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The purpose of this study was to examine the perceptions of key informants about the processes of institutional change and collaboration involved in the development of three early college high schools (ECHS)s over a 4-year period. The 15 study participants were members of early college high school councils and included high school principals, counselors, community college administrators, and school district administrators. Participants were located at two early college high schools located on community college campuses, and one was located on a school district site. This mixed methods study used a survey and structured interviews, both based loosely on case studies from "Not so easy going: The policy environments of small urban schools and schools-within-schools" (Raywid & Schmerler, 2003) and factors identified by the Wilder Collaboration Inventory (Mattessich & Monsey, 1992) as critical to successful collaboration. The findings of the study showed that the ECHS partnership, according to the majority of its members, exhibited (a) indicators of institutional change in policy and attitude toward collaboration; and (b) the success factors of history of collaboration, favorable political climate, appropriate cross section of members, collaboration seen in self interest, sharing a stake in process and outcome, shared decision making, concrete attainable goals and objectives, and shared vision. Success factors not showing a majority response were adequate resources, mutual respect, open and frequent communication, clear roles and policy guidelines, and sufficient funds.

Many colleges and universities are expected to produce more graduates while responding to an increasing level of racial and ethnic diversity among students. While the importance of diversity within executive management leadership teams may be accepted among nonprofit higher education institutions, the connection between diversity among the leadership in higher education and the retention of minority students has not been empirically established. This study, focusing on Texas public colleges and universities, finds that: 1) a diverse executive management team makes a positive difference in minority student retention at community colleges and 4-year universities institutions; and 2) the impact of a diverse executive management team on retention is not limited to race and ethnicity, but instead includes other demographic aspects. (Contains 1 table.)

Evidence clearly points to the presence of intercollegiate athletics at the early junior colleges established prior to World War I. Moving into more current times, the authors find among prominent reasons for institutional involvement with athletics giving students a "true college experience," expanding access, recruiting a more diverse student body, and addressing the "missing male phenomenon". This article uses national data to give an introductory overview regarding the depth and breadth of the involvement of America's community colleges in intercollegiate athletics. It provides the numbers and statistics related to the five most popular men's and women's community college sports teams, athletically related scholarship aid, expenses, and other pertinent topics associated with athletics at the community college. (Contains 4 tables.)

50 years after the "Brown v. Board of Education" decision, a high-stakes testing movement, significantly boosted by provisions contained in No Child Left Behind Act of 2001, has emerged with the potential of both positive and negative implications. This paper argues that assessment generally is not tied to the 3 positive outcomes of urban, suburban, or rural schools--admission to college, military, and workforce entry--which are relevant to the private and public sectors, and to students and their parents. Benchmarking performance directly in relation to positive outcomes that matter is crucial if high-stakes testing, which ostensibly has as its purpose the improvement of overall system performance, is to be tied to all the desired outcomes that matter. (Contains 2 tables.)

Many rural community colleges have long provided on-campus housing. This article profiles the availability of housing at rural community colleges in 2001-2002 and 2005-2006, examines the factors that will continue [...]

This qualitative study examined the learning styles of supplemental instruction (SI) leaders at a large, public university to determine whether or not leader learning styles influenced the way they designed out-of-class study sessions for students. No consistent pattern emerged among the themes; however, the results attributed out-of-class study session design to both the incorporation of personal learning style preferences as identified through the Kolb Learning Style Inventory (2007) and training conducted by the institution. Implications for future research include the need for continued study as to how and if supplemental instruction leader learning style influences out-of-class study session design. [ABSTRACT FROM AUTHOR]

