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Meeting the needs of students in schools has been challenging for many years. Consequently, some schools have responded with comprehensive, multi-tiered intervention systems (e.g., MTSS) aimed at addressing students' academic, behavioral, and social-emotional needs. However, most educators have a rudimentary understanding of these systems and the impact of trauma and traumatic experiences on students' response to interventions. Currently, there is limited research on how building level-administrators integrate trauma-informedness into these tiered systems. This conceptual article outlines the importance of administrators' perception, understanding, and implementation of using a trauma-informed lens in educational decision making, specifically regarding MTSS implementation. This article presents an overview of the literature and an approach to trauma-informed approach that administrators can utilize when making educational decisions, specifically within multi-tiered systems of intervention and student supports.

A major barrier to the impact of genomic diagnosis in patients with congenital malformations is the lack of understanding regarding how sequence variants contribute to disease pathogenesis and whether this information could be used to generate patient-specific therapies. Congenital diaphragmatic hernia (CDH) is among the most common and severe of all structural malformations; however, its underlying mechanisms are unclear. We identified loss-of-function sequence variants in the epigenomic regulator gene SIN3A in two patients with complex CDH. Tissue-specific deletion of Sin3a in mice resulted in defects in diaphragm development, lung hypoplasia, and pulmonary hypertension, the cardinal features of CDH and major causes of CDH-associated mortality. Loss of SIN3A in the lung mesenchyme resulted in reduced cellular differentiation, impaired cell proliferation, and increased DNA damage. Treatment of embryonic Sin3a mutant mice with anacardic acid, an inhibitor of histone acetyltransferase, reduced DNA damage, increased cell proliferation and differentiation, improved lung and pulmonary vascular development, and reduced pulmonary hypertension. These findings demonstrate that restoring the balance of histone acetylation can improve lung development in the Sin3a mouse model of CDH.

Abstract Aim The aim of this study was to investigate the psychosocial impact of malocclusion and the motivation for seeking orthodontic treatment among adolescents. Methods A cross-sectional study included 102 adolescents (ages 11–18) whose malocclusion was rated using 3 occlusal indices: IOTN, DAI, and PAR. The participants answered three structured questionnaires selected to measure Oral Health Related Quality of Life (OHRQoL) through the short form of the Child Oral Health Impact Profile (COHIP), the patient's perceived impact related to orthodontics through the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and self-esteem through the Rosenberg Self-Esteem Scale (RSES). Independent two-tailed t-tests, one-way mixed analysis of variance (ANOVA), and Spearman's correlations were used to test various associations. Results Patients with higher malocclusion scores displayed increased psychosocial impact with weak to moderate correlations (0.2

Cancer of unknown primary (CUP) tumors are biologically very heterogeneous, which complicates stratification of patients for treatment. Consequently, these patients face limited treatment options and a poor prognosis. With this study, we aim to expand on the current knowledge of CUP biology by analyzing two cohorts: a well‐characterized cohort of 44 CUP patients, and 213 metastatic patients with known primary. These cohorts were treated at the same institution and characterized by identical molecular assessments. Through comparative analysis of genomic and transcriptomic data, we found that CUP tumors were characterized by high expression of immune‐related genes and pathways compared to other metastatic tumors. Moreover, CUP tumors uniformly demonstrated high levels of tumor‐infiltrating leukocytes and circulating T cells, indicating a strong immune response. Finally, the genetic landscape of CUP tumors resembled that of other metastatic cancers and demonstrated mutations in established cancer genes. In conclusion, CUP tumors possess a distinct immunophenotype that distinguishes them from other metastatic cancers. These results may suggest an immune response in CUP that facilitates metastatic tumor growth while limiting growth of the primary tumor.

