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Despite high rates of mental health concerns among youth, they are unlikely to receive mental health care, with mental health stigma acting as a barrier. The present study explores youth perceptions of the influences of stigma and what should be done to address it, drawing on a large (n = 705) mixed methods dataset of youth aged 14 to 24 from the National MyVoice Text Message Cohort. Thematic analysis indicated four themes: (1) perceptions of high levels of ignorance about mental health, (2) a continuum from a desire for greater openness to a desire for privacy related to mental health, (3) feeling shamed and dismissed for mental health concerns, and (4) the role of adults in perpetuating of mental health stigma and adults' responsibility in combating it. Subgroup comparisons revealed variations in endorsement of themes based on gender, age, and race/ethnicity. Implications for research and practice are discussed.

Abstract Manganese-52 is gaining interest as an isotope for PET imaging due to its desirable decay and chemical properties for radiopharmaceutical development. Somatostatin receptor 2 (SSTR2) is significantly overexpressed by neuroendocrine tumors (NETs) and is an important target for nuclear imaging and therapy. As an agonist, [68Ga]Ga-DOTATATE has demonstrated significant internalization upon interaction with receptor ligands, whereas [68Ga]Ga-DOTA-JR11(as an antagonist) exhibits limited internalization but better pharmacokinetics and increased tumor uptake. The goal of this study was to label both DOTATATE and DOTA-JR11 peptides with 52Mn in high radiochemical yields (RCY) and sufficient specific activity. A comparison of these two compounds was performed in in vitro and in vivo studies in animals with somatostatin receptor-positive xenografts to characterize differences in cell, tumor, and tissue uptake. Radiolabeling of DOTATATE and DOTA-JR11 was carried out by combining varying concentrations of the peptides with [52Mn]MnCl2. In vitro stability of the radiotracers was determined in mouse serum. In vitro cell uptake and internalization assays were performed in SSTR2 + AR42J cells and negative controls. In vivo biodistribution and longitudinal PET imaging was evaluated in mice bearing AR42J tumors. Both [52Mn]Mn-DOTATATE and [52Mn]Mn-DOTA-JR11 showed affinity for SSTR2 in AR42J cells. However, the uptake of [52Mn]Mn-DOTATATE was higher (11.95 ± 0.71%/ mg) compared to [52Mn]Mn-DOTA-JR11 (7.31 ± 0.38%/ mg) after 2 h incubation. After 4 h incubation, 53.13 ± 1.83% of the total accumulated activity of [52Mn]Mn-DOTATATE was internalized, whereas only 20.85 ± 0.59% of the total accumulated activity of [52Mn]Mn-DOTA-JR11 was internalized. The PET images revealed similar biodistribution results, with [52Mn]Mn-DOTATATE showing a significant tumor uptake of 11.16 ± 2.97% ID/g, while [52Mn]Mn-DOTA-JR11 exhibited a lower tumor uptake of 2.11 ± 0.30% ID/g 4 h post-injection. The synthesis of both radiotracers was accomplished with high RCY and purity. The cell uptake and internalization of [52Mn]Mn-DOTATATE showed higher levels compared to [52Mn]Mn-DOTA-JR11. PET images of the radiotracers in AR42J tumor bearing mice demonstrated similar biodistribution in all organs except the tumor, with [52Mn]Mn-DOTATATE showing higher tumor uptake compared to [52Mn]Mn-DOTA-JR11. The variations in the properties of these tracers could be used to guide further imaging and treatment studies.

Atomically defined large metal clusters have applications in new reaction development and preparation of materials with tailored properties. Expanding the synthetic toolbox for reactive high nuclearity metal complexes, we report a new class of Fe clusters, Tp*4 W4 Fe13 S12 , displaying a Fe13 core with M-M bonds that has precedent only in main group and late metal chemistry. M13 clusters with closed shell electron configurations can show significant stability and have been classified as superatoms. In contrast, Tp*4 W4 Fe13 S12 displays a large spin ground state of S=13. This compound performs small molecule activations involving the transfer of up to 12 electrons resulting in significant cluster rearrangements.

