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Interoception refers to the processing of internal bodily states and plays a critical role in motivational processes and behaviours. Instruments for assessing its subjective components (i.e., interoceptive sensibility) during childhood are crucially needed. Thus, in this study, we adapted and evaluated the psychometric properties of the Self-Awareness Questionnaire (SAQ) in a sample of Italian children. The SAQ language was revised, and 239 children, ranging in age from 7 to 13 years, completed the adapted questionnaire (SAQ-C). A two-factor solution (visceral and somatosensorial domains) with 24 items showed the best fit of the data. The reliability was good. Convergent validity was fair, and the results indicated good discriminant validity. Moreover, correlational and regression analyses showed that interoceptive sensibility, particularly that associated with visceral sensations, increased with age. Current findings provide preliminary evidence that the SAQ-C may be a reliable and valid tool for assessing interoceptive sensibility in middle childhood.

BackgroundSleep difficulties are common in pregnancy, yet poor prenatal sleep may be related to negative long-term outcomes for the offspring, including risk for attention-deficit/hyperactivity disorder (ADHD). Existing studies are few and have not examined timing of exposure effects or offspring sex moderation. We thus aimed to test the hypotheses that poor sleep health in pregnancy is associated with increased risk for ADHD symptoms and offspring sleep problems at approximately 4 years of age.MethodsParticipants were 794 mother-child dyads enrolled in the NIH Environmental Influences on Child Health Outcomes Study (ECHO). Participants self-reported on sleep duration, quality, and disturbances during pregnancy and on children's ADHD symptoms and sleep problems on the Child Behaviour Checklist.FindingsPregnant participants were 32.30 ± 5.50 years and children were 46% female. 44 percent of pregnant participants identified as Hispanic or Latine; 49% identified as White. Second-trimester sleep duration was associated with offspring ADHD symptoms (b = -0.35 [95% CI = -0.57, -0.13], p = 0.026), such that shorter duration was associated with greater symptomatology. Poorer sleep quality in the second trimester was also associated with increased ADHD symptomatology (b = 0.66 [95% CI = 0.18, 1.14], p = 0.037). Greater sleep disturbances in the first trimester were associated with offspring ADHD (b = 1.03 [95% CI = 0.32, 1.03], p = 0.037) and in the second trimester with sleep problems (b = 1.53 [95% CI = 0.42, 2.92], p = 0.026). We did not document substantial offspring sex moderation.InterpretationPoor prenatal sleep health, particularly quality and duration in the second trimester, may be associated with offspring risk of neurodevelopmental disorders and sleep problems in early childhood. Further research is needed to understand mechanisms, yet our study suggests that prenatal maternal sleep may be a modifiable target for interventions aimed at optimizing early neurodevelopment.FundingNIH grants U2COD023375, U24OD023382, U24OD023319, UH3OD023320, UH3OD023305, UH3OD023349, UH3OD023313, UH3OD023272, UH3OD023328, UH3OD023290, K08MH117452 and NARSAD Young Investigator Award 28545.

Abstract Like many under resourced, island communities, most of the municipalities in Puerto Rico are medically underserved. However, there is limited information about changes in hospital capacity and any regional disparities in availability of hospital services in Puerto Rico, especially given the multiple public health emergencies the island has faced in recent years (e.g. hurricanes, earthquakes, and COVID-19). This study described the trends in hospital capacity and utilization for the Island of Puerto Rico and by health regions from 2010 to 2020. We analyzed the 2021–22 Area Health Resource File (AHRF) and aggregated the data by seven health regions, which are groupings of municipalities defined by the Puerto Rico Department of Health. Ten-year estimates for hospital utilization were adjusted for population size by health region. During the more recent five-year period, there were decreases in hospitals, hospital beds, and surgeries, which represent a shift from the earlier five-year period. Over the 10 years of the study period, there was an overall decrease in population-adjusted measures of hospital utilization on the island of Puerto Rico—despite multiple disasters that would, theoretically, increase need for health care services. We also found variation in hospital capacity and utilization by health regions indicating the rate of change was not uniform across Puerto Rico. The capacity of Puerto Rico’s hospital system has shrunk over the past decade which may pose a challenge when responding to recurrent major public health emergencies, especially within specific health regions.

