High Profile Research Articles

Combination of metronomic capecitabine and letrozole in metastatic hormone receptor positive, HER2 negative breast cancer: a randomized phase II trial.

First line endocrine therapy is the gold standard for advanced estrogen receptor positive, human epidermal growth factor receptor 2 negative breast cancer. Adding CDK4/6 inhibitors has improved progression free survival. Metronomic Capecitabine has proven to be safe to combine with endocrine therapy with promising efficacy. We conducted a phase II randomized, open label, single centre clinical trial on patients with metastatic ER positive and HER 2 negative breast cancer. Eligible patients were randomized (1:1) to arm A: metronomic dose of capecitabine (500 mg/m2 BID) combined with letrozole (2.5 mg OD) or arm B: letrozole single agent. The primary endpoint was progression free survival. The study was terminated early due to poor accrual and 60 eligible patients out of the planned 204 were randomized. This clinical trial is registered on ClinicalTrials.gov (MD-127-2019, NCT04571437). Between February 2019 and April 2022, 60 patients were randomized. This is the first report of the study, after a median follow-up of 18.6 months. The median age at diagnosis was 47 years with only 41.7% of patients post-menopausal. Half of our patients had bone-only disease, 45% had visceral metastasis (liver and lung) and 63% presented with endocrine sensitive disease. The estimated median PFS for the whole population was 16.2 months. Median PFS for capecitabine arm was 17.7 months versus 14.6 months for letrozole alone (p = 0.078). Overall response rate was 70% for capecitabine/letrozole arm and 56.6% for letrozole only. Clinical benefit rate was 90% in the capecitabine/letrozole arm versus 73.3% in the letrozole arm. Overall survival data is still immature after this short follow up duration. Adverse event assessment showed acceptable all grade and high grade toxicity profile consistent with the established adverse events of both capecitabine and letrozole. Anaemia (28.3%) and hand & foot syndrome (43.8%) were significantly more common in the capecitabine/letrozole arm. Capecitabine combined with letrozole have showed a trend towards improvement in progression free survival with potential more benefit to certain sub-groups and the combination showed acceptable safety profile consistent with the established known safety profile of both letrozole and capecitabine.

Experiences of UK clinical scientists (Physical Sciences modality) with their regulator, the Health and Care Professions Council: results of a 2022 survey.

In healthcare, regulation of professions is an important tool to protect the public. With increasing regulation however, professions find themselves under increasing scrutiny. Recently there has also been considerable concern with regulator performance, with high profile reports pointing to cases of inefficiency and bias. Whilst reports have often focused on large staff groups, such as doctors, in the literature there is a dearth of data on the experiences of smaller professional groups such Clinical Scientists with their regulator, the Health and Care Professions Council. This article reports the findings of a survey from Clinical Scientists (Physical Sciences modality) about their experiences with their regulator, and their perception of the quality and safety of that regulation. Between July-October 2022, a survey was conducted via the Medical Physics and Engineering mail-base, open to all medical physicists & engineers. Questions covered typical topics of registration, communication, audit and fitness to practice. The questionnaire consisted of open and closed questions. Likert scoring, and thematic analysis were used to assess the quantitative and qualitative data. Of 146 responses recorded, analysis was based on 143 respondents. Overall survey sentiment was significantly more negative than positive, in terms of regulator performance (negative responses 159; positive 106; significant at p < 0.001). Continuous Professional Development audit was rated median 4; other topics were rated as neutral (fitness to practice, policies & procedures); and some as poor (value). The Clinical Scientist (Physical Sciences) professional registrants rated the performance of their regulator more negatively than other reported assessments (by the Professional Standards Authority). Survey respondents suggested a variety of performance aspects, such as communication and fitness to practice, would benefit from improvement. Indications from this small dataset, suggest a larger survey of HCPC registrants would be useful.

Hayao Miyazaki’s Pastoral Nostalgia:

In the post-war years, rapid industrialization in the name of economic recovery resulted in several Japanese environmental crises. A number of these crises were high profile and reported by new agencies and environmental activists on a national and international level. As a result, Japanese culture and media has been influenced by images of pollutions' effect on the body and developed into robust Japanese environmental movements and policies. This essay builds on the environmental analysis of Hayao Miyazaki's films, but offers a counter perspective arguing that the body horror of Princess Mononoke and Spirited Away is more representative of Japanese pastoral nostalgia (which suggests a feeling of cultural loss and a rejection of a possible return human-nature harmony) rather than pure environmentalism.

Skeletonema marinoi ecotypes show specific habitat-related responses to fluctuating light supporting high potential for growth under photobioreactor light regime.