Abstract Chemotherapy induced ovarian failure and infertility is an important concern in female cancer patients of reproductive age or younger, and non-invasive, pharmacological approaches to maintain ovarian function are urgently needed. Given the role of reduced nicotinamide adenine dinucleotide phosphate (NADPH) as an essential cofactor for drug detoxification, we sought to test whether boosting the NAD(P)+ metabolome could protect ovarian function. We show that pharmacological or transgenic strategies to replenish the NAD+ metabolome ameliorates chemotherapy induced female infertility in mice, as measured by oocyte yield, follicle health, and functional breeding trials. Importantly, treatment of a triple-negative breast cancer mouse model with the NAD+ precursor nicotinamide mononucleotide (NMN) reduced tumour growth and did not impair the efficacy of chemotherapy drugs in vivo or in diverse cancer cell lines. Overall, these findings raise the possibility that NAD+ precursors could be a non-invasive strategy for maintaining ovarian function in cancer patients, with potential benefits in cancer therapy.

Abstract In this study, we evaluated and forecasted the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion, using a new people-centred methodology with an equity focus. Furthermore, we identified 1–2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Cali is one of South America's cities most impacted by traffic congestion. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through an iterative participatory design. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions with hourly assessments for 6–12 July 2020 and 23–29 November 2020. The interactive digital platform is openly available. Primary and secondary outcomes: We present descriptive statistics and population distribution heatmaps based on 20-min accessibility cumulative opportunities (ACO) isochrones for car journeys. There is no set national or international standard for these travel time thresholds. Most key informants found the 20-min threshold reasonable. These isochrones connect the population-weighted centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1–2 optimal locations where new services would maximize the 20-min ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-min ACO by car dropped from 91% of Cali’s urban population within a 20-min journey to the service during free-flow traffic to 31% during peak traffic for the week of 6–12 July 2020. Percentages represent the population within a 20-min journey by car from their residence to a radiotherapy service. Specific ethnic groups, individuals with lower educational attainment, and residents on the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1–2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors.

Aim. To evaluate the prognostic value of GDF-15 in relation the development of bleeding and events in stable CAD patients, receiving combined antithrombotic therapy. Materials and methods. The data was obtained from the prospective registry REGATA, 343 CAD patients (249 males), median age 68 [IQR 62; 75] years) were enrolled. Patients with sinus rhythm and concomitant PAD received acetylsalicylic acid in combination with rivaroxaban 2.5 mg bid (31.8%) or clopidogrel (24.8%). Other 43.4% with concomitant atrial fibrillation (AF) received direct oral anticoagulants in combination with antiplatelet therapy after elective percutaneous coronary interventions. Median follow-up was 12 months [IQR 9.0; 18.0]. The safety end point was major and clinically relevant bleedings (type 2–5) according to the BARC classification. Plasma samples for GDF-15 identification were taken at the inclusion and analyzed using ELISA assay. Results. Frequency of BARC 2–5 bleedings was 16% (BARC 2 – 46; BARC 3 – 9; BARC 4–5 – 0), median GDF-15 level was 1185.0 pg/ml [850.0; 1680.0]. In patients with AF and concomitant MFA, the level of GDF-15 was significantly higher than in the subgroups of patients with only AF or MFA (p=0.0022). According to the quintile analysis, GDF-15 values in the top three quintiles of distribution (cut-off value 943 pg/ml) were associated with higher frequency of bleeding events: 23.2% versus 5.1%; p=0.0001. The multivariable logistic regression model demonstrated that bleeding events were independently associated with GDF-15 level943 pg/ml (OR 2.65, 95% CI 1.11–6.30; p=0.0275), AF (OR 2.61, 95% CI 1.41–4.83; p=0.0023) and chronic kidney disease (OR 1.92, 95% CI 1.03–3.60; p=0.0401). Clinical factors determining the risk of bleeding events also determined a GDF-15 elevation. Conclusion. Assessment of GDF-15 level may improve bleeding risk stratification in CAD patients with concomitant AF and/or PAD receiving combined antithrombotic therapy.

