Aggressive Reduction Research Articles

Efficacy and Safety of Antiepileptic Drugs in the Management of Behavioral Issues in Autism Spectrum Disorders: A Systematic Review and Meta-analysis

Background: Autism spectrum disorder (ASD) is often accompanied by comorbidities such as epilepsy and behavioral problems. The interplay between epilepsy, behavior, and language suggests a potential role for antiepileptic drugs (AEDs) in managing ASD-related behavioral issues. Despite some preliminary studies indicating possible benefits, the evidence remains inconclusive. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of AEDs in managing behavioral issues in individuals with ASD. Methodology: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive search across multiple databases (PubMed, Ovid MEDLINE, Cochrane Library, Web of Science, and others) for double-blind, placebo-controlled randomized controlled trials (RCTs) published in English. Inclusion criteria focused on individuals with ASD exhibiting behavioral problems, with or without EEG abnormalities, treated with AEDs. Data extraction and quality assessment were performed by two independent reviewers. The primary outcome was focused on investigating the efficacy of AEDs in improving behavioral symptoms, predominantly irritability, and aggression. We also investigated the safety profiles of the AEDs. Results: Seven RCTs met the inclusion criteria, involving AEDs such as valproate, levetiracetam, and topiramate. Two RCTs were excluded due to incompatible outcome measures. Meta-analysis of the remaining five RCTs showed no significant difference in the reduction of aggression and irritability between AEDs and placebo, with high heterogeneity (I2 = 93%). Sensitivity analysis confirmed the nonsignificance and high heterogeneity (I2 = 87%). Adverse effects commonly reported included insomnia and weight gain. Conclusion: This meta-analysis found no significant benefit of AEDs in managing behavioral symptoms of ASD compared to placebo, consistent with previous findings. The high heterogeneity and methodological limitations highlight the need for more robust and larger-scale studies. Future research should consider the role of electroencephalography abnormalities and standardize outcome measures to better evaluate the potential of AEDs in this population or in a specific subgroup of ASD.

Survival Analysis of Prefabricated Zirconia Crowns with and Without Pulpotomy in Primary Teeth: A Retrospective Cohort Study.

Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible pulpitis and mechanical pulp exposure, is sometimes employed before PZCs. While pulpotomy is not routinely performed, its use raises important considerations about the interplay between restorative procedures and pulp therapy in pediatric dentistry, particularly regarding the long-term restoration outcomes of PZCs. This study aimed to investigate the impact of pulpotomy on the success rate of PZCs. We examined 81 anterior upper primary teeth treated with PZCs in children aged 2-5 years over a two-year period. Cases were divided into groups with and without pulpotomy. Follow-ups occurred at 6-month intervals, assessing clinical and radiographic outcomes. Analyses were performed using SPSS 25.0 software. The statistical significance was p < 0.05. A total of 81 anterior primary teeth were included. Chi-square analysis showed no association between pulp therapy and PZC success (χ2 = 0.051, p = 0.822). The Kaplan-Meier survival analysis revealed comparable survival curves and the log-rank test showed no statistically significant difference in survival time between pulpotomy-treated and untreated groups (χ2 = 0.051, p = 0.821). Pulpotomy did not significantly affect the success rate of PZCs within 2 years.

Do Environmental Tax and Energy Matter for Environmental Degradation in the UK? Evidence from Novel Fourier-Based Estimators

