Related Differences Research Articles

Entomophagy as an alternative source of protein and a new food strategy

With the projected growth of the world population, an increase in food production on a sustainable commercial scale, the search for alternative sources of protein and a shift to new eating strategies are needed. The article provides an overview of the existing relevant scientific information based on the analysis of publications in international (PubMed, MedLine, Google Scholar) and domestic (RSCI) electronic databases. The review considers the phenomenon of entomophagy as a potential solution to the problem of food shortage in the world, its biomedical, ecological, sociocultural, evolutionary and economic features. The species of the most commonly used edible insects and the countries in which insect biomass products have become traditional in the diet of the population are described. The nutritional value and consumer attitude to such products are highlighted. Insect biomass products are characterized by a high content of proteins, fats, minerals, vitamins and are superior in calories to traditional sources of animal and vegetable protein. In this regard, entomophagy has a preventive potential in the preparation of a diet and treatment for metabolic disorders, osteoporosis and other nosologies. The article notes gender differences in relation to adherence to entomophagy in Russia. Despite the revealed values of entomophagy, the issue of food safety for humans remains unresolved. Among the main concerns are the development of possible allergic reactions, the content of pathogenic microorganisms and harmful substances in the composition of food from insect biomass. The review presents the prospects for increasing the share of consumption of insect products and the economic benefits that the globalization of entomophagy will entail.

Motivational Profiles of High Achievers in Mathematics: Relations with Metacognitive Processes and Achievement Emotions

The current study aimed to explore alternative motivational profiles of high achievers in Mathematics, within the framework of the Situated Expectancy-Value Theory. Furthermore, it aimed to examine the profiles’ potential differences in relation to self-reported metacognitive processes, such as metacognitive awareness and experiences, and achievement emotions related to Mathematics. A comprehensive evaluation in Mathematics was conducted on a total of 492 ninth-graders, including students from regular junior high schools, experimental junior high schools, and an academically advanced summer program. The assessment involved a battery of school-type mathematical tasks, resulting in the identification of 141 high achievers. Cluster analysis, based on students’ expectancies for success, subjective value, and perceived cost in relation to Mathematics, revealed five motivational profiles labeled as follows: Cluster 1. Higher Motivation, Cluster 2: Higher Expectancies, Value, and Cost, Cluster 3: Lower Expectancies, Cluster 4: Lower Value, and Cluster 5: Lower Motivation. Differences were found among the five profiles in terms of students’ reported metacognitive awareness and their emotions of enjoyment, pride, anxiety, shame, and boredom toward Mathematics. Students with the Higher Motivation profile appeared to be the most adaptive across all of the examined variables, while students with the Lower Motivation profile reported less favorable levels of motivational and affective variables than most others. However, high achievers did not differ significantly regarding their metacognitive accuracy. Examination of the gender distribution within the clusters did not reveal any differences in gender representation.

Sex–related differences in non-ischemic myocardial injury in the emergency department: A real-world perspective

BackgroundMyocardial injury is associated with adverse outcomes. No data are reported about sex differences in incidence and factors associated with myocardial injury in an emergency department (ED) setting from a real-world perspective. We aimed to assess whether sex plays a major role in the diagnosis of myocardial injury in the ED. MethodsIn this subanalysis of a retrospective study, patients presenting at the ED with at least one high-sensitivity cardiac troponin T (hs-cTnT) value and without acute coronary syndromes diagnosis were compared. Results31,383 patients were admitted to the ED, 4660 had one hs-cTnT value, and 3937 were enrolled: 1943 females (49.4%) and 1994 males (50.6%). The diagnosis of myocardial injury was higher among men (36.8% vs. 32.9%, p < 0.01). Male sex was independently associated with myocardial injury. An older age, an elevated NT-proB-type Natriuretic Peptide and a lower estimated glomerular filtrate rate were independently associated with myocardial injury in both sexes. ConclusionsIn the ED, from a real-world perspective, myocardial injury occurred more frequently in males, and it was associated with older age and the presence of cardiac, lung, and kidney disease but not higher hs-cTnT values.

