Higher Initial Levels Research Articles

Diagnostic Accuracy of Carcinoembryonic Antigen (CEA) in Detecting Colorectal Cancer Recurrence Depending on Its Preoperative Level

BackgroundSerum carcinoembryonic antigen (CEA) increase in patients with colorectal cancer (CRC) recurrence was observed to vary depending on their initial values. This study aimed to evaluate the diagnostic accuracy of CEA for detecting CRC recurrence in patients with normal and elevated initial CEA levels. MethodsA total of 261 CRC recurrence patients who underwent curative resection were included and divided into two groups, normal and elevated initial CEA. Analysis was performed comparing patient, tumor, and recurrence characteristics retrospectively. ResultsThere were 192 patients with normal and 69 with high initial CEA levels. Patient and tumor characteristics were similar. Eighty-six patients had elevated CEA at the time of recurrence, and the overall sensitivity of CEA for recurrence was 33.0%. In the high initial CEA group, 59.4% exhibited increased CEA level at recurrence, whereas in patients with normal initial CEA levels, only 23.4% showed elevated levels (p < 0.001). Patients with both high CEA preoperatively and at recurrence had more local recurrence, but there was no statistical significance (p = 0.053), and the rate of lung metastasis was higher in patients whose CEA remained normal at recurrence (38.3% vs. 24.4%, p = 0.026). The overall survival of patients with elevated CEA at recurrence was worse than those with normal CEA levels (56.9% vs. 42.4%, p = 0.003). ConclusionThe diagnostic accuracy of CEA for detecting recurrence depends on initial CEA level. Regardless of the initial CEA level, elevation at recurrence was significantly associated with overall survival in patients with recurrent CRC.

Temporal correlations of ferroptosis, inflammation and oxidative stress under acute ammonia exposure in brain tissue of yellow catfish (Pelteobagrus fulvidraco)

Ammonia is one of the most serious environmental stressors which severely affect fishery production. Ammonia toxicity to fish has a tight relationship with oxidative stress, inflammation and ferroptosis (a type of programmed cell death characterized by iron-dependent lipid peroxidation), but the temporal response of the above three in brain remains unclear. In the present study, yellow catfish were exposed to three concentrations of ammonia: low concentration (TA-N ˂ 0.01 mg L−1, LA), middle concentration (TA-N 5.70 mg L−1, MA), high concentration (TA-N 28.50 mg L−1, HA) for 96 h. Brain was selected as target tissues for analysis. Results showed that ammonia stress resulted in firstly increased contents of hydroxyl radical at 1 h, total iron at 12 h, malondialdehyde at 48 h, respectively, and decreased contents of GSH at 3 h. The initial high expression levels of ferroptosis (GPX4, system xc−, TFR1) and inflammatory-related factors (NF-ƙB p65, TNF, COX-2, and LOX-15B), antioxidant enzymes genes (SOD and CAT) were observed at first hour upon MA or HA stress. Combining all, it suggested that brain ferroptosis and inflammation were the first to be activated at the initial stage of ammonia stress, and then that provoked oxidative stress.