Currently, the UK has ambitious plans to reach net zero by 2050, despite other countries such as Russia and India targeting 2060 and 2070, respectively. Assuming that the UK emissions unceasingly decline at a given rate annually towards achieving net zero by 2050, its economy would need to ensure a reduction of 105 MtCO2 per year of its emissions from the current 2021 levels. Given that global greenhouse gas emissions have not peaked and continue to rise, the UK seeks to implement costly and aggressive emission reduction policies towards fulfilling commitments under the 2021 Glasgow Climate Pact. This paper investigates the effect of environmental taxes on environmental degradation in the UK between 2000Q1 and 2019Q4 using novel Fourier approaches. Using the novel Fourier ARDL estimator, the long-run equilibrium estimates indicate that gross domestic product and environmental tax cause a fall in carbon emissions. However, in trade and primary energy use, a unit change caused rising carbon emissions in the UK. Especially, the results indicate that environmental taxes have a negative effect on environmental degradation in the UK, and ecological tax policy could be considered as an effective channel to attain environmental sustainability. The outcome provides the following policy insights: (i) The government of the UK should support international environmental tax coordination mechanisms, especially on carbon pricing, to avoid relocation of carbon-intensive investments. (ii) The UK government must note that imposing more taxes to encourage emissions reductions could bring complexity to the tax system and unnecessarily bring costly ways to deal with climate change. Higher domestic electricity prices could disproportionately hit low-income households and create distributional cost concerns, which require benefit payouts or compensation schemes. (iii) Switching to electric vehicles simultaneously requires investments in charging infrastructure and battery technologies. To avoid this chicken-and-egg problem, the government of the UK could play a coordinating role, including deploying targeted subsidies, regulations, direct government involvement, or setting higher carbon prices in special cases.

High prevalence of coronary artery calcium and aortic calcification in adults with repaired coarctation of the aorta and interrupted aortic arch

Abstract Background There is a high rate of late cardiovascular mortality in patients with repaired coarctation of the aorta (CoA) and interrupted aortic arch (IAA). Coronary artery calcium (CAC) is a marker of cardiovascular disease and there is growing evidence for aortic calcification as a predictor. Recent research in the general population suggests any CAC in males &amp;lt;35 years old and females ≤45 years places them at ≥90th percentile. Aims We aimed (1) to determine the prevalence of CAC, thoracic aorta calcification (TAC), and abdominal aorta calcification (AAC) in patients with CoA or IAA repair, and (2) to compare patients to a control group of Tetralogy of Fallot (TOF) patients, a condition with no known increased risk of atherosclerotic cardiovascular disease. Methods Retrospective cohort study of adult survivors of CoA/IAA repair followed up at an adult congenital heart disease (ACHD) clinic. Patients with at least 1 chest, abdomen, or pelvis computerised tomography (CT) scan for any indication were included. The presence/absence of calcification in the coronary arteries or aorta was assessed qualitatively. Patients on antihypertensive and statin therapy were considered hypertensive and hypercholesterolaemic, respectively. Patients were compared to adult survivors of TOF repair with CT scans for any indication (controls). Results Ninety-three CoA/IAA patients (87% CoA/13% IAA, median age at latest follow-up 34 years) had a total of 169 chest and 37 abdomen/pelvis CTs; 82, 93, and 37 patients had at least 1 CT suitable for CAC, TAC, and AAC review, respectively. CAC was present in 22% (18/82), TAC in 33% (31/93), and AAC in 23% (5/22) of CoA/IAA patients. CAC was present in 12% (18/153) and TAC in 11% (18/158) of TOF patients. CoA/IAA patients were more likely to have CAC and TAC than TOF patients (p=0.04 and p&amp;lt;0.0001; respectively) and be younger at the time of diagnosis (CAC p=0.03, TAC p=0.0001) despite TOF patients being older at time of latest CT scan (p=0.0003) (Table 1). Males aged &amp;lt;35 years and females ≤45 years represented 44% (8/18) of CoA/IAA patients with CAC. CoA/IAA patients with CAC were more likely to be hypertensive and hypercholesterolaemic than those without (78% [14/18] vs 48% [31/64], p=0.03; and 28% [5/18] vs 0% [0/64], p&amp;lt;0.0001; respectively) and was similar for TAC (hypertension p=0.005, hypercholesterolaemia p=0.04) but not AAC. After a mean follow-up of 11±7 years from first ACHD clinic, of the 93 patients, 2 patients died, 5 had coronary artery disease (at least mild stenosis on invasive angiography), 3 had a stroke, and 70% (65/93) were considered hypertensive at latest follow-up. Conclusions There is a high prevalence of CAC, aortic calcification, and hypertension in young adults with repaired CoA/IAA. Coronary and thoracic aortic calcification occurs at a younger age compared to controls. Further studies are warranted to assess the impact of aggressive cardiovascular risk reduction in this high-risk group.