Introduction: Minimally invasive surgery is today the main challenge of ENT surgeons who aim to achieve oncological radicality with less aesthetic and functional impact. This is the basis for the widespread transoral surgical techniques, as the Thunderbeat ® ., Objective: To date, the use of Thunderbeat ® in transoral surgery is still little known and widespread. So, this study analyzes, with a systematic review, current literature about the transoral use of Thunderbeat ® and shows our case studies., Methods: The research was carried out on Pubmed, Scopus, Web of Science and Cochrane databases using specific keywords. Then, a retrospective study was carried out on 10 patients who underwent transoral surgery by Thunderbeat ® in our ENT Clinic. Both in our cases and in the systematic review the following parameters have been evaluated: treated anatomical site and subsite, histological diagnosis, type of surgery, duration of nasogastric tube and hospitalization, post-operative complications, tracheostomy, resection margin status., Results: The review included 3 articles that described transoral use of Thunderbeat ® for a total of 31 patients suffering from oropharyngeal, hypopharyngeal and/or laryngeal carcinoma. Nasogastric tube was removed after 21.5 days on average, temporary tracheostomy was performed in 6 patients. The main complications were: bleeding (12.90%) and pharyngocutaneous fistula (29.03%). Thunderbeat ® shaft was 35 cm long and 5 mm large. Our case studies included 5 males and 5 females, mean age 64.4 ± 10.28, with oropharyngeal or supraglottic carcinoma, parapharyngeal pleomorphic adenoma and cavernous hemangioma of the tongue base. Temporary tracheostomy was performed in 8 patients. Free resection margins were achieved in all cases (100%). No peri-operative complications occurred. Nasogastric tube was removed after 5.3 ± 2 days on average. All patients were discharged without tracheal tube and NGT after 18.2 ± 4.72 days on average., Conclusion: This study demonstrated that Thunderbeat ® has several advantages over other transoral surgical approaches, such as CO2 laser and robotic surgery, in terms of best combination of oncological and functional success, less post-operative complications and costs. So, it could represent a step forward in transoral surgery., (© 2023. The Author(s).)

Increased expression or amplification of HER2 receptor tyrosine kinase gene ERBB2 is well-known and widely used as a prognostic biomarker of breast cancer (BC) response to the targeted treatment with trastuzumab and its analogs. Considering that part of the BC patients overexpressing HER2 does not respond to trastuzumab, clinical trial NCT03521245 was initiated to identify additional gene expression and molecular pathway activation response biomarkers to trastuzumab treatment in HER2-positive BC. Using RNA sequencing gene expression in 23 formalin-fixed, paraffin embedded HER2 positive BC tissue blocks from patients who either responded or not responded to trastuzumab treatment was profiled. Differentially regulated genes and molecular pathways were identified in the groups of trastuzumab responders and non-responders. These results were next compared with the 42 previously published BC trastuzumab responder and non-responder RNA sequencing profiles from the clinical trials NCT00513292 and NCT00353483. No correlation was observed between the response status and the expression levels of ERBB2 gene in the HER2 positive BC samples. Analysis of the differentially expressed genes and molecular pathways in the combined dataset revealed 15/27 commonly up/down regulated genes and 15/25 pathways, respectively. However, only the intersection of molecular pathways upregulated in trastuzumab responders vs non-responders was statistically significantly enriched compared to the random expectation model. A classifier built using the most significantly upregulated molecular pathway - cAMP Pathway Protein Retention - demonstrated the best performance for prediction of the HER2 positive BC response to trastuzumab for both our experimental and previously reported data. This pathway also predicted time to recurrence in the combined dataset with Log-rank p-value 0.041.

RNA sequencing is considered the gold standard for high-throughput profiling of gene expression at the transcriptional level. Its increasing importance in cancer research and molecular diagnostics is reflected in the growing number of its mentions in scientific literature and clinical trial reports. However, the use of different reagents and protocols for RNA sequencing often produces incompatible results. Recently, we published the Oncobox Atlas of RNA sequencing profiles for normal human tissues obtained from healthy donors killed in road accidents. This is a database of molecular profiles obtained using uniform protocol and reagents settings that can be broadly used in biomedicine for data normalization in pathology, including cancer. Here, we publish new original 39 breast cancer (BC) and 19 lung cancer (LC) RNA sequencing profiles obtained for formalin-fixed paraffin-embedded (FFPE) tissue samples, fully compatible with the Oncobox Atlas. We performed the first correlation study of RNA sequencing and immunohistochemistry-measured expression profiles for the clinically actionable biomarker genes in FFPE cancer tissue samples. We demonstrated high (Spearman's rho 0.65-0.798) and statistically significant ( p < 0.00004) correlations between the RNA sequencing (Oncobox protocol) and immunohistochemical measurements for HER2/ERBB2 , ER/ESR1 and PGR genes in BC, and for PDL1 gene in LC; AUC: 0.963 for HER2, 0.921 for ESR1, 0.912 for PGR, and 0.922 for PDL1. To our knowledge, this is the first validation that total RNA sequencing of archived FFPE materials provides a reliable estimation of marker protein levels. These results show that in the future, RNA sequencing can complement immunohistochemistry for reliable measurements of the expression biomarkers in FFPE cancer samples., Competing Interests: M.S. (Maxim Sorokin), A.G. and A.B. have a financial relationship with OmicsWay Corp. OmicsWay Corp. was not involved in the study design, collection, analysis, and interpretation of data. The remaining authors have nothing to disclose.