Abstract Background The addition of pertuzumab (P) to trastuzumab (H) and standard chemotherapy (CT) as neoadjuvant treatment (NaT) for patients with HER2 + breast cancer (BC), has shown to increase the pathological complete response (pCR) rate, without main safety concerns. The aim of NeoPowER trial is to evaluate safety and efficacy of P + H + CT in a real–world population. Methods We retrospectively reviewed the medical records of stage II–III, HER2 + BC patients treated with NaT: who received P + H + CT (neopower group) in 5 Emilia Romagna institutions were compared with an historical group who received H + CT (control group). The primary endpoint was the safety, secondary endpoints were pCR rate, DRFS and OS and their correlation to NaT and other potential variables. Results 260 patients were included, 48% received P + H + CT, of whom 44% was given anthraciclynes as part of CT, compared to 83% in the control group. The toxicity profile was similar, excluding diarrhea more frequent in the neopower group (20% vs. 9%). Three patients experienced significant reductions in left ventricular ejection fraction (LVEF), all receiving anthracyclines. The pCR rate was 46% (P + H + CT) and 40% (H + CT) (p = 0.39). The addition of P had statistically correlation with pCR only in the patients receiving anthra-free regimens (OR = 3.05,p = 0.047). Preoperative use of anthracyclines (OR = 1.81,p = 0.03) and duration of NaT (OR = 1.18,p = 0.02) were statistically related to pCR. 12/21 distant-relapse events and 14/17 deaths occurred in the control group. Patients who achieve pCR had a significant increase in DRFS (HR = 0.23,p = 0.009). Conclusions Adding neoadjuvant P to H and CT is safe. With the exception of diarrhea, rate of adverse events of grade > 2 did not differ between the two groups. P did not increase the cardiotoxicity when added to H + CT, nevertheless in our population all cardiac events occurred in patients who received anthracycline-containing regimens. Not statistically significant, higher pCR rate is achievable in patients receiving neoadjuvant P + H + CT. The study did not show a statistically significant correlation between the addition of P and long-term outcomes.

Nowadays, the scientific community and industry are increasingly pressed to provide solutions for developing compact and highly-performing trace-gas sensors for several applications of crucial importance, such as environmental monitoring or medical diagnostics. In this context, this work describes a novel configuration, making use of a mid-IR spectrophone combining the compactness of a photo-acoustic setup, a non-conventional micro-electro-mechanical (MEMS) acousto-to-voltage transducer, and the sensitivity enhancement given by a cost-effective and easy-to-build dual-tube resonator configuration. In the optimal condition of sample pressure, the system developed in this work can achieve a minimum detection limit (MDL) equal to 0.34 ppb when averaging up to 10 s. Compared with previous literature of single-pass photoacoustic-based sensors for N2O, this corresponds to a significant improvement both for the achieved normalized noise equivalent absorption coefficient (NNEA) equal to 1.41 × 10−9 cm−1WHz−1/2, and for a Noise-Equivalent-Concentration (NEC) of 1 ppb obtained at 1 s of averaging time.

The achievable sensitivity level of photo-acoustic trace-gas sensors essentially depends on the performances of the acoustic transducer. In this work, the mechanical response of different silicon-based micro-electro-mechanical systems (MEMS) is characterized, aiming at investigating both their mechanical properties, namely the resonance frequency and the quality factor, and the minimum detection limit (MDL) achievable when they are exploited as an acoustic-to-voltage transducer in a trace-gas photoacoustic setup. For this purpose, a 4.56µm Continuous-Wave (CW) quantum cascade laser (QCL) is used to excite a strong N2O roto-vibrational transition with a line strength of 2.14 × 10−19 cm/molecule, and the detection of MEMS oscillations is performed via an interferometric readout. As a general trend, the minimum detection limit decreases when the resonance frequency investigated increases, achieving a value of 15 parts per billion with a 3 dB cut-off lock-in bandwidth equal to 100 mHz, around 10 kHz.