A Role of Gender in the Reciprocal Relations Between Intrinsic Reading Motivation and Reading Comprehension

ABSTRACT Purpose This study aims to better understand the role of gender in the reciprocal relations between intrinsic reading motivation and reading comprehension during adolescence. Method Utilizing data from the National Educational Panel Study (NEPS), this study focuses on a representative sample (N = 8,317) of German secondary school students, with approximately 48% female students and 26% students with immigration backgrounds. On average, students were 10.64 years old (SD = 0.37) at wave 1 in grade 5. Measurements for intrinsic reading motivation and reading comprehension were taken at three separate time points: grades 5, 7, and 9. A multi-group cross-lagged panel model was employed to examine gender similarities and differences in the reciprocal relations between intrinsic reading motivation and reading comprehension over four years. Results The results revealed reciprocal cross-lagged effects between intrinsic reading motivation and reading comprehension for both male and female students from grades 5 to 9. The strengths of cross-lagged effects between intrinsic reading motivation and reading comprehension were largely similar across genders. Conclusions This study provides insights into the reciprocal relations between intrinsic reading motivation and reading comprehension from grades 5 to 9, emphasizing that these relations are largely consistent across genders. The findings reinforce the generalization of the positive reciprocal relations between intrinsic reading motivation and reading comprehension, regardless of gender or age. It calls for caution in interpreting gender differences without considering the complex, reciprocal nature of these variables and highlights potential avenues for future research.

Injury and performance related biomechanical differences between recreational and collegiate runners.

Running related injuries (RRI) are common, but factors contributing to running performance and RRIs are not commonly compared between different types of runners. We compared running biomechanics previously linked to RRIs and performance between 27 recreational and 35 collegiate runners. Participants completed 5 overground running trials with their dominant limb striking a force plate, while outfitted with standardised footwear and 3-dimensional motion capture markers. Post hoc comparisons revealed recreational runners had a larger vertical loading rate (194.5 vs. 111.5 BW/s, p < 0.001) and shank angle (6.80 vs. 2.09, p < 0.001) compared with the collegiate runners who demonstrated greater vertical impulse (0.349 vs. 0.233 BWs, p < 0.001), negative impulse (-0.022 vs. -0.013 BWs, p < 0.001), positive impulse (0.024 vs. 0.014 BWs, p < 0.001), and propulsive force (0.390 vs. 0.333 BW, p = 0.002). Adjusted for speed, collegiate runners demonstrated greater total support moment (TSM), plantar flexor moment, knee extensor moment, hip extensor moment, and had greater proportional plantar flexor moment contribution and less knee extensor moment contribution to the TSM compared with recreational runners. Unadjusted for speed, collegiate runners compared with recreational had greater TSM and plantar flexor moment but similar joint contributions to the TSM. Greater ankle joint contribution may be more efficient and allow for greater capacity to increase speed. Improving plantarflexor function during running provides a strategy to improve running speed among recreational runners. Moreover, differences in joint kinetics and ground reaction force characteristics suggests that recreational and collegiate runners may experience different types of RRI.

Psychometric evaluation of the Worst Pruritus Numerical Rating Scale (NRS), Atopic Dermatitis Symptom Scale (ADerm-SS), and Atopic Dermatitis Impact Scale (ADerm-IS)

Background Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritus, skin pain, and sleep impacts, which are only reportable by patients themselves. The goal of this research is to evaluate the reliability, validity, and interpretability of the scores from three patient-reported outcome measures within the context of a clinical trial for adolescents and adults with moderate to severe AD. Methods Data from a Phase 3 randomized, double-blind, placebo-controlled, multinational clinical trial for individuals 12–75 years of age with moderate to severe AD (AD Up [ClinicalTrials.gov NCT03568318]) were used to assess the reliability, validity, and interpretability of scores on the Worst Pruritus Numerical Rating Scale (NRS) and the Atopic Dermatitis Symptom and Impact Scales (ADerm-SS and ADerm-IS). Analyses were conducted separately for the adult and adolescent subgroups. Results Of the 882 participants included in the psychometric analyses, the majority were adults (n = 769, 87.2%), male (n = 536, 60.8%), and white (n = 630, 71.4%). Multi-item scores from the ADerm-SS and ADerm-IS had good internal consistency reliability, and most scores demonstrated acceptable test-retest reliability. Scores from the three questionnaires demonstrated adequate validity, exhibiting correlations with other conceptually related outcome assessments and score differences between clinically distinct subgroups. Finally, the score interpretation analyses provide estimates for meaningful within-person change and between-groups difference thresholds that may be useful for future research in adults and adolescents with moderate to severe AD. Conclusions These results provide evidence that the scores produced by the Worst Pruritus NRS, ADerm-SS, and ADerm-IS are reliable and construct-valid when completed by adults and adolescents with moderate to severe AD in a clinical trial setting. The results presented here expand upon the previous qualitative evidence of these tools and provide further support for their use in future clinical studies. While results are specific to clinical trials, next steps would be to evaluate the use of these questionnaires in clinical practice. This can provide clinicians and dermatologists a window into the patient’s disease experience outside of the clinic, aid in shared decision making, and support a patient-centric approach to management of moderate to severe AD.

