It’s never lupus: A case of atypical psychosis and neuropsychiatric lupus

Abstract:
Introduction
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving the production of autoantibodies with consequent involvement of multiple organ systems. Although not an uncommon condition, its pleomorphic neuropsychiatric manifestations imply consideration of SLE as a relevant differential diagnosis. As many as 50% of patients with SLE have neurological involvement throughout their disease course and it is associated with impaired quality of life, high morbidity and mortality rates.

Objectives
Case report study and discussion.

Methods
The authors present a case of a 50-year old woman without previous psychiatric history presenting to the psychiatric department with suicidal ideation in association with psychotic symptoms of rapid onset. She presented with various somatic symptoms including butterfly rash, alopecia, nail dystrophy and generalized myalgia and arthralgia. After conducting a thorough clinical investigation with subsequent unveiling of various alterations including those in the antibody panels and abnormal magnetic resonance imaging results, a diagnosis of neuropsychiatric lupus was established.

Results
Improvements in initial psychiatric symptoms were noted after completing pulse corticoid therapy for SLE with adjunct antipsychotic medication. On follow-up, the patient demonstrated a complete return to previous mental functioning with no reported relapses.

Conclusions
This case demonstrates the heterogeneous presentations that neuropsychiatric lupus can assume. The vast array of psychopathological signs and symptoms in SLE continue to exist as a significant diagnostic and therapeutic challenge. Timely identification resulting from a proactive approach in maintaining lupus as part of our differentials may prevent the significant morbidity and mortality commonly associated with the resultant central nervous system involvement in SLE.

Disclosure
No significant relationships.

S. Jesus
A. Costa
J. Alcafache
P. Garrido


SLEEP DISTURBANCES AMONG UNIVERSITY STUDENTS : A TUNISIAN STUDY

Abstract:
Introduction
Poor sleep quality is a major health problem worldwide. University students tend to suffer from problems of sleep regularity, quantity and quality, which can affect their academic performance, and have a serious impact on their psychological and physical well-being.
Objectives
The aim of this study was to assess the prevalence of insomnia among Tunisian university students, and to identify its associated factors.
Methods
We conducted a cross-sectional web-based study among university students from several Tunisian faculties. Data were collected using a questionnaire spread throughout social media (Facebook), using the Google Forms® platform, during September and October 2022.
We used the “Insomnia Severity Index” (ISI) to assess the severity of insomnia.
Results
A total of 144 students completed the questionnaire. Their mean age was 23.38±3.27 years, with a sex-ration (F/M) of 2.8. Among them, 70.1% were single and 68.8% lived with family. Among our participants, 10.4% were followed for chronic somatic disease, 11.1% for chronic mental disease, while 29.2% have already been diagnosed and treated for sleep disturbances.
ISI showed that 72.2% of students suffered from insomnia: 45.1% Subthreshold insomnia, 19.4% moderate clinical insomnia and 7.6% severe clinical insomnia. Insomnia was significantly more frequent among psychoactive substances users (75.7% vs 57.6%; p=0.043). ISI scores were significantly higher among cannabis users (17.4 vs 11.06; p=0.025).
Conclusions
Our study highlighted that insomnia is prevalent within the university student population, and psychoactive substances consumption seems to worsen it. Thus, when designing interventions to improve sleep quality among students, the main determinants need to be taken into consideration.
Disclosure of Interest
None Declared

M. Turki
J. Firas
H. E. Mhiri
F. Sahnoun
A. Guermazi
S. Ellouze
N. Halouani
J. Aloulou


Multimorbidity patterns and health care utilization among older adults with schizophrenia

Abstract:
Introduction
Older adults with schizophrenia often have multiple chronic conditions, or multimorbidity, yet most prior research has focused on single medical conditions.
Objectives
To characterize multimorbidity patterns and utilization among older adults with schizophrenia to understand how multimorbidity affects this population and their clinical service needs.
Methods
This retrospective cohort study included veterans aged 50 years and older with schizophrenia and followed their comorbid diagnoses and utilization (outpatient, inpatient, and emergency) from 2012 to 2019. Comorbid diagnoses included myocardial infarction, congestive heart failure, stroke, chronic obstructive pulmonary disease (COPD), cancer, dementia, traumatic brain injury, hepatitis C, osteoarthritis, renal disease, chronic pain, sleep disorder, depression, dysthymia, posttraumatic stress disorder (PTSD), general anxiety disorder, alcohol use disorder, other substance use disorder, and tobacco use disorder. Latent class analysis was used to identify latent profiles of psychiatric and medical comorbidity. Chi-square and F-tests were used to assess differences in demographics, comorbidities, and utilization across the latent classes.
Results
The cohort included 82,495 adults with schizophrenia. Three distinct multimorbidity classes were identified: Minimal Comorbidity (67.0% of the cohort), High Comorbidity (17.6%) and Substance Use Disorders and Related Conditions (SUDRC) (15.4%). The Minimal Comorbidity class had <10% prevalence of all comorbid diagnoses. The High Comorbidity class had >20% prevalence of congestive heart failure, COPD, dementia, renal disease, sleep disorder, and depression. The SUDRC class had >70% prevalence of alcohol and drug use disorders and >20% prevalence of COPD, hepatitis C, depression, and PTSD. Although the High Comorbidity class had the highest rates of chronic medical conditions, the SUDRC class had the highest rates of emergency and inpatient medical care and emergency, inpatient, and outpatient mental health care utilization. Comparing across classes, all p-values were <.001 for utilization.
Conclusions
Older adults with schizophrenia are a heterogeneous group with distinct multimorbidity classes and different patterns of utilization. Those with high prevalence of substance use disorders had the highest rates of emergency and inpatient medical and overall mental health care utilization. Tailoring integrated care services to target specific clinical needs could improve outcomes for this population.
Disclosure of Interest
None Declared


Socio-demographic predictors of the prevalence of dysfunctional breathing in a healthy population during the COVID-19 pandemic

Abstract:
Introduction
Dysfunctional breathing is a breathing patterns that do not correspond to the physiological needs of the body, provoke many poly-systemic symptoms. Dysfunctional breathing is experienced as a feeling of “difficulty in breathing”, which in the conditions of the COVID-19 pandemic may be similar to the symptoms of coronavirus infection (Taverne et al., 2021).

Objectives
To examine the role of socio-demographic predictors in the prevalence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.

Methods
The author’s socio-demographic questionnaire, the Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985), the STAI (Spielberger et al., 1983) and the “Perceived Stress Scale-10” (Cohen,Kamarck,Mermelstein,1983) were used. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia (38.3 ±11.4 y.o.).

Results
In men, the average values for NQ (11.19±7.74) are lower than among women (18.73±9.96, p=0.000). Persons with incomplete higher education have a higher score on NQ (N=103,NQ=20.44±11.8) than persons with higher education (N=1051,NQ= 17.40±9.63,p=0.048) and candidates/doctors of sciences (N=97,NQ= 15.34±11.20,p=0.005). There was also a connection between the severity of dysfunctional breathing and the level of income, which is associated with a negative correlation between income level and perception of stress (r=-0.215,p=0.000), state (r=-0.165,p=0.000) and trait anxiety (r=-0.127,p=0.000).

Conclusions
The severity of dysfunctional breathing is associated with gender, income levels and education, what can be used to identify a group of people who are most susceptible to the occurrence of dysfunctional breathing during the pandemic COVID-19. The study was supported of the Russian Science Foundation, project No.21-18-00624.

Disclosure
The study was supported of the Russian Science Foundation, project No. 21-18-00624.

J. Koniukhovskaia
E. Pervichko
V. Petrenko
O. Mitina
O. Stepanova
I. Shishkova
E. Dorokhov


Prevalence and correlates of explosive anger among pregnant and post-partum women in post-conflict Timor-Leste

Abstract:
               Background
               Little is known about explosive anger as a response pattern among pregnant and post-partum women in conflict-affected societies.

               Aims
               To investigate the prevalence and correlates of explosive anger among this population in Timor-Leste.

               Method
               We assessed traumatic events, intimate partner violence, an index of adversity, explosive anger, psychological distress and post-traumatic stress disorder among 427 women (257 in the second trimester of pregnancy, 170 who were 3–6 months postpartum) residing in two districts of Timor-Leste (response >99%).

               Results
               Two-fifths (43.6%) had explosive anger. Levels of functional impairment were related to frequency of explosive anger episodes. Explosive anger was associated with age (>35 years), being married, low levels of education, being employed, traumatic event count, ongoing adversity and intimate partner violence.

               Conclusions
               A combination of social programmes and novel psychological therapies may assist in reducing severe anger among pregnant and post-partum women in conflict-affected countries such as Timor-Leste.

Derrick Silove
Susan Rees
Natalino Tam
Mohammed Mohsin
Alvin Kuowei Tay
Wietse Tol


Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020–April 2021

Abstract:
Abstract

Objective:
To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity.

Design:
Prospective cohort study.

Setting:
An academic, tertiary-care hospital in St. Louis, Missouri.

Participants:
The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70–160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021.

Methods:
At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures.

Results:
Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30–45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up.

Conclusions:
In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity.

