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Purpose: Vocational educators in many countries enter teaching as a second career and authentic occupational expertise is seen as essential to good quality VET. The changing contexts of VET and the growing diversity of its learning populations also demand the development of teaching expertise. This dual professionalism is related to a unique combination of an occupational and a teacher identity, however, prior, and mainly qualitative research from a limited number of VET contexts suggests that often one side of this duality prevails. Our study aimed to explore the professional identity of vocational educators in Hungary and to identify some of the factors that might influence its formation. Methods: We applied a mixed method design, conducting a teacher survey (N=138) and semi-structured interviews (N=12). The quantitative and qualitative strands followed a parallel design, exploring the same topics but identity views and the organisational context were studied more deeply in the interviews. In the survey, we measured professional identity through a direct question about its type as well as questions about the importance of specific goals and teacher competence areas in vocational teaching. We used statistical and thematic analyses to study our quantitative and qualitative data. Results: Most vocational educators in our study identified as both a teacher and a professional, though the type of identity varied by gender and length of occupational work experience. Perceptions about the main goals in teaching revealed vocation/outcome-focused and student/education-focused goal orientations influenced by gender, qualifications and work experience, while our qualitative data also showed the impact of school culture and the wider socio-economic context. The goal orientations identified in the survey were more balanced for those with a dual identity, and they correlated with perceptions about the importance of different teacher competence areas, which were most influenced by whether or not the educator had obtained a pedagogical qualification. Conclusion: Our findings showed that although most vocational educators also in Hungary claim to have a dual identity, they often prioritise the development of occupational expertise as they believe it is what gives them credibility that is seen as essential to "good VET". Considering the significant impact we have found of teacher education and continued work in the occupation on identity views, it seems of utmost importance that policy and schools recognise and support the development of both occupational and teacher expertise, to ensure a balanced dual identity that seems best suited for vocational teaching.

In some European countries, the educational attainment of the Roma population is very low compared to the majority society. This study focuses on what supports the higher education pathways of Roma youth by using empirical data. Thirty-one Roma students, whose academic advancement was supported by a Roma Student Society, and ninety-three students who did not receive support participated in the study. The students in the control group got further subdivided into three groups based on their socioeconomic backgrounds, so four groups in total were included in our analysis. The research was conducted using mixed methodology: we analyzed the texts of reflective essays and data derived from a questionnaire. The results show that the students in the support group have significant external and internal capital in all areas, except for financial capital, which is offset by the social capital provided by their schools and university. It is important to highlight the supportive role of family, in which there is no difference between the Roma Student Society members and the students in the control groups with higher socioeconomic status. In the control group, a minority group emerged with a similar social background as the supported focus group, and they noticeably remain invisible to the institution. Our research also draws attention to the importance of creating and developing an inclusive learning environment that results in significant social capital, not only to retain low socioeconomic groups but also to retain groups with higher social status.

Purpose: One key aspect of European curriculum reforms is to empower students with the skills needed to engage actively in the pluralistic and multicultural global society of the 21st century. This study aims to examine the extent of multicultural education within the national core curricula of three European countries: Hungary, Finland and Ireland, focusing on its role in fostering social acceptance through education. Design/methodology/approach: A qualitative research applying discourse analysis was conducted to identify key multiculturalism concepts within the curricula. The analysis concentrated on understanding how multiculturalism is portrayed through various perspectives, emphasizing situational meanings and frameworks. Furthermore, a comparative analysis of the findings was carried out. Findings: The research found that all three curricula contain the concept of multicultural education, although the extent of emphasis varies. The Hungarian National Core Curriculum (NCC) primarily emphasizes national values and sporadically addresses multicultural issues, often from a local perspective. In contrast, the Irish NCC is tolerance-oriented, stressing not only the understanding of different cultures but also the importance of accepting them. The Finnish NCC reflects a global perspective and emphasizes respect for different cultures and minority groups, with a pluralistic approach. Originality/value: This study enhances our understanding of the discourse of multiculturalism within the curricula of three European countries, emphasizing both their similarities and differences. Additionally, it underscores the crucial role that curricula can play in effectively implementing multicultural education.