Mediators of parental educational differences in the intake of carbonated sugar-sweetened soft drinks among adolescents, and the moderating role of neighbourhood income

BackgroundExisting evidence suggests that the intake of sugar-sweetened beverages (SSB) among adolescents remains a public health concern and that socioeconomic differences in intake exist. Tackling these challenges requires identifying the factors associated with SSB intake and the mediators of socioeconomic differences in SSB intake among adolescents. Thus, this study aimed to explore (i) factors at different levels of the ecological model associated with the intake of carbonated soft drinks with added sugar (hereafter called soft drinks), (ii) mediators of the association between parental education and the intake of soft drinks(iii) whether neighbourhood income moderates the indirect effect of parental education on adolescents’ soft drink intake through potential mediators.MethodsData from 826 7th graders in Oslo, Norway, who participated in the TACKLE cross-sectional study conducted in 2020 were used. The association between factors at the individual, interpersonal and neighbourhood food environment levels and the intake of soft drinks among adolescents was assessed, as well as the mediating roles of these factors for the differences in intake by parental education, using multiple logistic regression and mediation analysis, respectively. Moderated mediation analyses were used to explore whether an indirect effect of parental education on adolescents' soft drink intake through potential mediators varies across neighbourhood income areas.ResultsHigher perceived accessibility of SSB at home, increased parental modelling for SSB intake, and increased frequency of food/drink purchased from the neighbourhood store were associated with a higher intake of soft drinks among adolescents and mediated the differences in intake by parental education. Neighbourhood food environment factors were neither statistically significantly associated with adolescents’ higher intake of soft drinks nor explained the differences in intake by parental education. Moderated mediation analysis showed that the mediating effect of perceived accessibility of SSB at home on the association between parental education and adolescent soft drink intake was stronger among those living in low neighbourhood income.ConclusionsOur study identified modifiable factors at the intrapersonal level (perceived accessibility of SSB at home and frequency of food/drink purchased from neighbourhood shops) and interpersonal levels (parental modelling for SSB intake) associated with a higher intake of soft drinks among adolescents and mediated the differences in the intake by parental education. The modifiable factors identified in this study could be targeted in public health initiatives among adolescents aimed at reducing the intake of soft drinks and the related differences by parental education.

Are adolescents more socially integrated in all-day schools than in half-day schools?&#x0D;

Abstract: In Germany, the number of all-day schools has been steadily increasing since 2001. This study examines the social relationships of students in all-day and half-day schools. We hypothesized that spending more time with different classmates in extracurricular activities and a greater emphasis on social skills in all-day schools contribute to higher levels of social integration. We also expected that classrooms with higher participation rates in extracurricular activities would exhibit higher levels of social integration. We analyzed data from the IQB Trends in Student Achievement 2018 study, including information from 10,010 ninth-grade students (15.49 years old; 49.0% girls) in 481 classrooms from 368 German secondary schools (202 half-day and 166 all-day schools). Linear regression analyses of different social integration measures at the classroom level, including self-reported and sociometric items, enabled us to explore differences in social relations based on extracurricular participation, controlling for school track and composition. Results showed that all-day schools exhibited higher levels of social integration than half-day schools. Additionally, classrooms with higher extracurricular participation rates displayed higher levels of social integration than classrooms with lower extracurricular participation rates. However, the effects of these findings were small.