MODERN COMBINED TREATMENT OF ACUTE COMPLICATED CYSTITIS IN WOMEN

One of the most common human diseases is acute cystitis, which affects mainly women. Annually in Russia there are 26-36 million cases of acute cystitis. The most severe contingent is considered to be patients with acute complicated cystitis, whose treatment efficiency is only 64.6–85.8% or less. Objective. Evaluation of the analgesic effect, efficacy and tolerability of phenazopyridine in combination with the antibiotic cefixime for the treatment of acute complicated cystitis in women of working age. Material and methods. A multicenter randomized open study of phenazopyridine in combination with the antibiotic cefixime in the treatment of 144 women with an average age of 42.2±3.8 years with acute complicated cystitis was performed in 5 polyclinics of the Perm region. In 55.6% of patients, the risk factors were not urological, but therapeutic and gynecological diseases. The international scale of cystitis ACSS, visual analogue scale (VAS) of pain, laboratory and bacteriological methods were used. The main group consisted of 72 women who received oral phenazopyridine (Urinalgin F) at a dose of 200 mg 3 times a day for 2 days and cefixime 400 mg 1 time per day for 7 days. The comparison group consisted of 72 women who received orally cefixime at the same dose for 7 days and No-spa (drotaverine hydrochloride) 80 mg 3 times a day for 2 days. Results. In the main group, a strong analgesic and antidysuric effect of phenazopyridine was noticed, which was confirmed by the analysis of the ACSS and VAS scales. Already after 20 minutes, an analgesic effect was detected, after 2 days pain symptoms and dysuria completely disappeared in 70 (97.2%) patients, despite the high initial level. The pain index on the VAS scale decreased from the initial 6.5 points to 0.03 points, i.e. by 217 times. The clinical efficacy (recovery) of combination therapy with phenazopyridine and cefixime was 91.7%, bacteriological efficacy was 91.8%, leukocyturia disappeared earlier, and the period of temporary disability decreased by 28.6%. In the comparison group, clinical (83.3%) and bacteriological (83.6%) efficiency was lower. Urinalgin F showed a favorable safety profile, only 1 (1.4%) patient had a side effect (nausea). Conclusion. Phenazopyridine (Urinalgin F) is a drug with high effectiveness and tolerability that eliminates pain, dysuria and other symptoms of acute complicated cystitis, eliminates leukocyturia earlier and more significantly, and reduces the period of temporary disability by 28.6%. Combined therapy of acute complicated cystitis with the antibiotic cefixime and the selective analgesic Urinalgin F has a high clinical and bacteriological efficacy.

Effects of the baseline prognostic factors on efficacy of the p62/SQSTM1-encoding plasmid combined with gemcitabine in patients with recurrent platinum-resistant ovarian cancer.

e17540 Background: We recently reported on the efficacy of the p62/SQTM1-encoding plasmid in patients with advanced, recurrent platinum-resistant ovarian cancer (PROC) receiving gemcitabine chemotherapy. Here we analyze the effects of baseline prognostic factors on efficacy. Methods: A prospective multicenter randomized study took place between 01/2020 and 08/2023. Cohort A (n=20) consisted of Gemcitabine 1000 mg/m2 days 1,8 every 3 weeks and Cohort B (n=20) consisted of Gemcitabine (Gem) 1000 mg/m2 days 1,8 every 3 weeks plus p62-plasmid 2.5 mg i.m. weekly. We stratified the patients into subgroups according to their baseline CA-125 level (normal vs high), number of lines of chemo (1 vs 2-3) received by a platinum-sensitive ovarian cancer (PSOC) patient before they became PROC, platinum-free interval (PFI) (up to 3 mo vs more than 3 mo), and presence or absence of peritoneal effusion. Cox proportional hazards regression analysis was utilized to determine effect of progression free survival (PFS). Results: The median follow-up was 13.8 months (mos). The median PFS was 2.8 mos in Gem (Arm A) and 7.2 mos in Gem + Plasmid (Arm B) respectively (p = 0.03). The overall response rate (ORR) by RESIST 1.1 was higher in the Gem +Plasmid arm: partial response (PR) - 5.0% and 20.0%, stable disease (SD) - 40.0% and 60.0%, and disease control rate 41.2 and 80% in Chemo and Plasmid arms respectively). In cohort A, all patients have progressed, whereas in Cohort B (Gem +Plasmid) 9 patients (45%) remained progression-free with the longest duration of response being 30 mo. Overall survival cannot be assessed yet. Analyzing prognostic factors with Cox Proportional Hazards Regression Analysis identified that the following factors increase p62 sensitivity: initial high CA-125 level PFS 2.5 and 6.5 (p = 0.01) in Arm A vs B, 1 line chemo vs 2 or 3 lines for PSOC, PFS 2.3 and 7.1 (p = 0.008) in Arm A vs B, and presence of peritoneal effusion PFS 2.4 and 7.6 (p = 0.008) in Arm A vs B (Table ). Conclusions: We observed maximal effect on PFS when combining the p62-encoding plasmid with Gem in the patients with the most dismal prognosis PROC: rapid progression (relapse as PROC after the first line of treatment and/or short PFI), in patients with an initial high level of CA-125, and/or pleural effusion. [Table: see text]