The present paper explores approaches to the classification of ethnic identity. In the framework of research on comparative classifications, we analyse the contextual factors that influence classification in Hungarian education. We compared the number of students who self-reported as Roma with the respective number reported by the school heads (as experts) and examined the discrepancies between the two indicators. We also examined whether there was a correlation between the estimation by the head of the school and the views and attitudes of the teaching staff and school heads. One important finding to emerge was the more than the twofold difference between the external classifications reported by individuals belonging to the majority population, and the students' self-identification. In other words, the school heads tended to overestimate the proportion of Roma students in their schools compared to the students' own self-identification, which was related to their pedagogical practices, beliefs, and commitment. In particular, school heads overestimated the proportion of Roma students in schools where teachers perceived that there were lower expectations and where teachers attributed school failure to cultural differences.

Cultural diversity is an important feature of today's classrooms, where learners come from a wide range of cultural backgrounds. In order to teach every individual in an appropriate and motivating way, teachers need a wealth of knowledge, skills, and attitudes, and teacher training plays a major role in their acquisition. The present research was undertaken in order to gain a better understanding of how teacher training contributes to the development of pre-service teachers' culturally responsive competencies. Overall, the findings indicate that there are differences in the components of CRP-related competencies that teacher education programs deliver to prepare teachers for key aspects of multicultural education. Most of the courses are stand-alone courses, one semester long and only focus on one of the competence elements (eg attitude). We found only a limited number of courses that incorporated culturally responsive pedagogy as a long-term, comprehensive approach into their curriculum, and were thus able to develop the majority of competence elements related to CRP.

During the research entitled "Teaching Creative Music," the focus is on getting to know creative music, which is becoming more and more widespread in Hungary, however using it, but still takes up little space in our music education, and its impact in high school and university environments is limited. The Kodaly Concept contains a number of well-established practices also Laszlo Sary's collection of "Creative Music Exercises" (Sary, 1999), mainly evoking Christian Wolff and John Cage, evoking the work of Stockhausen, also works well, but there is no teaching aid for the secondary school classes (9-12) based on different combinations of systematic vocal and rhythmic tasks -- although in the 2017 NAT ["National Curriculum"], creative music activity as a reproduction is included as a requirement among the development tasks. There is also less experience among those pursuing higher music studies in terms of methodological preparation at the national level. We believe that much more student-based assignments should be used in high school singing and music education so that their classroom motivation and musical creativity can develop further, and their subject-related knowledge deepen. We are interested in the "rehabilitation" of this field, as there are a lot of opportunities in the creative music exercises, during which repetitive activity and musical creativity are essential, and Odena and Welch have already studied the latter (Odena-Welch, 2007). Music pedagogical research supports the need to study the field, as high school students are undermotivated in their lessons and their musical creativity is not sufficiently exploited (Deliege-Wiggins, 2006). In this article, we would like to explore an analysis of some of the practices of a creative music course over a semester in terms of how student activity and creativity changed during the 9 hours of the practice (measured with 3 groups per week). For all of this, we also use elements of Teachout and McKoy's model, who examined music teacher attributes in terms of teacher success and failure.