Rachel E. Bosserman
Christopher W. Farnsworth
Caroline A. O’Neil
Candice Cass
Daniel Park
Claire Ballman
Meghan A. Wallace
Emily Struttmann
Henry Stewart
Olivia Arter
Kate Peacock
Victoria J. Fraser
Philip J. Budge
Margaret A. Olsen
Carey-Ann D. Burnham
Hilary M. Babcock
Jennie H. Kwon
for the CDC Prevention Epicenters

Antimicrobial Stewardship & Healthcare Epidemiology

Infectious and parasitic diseases
Public aspects of medicine


302 Antibiotic treatment and culture responsiveness for urinary tract infections differ by outpatient clinical setting

Abstract: Background: Wastewater surveillance has emerged as a powerful tool for monitoring community pathogen burden. However, its role in hospital infection prevention remains unclear. We evaluated hospital wastewater for detectable multidrug-resistant organisms (MDRO) at an academic tertiary-care center (AH) and a community hospital (CH). Methods: From April-September 2024, wastewater was collected longitudinally from an AH and a CH. Samples were collected from selective plumbing draining intensive care beds at both facilities. After a 24-hour collection, samples were processed using digital droplet PCR to detect and quantify resistance genes and pathogens, including blaCTX-M, blaTEM, blaCMY-2, blaSHV, IMP, VIM, OXA-48, KPC, NDM, and Candida auris. Results were reported as gene copies per swab. Concurrent hospital isolation logs were reviewed to identify unit isolation with corresponding MDROs at the time of sampling. Results: Wastewater from both hospitals consistently contained multiple MDRO genetic markers across all sampling periods (Figures 1-4). Extended-spectrum beta-lactamase (ESBL) genes blaCTX-M, blaTEM, and blaSHV were detected in every sample, often at high copy number. Carbapenemase (CRE) genes IMP, KPC, and VIM were frequently detected, whereas NDM and OXA-48 were present at low and variable levels. C. auris was rarely detected. Across both sites, quantitative gene copy numbers varied over time. AH demonstrated persistently high ESBL and CRE gene burdens with temporal surges (Figure 1-2), while CH showed lower and more episodic detection patterns (Figure 3-4). Isolation needs for ESBL and CRE at both hospitals are reported in Figures 1-4. Conclusion: Hospital wastewater harbors diverse MDRO genetic signatures that do not reliably track with isolation practices, reflecting contributions from both silent patient shedding and environmental sources. ESBL genes often remained high even when no patients required isolation, whereas carbapenemase surges frequently preceded increases in CRE isolation, suggesting wastewater may provide early warning of rising resistance pressure. Differences between hospitals likely reflect both patient populations and environmental persistence. Wastewater surveillance may complement infection prevention efforts but should not be interpreted as a direct surrogate for patient colonization. Figure 1. Temporal trends in ESBL-producing resistance genes in wastewater and isolation needs at an academic center Figure 2. Temporal trends in CRE-producing resistance genes in wastewater and isolation needs at an academic center Figure 3. Temporal trends in ESBL-producing resistance genes in wastewater and isolation needs at a community hospital Figure 4. Temporal trends in CRE-producing resistance genes in wastewater and isolation needs at a community hospital

Alfredo Mena Lora
Scott Borgetti
Lior Cohen Yatziv
Mirza Ali
Susan Bleasdale Casey


Schizophrenic with childhood trauma: characterization of a Tunisian sample

Abstract:
Introduction
Schizophrenia is a neurodevelopmental process affecting approximately 1% of the population. Multiple studies have found that Childhood trauma is an important risk factor in the emergence and clinical course of schizophrenia.
Objectives
The purpose of this study was to assess the characteristics of schizophrenic inpatients with childhood trauma among a tunisian sample.
Methods
Stabilized inpatients with schizophrenia at the Psychiatry C department at University Hospital in Sfax were involved in our study. Sociodemographic and clinical data of patients were collected from medical records.
We used Childhood Trauma Questionnaire-Short Form (CTQ-SF) to evaluate the occurrence of childhood maltreatment.
Results
We recruited 33 patients, all men with a mean age of 35 years and 4 months (SD=9.44 years).
They were married in 6.1% and 24.2% of patients had regular work.
The mean age of onset of the disorder was 24.42(3.25).The level of poor psychotropic medication adherence was 72.7%.
According to CTQ-SF, 78.8% of patients had experienced child trauma with a mean score of 35.67 (SD =8.61).
A rate of 39.4% reported having experienced one child trauma, while 60.6% reported having experienced more than one.
We found high rates of emotional neglect (87.8%) while emotional and physical abuse during childhood were experienced by 39.4%, and 6% respectively and physical neglect were found in 30.3% of cases.
Patients with more than one childhood trauma were found to have an earlier onset of psychosis (p=0.004)
The occurrence of childhood trauma was not associated with the socio-demographic characteristics of the respondents or the clinical features of the disease.
Conclusions
The results point toward childhood emotional neglect being of specific importance to schizophrenia, which may be an area for future prevention and clinical attention.
Disclosure of Interest
None Declared

A. Syrine
F. Rim
B. Olfa
G. Imen
S. Najeh
O. Sana
M. B. Manel
Z. Lobna
C. Nada
B. T. Jihen
M. Mohamed


Impact of COVID19 Lockdown in Eating Disorders: A Multicenter Collaborative International Study

Abstract:
Introduction
COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable.

Objectives
1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries; and 2) to assess differences related to diagnostic subtypes, age and geography.

Methods
The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES).

Results
On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation.

Conclusions
The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients.

Disclosure
No significant relationships.

M. Etxandi
I. Baenas
L. Munguía
R. Granero
G. Mestre-Bach
I. Sánchez
S. Jimenez-Murcia
F. Fernandez-Aranda


2263

Abstract: OBJECTIVES/SPECIFIC AIMS: The current study examined hangover following IV alcohol self-administration (IV-ASA) using the Computer-Assisted Infusion System. The goal of the study was to identify predictors of hangover, including drinking history, alcohol sensitivity, family history, expectancies, and sex differences in nondependent drinkers. METHODS/STUDY POPULATION: The study sample included 89 healthy, nondependent drinkers aged 21–45 years. After a screening to exclude any medical illness or psychiatric disorders, participants completed an IV-ASA session. Each session consisted of a 25-minute priming phase, during which participants were prompted to press a button to receive individually standardized alcohol infusions, followed by a 2-hour “open bar” phase, during which they were instructed to recreate a typical drinking experience. Results from the IV-ASA included peak and average BrAC. Drinking patterns were assessed using the Alcohol Use Disorders Identification Test, which provided 3 subscales: consumption (AUDIT-C), dependence (AUDIT-D), and harmful drinking (AUDIT-H). Subjective response to alcohol was measured using the Drug Effects Questionnaire (DEQ). The Alcohol Hangover Scale (AHS) was used to assess hangover for the period between participants’ departure from the study unit and 10 am the next morning. The Alcohol Effects Questionnaire (AEFQ) is a measure which includes 40 true/false statements about how alcohol typically makes respondents feel, and was used to measure alcohol expectancies. RESULTS/ANTICIPATED RESULTS: Results showed that 78% of participants endorsed having at least 1 hangover symptom following IV-ASA. The most commonly reported items were tired, thirsty, headache, and hangover. There was no association between hangover scores and the AUDIT-C or IV-ASA. Because alcohol consumption was not related to hangover symptoms, risky drinking behavior was examined. Results indicated that participants endorsing 4 or more items on the AUDIT-D plus AUDIT-H subscales showed significantly higher average hangover scores. Linear regression analyses indicated that alcohol hangover scores were associated with DEQ items feel, high, and intoxicated. Ongoing analyses are examining additional predictors of hangover including family history, alcohol expectancies, sex differences, and other alcohol sensitivity measures. DISCUSSION/SIGNIFICANCE OF IMPACT: The results indicated that risky drinking patterns and alcohol response measures were positively associated with hangover symptoms in non-dependent drinks, while no correlation between consumption and hangover symptoms were found. Since previous research has shown than greater subjective response is associated with heavy drinking and predictive of alcohol use disorder, it is possible that hangover symptoms is a marker of this relationship. Since the role of hangover in the transition from heavy drinking to disorder still remains unclear, it will be important to characterize this relationship between alcohol sensitivity and hangover as a function of drinking patterns. This understanding may help to prevent this transition from at-risk drinking to alcohol dependent drinking.

Corbin Daniel Ester
Bethany Stangl
Aruna Gogineni
Lauren Blau
Vatsalya Vatsalya
Vijay Ramchandani

Journal of Clinical and Translational Science


The new frontier: social media’s influence on farming practices in the Brazilian Amazon

Abstract: Social media has the potential to reshape rural agriculture in developing nations in ways that differ from other Information and Communication Technologies (ICTs) because the communication method is mediated through social capital that expands and strengthens relationships. This paper uses two quasi-experimental approaches to estimate the impact of four different communication treatments (including three ICTs) on production practices of small-scale farmers in Rondônia, Brazil. Our difference-in-differences estimation controls for time-invariant unobservable differences in the characteristics of households that do and do not engage with ICTs and draws on a panel from 2009 and 2019. Our propensity score matching is estimated with over 1,200 farmer households surveyed in 2019. We find that the use of social media increases the uptake of both old and new pasture management and cattle practices that are promoted by state and federal agencies via their social media feeds. We also test the impact of the interaction between social media and extension agent visits and find evidence appear to operate independently, potentially as substitutes. Our results suggest that social media is an effective and low-cost way for extension agencies to reach farmers, although we are uncertain as to whether these effects would be stronger with targeted extension visits that use social media to reinforce messaging.

Cassandra Sevigny
Jill Caviglia-Harris
Thaís Ottoni Santiago
Katrina Mullan

Agricultural and Resource Economics Review

Agriculture (General)
Economic growth, development, planning


Frequency and correlates of suicidal ideation in preoperative cardiac surgery patients

Abstract:
Introduction
Depressive disorders are common for cardiac patients; however, a surgical intervention enhances their distress. How typical is suicidal ideation for cardiac surgery patients and with what clinical and psychological signs does it correlate?

Objectives
To estimate the frequency of suicidal ideation and correlations between suicidal ideation, clinical and psychological manifestations in cardiac surgery patients.

Methods
We examined 60 cardiac surgery patients, aged 25 – 65, prior to their operation. The Pierson correlation between manifestation of suicidal ideation, clinical and psychological signs was calculated with p<0.05.

Results

We revealed suicidal ideation in 3.33% of cardiac surgery patients. Its intensity credibly correlated with the frequency of taking alcohol (r=.32), as well as with manifestation of dysorexia (r=.59), dissatisfaction with life (r=.53), general level of depression (r=.49), sleeping disorders (r=.44), sense of guilt (r=.43), asthenia (r=.31), self-abhorrence (r=.29), and irritability(r=.29). A higher level of suicidal ideation correlated with a lower index of Positive-Past in their personal time perspective (r=-.27), which revealed itself in a patient having lack of positive impressions and recollections of their past life, which reduced a person’s adaptability in the present.

Conclusions
The frequency of suicidal ideation in preoperative cardiac surgery patients is not high. Nevertheless, we should bear in mind that high suicidal risk is characteristic for patients with not only depression, but also alcohol problems, as well as for those who have manifestations of negative attitude to their past.

Disclosure
No significant relationships.

