Adverse Impact Research Articles

Reconciling British Values with Professional Identity: The Pursuit of Ontological Security Among Muslim Teachers in England

This article aims to investigate how the legal requirement to promote fundamental British values (FBVs) impacts Muslim teachers’ professional identity formation, utilising Interpretive Phenomenological Analysis. Semi-structured interviews were conducted with self-identified Muslim teachers, including both male and female individuals from diverse ethnic backgrounds, employed in secondary schools across England. This study seeks to interpret Muslim teachers’ experiences through Anthony Giddens’ ontological security theory. Firstly, Muslim teachers expressed pride in being British and their successful integration into society. Secondly, the meaning of Britishness was elucidated by the participants through references to the values described in the current government guidelines on promoting FBVs. Finally, the impact of the obligation to promote FBVs on the professional identity formation of Muslim teachers points to a degree of ambivalence rooted in seeking ontological security. Certain teachers adopted an uncritical stance towards FBV policy, prioritising ‘values’ within the debate and thereby normalising the discourse surrounding FBVs. In contrast, others engaged in a critical analysis of FBV rhetoric, highlighting its adverse impact on academic discussions and their professional identities. From the perspective of ontological security theory, Muslim teachers are situated in a fragile position; while the majority grapple with ontological insecurity, others exist in a realm between ontological security and insecurity.

Toxicological evaluation of LivLonga®, a polyherbal combination, in rodents.

There has been keen interest on herbs and phytoconstituents with hepatoprotective property to help restore healthy liver function. Ayurveda, the ancient Indian traditional system of medicine mentions about Curcuma longa, Garcinia indica and Piper nigrum which are reported to have hepatoprotective activity. Apart from supporting metabolism, liver plays pivotal role in numerous bodily processes, immune functions to digestion, detoxification, and storage of nutrients. Factors such as sedentary lifestyle, viral infections, drugs/chemicals, high calorie diet, excess intake of alcohol etc have adverse impact on normal functioning of liver. Development of novel herbal combination with standards of safety and efficacy can help manage liver ailments and protect liver health. LivLonga® is a polyherbal combination of scientifically validated ingredients- curcuminoids, garcinol and piperine to support healthy liver function. The present work was conducted to evaluate toxicity of LivLonga® using in vivo models when administered orally. The acute, subacute, and subchronic toxicity studies were carried out in accordance with the test guidelines established by the Organization for Economic Cooperation and Development. A single-dose acute oral toxicity produced no toxic effects after 14 days of treatment. Four-week (subacute) and 3-months (subchronic) oral toxicity studies were conducted and observed no abnormal clinical signs, no alterations in the body weight, hematology and biochemical parameters or gross and histopathological changes. Thus, oral administration of LivLonga® showed no signs of toxicity when dosed orally to rats, with a no observed adverse effect level (NOAEL) of 600 mg/kg/day.

Comparative assessment of a COVID-19 vaccine after technology transfer to Iran from critical quality attributes to clinical and immunogenicity aspects.

During COVID-19 pandemic, international pharmaceutical companies put effort to build global manufacturing networks for vaccines. Soberana Plus vaccine, a recombinant protein based vaccine (RBD dimer), with the trade name of PastoCovac Plus in Iran, is based on a protein subunit platform in Cuba and completed preclinical and toxicological assessments. This study aimed at presenting the steps of vaccine technology transfer from Cuba to Iran. This study provides the first practical comparability results in Iran to ensure the quality, safety and efficacy of a protein subunit vaccine against COVID-19 after a successful technology transfer from Cuba. PastoCovac Plus was transferred to Iran at the formulation stage. The assessment of the active ingredient pharmaceutical (API) was achieved through physicochemical and clinical data collection and tests to assure if there was any adverse impact on the vaccination results. In order to assess the quality of the vaccine product after technology transfer, we sought different properties including regulatory features, physicochemical quality, vaccine potency and stability as well as its immunogenicity and safety. Following the evaluation of the clinical quality attributes (CQAs) based on the standard protocols, the results showed that the two vaccines are highly similar and comparable, with no considerable effect on safety or efficacy profiles. The CQAs were all in the acceptance limits in terms of safety and efficacy as well as clinical evaluation results. The immunogenicity evaluation also confirmed no significant differences between the vaccines regarding reinfection (P = 0.199) or vaccine breakthrough (P = 0.176). Furthermore, the level of anti-spike and neutralizing antibodies in the both vaccine groups was not significantly different indicating the equality of performance between the two vaccines. According to the results of the quality and clinical assessment of this study, we achieved an acceptable quality attributes and acceptant limits in terms of safety and efficacy of the vaccines pre and post technology transfer.