Applying Energy Taxes to Promote a Clean, Sustainable and Secure Energy System: Finding the Preferable Approaches

The growing importance of climate change and the depletion of natural resources, as well as geopolitical risks associated with the distribution of energy resources, cause an increase in the urgency of ensuring energy security. In modern conditions, the criteria of energy security are the level of production of traditional and renewable energy, the efficiency of energy production, the rationality of its consumption, and the level of pollution arising in the process of the functioning of the energy sector. Different types of regulatory instruments are used internationally to achieve different goals related to energy security. This study involves testing the hypothesis that the effectiveness of energy taxes in ensuring energy security is determined based on the choice of the object of taxation and should be measured via the complex effect of changes in various parameters of energy security. To test this hypothesis, a sample of data from 24 European countries for the period 1994–2020 was formed and energy taxes were grouped into 12 groups (energy taxes on the consumption of different energy sources, energy taxes on fossil fuels, taxes on electricity consumption, taxes to stimulate renewable energy production, contributions to energy funds, etc.). The assessment was carried out with the help of panel regression modeling tools with the installation of a three-year time lag in the model. This method made it possible to determine the short- and medium-term effects of the regulatory influence of certain types of energy taxes. Moreover, the research provides an assessment of the regulatory effectiveness of various types of energy taxes across countries with different initial structures of energy production. The obtained results proved that the comprehensive efficiency of different types of energy taxes is different and depends on the features of the construction of the country’s energy system. In general, complex energy taxes are the most effective method of taxation, while contributions to energy funds are the least effective method of taxation. In the countries with energy systems based on fossil fuels, taxes on mineral oils are the most effective in ensuring of energy security, as well as in the countries with a high initial level of renewable energy use, while complex energy taxes are the most effective in the countries with well-diversified energy systems. This study creates the basis for improving strategies for the use of regulatory instruments of energy transformation in building a clean, secure, and sustainable energy system for the country.

Multi-omics analysis reveals a molecular landscape of the early recurrence and early metastasis in pan-cancer.

Cancer remains a formidable challenge in medicine due to its propensity for recurrence and metastasis, which can result in unfavorable treatment outcomes. This challenge is particularly acute for early-stage patients, who may experience recurrence and metastasis without timely detection. Here, we first analyzed the differences in clinical characteristics among the primary tumor, recurrent tumor, and metastatic tumor in different stages of cancer, which may be caused by the molecular level. Moreover, the importance of predicting early cancer recurrence and metastasis is emphasized by survival analyses. Next, we used a multi-omics approach to identify key molecular changes associated with early cancer recurrence and metastasis and discovered that early metastasis in cancer demonstrated a high degree of genomic and cellular heterogeneity. We performed statistical comparisons for each level of omics data including gene expression, mutation, copy number variation, immune cell infiltration, and cell status. Then, various analytical techniques, such as proportional hazard model and Fisher's exact test, were used to identify specific genes or immune characteristics associated with early cancer recurrence and metastasis. For example, we observed that the overexpression of BPIFB1 and high initial B-cell infiltration levels are linked to early cancer recurrence, while the overexpression or amplification of ANKRD22 and LIPM, mutation of IGHA1 and MUC16, high fibroblast infiltration level, M1 polarization of macrophages, cellular status of DNA repair are all linked to early cancer metastasis. These findings have led us to construct classifiers, and the average area under the curve (AUC) of these classifiers was greater than 0.75 in The Cancer Genome Atlas (TCGA) cancer patients, confirming that the features we identified could be biomarkers for predicting recurrence and metastasis of early cancer. Finally, we identified specific early sensitive targets for targeted therapy and immune checkpoint inhibitor therapy. Once the biomarkers we identified changed, treatment-sensitive targets can be treated accordingly. Our study has comprehensively characterized the multi-omics characteristics and identified a panel of biomarkers of early cancer recurrence and metastasis. Overall, it provides a valuable resource for cancer recurrence and metastasis research and improves our understanding of the underlying mechanisms driving early cancer recurrence and metastasis.