Background: Left atrial catheterization is a common procedure in electrophysiology labs to treat arrhythmogenic substrates on the left side of the heart. Needle transseptal puncture is the standard approach, but it can lead to complications related to device design or operator technique. To reduce these complications, needle-free alternatives have been explored. Objective: This study aims to report the first multicenter application of the needle-free transseptal access (NeFTA) approach, assessing its safety and efficacy in patients undergoing electrophysiological procedures. Methods: This retrospective, observational multicenter study evaluated the safety and efficacy of the NeFTA approach in patients undergoing ablation of left arrhythmogenic substrates across 3 electrophysiology centers in Mexico. NeFTA uses only a guidewire, without a needle or sharp guidewire. The sheath, with a dilator, is guided into the fossa ovalis under fluoroscopic guidance, using anterior force and clockwise torque to allow the guidewire to puncture the septum with minimal risk. Results: The NeFTA technique was used in 366 patients. Most sheaths were deflectable, with nondeflectable sheaths in 43.4% of cases. Left atrial access via NeFTA was successful in 96.18% of cases, with pericardial effusion as the only complication (0.55% rate). Conclusion: This technique was reproducible and safe, achieving successful access on the first or second attempt in 96.18% of cases, regardless of the operator.

BACKGROUND: Chronic cardiac failure belongs to the most threatening and delayed manifestations of cardiotoxicity in oncology patients receiving the treatment with antitumor medicines. As of today, only two groups of drugs were proven to have significant cardioprotective effects in these categories of patients: angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and beta-adrenergic blockers. Recently, the first data were published on the successful use of sodium-glucose cotransporter type 2 inhibitors in patients with chronic cardiac failure, receiving anthracycline therapy. AIM: optimization of cardioprotective therapy in the treatment of chronic cardiac failure in oncology patients receiving cardiotoxic chemotherapy. METHODS: A prospective observational open-label research was carried out with an enrollment of 116 oncology patients with verified chronic cardiac failure, which were receiving cardiotoxic chemotherapy, of which 60 patients of the control group were receiving double cardioprotective therapy (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) and the 56 patients of the test group were receiving similar therapy with an addition of Dapagliflozin at a dosage of 10 mg once daily in the morning. The controls of the results were conducted in 6 months by means of laboratory and instrumental examinations, as well as by using additional methods of controlling the results. RESULTS: The groups compared did not differ by the combined primary clinical endpoint (the rate of hospitalizations due to cardio-vascular reasons, the refusal to undergo chemotherapy for the reason of chronic cardiac failure progression and the safety of using the drug products: the presence of urinary tract infections and sepsis), but they differed by the surrogate clinical endpoints that included the dynamic trend of the levels of the groups compared did not differ by the combined primary clinical endpoint (the rate of hospitalizations due to cardio-vascular reasons, the refusal to undergo chemotherapy for the reason of chronic cardiac failure progression and the safety of using the drug products: the presence of urinary tract infections and sepsis), but they differed by the surrogate clinical endpoints that included the dynamic trend of the levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and the global longitudinal strain (GLS) of the left ventricle, determined within the timeframes established for the research — before the initiation of chemotherapy and in 6 months. The patients that have passed all the control tests (n=47), after the end of the 6 months period, underwent a comparison of the levels of troponin Т, left ventricle ejection fraction (LVEF), NT-proBNP and GLS. It was found that the dynamic changes of troponin T levels in both groups did not significantly differ (p=0,260), as well as the LVEF indicator (p=0.340), while the NT-proBNP level was significantly decreasing in the test group — by 7.8% comparing to the control group (p=0.006). Comparable data were obtained for the GLS (the decrease in the test group by 6.5% in relative values) comparing to the control group (p=0.008). In 22/47 (46,8%) patients, chronic cardiac failure was diagnosed before the initiation of chemotherapy, in 25/47 (53,2%), chronic cardiac failure was developing during the antitumor medication therapy. In both groups, a total of 17 (16%) fatal outcomes were registered, none of which was caused by the cardiac failure. CONCLUSION: We suppose that the decrease in the levels of the cardiac failure marker and the less intensive impairment of the left ventricle longitudinal strain with a background of adding sodium-glucose cotransporter type 2 inhibitors to baseline therapy for chronic cardiac failure in oncology patients receiving cardiotoxic chemotherapy, reflects their cardioprotective potential. Thus, the sodium-glucose cotransporter type 2 inhibitor Dapagliflozin slows down the progression of chronic cardiac failure in oncology patients receiving cardiotoxic chemotherapy.