Diatoms are a diverse group of phytoplankton usually dominating areas characterized by rapidly shifting light conditions. Because of their high growth rates and interesting biochemical profile, their biomass is considered for various commercial applications. This study aimed at identifyingstrains with superior growth in a photobioreactor (PBR) by screening the natural intraspecific diversity of ecotypes isolated from different habitats. We investigated the effect of PBR light fluctuating on a millisecond scale (FL, simulating the light in a PBR) on 19 ecotypes of the diatom Skeletonema marinoi isolated from the North Sea-Baltic Sea area. We compare growth, pigment ratios, phylogeny, photo-physiological variables and photoacclimation strategies between all strains and perform qPCR and absorption spectra analysis on a subset of strains. Our results show that the ecotypes responded differently to FL, and have contrasting photo-physiological and photoprotective strategies. The strains from Kattegat performed better in FL, and shared common photoacclimation and photoprotection strategies that are the results of adaptation to the specific light climate of the Kattegat area. The strains that performed better with FL conditions had a high light (HL)-acclimated phenotype coupled with unique nonphotochemical quenching features. Based on their characteristics, three strains were identified as good candidates for growth in PBRs.

Rx -to- OTC switch increased access and lowered cost of topical adapalene.

Topical adapalene gel is an effective and well tolerated acne treatment that transitioned from prescription to over-the-counter (OTC) availability in 2016. Historically, prescription to OTC transitions have lowered costs to patients and payers and increased access to medications. This study used sales and prescriber data to assess access to topical retinoid therapies and their costs in the pre- and post- Rx-to-OTC transition. We demonstrate that the prescription to OTC transition of adapalene gel increased access to this medication, while lowering costs to patients and payers, including Medicare patients. These results provide a necessary call to action for future OTC shifts with other high safety profile, well-tolerated medications in ultimate efforts and hopes of cost savings for patients, insurers, and Medicare within our healthcare industry.

Inhibition of LPS-Induced Skin Inflammatory Response and Barrier Damage via MAPK/NF-κB Signaling Pathway by Houttuynia cordata Thunb Fermentation Broth

Houttuynia cordata Thunb is rich in active substances and has excellent antioxidant and anti-inflammatory activity. Scanning electron microscopy and gel permeation chromatography were used to analyze the molecular characteristics of the fermentation broth of Houttuynia cordata Thunb obtained through fermentation with Clavispora lusitaniae (HCT-f). The molecular weight of HCT-f was 2.64265 × 105 Da, and the polydispersity coefficient was 183.10, which were higher than that of unfermented broth of Houttuynia cordata Thunb (HCT). By investigating the active substance content and in vitro antioxidant activity of HCT-f and HCT, the results indicated that HCT-f had a higher active substance content and exhibited a superior scavenging effect on 2,2-diphenyl-1-picrylhydrazyl radicals and hydroxyl radicals, with IC50 values of 11.85% and 9.01%, respectively. Our results showed that HCT-f could effectively alleviate the increase in the secretion of inflammatory factors and apoptotic factors caused by lipopolysaccharide (LPS) stimulation, and had a certain effect on repairing skin barrier damage. HCT-f could exert an anti-inflammatory effect by down-regulating signaling in the MAPK/NF-κB pathway. The results of erythrocyte hemolysis and chicken embryo experiments showed that HCT-f had a high safety profile. Therefore, this study provides a theoretical basis for the application of HCT-f as an effective ingredient in food and cosmetics.

Modern view on the use of alpha lipoic acid in neurological practice

Alpha lipoic acid (ALA) is an essential cofactor for mitochondrial enzymes, a powerful antioxidant, and an important component of many metabolic processes. Most research on ALA has focused specifically on its antioxidant properties. A number of conditions – aging, atherosclerosis, liver cirrhosis, diabetes mellitus, various types of polyneuropathy, psoriasis and others can significantly reduce the level of ALA in the body. The article analyzes modern literature (107 sources, including 17 systematic reviews and meta-analyses). Traditionally, ALA is used in complex therapy of patients suffering from diabetic and alcoholic polyneuropathy. However, the analysis of studies conducted around the world is not limited to these two nosological forms. The use of ALA as adjuvant therapy for a number of conditions and diseases is justified, as confirmed by clinical studies, systematic reviews and meta-analyses. All studies assessed not only the effectiveness of ALC, but also its safety and the incidence of adverse events and showed that ALC has a high safety profile. ALA has not only a pronounced antioxidant effect, but also the ability to chelate toxic metals, increase intracellular glutathione levels, reduce blood glucose levels, overcome insulin resistance, participate in mitochondrial metabolism, stimulate the production of cAMP, normalize the lipid profile, reduce the level of inflammatory markers, etc. Based on Because of the positive effect of using ALC in the treatment of various symptoms and nosologies, the list of indications requires revision, expansion and addition.