Determinants of under-five mortality in Sri Lanka: A multilevel analysis of 2016 Sri Lankan DHS data.

Under-five mortality (U5M) is considered a major public health issue directly impacts a country's development. This study analyzed the prognostic factors of U5M in Sri Lanka using data from the 2016 Demographic and Health Survey (DHS) of 8123 children. The study employed both a binary logistic regression model (BLRM) and a binary logistic random intercept multilevel model (BLRIMM) and compared the accuracy of each model's prediction percentage. The results showed that the BLRIMM had a higher correct prediction percentage (98.67%) compared to the BLRM (98.31%). The study found that children who were not breastfed (Odds Ratio (OR) = 116.74, 95% Confidence Interval (CI) = 62.97-216.41), were part of multiple births (OR = 3.73, 95% CI = 1.21-11.51), did not have a normal delivery (OR = 1.86, 95% CI = 1.11-3.12), were born to mothers who had experienced previous miscarriages or child loss (OR = 2.27, 95% CI = 1.26-4.11), and were born to mothers with a higher Body Mass Index (BMI) (OR = 1.05, 95% CI = 1.003-1.10) had higher odds of U5M. The odds of U5M were found to be lower among Buddhists (OR = 0.06, 95% CI = 0.01-0.50), Hindus (OR = 0.05, 95% CI = 0.01-0.46), and Roman Catholics (OR = 0.032, 95% CI = 0.003-0.307) compared to the "Other Religions" category in the dataset. The estimated covariance parameter of the random intercept (0.8231, p-value = 0.0405) indicated significant unobserved cluster-level variation in U5M. The study's results emphasize the importance of addressing religion related differences of U5M and improving maternal education regarding healthy lifestyle, proper food intake, the significance of breastfeeding, safe delivery methods, safety measures during pregnancy and childbirth in cases of multiple births, and proper child care after birth.

A tale of two cities: How a psychological network approach can improve our understanding of local residents’ risk perception of the process industries

The current study illustrates how an empirical psychological network approach can be employed to shed light onto the interplay of risk perception and related psychological variables. In doing so, we present a case study on local residents’ perception of risk related to the handling of hazardous substances in their direct living environment, which combines different levels of the integrative risk perception framework in a network estimated with survey data from Dutch residents (N = 1026). Additionally, we examine the impact of a form of personal relevance by comparing cities (i.e., Zaandam nearby a chemical cluster [n = 457] and Deventer with fewer chemical companies [n = 569]). Results showed how, in the context of handling hazardous substances, 1) the different levels of the integrative risk perception framework are interrelated, 2) this approach can help prioritize levels of the framework and specific elements for future research (i.e., cognitive-affective factors appear to be relatively important), and 3) comparing the risk perception networks of different cities revealed that they are generally comparable, although differences in relations between specific variables can be observed. Future research should obtain insight into directions of relations between variables in the risk perception network related to handling hazardous substances to improve our understanding of the network dynamics. Employing a psychological network approach in other risk contexts could improve the understanding of risk perception in more safety domains.

Triglyceride Clearance in Hypertriglyceridemic Pancreatitis: Time Course and Its Implications for Management

ObjectiveTo characterize the time course of triglyceride (Tg) lowering in hypertriglyceridemic (HTg) pancreatitis according to the initial Tg values, causes, and interventions. MethodsPatients hospitalized from October 2013 through December of 2018 with a diagnosis of pancreatitis associated with HTg (Tg level, ≥500 mg/dL), in the absence of other causes, were identified by medical record review. Tg lowering was retrospectively assessed for differences in relation to the initial Tg values, use of intravenous insulin, ethanol-associated versus nonethanol-associated causes, and time to Tg values of <500 versus <1000 mg/dL. ResultsSixty-six cases were identified, and 45 had multiple measurements for time-course evaluation. Those with initial Tg values of <4000 mg/dL achieved Tg levels of <1000 mg/dL in <3 days, whereas 18.8% with higher values took 5–9 days. Insulin therapy was associated with a longer duration of HTg, whereas ethanol was associated with a shorter duration. Tg clearance in ethanol-associated HTg appeared independent of insulin treatment. Time to Tg levels of <500 mg/dL versus <1000 mg/dL was significantly longer when the initial Tg levels were >2000 mg/dL. ConclusionA threshold of 4000 mg/dL for the initial Tg levels in HTg pancreatitis appears to separate patients who are likely to achieve Tg levels of <1000 mg/dL in <3 versus >3 days, independent of cause or treatment. Insulin therapy is appropriate for patients with hyperglycemia but appears unnecessary for those with isolated ethanol-associated HTg. A threshold Tg level of <1000 mg/dL appears more practical than that of <500 mg/dL for resuming nutritional intake.