When designing a resilient computing system, the desired degree of Reliability, Availability, and Serviceability (RAS) must be assessed and guaranteed. This article presents a Hardware-Software (HW-SW) Interface for Error Logging and Reporting independent of specific Instruction Set Architectures (ISA), aiming to improve RAS in computing systems. A HW-SW Interface defines the facilities by which detected hardware errors are logged into an ad hoc set of registers (i.e., Error Record) and then reported to system software. System software will promptly address and recover from those errors, preventing system failures. Our architecture offers flexible and configurable Error Logging and Reporting features, satisfying the requirements of different application scenarios by selectively incorporating or removing specific features. After reporting the most relevant results from synthesis on FPGA (Xilinx UltraScale+ MPSoC) and Standard-Cell technologies (45nm and 7nm libraries), we discuss them to provide valuable insights on the dependency of resource utilization on error logging capability. The principal findings demonstrate that the developed module would not limit system operating frequency, and its area occupation can be readily configured to align with desired logging and reporting features to be implemented. Then, we validate the Error Logging and Reporting features of our architecture by developing a test SoC on FPGA that emulates a computing system, including a 32-bit RISC-V core and two ECC-protected (Error Correcting Code) memories. The proposed HW-SW Interface extends beyond monitoring only ECC-protected memories, yet it can monitor any system module incorporating error control logic.

This research explores how different organic waste transformation methods influence the production of humic substances (HSs) and their impact on soil quality. Using olive and orange wastes as substrates, the study compares vermicomposting, composting, and anaerobic digestion processes to determine which method produces the most humic-substance-rich products. The characterization of HSs in each product included analyses of total organic carbon (TOC), humic and fulvic acid content, humification rate, humification degree, and E4/E6 ratio, with HSs extracted using potassium hydroxide (KOH) and analyzed via Diffuse Reflectance Infrared Fourier-Transform (DRIFT) spectroscopy to assess structural complexity. The results revealed that the chemical composition of the input materials significantly influenced the transformation dynamics, with orange by-products exhibiting a higher humification rate and degree. Vermicomposting emerged as the most efficient process, producing fertilizers with superior humic content, greater microbial biodiversity, and enhanced cation exchange capacity, thus markedly improving soil quality. Composting also contributed to the stabilization of organic matter, albeit less effectively than vermicomposting. Anaerobic digestion, by contrast, resulted in products with lower levels of HSs and reduced nutrient content. Aerobic processes, particularly vermicomposting, demonstrated the most rapid and effective transformation, producing structurally complex, stable humus-like substances with pronounced benefits for soil health. These findings underscore vermicomposting as the most sustainable and efficacious approach for generating HS-rich organic fertilizers, presenting a powerful alternative to synthetic fertilizers. Furthermore, this study highlights the potential of organic waste valorization to mitigate environmental pollution and foster circular economy practices in sustainable agriculture.

Background and Objectives: The Albumin-to-Alkaline Phosphatase ratio (AAPR) is an easily applicable and cost-effective marker investigated as an outcome predictor in solid cancers. Preliminary evidence in breast cancer suggests that a low AAPR correlates with a poor response to neoadjuvant chemotherapy (NAC) in primary tumors. However, data regarding the axillary response are lacking. This study aims to evaluate whether the AAPR can predict the axillary response in initially nodal-positive (cN+) breast cancer patients undergoing NAC. Materials and Methods: Clinical and biochemical variables of cN+ breast cancer patients undergoing NAC were collected. Pre-NAC albumin and alkaline phosphatase serum values were utilized in the AAPR calculation. Fisher’s exact test was performed to identify differences between the two groups of patients (high and low AAPR according to the cut-off reported in the literature). The primary outcome was the nodal pathologic complete response (pCR) rate in the two groups of patients. Results: Nodal pCR was achieved in 20/45 (44.4%) patients. A total of 36/45 (80%) patients had an AAPR > 0.583. Among patient and tumor characteristics, the only statistically significant difference between the two groups was the axillary pCR between the low and high AAPR groups (p-value = 0.03, OR = 0.129, 95% CI = 0.00–0.835). Conclusions: This pilot study suggests that the pre-treatment AAPR might be an early predictor of axillary response in cN+ breast cancer patients undergoing NAC. This result justifies further investigation in larger prospective trials to validate this finding.

Acute coronary syndromes (ACSs) represent a significant global health challenge arising from atherosclerotic cardiovascular disease (ASCVD), with elevated low-density lipoprotein cholesterol (LDL-C) levels being a primary contributor. Despite standard statin therapy, individuals with ACS remain at high risk for recurrent cardiovascular events, particularly in the initial post-ACS period. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9), such as evolocumab and alirocumab, offer a potential strategy to reduce LDL-C levels further and mitigate this residual risk. This review delves into the molecular mechanisms, effects on cholesterol metabolism, inflammatory modulation, and clinical outcomes associated with early administration of PCSK9 inhibitors following ACS.