Abstract An estimated 70% of critically ill patients receive antibiotics, most frequently beta-lactams. The pharmacokinetic properties of these substances in this patient population are poorly predictable. Therapeutic drug monitoring (TDM) is helpful in making personalized decisions in this field, but its overall impact as a clinical decision-supporting tool is debated. We aimed to evaluate the clinical implications of adjusting beta-lactam dosages based on TDM in the critically ill population by performing a systematic review and meta-analysis of available investigations. Randomized controlled trials and observational studies were retrieved by searching three major databases. The intervention group received TDM-guided beta-lactam treatment, that is, at least one dose reconsideration based on the result of the measurement of drug concentrations, while TDM-unadjusted dosing was employed in the comparison group. The outcomes were evaluated using forest plots with random-effects modeling and subgroup analysis. Eight eligible studies were identified, including 1044 patients in total. TDM-guided beta-lactam treatment was associated with improved clinical cure from infection [odds ratio (OR): 2.22 (95% confidence interval (CI): 1.78–2.76)] and microbiological eradication [OR: 1.72 (CI: 1.05–2.80)], as well as a lower probability of treatment failure [OR: 0.47 (CI: 0.36–0.62)], but the heterogeneity of studies was remarkably high, especially in terms of mortality (70%). The risk of bias was moderate. While the TDM-guided administration of beta-lactams to critically ill patients has a favorable impact, standardized study designs and larger sample sizes are required for developing evidence-based protocols in this field.

Background: There is an emerging concern regarding the indirect effect the Covid-19 pandemic has had on the care provided to patients. New resuscitation guidance including the donning of Personal Protective Equipment before commencing resuscitation efforts, the avoidance of bag-mask ventilation, limiting the number of responders and stopping resuscitation efforts earlier could have led to worse outcomes following in-hospital cardiac arrest (IHCA) when compared to the non-pandemic period. The primary objective was to understand the impact of the pandemic on patient outcomes following IHCA by comparing the pandemic and non-pandemic periods. Methods: Our systematic search was conducted on the 13th of September 2022 in three databases: Medline, Embase and Central. Randomised or non-randomised clinical trials and observational studies were included. The search was repeated on 31st December 2023 and there were no new studies appropriate for inclusion which had been published in the interim. The patient population consisted of adult patients who suffered IHCA due to any cause. The primary outcome was survival to hospital discharge (SHD). The secondary outcomes were return of spontaneous circulation (ROSC) and length of resuscitation. Results: We identified 1873 studies, 9 were included in our qualitative analysis. SHD was reported in 8 studies with no difference between the two periods (OR 0.69; 95% CI 0.47–1.03) along with resuscitation (MD: 0.74; 95% CI: −0.67 to 2.14; p = 0.153. ROSC was included in all studies and showed significant difference between the two periods (OR 0.75; 95% 0.60–0.95) Conclusion: Although SHD was similar between the two periods, ROSC was significantly lower during the pandemic with longer resuscitation times highlighting a substantial impact of the pandemic on patient outcomes.

One of the most reliable predictors of school effectiveness is student engagement, which is not only related to students’ current achievement but also long-term outcomes. Using linear regression and structural equation modeling procedures, the present study was aimed at examining the relationship between dropout risk, dimensions of student engagement, and family background. The survey study involved 3251 7th grade Hungarian students who completed the adapted Student Engagement Instrument and self-reported background questionnaire. According to the results, student performance is mainly related to parents’ educational attainment, but a moderate or weak correlation with behavioral, academic, and cognitive engagement is also detectable. While affective engagement shows a weak association with performance, it correlates with other engagement dimensions linked to achievement. This result suggests that support from parents, peers, and teachers may have an indirect effect on achievement; however, the present study could not confirm this hypothetical model. Based on our data, parental educational attainment and student engagement account for approximately 41 % of student performance which draws attention to the complexity of the relationship between student engagement and performance and highlights the importance of a comprehensive approach to dropout and student engagement in this context.