Response to oxalic acid: an important supplement screening against stem rot resistance in groundnut (Arachis hypogaea L.)

BackgroundStem rot, caused by the soil-borne pathogen Sclerotium rolfsii, pose a serious challenge in the groundnut (Arachis hypogaea L) cultivation. Although this disease is widespread globally but had most adverse impact in groundnut growing regions of United States, India, and Australia. The pathogen primarily targets the crown region of the plant, resulting in systemic collapse and potentially leading to yield losses up to 80%. Effective genetic control measures are essential to mitigate the impact of this disease on groundnut production. Realizing the time and resource-consuming complex field-based phenotyping, the availability of easy and repeatable phenotyping methods may fasten the process of donor and gene discovery efforts.ResultsMulti-season phenotyping was performed for stem rot on 184 minicore germplasm accessions, including checks, under two conditions: sick field screening and response to oxalic acid assay. This study demonstrated medium to high heritability (52–63% broad-sense heritability) and significant environmental influence (36%). The response to the oxalic acid assay showed a high proportion of similarity (approximately 80%) with the percent mortality observed in the sick field indicating an easy way of performing precise phenotyping. Notably, seven genotypes—ICG163, ICG721, ICG10479, ICG875, ICG11457, ICG111, and ICG2857—exhibited stable resistance, with less than 30% mortality against stem rot disease. Among these, ICG163, ICG875, and ICG111 displayed low mortality and consistent stability across multiple seasons in both the sick field and controlled conditions of the oxalic acid assay.ConclusionsThe oxalic acid assay developed in this study effectively complements field phenotyping, as a reliable method for assessing stem rot resistance. Seven resistant genotypes identified through this assay can be utilized for the introgression of stem rot resistance into elite genotypes. Given the significant influence of the environment on stem rot resistance, it is essential to implement multi-season phenotyping to obtain precise results. Furthermore, the response to oxalic acid serves as a valuable supplement to traditional field phenotyping, since maintaining uniform disease pressure during field screenings is often challenging.

Evaluating machine learning model bias and racial disparities in non-small cell lung cancer using SEER registry data.

Despite decades of pursuing health equity, racial and ethnic disparities persist in healthcare in America. For cancer specifically, one of the leading observed disparities is worse mortality among non-Hispanic Black patients compared to non-Hispanic White patients across the cancer care continuum. These real-world disparities are reflected in the data used to inform the decisions made to alleviate such inequities. Failing to account for inherently biased data underlying these observations could intensify racial cancer disparities and lead to misguided efforts that fail to appropriately address the real causes of health inequity. Estimate the racial/ethnic bias of machine learning models in predicting two-year survival and surgery treatment recommendation for non-small cell lung cancer (NSCLC) patients. A Cox survival model, and a LOGIT model as well as three other machine learning models for predicting surgery recommendation were trained using SEER data from NSCLC patients diagnosed from 2000-2018. Models were trained with a 70/30 train/test split (both including and excluding race/ethnicity) and evaluated using performance and fairness metrics. The effects of oversampling the training data were also evaluated. The survival models show disparate impact towards non-Hispanic Black patients regardless of whether race/ethnicity is used as a predictor. The models including race/ethnicity amplified the disparities observed in the data. The exclusion of race/ethnicity as a predictor in the survival and surgery recommendation models improved fairness metrics without degrading model performance. Stratified oversampling strategies reduced disparate impact while reducing the accuracy of the model. NSCLC disparities are complex and multifaceted. Yet, even when accounting for age and stage at diagnosis, non-Hispanic Black patients with NSCLC are less often recommended to have surgery than non-Hispanic White patients. Machine learning models amplified the racial/ethnic disparities across the cancer care continuum (which are reflected in the data used to make model decisions). Excluding race/ethnicity lowered the bias of the models but did not affect disparate impact. Developing analytical strategies to improve fairness would in turn improve the utility of machine learning approaches analyzing population-based cancer data.