Deep vein thrombosis and pulmonary artery thromboembolism are the most commonly occurring cardio-vascular complications of oncological diseases, which may develop at any stage of the oncological process. These life-threatening complications take the leading positions within the structure of mortality among cancer patients, giving place only to the oncology disease itself. It is important to note that the patients with cancer-associated thromboses are the most difficult group of patients, in which the development of thromboses and thromboembolisms may not only delay the vitally important treatment of the main disease, but also to completely cease the treatment due to the lack of possibility for its adequate performing. This is an important social and economic task, taking into consideration the costs for the healthcare system required to treat the disease itself and its concomitant complications. Thus, there is a criticality factor of not only the treatment itself, but also of the prevention of oncology-associated thromboses and thromboembolisms. Currently, due to the wide spreading of the said complications, the therapy and the prevention of them undergo significant changes. The traditionally used warfarin is being switched to low molecular weight heparin. At the present moment, oral anticoagulants are used more and more often. The analysis of special scientific literature has allowed for evaluating the novel principles of treatment in cases of oncology-associated thromboses and thromboembolisms depending on the location of the process, on its stage, on the severity of the patient status, as well as to define the risk factors of oncology-associated thromboses, the practicability and possible methods of its prevention in various groups of patients.

The mixed assessment by critics and theorists of the deus ex machina artistic device common in popular cinema requires a more thorough study of its dramatic and narrative functions in science fiction films. It is in the construction of film images of the future that this technique is combined with a fantastic assumption, expressing the narrator’s attitude towards artistic narration and becoming an argument in dialogue with the viewer. The study reveals, based on the analysis of empirical material, the multifunctionality of deus ex machina using the example of the development of the theme of technological singularity in cinema. The analysis of films significant for the development of the science fiction (Sci-Fi) genre and the most popular television series among science fiction fans today demonstrates the evolution of the deus ex machina technique. In addition to the trivial function of arbitrary resolution of peripeteia, it acquires various dramatic functions (accelerating or slowing down the rhythm of action, connecting parts of the plot in a large form), obtains the properties of scaling and fragmentation, synchrony and asynchrony with a fantastic assumption, adding complex narrative functions to the toolkit of expressive means, through which the narrator reveals or, on the contrary, conceals his attitude to artistic reality, involving the viewer into the game of probable meanings. The authors of the article come to the conclusion that the theme of technological singularity has been penetrating cinema since its appearance in the work of L. Lumiere and determines, depending on the narrator’s attitude to the topic, the vector of techno-skepticism or techno-optimism in the eschatological dilemma that characterizes the cosmogony of traditional religions. The article is of interest to researchers and film lovers and contributes to the study of artistic and scientific communication.

The assessment of Intellectual Disability (ID) under the Individuals With Disabilities Education Improvement Act 2004 (IDEIA; Public Law 108-446, 2004) requires the measurement of both intelligence and adaptive behavior (i.e., conceptual, social, and practical skills). This study expands past research by examining current state special education guidelines based on IDEIA and their alignment with best practices in assessment across all U.S. states and the District of Columbia (DC) for the assessment of ID. Aggregated and disaggregated data pertaining to special education guidelines and recommendations are examined, including cut-scores and confidence intervals, information specific to composite adaptive behavior scores versus domain scores, and multiple informants.