O. Nikolaeva
E. Nikolaev
D. Hartfelder
E. Lazareva
S. Petunova
N. Grigorieva


Addressing the challenges of conducting community-engaged research during COVID-19: Rapid development and evaluation of a COVID-19 Research Patient and Community Advisory Board (PCAB) – CORRIGENDUM

J. Harrison
N. Palmer
A. Cabrera
P. Fleisher
E. Wong
M. LeSarre
K. Grumbach
J. Banta
L. Tealer
A. Reynolds
A. Wassmann
T. Rose
T. Nguyen


How to Manage Suicidal Risk at Digital Distance

Abstract: Suicide prevention remains very difficult to achieve for many reasons, notably because we do not have any indicator of risk prediction, short-term risk factors being little explored, and evaluations being retrospective they are biased. Furthermore, patients at risk are not followed up, because of their lack of confidence in care, stigma, shame. On the other hand, the gap observed during the covid19 pandemic between distress and less occurrence of suicides could be linked to more virtual contacts. Then, the smartphone might be a good tool to stay connected to a protective network. We will discuss the opportunity offered by the smartphone to monitor patients with ecological momentary assessment, allowing to better characterize their acute states and detect an increased risk in real time, and thanks to the ecological momentary intervention 24/7 availability, improve access to care and better coordinate resources, and encourage self-care. These tools while offering new solutions for an efficient real time suicide prevention, may also raise some ethical issues that should be addressed.


Identifying research priorities for psychosocial support programs in humanitarian settings

Abstract: Background.Given the range and reach of psychosocial support (PSS) interventions in humanitarian settings, within the continuum of mental health and psychosocial support services, evaluation of their impact is critical. Understanding stakeholders' perspectives on which PSS interventions of unknown effectiveness warrant rigorous evaluation is essential to identify research priorities. This project aimed to facilitate a process with stakeholders to reach consensus on PSS interventions that are of high priority for further research based on existing evidence and stakeholders' opinions.Methods.Interviews with 109 stakeholders working on PSS programming in humanitarian settings served as the foundation for two in-person regional meetings and four webinars. Nominal Group Technique (NGT) was used to develop a priority PSS program list. The top five priorities from each meeting were combined for a final online survey distributed globally.Results.Seventy participants across six meetings contributed to the prioritization process. Eighty-seven individuals completed the final online survey. ‘Community based PSS’ was the top-ranked research priority, followed by PSS integrated into basic services, providing PSS to caregivers to improve child wellbeing, PSS-focused gender-based violence programming, and classroom-based PSS interventions.Conclusions.NGT and online surveys were effective methods to engage stakeholders in a priority setting exercise to development a research agenda. Information from this stage of the project will be combined with findings from a concurrent systematic review to form the base of a second phase of work, which will include the development and implementation of a research strategy to strengthen the evidence base for those prioritized interventions.

C. Lee
A. J. Nguyen
E. Haroz
W. Tol
Y. Aules
P. Bolton

Neurosciences. Biological psychiatry. Neuropsychiatry


Isolating and Characterizing the Translatome From Human Alzheimer's Disease (AD) Brains

Abstract:
Aims
Local protein synthesis at the synapse is a key determinant of learning and memory and is predicted to be severely disrupted in Alzheimer's disease (AD). Omics approaches have played a key role in deciphering molecular mechanisms underlying AD pathology. However, isolating the transcriptome may be biased due to inherent variations in transcript levels, or by transcription-on-demand models employed by several genes, whereas mass-spec based proteomics approaches fail to capture low abundance peptides. The translatome bypasses these inherent limitations of other omics methods by capturing actively translating mRNA species trapped inside ribosomes and subjecting them to unbiased RNA-seq analysis capturing even very low abundance transcripts.

Methods
Isolating the neuronal ribosomes from human post-mortem brains without interference from non-neuronal cells remains a challenge. We used frozen brain tissue from Alzheimer's patients and healthy controls obtained from the Cambridge Brain Biobank. Synaptoneurosomal fractions were prepared using sucrose gradients in non-denaturing buffers with RNAse inhibitors to preserve ribosomal composition and trapped mRNA. We isolated functional ribosomes on affinity columns following recombinant RNAse digestion. Finally, actively translating ribosome-trapped mRNAs were sequenced using RNA-seq, aligned to human genome using STAR alignment and analysed for differential expression using DeSeq2 followed by pathway analysis.

Results
We have successfully isolated ribosome-associated RNA transcripts in the dendritic spines from cortical neurons of postmortem Alzheimer's brains with little interference from glial and non-neuronal material. The novel AD translatome disruptions identified by isolating endogenous ribosome bound mRNA will help detect downstream molecular targets. We will also integrate targeted translatome data with published transcriptome and GWAS DNA variant data to identify novel biomarkers.

Conclusion
This is the first successful isolation of the dendritic translatome from human postmortem AD brains. Future studies will verify functional significance of key targets using gain- and loss-of-function studies in animal models of AD and human iPSCs.


3283 Comparative Effectiveness of Levetiracetam versus Phenobarbital for Infants Aged One Month to One Year, using US Medicaid Claims

Abstract: OBJECTIVES/SPECIFIC AIMS: Using national Medicaid claims, this retrospective cohort study aims to compare the outcomes of levetiracetam (LEV) versus phenobarbital (PHB) as initial monotherapy in infants with epilepsy aged one month to one year. We primarily analyzed health services outcomes, as follows: (1) Emergency Department (ED) visits: proportion of those with at least 1 ED visit, time to first ED visit, total number of ED visits, proportion leading to inpatient admission (2) Inpatient Admissions: proportion of those with at least 1 admission, time to first admission, total number of inpatient admissions, total length of stay (3) Treatment discontinuation: proportion of those who discontinued medication, time to discontinuation, proportion of those with prescription of second antiepileptic drug (AED) (4) Cost: total cost at 1 year from first prescription. METHODS/STUDY POPULATION: The project is a retrospective cohort study utilizing Medicaid claims from 2009-2012 from all states and DC. Inclusion criteria were: (1) Epilepsy diagnosis (ICD9 345.x) at age 1 month to 1 year (2) 1 year of continuous Medicaid enrollment Exclusion criteria were: (1) Neither LEV nor PHB monotherapy as initial treatment (2) Neither LEV nor PHB prescription within 45 days of epilepsy diagnosis (3) Less than 1 year of follow-up after first LEV or PHB prescription (4) Infantile Spasms diagnosis (5) Brain Surgery (6) Death within 1 year of follow-up Using R for statistical analysis, we analyzed outcomes including ED visits, inpatient admissions, treatment discontinuation, and total cost. In this abstract, we present our preliminary bivariate analysis. RESULTS/ANTICIPATED RESULTS: Demographics and Etiology: Compared to infants prescribed PHB (n = 1954), infants prescribed LEV (n = 1248) were older (median 6 months [IQR 3-9] vs 3[2-6]; p < 0.001), more likely to be white (44.2% vs 38.9%; p < 0.05) and not Hispanic (63.5% vs 58.9%; p<0.05). There were also important differences in epilepsy etiologies (p < 0.05). For example, infants prescribed LEV were more likely to have a diagnosis of tuberous sclerosis (1% vs 0.15%) or traumatic brain injury (12.8% vs 0.56%). Health Services Outcomes: After 1 year, infants prescribed LEV had more ED visits (2 [0-4] vs 1 [0-3]; p < 0.001) but shorter inpatient length of stay when admitted (3 days [2-5] vs 3 [2-6]; p < 0.001). They were less likely to discontinue the medication (46.6% vs 64.3%; p<0.001) but more likely to have a second AED prescription (53.3% vs 43.4%; p < 0.001). Other outcomes, including total cost, were similar. DISCUSSION/SIGNIFICANCE OF IMPACT: This preliminary analysis suggests that the healthcare trajectory of infants treated with LEV and PHB differ in complex ways. In ongoing work, we are conducting a multivariable comparative effectiveness analysis of LEV versus PHB using propensity score weighting to account for observable selection bias and multiple imputation to account for missing data.

Michelle Yun
Manyao Zhang
Alan Wu
Natasha Basma
Zachary Grinspan


Readmission of Patients to Acute Psychiatric Hospitals: Determining Factors and Interventions to Reduce Inpatient Psychiatric Readmission Rates.

Abstract:
Introduction
Appropriate and adequate treatment of psychiatric conditions in the community or at first presentation to the hospital may prevent rehospitalization. Information about hospital readmission factors may help to reduce readmission rates.
Objectives
The scoping review sought to examine the readmission of patients to acute psychiatric hospitals to determine predictors and interventions to reduce psychiatric readmission rates.
Methods
A scoping review was conducted in eleven bibliographic databases to identify the relevant peer‐reviewed studies. Two reviewers independently assessed full‐text articles, and a screening process was undertaken to identify studies for inclusion in the review. PRISMA checklist was adopted, and with the Covidence software, 75 articles were eligible for review. Data extraction was conducted, collated, summarized, and findings were reported.
Results
The outcome of the review shows that learning disabilities, developmental delays, and alcohol, drug, and substance abuse, were crucial factors that increased the risk of readmission. It was also established through the review that greater access to mental health services in residential treatment and improved crisis intervention in congregate care settings were indicated as factors that reduce the risk of readmission.
Conclusions
High rates of readmission may adversely impact healthcare spending. This study suggests a need for focused health policies to address readmission factors and improve community‐based care.
Disclosure of Interest
None Declared

E. Owusu
N. Nkire
F. Oluwasina
M. A. Lawal
V. I. Agyapong


Introduction to the Symposium on B.S. Chimni, “Customary International Law: A Third World Perspective”

Comparative law. International uniform law

Private international law. Conflict of laws


A general theory of glacier surges

Abstract: We present the first general theory of glacier surging that includes both temperate and polythermal glacier surges, based on coupled mass and enthalpy budgets. Enthalpy (in the form of thermal energy and water) is gained at the glacier bed from geothermal heating plus frictional heating (expenditure of potential energy) as a consequence of ice flow. Enthalpy losses occur by conduction and loss of meltwater from the system. Because enthalpy directly impacts flow speeds, mass and enthalpy budgets must simultaneously balance if a glacier is to maintain a steady flow. If not, glaciers undergo out-of-phase mass and enthalpy cycles, manifest as quiescent and surge phases. We illustrate the theory using a lumped element model, which parameterizes key thermodynamic and hydrological processes, including surface-to-bed drainage and distributed and channelized drainage systems. Model output exhibits many of the observed characteristics of polythermal and temperate glacier surges, including the association of surging behaviour with particular combinations of climate (precipitation, temperature), geometry (length, slope) and bed properties (hydraulic conductivity). Enthalpy balance theory explains a broad spectrum of observed surging behaviour in a single framework, and offers an answer to the wider question of why the majority of glaciers do not surge.