Abstract Tritrichomonas foetus is a flagellated and anaerobic parasite able to infect cattle and felines. Despite its prevalence, there is no effective standardized or legal treatment for T. foetus-infected cattle; the vaccination still has limited success in mitigating infections and reducing abortion risk; and nowadays, the diagnosis of T. foetus presents important limitations in terms of sensitivity and specificity in bovines. Here, we characterize the plasma membrane proteome of T. foetus and identify proteins that are represented in different isolates of this protozoan. Additionally, we performed a bioinformatic analysis that revealed the antigenicity potential of some of those proteins. This analysis is the first study to identify common proteins at the plasma membrane of different T. foetus isolates that could be targets for alternative diagnostic or vaccine techniques in the future.

In one university-based school leadership preparation program, aspiring school principals were asked to intern virtually with principals during the COVID-19 school closures. During this internship experience, they interviewed principals about leading during a pandemic and wrote reflective responses explaining what they learned about leading during the pandemic. This case study examines the reflections and lessons learned of leading schools during COVID-19 from 27 aspiring principals in two cohorts of a university-based school leadership preparation program. The researchers employed an abductive qualitative analysis for each aspiring principals' reflection using both deductive and inductive coding methods. Findings revealed fourth themes: (1) the need for structure and organization, (2) attending humanistic needs, (3) struggling to respond to policy changes; and (4) finding meaning and uplifting morale. This study can be used to help inform and guide educational leadership preparation and development programs on how to redirect coursework and field-based experiences to better prepare aspiring school principals to lead during school closures.

Abstract The COVID-19 pandemic has been the largest pandemic of the past century, and various genetic factors have played a significant role in this context. This study aimed to analyze the frequency and association between specific SNPs rs3806268 (NLRP3), rs4925543 (NLRP3), rs12150220 (NLRP1), rs455060 (NLRC4), rs699 (AGT), rs1137101 (LEPR), and rs1801133 (MTHFR) and severe/critical outcomes in Brazilian patients with COVID-19. A total of 100 patients were included in the study, comprising 66 cases and 34 controls. DNA was extracted, sequenced, and genotyped via next-generation sequencing (NGS). For non-parametric data, the Mann-Whitney and Kruskal-Wallis tests were used. Fisher’s test and multivariate logistic regression, considering AIC and BIC criteria, were employed for risk analysis. Odds Ratios (OR) were calculated, with significance set at p

Cholesterol crystals (CC) can be responsible for a range of clinical syndromes in the retina from asymptomatic plaques to retinal artery occlusion with clinical trials providing evidence for the efficacy in lipid lowering therapies in preventing ocular pathology. Much of the literature has focused on CC in retinal circulation as a marker of poor systemic health and have attempted to use them to categorize risk of mortality and stroke. More recently cholesterol accumulation and CC formation have been linked to development of diabetic retinopathy with CC formation in the retina due to aberrant retinal cholesterol homeostasis and not simply systemic dyslipidemia.

Abstract Background Breast and cervical cancers pose significant health challenges for women globally, emphasizing the critical importance of effective screening programs for early detection. In Canada, despite the implementation of accessible healthcare systems, ethnic and racialized disparities in cancer screening persist. This study aims to assess ethnic and racialized disparities in breast and cervical cancer screening in Canada. Methods Using 2015–2019 data from the Canadian Community Health Survey, we analyzed women aged 18–70 in distinct ethnic and racial groups. The primary outcome was mammography or Papanicolaou test (pap smear). The secondary outcome was time since the last screening. We used weighted multivariable logistic regression to estimate the odds of having a pap smear or mammography across the ethnic and racialized groups, adjusted for relevant covariates. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results We included 14,628,067 women of which 72.5% were White, 8.4% Southeast Asian, 4.7% South Asian, 3.4% Indigenous, 2.7% Black, 2.0% West Asian, and 1.6% Latin American. In comparison with the White reference group, a higher odds ratio of not having a pap smear was estimated for the West Asian (5.63; CI 3.85, 8.23), South Asian (5.19; CI 3.79, 7.12), Southeast Asian (4.35; CI 3.46, 5.46), and Black groups (2.62; CI 1.82, 3.78). Disparities in mammography screening were found only for the Southeast Asian group with higher odds of not having screening (1.85; CI 1.15, 2.98) compared to the White reference group. Conclusion This study reveals significant disparities in pap smear and mammography screenings affecting various ethnic groups, particularly in West Asia, South Asian, and Black communities. These findings underscore the urgent need for targeted interventions, policies, and healthcare strategies to address these gaps and ensure equitable access to essential breast and cervical cancer prevention across all ethnicity.