Impact of value-consciousness and brand-self value congruity on sustainable luxury brands and commodities

ABSTRACT Drawing on Self-Congruity and Equity Theories, this research examines the distinct impacts of communicating uniform sustainability initiatives for luxury brands versus commodity brands. This paper introduces a conceptual model that highlights the moderated mediation effect of brand-self value congruity and the three-way moderating effect of value-consciousness on the adverse impact of sustainability on luxury versus commodity brands. The findings from two experimental studies demonstrate that communicating sustainability initiatives has distinct effects on different brands. Specifically, sustainability initiatives enhance the evaluations of commodity brands but diminish the evaluations of luxury brands. The negative impact of sustainability on luxury brands is mediated by brand-self congruity. Moreover, value-consciousness moderates the relationship between sustainability and luxury brands, such that low value-conscious consumers tend to value sustainable luxury brands less than their non-sustainable counterparts, unlike high value-conscious consumers. These findings offer valuable managerial and practical insights for brand managers and communication strategists considering adopting sustainability communication strategies.

A Novel Mn‐MOF Sensitive Detection of Antibiotic Difloxacin Hydrochloride in Water

ABSTRACTAntibiotic pollution in hydrophytic ecosystems has aroused widespread notice due to its adverse impact on both the ecological environment and human physical well‐being. Thus, the development of effective antibiotic detection materials is not only urgently needed but is also challenging. Herein, the luminescent metal–organic framework [Mn3/2(HBCTC)·5H2O] (1) was successfully synthesized based on [9,9′‐bicarbazole]‐3,3′,6,6′‐tetracarboxylic acid (H4BCTC) under solvothermal conditions. Compound 1 can be employed as a fluorescent probe to detect antibiotic difloxacin hydrochloride (DIF) in water, demonstrating a remarkable linear relationship between fluorescence intensity ratio I0/I and the concentration of DIF (0–40 μM), with Ksv of 79,405 M−1 and LOD of 114 nM. More importantly, 1 represents the first fluorescent sensing material based on MOF for the detection of DIF, exhibiting exceptional selectivity, sensitivity, and anti‐interference capability. Furthermore, the mechanism of fluorescence quenching was studied comprehensively.

Molecular dynamics simulations reveal concentration-dependent blockage of graphene quantum dots to water channel protein openings

Graphene quantum dots (GQDs) have attracted significant attention across various scientific research areas due to their exceptional properties. However, studies on the potential toxicity of GQDs have yielded conflicting results. Therefore, a comprehensive evaluation of the toxicity profile of GQDs is essential for a thorough understanding of their biosafety. In this work, employing a molecular dynamics (MD) simulation approach, we investigate the interactions between GQDs and graphene oxide quantum dots (GOQDs) with the AQP1 water channel protein, aiming to explore the potential biological influence of GQDs/GOQDs. Our MD simulation results reveal that GQDs can adsorb to the loop region around the openings of AQP1 water channels, resulting in the blockage of these channels and potential toxicity. Interestingly, this blockage is concentration-dependent, with higher GQD concentrations leading to a greater likelihood of blockage. Additionally, GOQDs show a lower probability of blocking the openings of AQP1 water channels compared to GQDs, due to the hydrophobicity of the loop regions around the openings, which ultimately leads to lower interaction energy. Therefore, these findings provide new insights into the potential adverse impact of GQDs on AQP1 water channels through the blockage of their openings, offering valuable molecular insights into the toxicity profile of GQD nanomaterials.

