and partnership district.

Teacher racial diversity has been widely considered important in education. However, it remains unclear to what extent and how teacher racial diversity has been addressed at the federal, state, and district levels. In this study, we employed text mining to collect and analyze over three million documents at the federal, state, and district levels. We found that while students of color had disproportionately less access to racially diverse teachers, the documents under our analysis insufficiently discussed the recruitment and retention of racially diverse teachers. Our findings also reveal that education agencies at the federal, state, and district levels paid scant attention to recruiting and retaining Hispanic teachers. For the states and districts that discussed the recruitment of racially diverse teachers, they primarily recruited teachers from institutions and organizations that primarily serve people of color, such as Historically Black Colleges and Universities, the Columbia Latino/a Law Student Association, the National Association of Asian American Professionals, and the National Black MBA Association. Given the findings and the projected growth of Black and Hispanic student enrollment in the United States, we provide five policy recommendations for policymakers and leaders to racially diversify the teacher workforce amid shifting student demographics, particularly Hispanic students.

The aim of the present study is to explore the bacterial diversity within the gut microbiome of chronic inflammatory demyelinating polyneuropathy patient. A stool sample was collected and analyzed to study the gut microbiota through bacterial 16S rRNA gene sequencing. The gut microbiota of chronic inflammatory demyelinating polyneuropathy patient exhibited a dominance of Firmicutes and Bacteroides phyla, with 58.19% and 33.31%, respectively. The data showed a notable abundance of Lachnospiraceae bacterium and Bacteroides sp species, 17.79% and 16.56%, respectively within the gut microbiota chronic inflammatory demyelinating polyneuropathy patient. Lachnospiraceae, a member of the Firmicutes phylum, plays a pivotal role in the production of short-chain fatty acids. At high concentration, short-chain fatty acids can trigger autoimmune leading to the chronic inflammatory demyelinating polyneuropathy. These findings strengthen the possible involvement of short-chain fatty acids in the chronic inflammatory demyelinating polyneuropathy pathogenesis process and could pave new paths in its diagnosis and therapies based on regulation of microbiota dysbiosis.

The evolution of the management of smart grids, which mainly aims to integrate various high-capacity energy sources, more specifically photovoltaic units, on the one hand, as well as optimal control of loads connected to the network in order to ensure coordination between production and consumption, leads not only to the management of production units but also to the management of consumption power using different static converters. This makes this operation possible, and feasible but complex because of their effects on the quality of energy and the need for reliable control. There are currently many studies focusing on power management from the consumption side. This article then proposes a new controller for managing the requested power by combining an optimization technique, which is the Ant Colony Optimization (ACO), with an adaptive PI regulator, which is the Result-Adaptive PID (RAPID) Control, as the controller of the operation of the battery. The battery represents an essential part in solar installations, enabling energy-efficient operation of the network by regulating the operation of controllable loads. To adjust the RAPID regulator using the ACO algorithm, we used an objective function to minimize the error between the input and output of the new regulator. Demonstrated on an isolated DC-AC network, the performance of the proposed controller for energy management on the consumption side is established after comparison with standard controllers such as the classic PI based trial & error methods and the RAPID tuned by ACO.

Abstract Background Poverty-related diseases (PRD) remain amongst the leading causes of death in children under-5 years in sub-Saharan Africa (SSA). Clinical practice guidelines (CPGs) based on the best available evidence are key to strengthening health systems and helping to enhance equitable health access for children under five. However, the CPG development process is complex and resource-intensive, with substantial scope for improving the process in SSA, which is the goal of the Global Evidence, Local Adaptation (GELA) project. The impact of research on PRD will be maximized through enhancing researchers and decision makers’ capacity to use global research to develop locally relevant CPGs in the field of newborn and child health. The project will be implemented in three SSA countries, Malawi, South Africa and Nigeria, over a 3-year period. This research protocol is for the monitoring and evaluation work package of the project. The aim of this work package is to monitor the various GELA project activities and evaluate the influence these may have on evidence-informed decision-making and guideline adaptation capacities and processes. The specific project activities we will monitor include (1) our ongoing engagement with local stakeholders, (2) their capacity needs and development, (3) their understanding and use of evidence from reviews of qualitative research and, (4) their overall views and experiences of the project. Methods We will use a longitudinal, mixed-methods study design, informed by an overarching project Theory of Change. A series of interconnected qualitative and quantitative data collections methods will be used, including knowledge translation tracking sheets and case studies, capacity assessment online surveys, user testing and in-depth interviews, and non-participant observations of project activities. Participants will comprise of project staff, members of the CPG panels and steering committees in Malawi, South Africa and Nigeria, as well as other local stakeholders in these three African countries. Discussion Ongoing monitoring and evaluation will help ensure the relationship between researchers and stakeholders is supported from the project start. This can facilitate achievement of common goals and enable researchers in South Africa, Malawi and Nigeria to make adjustments to project activities to maximize stakeholder engagement and research utilization. Ethical approval has been provided by South African Medical Research Council Human Research Ethics Committee (EC015-7/2022); The College of Medicine Research and Ethics Committee, Malawi (P.07/22/3687); National Health Research Ethics Committee of Nigeria (01/01/2007).