The availability of cheap Wi-Fi Internet connections has encouraged schools to adopt Web 2.0 platforms for teaching, with the intention of stimulating students' academic achievement and participation in school. Moreover, during the recent explosion of the COVID-19 crisis that forced many countries to close schools (as well as offices and factories), the widespread diffusion of these applications kept school systems going. Despite their widespread use as teaching tools, the effect of adopting Web 2.0 platforms on student performance has never been rigorously tested. We fill this gap in the literature by analyzing the impact of using Twitter as a teaching tool on high school students' literature skills. Based on a large-scale, randomized controlled trial that involved seventy schools and about 1,500 students, we find that using Twitter to teach literature has an overall negative effect on students' average achievement, reducing standardized test scores by about 25 percent of a standard deviation. The negative effect is stronger on students who usually perform better.

Background: Why Puerto Rican youths have higher rates of severe asthma exacerbations (SAEs) than their non-Hispanic White peers is unclear. Objective: We aimed to identify risk factors associated with recurrent SAEs in Puerto Rican youths with asthma. Methods: We performed cross-sectional and longitudinal analyses of recurrent SAEs in 209 Puerto Rican youths with asthma who participated in 2 cross-sectional studies approximately 5.2 years apart: the Puerto Rico Genetics of Asthma and Lifestyle study (visit 1, participants aged 6-14 years) and the Epigenetic Variation and Childhood Asthma in Puerto Ricans study (visit 2, participants aged 9-20 years). Recurrent SAEs were defined as at least 2 SAEs in the previous year. Results: Of the youths in our study, there were 80 (38.3%) and 47 (22.4%) with recurrent SAEs at visit 1 and visit 2, respectively, and 31 participants (14.8%) had persistent recurrent SAEs (ie, recurrent SAEs at both visits). In multivariable analyses, low household income was significantly associated with 2.4 to 12.3 times increased odds of recurrent SAEs in all analyses, with stronger longitudinal associations. Low parental education level, nonprivate or employer-based health insurance, overweight or obesity, residential proximity to a major road, and low or moderate level of outdoor activity were each significantly associated with recurrent SAEs in at least 1 analysis. Further, persistence of low parental numeracy level, low household income, and an unhealthy diet were each associated with persistent recurrent SAEs. Conclusion: In this study of Puerto Rican youths with asthma, persistence of low parental numeracy level, a low household income, and an unhealthy diet were associated with persistent recurrent SAEs. Our findings support policies promoting equity and healthy lifestyles for Puerto Rican children and their families.

Variability in response to short-acting β2-agonists (e.g., albuterol) among patients with asthma from diverse racial/ethnic groups may contribute to asthma disparities. We sought to identify genetic variants associated with bronchodilator response (BDR) to identify potential mechanisms of drug response and risk factors for worse asthma outcomes. Genome-wide association studies of bronchodilator response (BDR) were performed using TOPMed Whole Genome Sequencing data of the Asthma Translational Genomic Collaboration (ATGC), which corresponded to 1136 Puerto Rican, 656 Mexican and 4337 African American patients with asthma. With the population-specific GWAS results, a trans-ethnic meta-analysis was performed to identify BDR-associated variants shared across the three populations. Replication analysis was carried out in three pediatric asthma cohorts, including CAMP (Childhood Asthma Management Program; n = 560), GACRS (Genetics of Asthma in Costa Rica Study; n = 967) and HPR (Hartford-Puerto Rico; n = 417). A genome-wide significant locus (rs35661809; P = 3.61 × 10-8) in LINC02220, a non-coding RNA gene, was identified in Puerto Ricans. While this region was devoid of protein-coding genes, capture Hi-C data showed a distal interaction with the promoter of the DNAH5 gene in lung tissue. In replication analysis, the GACRS cohort yielded a nominal association (1-tailed P