Impact of Ozone Exposure on the Biochemical Composition of Wheat, Broccoli, Alfalfa, and Radish Seeds During Germination

In recent years, there has been an increasing interest in the use of gaseous ozone (O3) to promote the germination of edible seeds. While its ability to improve seedling vigor and stimulate germination is acknowledged, there has been limited research on the impact of gaseous O3 on the biochemical profile, including phenolic compounds (TPC) and antioxidant activity, of cereals, seeds, and their sprouts. The lack of information has led to the initiation of this study, which aims to assess the impact of ozone treatment duration at a concentration of 50 ppm 1 L min−1, ranging from 1 to 5 h, on the biochemical attributes of broccoli (Brassica oleracea), radish (Raphanus sativus), alfalfa (Medicago sativa) seeds, and sprouts, as well as wheat (Triticum aestivum) grains and sprouts. By optimizing O3 exposure parameters, including duration, this approach has the potential to serve as a valuable tool for enhancing the microbiological and nutritional quality of seeds and cereals. The findings revealed that O3 treatment generally had an adverse impact on TPC in seeds, cereals, and sprouts, resulting in a significant reduction in TPC post O3 treatment. Wheat grains, in particular, displayed the lowest TPC following ozone exposure, with an average decrease of 39.4% compared to the untreated sample. However, it is noteworthy that alfalfa seeds exhibited a positive response to 4 and 5 h O3 treatment, manifesting an average increase in TPC of 13.0% and 27.7%, respectively. In turn, broccoli, radish, and wheat sprouts displayed the lowest TPC, with values of 47.7%, 20.2%, and 18.0% lower than the control samples, respectively. This study revealed that plant responses to O3 exposure varied, and the effects of O3 treatment on TPC levels depended on O3 exposure time. Furthermore, the effect of O3 on the sugar content of the seeds, cereals, and sprouts varied among different plant types, with some showing an increase in content and others showing no substantial changes. This suggests that, depending on the type of seed, O3 may have both positive and neutral effects.

Effects of Early Life Scarcity-Adversity on Maturational Milestones in Male and Female Rats.

Although many studies have shown a long-term negative impact of early life adversity (ELA) in rodents, literature regarding its effects on maturational milestones in rats is scarce. Available evidence suggests that ELA interferes with normal growth and development in rodents and that effects may be sex-dependent even at an early age. In accordance, we hypothesized that early life scarcity-adversity would impair physical and reflex development in male and female rats. To test this, we used an early life resource scarcity paradigm based on reducing home cage bedding during postnatal days (PND) 2-9 and assessed physical landmarks by measuring weight gain, incisor presence, fur development, and eye opening. We also evaluated the impact of early life scarcity-adversity on developmental reflexes by measuringsurface righting and grasp reflexes, negative geotaxis, cliff avoidance, bar holding, and auditory startle. Early life scarcity-adversity resulted in earlier complete lower incisor presence in males (PND 6), impaired surface righting(PND 6) and grasp reflexes (PND 8) in both sexes, and impaired cliff avoidance responses in females (PND 12). These results extend previous research examining the effects of ELA on developing male and female rodents by showing that it negatively impacts a subset of physical landmarks and developmental reflexes in a sex-dependent manner.