D. I. Benn
A. C. Fowler
I. Hewitt
H. Sevestre

Environmental sciences
Meteorology. Climatology


159 Community Engagement (CE) Brokers: Diversity and the Science of CE

Abstract: OBJECTIVES/GOALS: Since 2013, managers of community engagement (CE) programs across the Clinical and Translational Science Award (CTSA) consortium funded by the National Center for Advancing Translational Sciences (NCATS) have convened monthly to build connections, share knowledge, and enable collaboration. METHODS/STUDY POPULATION: Notable for focus on staff leadership, the CE Brokers group has been central to the ongoing success of CTSA community engagement partnerships and approaches to research. In early 2022, a survey of the 139-member group asked about their roles and responsibilities, the ways the CE Brokers network has contributed to their hubs adoption and development of best practices and innovations, resources and lessons learned, and the creation of opportunities for members to collaboratively conduct and disseminate original research, and research on the science of community engagement. The survey also asked CE Brokers if they or their community partners are part of an underrepresented community. RESULTS/ANTICIPATED RESULTS: These demographic data will be shared, along with analyses of data on growth of the group over time, evolving themes, and a SWOT analysis completed in 2021. DISCUSSION/SIGNIFICANCE: This will provide a platform to explore new avenues for the CE Brokers and their impact within the NCATS CTSA consortium, in line with the evolving direction of the clinical and translational research enterprise.

Patricia Piechowski
Gina Claxton
Nicola Spencer
Elizabeth Vasile
Robynn Zender


Suicidal behavior and Autism Spectrum Disorder, what are the risk factors? – Case Report

Abstract:
Introduction
Autism is a neurodevelopmental disorder characterized by deficits in the ability to initiate and maintain social interaction, as well as a set of restricted and inflexible behavior patterns and interests. Individuals with Autism Spectrum Disorder (ASD) are at increased risk of suicidal behavior, including suicidal ideation, suicide attempts and death by suicide, as compared to the general population. Among the underlying causes, the co-occurrence of other psychiatric disorders, such as depression and anxiety, is common and can contribute to the reduction of the quality of life, as well as a worse prognosis of the disease.
Objectives
Case report and brief review of risk factors associated with suicidal behavior in individuals with ASD.
Methods
Review of the patients clinical file; Brief non-sistematic literature review of articles indexed to Pubmed with the key words: “Autism Spectrum Disorder”, “Suicide”, ”Suicidal behaviour”, ”Mood disorder”.
Results
J., 18 years old, male, with ASD, the best student at school, with above-average results since childhood. Two years ago he showed a non-reciprocal love interest. Since then, he has had multiple visits to the emergency department and successive hospitalizations, mostly because of mood and behaviour alterations, with suicidal ideation. After 1 month with depressive and anxious symptoms, he ended up making a suicide attempt through voluntary intoxication by prescribed medication. He was taken to the emergency room. Examination of mental status highlighted depressed mood, elevated anxiety levels, hypoprosody, and active suicidal ideation. Blood tests and CE-CT scan without changes. He was admitted in the psychiatry ward and treated with fluvoxamine, risperidone and lorazepam. He showed a good evolution of the psychopathological condition. Discharged at day 44, he was referred to a psychiatric and psychological outpatient clinics.
Conclusions
Mood disorders have a significant impact on the well-being of individuals with ASD, contributing to a worse quality of life and higher suicide mortality. Cognition has been associated with different levels of death by suicide, and individuals with ASD without intellectual disability, such as this patient, are at increased risk of suicide, which may be due to a greater awareness of their own difficulties. The role of genetics has been a subject of interest. The overlap of genes strongly associated with suicidal behavior and ASD has been described. However, there is still need of large scale genetic studies, for a better understanding of the genetic mechanisms involved in this association. The identification of vulnerable individuals and early initiation of preventive and therapeutic strategies is essential to improve the prognosis of ASD.
Disclosure of Interest
None Declared

C. Bayam
M. Tomé
C. Pedro
F. Cordeiro
M. J. Piçarra
L. Vale


63 Correlation between gait performance and global cognitive functions in senior adults: A systematic review

Abstract: Objectives/Goals: Gait performance (GP) and global cognitive functions (GCF) are both critical for maintaining independence and quality of life in senior adults. Recent studies have explored the potential link between GP and GCF, encompassing executive functions. Methods/Study Population: PRISMA guidelines will govern this systematic review. This systematic review synthesizes published research from 2000 to 2024, including peer-reviewed articles, pilot studies, and randomized controlled trials, to examine the relationship between GP (how a person walks and stands) and GCP in older adults. The exclusion criteria will be based on studies focused on physical activities unrelated to balance, meta-analysis, and systematic reviews and those published in languages other than English or Spanish. Results/Anticipated Results: Our preliminary data indicate that gait, or walking speed, is significantly correlated with GCP in older adults, with slower walking associated with poorer global cognition. Specifically, gait speed during dual-task walking shows a strong correlation with working memory (p < .001) and processing speed (p < .05) in individuals aged over 60 years. Gender differences were observed, with women over 80 walking slower than men over 85 years, who walked faster, and women exhibited poorer global cognition than men. Discussion/Significance of Impact: Overall, a gait slowing between 0.68 and 1.1 m per second could predict a marker for the risk of developing dementia, indicating that monitoring gait speed in older adults may provide early warning signs, allowing for timely interventions. Enhancing GP and GCF can improve the quality of life and independence in older adults. Acknowledgments: Research supported by NIH: Award Number HCTRECD R25MD007607 from the NIMHD.

Joel Acevedo
Joel Acevedo-Nieto
P Karen Martínez
Claudia Amaya
Kun Liu


Equality in healthcare: transcultural psychiatry

Abstract:
Introduction
Migratory flows are increasing more and more, especially regarding the refugee crisis during the last years. There are around 86,7 million migrants in Europe. Migrants share similar experiences that may affect their physical and mental health, such as loss of a social network, lack of economical support or high levels of stress and discrimination.

Objectives
To analyze the obstacles that migrants must face to obtain a mental health assistance and the importance of an intercultural approach.

Methods

A narrative review of the existing literature on the subject.

Results
Although there exists evidence that shows that migrants tend to have more health needs, they usually seek less medical advice and receive a poor-quality attention, fulfilling the inverse-care law. This is due to several reasons. Many migrants are excluded of the health care system due to bureaucratic impediments. Also, the language has a determining role, since a higher quality of communication could lead to a better understanding of the symptoms, reducing the risk of erroneous evaluations. Besides, different background and culture between the patient and the doctor can result in lack of communication, mistrust, mistreatment, poor adherence, and worse prognosis.

Conclusions
Despite the exponential growth of migration in the last decade and the continue progression, migrants still face many barriers to receive healthcare. It is necessary to do more research on the mental health of migrants and ethnic minorities to ensure quality care to different cultures.

Disclosure
No significant relationships.


Working memory after and during 6 Hz transcranial alternating current stimulation

Abstract:
Introduction
Transcranial alternating current stimulation (tACS) is a non-invasive brain stimulation technique allowing to induce changes in oscillatory activity. Theta activity has been reported to play a major role in maintenance of information in working memory (WM).

Objectives
The current study had the initial goal to check the effect of theta tACS on accuracy and resting state EEG in a set of match-to-sample WM tasks.

Methods
In the first experiment, we tested 31 participants in the WM task after 20-min tACS applied at Fpz and CPz at 6 Hz, 1 mA.). In the second experiment, we compared the after-effects and online effects of the stimulation in a sample of 25 individuals. Five similar 25-min blocks filled with the same working memory task were distributed over 3 days. We assessed the same group of participants in all three sessions. On the Training day, the participants performed one block without stimulation. On the Sham-Verum day (SV), the first block with Sham stimulation followed by the second block with Verum stimulation. On the Verum-Sham day (VS), the blocks order reversed.

Results
After-effects of the stimulation did not produce any significant changes either in behavior (accuracy in the task) or resting-state EEG (theta frequency band spectral power in the first experiment. In the second experiment, 6 Hz tACS delivered before the WM task was not able to produce any observable changes in working memory performance. The same hold true for online stimulation.

Conclusions
Theta frequency tACS applied to Fpz-CPz electrodes is not an efficient method to improve WM.


Enhancing community engagement in Patient-Centered Outcomes Research: Equipping learners to thrive in translational efforts

Abstract: Community engagement is a critical component of translational research. Innovative educational approaches to support meaningful involvement of stakeholders in clinical research allows for bidirectional learning and greater engagement in translational efforts. Our Penn State Community-Engaged Research Core (CeRC) team has developed an innovative research curriculum for a variety of stakeholders, including patient partners, organizational representatives, and Community Health Workers (CHWs). This brief report will outline unique curricular approaches, guided by adult learning principles, to enhance stakeholder education and engagement in activities. Initial evidence of impact on learning is also reported.

Jennifer M. Poger
Andrea E. Murray
Emily A. Schoettler
Evelyn S. Marin
Betsy B. Aumiller
Jennifer L. Kraschnewski


Wearable armband with a floating mobile exploratory electrode at fingertip for on-demand touch-and-measure multilead electrocardiography

Abstract: Spurred by the global pandemic, research in health monitoring has pivoted towards the development of smart garments, enabling long-term tracking of individuals’ cardiovascular health by continuously monitoring the electrocardiogram (ECG) and detecting any abnormality in the signal morphology. Many types of dry electrodes have been proposed as alternatives to gold standard Ag/AgCl wet electrodes, and they have been integrated into clothes capable of acquiring only a limited number of the different ECG traces. This limitation severely diminishes the diagnostic utility of the collected ECG data and obstructs the garment’s potential for clinical-level evaluation. Here, we demonstrate a special ECG upper armband with a glove component which houses graphene-textile electrodes, where a fully mobile, exploring electrode located at the index finger enables the user to strategically position the electrode on-demand to desired body areas and measure the different ECG traces that are bipolar limb and unipolar chest leads. Based on measurements with and without employing the well-known Wilson Central Terminal (WCT) arrangement, the correlation ratio of unipolar ECG chest leads acquired with the graphene textile-based armband and Ag/AgCl electrodes both in “WCT-less” configuration reach up to %99.65; and up to %99.54 when Ag/AgCl electrodes are utilized “with WCT” while the graphene-based armband in “WCT-less” configuration. To the authors’ best knowledge, this study reports the first multilead on-demand “touch-and-measure” ECG recording from a fully wearable textile garment. Moreover, owing to the human-centered armband design, we achieved a more than three-fold reduction in electrode count from 10 in clinical ECG practice down to 3.