Objective: Osteoporosis is a common disease that is underdiagnosed and undertreated. A multidisciplinary intervention may improve the identification and treatment of osteoporosis and may consequently prevent secondary fractures., Method: Retrospective, single-centre study comparing attitude to screening and treatment of patients admitted to the orthopaedic unit of the general hospital AZ Sint-Jan Brugge-Oostende AV (Belgium) before and after the implementation of a clinical pathway., Results: A total of 172 patients (86 before and 86 after) were included in this study. The implementation of the pathway resulted in an increase in bone mineral density tests performed, an increment in the number of referrals to a specialist in the field of osteoporosis, and an increase in prevention and treatment of osteoporosis., Conclusion: The implementation of a clinical pathway coordinated and evaluated by a clinical pharmacist improved the identification, referral and treatment of osteoporosis in patients hospitalised due to low-impact fractures., Competing Interests: Competing interests: None declared.

Background: Sacral chordoma (SC) is a neoplasm arising from residual notochordal cells degeneration. SC is difficult to manage mainly because of anatomic location and tendency to extensive spread. Carbon ion radiotherapy (CIRT) is highly precise to selectively deliver high biological effective dose to the tumor target sparing the anatomical structure on its path even if when SC is contiguous to the intestine, and a surgical spacer might be an advantageous tool to create a distance around the target volume allowing radical curative dose delivery with a safe dose gradient to the surrounding organs. This paper describes a double approach-open and hand-assisted laparoscopic-for a silicon spacer placement in patients affected by sacral chordoma undergoing carbon ion radiotherapy., Methods: Six consecutive patients have been enrolled for surgical spacer placement-open (three) or hand-assisted (three)-prior carbon ion radiotherapy treatment in order to increase efficacy of carbon ion radiotherapy minimizing its side effects., Results: Results showed that silicon spacer placement for SC treatment is feasible both via laparoscopic and laparotomic approach., Conclusions: Its use might improve CIRT safety and thus efficacy for SC treatment.

Antinuclear antibodies (ANAs) are significant biomarkers in the diagnosis of autoimmune diseases in humans, done by mean of Indirect ImmunoFluorescence (IIF) method, and performed by analyzing patterns and fluorescence intensity. This paper introduces the AIDA Project (autoimmunity: diagnosis assisted by computer) developed in the framework of an Italy-Tunisia cross-border cooperation and its preliminary results. A database of interpreted IIF images is being collected through the exchange of images and double reporting and a Gold Standard database, containing around 1000 double reported images, has been settled. The Gold Standard database is used for optimization of a CAD (Computer Aided Detection) solution and for the assessment of its added value, in order to be applied along with an Immunologist as a second Reader in detection of autoantibodies. This CAD system is able to identify on IIF images the fluorescence intensity and the fluorescence pattern. Preliminary results show that CAD, used as second Reader, appeared to perform better than Junior Immunologists and hence may significantly improve their efficacy; compared with two Junior Immunologists, the CAD system showed higher Intensity Accuracy (85,5% versus 66,0% and 66,0%), higher Patterns Accuracy (79,3% versus 48,0% and 66,2%), and higher Mean Class Accuracy (79,4% versus 56,7% and 64.2%).