Children With Bilateral Cerebral Palsy Exhibit Bimanual Asymmetric Motor Deficits and EEG Evidence of Dominant Sensorimotor Hemisphere Overreliance During Reaching.

Reaching is a fundamental motor skill often impaired in cerebral palsy (CP). Studies on manual function, intervention, and underlying brain mechanisms largely focus on unilateral CP. This first electroencephalography (EEG) evaluation of reaching exclusively in bilateral CP aims to quantify and relate brain activation patterns to bimanual deficits in this population. A total of 15 children with bilateral CP (13.4 ± 2.9 years) and 13 with typical development (TD: 14.3 ± 2.4 years) performed 45 reaches per hand while recording motion capture and EEG data. The Box and Blocks test was administered bilaterally. Cortical sources were identified using independent component analysis and clustered using k-means. Alpha (8-12 Hz) and beta (13-30 Hz) band event-related desynchronization (ERD) values were compared across groups and hands within clusters, between dominant and non-dominant sensorimotor clusters, and related to reach kinematics and the Box and Block test. The group with CP demonstrated bimanual motor deficits with slower reaches, lower Box and Blocks scores, and stronger hand preference than in TD. Beta ERD, representing motor execution, was notably higher in the dominant sensorimotor cluster in CP compared to TD. Both groups demonstrated more contralateral than ipsilateral activity in both hands and clusters, with CP showing a less lateralized (more bilateral) alpha response. Higher brain activation was generally related to better function. Bimanual deficits in bilateral CP and related EEG differences warrant more clinical and research attention particularly earlier in life when greater potential for neural and functional recovery exists.

Analysis of Australian public acceptance of fully automated vehicles by extending technology acceptance model

There has been an increasing trend in using user acceptance models to explore the public acceptance of automated vehicles (AVs) in different countries. Most of the previous studies have analysed perceived usefulness, behavioural attitude, subjective norms as well as perceived ease of use, but other important factors, such as trust and data privacy, have not been adequately considered. Likewise, public perceptions of fully AVs are limited in the literature as most studies focus on different levels of automation. This study aims to assess the behavioural intention to use fully AVs in Australia by extending the Technology Acceptance Model (TAM) that includes data privacy and trust in the TAM constructs. Based on a survey of 809 adult respondents from Australia, the model was evaluated with Structural Equation Modelling.The research revealed perceived trust and perceived data privacy is the first and second most important variable affecting the attitude, followed by perceived ease of use and usefulness. Perceived data privacy was discovered to positively impact attitude, perceived trust, perceived usefulness, perceived ease of use as well as behavioural intentions. The perceived trust mediated perceived data privacy on the attitudes in this study. Additionally, the two major variables in the proposed model – perceived trust and data privacy- affect attitudes of AVs significantly, with total effects being 0.637 and 0.604, respectively. Attitude is the most significant variable that correlates with behavioural intentions, which leads to acceptance of fully AVs. Multigroup analysis showed the gender, age and income related differences regarding the public acceptance of AVs. Several theoretical and practical implications are discussed in this paper.

Neural Differences in Relation to Risk Preferences during Reward Processing: An Event-Related Potential Study.