Saygun Guler
Emre Aslanger
Murat Kaya Yapici

Mechanical engineering and machinery
Electronics


3574 Effect modification between kidney function and adiposity in the association with central and peripheral insulin sensitivity among Nondiabetic patients with moderate Chronic Kidney Disease and Healthy Controls

Abstract: OBJECTIVES/SPECIFIC AIMS: The main aim of this study was to investigate the interaction between glomerular filtration rate (GFR) and body mass index (as well as serum leptin) as determinants of peripheral and central insulin sensitivity (IS). METHODS/STUDY POPULATION: This was a cross-sectional investigation of 140 nondiabetic participants – 56 with CKD (GFR = 15-59 ml/min/1.73m2) and 94 with normal GFR (≥ 60 ml/min/1.73m2) – recruited as part of the relationship of insulin sensitivity in kidney disease and vascular health (RISKD) study. Peripheral (skeletal muscle) and central (hepatic) IS were assessed with the hyperinsulinemic euglycemic glucose clamp (HEGC) and homeostasis assessment of insulin resistance (HOMA-IR) respectively. Creatinine-based estimated GFR (eGFR) was obtained using the CKD-EPI equation and body mass index (BMI) was computed from baseline weight and height measurements. Linear regression models with robust standard errors (to relax homoscedasticity assumptions) and interaction terms were used to investigate GFR and BMI as predictors of HEGC-derived insulin sensitivity index (ISI) and HOMA-IR. RESULTS/ANTICIPATED RESULTS: The mean (SD) age was 53.9 (14.5) years; 50.7% were female and 36.7% were African-American. Compared to controls, CKD patients had significantly lower mean (SD) ISI [5.4 (3.2) vs. 3.1 (1.6), p < 0.0001]. Log ISI was positively correlated (r = 0.39, p < 0.0001) with eGFR and inversely correlated (−0.30, p < 0.0001) with BMI and log leptin (−0.42, p < 0.0001). In multivariable models adjusted for age, sex and race, a 10 ml/min/1.73m2 lower eGFR was associated with a greater decrease in ISI among non-obese (0.48; 95% CI: −0.25, −0.70) compared to obese participants (−0.18; 95% CI: −0.02, −0.35) (p-interaction = 0.04). Patients with low eGFR (in particular, the lower margin of the CKD stage 3 range, 30ml/min) had lower ISI even with BMI within normal range (Figure 1a). At higher eGFR, BMI had a greater impact on ISI. P-interaction = 0.046, for differential BMI effects at lower vs. higher eGFR. Log HOMA-IR was inversely correlated with eGFR (r = - 0.49, p < 0.0001) and positively correlated with BMI (r = 0.52, p < 0.0001) and log leptin (0.46, p < 0.0001). HOMA-IR was lower for persons with higher GFR compared to lower GFR, at any BMI value. For example, at a BMI of 30 and a GFR of 120, HOMA-IR was 1.2 compared to 4.8 at a GFR of 30 (Figure 1b). Also, persons with high GFR had low HOMA-IR even with BMI in the obese range. BMI had a greater effect on HOMA-IR at lower eGFR. P-interaction = 0.005, for differential BMI effects at lower vs. higher eGFR. Similar findings were obtained when using log leptin in lieu of BMI in models for ISI and HOMA-IR. DISCUSSION/SIGNIFICANCE OF IMPACT: Measures of adiposity (BMI and leptin) and GFR were independently predictive of insulin sensitivity (IS) but the magnitude of the effect of BMI (or leptin) on IS varied significantly across GFR levels and type of IS (peripheral versus central). The effect of BMI on central IS (HOMA-IR) was more pronounced at lower GFR with small changes in BMI translating into greater variations in IS. Conversely, at low GFR, peripheral IS (ISI) is less affected by BMI. Persons with GFR at the lower margin of the CKD stage 3 range were significantly insulin resistant (low ISI) regardless of their BMI. More studies are required to further elucidate these interaction patterns for central and peripheral IS.

Elvis Akwo
Aseel Alsouqi
Edward Siew
Alp Ikilzer
Adriana Hung


Effectiveness of 2,4-D/dicamba/dichlorprop-p premixture for controlling glyphosate-resistant kochia (Bassia scoparia L.) in Central Great Plains

Abstract: Widespread evolution of glyphosate resistance among kochia populations is a serious challenge for growers across the North American Great Plains. Dicamba has historically been used to control glyphosate-resistant (Gly-R) kochia. However, the increasing spread of dicamba-resistant kochia and current restrictions on dicamba use (low volatile formulations) warrant alternative herbicide options to control Gly-R kochia. In this context, field-based dose response experiments were conducted in fallow at Kansas State University Agricultural Research Center, Hays, KS, during 2021 and 2022 to determine and compare the effectiveness of 2,4-D, dicamba, and dichlorprop-p applied alone, and in a premixture of 2,4-D/dicamba/dichlorprop-p for controlling Gly-R kochia. Averaged across two years, results indicated that substantially lower doses of 2,4-D, dicamba, and dichlorprop-p were required in a premixture to achieve effective control of Gly-R kochia compared with their standalone applications. Specifically, the ED90 values for Gly-R kochia control were reduced by 90-, 4-, and 6-times for 2,4-D, dicamba, and dichlorprop-p, respectively, when applied as a premixture. Similarly, achieving 90% biomass reduction required approximately 1021-, 3-, and 4-times lower doses of 2,4-D, dicamba, and dichlorprop-p, respectively, in the premixture than when applied alone. Altogether, these results demonstrated that the premixture of 2,4-D/dicamba/dichlorprop-p can be an effective alternative for managing Gly-R kochia in fallow. The reduced dose requirements in a premixture also suggested potential benefits for resistance management, cost efficiency, and environmental stewardship.


Mediterranean Diet Score and prostate cancer risk in a Swedish population-based case–control study

Abstract: Several individual components of the Mediterranean diet have been shown to offer protection against prostate cancer. The present study is the first to investigate the association between adherence to the Mediterranean diet and the relative risk of prostate cancer. We also explored the usefulness of the Mediterranean Diet Score (MDS) in a non-Mediterranean population. FFQ data were obtained from 1482 incident prostate cancer patients and 1108 population-based controls in the Cancer of the Prostate in Sweden (CAPS) study. We defined five MDS variants with different components or using either study-specific intakes or intakes in a Greek reference population as cut-off values between low and high intake of each component. Unconditional logistic regression was used to estimate the relative risk of prostate cancer for high and medium v. low MDS, as well as potential associations with the individual score components. No statistically significant association was found between adherence to the Mediterranean diet based on any of the MDS variants and prostate cancer risk (OR range: 0·96–1·19 for total prostate cancer, comparing high with low adherence). Overall, we found little support for an association between the Mediterranean diet and prostate cancer in this Northern European study population. Despite potential limitations inherent in the study or in the build-up of a dietary score, we suggest that the original MDS with study-specific median intakes as cut-off values between low and high intake is useful in assessing the adherence to the Mediterranean diet in non-Mediterranean populations.

Elisabeth Möller
Carlotta Galeone
Therese M.-L. Andersson
Rino Bellocco
Hans-Olov Adami
Ove Andrén
Henrik Grönberg
Carlo La Vecchia
Lorelei A. Mucci
Katarina Bälter

Nutrition. Foods and food supply
Medicine


Surface meltwater drainage and ponding on Amery Ice Shelf, East Antarctica, 1973–2019

Abstract: Surface melting on Amery Ice Shelf (AIS), East Antarctica, produces an extensive supraglacial drainage system consisting of hundreds of lakes connected by surface channels. This drainage system forms most summers on the southern portion of AIS, transporting meltwater large distances northward, toward the ice front and terminating in lakes. Here we use satellite imagery, Landsat (1, 4 and 8), MODIS multispectral and Sentinel-1 synthetic aperture radar to examine the seasonal and interannual evolution of the drainage system over nearly five decades (1972–2019). We estimate seasonal meltwater input to one lake by integrating output from the regional climate model [Regional Atmospheric Climate Model (RACMO 2.3p2)] over its catchment defined using the Reference Elevation Model of Antarctica. We find only weak positive relationships between modeled seasonal meltwater input and lake area and between meltwater input and lake volume. Consecutive years of extensive melting lead to year-on-year expansion of the drainage system, potentially through a link between melt production, refreezing in firn and the maximum extent of the lakes at the downstream termini of drainage. These mechanisms are important when evaluating the potential of drainage systems to grow in response to increased melting, delivering meltwater to areas of ice shelves vulnerable to hydrofracture.

Julian J. Spergel
Jonathan Kingslake
Timothy Creyts
Melchior van Wessem
Helen A. Fricker


Maintenance efficacy designs in psychiatry: Randomized discontinuation trials – enriched but not better

Abstract:
               Introduction
               Although classical randomized clinical trials (RCTs) are the gold standard for proof of drug efficacy, randomized discontinuation trials (RDTs), sometimes called “enriched” trials, are used increasingly, especially in psychiatric maintenance studies.

               Methods
               A narrative review of two decades of experience with RDTs.

               Results
               RDTs in psychiatric maintenance trials tend to use a dependent variable as a predictor: treatment response. Treatment responders are assessed for treatment response. This tautology in the logic of RDTs renders them invalid, since the predictor and the outcome are the same variable. Although RDTs can be designed to avoid this tautologous state of affairs, like using independent predictors of outcomes, such is not the case with psychiatric maintenance studies
               Further, purported benefits of RDTs regarding feasibility were found to be questionable. Specifically, RDTs do not enhance statistical power in many settings, and, because of high dropout rates, produce results of questionable validity. Any claimed benefits come with notably reduced generalizability.

               Conclusions
               RDTs appear to be scientifically invalid as used in psychiatric maintenance designs. Their purported feasibility benefits are not seen in actual trials for psychotropic drugs. There is warrant for changes in federal policy regarding marketing indications for maintenance efficacy using the RDT design.


Past, Present, and Future of Involuntary Admission in Georgia

Abstract: Since gaining independence in 1991, Georgia has struggled to transform the old-Soviet mental health care structure into a humane system to meet basic human rights standards.