Background: Classifying the location of an occlusion in the culprit artery during ST-elevation myocardial infarction (STEMI) is important for risk stratification to optimize treatment. We developed a new logistic regression (LR) algorithm for 3-group classification of occlusion location as proximal right coronary artery (RCA), middle-to-distal RCA or left circumflex (LCx) coronary artery with inferior myocardial infarction. We compared the performance of the new LR algorithm with the recently introduced decision tree classifier of Fiol et al (Ann Noninvasive Electrocardiol. 2004;4:383-388) in the classification of the same 3 categories., Methods: The new algorithm was developed on a set of electrocardiograms from an emergency department setting (n = 64) and tested on a different set from a prehospital setting (n = 68). All patients met the current STEMI criteria with angiographic confirmation of culprit artery and occlusion location. Using LR, 4 ST-segment deviation features were chosen by forward stepwise selection. Final LR coefficients were obtained by averaging more than 200 bootstrap iterations on the training set. In addition, a separate 4-feature classifier was designed adding ST features of V4R and V8, only available in the training set., Results: The LR algorithm classified proximal RCA occlusion vs combined LCx occlusion and middle-to-distal RCA occlusion, with a sensitivity of 76% and specificity of 81% as compared with 71% and 62% for the Fiol classifier. The difference in specificity was statistically significant. The LR classifier trained with additional ST features of V4R and V8, but still limited to 4, improved the overall agreement in the training set from 65% to 70%., Conclusion: Discrimination of proximal RCA lesion location from LCx or middle-to-distal RCA using the new LR classifier shows improvement over decision tree–type classification criteria. Automated identification of proximal RCA occlusion could speed up the risk stratification of patients with STEMI. The addition of leads V4R and V8 should further improve the automated classification of the occlusion site in RCA and LCx.

Proximal occlusion within the left anterior descending (LAD) coronary artery in patients with acute myocardial infarction leads to higher mortality than does nonproximal occlusion. We evaluated an automated program to detect proximal LAD occlusion. All patients with suspected acute coronary syndrome (n = 7,710) presenting consecutively to the emergency department of a local hospital with a coronary angiogram–confirmed flow-limiting lesion and notation of occlusion site were included in the study (n = 711). Electrocardiograms (ECGs) that met ST-segment elevation myocardial infarction (STEMI) criteria were included in the training set (n = 183). Paired angiographic location of proximal LAD and ECGs with ST elevation in the anterolateral region were used for the computer program development (n = 36). The test set was based on ECG criteria for anterolateral STEMI only without angiographic reports (n = 162). Tested against 2 expert cardiologists' agreed reading of proximal LAD occlusion, the algorithm has a sensitivity of 95% and a specificity of 82%. The algorithm is designed to have high sensitivity rather than high specificity for the purpose of not missing any proximal LAD in the STEMI population. Our preliminary evaluation suggests that the algorithm can detect proximal LAD occlusion as an additional interpretation to STEMI detection with similar accuracy as cardiologist readers.

Objective: to provide information on epidemiology of dementia in Tuscany needed to plan for dedicated health and social services., Design: analysis of pooled baseline data from 4 population-based longitudinal studies., Setting: 4 municipalities in Tuscany., Participants: 4,056 elderly subjects enrolled in 4 longitudinal studies., Main Outcome Measures: age- and sex-specific dementia prevalence rates and estimated number of demented people, by degree of cognitive impairment and BADL disability in the elderly population of Tuscany., Results: out of the evaluated subjects, 293 are demented. Prevalence of dementia increases from about 1 % in the 65-69 age group to about 28 % in the 90+ age group both among women and men. About 43% of the demented study subjects suffer from severe mental deterioration (MMSE < 14) and56% are disabled in at least one Basic Activity of Daily Living (BADL). We estimate that about 19 thousand demented elderly men and 40 thousand demented elderly women are currently living in Tuscany of whom 26 thousand severely mentally impaired and 34 thousand disabled in at least one BADL. The resulting overall dementia prevalence standardised on the Italian 65+ population is 5,3% for men and 7,7% for women., Conclusions: these estimates could be used as a basis for the evaluation and the planning of social and health care services dedicated to demented people.