Purpose: Inclusive education of Roma students is a priority goal of the European Union. However, synthesising analyses reveal precious little progress scored in this area. This study aims to explore the factors that have affect Roma students' academic achievement, specifically, whether the views of their teachers have an impact on the performance besides individual and family background factors. Design/methodology/approach: A large-sample questionnaire-based research study was conducted in the 2019/2020 academic year involving 4,674 seventh-grade students and 2,656 teachers from 194 Hungarian schools. On a self-admission basis, 374 of the students were Roma. Findings: In the schools examined, the performance of Roma students is poorer, their commitment to learning is weaker, yet they have a higher opinion of their school and their teachers than their non-Roma peers. The involvement of majority students in extracurricular private tutoring, particularly foreign language learning, is greater. Roma students' academic achievement is mainly affected by individual background factors, in particular by their school history. Originality/value: The findings suggest that although the role of the school and pedagogical views is important, they are not predominant factors determining Roma students' performance. The explanatory power of individual characteristics is stronger than that of school factors. The comparison between Roma and non-Roma students also shows that cooperation between different sectors (education, social and health) would be essential within and outside school in terms of home learning conditions, digital access and student well-being.

This paper evaluates a Hungarian gifted education programme aimed at providing equal opportunities for students with social and economic disadvantages. In the context of a retrospective study, the differences in academic success and learning pathways were examined in a cohort comprising a group that participated in the programme and a group that did not. The analysis used the data of grade 6 and grade 10 students in the Hungarian National Competence Assessment. The analysis found that the scholastic achievement of the students participating in the programme was higher than that of the control group. By grade 6, participants presented higher scholastic achievement, better results in the competence tests and better school grades, and the difference between the two groups increased again by grade 10. The programme contributed to compensating for the participants' educational inequalities and promoted their integrational social mobility. However, it was found that inclusion in the programme was greatly influenced by teachers' perception, which was not always consistent with the aptitude of students.

Our study presents the phenomena of inclusion and resilience through a Hungarian education programme (Arany János Programme) aimed at enhancing equity. The focus of the research conducted in 2017/2018 was to explore the family backgrounds and personal stories of disadvantaged Roma/Gypsy students and youth, as well as to examine the correlation between student success (resilience) and integration of support programmes (inclusive environment). This study focuses on two target groups: students currently enrolled in the programme and students who have already completed the programme. Questionnaire-based data were collected from all of the AJP students (N = 3279). Life path interviews were also conducted with young adults who had finished the programme (N = 28). The research study has identified a correlation between student success (resilience) and the support programmes (inclusive environment), the former manifesting itself despite disadvantaged family backgrounds and lack of initial capital.

Az Európai Unión belül a korai iskolaelhagyás arányát tekintve Magyarország a legutolsó harmadba tartozik – évről évre lefelé irányban eltávolodva az uniós átlagtól. A cigány, roma fiatalok alacsonyabb iskolázottságát, lemorzsolódásuk nagyobb esélyét már számos kutatás megerősítette, azonban a leírások, akárcsak a nemzetközi megközelítésekben is, gyakran kétdimenziósak. A Magyar Ifjúság 2020 adatbázisa lehetőséget teremtett arra, hogy a magyarázó változók szélesebb körét bevonjuk az elemzésbe. Tanulmányunkban megvizsgáljuk a 20-29 éves roma fiatalok iskolai végzettségét, majd a roma és a nem roma lemorzsolódók almintáit hasonlítjuk össze. Végül az adatbázison bináris regressziós modellt futtattunk le, amelynek függő változója a korai iskolaelhagyás ténye volt, míg a magyarázó változókat olyan háttérmutatók alkották, amelyek a korai iskolaelhagyás esélyét alakíthatják. A roma és nem roma korai iskolaelhagyók társadalmi, gazdasági háttere eltérő, a szülők végzettsége, illetve a szubjektív anyagi helyzete kedvezőtlenebb mintát mutatott a romák esetében. A roma identitás hatása a regressziós modellben szignifikáns volt, azonban a magyarázó erő nem érte el a szülők alacsonyabb iskolai végzettségének a hatását. Vagyis az etnikai háttér valószínűsíti a lemorzsolódást, ugyanakkor a családi helyzet más elemei meghatározóbbak.

