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Despite demonstrated efficacy of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease-2019 (COVID-19), widespread hesitancy to vaccination persists. Improved knowledge regarding frequency, severity, and duration of vaccine-associated symptoms may help reduce hesitancy. In this prospective observational study, we studied 1032 healthcare workers who received both doses of the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine and completed post-vaccine symptom surveys both after dose 1 and after dose 2. We defined appreciable post-vaccine symptoms as those of at least moderate severity and lasting at least 2 days. We found that symptoms were more frequent following the second vaccine dose than the first (74% vs. 60%, P 80% of all symptoms resolving within 2 days. The most common symptom was injection site pain, followed by fatigue and malaise. Overall, 20% of participants experienced appreciable symptoms after dose 1 and 30% after dose 2. In multivariable analyses, female sex was associated with greater odds of appreciable symptoms after both dose 1 (OR, 95% CI 1.73, 1.19-2.51) and dose 2 (1.76, 1.28-2.42). Prior COVID-19 was also associated with appreciable symptoms following dose 1, while younger age and history of hypertension were associated with appreciable symptoms after dose 2. We conclude that most post-vaccine symptoms are reportedly mild and last

The complex nature of the steel manufacturing environment, characterized by different types of hazards from materials and large machinery, makes the need for objective and automated monitoring very critical to replace the traditional methods, which are manual and subjective. This study explores the feasibility of implementing computer vision for safety management in steel manufacturing, with a case study implementation for automated hard hat detection. The research combines hazard characterization, technology assessment, and a pilot case study. First, a comprehensive review of steel manufacturing hazards was conducted, followed by the application of TOPSIS, a multi-criteria decision analysis method, to select a candidate computer vision system from eight commercially available systems. This pilot study evaluated YOLOv5m, YOLOv8m, and YOLOv9c models on 703 grayscale images from a steel mini-mill, assessing performance through precision, recall, F1-score, mAP, specificity, and AUC metrics. Results showed high overall accuracy in hard hat detection, with YOLOv9c slightly outperforming others, particularly in detecting safety violations. Challenges emerged in handling class imbalance and accurately identifying absent hard hats, especially given grayscale imagery limitations. Despite these challenges, this study affirms the feasibility of computer vision-based safety management in steel manufacturing, providing a foundation for future automated safety monitoring systems. Findings underscore the need for larger, diverse datasets and advanced techniques to address industry-specific complexities, paving the way for enhanced workplace safety in challenging industrial environments. [ABSTRACT FROM AUTHOR]

Introduction The Myc family of proto-oncogenes (MYC, MYCN, MYCL) encodes bHLHZ (basic helix-loop-helix leucine zipper) transcription factors, which regulate thousands of genes coordinating numerous cellular processes, including proliferation, differentiation, self-renewal, [...], Myc activation is a primary oncogenic event in many human cancers; however, these transcription factors are difficult to inhibit pharmacologically, suggesting that Myc-dependent downstream effectors may be more tractable therapeutic targets. Here, we show that Myc overexpression induces endoplasmic reticulum (ER) stress and engages the inositol-requiring enzyme 1[alpha] (IRE1[alpha])/X-box binding protein 1 (XBP1) pathway through multiple molecular mechanisms in a variety of c- Myc- and N-Myc-dependent cancers. In particular, Myc-overexpressing cells require IRE1[alpha]/XBP1 signaling for sustained growth and survival in vitro and in vivo, dependent on elevated stearoyl-CoA-desaturase 1 (SCD1) activity. Pharmacological and genetic XBP1 inhibition induces Myc-dependent apoptosis, which is alleviated by exogenous unsaturated fatty acids. Of note, SCD1 inhibition phenocopies IRE1[alpha] RNase activity suppression in vivo. Furthermore, IRE1[alpha] inhibition enhances the cytotoxic effects of standard chemotherapy drugs used to treat c-Myc-overexpressing Burkitt's lymphoma, suggesting that inhibiting the IRE1[alpha]/XBP1 pathway is a useful general strategy for treatment of Myc- driven cancers.