Salinity presents a significant obstacle to crop productivity, particularly in dry and semi-arid regions. Sweet bell pepper (Capsicum annuum L.), a widely grown and consumed horticultural crop, is especially vulnerable to salinity. Consequently, it is vital to determine the salinity threshold that impacts bell pepper growth and quality, enabling sustainable production in salinized areas. This study aimed to evaluate the effects of varying sodium chloride concentrations (0, 50, and 75 mM) on bell pepper growth, nutritional value, and phytochemical composition, aiming to identify the adaptable threshold in salinized environments. The results suggested that the application of 75 mM NaCl not only had no adverse impact on fruit quality in terms of biomolecules and phytochemicals but also led to significant improvements. Specifically, under these conditions, there was a remarkable increase, in respect to control, in total protein (TPRO by 50 %), total carbohydrates (TCARB by 18 %), lycopene (LIC by 68 %), total Carotenoids (TCAR by 13 %), and total phenols (TPHE by 18 %) in terms of antioxidants.In contrast, the content of ascorbic acid and antioxidant activities remained consistent. Moderate salt stress exhibited the most positive influence on sweet bell pepper quality, leading to higher concentrations of essential nutrients and nutraceutical compounds, including minerals, phenolic acids, and flavonoids.

Puerto Rico is a US territory and a popular destination for Latino immigrants in the Caribbean. Even with few language and cultural barriers, however, many Latino immigrants in Puerto Rico are uninsured. Using data from the 2014-19 Puerto Rico Community Survey, we examined inequities in health insurance coverage for non-Puerto Rican Latinos ages 18-64 living in Puerto Rico according to citizenship status and Latino subgroup (Dominican, Cuban, Mexican, and other Latino). After controlling for potential confounders, we found that noncitizen Dominicans had a significantly lower probability of having any health insurance (57.2 percent) and having any private insurance (31.5 percent). Regardless of similarities in culture and language, Latino immigrants on the island, particularly Dominicans, experience major health insurance coverage inequities. Considering that Puerto Rico's immigration system is regulated by US federal statute, both federal and local policy makers should acknowledge and focus on reducing these immigrant disparities in health insurance coverage.

The off-season for natural bodybuilders (BB) is characterized by increased training loads and fluctuations in caloric intake, which may lead to insufficient recovery. The autonomic nervous system (ANS) plays a pivotal role in recovery. The purpose of this study was to evaluate resting ANS activity and recovery following a maximal exercise bout in off-season BB and compare them to those of recreationally active individuals. Fifteen males participated; 7 recreationally active (RA) (24.6 ± 2.1 years, 81.1 ± 10.8 kg) and 8 BB (21.8 ± 2.9 years, 89.3 ± 13.0 kg). Each performed a graded exercise test. Heart rate variability (HRV) was measured at rest and during a 45 min recovery period. HRV was analyzed as: root mean square of successive differences (lnRMSSD), standard deviation of normal-to-normal sinus beats (lnSDNN), high frequency (lnHF), low frequency (lnLF), and the ratio of low frequency to high frequency (lnLF/lnHF). A one-way ANOVA showed no differences for any resting marker of HRV, HR, and HR recovery. A significant depression in all markers of HRV was observed in the BB group at the 15 min point, and no recovery was observed before 45 min when compared to RA. The results of this study demonstrated depressed HRV recovery following the graded exercise test in BB when compared to the RA group.

In this study, a UHPLC-PDA method for the simultaneous identification of polyphenols and bitter acids (alpha, beta, and isoalpha) in beer was developed. The resulting chemical profiles were leveraged to distinguish the characteristics of four (IPA, Lager, Blanche, ALE) bergamot-flavored beers, produced on a pilot-scale plant. In a streamlined 29 min analysis, thirty polyphenols and fourteen bitter acids were successfully identified under optimized separation conditions. Validation, encompassing parameters such as LOD (from 0.028 ppm for isorhamnetin to 0.106 for narirutin), LOQ (from 0.077 ppm for naringenin to 0.355 for narirutin), R2 (always more than 0.9992), repeatability (from 0.67% for tangeretin to 6.38% for myricetin), and reproducibility (from 0.99% for sinensetin to 6% for naringin), was conducted for polyphenol quantification using constructed calibration curves with seven levels. Exploring polyphenolic components as potential discriminators among different beer styles, a total of thirty-two polyphenolic compounds were identified and quantified, including characteristic bergamot peel polyphenols like neoeriocitrin (from 7.85 ppm for CBS2 to 11.95 ppm in CBS1); naringin (from 4.56 ppm for CBS4 to 10.96 in CBS1), and neohesperidin (from 5.93 in CBS3 to 15.95 for CBS2). The multivariate analysis provided additional insights into variations among specific beer styles, revealing discrepancies in the presence or relative concentrations of specific compounds linked to brewing ingredients and processes. This research enhances the fingerprinting of the chemistry governing beer quality through a straightforward and cost-effective analytical approach.