New culling technique provides localised reductions in interspecific aggression and density of Noisy Miners (Manorina melanocephala) without recolonisation

ABSTRACT The Noisy Miner (Manorina melanocephala) is a native Australian honeyeater that reduces avian biodiversity at sites it occupies through aggressive defence. Culling to remove miners has had limited success in some areas due to rapid recolonisation. This experiment trialled ‘doughnut culls’ as a new approach to reduce Noisy Miner aggression within a central area of colonies, by removing up to half the miners present within a 50 m radius of an identified central location in 29 different colonies on the New England Tablelands of NSW. Aggression from miners onsite within this central area was quantified before and after culling by presenting 3D printed models of three different bird species with accompanying vocal playback to resident miners at the centre of culled areas. These presentations identified a significant decline in Noisy Miner aggression onsite after doughnut culls, with this reduced rate of aggression (e.g. over 50% reduction in the maximum number of miners within a 20 m radius of models) remaining until the conclusion of the experiment at 28 days post culling, a timeframe commensurate with the duration of many passerine nesting attempts. Social hierarchy changes among remaining Noisy Miners may be the primary cause of this reduced aggression, with sufficient miners remaining onsite to prevent colony collapse and thus any recolonisation. While additional trials during peak Noisy Miner dispersal periods are warranted, this method provides an effective tool for land managers to reduce localised Noisy Miner aggression over the short to medium term when high conservation areas are identified.

Soundscape augmentation as a nonpharmacological intervention to reduce the behavioural effect of dementia: a randomized controlled trial

Soundscape is an important environmental factor that influences people's behaviour and well-being. People with dementia can benefit from a personalized soundscape to improve the behavioural and psychological syndrome of dementia. This paper is based on a single-blind, repeated-measure pilot randomized clinical trial of soundscape augmentation on the treatment effect of people with severe dementia. Participants were randomized to a personalized soundscape intervention delivered in their room in the morning and evening or treatment-as-usual, with two baseline weeks and four weekly post-randomization assessments of the primary and secondary behavioural outcomes. A linear mixed effects model showed that the soundscape intervention was possible and acceptable. There were improvements in the Neuropsychiatric Inventory (resistance to care) and a significant reduction in aggression in the soundscape group. This study is the first pilot randomized controlled trial of a soundscape intervention for older adults with dementia to improve the behavioural and psychological syndrome of dementia. In this pilot study, soundscape augmentation was a feasible and effective non-pharmacological approach to reducing resistance and improving participants' behaviour. Further studies with larger samples are recommended to confirm our findings. Longitudinal studies are necessary to investigate the long-term effect of an augmented sonic environment on people with dementia.

Psychological climate of class – factor for prevention and reduction of school aggressiveness

Current research and studies demonstrate that the problem of bullying-type aggressiveness in school is worsening internationally as well as nationally. Various factors that lead to aggressiveness and violence among students are extensively analyzed, including non-vulnerable factors. In recent decades, the focus has been on addressing the problem of bullying in school that is becoming complex and difficult to realize. In the given article, an attempt is made to address the issue of reducing and preventing student aggression by valorizing the values and functions of the students’ class and, above all, the healthy psychological climate. Namely the psychological climate creates a favorable environment for learning and education that strongly influences the behavior of students. The characteristics of psychological climate, the ways of forming a healthy psychological climate, principles and ways of valorizing the classroom climate in preventing and reducing aggressiveness and bullying-type aggressiveness in school are analyzed. Some forms and methods of carrying out this process were also described. The proposed concept opens up new perspectives for preventing and reducing aggressiveness, including bullying in educational institutions.