The commercial introduction of a novel electronic device is often preceded by a lengthy material optimization phase devoted to the suppression of device noise as much as possible. The emergence of novel computing architectures, however, triggers a paradigm shift in noise engineering, demonstrating that non-suppressed but properly tailored noise can be harvested as a computational resource in probabilistic computing schemes. Such a strategy was recently realized on the hardware level in memristive Hopfield neural networks, delivering fast and highly energy efficient optimization performance. Inspired by these achievements, we perform a thorough analysis of simulated memristive Hopfield neural networks relying on realistic noise characteristics acquired on various memristive devices. These characteristics highlight the possibility of orders of magnitude variations in the noise level depending on the material choice as well as on the resistance state (and the corresponding active region volume) of the devices. Our simulations separate the effects of various device non-idealities on the operation of the Hopfield neural network by investigating the role of the programming accuracy as well as the noise-type and noise amplitude of the ON and OFF states. Relying on these results, we propose optimized noise tailoring and noise annealing strategies, comparing the impact of internal noise to the effect of external perturbation injection schemes.

Polycystic ovary syndrome is a common endocrine disorder, characterized by hyperandrogenism and/or chronic oligo/anovulation, which leads to infertility. The aim of this systematic review and meta-analysis was to explore the efficacy of letrozole compared with clomiphene citrate for ovulation induction in women with polycystic ovarian syndrome. The study protocol has been registered with PROSPERO (registration number CRD42022376611). The literature search included randomized clinical trials. We conducted our systematic literature search across three medical databases: MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Embase. The data synthesis employed a random effects model. Out of the 1994 articles screened, 25 studies fulfilled the inclusion criteria. The letrozole group exhibited a significant increase in endometrial thickness (mean difference = 1.70, confidence interval: 0.55–2.86; I2 = 97%, p-value = 0.008). The odds of ovulation (odds ratio = 1.8, confidence interval: 1.21–2.69; I2 = 51%, p-value = 0.010) and pregnancy (odds ratio = 1.96, confidence interval: 1.37–2.81; I2 = 32%, p-value = 0.002) were significantly higher. The resistance index of the subendometrial arteries showed a significant decrease (mean difference = −0.15, confidence interval: −0.27 to −0.04; I2 = 92%, p-value = 0.030). Women diagnosed with polycystic ovarian syndrome and treated with letrozole for ovulation induction had increased ovulation and pregnancy rates and increased endometrial thickness. The lower resistance index of subendometrial arteries can enhance intrauterine circulation, creating more favorable conditions for embryo implantation and development.

Abstract Currently, there is no specific pharmaceutical agent for treating acute pancreatitis (AP). Somatostatin and its analogues have been used to prevent the autolysis of the pancreas in AP, however, their effectiveness has not been confirmed. This investigation aimed to examine the efficacy of ulinastatin, a protease inhibitor, combined with somatostatin analogues in the treatment of AP. We conducted a systematic database search in 4 databases to identify randomized controlled trials in which the efficacy of ulinastatin in combination with somatostatin analogue was compared to somatostatin analogue alone in patients with AP. Since the patient populations of analysed papers were slightly different, we used random effect models to pool odds ratios (OR) and mean differences (MD) and the corresponding 95% confidence intervals (CI). A total of 9 articles comprising 1037 patients were included in the meta-analysis. The combination therapy significantly reduced the complication rates for acute respiratory distress syndrome, acute kidney injury, and multiple organ dysfunction. Symptoms were relieved threefold with the combination therapy compared to somatostatin alone, and combination therapy significantly shortened the length of hospital stay. The decrease in mortality was not statistically significant.