BackgroundAsthma is a common respiratory disorder with a highly heterogeneous nature that remains poorly understood. The objective was to use whole genome sequencing (WGS) data to identify regions of common genetic variation contributing to lung function in individuals with a diagnosis of asthma.MethodsWGS data were generated for 1,053 individuals from trios and extended pedigrees participating in the family-based Genetic Epidemiology of Asthma in Costa Rica study. Asthma affection status was defined through a physician's diagnosis of asthma, and most participants with asthma also had airway hyperresponsiveness (AHR) to methacholine. Family-based association tests for single variants were performed to assess the associations with lung function phenotypes.ResultsA genome-wide significant association was identified between baseline FEV1/FVC ratio and a single-nucleotide polymorphism in the top hit cysteine-rich secretory protein LCCL domain-containing 2 (CRISPLD2) (rs12051168; P = 3.6 × 10-8 in the unadjusted model) that retained suggestive significance in the covariate-adjusted model (P = 5.6 × 10-6). Rs12051168 was also nominally associated with other related phenotypes: baseline FEV1 (P = 3.3 × 10-3), postbronchodilator (PB) FEV1 (7.3 × 10-3), and PB FEV1/FVC ratio (P = 2.7 × 10-3). The identified baseline FEV1/FVC ratio and rs12051168 association was meta-analyzed and replicated in three independent cohorts in which most participants with asthma also had confirmed AHR (combined weighted z-score P = .015) but not in cohorts without information about AHR.ConclusionsThese findings suggest that using specific asthma characteristics, such as AHR, can help identify more genetically homogeneous asthma subgroups with genotype-phenotype associations that may not be observed in all children with asthma. CRISPLD2 also may be important for baseline lung function in individuals with asthma who also may have AHR.

This manuscript delves into the pivotal role of sustainable agriculture in addressing environmental challenges and meeting the nutritional demands of a burgeoning global population. The primary objective is to assess the impact of a recently developed eco-friendly fertilizer, denoted as SBO, which arises from the blend of organic and mineral components derived from agricultural waste, sulfur, and residual orange materials. These elements are bound together with bentonite. This study compares SBO with distinct fertilizer treatments, including horse manure (HM) and nitrogen–phosphorous–potassium (NPK), on two diverse tomato-growing soils, each characterized by unique chemical and biological properties. Furthermore, the research extends to evaluate the environmental implications of these fertilizers, with a specific focus on their carbon and water footprints. Soils have been chemically and biochemically analyzed, and carbon and water footprints (CF and WF, respectively) have been assessed. The results reveal substantial enhancements in soil quality with the application of SBO fertilizer. Both soils undergo a transition towards near-neutral pH levels, an increase in organic matter content, and heightened microbial biomass. SBO-treated soils exhibit notably superior enzyme activities. The Life Cycle Assessment (LCA) results affirm the sustainability of the SBO-based system, boasting the lowest CF, while NPK demonstrates the highest environmental impact. Consistently, the WF analysis aligns with these findings, indicating that SBO necessitates the least water for tomato production. In summary, this study underscores the critical importance of adopting sustainable fertilization practices for enhancing soil quality and reducing environmental footprints in agriculture. The promising results offer potential benefits for both food production and environmental conservation.