The Association Between Pulmonary Vascular Resistance and Posttransplant Outcomes Differs by Left Ventricular Assist Device Status.

Elevated pulmonary vascular resistance (PVR) is a risk factor for mortality after heart transplantation (HT), but whether this association differs for patients with and without left ventricular assist device (LVAD) support before HT is unknown. We analyzed adult first-time HT recipients from the United Network for Organ Sharing (UNOS) registry transplanted between 2010 and 2021. We quantified the association between PVR and the outcomes of 30 day graft failure and 1 year mortality using multivariable logistic regression, stratified by LVAD support status at the time of HT. Pulmonary vascular resistance was modeled using restricted cubic splines to identify clinically relevant risk thresholds. We also examined the association with 10 year survival using multivariable Cox proportional hazards regression. For PVR values less than approximately 2 WU, higher PVR was independently associated with a higher risk of early graft failure (odds ratio [OR] = 1.58, 95% CI: 1.06-2.36) and a higher risk of 1 year mortality (OR = 1.32, 95% CI: 1.10-1.59) among LVAD patients only (interaction p = 0.023 and 0.03, respectively). However, for patients surviving at least 1 year, PVR was not associated with long-term mortality among either subgroup. Whether more aggressive reduction of PVR among HT candidates supported with LVADs can mitigate these risks requires further study.

Examining the impact of brief couples-based posttraumatic stress disorder treatments on anger and psychological aggression in veterans and their partners.

Anger can adversely impact functioning in veterans. Psychological aggression, which is related to but distinct from anger, is particularly detrimental to veterans' mental health. Research examining anger and psychological aggression following individual therapy for posttraumatic stress disorder (PTSD) has demonstrated small effect sizes. Treatments that directly target conflict management and interpersonal functioning, both regarding content and delivery to veterans and their loved ones (e.g., couples-based PTSD treatments), may be more effective in alleviating anger symptoms. This study examined whether larger reductions in anger and psychological aggression would be observed in a couples-based intervention compared to an active comparator at posttreatment and follow-up. Data were derived from a randomized trial comparing brief cognitive-behavioral conjoint therapy for PTSD (bCBCT) and PTSD family education (PFE). Participants were 137 veterans and their intimate partners (bCBCT: n = 92, PFE: n = 45). We observed within-condition significant reductions in angry temperament, d = -0.47, p <.001, and angry reaction, d = -0.26, p =.004, among veterans in bCBCT but not PFE, |d|s = 0.13-0.17, ps =.166-.268. Veterans and partners in both conditions reported reductions in psychological aggression, |d|s = 1.09-1.46, ps <.001. There were no significant differences between the treatment conditions on any outcome, ps =.103-.443, and there were no significant changes in anger between posttreatment and follow-up, |d|s = 0.07-0.24, ps =.052-.582. Couples-based interventions for PTSD, including bCBCT and PFE, can be effective in improving aspects of anger among veterans and their intimate partners.

Tax avoidance, CSR performance and CEO characteristics: Evidence from developed and developing countries

We explore the association between tax avoidance, CEO characteristics, and corporate social responsibility based on environmental, social, and corporate governance (ESG) ratings, with a specific focus on financial firms in both developed and developing countries. Despite extensive literature on CSR and tax behavior, there is a gap in understanding how these elements interact within the financial sector across diverse economic environments. Using a dataset comprising 996 financial firms from 51 countries, spanning the period from 2002 to 2021, we find a significant negative association between ESG performance and tax avoidance for firms in developed countries, suggesting that firms in developed countries with higher ESG engagement tend to pay more taxes. The results in developed countries also indicate that governance and the social pillar are the factors contributing to the reduction of tax aggressiveness. On the contrary, our results reveal a significant positive relationship between CEO duality and tax avoidance for firms in developing countries. These results not only fill the existing research gap by providing empirical evidence in the links between ESG, CEO characteristics, and tax avoidance in the financial sector but also underscore the importance of institutional differences between developed and developing countries. Our results remain robust when using alternative estimators that control for heteroskedasticity and endogeneity. Our findings have important implications for policymakers and market participants, highlighting the need of a strong corporate governance and tax regulation that consider both ESG performance and CEO attributes.