Development of Gambling Behaviour and Its Relationship with Perceived Social Support: A Longitudinal Study of Young Adult Male Gamblers

Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time Study), we applied hierarchical linear models to investigate the longitudinal association of changes in perceived emotional and social support (hereafter PESS; operationalized as ENRICHD Social Support Instrument score) with gambling intensity, gambling frequency, and fulfilled criteria for gambling disorder. Pooling data from three time points (baseline, 12-month and 24-month follow-ups) to assess two 1-year intervals, these models disentangle the associations of (a) “level of PESS” (cross-sectional, between participants) and (b) “changes in individual PESS” (longitudinally, within-participants). Among the 169 study participants, higher levels of PESS were associated with fewer gambling-related problems (− 0.12 criteria met; p = 0.014). Furthermore, increasing individual PESS was associated with lower gambling frequency (− 0.25 gambling days; p = 0.060) and intensity (− 0.11 gambling hours; p = 0.006), and fewer gambling-related problems (− 0.19 problems; p < 0.001). The results suggest a mitigating influence of PESS on gambling behaviour and gambling-related problems. Increasing individual PESS appears more decisive for this pathway than high initial levels of PESS. Treatment and prevention strategies that activate and reinforce beneficial social resources in people with gambling-related problems are recommended and promising.

Transforming Learning to Online Education 4.0 during COVID-19: Stakeholder Perception, Attitude, and Experiences in Higher Education Institutions at a Tier-III City in India

Higher education institutions worldwide had to quickly pivot to delivering online classes as the COVID-19 pandemic set in. This disruption brought into focus institutional preparedness to ensure academic continuity, faculty proficiency in the use of ICT, and student readiness to adapt to an online-only model suggested in Education 4.0 framework. The Education 4.0 framework emphases to use advance technology and tools to transform education system. It was initially envisaged that the online-only model of education will at best be a stop-gap arrangement. However, as the pandemic continues unabated across India, the education community needs actionable data to fine-tune its online delivery model, to ensure its effectiveness, and retain its value perception in the eyes of the stakeholders. This is a critical aspect as evidence suggests that the initial high level of online engagement is petering out due to overexposure, mental saturation, and fatigue among both the students and faculty members. This research paper examines the perceptions, attitudes, and experiences of stakeholders involved in online education from Jammu, a Tier-III city in India. The study asserts that real “value creation” in an online mode can happen when all the stakeholders are equally motivated and working together. Institutions need to prioritize value delivery, support faculty members, provide the needed resources, and set clear expectations.

The development of the 5Cs of positive youth development in a school year: A 3-wave longitudinal study of Slovenian youth during the COVID-19 pandemic.