Inter-individual variability in risk preferences can be reflected in reward processing differences, making people risk-seekers or risk-averse. However, the neural correlates of reward processing in individuals with risk preferences remain unknown. Consequently, this event-related potential (ERP) study examined and compared electrophysiological correlates associated with different stages of reward processing in risk-seeking and risk-averse groups. Individuals scoring in the bottom and top 20% on the Balloon Analogue Risk Task (BART) were deemed risk-averse and risk-seeking, respectively. Participants engaged in a gambling task while their electroencephalogram (EEG) was recorded. Risk-seekers tended to choose high-risk options significantly more frequently than low-risk options, whereas risk-averse individuals chose low-risk options significantly more frequently than high-risk ones. All participants selected the low-risk alternative more slowly than the high-risk option. During the anticipation stage, the low-risk option elicited a relatively attenuated stimulus-preceding negativity (SPN) response from risk-seekers compared to risk-averse participants. During the outcome stage, feedback-related negativity (FRN) increased in risk-seekers responding to greater losses but not in risk-averse participants. These results indicate that ERP components can detect differences in reward processing during risky situations. In addition, these results suggest that motivation and cognitive control, along with their associated neural processes, may play a central role in differences in reward-based behavior between the two groups.

Inhibition of Acinetobacter baumannii Biofilm Formation Using Different Treatments of Silica Nanoparticles.

There exists a multitude of pathogens that pose a threat to human and public healthcare, collectively referred to as ESKAPE pathogens. These pathogens are capable of producing biofilm, which proves to be quite resistant to elimination. Strains of A. baumannii, identified by the "A" in the acronym ESKAPE, exhibit significant resistance to amoxicillin in vivo due to their ability to form biofilm. This study aims to inhibit bacterial biofilm formation, evaluate novel silica nanoparticles' effectiveness in inhibiting biofilm, and compare their effectiveness. Amoxicillin was utilized as a positive control, with a concentration exceeding twice that when combined with silica NPs. Treatments included pure silica NPs, silica NPs modified with copper oxide (CuO.SiO2), sodium hydroxide (NaOH.SiO2), and phosphoric acid (H3PO4.SiO2). The characterization of NPs was conducted using scanning electron microscopy (SEM), while safety testing against normal fibroblast cells was employed by MTT assay. The microtiter plate biofilm formation assay was utilized to construct biofilm, with evaluations conducted using three broth media types: brain heart infusion (BHI) with 2% glucose and 2% sucrose, Loria broth (LB) with and without glucose and sucrose, and Dulbecco's modified eagle medium/nutrient (DMEN/M). Concentrations ranging from 1.0 mg/mL to 0.06 µg/mL were tested using a microdilution assay. Results from SEM showed that pure silica NPs were mesoporous, but in the amorphous shape of the CuO and NaOH treatments, these pores were disrupted, while H3PO4 was composed of sheets. Silica NPs were able to target Acinetobacter biofilms without harming normal cells, with viability rates ranging from 61-73%. The best biofilm formation was achieved using a BHI medium with sugar supplementation, with an absorbance value of 0.35. Biofilms treated with 5.0 mg/mL of amoxicillin as a positive control alongside 1.0 mg/mL of each of the four silica treatments in isolation, resulting in the inhibition of absorbance values of 0.04, 0.13, 0.07, 0.09, and 0.08, for SiO2, CuO.SiO2, NaOH.SiO2 and H3PO4.SiO2, respectively. When amoxicillin was combined, inhibition increased from 0.3 to 0.04; NaOH with amoxicillin resulted in the lowest minimum biofilm inhibitory concentration (MBIC), 0.25 µg/mL, compared to all treatments and amoxicillin, whereas pure silica and composite had the highest MBIC, even when combined with amoxicillin, compared to all treatments, but performed better than that of the amoxicillin alone which gave the MBIC at 625 µg/mL. The absorbance values of MBIC of each treatment showed no significant differences in relation to amoxicillin absorbance value and relation to each other. Our study showed that smaller amoxicillin doses combined with the novel silica nanoparticles may reduce toxic side effects and inhibit biofilm formation, making them viable alternatives to high-concentration dosages. Further investigation is needed to evaluate in vivo activity.