FC51: A Big BIT: Utilizing Behavioral Intervention Team Approaches to Improve the Care of Older Adults on Med-Surg Units

Background: Older adults may exhibit behavioral disturbance while medically hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events including falls, elopements, or violence. The traditional consultation-liaison model addresses challenging or high-risk behaviors but is often reactive and may lead to missed opportunities. The interdisciplinary Behavioral Intervention Team (BIT) was implemented on the campus of Prisma Health Baptist Hospital in Columbia, SC to address and anticipate the need for behavioral health support on medical units.Methods: A pilot BIT program was implemented in September 2019. Two psychiatric nurses were embedded on med-surg units as a part of medical and psychiatric interdisciplinary teams. After obtaining approval from the Prisma Health Institutional Review Board, a retrospective review was conducted to evaluate the correlation between BIT interventions and patient safety events. Two time periods were examined: six months with early-BIT efforts and six months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated p- values (p &lt; 0.05).Results: Of admitted patients during the study period (N = 1413), almost half were age 65+. Pre- existing psychiatric diagnoses were present in 58% of cases with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% vs 61.3%, p &lt; 0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% vs 2.3%, p &lt; 0.001), use of restraints (5.8% vs 3.4%, p = 0.034) and need for security (4.2% vs 0.8%, p &lt; 0.001) were observed. Geriatric subgroup analysis demonstrated a significant decrease in the need for security only (4.6% vs 0.6%, p &lt; 0.001).Conclusions: Engaging BIT significantly reduced aggression, restraint use, and security interventions. As psychiatric comorbidities continue to impact overall treatment plans, care teams will need to prevent high-risk behaviors and events. Implementing an interdisciplinary BIT is feasible and effective in reducing negative outcomes.

Agonistic behaviors of boxer shrimps (Stenopus Species): Insights into the importance of antennae, antennules and tactile contact

Agonistic behaviors are crucial and ubiquitous among animals for the competition of limited resources. Although the study of aggression has been a popular topic, plenty of studies focused on model organisms, and typically on crayfish and lobsters for crustaceans. Variations of the agonistic behaviors and the underpinning eliciting cues of other crustaceans therefore have not been fully explored. In the present study, we targeted Stenopus, a genus of shrimp-like crustaceans that displays prominent agonistic behaviors when encountering conspecifics of the same sex owing to their monogamous social structure. Using S. hispidus (Olivier, 1811) and S. cyanoscelis (Goy, 1984) as representatives, we characterized their agonistic behaviors and fighting pattern, conducted experiments to investigate the contribution of visual, olfactory and tactile cues to inducing aggression, and examined the effects of antennal and antennular ablation on their agonistic interactions. A total of seven agonistic behaviors were documented, where antennal entwining and tactile contact is the major driver and seemingly important cue, respectively, in inducing agonistic behaviors in Stenopus. Although ablation of antennae and antennules did not inhibit fighting, behavioral changes, such as the prolonged agonistic interactions and the delayed establishment of dominance were observed, suggesting a reduction of aggressiveness. A comparison of agonistic behaviors with other crustaceans showed that certain features appeared to be unique or distinct in Stenopus, including the potential functional overlap of antennae and antennules, a higher aggressiveness of the fighting behaviors, and the exhibition of crouching behavior by submissive individuals. The present study provides a crucial background understanding for subsequent research on Stenopus and paves the way for its establishment as another crustacean model for studying aggression.