The paper analyses the longitudinal pathways for the 5Cs of positive youth development outcomes (Competence, Confidence, Character, Caring, Connection) in a school context during the COVID-19 pandemic. The theoretical framework for the paper is provided by the Positive youth development (PYD) perspective, which focuses on the importance of the interplay between individual characteristics and contexts. In the period of adolescence, school and its characteristics are one of the most influential contexts for the promotion of positive youth development. Therefore, the paper focused on the changes in the 5Cs in one school year using the methodology of longitudinal research (latent growth modeling) with three measurement points (beginning of the school year, middle of the school year, and the end of the school year). We used a sample of Slovenian youth (N = 1241 participants; 59,5% female; M age = 15.35, SD = 1.21) who participated in the PYD-SI-MODEL study and responded to the PYD questionnaire during the current COVID-19 pandemic. In addition, we tested whether the development of the 5Cs in a school year differed by gender, age, and school level (lower-secondary, upper-secondary). The results indicated a significant decrease in Connection, Caring, and Character from the beginning to the end of the school year and an increase in Competence and Confidence in the same period. Significant intercept-slope interactions were detected in Confidence and Connection indicating that their higher initial level is associated with a more stable trajectory throughout the school year. In addition, we found that gender and school level play a significant role in several of the pathways while age was not a significant covariate with any of the Cs. The study is the first to test 5Cs pathways in one school year, using Slovenian data. In addition to the important role of contexts on positive developmental outcomes, the study highlights the significance of 5Cs promotion in pandemic times as much as in more stable times.

Temporal development of student burnout symptoms: Sociodemographic differences and linkage to university dropout intentions

Considering the demanding higher education context, university students are at risk to experience burnout symptoms such as emotional exhaustion, cynicism, and reduced professional efficacy. Theoretical models (e.g., Job Demands-Resources Model) state that burnout symptoms develop over time, vary between individuals, and bear adverse consequences. To date, the temporal development of student burnout symptoms within semesters, inter-individual differences in their development, and the role of their development for academic outcomes like student dropout are understudied. To complement this limited research, we used date of a three-wave longitudinal study with N = 1435 undergraduate students over one semester. First, we modeled unconditional second-order latent growth curves to examine the initial levels and trajectories of each burnout symptom (emotional exhaustion, cynicism, and reduced professional efficacy). We then modeled conditional second-order latent growth curves to examine whether initial levels and trajectories differed depending on students’ sociodemographic characteristics (gender, age, study progress, and academic major) and associated with students’ intentions to drop out from university. Results indicated a linear increase in student burnout symptoms over the semester. Sociodemographic differences existed in the initial levels of emotional exhaustion and reduced professional efficacy and the trajectories of each symptom. Generally, female, STEM, and higher- and lower- semester students were particularly affected by burnout symptoms. Further, higher initial levels and an increase in each symptom corresponded with higher dropout intentions. Summarizing, the results highlighted that student burnout symptoms increase as the semester progresses, seem more pronounced among certain student groups, and operate as strong predictors for dropout intentions.

The Effect of the Write Pair Switch Method on Student’s Reasoning Ability Based on Initial Ability

abilities of students who studied with conventional methods and those who studied with the write-pair-switch method. This study was carried out at one of the public high schools for the 2022–2023 academic year. A posttest-only control design was used in the quasi-experimental research methodology. The study sample consisted of 85 students, consisting of 43 control class students and 42 experimental class students. Each class is subdivided into 3 levels based on their initial mathematical ability, namely low, medium, and high levels. Two-way ANOVA is the method of data analysis employed. The findings indicated that students' mathematical reasoning skills were impacted by the learning strategies used. The degree of a student's initial mathematical proficiency affects their capacity for mathematical reasoning. There is no relationship between learning strategies and the degree of pupils' innate mathematical competence in terms of their capacity for mathematical reasoning.

Principles of Customization for Models of Complexly Organized Intelligent Systems

The article presents classification and formats developed by the author for descriptions of operations for expanding and detailing formal models of intelligent systems. Operations are proposed that allow automating the processes of creating such models adapted to the properties of subject areas. Model descriptions are based on the formalization of universal parameters and properties associated with intelligent systems. The basis for building various models is the universal model. It presents the concepts and properties of knowledge representation formalisms, descriptions formats of knowledge flows and processes and control elements of intelligent systems. When creating a universal model, the principles of hierarchy and plurality of descriptions are taken into account. This provides a high initial level of the de­sign process based on generalizing unified designs of the universal model. Descriptions of additional common model elements adapt the initial universal model. Such an approach allows overcoming the problem of multiple properties of intelligent systems, reflecting ideas about them that formed in different fields of knowledge. Transformations of the universal model into a model with given properties are implemented as transformations of formalized descriptions of parameters and properties. Transformations adjust the universal model, from which general and applied models of intelligent systems are constructed. Model execution algorithms allow you to create specific intelligent systems. Such systems exist as software implementations of algorithms in the digital spaces of these areas.