Air pollution is a foremost public health problem worldwide. The pulmonary effects of air pollution have been well established for decades, and substantial epidemiological evidence is consistently showing that both acute and chronic exposure to air pollution is linked to cardiovascular morbidity and mortality. The underlying cause for this link is, however, still unknown, and many questions remain open. Most of the epidemiological studies focusing on health consequences of exposure to urban air used data from air monitoring stations or—when applying personal sampling or monitoring—measured a limited number of components to assess the exposure. On the other hand, studies conducting a decent exposure characterization and measuring a relatively large number of components with personal sampling had little or no focus on the effects and investigated only a few biomarkers. The number of research studies on this topic is huge, but at the same time, it seems as if there was no need for a comprehensive examination of the effects of urban air pollution on health. Researchers and research supporting organizations, in their fascination with the search for “novelty” and “beyond state-of-the-art”, do not seem to be aware of that they will never be able to assemble the whole picture from the puzzle pieces of research activities focusing only on certain aspects. Without a comprehensive investigation, we might never be able to answer such questions as (i) which of the urban air pollutants are forerunners in causing health effects, especially cardiovascular effects? (ii) Which biomarkers have the best predictor performance in early effects? (iii) Are there biomarkers or combinations of biomarkers that can help determine the degree of individual susceptibility and sensitivity and the dependence of these by different factors (e.g., age, gender, and physical activity)? The authors of this article aim to go through the already investigated—at the same time, essential—elements of the topic and propose a more comprehensive study, which, of course, can be expanded, debated, and improved.

Restrictions on the use of antimicrobial compounds have led to a surge of interest in alternative solutions, such as natural, plant-based compounds. In our study, we investigated the efficacy of three feed supplements containing different additives, namely, probiotics (Lactobacillus spp., “Test substance A”), turmeric (Curcuma longa L., “Test substance B”), and fenugreek (Trigonella foenum graecum, “Test substance C”). In the experiment, we tested 180 birds of the Bábolna Tetra-SL laying hybrid breed that were infected with Salmonella enteritidis strains. The birds were randomly divided into six groups: three groups treated with the different additives, a negative control group, a positive control group, and an antibiotic-treated group using enrofloxacin. We examined the maturation and the time course of shedding of Salmonella; at the end of rearing, pathological and histopathological examinations were performed. When Salmonella was isolated from the cloacal swab samples, the enrofloxacin-treated group had a high number of animals shedding Salmonella by day 9, which was like the group treated with test material C. The greatest reduction in Salmonella shedding was observed in the groups treated with test materials A and B. In terms of pathological parameters, villus length and crypt depth were significantly better in the group treated with test material C compared to the positive and negative controls, and when comparing the body weight of the tested animals, the group treated with test material B had a significantly larger absorption surface area compared to the positive control group. Overall, the supplement with test material C proved to be the most effective. In the future, it is worthwhile to investigate the combination of the tested active substances for their possible synergistic effects and to perform a dose-response study to select the optimal dosage.

Background: This study investigates teacher collaboration in Hungarian vocational education and training (VET) schools based on an online survey of teachers (n = 303). Collaboration of teachers has long been appreciated for its significant benefits including increased motivation, job satisfaction, self- and collective efficacy, as well as its role in teacher professional development and school improvement. Collaboration of teachers working in VET schools, especially in VET systems where initial VET is provided to young people and (in part) within compulsory education, appears as particularly desirable, given the special context, objectives and challenges of this sector and the spread of competence-based education. However, relatively little is known about VET teacher collaboration, especially in Hungary, where three different profiles of teachers--general subject and vocational teachers and vocational trainers--work in VET schools. The aim of our study was to provide data about how Hungarian VET teachers collaborate, which could validate prior research results on teacher collaboration as well as identify any special features of the VET context. Method: Our study design was exploratory, descriptive and correlational, applying quantitative statistical analysis. We measured teacher collaboration (practice and perception of impact) and explanatory individual and organisational factors selected for our research framework by adapting instruments of previous empirical studies (most importantly, OECD's TALIS). We analysed connections between collaboration and independent variables created by principal component analysis. Results: Our data show that sharing-type collaboration (professional discussions and exchange of materials) are widespread among Hungarian VET teachers. They are much less likely to participate in deeper collaborative activities that presuppose higher levels of interdependence, and they also appreciate the impact of deeper collaboration less. Female respondents participate in sharing-type activities more than their male colleagues, and middle-aged (40-55) are most active in both types of collaboration and perceive the most impact. Collaboration practices correlate most with perceptions of their impact. More frequent collaboration and perceptions of higher impact are related to teachers' sense of higher self-efficacy and relaxed, tolerant and encouraging collegial relationships. Structural barriers seem to influence only sharing and perceptions of impact. Small, but statistically significant differences in collaboration were found between the three teacher profiles. Vocational trainers (who instruct vocational school practice) showed the highest level of participation in deeper collaboration, while vocational teachers were least likely to participate and perceived the least impact. No significant associations were found between collaboration and prior or current work experience in the taught vocation. Conclusions: Our results largely confirm and validate previous research on teacher collaboration in lower level and general educational contexts by providing data on VET teacher collaboration. They also note the role of some VET-specific factors, such as structural barriers and small, but statistically significant differences between different VET teacher profiles.