Introduction: Patient‐reported outcomes (PROs) are increasingly used to evaluate quality of life (QoL) in Atrial Fibrillation (AF) patients, providing crucial insights in clinical trials. This study examines the frequency of PRO use in AF trials and the linguistic accessibility of AF‐specific PROs. Background: As the United States becomes more multilingual, ensuring PROs are available in various languages is vital. The number of people speaking a language other than English at home has tripled from 23.1 million in 1980 to 67.8 million in 2019. This diversity necessitates the availability of PROs in multiple languages for inclusive clinical assessments. Methods: We queried ClinicalTrials.gov for all US interventional AF trials up to November 28, 2023, reviewing each for PRO usage as primary or secondary outcomes. We identified the five most common AF‐specific and generic PROs, extracting their available translations and original languages from published sources. Results: Of 233 identified trials, 191 had associated publications, with 180 (94.2%) conducted solely in English. Only one trial (0.4%) used an AF‐specific PRO as a primary outcome, compared to four (1.7%) with a generic PRO. Ten trials (4.3%) used AF‐specific PROs as secondary endpoints, versus 22 (9.4%) using generic PROs. AF‐specific PROs had significantly fewer translations than generic PROs (11.2 vs. 148.8; p <.001). The AF Effect on Quality‐of‐Life (AFEQT) was available in 24 languages, with limited translations in commonly spoken US languages like Arabic and Asian languages. Conclusion: The limited availability of AF‐specific PRO translations highlights a barrier to inclusive AF clinical trials. Expanding translations for AF‐specific PROs is crucial for equitable QoL assessments. [ABSTRACT FROM AUTHOR]

Background: Clinicians typically estimate heart failure health status using the New York Heart Association Class, which is often discordant with patient-reported health status. It is unknown whether collecting patient-reported health status improves the accuracy of clinician assessments. Methods: The PRO-HF trial (Patient-Reported Outcomes in Heart Failure Clinic) is a randomized, nonblinded trial evaluating routine Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) collection in heart failure clinic. Patients with a scheduled visit to Stanford heart failure clinic between August 30, 2021 and June 30, 2022 were enrolled and randomized to KCCQ-12 assessment or usual care. In this prespecified substudy, we evaluated whether access to the KCCQ-12 improved the accuracy of clinicians' New York Heart Association assessment or patients' perspectives on their clinician interaction. We surveyed clinicians regarding their patients' New York Heart Association Class, quality of life, and symptom frequency. Clinician responses were compared with patients' KCCQ-12 responses. We surveyed patients regarding their clinician interactions. Results: Of the 1248 enrolled patients, 1051 (84.2%) attended a visit during the substudy. KCCQ-12 results were given to the clinicians treating the 528 patients in the KCCQ-12 arm; the 523 patients in the usual care arm completed the KCCQ-12 without the results being shared. The correlation between New York Heart Association Class and KCCQ-12 Overall Summary Score was stronger when clinicians had access to the KCCQ-12 (r=−0.73 versus r=−0.61, P <0.001). More patients in the KCCQ-12 arm strongly agreed that their clinician understood their symptoms (95.2% versus 89.7% of respondents [odds ratio‚ 2.27; 95% CI‚ 1.32–3.87]). However, patients in both arms reported similar quality of clinician communication and therapeutic alliance. Conclusions: Collecting the KCCQ-12 in heart failure clinic improved clinicians' accuracy of health status assessment; correspondingly, patients believed their clinicians better understood their symptoms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04164004. [ABSTRACT FROM AUTHOR]

The United States witnessed a nearly 4-fold increase in personal health care expenditures between 1980 and 2010. Despite innovations and obvious benefits to health, participants enrolled in clinical trials still do not accurately represent the racial and ethnic composition of patients nationally or globally. This lack of diversity in cohorts limits the generalizability and significance of results among all populations and has deep repercussions for patient equity. To advance diversity in clinical trials, robust evidence for the most effective strategies for recruitment of diverse participants is needed. A major limitation of previous literature on clinical trial diversity is the lack of control or comparator groups for different strategies. To date, interventions have focused primarily on (1) community-based interventions, (2) institutional practices, and (3) digital health systems. This review article outlines prior intervention strategies across these 3 categories and considers health policy and ethical incentives for substantiation before US Food and Drug Administration approval. There are no current studies that comprehensively compare these interventions against one another. The American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials represents a multicenter, collaborative network between Stanford School of Medicine and Morehouse School of Medicine created to understand the barriers to diversity in clinical trials by contemporaneous head-to-head interventional strategies accessing digital, institutional, and community-based recruitment strategies to produce informed recruitment strategies targeted to improve underrepresented patient representation in clinical trials.