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The present research aims to identify the depth of reflection attained by primary school teachers through the Critical Incident Technique (CIT) according to the categorisation of Lee (2005) and specific factors that could determine a higher level of reflection. For the first research phase twenty teacher semi-structured interviews were conducted. The results so far indicate that the majority of participants tend to reflect at Rationalisation Level while a small percentage of the sample were considered to have attained Reflective Level, in accordance with Lee's three-level categorisation of reflective thinking depth (namely Recall Level, Rationalisation Level, Reflective Level). The research also highlights specific factors, such as age, level of education, years of teaching experience that have a crucial impact on teachers developing a higher level of reflection.

The aim of this study is to investigate how amplifiers are used in Twitter (now called “X”) during election campaigns. Specifically, the main purpose is to identify the role and engagement of Twitter amplifiers in the 2019 European elections, the visibility of political parties and leaders, and the way in which automated tools are used to manipulate public opinion by influencing voting decisions. The countries considered in the study are two economic powers of Western Europe, France and Germany, as well as two countries of the European South, which are affected by the economic and financial crisis, Greece and Italy. The countries from Southern Europe were included in the sample as they are often used by mass media as political campaign tools. This paper emphasizes the Twitter platform through which the data collection was implemented using the official API of the social networking tool, focusing on the 2019 European elections. We collected data on 88 party leaders and MEP candidates between 10 May and 30 May 2019, as well as on 44,651 accounts that retweeted them. We concluded using 237,813 election-related tweets and used network theory to analyze and visualize the data. The results demonstrate that all political parties use amplifiers to promote their tweets, and some use the same amplifiers between different countries.

ObjectiveRheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a significant pulmonary complication of RA. This study tried to elucidate the mechanisms enhancing inflammation and causing lung injury in RA-ILD, focusing on the role of neutrophil extracellular traps (NETs). The study also investigated the potential benefits of nintedanib in advanced disease.MethodsNine RA-ILD patients and nine healthy controls were included in the study. Inflammatory markers in patients’ circulation were evaluated with immunoassays. The formation of NETs was examined using a citrullinated histone H3 (CitH3) ELISA and cell immunofluorescence. Inflammatory proteins expressed in neutrophils/NETs were studied with real-time qPCR and NET ELISA. To assess the effect of nintedanib, an intracellular tyrosine kinase inhibitor with antifibrotic properties, in RA-ILD a paired study was conducted in five patients before treatment administration and 16 weeks later.ResultsThe soluble terminal complement complex sC5b-9 and the levels of CitH3 were significantly elevated in patients with RA-ILD, compared to healthy controls. In addition, neutrophils isolated from RA-ILD patients released NETs enriched with tissue factor and interleukin-17A. Inflammatory NETs had a dynamic role, increasing the fibrotic potential of human pulmonary fibroblasts (HPFs). On the other hand, nintedanib treatment decreased NETs and sC5b-9 levels in RA-ILD patients.ConclusionThe findings propose an interplay between circulating NETs and HPFs, establishing the immunofibrotic aspects of RA-ILD. They also support the effectiveness of nintedanib in reducing key pathological processes of the disease. Further research is needed to fully understand these mechanisms and optimize treatment strategies for RA-ILD.

IntroductionThis study aimed to describe the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with glomerular diseases (GDs) and its impact on the probability of relapse.MethodsPatients with biopsy-proven GD and positive PCR test for SARS-CoV-2 from glomerular clinics across Greece were studied retrospectively. Those who received the GD diagnosis after the SARS-CoV-2 vaccination or coronavirus disease 2019 (COVID-19) or ended in ESKD prior to infection were excluded. Demographics, histopathological diagnoses, past medical history, immunosuppression, and GD activity status were recorded.ResultsA total of 219 patients with GDs and documented SARS-CoV-2 infection were included. The mean time from the diagnostic kidney biopsy to SARS-CoV-2 infection was 67.6 ( ± 59.3) months. Among the participants, 82.5% had been vaccinated against SARS-CoV-2 with three doses (range: 2.5–3) without subsequent GD reactivation in 96.2% of them. Twenty-two patients (10%) were hospitalized for COVID-19 and one (0.5%) required mechanical ventilation. Four (1.8%) died due to COVID-19 and one (0.5%) had long COVID-19 symptoms. Among patients in remission prior to SARS-CoV-2 infection, 22 (11.2%) experienced a GD relapse within 2.2 (range: 1.5–3.7) months from the diagnostic test. The relapse-free survival after COVID-19 was significantly shorter for patients with minimal change disease, pauci-immune glomerulonephritis, and focal segmental glomerulosclerosis. No difference was observed in the relapse-free survival post-COVID-19 based on the history of SARS-CoV-2 vaccination.ConclusionsSARS-CoV-2 infection appears to have a symptomatic but uncomplicated sequence in vaccinated patients with GDs, with a significant impact on the clinical course of GD, associated with an increased probability of relapse in certain histopathological types.