Abstract Pancreatic necrosis is a consistent prognostic factor in acute pancreatitis (AP). However, the clinical scores currently in use are either too complicated or require data that are unavailable on admission or lack sufficient predictive value. We therefore aimed to develop a tool to aid in necrosis prediction. The XGBoost machine learning algorithm processed data from 2387 patients with AP. The confidence of the model was estimated by a bootstrapping method and interpreted via the 10th and the 90th percentiles of the prediction scores. Shapley Additive exPlanations (SHAP) values were calculated to quantify the contribution of each variable provided. Finally, the model was implemented as an online application using the Streamlit Python-based framework. The XGBoost classifier provided an AUC value of 0.757. Glucose, C-reactive protein, alkaline phosphatase, gender and total white blood cell count have the most impact on prediction based on the SHAP values. The relationship between the size of the training dataset and model performance shows that prediction performance can be improved. This study combines necrosis prediction and artificial intelligence. The predictive potential of this model is comparable to the current clinical scoring systems and has several advantages over them.

Introduction and AimRadial artery approach angiography is the current gold standard for coronary status diagnostics and eventual percutaneous revascularization (PCI). Currently, application of adequate, patent hemostasis based physical torniquets are used for puncture site control, to avoid bleeding, radial artery occlusion and damage (RAO and RAD). The Radial Artery Puncture Hemostasis Evaluation (RAPHE) is a prospective, randomized, multicenter clinical trial designed to investigate new, simplified techniques of radial artery hemostasis utilizing physical compression free methods.Methods and ResultsThe RAPHE study has been designed to evaluate the efficacy and safety of two non-compression based radial artery hemostasis methods: a 100% chitosan bioactive hemostatic dressing and a purpose-built radial potassium-ferrate based topical hemostasis disc. These devices will be investigated in a standalone configuration. Control group is a standard pneumatic airbladder-based compression device. A total of 600 patients will be enrolled in a three-way randomization (1:1:1) with two study and one control groups. Safety and efficacy endpoints are RAO, puncture site hematoma formation and RAD respectively, consisting of dissection, (pseudo)aneurism and/or fistula formation, measured post-procedure and at sixty days.ConclusionThe results from this trial will provide valuable information on new, simplified methods of radial artery hemostasis options and possibly simplify post-puncture management of patients.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT04857385].