Implementing Agile Data Workflows to Unlock Climate-Resilient Urban Planning

Cities around the world are facing the implications of a changing climate as an increasingly pressing issue. The negative effects of climate change are already being felt today. Therefore, adaptation to these changes is a mission that every city must master. Leading practices worldwide demonstrate various urban efforts on climate change adaptation (CCA) which are already underway. Above all, the integration of climate data, remote sensing, and in situ data is key to a successful and measurable adaptation strategy. Furthermore, these data can act as a timely decision support tool for municipalities to develop an adaptation strategy, decide which actions to prioritize, and gain the necessary buy-in from local policymakers. The implementation of agile data workflows can facilitate the integration of climate data into climate-resilient urban planning. Due to local specificities, (supra)national, regional, and municipal policies and (by) laws, as well as geographic and related climatic differences worldwide, there is no single path to climate-resilient urban planning. Agile data workflows can support interdepartmental collaboration and, therefore, need to be integrated into existing management processes and government structures. Agile management, which has its origins in software development, can be a way to break down traditional management practices, such as static waterfall models and sluggish stage-gate processes, and enable an increased level of flexibility and agility required when urgent. This paper presents the findings of an empirical case study conducted in cooperation with the City of Constance in southern Germany, which is pursuing a transdisciplinary and trans-sectoral co-development approach to make management processes more agile in the context of climate change adaptation. The aim is to present a possible way of integrating climate data into CCA planning by changing the management approach and implementing a toolbox for low-threshold access to climate data. The city administration, in collaboration with the University of Applied Sciences Constance, the Climate Service Center Germany (GERICS), and the University of Stuttgart, developed a co-creative and participatory project, CoKLIMAx, with the objective of integrating climate data into administrative processes in the form of a toolbox. One key element of CoKLIMAx is the involvement of the population, the city administration, and political decision-makers through targeted communication and regular feedback loops among all involved departments and stakeholder groups. Based on the results of a survey of 72 administrative staff members and a literature review on agile management in municipalities and city administrations, recommendations on a workflow and communication structure for cross-departmental strategies for resilient urban planning in the City of Constance were developed.

Three-dimensional echocardiographic evaluation of longitudinal and non-longitudinal components of right ventricular contraction: results from the World Alliance of Societies of Echocardiography study.

Right ventricular (RV) functional assessment is mainly limited to its longitudinal contraction. Dedicated three-dimensional echocardiography (3DE) software enabled the separate assessment of the non-longitudinal components of RV ejection fraction (EF). The aims of this study were (i) to establish normal values for RV 3D-derived longitudinal, radial, and anteroposterior EF (LEF, REF, and AEF, respectively) and their relative contributions to global RVEF, (ii) to calculate 3D RV strain normal values, and (iii) to determine sex-, age-, and race-related differences in these parameters in a large group of normal subjects (WASE study). 3DE RV wide-angle datasets from 1043 prospectively enrolled healthy adult subjects were analysed to generate a 3D mesh model of the RV cavity (TomTec). Dedicated software (ReVISION) was used to analyse RV motion along the three main anatomical planes. The EF values corresponding to each plane were identified as LEF, REF, and AEF. Relative contributions were determined by dividing each EF component by the global RVEF. RV strain analysis included longitudinal, circumferential, and global area strains (GLS, GCS, and GAS, respectively). Results were categorized by sex, age (18-40, 41-65, and >65 years), and race. Absolute REF, AEF, LEF, and global RVEF were higher in women than in men (P < 0.001). With aging, both sexes exhibited a decline in all components of longitudinal shortening (P < 0.001), which was partially compensated in elderly women by an increase in radial contraction. Black subjects showed lower RVEF and GAS values compared with white and Asian subjects of the same sex (P < 0.001), and black men showed significantly higher RV radial but lower longitudinal contributions to global RVEF compared with Asian and white men. 3DE evaluation of the non-longitudinal components of RV contraction provides additional information regarding RV physiology, including sex-, age-, and race-related differences in RV contraction patterns that may prove useful in disease states involving the right ventricle.

Relevance of Sociocultural Inequalities and Parents' Origins in Relation to the Oral Health of Preschoolers in Lanzarote, Spain.

Approaching inequalities to achieve health equity requires joint action. Early childhood caries affects disadvantaged population groups. The objective of this study was to determine the relevance of sociocultural inequalities and parental origin with respect to oral health in preschool children in Lanzarote. A transversal epidemiological study was carried out. Sociocultural data and information about parental origin were collected via a questionnaire. The decayed and filled teeth (dft), decayed teeth (dt), filled teeth (ft), restorative index (RI), plaque index (PI) and gingival index (GI) were obtained via an investigator's examination. Statistical analysis of the data indicated that children of semi-skilled manual workers (28.15%) had the highest prevalence of caries (46.9%). Additionally 43.7 of the mothers had second grade and first cycle studies. When relating the medium and high level of education, there were statistically significant differences in relation to the cod index (p = 0.046). When the origin was foreign (48.4%), preschoolers presented 10.7% more active or untreated caries than Spaniards (p = 0.038). Low socioeconomic cultural level and foreign origin is associated with a more deficient state of oral health in preschoolers. Oral health programs are needed to minimize social inequalities.