Inverse relationship between LDL-C/HDL-C ratio and atrial fibrillation in chronic kidney disease patients

Atrial fibrillation (AF) is more prevalent in individuals with chronic kidney disease (CKD) compared to the general population. While a potential inverse correlation between lipid levels and AF has been proposed, it remains unclear if this relationship applies to CKD patients. This study examined the connection between the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) and the likelihood of AF in CKD patients. Data was gathered from 21,091 consecutive CKD patients between 2006 and December 31, 2015. We examined the link between the LDL-C/HDL-C ratio and AF in CKD patients through binary logistic regression, as well as various sensitivity and subgroup analyses. The dataset that backs up these analyses is available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230189. Of the 21,091 CKD patients, 211 (1.00%) were diagnosed with AF. The cohort, predominantly male (79.93%), had a mean age of 60.89 ± 10.05 years. The mean LDL-C/HDL-C ratio was 1.39 ± 0.35. After adjusting for covariates, a significant inverse association was observed between the LDL-C/HDL-C ratio and the incidence of AF in CKD patients (OR = 0.422, 95% CI 0.273–0.652, P = 0.00010). The robustness of these findings was confirmed through sensitivity analysis. Subgroup analysis revealed a strong correlation between the LDL-C/HDL-C ratio and incident AF in patients without hypertension (HR = 0.26, 95% CI 0.15–0.45). Conversely, this association was absent in hypertensive patients (HR = 1.09, 95% CI 0.54–2.17). Our research shows an independent inverse correlation between the LDL-C/HDL-C ratio and the risk of AF in CKD patients. It is advised to refrain from excessively aggressive reduction of LDL levels in CKD patients, as this could elevate the risk of developing AF.

Sustained corneal nerve loss predicts the development of diabetic neuropathy in type 2 diabetes.

This study was undertaken to investigate whether sustained rather than a single measure of corneal nerve loss was associated with the onset of diabetic peripheral neuropathy (DPN) and the progression of neuropathic symptoms and deficits in individuals with type 2 diabetes (T2D). Participants underwent clinical, metabolic testing and assessment of neuropathic symptoms, vibration perception threshold (VPT), sudomotor function, and corneal confocal microscopy (CCM) at baseline, 1, 2, and 4-7 years. Sustained corneal nerve loss was defined as abnormal corneal nerve fiber density (CNFD, <24 fibers/mm2), corneal nerve branch density (CNBD, <21 branches/mm2), and corneal nerve fiber length (CNFL, <16 mm/mm2) persisting for ≥50% of the study duration. A total of 107 participants with a mean duration of T2D of 13.3 ± 7.3 years, aged 54.8 ± 8.5 years, underwent baseline and follow-up assessments over a median duration of 4 years, ranging from 1 to 7 years. The DPN prevalence at baseline was 18/107 (16.8%), and of the 89 participants without DPN at baseline, 13 (14.6%) developed DPN during follow-up. Approximately half of the cohort had sustained corneal nerve damage, and corneal nerve measures were significantly lower in this group than those without sustained damage (p < 0.0001). Sustained corneal nerve damage was associated with the development of DPN (p < 0.0001), a progressive loss of vibration perception (p ≤ 0.05), an increased incidence of burning pain, numbness, or a combination of both (p = 0.01-0.001), and a borderline association with progressive sudomotor dysfunction (p = 0.07). Sustained abnormal CNFL effectively distinguished between participants who developed DPN and those who did not (AUC: 76.3, 95% CI: 65.9-86.8%, p < 0.0001), while baseline and other sustained measures did not predict DPN onset. Sustained abnormal CCM is associated with more severe corneal nerve damage, DPN development, and the progression of neuropathic symptoms and deficits. Regular CCM monitoring may enable the identification of those at greater risk of developing and worsening DPN who may benefit from more aggressive risk factor reduction.

Evaluation of Tumorigenic Properties of MDA-MB-231 Cancer Stem Cells Cocultured with Telocytes and Telocyte-Derived Mitochondria Following miR-146a Inhibition.