Strategic tone management in ESG reports and ESG risk

In this study, we investigate whether strategic tone management in environmental, social, and governance (ESG) reports can serve as an indicator of future ESG risk. Our baseline results reveal a positive association between abnormal positive tone in ESG reports and future ESG risk. The findings suggest that firms employ impression management strategy in their ESG reports to provide misleading information. Analyst coverage and media attention can mitigate this positive association. Heterogeneity analysis reveals that the positive correlation is stronger for firms mandated to disclose ESG reports and those adhering to the Global Reporting Initiative guidelines. Additional tests indicate that abnormal positive tone is positively associated only with future environmental risk, not with future social and governance risk. We observe this positive association exclusively in government-reported ESG risk, not in media-reported ESG risk. Our results offer valuable implications for mitigating the adverse impact of strategic tone management on corporate sustainability practices.

Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality.

We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality. Longitudinal, prospective observational study. We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018). Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class. Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.

OPTIMALISASI POTENSI PENDAPATAN MELALUI INOVASI SI-ERPIN (SISTEM INFORMASI ENTERPRISE RESOURCE PLANNING INNOVATION)

PT Dunia Sandang Pratama is a fabric supplier company experiencing difficulties monitoring orders, ensuring timely deliveries, and producing accurate financial reports. These challenges have an adverse impact on customer satisfaction and operational efficiency. Because of the acute urgency of these issues, this community service project is designed to develop an integrated ERP system with e-commerce functionality to overcome the existing problems, increase efficiency, expand market reach and provide more accurate information to management. This community service is aligned with the United Nations Sustainable Development Goals (SDGs), particularly in fostering innovation and narrowing the digital divide. The service team, comprising four lecturers and five students, employed the Scrum methodology, which is flexible and interactive, to observe, analyse and design the system in collaboration with the partner, PT Dunia Sandang Pratama. The project's initial phase has been completed, including developing e-commerce features and sales modules. The preliminary results indicate an increase in efficiency concerning order management and reporting. Implementing the ERP system has enhanced data accuracy, operational efficiency, and employee competence. From a quantitative perspective, order processing time has been reduced, the incidence of data errors has decreased, and company revenue has increased. From a qualitative standpoint, employee competence in ERP usage has also improved, positively impacting decision-making. In conclusion, the project has successfully supported the company's decision-making processes.

Seroprevalence of Avian Influenza in Guinea Fowls in Some Districts in the Upper East Region of Ghana.

The guinea fowl (Numida meleagris) holds significant agricultural importance in Ghana, particularly in the Northern, Upper East and Upper West Regions. Despite their economic and cultural significance, guinea fowls face a potential threat from avian influenza, a global concern for its adverse impact on poultry populations. This study assessed the seroprevalence of the virus in mature guinea fowls in the Upper East Region. A cross-sectional survey was conducted in three districts within the Upper East Region from April to June 2023. Blood samples were collected from 397 guinea fowls that are over 4 weeks old, and seroprevalence was determined using ID Screen Influenza A Antibody Competition Enzyme-linked immunosorbent assay (ELISA). The study analysed demographic factors such as sex, age and source of birds, employing statistical methods to establish associations. Among the sampled guinea fowls, 24.7% tested positive for avian influenza antibodies, whereas 75.3% were seronegative. Age did not show statistically significant associations with seroprevalence, but intriguing patterns were observed. Adult guinea fowls exhibited higher seroprevalence (23.7%) compared to growers (1.0%). The source of birds showed no significant association, but birds from slaughter points demonstrated higher seroprevalence (11.6%) compared to households (5.0%) and live bird markets (8.1%). In conclusion, the study underscores the importance of monitoring avian influenza in guinea fowls to implement effective control measures. The presence of antibodies suggests guinea fowls may contribute to virus transmission in the Upper East Region. The study recommends ongoing nationwide surveillance to assess the true prevalence of avian influenza in guinea fowls across Ghana.