Convergence of food consumption across Ukrainian regions: approach using spatial panel data models

Purpose. The article studies the convergence between the regions of Ukraine in terms of the basic foodstuff consumption per capita during 2000–2019, taking into account the effects of spatial interaction across regions. &#x0D; Methodology / approach. The convergence analysis between regions of Ukraine is based on the concept of β-convergence which can be tested using spatial econometric models namely spatial autoregressive models and spatial error models. The need for considering spatial interaction can be explained by the fact that regions are characterized by constant interaction with each other. Therefore, region should not be considered as isolated objects in space in empirical research with usage of panel data. Ignoring the spatial interaction between regions and using standard evaluation procedures can reduce the reliability and validity of the obtained results to some extent.&#x0D; Results. The results of our calculation confirm the process of β-convergence of average per capita consumption of all food groups, which means that food consumption in regions with an initial low level of consumption is growing faster than in regions with high initial levels of consumption. Also, as part of the use of spatial econometric models the convergence process was determined to be influenced by spatial interaction between regions while the influence of neighbouring regions has a positive effect on food consumption in particular region.&#x0D; Originality / scientific novelty. The article further develops the main ideas of modeling interregional differentiation based on convergence theory and for the first time, spatial econometric models were used to estimate β-convergence of Ukrainian regions by the levels of consumption of basic foodstuffs. &#x0D; Practical value / implications. The approach proposed by the authors and the obtained results can be used both by state authorities on agrarian policy and food issues, and by enterprises of the agricultural sector in the analysis and forecasting of trends in the consumption of basic foodstuffs at the regional level; when planning the production, processing and delivery of agricultural products, when planning state or regional trade policy in the field of food. At the same time, the inclusion of spatial effects in the model of evaluating convergence will allow policymakers to take into account the geographical features of the convergence process and, accordingly, make more informed decisions to reduce the differentiation of regions of Ukraine by the levels of consumption of basic foodstuffs.

The Longitudinal Association Between Frailty, Cognition, and Quality of Life in Older Europeans.

Evidence on the association between frailty and quality of life (QoL) is mostly limited to cross-sectional studies. Thus, the temporal order and potential mechanisms of this association are largely unknown. Our study examines both the directionality of this association and the role of cognition in this association in longitudinal data. Cross-lagged panel models were employed to examine the temporal relationship between frailty and QoL, as well as cognition's role among 19,649 older adults in Europe. Frailty, QoL, and cognition were assessed using the health deficit index, CASP-12, and 3 standard cognitive tests, respectively. We observed a bidirectional association between frailty and QoL and their dynamics. High initial levels of frailty predicted poorer QoL later and vice versa (β=-0.151 and -0.052, p < .001). The early change in frailty predicted the late change in QoL, and vice versa (β=-0.093 and -0.061, p < .001). Frailty or its early change drives this interrelationship. Cognition at Wave 5 partially mediated frailty's effect at Wave 4 on QoL at Wave 6 (indirect effect: β=-0.005, 95% confidence interval=-0.006, -0.004). Our findings supported that early prevention of frailty and its risk factors may have more influential protective effects on later physical and mental health, as well as the need for ongoing screening for mental health in aging population. Also, the maintenance of good cognitive performance may help interrupt this possible vicious cycle linking frailty and QoL decline.

Mechanistic Insights into Molecular Crystalline Organometallic Heterogeneous Catalysis through Parahydrogen-Based Nuclear Magnetic Resonance Studies.