Abstract Background The informed consent process is an important step in conducting ethical clinical trials, as it ensures that research participants are aware of their rights and responsibilities in clinical trials. This study explored participants’ perceptions, experiences and the factors motivating their participation in a COVID-19 vaccine trial in South Africa. Methods This descriptive qualitative study was conducted among twenty-five adult participants (18 to 64 years old) who participated in a COVID-19 vaccine trial in South Africa. Three focus group discussions and fifteen semi-structured interviews were carried out. Data were collected at a Clinical Research Site located in Prince Mshiyeni Memorial Hospital, in Umlazi Township, Durban, South Africa, where the COVID-19 vaccine trial participants were initially enrolled. Data were analysed iteratively using a thematic analysis approach. Results Four key findings emerged: 1) Participants who experienced an event (such as tested positive for COVID-19) during the clinical trial were more likely to talk about the informed consent more thoroughly compared to the other participants. 2) Participants understood the purpose of informed consent process better when it was repeated multiple times throughout the course of the trial. 3) Where participants did not recall or understand various elements of the informed consent, participants were likely to create their own interpretations. 4) Factors influencing participations in trials were reimbursement for participation, access to health care, protection of family members, and ability to socialize without fear of COVID-19. Conclusion Overall, the findings show that the informed consent process should be regarded as an ongoing process rather than a once-off event that only happens at the start of a clinical trial. An understanding of participants’ perspectives, experiences, and motivations for participating in clinical trials, can help trial staff strengthen the consent documents and processes.

Dittrichia viscosa is a perennial herb that has been used for generations in traditional medicine to address a variety of diseases, including diabetes, hypertension, cancer, microbial disorders, inflammatory conditions, and wound healing. The objective of this review is to provide an overview of existing knowledge on D. viscosa with regards to its botanical description, ethnomedicinal uses, and pharmacological properties. Databases such as Scopus, Wiley-Online, PubMed, Springer, Google Scholar, and ScienceDirect were used to select relevant articles based on their title and abstract.The reviewed studies found a strong correlation between D. viscosa's traditional uses and its observed biological effects. Pharmacological research has shown that the essential oils and extracts from D. viscosa possess a variety of biological activities, such as anti-inflammatory, anticancer, antibacterial, antifungal, analgesic, and antioxidant properties. The chemical compounds found in D. viscosa include sesquiterpenes, monoterpenes, flavonoids, and phenolic acids; some of these compounds, such as tometosin and inuviscolide, have been isolated and displayed promising cytotoxic and anti-inflammatory activity.The present review suggests that the pharmacological properties of D. viscosa align well with its ethnomedicinal uses. These findings support the traditional use of D. viscosa in treating various illnesses. Additionally, toxicological examinations of D. viscosa extracts and essential oil have demonstrated the plant's safety, which supports the need for comprehensive pharmacological studies, in vivo studies, and clinical trials to evaluate the best doses for optimal medicinal effects. This work underscores the medicinal value of D. viscosa and its potential in developing new pharmacological agents to address major health challenges like antibiotic resistance and cancers.

Nasopharyngeal carcinoma (NPC) is a distinct malignancy of the nasopharynx and is consistently associated with the Epstein-Barr virus (EBV) infection. Its unique anatomical location and complex aetiology often result in advanced-stage disease at first diagnosis. While radiotherapy (RT) and chemotherapy have been the mainstays of treatment, they often fail to prevent tumour recurrence and metastasis, leading to high rates of treatment failure and mortality. Recent advancement in cell-based therapies, such as chimeric antigen receptor (CAR)-T cell therapy, have shown great promise in hematological malignancies and are now being investigated for NPC. However, challenges such as targeting specific tumour antigens, limited T cell persistence and proliferation, and managing treatment-related toxicities must be addressed. Extensive research is needed to enhance the effectiveness and safety of these therapies, paving the way for their integration into standard clinical practice for better management of NPC and a better quality of life for human health.