Abstract The donor–acceptor (D–A) dye 4‐(bis‐4‐(5‐(2,2‐dicyano‐vinyl)‐thiophene‐2‐yl)‐phenyl‐amino)‐benzoic acid (P1) has been frequently used to functionalize NiO photocathodes and induce photoelectrochemical reduction of protons when coupled to a suitable catalyst. Photoinduced twisting of the P1 dye is steered on NiO by co‐adsorption of tetradecanoic acid (C14, myristic acid (MA)). Density Functional Theory and time‐resolved photoluminescence studies confirm that twisting lowers the energy levels of the photoexcited D–A dye. The apolar environment provided by the MA suppresses photoinduced D–A twisting, retards charge recombination following photoinduced charge separation between P1 and NiO, and provides a larger electrochemical potential increasing the photocurrent. Very interestingly, co‐adsorption of MA induces H2 evolution upon photoexcitation without the presence of an H2 evolution catalyst. Based on prior art, the formation of H2 is assigned to the dissolution of Ni2+, followed by reduction and re‐deposition of Ni nanoparticles acting as the catalytically active site. It propose that only excited P1 with suppressed twisting provides the sufficient electrochemical potential to induce deposition of Ni nanoparticles. The work illustrates the importance of understanding the effects of photoinduced intramolecular twisting and highlights the promise of designing twisting‐limited D–A dyes to create efficient solar fuel devices.

The population of Hispanic older adults is growing along with the burden of chronic diseases. This cross-sectional study aims to assess the factors associated with frailty among community-dwelling Hispanic women aged ≥60 years ( n = 357) enrolled in the Panama Aging Research Initiative—Health Disparities study of cognitive-functional health of older persons in Panama. Cognitive function was assessed with a neuropsychological test battery. Depression was measured with the Geriatric Depression Scale. Frailty was defined using the Fried criteria and participants were classified as non-frail, pre-frail or frail. A subsample ( n = 281) provided fasting blood samples for quantification of protein biomarkers. Associations were examined using hierarchical multiple linear regressions. 59.4% and 9.0% of participants ( M = 69.2 years, SD = 6.3) were pre-frail and frail, respectively. Having more depression (β = .28, p

Abstract Drug type and dosing recommendation have been designed and optimized based on average response in the general population. Yet, there is significant inter‐individual variability in drug response, which results in treatment inefficacy or adverse drug reactions in a subset of patients. This is partly due to genetic factors that typically affect drug metabolism or clearance. To verify the relevance and applicability of international pharmacogenetic guidelines in the Swiss population, we genotyped 1533 patients from a hospital‐based biobank who received at least 30 different drugs, as documented in their electronic health record. We then assessed the prevalence of clinically actionable variants in 13 high‐risk pharmacogenes. We compared the allele frequencies obtained in the hospital‐based cohort with those of a Swiss population‐based cohort of 4791 individuals. The prevalence of clinically actionable variants was comparable between the two cohorts, with most study participants (97.3%) carrying at least one actionable pharmacogenetic variant. We then assessed the frequency of high‐risk prescriptions due to actionable gene–drug interactions and observed that 31% of patients in the hospital‐based cohort were prescribed at least one drug for which they carried a high‐risk variant, and for which international guidelines recommend a change of drug or dosage. Our analysis confirms the high prevalence of actionable pharmacogenetic variants in the Swiss population. It also shows that a substantial minority of patients are exposed to drugs for which they carry potentially problematic variants. Implementing a genetically informed approach to drug prescribing could have a positive impact on the quality of healthcare delivery.