Telocytes have some cytoplasmic extensions called telopodes, which are thought to play a role in mitochondrial transfer in intercellular communication. Besides, it is hypothesized that telocytes establish cell membrane-mediated connections with breast cancer cells in coculture and may contribute to the survival of neoplastic cell clusters together with other stromal cells. The aim of this study is to investigate the contribution of telocytes and telocyte-derived mitochondria, which have also been identified in breast tumors, to the tumor development of breast cancer stem cells (CSCs) via miR-146a-5p. The isolation/characterization of telocytes from bone marrow mononuclear cells and the isolation of mitochondria from these cells were performed, respectively. In the next step, CSCs were isolated from the MDA-MB-231 cell line and were characterized. Then, miR-146a-5p expressions of CSCs were inhibited by anti-miR-146a-5p. The epithelial-mesenchymal transition (EMT) was determined by evaluating changes in vimentin protein levels and was evaluated by analyzing BRCA1, P53, SOX2, E-cadherin, and N-cadherin gene expression changes. Our results showed that miR-146a promoted stemness and oncogenic properties in CSCs. EMT (N-cadherin, vimentin, E-cadherin) and tumorigenic markers (BRCA1, P53, SOX2) of CSCs decreased after miR-146a inhibition. Bone marrow-derived telocytes and mitochondria derived from telocytes favored the reduction of CSC aggressiveness following this inhibition.

Uncovering Complexities in Reducing Aggression, Conflict and Restrictive Practices in Acute Mental Healthcare Settings: An Overview of Reviews.

Aggression, conflict and restrictive practices present complexities in acute mental health services, as do implementing service changes to reduce them. Existing published literature needs to offer more high-level guidance on the effectiveness of these service changes and their associated implementation factors. As a result, an overview of systematic reviews was undertaken to identify (i) nonpharmacological interventions to reduce conflict, aggression and restrictive practices in acute mental health settings, and (ii) their effects across different clinical outcomes. A parallel re-extraction from primary studies was then utilised (iii) to identify factors influencing successful intervention implementation. Of 124 articles sourced from nine databases and registries, four reviews were retained for the final analysis, using the direction of effect and tabular and narrative summaries. These reviews included programmes or interventions focused on inpatient adolescent, adult and older adult populations. They reported on alternative containment strategies, risk assessments, Safewards, sensory rooms and equipment, Six Core Strategy-based interventions and staff training. The overview found that a combination of interventions intended to improve relationships and reduce interpersonal conflict may help reduce aggression, conflict and restrictive practices. At the same time, stand-alone staff training and sensory rooms and equipment may have mixed effects. The quality of the evidence linking these interventions to reductions in aggression, conflict and restrictive practices is limited. Successful implementation hinges on multiple factors: intervention characteristics, preparation and planning, evaluation and monitoring, outcome interpretation, stakeholder involvement/investment, staff-related factors and contextual factors. Any implementation initiative may benefit from using pragmatic and complexity-informed research methodologies, including integrating meaningful involvement with service users, peer workers and culturally diverse groups.

Сучасні підходи до організації партнерської взаємодії між учнями початкової школи

The article touches upon the problem of organization of partnership between modern primary school students as representatives of the Alpha generation. Scientific works on the outlined problem are analyzed: the essence of the concept of «partner interaction» in the philosophical, psychological, sociological and pedagogical contexts; Guidelines for distinguishing between models of partnership and traditional interaction at school are indicated. Particular attention is paid to the problem of developing students' emotional and social intelligence as important factors of effective partnership. It has been researched that the enrichment of emotional competence of schoolchildren contributes to the awareness and regulation of emotional states and behavior, the development of a sense of empathy and understanding of the world of other people, the formation of communication skills and the ability to resolve conflicts, the reduction of aggressiveness and antisocial behavior. And also, that the school class is an important formal group where the child's socialization takes place through relationships with classmates, emotionally rich and activity-mediated contacts and connections. To organize partnerships, it is necessary to select the most effective means, not forgetting that mutual understanding, mutual assistance, interdependence and complementarity are important in the student-student relationship. It is indicated that during the lessons it is advisable for the teacher to use role-playing games and special tasks that will contribute to mastering the techniques of interpersonal communication. Students gain experience of interaction in variable micro-groups and teams in the classroom, learn to recognize the contribution of others to joint work, the ability to adequately assess their abilities and capabilities, their contribution to joint activities related to the search for new information, the creation of research projects. Modern approaches and conditions for the organization of partnership interaction are outlined, specific examples are given.