Understanding Nigeria’s antibiotic resistance crisis among neonates and its future implications

Abstract: Abstract A well-documented mounting public health crisis is the antibiotic crisis, which is most significantly felt in low-resource countries like Nigeria. This article sheds light on the rising level of antibiotic resistance in newborns in Nigeria, a trend that poses a severe threat to neonatal survival and public health at large. A thorough database search was carried out using terms associated with antibiotic resistance in Nigerian neonates, including PubMed, Google Scholar, and other scholarly sources. Only original research conducted between the start of the study and June 2024 was included; articles without an English translation were not. Independent reviewers handled data management and screening. There has been an increasing prevalence of sepsis among newborns primarily due to Gram-negative bacteria, which highlights the urgency and need to be addressed. Studies show a significant rise in multi-drug-resistant infections, with almost half of Escherichia coli and 86% of Staphylococcus aureus strains among newborns resistant to conventionally used antibiotics like penicillin. Some reasons for the continuous trend include but are not limited to unregulated antibiotic purchase and use, inadequate surveillance systems, and cultural determinants and socioeconomic issues. Effective strategies are needed to curb the neonatal antibiotic crisis in Nigeria. This problem can be mitigated by enhancing public education, strengthening healthcare infrastructure, advocating for better maternal health, and promoting the rational use of antibiotics. Additionally, more research into non-antibiotic medications and understanding the barriers to compliance need to be addressed.

Victor Oluwatomiwa Ajekiigbe
Ikponmwosa Jude Ogieuhi
Temiloluwa Adebayo Odeniyi
Praise Oluwatobi Ogunleke
Josiah Temitope Olatunde
Adedoyin Veronica Babalola
Akintunde Abisoye Omoleke
Tolulope Felix Omitade
Damilare Emmanuel Olakanmi
Adewunmi Akingbola
Chidera Stanley Anthony


A game-theoretic sequential three-way decision using probabilistic rough sets and multiple levels of granularity

Abstract: Abstract The sequential three-way decision accepts additional information at each level and makes more accurate definite decisions with less uncertainty. This process can also be extended to two-way classification with the finer-grained information level. However, both the decision process cost and decision result cost of the model must be considered for optimal performance. The proposed model adapts the game-theoretic approach to deal with the trade-off between the decision process cost and the decision result cost, and thereby balance the number of levels of the model. The time complexity, information level, and feature importance contribute to the process cost while evaluation metrics stand for the result cost. The model starts with reliable initial results by using the most significant features at the first level itself and follows an objective function-based method to determine threshold pairs at each level, which avoids relying on domain experts. Furthermore, if the process cost outweighs the result cost, the number of levels is adjusted accordingly. Using the experimental datasets, instances are classified at each level at the optimal threshold pairs; therefore the trisection is obtained with the highest precision/recall value. The obtained results prove that the proposed model outperforms existing models in terms of precision, recall, and time complexity with balanced decision costs. In summary, the proposed model is cost-efficient, interpretable, termination-aware, and result-oriented, ensuring effective and practical decision-making.


Deficient DNA mismatch repair and Nectin-4 expression in upper tract urothelial carcinoma (UTUC)

Abstract: Abstract Purpose To investigate the prevalence of deficient DNA mismatch repair (dMMR) status in upper tract urothelial carcinoma (UTUC) and its association with clinicopathological characteristics as well as Nectin-4 immunohistochemical expression. Methods We retrospectively identified histologically confirmed UTUC cases treated at Peking University Third Hospital between December 2016 and September 2023. Eligible participants were required to also possess complete clinicopathological records and available formalin-fixed, paraffin-embedded (FFPE) tumor specimens suitable for immunohistochemical evaluation. MMR protein expression was categorized as either dMMR or proficient mismatch repair (pMMR), while Nectin-4 expression was quantitatively assessed using the H-score system. Samples were then classified as negative (H-score 0–14), low (H-score 15–99), medium (H-score 100–199), and high (H-score 200–300). Statistical significance was established at P < 0.05 using two-tailed tests. Results A total of 339 patients were deemed eligible, with specimens successfully evaluated. 25 patients (7.4%) demonstrated dMMR status. High Nectin-4 expression was observed in 124 patients (36.7%). A statistically significant association was identified between dMMR status and elevated Nectin-4 expression (P = 0.044). No significant differences were detected between dMMR and pMMR groups regarding clinical parameters, including gender, age, tumor grade, or immunophenotypic characteristics. Conclusion Our study revealed that 7.4% of UTUC patients exhibited dMMR status, with heterogeneous Nectin-4 expression observed across the cohort. Notably, we demonstrated a statistically significant correlation between dMMR status and elevated Nectin-4 expression, suggesting potential biological interplay. The combined biomarker profile warrants further investigation as a predictive tool for therapeutic strategies involving antibody–drug conjugates (e.g., enfortumab vedotin) and immune checkpoint inhibitors.

Peichen Duan
Le Yu
Yichang Hao
Shaohui Deng
Peng Hong
Min Lu
Shudong Zhang

Journal of Cancer Research and Clinical Oncology

Neoplasms. Tumors. Oncology. Including cancer and carcinogens


Lattice-based ring signcryption for consortium blockchain

Abstract: Ring signcryption with no group administrator satisfies the decentralization and blockchain anonymity. In this article, we construct new lattice-based ring signcryption scheme suitable for consortium blockchain (CB-LRSCS), in which the smart contract controls the process of signcryption and unsigncryption to make the system be fair and reliable. CB-LRSCS can protect the user privacy by reducing the connection between blockchain and user information, and it satisfies the reliability in ethereum environment. CB-LRSCS also has the characteristics of high efficiency, anti-quantum, anti-forgery, confidentiality and unconditional anonymity, and it can be applied in the electronic finance system.

Journal of King Saud University: Computer and Information Sciences


CL-BPUWM: continuous learning with Bayesian parameter updating and weight memory

Abstract: Abstract Catastrophic forgetting in neural networks is a common problem, in which neural networks lose information from previous tasks after training on new tasks. Although adopting a regularization method that preferentially retains the parameters important to the previous task to avoid catastrophic forgetting has a positive effect; existing regularization methods cause the gradient to be near zero because the loss is at the local minimum. To solve this problem, we propose a new continuous learning method with Bayesian parameter updating and weight memory (CL-BPUWM). First, a parameter updating method based on the Bayes criterion is proposed to allow the neural network to gradually obtain new knowledge. The diagonal of the Fisher information matrix is then introduced to significantly minimize computation and increase parameter updating efficiency. Second, we suggest calculating the importance weight by observing how changes in each network parameter affect the model prediction output. In the process of model parameter updating, the Fisher information matrix and the sensitivity of the network are used as the quadratic penalty terms of the loss function. Finally, we apply dropout regularization to reduce model overfitting during training and to improve model generalizability. CL-BPUWM performs very well in continuous learning for classification tasks on CIFAR-100 dataset, CIFAR-10 dataset, and MNIST dataset. On CIFAR-100 dataset, it is 0.8%, 1.03% and 0.75% higher than the best performing regularization method (EWC) in three task partitions. On CIFAR-10 dataset, it is 2.25% higher than the regularization method (EWC) and 0.7% higher than the scaled method (GR). It is 0.66% higher than the regularization method (EWC) on the MNIST dataset. When the CL-BPUWM method was combined with the brain-inspired replay model under the CIFAR-100 and CIFAR-10 datasets, the classification accuracy was 2.35% and 5.38% higher than that of the baseline method, BI-R + SI.

Yao He
Jing Yang
Shaobo Li
Jianjun Hu
Yaping Ren
Qing Ji

Electronic computers. Computer science
Information technology


A short review on water management and reuse in textile industry – a sustainable approach

Abstract: Abstract The textile industry is one of the important and largest industry that consumes major chunk of the water in the world. This industry produces a large amount of wastewater during the processes such as sizing, de-sizing, scouring, bleaching, mercerizing, dyeing, printing, and finishing. The used water produced after such processes affects the environment heavily due to its composition such as mineral salts and oils present in suspended state, metals and metal complexes, dyes, various chemicals, some readily-biodegradable products and some constituents that are hard to biodegrade. The treatment of such hazardous effluent to reuse the water in certain water demanding processes is essential. Considering the worldwide application of the textiles, the appropriate management of water resources in the sector includes the treatment of effluent by efficient technology and the reuse of the water. This article displays an overview of waste management during textile industrial processes. It aims at giving oversight on waste minimization and reuse along with wastewater treatment methods. It also involves the cross-utilization of effluent between processes for achieving water efficiency. This review covers advanced waterless textile dyeing processes, zero liquid discharge techniques, advanced oxidation processes, biological treatment methods, which can be a sustainable and greener approach to reducing the waste generation.

Nitin Thombre
Pritesh Patil
Ankita Yadav
Anand Patwardhan

Water supply for domestic and industrial purposes


Outcomes of primary gastrointestinal diffuse large B cell lymphoma in the rituximab era

Abstract: Abstract Background Primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) constitutes 30%-40% of primary extranodal lymphomas. While rituximab has significantly improved survival in nodal DLBCL, its impact on the prognosis of PGI-DLBCL remains inadequately defined. This study aimed to compare the survival outcomes of PGI-DLBCL patients between the pre-rituximab and rituximab eras. Methods We identified all PGI-DLBCL cases from the Surveillance, Epidemiology, and End Results (SEER) registry (1975–2015). Patients were categorized into pre-rituximab (diagnosed before 2006) and rituximab-era (diagnosed in or after 2006) groups. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between the two groups. Results Among 2780 patients, median age was 68 years; 72.2% had stage I/II disease. The rituximab-era group showed significantly longer median OS (119 months vs. 43 months, p < 0.0001). Median LSS was not reached in the rituximab era versus 115 months in the pre-rituximab group (p < 0.0001), with an 11-year LSS rate of 58%. Multivariable analysis confirmed that the rituximab era, younger age, early stage, and chemotherapy were associated with better OS and LSS. Conclusions PGI-DLBCL represents a significant subset of non-Hodgkin lymphomas and is the most prevalent type within the gastrointestinal tract. Younger age, female, Asian, marital status, early-stage and with chemotherapy, as well as the period of lymphoma diagnosis (rituximab era), are associated with better prognosis.