Background: Alopecia areata (AA) is a chronic autoimmune condition that can lead to a serious deterioration in patients’ quality of life. The first line of treatment in patchy AA is triamcinolone acetonide (TrA); however, the efficacy of the treatment varies greatly. Our aim was to investigate the therapeutic effects of platelet-rich plasma (PRP) in the treatment of AA. Method: We performed a systematic literature search in four databases. Randomized clinical trials (RCT) reporting on patients with AA treated with PRP were included, comparing PRP with TrA or a placebo. The primary outcome was the Severity of Alopecia Tool (SALT) score. Results: Our systematic search provided a total of 2747 articles. We identified four studies eligible for quantitative analysis. The pooled mean differences from the four studies did not exhibit a significant difference in the mean change in the SALT score when PRP and TrA groups were compared (MD =−2.04, CI: −4.72–0.65; I2 = 80.4%, p = 0.14). Conclusions: PRP is a promising topical, steroid-free treatment modality in the therapy of AA. No significant difference was found between PRP and TrA treatment; however, further high-quality RCTs are needed to further assess the efficacy of PRP treatment and strengthen the quality of evidence.

Abstract Background Avian host species have different roles in the amplification and maintenance of West Nile virus (WNV), therefore identifying key taxa is vital in understanding WNV epidemics. Here, we present a comprehensive case study conducted on red-footed falcons, where host-vector, vector-virus and host-virus interactions were simultaneously studied to evaluate host species contribution to WNV circulation qualitatively. Results Mosquitoes were trapped inside red-footed falcon nest-boxes by a method originally developed for the capture of blackflies and midges. We showed that this approach is also efficient for trapping mosquitoes and that the number of trapped vectors is a function of host attraction. Brood size and nestling age had a positive effect on the number of attracted Culex pipiens individuals while the blood-feeding success rate of both dominant Culex species (Culex pipiens and Culex modestus) markedly decreased after the nestlings reached 14 days of age. Using RT-PCR, we showed that WNV was present in these mosquitoes with 4.2% (CI: 0.9–7.5%) prevalence. We did not detect WNV in any of the nestling blood samples. However, a relatively high seroprevalence (25.4% CI: 18.8–33.2%) was detected with an enzyme-linked immunoabsorbent assay (ELISA). Using the ELISA OD ratios as a proxy to antibody titers, we showed that older seropositive nestlings have lower antibody levels than their younger conspecifics and that hatching order negatively influences antibody levels in broods with seropositive nestlings. Conclusions Red-footed falcons in the studied system are exposed to a local sylvatic WNV circulation, and the risk of infection is higher for younger nestlings. However, the lack of individuals with viremia and the high WNV seroprevalence, indicate that either host has a very short viremic period or that a large percentage of nestlings in the population receive maternal antibodies. This latter assumption is supported by the age and hatching order dependence of antibody levels found for seropositive nestlings. Considering the temporal pattern in mosquito feeding success, maternal immunity may be effective in protecting progeny against WNV infection despite the short antibody half-life measured in various other species. We conclude that red-footed falcons seem to have low WNV host competence and are unlikely to be effective virus reservoirs in the studied region.

Arterial stiffness (AS) is a complex vascular phenomenon with consequences for central hemodynamics and left-ventricular performance. Circulating biomarkers have been associated with AS; however, their value in heart failure is poorly characterized. Our aim was to evaluate the clinical and biomarker correlates of AS in the setting of heart failure with reduced ejection fraction (HFrEF). In 78 hospitalized, hemodynamically stable patients (20 women, 58 men, mean age 65.8 ± 1.41 years) with HFrEF, AS was measured using aortic pulse wave velocity (PWV). Serum OPG, RANKL, sclerostin, and DKK-1 were determined, and the relationships between the clinical variables, vascular-calcification-related biomarkers, and PWV were evaluated by correlation analysis and linear and logistic regression models. OPG and the OPG/RANKL ratio were significantly higher in the group of patients (n = 37, 47.4%) with increased PWV (>10 m/s). PWV was positively correlated with age, left-ventricular ejection fraction, and carotid intima-media thickness (cIMT), and negatively correlated with the glomerular filtration rate. OPG and cIMT were significantly associated with PWV in the logistic regression models when adjusted for hypertension, EF, and the presence of atherosclerotic manifestations. Elevated serum OPG, together with cIMT, were significantly related to increased AS in the setting of HFrEF.