The heterogeneous solid-gas reactions of crystals of [Rh(L2)(propene)][BArF4] (1, L2 = tBu2PCH2CH2PtBu2) with H2 and propene, 1-butene, propyne, or 1-butyne are explored by gas-phase nuclear magnetic resonance (NMR) spectroscopy under batch conditions at 25 °C. The temporal evolution of the resulting parahydrogen-induced polarization (PHIP) effects measures catalytic flux and thus interrogates the efficiency of catalytic pairwise para-H2 transfer, speciation changes in the crystalline catalyst at the molecular level, and allows for high-quality single-scan 1H, 13C NMR gas-phase spectra for the products to be obtained, as well as 2D-measurements. Complex 1 reacts with H2 to form dimeric [Rh(L2)(H)(μ-H)]2[BArF4]2 (4), as probed using EXAFS; meanwhile, a single-crystal of 1 equilibrates NMR silent para-H2 with its NMR active ortho isomer, contemporaneously converting into 4, and 1 and 4 each convert para-H2 into ortho-H2 at different rates. Hydrogenation of propene using 1 and para-H2 results in very high initial polarization levels in propane (>85%). Strong PHIP was also detected in the hydrogenation products of 1-butene, propyne, and 1-butyne. With propyne, a competing cyclotrimerization deactivation process occurs to afford [Rh(tBu2PCH2CH2PtBu2)(1,3,4-Me3C6H3)][BArF4], while with 1-butyne, rapid isomerization of 1-butyne occurs to give a butadiene complex, which then reacts with H2 more slowly to form catalytically active 4. Surprisingly, the high PHIP hydrogenation efficiencies allow hyperpolarization effects to be seen when H2 is taken directly from a regular cylinder at 25 °C. Finally, changing the chelating phosphine to Cy2PCH2CH2PCy2 results in initial high polarization efficiencies for propene hydrogenation, but rapid quenching of the catalyst competes to form the zwitterion [Rh(Cy2PCH2CH2PCy2){η6-(CF3)2(C6H3)}BArF3].

Trajectories of depression among patients in treatment for opioid use disorder: A growth mixture model secondary analysis of the XBOT trial.

To inform clinical practice, we identified subgroups of adults based on levels of depression symptomatology over time during opioid use disorder (OUD) treatment. Participants were 474 adults in a 24-week treatment trial for OUD. Depression symptoms were measured using the 17-item Hamilton Depression Rating Scale (HAM-D) at nine-timepoints. This was a secondary analysis of the Clinical Trials Network Extended-Release Naltrexone versus Buprenorphine for Opioid Treatment (XBOT) trial using a growth mixture model. Three distinct depression trajectories were identified: Class 1 High Recurring-10% with high HAM-D with initial partial reductions (of HAM-D across time), Class 2 Persistently High-5% with persistently high HAM-D, and Class 3 Low Declining-85% of the participants, with low HAM-D with early sustained reductions. The majority (low declining) had levels of depression that improved in the first 4 weeks and then stabilized across the treatment period. In contrast, 15% (high recurring and persistently high) had high initial levels that were more variable across time. The persistently high class had higher rates of opioid relapse. In this OUD sample, most depressive symptomatology was mild and improved after medication treatment for opioid use disorder (MOUD). Smaller subgroups had higher depressive symptoms that persisted or recurred after the initiation of MOUD. Depressive symptoms should be followed in patients initiating treatment for OUD, and when persistent, should prompt further evaluation and consideration of antidepressant treatment. This study is the first to identify three distinct depression trajectories among a large clinical sample of individuals in MOUD treatment.

Implementing ICT in classroom practice: what else matters besides the ICT infrastructure?