Pathogenic spirochetes of the genus Leptospira are the causative agent of leptospirosis, a widely disseminated zoonosis that affects humans and animals. The ability of leptospires to quickly cross host barriers causing infection is not yet fully understood. Thus, understanding the mechanisms of pathogenicity is important to combat leptospiral infection. Outer membrane proteins are interesting targets to study as they are able to interact with host molecules. Proteins containing leucine-rich repeat (LRR) domains are characterized by the presence of multiple regions containing leucine residues and they have putative functions related to host-pathogen interactions. Hence, the present study aimed to clone and express the recombinant protein encoded by the LIC11098 gene, an LRR protein of L. interrogans serovar Copenhageni. In silico analyses predicted that the target protein is conserved among pathogenic strains of Leptospira, having a signal peptide and multiple LRR domains. The DNA sequence encoding the LRR protein was cloned in frame into the pAE vector, expressed without mutations in Escherichia coli and purified by His-tag chromatography. Circular dichroism (CD) spectrum showed that the recombinant protein was predominantly composed of β-sheets. A dose-dependent interaction was observed with cellular and plasma fibronectins, laminin and the complement system component C9, suggesting a possible role of the protein encoded by LIC11098 gene at the initial stages of infection.

BACKGROUND: Up to 95% of digital fluoroscopy screening studies are free of pathologic changes. Radiologists typically spend the majority of their time reviewing and describing such studies. In these cases, artificial intelligence systems can be used to automate the description, thereby saving physicians’ time [1–3]. AIM: The aim of this study was to compare the efficacy of various algorithms within an existing artificial intelligence system in an ultra-high sensitivity scenario and to estimate the percentage of X-rays that could be automatically characterized. MATERIALS AND METHODS: The artificial intelligence system “Cels.Fluorography” version 0.15.3 was used for the analysis. A dataset derived from disparate medical organizations, comprising 11,707 studies devoid of pathology and 5,846 studies exhibiting pathology, was selected for comparison. A subsample of 500 studies with pathology and 9,500 studies without pathology (5% to 95% balance) was randomly selected 1,000 times from the dataset to calculate the metrics. The resulting metrics were then averaged. The markup of two physicians was used as the source of the target variable. In the event of a discrepancy in opinion, the study was subjected to an expert physician evaluation. An X-ray was considered pathological if the final markup contained at least one of 12 radiological features [4]. Five methods were used to compare metrics: by maximum (1) and mean (2) probability of radiological features localized by the neural network-detector; by maximum (3) and mean (4) probability of feature presence derived from dedicated “heads” of the neural network trained to determine the presence of each feature on the image (0 for no feature, 1 for presence); by probability (5) derived from a separate “head” of the neural network trained to determine the binary presence of pathology on the study (0 for normal, 1 for pathology). For each method, a response threshold was selected to ensure that no more than one missed pathology was identified per 1,000 examinations in the current subsample. The percentage of X-rays that could be correctly identified as pathology-free by artificial intelligence was calculated as the main quality metric. RESULTS: The methods demonstrated the following average percentages of norm dropout: 66.4%, 72.2%, 69.0%, 74.1%, 68.7%—and the following area under the ROC curve: 0.948, 0.957, 0.964, 0.967, 0.971. The 95% confidence interval for the dropout rate associated with the optimal method was found to be 66.1% to 79.4%. CONCLUSIONS: Modern artificial intelligence systems can be used to automate the description of a significant portion of screenings. The most efficacious method for norm screening (over 74% of the flow) was demonstrated by the averaging of probabilities derived from special “heads” of the neural network trained to identify the presence of pathology.