Computer-based learning environments (CBLEs) are powerful tools to support student learning. Increasingly of interest is the data that is recorded as learners interact with a CBLE. This "process data" yields opportunities for researchers to examine learners' engagement with a CBLE and explore whether specific interactions are associated with learner variables, with direct implications for improving learning outcomes and CBLE design. As CBLEs increase in number and complexity, researchers continue to seek more effective strategies to analyze process data. While a variety of strategies are in use, from visualizations to predictive modeling, none yet offer the capabilities to both uncover hidden, meaningful interactions and descriptively analyze those interactions rapidly across the complete data set. This paper details a method that addresses current challenges, and then applies the method to existing data from a prior study which investigated the effects of adding a visual scaffold to a chemistry-based CBLE. Using a biochemical coding approach through a cultural-historical activity theory (CHAT) framework, the method successfully identified 257 unique, meaningful patterns of interaction that were strategically grouped into nine categories of mediated actions. Though no differences in mediated actions were observed between learners in the experimental (visual scaffolds) and control conditions, three mediated actions were significantly and positively associated with higher learning outcomes in the visual scaffold condition. The results not only provide insight into why the addition of visual scaffolds led to higher learning outcomes among participants but have broader implications for filling a gap in the field of process data analytics for CBLEs in science education.

Abstract Plant phenology is affected by both abiotic conditions (i.e., temperature, nitrogen enrichment, and drought) and biotic conditions (i.e., species diversity). The degree of spatial heterogeneity in soil resources is known to influence community assembly and dynamics, but the relationship between resource heterogeneity and phenology or the potentially interactive effects of soil resources on phenology are less understood. We leveraged a tallgrass prairie restoration experiment that has manipulated soil nitrogen availability and soil depth over 20 years to test the effects of environmental heterogeneity, nutrient enrichment, and potentially interactive effects of global change drivers (nutrient enrichment and a drought manipulation) on the phenology of a highly dominant prairie grass (Andropogon gerardii). We recorded the timing of major developmental stages of A. gerardii in plots containing four soil heterogeneity treatments (control, soil depth heterogeneity, nutrient/depth heterogeneity, and nutrient/precipitation heterogeneity). We found that the boot, first spikelet, and emerged spikelet stages of A. gerardii occurred earlier in treatments with greater heterogeneity of soil nitrogen, and this effect was driven by the accelerative effect of nitrogen enrichment on phenology. Reduced precipitation increased the flowering length of A. gerardii but did not otherwise affect developmental phenology. There were no interactive effects among any soil resource treatments on phenology. These results advance our understanding of the relationship between plant phenology and global change drivers, which is important for understanding and predicting the timing of plant resource use and the provision of resources to higher trophic levels by plants under varying levels of resource availability.

Telehealth was widely adopted in pediatric occupational therapy practice during the COVID-19 pandemic; however, there is limited knowledge on telehealth use post-pandemic. This study collected 132 responses to a mixed-methods survey from March-October 2023 to explore pediatric occupational therapists’ current use and perceptions on telehealth. Results indicated that over half of respondents continue to use telehealth. Frequency of use was differentiated by setting, with a significantly lower proportion of school-based respondents using telehealth compared to outpatient (p

Aim: Abrocitinib is a JAK-1 inhibitor approved for the treatment of moderate-to-severe atopic dermatitis (AD). We conducted a 16-week multicenter retrospective study to assess the short-term effectiveness and safety of abrocitinib in patients with moderate-to-severe AD.Our retrospective study included 85 adult patients from 14 Italian Dermatology Units affected by moderate-to-severe AD treated with abrocitinib 100/200 mg.Methods: Effectiveness of abrocitinib at weeks 4 and 16 was assessed by using the Eczema Area and Severity Index (EASI), the Investigator Global Assessment (IGA), the peak pruritus and sleep- Numerical Rating Scale (PP-NRS and S-NRS, respectively).Results: At week 16, improvement of at least 90% in EASI (EASI90) and IGA 0/1 was observed in 49.4% and 61.2% of patients, respectively. A reduction of at least 4 points in PP-NRS and S-NRS compared with baseline was achieved by 70.6% of patients for both endpoints. No significant safety reports were observed during the study period. Naïve patients had better rates of EASI 90 compared to patients who previously failed dupilumab.Conclusion: Our data confirm the effectiveness of abrocitinib in a real-world setting with better clinical responses at weeks 4 and 16, compared with Phase-III clinical trials. Longer analyses are required to further establish the safety profile of abrocitinib.