Abstract Variability in response to short-acting β2-agonists (e.g., albuterol) among patients with asthma from diverse racial/ethnic groups may contribute to asthma disparities. We sought to identify genetic variants associated with bronchodilator response (BDR) to identify potential mechanisms of drug response and risk factors for worse asthma outcomes. Genome-wide association studies of bronchodilator response (BDR) were performed using TOPMed Whole Genome Sequencing data of the Asthma Translational Genomic Collaboration (ATGC), which corresponded to 1136 Puerto Rican, 656 Mexican and 4337 African American patients with asthma. With the population-specific GWAS results, a trans-ethnic meta-analysis was performed to identify BDR-associated variants shared across the three populations. Replication analysis was carried out in three pediatric asthma cohorts, including CAMP (Childhood Asthma Management Program; n = 560), GACRS (Genetics of Asthma in Costa Rica Study; n = 967) and HPR (Hartford-Puerto Rico; n = 417). A genome-wide significant locus (rs35661809; P = 3.61 × 10–8) in LINC02220, a non-coding RNA gene, was identified in Puerto Ricans. While this region was devoid of protein-coding genes, capture Hi-C data showed a distal interaction with the promoter of the DNAH5 gene in lung tissue. In replication analysis, the GACRS cohort yielded a nominal association (1-tailed P

Abstract Background Current guidelines consider T-DM1 the standard 2nd line therapy for HER2 positive metastatic breast cancer (MBC) patients following trastuzumab (T) + pertuzumab (P) and taxane 1st line treatment. Despite this, there are no prospective studies supporting this sequence. Methods We performed a meta-analysis using real world data to determine the efficacy of T-DM1 after 1st line TP in HER2 positive MBC patients. We used a random-effect model to find differences in the rate of 1-year progression free survival (PFS) between TP pre-treated population and the EMILIA phase III pivotal trial. Results Seven studies were eligible. The meta-analysis showed a combined 1-year PFS risk difference for T-DM1 efficacy after TP in 2nd or more lines of -0.122, with lower and upper limits of -0.253 and 0.010, respectively (p = 0.07), with low heterogeneity among studies (I2 0.01%, p = 0.836). Considering the four studies on T-DM1 in 2nd line setting, 1-year PFS risk was -0.034 (95% CI -0.207 – 0,139; p = 0.701) (I2 0.01%, p = 0.91). Conclusion Overall, the efficacy of T-DM1 after TP seems to be similar to that previously reported in the EMILIA trial. In the second line setting, data are not mature enough to confirm T-DM1 efficacy in TP pre-treated population.

BackgroundTobacco smoking is a major independent risk factor for chronic disease, and the prevalence of smoking among people with behavioral health disorders is 2-fold in comparison with the general population. Smoking rates remain high for various subgroups within the Latine community, the largest ethnic minority group in the United States. Acceptance and commitment therapy (ACT) is a theoretically sound and clinically validated therapeutic approach for several behavioral health conditions with growing evidence of its effectiveness for smoking cessation. Unfortunately, the evidence of ACT effectiveness for smoking cessation among Latine individuals is scarce, and none of the existing studies have tested a culturally targeted intervention for this population. ObjectiveThis study aims to address the co-occurrence of smoking and mood-related challenges among Latine adults via the development and testing of a culturally tailored ACT-based wellness program: Project PRESENT. MethodsThis study entails 2 phases. Phase 1 consists of the intervention development. Phase 2 entails the pilot testing of the behavioral intervention along with the administration of baseline and follow-up measures to 38 participants. Primary outcomes include feasibility of recruitment and retention, and treatment acceptability. Secondary outcomes are smoking status and depression and anxiety scores at end of treatment and 1-month follow-up. ResultsThis study received institutional review board approval. Phase 1 outputs were the health counselors’ treatment manual and participant guide. Recruitment was completed in 2021. Phase 2 outcomes will be determined after project implementation and data analyses are complete, which are expected by May 2023. ConclusionsFindings from this study will determine the feasibility and acceptability of an ACT-based, culturally relevant intervention for Latine adults who smoke and have probable depression and/or anxiety. We expect feasibility of recruitment, retention and treatment acceptability, and reductions in smoking status, depression, and anxiety. If feasible and acceptable, the study will inform large-scale trials, which will ultimately contribute to narrowing the gap between research and clinical practice for the co-occurrence of smoking and psychological distress among Latine adults. International Registered Report Identifier (IRRID)DERR1-10.2196/44146