The article deals with the linguistic and psychological concepts explaining the perception of multimodal texts that imply information about violence. The importance of the subject is verified by the task of countering the spread of ideologies of violence, extremism, and terrorism in Internet communication. The multimodal text is considered a popular means of propagating radical ideas relating to incitement to social discord. The absence of complex models explaining the transmission of violence through multimodal texts is observed. It is shown that linguistic and psychological concepts can be relevant resources for building such a model. The purpose of the article is to generalize concepts in the form of intra- and extralinguistic factors that determine the perception of information about violence in a multimodal text. The generalization of cognitive linguistic theories into the group of intralinguistic factors is complemented by the conclusion that the semantic structure of a multimodal text is formed by visual, sign, and verbal coding systems; the perception of information about violence is determined by the typicality of linguistic means and the presence of logical and semantic links between the elements of a multimodal text. The conclusion is made about the influence of aggressiveness, personal attitude toward violence, and the experience of using violence on the perception of multimodal information about violence by the reader. The article may be interesting to linguists, psychologists, and a wide range of researchers in the field of humanities and humanities-related social sciences.

Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children’s behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

Abstract Purpose Immunoglobulin replacement therapy is a standard treatment for patients with antibody production deficiencies, which is of interest in patients with chronic obstructive pulmonary disease (COPD). This systematic review, registered with PROSPERO (CRD42021281118), assessed the current literature regarding immunoglobulin replacement therapy on COPD clinical outcomes in patients with low immunoglobulin G (IgG) serum concentrations. Methods Literature searches conducted from inception to August 23, 2021, in databases including MEDLINE, EMBASE, and CINAHL. Population (sex, age, comorbidities), baseline clinical characteristics (pulmonary function testing results, IgG levels), and outcome (hospitalizations, emergency department visits) were extracted after title/abstract and full text screening. The Cochrane risk of bias assessment form was used for risk of bias assessment of randomized controlled trials and the National Heart, Lung, and Blood Institute (NHLBI) assessment was used for pre and post studies. Results A total of 1381 studies were identified in the preliminary search, and 874 records were screened after duplicates were removed. Screening 77 full texts yielded four studies that were included in the review. Conclusion It is unclear whether immune globulin replacement therapy reduces acute exacerbation frequency and severity in COPD. Current evidence suggests that it is worth considering, but better developed protocols for administration of immune globulin supplementation is required for future randomized controlled trials.

Amateur film discourse is a new special subtype of discourse that has not yet been subjected to scientific research. Its participants have no special cinema education: they discuss the film industry based on their own life experience, ideas, and values. This work was part of the contemporary anthropocentric paradigm, where language comes to the fore as the most important property of human beings. The article identifies the genre of amateur film discourse using online Russian comments to the screen adaptation of Henry James’s What Maisie Knew (1897), directed by S. McGehee and D. Siegel (2012). The methods of comparison and discourse analysis revealed sincerity in the way the commentors evaluated their impressions. The commentors seemed focused on the plot and the action. The discourse was highly emotional and colloquial, filled with aposiopesis and rhetorical questions.

The textile industry in the world keeps increasing, but it harms environmental pollution caused by textile dye waste. Synthetic dyes contain carcinogenic and mutagenic ingredients that can demage the environment and aquatic biota. The alternative to handling dye pollution with a low-cost method is adsorption using nitric acid-activated coconut fiber. Coconut fiber was an abundant agricultural waste and economical, and it had an active site that contained many compounds such as cellulose, lignin, pyroligneous acid, and tannin molecules. This study used the UV-Vis Spectrophotometer analysis method to determine the effect of pH, contact time, and coconut fiber on the adsorption capacity of methylene blue. The result showed that the optimal conditions for adsorption were a pH of 5, a contact time of 75 minutes, and a percentage adsorption of the variation of contact time of 99.628%. The adsorption study was according to a pseudo-second-order reaction with a constant reaction rate of 0.050 g mg-1 minute-1. The maximum adsorption capacity was 2 mg g-1, with the percentage of methylene blue adsorbed at 99.84%. Adsorption occurs chemically with an energy of 35.4 kJ mol-1, so it can be determined that it occurs with a monolayer mechanism.