In recent years, following the groundbreaking achievements of chimeric antigen receptor (CAR) T cell therapy in hematological cancers, and advancements in cell engineering technologies, the exploration of other immune cells has garnered significant attention. CAR-Therapy extended beyond T cells to include CAR natural killer (NK) cells and CAR-macrophages, which are firmly established in the clinical trial landscape. Less conventional immune cells are also making their way into the scene, such as CAR mucosal-associated invariant T (MAIT) cells. This progress is advancing precision medicine and facilitating the development of ready-to-use biological treatments. However, in view of the unique features of natural killer cells, adoptive NK cell immunotherapy has emerged as a universal, allogenic, “off-the shelf” therapeutic strategy. CAR-NK cytotoxic cells present targeted tumor specificity but seem to be devoid of the side effects associated with CAR-T cells. CAR-NK cells appear to be potentially promising candidates for cancer immunotherapy. However, their application is hindered by significant challenges, particularly the limited persistence of CAR-NK cells in the body, which poses a hurdle to their sustained effectiveness in treating cancer. Based upon the foregoing, this review discusses the current status and applications of both CAR-T cells and CAR-NK cells in hematological cancers, and provides a comparative analysis of the structure, genetics, and clinical outcomes between these two types of genetically modified immune cells.

The aims of this study are the phytochemical exploration and food valorization of Schinus molle L. (S. molle) and Schinus terebinthifolia Raddi (S. terebinthifolia) from the Rabat, Morocco. Gas chromatography (GC) and high-performance liquid chromatography (HPLC) were used to analyze the chemical composition of the oils extracted from both species by soxhlet and maceration. Moreover, physicochemical characteristics such as lipid quality indexes such as thrombogenic index (TI), atherogenic index (AI), oxidation susceptibility (OS), and calculated oxidability (Cox) were determined. These characteristics included percentage acidity, peroxide, saponification, iodine, specific extinction values, chlorophyll, and carotenoid pigments. As results, the oil yields varied from 7% (S. molle) to 13% (S. terebinthifolia). In addition, unsaturated fatty acids represented the major fraction for S. terebinthifolia (79%) and S. molle (81%). However, S. terebinthifolia contains more saturated fatty acids (20%) than S. molle (16%) with a predominance of linoleic acid (59.53% and 55%, C18,2), oleic acid (19.29% and 21.69%, C18,1), and palmitic acid (12.56% and 15.48%, C16,0) in S. molle and S. terebinthifolia, respectively. Moreover, the main sterols are β-sitosterol followed by campesterol and then Δ-5-avenasterol, while β-sitosterol varies according to the species and the extraction method. Results revealed also that campesterol is influenced by the extraction results in a content of 179.66 mg/kg (soxhlet) and 63.48 mg/kg (maceration) for S. molle, while S. terebinthifolia yeilds concentrations of 170 mg/kg and 138 mg/kg, then Δ-5-avenasterol, which present with (117 mg/kg and 136 mg/kg), (34 mg/kg and 80 mg/kg) of the total amount of sterols for the oils extracted by soxhlet and maceration, respectively. In addition, there are favorable physicochemical properties for all oils, such as chlorophylls (0.4 to 0.8 mg/kg) and carotenoids (0.7 to 2 mg/kg). However, further investigations are needed to determine other chemical compounds of both extracts as well as to evaluate their biological and health benefits.

PurposeTo report a rare case of a combined central retinal artery (CRA) and medial posterior ciliary artery (MPCA) occlusion due to an atherosclerotic lesion in the common trunk supplying both arteries.ObservationsA 75-year-old man presented with acute vision loss associated with elevated intraocular pressure in the right eye. Multi-modal imaging revealed a combined retinal and choroidal infarction in the distribution of the CRA and MPCA, localizing the lesion to the common trunk of the ophthalmic artery supplying both the CRA and MPCA. Neurovascular imaging provided supportive evidence for the diagnosis.Conclusions and importanceA simultaneous retinal and choroidal vascular occlusion is an uncommon presentation. Familiarity with the anatomy of the ophthalmic arteries and its branches facilitates localizing the lesion.