Non-melanoma skin cancers (NMSCs) are the most common human neoplasms world-wide. In detail, basal cell carcinoma (BCC) is the most frequent malignancy in the fair-skinned population. The incidence of BCC remains difficult to assess due to the poor registration practice; however, it has been increasing in the last few years. Approximately, 85% of sporadic BCCs carry mutations in Hedgehog pathway genes, especially in PTCH, SUFU and SMO genes, which lead to the aberrant activation of GLI transcriptional factors, typically silent in cells of adult individuals. The management of advanced BCC (aBCC), both metastatic (mBCC) and locally advanced BCC (laBCC), not candidates for surgical excision or radiotherapy, remains challenging. The discovery of mutations in the Hh signaling pathway has paved the way for the development of Hh pathway inhibiting agents, such as vismodegib and sonidegib, which have represented a breakthrough in the aBCC management. However, the use of these agents is limited by the frequent occurrence of adverse events or the development of drug resistance. In this review, we thoroughly describe the current knowledge regarding the available options for the pharmacological management of aBCCs and provide a forward-looking update on novel therapeutic strategies that could enrich the therapeutic armamentarium of BCC in the near future.

Abstract Background Barriers to mental health care access among Latinx children contribute to mental health disparities. It is unclear whether traditional spiritual guides in Latinx communities may function more as gateway providers or in some instances as deterrents to mental health treatment. This study assesses whether family involvement in Espiritismo and/or Santeria, two forefront non-Christian spiritual traditions among Latinx families, is associated with mental health care utilization among Puerto Rican children in two contexts. Methods Data are from Waves 1–3 (2000–2004) of the Boricua Youth Study, a population-based longitudinal cohort study of Puerto Rican children from San Juan and Caguas, Puerto Rico (PR), and the South Bronx, New York (SBx), 5 to 17 years of age (N = 2491). Results At baseline, 5.02% (n = 58) of the families reported involvement with Espiritismo and/or Santeria in the SBx and 3.64% (n = 52) in PR. Logistic regression models predicting mental health service use found, after adjusting for multiple risk and protective factors, that families involved with Espiritismo and/or Santeria were 2.41 times more likely (p = 0.0034) to use mental health services over the course of 3 years than children with no family involvement in these practices in the SBx. The same association was not found in PR. Conclusions The findings among PR families in the SBx lend support to the gateway provider model in which spiritual guides open doors to mental health treatment. Forming community connections between mental health providers and traditional spiritual groups may be a culturally considerate, fruitful approach to reducing barriers to mental health treatment among Latinx families.

IntroductionTransitional age youth (i. e., ages 16–24; TAY) use higher levels of substances than any age group in the United States. Understanding what factors increase substance use during TAY could suggest novel targets for prevention/intervention. Studies suggest that religious affiliation is inversely associated with substance use disorders (SUDs). However, the association of religious affiliation and SUD, including the role of gender and social context, has not been studied in TAY of Puerto Rican ethnicity.MethodsUsing data from N = 2,004 TAY of Puerto Rican ethnicity across two social contexts—Puerto Rico (PR) and the South Bronx, NY (SBx)—we tested the association of religious identity (Catholic, Non-Catholic Christian, Other/Mixed, and no religious affiliation, or “None”), and four SUD outcomes (alcohol use disorder, tobacco use disorder, illicit SUD, and any SUD). Logistic regression models were used to examine the association between religious identity and SUDs, then we tested for interaction by social context and gender.ResultHalf the sample identified as female; 30, 44, and 25% were 15–20, 21–24, and 25–29 years of age, respectively; 28% of the sample received public assistance. There was a statistically significant difference between sites for public assistance (22 and 33% in SBx/PR, respectively; p < 0.001); 29% of the sample endorsed None (38 and 21% in SBx/PR, respectively.) Compared to None, identifying as Catholic was associated with reduced risk of illicit SUD (OR = 0.51, p = 0.02), and identifying as Non-Catholic Christian with reduced risk for any SUD (OR = 0.68, p = 0.04). Additionally, in PR but not SBx, being Catholic or Non-Catholic Christian was protective for illicit SUD when compared to None (OR = 0.13 and 0.34, respectively). We found no evidence of an interaction between religious affiliation and gender.DiscussionThe percentage of PR TAY who endorse no affiliation is higher than the general PR population, reflective of increasing religious non-affiliation among TAY across cultures. Critically, TAY with no religious affiliation are twice as likely as Catholics to have illicit SUD, and 1.5 times as likely as Non-Catholic Christians to have any SUD. Endorsing no affiliation is more adverse for illicit SUD in PR than the SBx, underscoring the importance of social context.