Self-measured home blood pressure highlights cardiovascular risk in women: the HOMED-BP study.

No studies examined sex differences in relation to the prognostic significance of self-measured home blood pressure (HBP). We compared the predictive power for the risk of cardiovascular events in 1547 women and 1516 men with hypertension using HBP captured at treatment-free baseline and during on-treatment follow-up, based on the Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP) study. To express the change in risk for the composite cardiovascular endpoint associated with a 1-SD increase in HBP at baseline or on treatment, we derived multivariable-adjusted hazard ratios (HR) based on a Cox regression model. Over a median follow-up of 7.3 years, 100 composite events occurred, including 40 events in women. In women, systolic HBP both at baseline and on-treatment showed significant risk increment (at baseline: HR per 1-SD increment, 1.62; 95% confidence interval [CI], 1.17-2.24. on-treatment: HR, 1.74; 95% CI, 1.32-2.29). However, systolic HBP at baseline did not predict cardiovascular events in men (P = 0.25). On-treatment HBP was significantly associated with cardiovascular risk (P ≤ 0.012) irrespective of sex. Nevertheless, the point estimate of HR for systolic HBP in men (1.33) was less than that in women (1.74), and the interaction of sex with 1 SD-increase in systolic HBP in cardiovascular risk was significant irrespective of baseline (P = 0.039) or follow-up (P = 0.040) measurement when they were mutually adjusted. The increase in cardiovascular risk with the systolic HBP was steeper in women than in men for both baseline and on-treatment. The current findings unveil the importance of the control of systolic HBP, especially in women. Clinical Trial Registration: UMIN Clinical Trial Registry ( http://www.umin.ac.jp/ctr ), Unique identifier: C000000137.

DNA Methylation Identifies Epigenetic Subtypes of Triple-Negative Breast Cancers With Distinct Clinicopathologic and Molecular Features

Triple-negative breast cancers (TNBC) include diverse carcinomas with heterogeneous clinical behavior. DNA methylation is a useful tool in classifying a variety of cancers. In this study, we analyzed TNBC using DNA methylation profiling and compared the results to those of mutational analysis. DNA methylation profiling (Infinium MethylationEPIC array, Illumina) and 50-gene panel–targeted DNA sequencing were performed in 44 treatment-naïve TNBC. We identified 3 distinct DNA methylation clusters with specific clinicopathologic and molecular features. Cluster 1 (phosphoinositide 3-kinase/protein kinase B–enriched cluster; n = 9) patients were significantly older (mean age, 71 years; P = .008) with tumors that were more likely to exhibit apocrine differentiation (78%; P < .001), a lower grade (44% were grade 2), a lower proliferation index (median Ki-67, 15%; P = .002), and lower tumor-infiltrating lymphocyte fractions (median, 15%; P = .0142). Tumors carried recurrent PIK3CA and AKT1 mutations and a higher percentage of low HER-2 expression (89%; P = .033). Cluster 3 (chromosomal instability cluster; n = 28) patients were significantly younger (median age, 57 years). Tumors were of higher grade (grade 3, 93%), had a higher proliferation index (median Ki-67, 75%), and were with a high fraction of tumor-infiltrating lymphocytes (median, 30%). Ninety-one percent of the germline BRCA1/2 mutation carriers were in cluster 3, and these tumors showed the highest level of copy number alterations. Cluster 2 represented cases with intermediate clinicopathologic characteristics and no specific molecular profile (no specific molecular profile cluster; n = 7). There were no differences in relation to stage, recurrence, and survival. In conclusion, DNA methylation profiling is a promising tool to classify patients with TNBC into biologically relevant groups, which may result in better disease characterization and reveal potential targets for emerging therapies.