Abstract The aim of this study was to produce an alcohol gel hand sanitizer containing green glycerol. Crude glycerol was purified using chemical and physical treatments. The sanitizer was prepared using 71.100 g of 99.3° GL ethanol, 28.0 g H2O, 0.5 g of Carboxypolymethylene [Carbopol 940® or Carbomer], 5 drops of triethanolamine (pH 5–7), and glycerol (1.5% w/w). The thermal behavior of the ethanol, carbopol, triethanolamine, glycerol, and alcohol gels were evaluated using Thermogravimetry and Differential Thermal Analysis. The apparent viscosity was obtained using a rotary viscometer. The determination of in vitro spreadability was achieved by an adaptation of the Knorst method. The ethanol content was measured by headspace gas chromatography using a flame ionization detector. The thermal behavior of the gels was influenced by the presence of glycerol, which confirms the possible network interactions formed. The relative densities of the samples were between 0.887 and 0.890 g/cm3. No alteration of the pH of the formulation resulted from the incorporation of glycerol. The apparent viscosities of the alcohol gels were greater than 20,000 cP. No alteration in the in vitro spreadability of the gel alcohol (530.6 mm2) resulted from the addition of glycerol. Hand sanitizer was produced using glycerol from a transesterification reaction. It represents an alternative use for the glycerol being produced in biodiesel processes. The product satisfied the requirements of WHO that preconize a formulation containing 1.45% glycerol as an humectant to protect skin against dryness and dermatitis.

Background: The perspectives of community partners about their experiences working with medical students and how service-learning experiences affect the communities they serve remains understudied. Objective: This study addressed gaps in the literature by reporting on in-depth interviews conducted with community partners who participated in a well-established medical school service-learning programme. Design: A qualitative study was undertaken using semi-structured interviews and an edited coding strategy. Setting: A convenience sample was recruited from a database of organisations working with the medical school's service-learning organisation. Method: Between 2017 and 2020, the researchers conducted semi-structured interviews with community-based organisation partners who worked with medical students through a service-learning initiative in an urban, underserved area of New Jersey, USA. The authors coded transcripts and identified themes after extensive reading, reflection and team discussion of transcripts and coded text. Authors confirmed thematic saturation after 20 interviews with 21 participants representing 18 different agencies. Results: Three main themes were developed: (1) medical students as role models, (2) community partners' role in shaping medical student education, and (3) reciprocity between community-based organisations and the service-learning programme. Participants found that medical students connected well with young clients and motivated them to pursue higher education or healthcare careers especially when they had a shared ethnic or cultural background. Community partners helped medical students better understand ethnically and socioeconomically diverse communities from a whole-person perspective. Participants described collaborative learning and reciprocity between the service-learning programme and community-based organisations as a 'win-win' situation -- with clients, the organisation and medical students all benefitting. Conclusion: Findings illustrate the importance of reciprocity between medical students and community partners. Incorporating partners in the design and evaluation of service-learning programmes is essential to understanding how community and academic health centres can better collaborate to promote health equity.

Teacher education and training vary across the world, yet research from diverse cultures supports the development of reflective teachers. Claiming that the complex dynamics of the 21st-century classroom can be managed best by reflective teachers. Through the reflective process, teachers are empowered as change agents to modify learning environments to benefit their students. Teachers hold the power to influence student learning. Therefore, it is important to understand the training processes that serve to produce reflective practitioners. In conducting rigorous cross-cultural comparative research, identifying common evaluative indicators underpinned by a theoretical framework is critical. Hence, the principles of the pre-service emerging reflective teacher training (PERTT) model were explored quantitatively and explained qualitatively to specifically focus on teachers' perceptions of their experiences of the psychosocial interpersonal process outcomes of the teacher-training environment (i.e. reflective practices, instructional scaffolding, guidance and support, modelled behaviours and reinforcement) provided during their teacher training. Such an exploration is critical because the philosophical underpinnings of the PERTT model have not been interrogated outside of Barbados. The findings demonstrate that there is merit to key theoretical principles of the PERTT model based on the lived experiences of the teachers in Antigua and Barbuda, England, and Canada during their teacher training.