In recent years, the role of the leader in the effective operation of the school has been vastly debated in the international educational community. Through a historical study of educational leadership, this research discovered that the position of the leader is constantly being reshaped and adapted to the current social, cultural, and economic circumstances. During the last year, due to the coronavirus disease 2019 pandemic, the educational leadership has had to be reshaped worldwide. The aim of this study is to investigate the issues that have arisen from the aforementioned situation, as well as to try to figure out how a school's principal might apply the basic principles of educational leadership, in a period of crisis. This investigation was focused on the use of the qualitative method. The study included 88 teachers and 5 principals from Cyprus, as well as teachers and parents. Based on the findings of the study, we discovered that the challenges faced by school principals and teachers are primarily linked to alienation, marginalization, time management, improving bureaucracy, problems with technical equipment and distance learning programs. Solution to these obstacles seemed to be the: Empathy, teamwork, and decentralization of the educational system, which are all promoted by the principal, who occasionally has additional authority.

Objective To estimate real-life European Alliance of Associations for Rheumatology (EULAR)/European Renal Association (ERA)-European Dialysis and Transplantation Association (EDTA) response rates and predictors for no response in patients with lupus nephritis (LN) managed with conventional immunosuppressive therapies.Methods Ambidirectional cohort study of patients with new-onset LN (period 2014–to date). Response rates in the first year were calculated, and all treatment modifications were recorded. Univariate and multivariate regression analyses were performed to assess determinants of failure to respond at 12 months.Results 140 patients were included (81.4% women, median (IQR) age at LN diagnosis 38 (22) years). Among them, 32.1% presented with nephrotic range proteinuria, 28.6% with glomerular filtration rate

Background: Graphene Oxide (GO) has shown great potential in biomedical applications for cancer therapeutics. The biosafety and stability issues of GO in biological media have been addressed by functionalization with polyethylene glycol (PEG). Methods: In this work, carboxylated, nanosized GO (nCGO) was evaluated as a potential carrier of paclitaxel (PCT). The effect of PEG characteristics on particle size and surface charge, colloidal stability, drug, and release, and the hemolytic potential of nCGO, was investigated. Optimum PEG-nCGO/PCT formulations based on the above properties were evaluated for their anticancer activity (cytotoxicity and apoptosis induction) in the A549 lung cancer cell line. Results: An increase in the length of linear PEG chains and the use of branched (4-arm) instead of linear PEG resulted in a decrease in hydrodynamic diameter and an increase in ζ potential of the pegylated nCGO particles. Pegylated nCGO exhibited high colloidal stability in phosphate-buffered saline and in cell culture media and low hemolytic effect, even at a relatively high concentration of 1 mg/mL. The molecular weight of PEG and branching adversely affected PCT loading. An increased rate of PCT release at an acidic pH of 6.0 compared to the physiological pH of 7.4 was observed with all types of pegylated nCGO/PCT. Pegylated nCGO exhibited lower cytotoxicity and apoptotic activity than non-pegylated nCGO. Cellular uptake of pegylated nCGO increased with incubation time with cells leading to increased cytotoxicity of PEG-nCGO/PCT with incubation time, which became higher than that of free PCT at 24 and 48 h of incubation. Conclusions: The increased biocompatibility of the pegylated nCGO and the enhanced anticancer activity of PEG-nCGO/PCT compared to free PCT are desirable properties with regard to the potential clinical application of PEG-nCGO/PCT as an anticancer nanomedicine.