Luyao Zhang
Jianwen Zhou
Yanyan Sun
Yaodong Zhang
Tianhui Chen
RuoJin Ma
Chongjian Wang


Formation of surfaces oxide vacancies in porous ZnCo2O4 nanoflowers for enhanced energy storage performance

Abstract: Abstract A cost-effective and large-scale method for synthesizing ZnCo2O4 nanoflowers with surface oxygen vacancies as electrode materials for supercapacitors is presented. The existence of oxygen vacancies on the surface of the ZnCo2O4 nanoflowers has been confirmed through X-ray photoelectron spectroscopy (XPS). The energy bands and density of states (DOS) of ZnCo2O4 are examined using density functional theory, revealing that treatment with NaBH4 reduces the band gap of ZnCo2O4 while increasing the DOS near the Fermi level compared to pristine ZnCo2O4. Furthermore, the specific capacitance of reduced ZnCo2O4 is nearly double that of its unmodified counterpart. This straightforward and practical approach significantly enhances both conductivity and specific capacitance in metal oxides, making it applicable to other similar materials.

Deyang Zhang
Binhe Feng
Wenbo Guo
Jinbing Cheng
Kangwen Qiu
Ying Guo

Materials of engineering and construction. Mechanics of materials


Dynamic Characteristics of Aerosol Optical Properties over Dibrugarh City in the North-Eastern Indian Region during 2018–2021

Abstract: Abstract Aerosols play an important role in the earth’s environment across the globe through their involvement in various earth system cycles. The change in the aerosol properties may cause short and long-term impacts, the knowledge of such changes is useful in the estimation of the pollution sources of any region. We have carried out the analysis of the aerosols’ optical and radiative properties using AERONET station data from 2018 to 2021 in Dibrugarh City. The higher Aerosol Optical Depth (AOD) values during winter and pre-monsoon months indicate high anthropogenic activities, and biomass burning in Dibrugarh. The impact of various sources and daily meteorological parameters help in understanding the diurnal variations of the AOD, Ångström Exponent (AE), and column water (CW). Fine aerosol fractions dominate the aerosol volume, but sometimes the long-range transport of dust affects aerosol properties during pre-monsoon months (MAM). MODIS-derived AOD and AERONET AOD values show a good correlation, with R2 = 0.68. The highest volume of the aerosols reaches up to 0.11 µm3 µm−2 during pre-monsoon months, whereas it lies below 0.05 µm3 µm−2 in other seasons. SSA values indicate the presence of scattering aerosols but in 2020, a sudden decline in the SSA values shows a strong rise in the absorbing aerosols. Throughout the study period (2018–2021), the positive radiative forcing indicates a rise in atmospheric heating.

Akshansha Chauhan
Shukla Acharjee
Ramesh P. Singh
Brent Holben


Protective effects of ceria nanoclusters against delayed paraplegia after spinal cord ischemia

Abstract: Abstract Spinal cord ischemia reperfusion injury (SCIRI) induced delayed paraplegia is a complex complication of thoracoabdominal aortic surgery. Reactive oxygen species (ROS) play a critical role in the pathogenesis of delayed paraplegia, suggesting that antioxidants could be a promising therapeutic strategy. Ceria nanomaterials have demonstrated potent antioxidant properties and therapeutic potential in various central nervous system disorders. Herein, the preventive effects of ceria nanoclusters (NCs) against delayed paraplegia were investigated. NCs were synthesized using a facile and green method, incubated with albumin, and exhibited excellent biocompatibility and ROS scavenging activity in vitro, providing neuroprotective effects on neuronal cells. To explore the protective effects against delayed paraplegia in vivo, NCs were intravenously injected into SCIRI rabbits both before ischemia and after reperfusion. Post-reperfusion NCs treatment significantly preserved hindlimb motor function and reduced the incidence of delayed paraplegia. Histopathological and biochemical analyses revealed that NCs protected motor neurons, mitigated oxidative stress, and reduced apoptosis and inflammation in the ischemic spinal cord. These results showed that NCs successfully prevented the development of delayed paraplegia by eliminating excessive ROS.

Wang Yang
Ling Zou
Qianqian Wu
Lu Yang
Yonghui Wu
Qingshan Liu
Guangyou Shi
Renqing Jiang
Ying Xia
Jian Sun
Xiaochao Yang

Journal of Materials Science: Materials in Medicine


Understanding the psychosocial needs of breast cancer survivors in the United Arab Emirates: a qualitative study

Abstract: Abstract Background Breast cancer is the most common cancer among women in the United Arab Emirates; yet there is little known about the psychosocial concerns of the survivors. Research shows that meeting the psychosocial needs significantly contributes to cancer survivor’s wellbeing and potentially elevates the quality of the patient’s life. Therefore the study aims to understand the psychosocial needs of breast cancer survivors through a qualitative approach. Methods A qualitative study was conducted using semi structured in-depth interviews among ten breast cancer survivors. The recorded texts were coded and salient themes were generated using an inductive approach. Thematic analysis of the interviews was done observing for meaning, repeating phrases and keywords. Results Analysis yielded three major themes which included survivors’ living experience with breast cancer, concerns of breast cancer survivors and the survivors’ expectations of healthcare delivery or support needed. The breast cancer survivors had psychosocial concerns that are not well understood and addressed by the healthcare. The experiences, concerns and expectations differ from individuals and through the continuum of survivorship. Conclusion Understanding the unmet psychosocial concerns of the cancer survivors is essential to design a structured survivorship program and offer timely and effective interventions. This would improve survivorship care in the country and offers opportunities to redesign cancer services towards patient-centred care.

Maria Aamir
Mouza Al Ameri
Subhashini Ganesan
Fatima Alharmoudi
Anood Alshehhi
Fatima Alhashmi
Dina Alawlaqi
Flavia Martinez Cantarutti
Linda Dubrow-Marshall
Roderick Dubrow-Marshall
Walid Abbas Zaher


Unrevealing the dual role of paired box and sex determining region Y related high mobility group box in glioblastoma

Abstract: Abstract This narrative review summarises glioblastoma (GBM), a very frequent invasive kind of brain tumour in the elderly that is extremely aggressive, resistant to treatment, and has a bad prognosis because of its substantial genetic and cellular heterogeneity. With a median survival of about 15 months, GBM is still an incurable cancer. This review takes full 3 months for collect all relevant knowledge about PAX and SOX gene families, which have crucial roles in the biology of GBM, as shown by recent developments in molecular pathology. Depending on certain gene expression patterns, members of these transcription factor families have been shown to have both oncogenic and tumor suppressive properties. They are important regulators of brain development, stem cell maintenance, and tumor progression. While PAX6 functions as a tumor suppressor, preventing growth and angiogenesis, PAX3, PAX5, and PAX8 are increased in GBM, encouraging proliferation, stemness, and survival. Similarly, SOX7 and SOX11 act as suppressors, and their downregulation is associated with malignancy and a bad prognosis, while SOX2, SOX3, SOX4, and SOX9 increase tumor aggressiveness and resistance to treatment. Glioma cell migration, growth, and death inhibition are further fueled through the complex interactions between canonical and non-canonical WNT signaling that modulate PAX and SOX pathways. These results highlight how crucial thorough molecular profiling is for improved categorization, prognostication, and the creation of focused treatment plans in GBM. The discovery of the dual functions of the PAX and SOX genes in GBM highlights their potential as therapeutic targets and biomarkers, opening up new possibilities for more individualised and accurate treatment approaches.


Interpretability-preserving knowledge distillation via multi-granular feature alignment for resource-efficient CNNs

Abstract: Abstract The application of deep learning models in resource-constrained environments requires a trade-off among accuracy, efficiency, and interpretability a trilemma frequently neglected in conventional knowledge distillation (KD) approaches. This paper introduces an interpretable knowledge distillation framework that transcends these goals through three innovations: (1) multi-granular semantic alignment for hierarchical feature structure preservation, (2) attention-gated distillation to impose spatial reasoning consistency, and (3) concept activation preservation for human-interpretable decision logic. Measured on CIFAR-10 and CUB-200-2011 benchmark datasets, our method obtains 92% accuracy (99.57% retention) and 86.94% accuracy (89.54% retention), respectively, with 0.576 average saliency similarity to the teacher model. By lowering the complexity of the model by 13.7 $$\times $$ compression ratio without forgoing interpretability, our method facilitates the deployment of interpretable, resource-efficient models in safety-critical settings like medical diagnosis and ecological surveillance. This paper closes the performance explainability gap, pushing the frontiers of reliable AI for edge computing. This framework maintains competitive performance relative to dominant baselines, whilst also optimizing all three aspects of the trilemma, something which prior work has not tackled.


The immune suppressive microenvironment affects efficacy of radio‐immunotherapy in brain metastasis

Abstract: Abstract The tumor microenvironment in brain metastases is characterized by high myeloid cell content associated with immune suppressive and cancer‐permissive functions. Moreover, brain metastases induce the recruitment of lymphocytes. Despite their presence, T‐cell‐directed therapies fail to elicit effective anti‐tumor immune responses. Here, we seek to evaluate the applicability of radio‐immunotherapy to modulate tumor immunity and overcome inhibitory effects that diminish anti‐cancer activity. Radiotherapy‐induced immune modulation resulted in an increase in cytotoxic T‐cell numbers and prevented the induction of lymphocyte‐mediated immune suppression. Radio‐immunotherapy led to significantly improved tumor control with prolonged median survival in experimental breast‐to‐brain metastasis. However, long‐term efficacy was not observed. Recurrent brain metastases showed accumulation of blood‐borne PD‐L1+ myeloid cells after radio‐immunotherapy indicating the establishment of an immune suppressive environment to counteract re‐activated T‐cell responses. This finding was further supported by transcriptional analyses indicating a crucial role for monocyte‐derived macrophages in mediating immune suppression and regulating T‐cell function. Therefore, selective targeting of immune suppressive functions of myeloid cells is expected to be critical for improved therapeutic efficacy of radio‐immunotherapy in brain metastases.

Katja Niesel
Michael Schulz
Julian Anthes
Tijna Alekseeva
Jadranka Macas
Anna Salamero‐Boix
Aylin Möckl
Timm Oberwahrenbrock
Marco Lolies
Stefan Stein
Karl H Plate
Yvonne Reiss
Franz Rödel
Lisa Sevenich


Development and characterization of 3D spinal cord organoids to advance the study of amyotrophic lateral sclerosis

Matteo Bordoni
Eveljn Scarian
Letizia Messa
Maria Garofalo
Emanuela Jacchetti
Manuela Teresa Raimondi
Luca Diamanti
Stella Gagliardi
Stephana Carelli
Cristina Cereda
Orietta Pansarasa


Mentored undergraduate research in global contexts: outcomes of a collaborative Euro-U.S. program focused on water-related sustainability issues confronting the Danube delta

Abstract: Abstract This interview-based research study utilizes a phenomenological lens to explore student (n = 8) and faculty (n = 6) experiences associated with an international undergraduate research program named CHANCE. This program ran for three years (2021–2023) in Romania and focused on water issues confronting the Danube Delta according to the EU Water Framework Directive and Danube River Basin Management Plan and combined undergraduate research (UR) experiences and global learning utilizing a multi-faceted mentoring model. The qualitative coding process revealed that the distinctive form of social learning, among and between faculty and students, contributes to the perceived acquisition of scientific and essential workforce skills, career identity, and advocacy for environmental protection for students and personal fulfillment and pedagogical enrichment for faculty. The findings suggest insights into how new modes of collaborative, transdisciplinary, and applied knowledge can be integrated into the higher education curriculum.