Effect of the second and third COVID-19 pandemic waves on routine outpatient malaria indicators and case management practices in Uganda: an interrupted time series analysis

BackgroundReports on the impact of COVID-19 pandemic on the quality of malaria care and burden in sub Saharan Africa have provided a mixed picture to date. The impact of the 2nd (Delta) and 3rd (Omicron) COVID-19 waves on outpatient malaria indicators and case management practices was assessed at three public health facilities with varying malaria transmission intensities in Uganda.MethodsIndividual level data from all patients presenting to the out-patient departments (OPD) of the three facilities (Kasambya, Walukuba and Lumino) between January 2019 and February 2022 were included in the analysis. Outcomes of interest included total number of outpatient (OPD) visits, proportion of patients suspected to have malaria, proportion of suspected malaria cases tested with a malaria diagnostic test, test positivity rates (TPR) and proportion of malaria cases prescribed artemether-lumefantrine (AL). Using the pre-COVID-19 trends between January 2019 and February 2020, interrupted time series analysis was used to predict the expected trends for these study outcomes during the 2nd wave (May 2021–August 2021) and 3rd wave (November 2021–February 2022). The observed trends of the study outcomes were compared with the expected trends.ResultsThere were no significant differences between the observed versus expected overall outpatient visits in the 2nd wave, however, a significant decline in OPD attendance was observed during the 3rd wave (15,101 vs 31,154; incidence rate ratio (IRR) = 0.48 [0.41–0.56]). No significant differences in the overall observed versus expected proportions of suspected malaria cases and test positivity rates in both COVID waves. However, a significant decrease in the overall proportion of suspected malaria cases tested with a malaria diagnostic test was observed during the 3rd wave (99.86% vs 99.99%; relative percent ratio [RPR] = 0.99 [0.99–0.99]). Finally, a significant decline in the overall proportion of malaria cases prescribed AL was observed during the 2nd wave (94.99% vs 99.85%; RPR = 0.95 [0.92–0.98]) but not the 3rd wave.ConclusionSignificant declines in OPD attendance and suspected malaria cases tested with malaria diagnostic test were observed during the 3rd COVID-19 wave, while AL prescription significantly reduced during the 2nd COVID-19 wave. These findings add to the body of knowledge highlighting the adverse impact of COVID-19 pandemic on the malaria which could explain the increase in the malaria burden observed during this period.

Shifting focus - the need to prioritise an inclusive public health approach to trauma

Abstract Since 2017, the Welsh government has prioritised the development of a Public Health Approach to understanding the impact of Adverse Childhood Experiences. Taking the work of Bellis et al, and the population level research to understand the prevalence of ACEs, and associated risks (Bellis etc al, 2015), the ACE Hub Wales was established to coordinate a multi-agency, cross sector approach to preventing, tackling and mitigating the impact of adversity in childhood. The Hub developed its approach to advocate for more public awareness of the life course risks to health if the right support was not accessed or available to children, such as poor mental health and chronic conditions such as type 2 diabetes and heart disease in adulthood. From 2021 there has been a dramatic shift to attempting to understand the experiences, and unmet needs, of children and people who have come to Wales to seek sanctuary, migrant women who have no recourse to public funds, and people experiencing racism and discrimination. In 2021, the ACE Hub Wales co-produced a Wales national trauma-informed practice framework including a set of principles placing inclusion at the heart of the approach in Wales; shining a light on the need to have a cultural, intergenerational and gender-based understanding of adversity and trauma which links directly to, informs and supports the government’s ambitions to be a nation of sanctuary and to be anti racist by 2030. To continue to ignore the experiences of adversity and trauma by people of colour, and Gypsy, Roma and Traveller people; is to perpetuate the health inequity experienced in healthcare, and justice systems. Wales has committed to developing wisdom, not just knowledge, that means that a public health approach is inclusive of all of our communities in Wales. Key messages • The experiences of racialised ad minoritised communities from population studies of adversity and trauma is traumatizing. • Understanding the life course impact of adversity and trauma must include the experiences of racism and discrimination to be inclusive and trauma-informed.