As artificial intelligence (AI) becomes increasingly prevalent, it has become a topic of interest in education. The use of AI in education poses complex issues, not only in terms of its impact on teaching and learning outcomes but also in terms of the ethical considerations regarding personal data and the individual needs of each student. Our study systematically analyzed empirical research on the use of AI in primary education, specifically for children aged 4–12 years old. We reviewed 35 articles indexed in SCOPUS, filtered them according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzed them, and categorized the findings. The research focused on the studies’ objectives, learning content, learning outcomes, learning activities, and the pedagogy of activities or the AI tools. Our categorization resulted in three main categories of research objectives regarding the creation, implementation, and evaluation of AI tools and five categories for learning content: AI and ML (machine learning) concepts in STEM and STEAM, language learning, mathematics, arts, and various other subjects. The learning activities were split into four categories: apply, engage, interact, use; project-based learning with multiple activities; experience and practice; and students as tutors. The learning outcomes were split into three levels: cognitive, affective, and psychomotor. The pedagogy of AI tools falls into four categories: constructivism, experiential learning, AI-assisted learning, and project-based learning. The implications for teacher professional development are discussed.

PurposeThe randomized phase III coBRIM study (NCT01689519) demonstrated improved progression-free survival (PFS) and overall survival (OS) with addition of cobimetinib to vemurafenib compared with vemurafenib in patients with previously untreated BRAFV600 mutation-positive advanced melanoma. We report long-term follow-up of coBRIM, with at least 5 years since the last patient was randomized.Patients and methodsEligible patients were randomized 1:1 to receive either oral cobimetinib (60 mg once daily on days 1-21 in each 28-day cycle) or placebo in combination with oral vemurafenib (960 mg twice daily).Results495 patients were randomized to cobimetinib plus vemurafenib (n = 247) or placebo plus vemurafenib (n = 248). Median follow-up was 21.2 months for cobimetinib plus vemurafenib and 16.6 months for placebo plus vemurafenib. Median OS was 22.5 months (95% CI, 20.3-28.8) with cobimetinib plus vemurafenib and 17.4 months (95% CI, 15.0-19.8) with placebo plus vemurafenib; 5-year OS rates were 31% and 26%, respectively. Median PFS was 12.6 months (95% CI, 9.5-14.8) with cobimetinib plus vemurafenib and 7.2 months (95% CI, 5.6-7.5) with placebo plus vemurafenib; 5-year PFS rates were 14% and 10%, respectively. OS and PFS were longest in patients with normal baseline lactate dehydrogenase levels and low tumor burden, and in those achieving complete response. The safety profile remained consistent with previously published reports.ConclusionsExtended follow-up of coBRIM confirms the long-term clinical benefit and safety profile of cobimetinib plus vemurafenib compared with vemurafenib monotherapy in patients with BRAFV600 mutation-positive advanced melanoma.

Calcium pyrophosphate deposition (CPPD) disease is a form of crystal-induced arthropathy that arises from the accumulation of calcium pyrophosphate crystals within joints and soft tissues. This process leads to inflammation and damage to the affected joints. It can present asymptomatically or as acute or chronic inflammatory arthritis. Risk factors and comorbidities, including prior joint injury, osteoarthritis, hereditary or familial predisposition, and metabolic diseases, should be evaluated in CPPD cases. The management of CPPD remains a challenge in the sparsity of randomized controlled trials. The lack of such trials makes it difficult to establish evidence-based treatment protocols for CPPD. This review provides an overview of the current pharmacological management of CPPD, focusing on reducing inflammation, alleviating symptoms, and preventing acute flares. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine are effective in managing acute CPP arthritis. Colchicine may also be used prophylactically to prevent recurrent flares. In cases where other treatments have failed, anakinra, an interleukin-1 receptor antagonist, can be administered to alleviate acute flares. The management of chronic CPP inflammatory arthritis includes NSAIDs and/or colchicine, followed by hydroxychloroquine, low-dose glucocorticoids, and methotrexate, with limited data on efficacy. Tocilizumab can be used in refractory cases. In small studies, synovial destruction using intra-articular injection of yttrium 90 can decrease pain. To date, no disease-modifying therapies exist that reduce articular calcification in CPPD.