Jacqueline McLaughlin
Laura Cruz
Carmen Postolache
Makayla Shank
Princeton Bijou
Kathleen Fadigan


Mapping the landscape of work-life balance of teachers: a bibliometric review of scholarly contributions

Abstract: Abstract The research on work-life balance of teachers highlights the significant challenges faced by educators in balancing their professional and personal lives. The study emphasizes the evolving role of teachers, the impact of technology, and the increasing demands placed on them. It also underscores the importance of achieving a healthy work-life balance to reduce stress and improve job satisfaction. This study critically examines research papers and articles related to work-life balance of teachers published between 2014–2024 in the Scopus database. Bibliometric analysis was done with the help of a biblioshiny package of Rstusio and VoS viewer. Out of 554 articles, 112 were located after restricting the search to the English language and publications related to social science, psychology, business, management, and economics for the selected time (2014–2024). The research on the work-life balance of teachers has seen significant growth, especially during the COVID-19 pandemic. The findings highlight that the USA in countries, Fokkens-Bruinsma, M. in authors and Frontiers in Psychology in sources have the highest contribution of articles in related field. Key topics include “human,” “teaching,” “work-life balance,” “questionnaire,” and “education. This study provides a comprehensive overview of the research trends, key contributors, and important topics in the field of work-life balance of teachers. Moreover, it also highlights the growing interest in this area and the need for further research to address the challenges faced by educators. The findings suggest that implementing work-life policies and initiatives tailored to the teaching profession can help address these challenges and promote better well-being among teachers. Overall, the study calls for a greater focus on supporting teachers to ensure they can effectively manage their work and personal responsibilities.

Ruby Bisht
Amit Kumar Uniyal
Amar Johri
Seema Khurshid Qureshi
Hanen Louati


Reflections on the Utility of the Retina as a Biomarker for Alzheimer’s Disease: A Literature Review

Abstract: Abstract As a part of the central nervous system, the retina may reflect both physiologic processes and abnormalities related to diseases of the brain. Indeed, a concerted effort has been put forth to understand how Alzheimer’s disease (AD) pathology may manifest in the retina as a means to assess the state of the AD brain. The development and refinement of ophthalmologic techniques for studying the retina in vivo have produced evidence of retinal degeneration in AD diagnosed patients. In this review, we will discuss retinal imaging techniques implemented to study the changes in AD retina as well as highlight the recent efforts made to correlate such findings to other clinical hallmarks of AD to assess the viability of the retina as a biomarker for AD.

Jennifer Ngolab
Patrick Honma
Robert A. Rissman

Neurology. Diseases of the nervous system


Correction: The relationships between Dark Tetrad traits and adolescent cyberbullying and cybertrolling with online time and life satisfaction as moderators

Masoumeh Alavi
Anchal Garg
Niroshya Wanigatunga


Low-frequency noise analysis on asymmetric damage and self-recovery behaviors of ZnSnO thin-film transistors under hot carrier stress

Abstract: Abstract The need for understanding the low-frequency noise (LFN) of metal oxide semiconductor thin-film transistors (TFTs) is increasing owing to the substantial effects of LFN in various circuit applications. A focal point of inquiry pertains to the examination of LFN amidst bias stress conditions, known to compromise TFT reliability. In this study, we investigate the effects of hot carrier stress (HCS) on zinc tin oxide (ZTO) TFTs by low-frequency noise (LFN) analysis. Asymmetric damage caused by HCS is analyzed by measuring the power spectral density at the source and drain sides. The excess noise generated by the HCS is analyzed with consideration of trap density of states (DOS). It is revealed that the needle defects are generated during the HCS, significantly affecting the LFN characteristics of the ZTO TFTs. Additionally, we observe a self-recovery behavior in the devices and demonstrate the relevant changes in the LFN characteristics following this phenomenon. This study provides valuable insights into the LFN characteristics of ZTO TFTs under HCS conditions and sheds light on the underlying mechanisms.

Wonjun Shin
Ji Ye Lee
Jangsaeng Kim
Sang Yeol Lee
Sung-Tae Lee


Effect of Intravenous Thrombolytic Dose of Alteplase on Long-Term Prognosis in Patients with Acute Ischemic Stroke

Abstract: Abstract Introduction This study aimed to investigate the long-term prognostic effects of different alteplase doses on patients with acute ischemic stroke (AIS). Methods In this cohort study, we enrolled 501 patients with AIS treated with intravenous thrombolysis with alteplase, with the primary endpoint event of recurrence of ischemic stroke and the secondary endpoint event of death. The effects of different doses of alteplase on recurrence of ischemic stroke and death were analyzed using a Cox proportional risk model. Results Among 501 patients with AIS treated with thrombolysis, 295 patients (58.9%) and 206 patients (41.1%) were treated with low-dose and standard-dose alteplase, respectively. During the study period, 61 patients (12.2%) had a confirmed recurrence of ischemic stroke. Multivariate Cox proportional risk analysis showed that standard-dose alteplase thrombolysis (HR 0.511, 95% CI 0.288–0.905, P = 0.021) was significantly associated with a reduced risk of long-term recurrence of AIS, whereas atrial fibrillation was associated with an increased risk of long-term recurrence of AIS. Thirty-nine (7.8%) patients died during the study period. Multivariate Cox proportional risk analysis showed that age, baseline National Institutes of Health Stroke Scale (NIHSS) score, and symptomatic steno-occlusion were associated with an increased long-term risk of death from AIS. The alteplase dose was not associated with the risk of death from AIS. Conclusions Standard-dose alteplase treatment reduced the risk of long-term recurrence of AIS after hospital discharge and the alteplase dose was not associated with the long-term risk of death from AIS.

Mingfeng Zhai
Shugang Cao
Jinwei Yang
Xiaoyan Cao
Zhong Dong
Wanyin Liu
Yongzhan Fu
Qiyue Guan
Yu Wang
Hongbo Liu


Bread wheat quality under limiting environmental conditions: II – Rheological properties of Lebanese wheat genotypes

Abstract: In the general framework of a program to improve the local production of common wheat by the Lebanese State, we have characterized the rheology of different bread wheat cultivars selected for their adaptation to semi-arid weather conditions. After a biochemical characterization [i.e. synthesis and accumulation of the major constituents of the grains (mainly storage proteins and starch)] of the plant material selected in a previous work, the main technological behavior of the flour that resulted from these grains and associated with bread-making properties was evaluated in the present study. Despite the selection of the plant material used in this study, the results demonstrate that environmental conditions inducing limitations in reserve accumulation [i.e. high gliadin content, very high level of polymerization/aggregation of polymeric prolamins, significant increase in the amylopectin/amylose ratio, modifications in the distribution of starch granules (A-type vs. B-type)] during grain filling affected the rheological behavior. The studied flours showed high wet and dry gluten contents, high Zeleny values, and a low gluten index value. They also showed high extensibility on the alveograph and extensograph and elevated dough strength on the farinograph, as well as great water absorption. Furthermore, flours of the studied cultivars did not express their optimal rheological potential in spite of their favorable glutenin subunit composition.

Journal of the Saudi Society of Agricultural Sciences


ROsulord® sAfety for Patients with Dyslipidemia Study: A Non-interventional, Multicenter, Prospective, Observational Study in South Korea

Abstract: Abstract Introduction The ROsulord® sAfety for patients with Dyslipidemia study (ROAD study) in the Republic of Korea investigated the safety and efficacy of rosuvastatin in routine clinical practice. Methods This non-interventional, multicenter, prospective, observational study was conducted over a period of approximately 4.6 years and involved 14,243 participants. During this study, we assessed the adverse events, changes in laboratory test results, and efficacy endpoints associated with rosuvastatin use. Results The findings revealed a notably low adverse event rate of 1.63%, indicating a favorable safety profile for rosuvastatin in the management of dyslipidemia. Importantly, no clinically significant incidences of statin-associated myopathy, hepatotoxicity, or diabetes were observed during the study period. Moreover, this study demonstrated significant improvements in lipid profiles among patients receiving rosuvastatin treatment, with a reduction in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. These improvements contributed to a lower cardiovascular risk in the study population. Conclusion Overall, these findings suggest that rosuvastatin is safe and effective in managing dyslipidemia in real-world clinical settings, providing clinicians with valuable insights into the benefits and risks associated with statin therapy in this patient population.

Do Young Kim
Sung Hea Kim
Eung-Ju Kim
Sang-Jin Han
Ji-Yeong Park
Jong-Chan Youn
Hee-Seok Kim
Ji-Eun Jeong
Kyu-Hyung Ryu

Diseases of the circulatory (Cardiovascular) system


Explainable and perturbation-resilient model for cyber-threat detection in industrial control systems Networks

Abstract: Abstract Deep learning-based intrusion detection systems (DL-IDS) have proven effective in detecting cyber threats. However, their vulnerability to adversarial attacks and environmental noise, particularly in industrial settings, limits practical application. Current IDS models often assume ideal conditions, overlooking noise and adversarial manipulations, leading to degraded performance when deployed in real-world environments. Additionally, the black-box nature of DL model complicates decision-making, especially in industrial control systems (ICS) network, where understanding model behavior is crucial. This paper introduces the eXplainable Cyber-Threat Detection Framework (XC-TDF), a novel solution designed to overcome these challenges. XC-TDF enhances robustness against noise and adversarial attacks using regularization and adversarial training respectively, and also improves transparency through an eXplainable Artificial Intelligence (XAI) module. Simulation results demonstrate its effectiveness, showing resilience to perturbation by achieving commendable accuracy of 100% and 99.4% on the Wustl-IIoT2021 and Edge-IIoT datasets, respectively.

Urslla Uchechi Izuazu
Cosmas Ifeanyi Nwakanma
Dong-Seong Kim
Jae Min Lee

Computer engineering. Computer hardware
Computer software