How does family support mitigate the impact of childhood adversity on adolescent mental health?

Abstract Background Childhood adversity is associated with increased risk of developing mental health problems over the life course. We investigated how family emotional support in adolescence may mitigate the impact of childhood adversity on adolescent mental health. Methods We used longitudinal data from the UK Millennium Cohort Study on 9,269 children followed to age 17 years. Individuals were assigned to exposure trajectories characterised using group-based trajectory models that included measures of poverty and family adversities (parental mental ill health, parental alcohol misuse and domestic violence) up to age 14 years. Using counterfactual causal mediation analysis and four-way decomposition modelling approach, we evaluated how perceived family emotional support at age 14 (measured using the three-item Short Social Provisions Scale) influences the association of childhood adversity trajectories on mental health at ages 14 and 17, assessing the relative contributions of mediation and interaction simultaneously. Results Compared with children experiencing low adversity and poverty, those exposed to childhood adversity were almost three times more likely to experience poor mental health (RR 2·99, 95% CI 2 ·41 to 3·57) at age 14 and age 17 (RR 2·58, 95% CI 2·09 to 3·06). Perceived emotional support mitigates up to 18% (95% CI: 9% to 26%) of this effect at age 14, and 13% (95% CI: 5% to 22%) at age 17, mainly due to interactive mechanisms. Conclusions Childhood adversity has a strong effect on mental health, which is partially mitigated by perceived family support in adolescence. Policies that support positive family functioning may be particularly beneficial for children who have experienced adversity. Key messages • Socio-economic – associated mental health problems in adolescence differed based on levels of family support. • Approximately 20% of the social inequality in mental health outcomes in adolescence may be mitigated or reduced by improving levels of family support.

Defibrillator shocks and their effect on objective asian patient outcomes: results of the painfree SST clinical trial

Abstract Background The implantable cardioverter defibrillator (ICD) reduces mortality in patients at risk of sudden cardiac death. However, the effect of ICD shock on device-measured activity is unknown. The aim of this analysis was to analyze the acute and long-term effects of ICD shock on objective behavioral data. Methods The PainFree SST study was a prospective, multicenter, global study that enrolled 2770 patients including 225 from from Asia (181 from Japan, 25 from India, and 19 from Malaysia). Patient physical activity was determined from the device built-in accelerometer. The device translates the accelerometer output into a count of active minutes, which is stored as a daily total value in device memory for a rolling window of 425 days. Obviously, activity is measured only after device implantation. Early after implant, activity is reduced due to the procedure and thus not representative. Therefore, no baseline can be reported for activity. The follow-up activity data was analyzed with a linear mixed model, with a random effect for patient and an auto-regressive correlation matrix for subsequent measurements of individual patients. Results Figure 1 shows average daily activity between 90 days before and 90 days after a shock. The dashed vertical line indicates the day of shock. Both patients from Asia and from other countries show a drop in activity after a shock with recovery in the subsequent 30-60 days. The curve for Asian patients is more variable than the curve for other countries due to the lower number of patients (there were 33 Asian patients with shocks contributing data). Figure 2 shows average daily activity before and after ATP therapy. Any post shock measurement is excluded. Contrary to the temporary reduction in activity around a shock (Figure 1), ATP therapies do not seem to have an impact on activity. In patients from the other countries, activity is significantly reduced when patients are hospitalized (-66.3 minutes/day, p<0.0001), but not in Asian patients (-5.1 minutes/day, p=0.71). Both in Asian and other countries, activity is significantly reduced after an ICD shock (Asian: -47.5 minutes/day, p=0.0002; Other countries: -21.5 minutes/day, p<0.0001). The effect of shock for Asian is greater than the other countries (p=0.054). In the month after the shock there is a significant recovery, +34.8 minutes/day in Asian patients (p=0.0077) and +7.7 minutes/day in patients from other countries (p=0.031). The recovery is trended to be bigger in Asian patients (p=0.058). Conclusions ICD shocks have a lasting adverse impact on objective, device-measured physical activity, particularly among Asian individuals. Successful management of patients with an ICD necessitates specific attention to clinically relevant behavioral outcomes, aiming to expedite recovery and facilitate a return to activities of daily living, with a particular focus on the Asian population.