Retinoic acid receptor β2 (RARβ2) is an emerging therapeutic target for spinal cord injuries (SCIs) with a unique multimodal regenerative effect. We have developed a first-in-class RARβ agonist drug, C286, that modulates neuron-glial pathways to induce functional recovery in a rodent model of sensory root avulsion. Here, using genome-wide and pathway enrichment analysis of avulsed rats' spinal cords, we show that C286 also influences the extracellular milieu (ECM). Protein expression studies showed that C286 upregulates tenascin-C, integrin-α9, and osteopontin in the injured cord. Similarly, C286 remodulates these ECM molecules, hampers inflammation and prevents tissue loss in a rodent model of spinal cord contusion C286. We further demonstrate C286's efficacy in human iPSC-derived neurons, with treatment resulting in a significant increase in neurite outgrowth. Additionally, we identify a putative efficacy biomarker, S100B, which plasma levels correlated with axonal regeneration in nerve-injured rats. We also found that other clinically available retinoids, that are not RARβ specific agonists, did not lead to functional recovery in avulsed rats, demonstrating the requirement for RARβ specific pathways in regeneration. In a Phase 1 trial, the single ascending dose (SAD) cohorts showed increases in expression of RARβ2 in white blood cells correlative to increased doses and at the highest dose administered, the pharmacokinetics were similar to the rat proof of concept (POC) studies. Collectively, our data suggests that C286 signalling in neurite/axonal outgrowth is conserved between species and across nerve injuries. This warrants further clinical testing of C286 to ascertain POC in a broad spectrum of neurodegenerative conditions.

Abstract This observational study aimed retrospectively assess the impact of the COVID-19 pandemic on the head and neck squamous cell carcinoma (HNSCC) diagnosis and severity of the disease in southern Brazil. All new cases diagnosed with HNSCC from March 11, 2019 to March 10, 2020 (pre-COVID-19) and from March 11, 2020 to March 10, 2021 (COVID-19) were included. The data collected were: date of the histopathological diagnosis, sociodemographic data, place of residence, data related to the tumor (location of the primary tumor, lymph node involvement, distant metastasis and TNM clinical staging), time elapsed between the diagnosis and treatment initiation. There was no significant difference in the number of new diagnoses in the COVID-19 group (n=45) compared to the pre-COVID-19 group (n=47). There was also no statistical difference regarding patients’ sociodemographic profile, time between diagnosis and treatment, and overall TNM staging. However, the clinical N classification was more severe in the COVID-19 group (p=0.021). Patients diagnosed during the COVID-19 pandemic were 4.05 times more likely to have the N-stage more advanced (95% CI:1.62 – 10.12). Although there was no reduction in the number of new diagnosis of HNSCC during COVID-19 pandemic, the diagnosed cases showed lymph node metastasis in more advanced stages.

Summary: Microsatellite instability-high (MSI-H) tumors are malignant tumors that, despite harboring a high mutational burden, often have intact TP53. One of the most frequent mutations in MSI-H tumors is a frameshift mutation in RPL22, a ribosomal protein. Here, we identified RPL22 as a modulator of MDM4 splicing through an alternative splicing switch in exon 6. RPL22 loss increases MDM4 exon 6 inclusion and cell proliferation and augments resistance to the MDM inhibitor Nutlin-3a. RPL22 represses the expression of its paralog, RPL22L1, by mediating the splicing of a cryptic exon corresponding to a truncated transcript. Therefore, damaging mutations in RPL22 drive oncogenic MDM4 induction and reveal a common splicing circuit in MSI-H tumors that may inform therapeutic targeting of the MDM4-p53 axis and oncogenic RPL22L1 induction.