Determinants of 1-year mortality after acute myocardial infarction in patients with and without diabetes

The gap in excess mortality between patients with and without diabetes has not decreased over time. The aim of this study was to investigate the determinants of mortality after acute myocardial infarction (AMI) in patients with diabetes and without diabetes in a contemporary population. A retrospective analysis of a cohort of 266 patients with a diagnosis of AMI during 2022 was carried out. Patients living with diabetes had higher 1-year mortality, even after adjustment for covariates. Estimated glomerular filtration (eGFR) rate was independently associated with increased mortality in patients with diabetes. Plasma glucose was independently associated with peak troponin in patients both with and without diabetes. These data suggest that patients living with diabetes and with a low eGFR warrant more aggressive risk reduction and use of nephroprotective medications. Further studies are needed to assess whether early blood glucose control improves cardiovascular outcomes in all patients with AMI.

Sparse deep encoded features with enhanced sinogramic red deer optimization for fault inspection in wafer maps

AbstractDue to the complexity and dynamics of the semiconductor manufacturing processes, wafer bin maps (WBM) present various defect patterns caused by various process faults. The defect type detection on wafer maps provides information about the process and equipment in which the defect occurred. Recently, automatic inspection has played a vital role in meeting the high-throughput demand, especially with deep convolutional neural networks (DCNN) which shows promising efficiency. At the same time, the need for a large amount of labeled and balanced datasets limits the performance of such approaches. In addition, complex DCNN in recognition tasks can provide redundant features that cause overfitting and reduce interpretability. In this paper, a new hybrid deep model for wafer map fault detection to get over these challenges is proposed. Firstly, a new convolutional autoencoder (CAE) is employed as a synthetization model to fix the high imbalance problem of the dataset. Secondly, for efficient dimensionality reduction, an embedding procedure is applied to the synthesized maps to get sparse encoded wafer maps by reinforcing a sparsity regularization in an encoder-decoder network to form a sparsity-boosted autoencoder (SBAE). The sparse embedding of wafer maps guarantees more discriminative features with 50% reduction in spatial size compared to the original wafer maps. Then, the 2D encoded sparse maps are converted to 1D sinograms to be fed later into another aggressive feature reduction stage using a new modified red deer algorithm with a new tinkering strategy. The resultant feature pool is reduced to ~ 25 1D feature bases, i.e., ~ 1.5% of the initial size of the 2D wafer maps. Finally, for the prediction stage, a simple 1DCNN model is introduced. The proposed inspection model is tested via different experiments on real-world wafer map dataset (WM-811K). Compared to state-of-the-art techniques, the proposed model outperforms their performance even with small-sized 1D feature pool. The average testing accuracy are 98.77% and 98.8% for 9 and 8 types of faults, respectively.

Optimal robust monetary and fiscal policy under uncertainty on the lower bound

This paper studies robust policy when the policymaker has Knightian uncertainty about the exact position of the effective lower bound (ELB). First, we characterize optimal discretionary policy when a benevolent policymaker controls the nominal interest rate and the level of government spending. Compared to the full information case, an uncertainty-averse policymaker overestimates the level of the ELB, thereby triggering a more aggressive reduction in the nominal interest rate prior to the liquidity trap. Furthermore, the anticipation of a larger increase in public spending improves the trade-off between inflation and the output gap, and dampens the perceived worst-case level of the ELB. As a result, a less conservative fiscal stabilization is desirable to address the uncertainty concerns of the policymaker by partially substituting for the nominal interest rate at the ELB. Moreover, an inflation-conservative policymaker mitigates the impact of uncertainty on equilibrium outcomes even better than a fiscally active policymaker.