Impact of plasma from patients with severe aortic stenosis on valvular endothelial cells

Abstract Background The natural history of aortic stenosis (AS) encompasses a spectrum of pathophysiological stages, including endothelial dysfunction, inflammation, fibrosis and calcification. Accumulating data underscore the detrimental impact of the haemostatic system on AS, contributing to disease progression and the development of a prothrombotic phenotype within the valve. Understanding these mechanisms is pivotal for the exploration of novel therapeutic avenues, particularly in the context of transcatheter aortic valve replacement (TAVR). Following TAVR, the native diseased aortic valve persists, maintaining its pathological activity and thrombogenic effects on the bioprosthetic valve, potentially influencing its durability and patient outcomes. The precise effects of plasma and its various components on valvular endothelial cells (VECs) dysfunction remains inadequately explored. Purpose To evaluate the influence of plasma derived from individuals with severe AS on aortic VECs. Methods Plasma samples obtained from patients with severe AS undergoing TAVR (n=100) were collected immediately before the procedure, alongside plasma samples from healthy individuals. Factor (F)Xa activity within the plasma samples was quantified using fluorometer-based method. Porcine VECs were then exposed to either plasma (at 10% concentration) or isolated FXa (1 nM), with or without different pharmacological modulators. Protein expression levels were assessed by Western blot analyses. The level of reactive oxygen species (ROS) was evaluated by dihydroethidium staining. Results Exposure of VECs to plasma from severe AS patients promoted ROS formation compared to plasma from healthy individuals (1402 ± 438 AU vs 732 ± 137 AU, p=0.001) (Figure 1). The heightened oxidative stress elicited by plasma from severe AS patients was attenuated by empagliflozin, perindoprilat, losartan, neutralizing antibodies directed against IL-1, IL-6 and TNF-α. Plasma from severe AS patients showed elevated FXa activity compared to plasma from healthy individuals (179.4 ± 101.3 ng/mL vs 63.2 ± 87.2 ng/mL, p=0.02). Stimulation of VECs with isolated FXa resulted in a sustained formation of ROS, which was blunted by empagliflozin, perindoprilat, losartan, rivaroxaban, dabigatran and PAR-1, 2 and 4 antagonists. Quantification of protein expression in VECs stimulated by isolated FXa revealed an endothelial dysfunction phenotype characterized by increased expression of SGLT2, VCAM-1 and COX-1, and decreased expression of eNOS. Conclusions Plasma from patients with severe AS exerts a detrimental effect on aortic VECs, characterized by a pronounced oxidative stress response. This adverse impact is mediated by multiple mechanisms, including activation of the AT1R/NADPH oxidase/SGLT2 pathway, upregulation of pro-inflammatory cytokines, and activation of PAR. FXa plays a pivotal role by promoting oxidative stress in VECs and contributing to valvular endothelial dysfunction.Pro-oxidant state in VECs.

Impact of Uncertainty Shocks on Income and Wealth Inequality

AbstractWe analyze the distributional consequences of uncertainty shocks in the U.S. economy. While their impact on income inequality appears marginal when measured by a single statistic, there are important variations: inequality between the rich and middle‐income groups decreases, while inequality between the middle and poor‐income groups increases significantly. Additionally, uncertainty shocks increase labor income inequality through higher unemployment rates but simultaneously decrease nonlabor income inequality by reducing business and interest income. Uncertainty shocks reduce disposable income inequality, demonstrating the role of redistribution policy. Finally, they tend to reduce wealth inequality, mainly due to their adverse impact on financial asset prices, predominantly owned by wealthy households.