BackgroundThe large-scale International Computer and Information Literacy Study (2018) has an interesting finding concerning Luxembourg teachers. Luxembourg has one of the highest reported level of technology-related resources for teaching and learning, but a relatively lower reported use of ICT in classroom practice.MethodsICT innovation requires a high initial level of financial investment in technology, and Luxembourg has achieved this since 2015. Once the necessary financial investment in ICT technology has been made, the key question is what else matters to increase the use of ICT in teaching. To identify the relevant factors, we used the “Four in Balance” model, aimed explicitly at monitoring the implementation of ICT in schools.ResultsUsing data for 420 teachers in Luxembourg, we identify that within such a technology-driven approach to digitalization, teachers’ vision of ICT use in teaching, level of expertise, and the use of digital learning materials in class are significant support factors. Leadership and collaboration, in the form of an explicit vision of setting ICT as a priority for teaching in the school, also prove to be important.ConclusionsThrough these findings, we show that the initial investment in school infrastructure for ICT needs to be associated in its implementation with teachers’ ICT-related beliefs, attitudes, and ICT expertise.

The impact of governance quality on central bank’s independence

The stable functioning of the public finance system requires a rational regulatory apparatus. The central bank occupies a special place in this system. Science and practice prove that the central bank’s political and economic independence determines its effectiveness. Thus, it is crucial to determine the prerequisites for ensuring its independence. The study aims to assess the influence of governance quality on the central bank’s independence, considering the variance of the socio-political development of countries. The analysis was conducted based on 53 countries. Panel regression modeling with random effects was chosen as a research method. The analysis approach involves calculations for the groups of countries that differ in social and political development parameters according to the following criteria: the initial level of the central bank independence; level of human development; political rights freedom; level of civil liberties; and political regime. Socio-political factors significantly affect the central bank’s independence in the following conditions: a high initial level of independence of the central bank, a high level of human development, and an average level of political and civil freedom. At the same time, the governance quality ensures the growth of the central bank’s independence regardless of the countries’ political regime. Three factors have the most significant influence on ensuring the independence of the central bank, namely “government efficiency,” “quality of regulation,” and “rule of law.”

Blowup phenomena for a fourth order wave equation at high initial energy level

Blowup phenomena for a fourth order wave equation at high initial energy level

Firefighters’ knowledge of the knowledge of procedures for clearing the respiratory tract in an injured person with suspected infection with biological material (SARS-CoV-2) — a nationwide cross- -sectional study

Introduction: The aim of the study was to assess the knowledge of the procedure for clearing the respiratory tract and updated qualified first aid (QFA) 1a and 2a procedures by firefighters serving in State Fire Service (SFS) rescue and firefighting units, and their knowledge of the transmission of the SARS-CoV-2 virus. Material and methods: The cross-sectional study covered 19 408 firefighters (officers serving in SFS rescue and firefighting units from all over Poland). The study was conducted using the diagnostic survey method, the Computer Assisted Web Interview (CAWI) technique consisting of a set of particulars regarding a specific officer and the appropriate medical part of the survey. Results: In the group of 19,408 respondents, 99.31% were men (n = 19,275), while women accounted for 0.69% (n = 133; p &lt; 0.001). The age of the respondents was in the range of 18–66 years, and the average age was 35.88 ± 7.14 years. The length of service was 11.95 ± 6.44 years. The knowledge of procedures 1a and 2a declared by the respondents [OR = 1.51 (95% CI: 1.22–1.86), x2 = 14.76], the ability to operate a suction unit [OR = 1.73 (95% CI: 1.44–2.08, x2 = 34.58)], the frequency of airway clearance training (p &lt; &lt; 0.001, x2 = 61.74). Only 15% of respondents used a suction unit on an injured person during operations. Conclusions: The knowledge of firefighters in the subject matter covered by the analysis is diverse, some firefighters have additional experience and practice from working in health care units. Professional development in the field of QFA supplemented with procedures 1a and 2a may translate into a lower risk of infection associated with airway clearing in the era of the pandemic. There is a visible need for constant training of SFS officers in terms of medical activities to maintain the knowledge of firefighters at a high initial level.