Preventive Efficacy, Safety, Immunogenic Activity, and Evaluation of Post-Vaccination Responses Following Immunization with Combined Trivalent Vaccine Vaktrivir (Measles-Rubella-Parotitis) in Premature Infants

Background. Registration of combined trivalent vaccine Vaktrivir (measles-rubella-parotitis) in Russia necessitates studies on its preventive efficacy, safety, immunogenic activity, and post-vaccination responses following the immunization of premature infants. Objective. The aim of the study is to evaluate efficacy, safety, and immunogenic activity of combined trivalent vaccine (measles-rubella-parotitis) and level of post-vaccination responses following the immunization of premature infants. Methods. Experimental studies were conducted to evaluate safety, immunogenicity, and postvaccinal responses after immunization of premature infants with combined within prospective comparative clinical observation. Results. Administration of the combined trivalent vaccine Vaktrivir (measles-rubella-parotitis) in premature infants has shown: no cases of measles, rubella or parotitis among vaccinated persons within prospective clinical observation for 2 years; no disturbances in parameters of clinical blood analysis, biochemical blood count, total IgE, IgA, IgM, IgG (immunogram), or urine analysis among vaccinated children over time; no subjective perceptions, adverse events signs at physical examination among vaccinated compared to baseline parameters; low post-vaccination reactions (6.7%) and similar tolerance of trivalent vaccine Vaktrivir among full-term infants (3.3%) (p = 0.301). Conclusion. Administration of the combined trivalent vaccine Vaktrivir (measles-rubella-parotitis) in premature infants has demonstrated high safety profile and immunogenic properties for measles, rubella and parotitis components, good tolerability, and low post-vaccination responses after immunization, comparable to vaccination of full-term infants.

Mechanical circulatory support in high-risk PE for more than a decade

Abstract Funding Acknowledgements None. Background/Introduction Absence of solid evidence in clinical practice guidelines on the management of patients with a severe pulmonary thromboembolism (PTE) in a situation of cardiogenic shock requiring mechanical circulatory support (veno-arterial ECMO). A registry has been carried out in a tertiary hospital of patients admitted to the Cardiological Critical Care Unit (CCCU) with a diagnosis of high-risk PTE and V-A ECMO implantation. Purpose The objective is to describe the experience of our center due to the paucity of evidence from current guidelines in this area iin terms of morbimortality and expected outcomes. Methods Data were collected from all patients admitted with a diagnosis of high-risk PE in the CCCU from 05/01/2010 to 05/01/2023. Of these, only those in whom V-A ECMO was implemented during admission were analyzed and described below. Clinical, analytical and survival variables were explored. Results A total of 11 patients were included, 3 (27.27%) being women. The mean age was 53 years (SD 10.64). Every V-A ECMO cannulation was performed in a femoro-femoral configuration by a surgical approach. The mean length of stay in the Critical Care Unit, total hospital stay length and circulatory support time were respectively: 8 days (SD 5.5); 20.7 days (DS 16.5) and 3 days (DS 1.9). The indication for the implantation of V-A ECMO was in a situation of SCAI-E in 7 patients (in 2 of them, V-A ECMO was implanted during cardiac arrest, and a 100% of mortality was described in the first 24 hours). On the other hand, in the remaining 4 patients, the indication for support was a deteriorating evolution despite amines. Of these, in 2 of them, there was a formal contraindication for the administration of systemic fibrinolytic treatment (recent major surgery, in one of them oncology). It should be noted that VA ECMO without adjuvant fibrinolysis was used in 6 of the patients (54.5%), and in 1 of them (16%) of them died (anoxic encephalopathy). However, the remaining 5 patients received combined VA ECMO therapy and systemic fibrinolysis (45.5%), with 2 deaths reported in this subgroup (40%). Those deceases happened both due to adequacy of the therapeutic effort in the context of multiple organ failure. No major bleeding was reported, even in the combination therapy group. Conclusions Support with V-A ECMO has allowed survival &amp;gt;70% in patients diagnosed with high-risk pulmonary embolism, including in those cases with absolute contraindication for systemic fibrinolysis. High safety profile in terms of bleeding even in those patients with a combined approach.

Mesenchymal stromal cells in the treatment of pediatric hematopoietic cell transplantation-related complications (graft vs. host disease, hemorrhagic cystitis, graft failure and poor graft function): a single center experience

ObjectivesTo describe mesenchymal stromal cells (MSCs) in the treatment of hematopoietic stem cell transplantation (HSCT) complications and to assess its safety and efficacy.MethodsSingle-center retrospective study (2016–2023). Patients under 20 years who received MSCs for the treatment of HSCT-related complications were included.ResultsThirty patients (53.7% boys), median age at transplant 11 years (range 2–19) were included. MSCs indications were: graft-vs.-host disease (GVHD) in 18 patients (60%), of them 13 had acute GVHD (43.3%) and 5 chronic GVHD (16.7%); Grade 3–4 hemorrhagic cystitis (HC) in 4 (13.3%); poor graft function (PGF) in 6 (20%), 5 of them receiving MSCs with a CD34 stem cell-boost coinfusion; graft failure (GF) in 2 (6.7%), to enhance engraftment after a subsequent HSCT. Infusion-related-adverse-events were not reported. Overall response (OR) was 83% (25/30); 44% of responders (11/25) showed complete response (CR). OR for GVHD, HC, PGF and GF was 83.3%, 100%, 66.7% and 100% respectively. Response rate was 40% (95% CI: 20–55) and 79% (95% CI: 57–89) at 15 and 30 days. With a median follow-up of 21 months (IQR11–52.5), overall survival (OS) was 86% (95% CI: 74–100) and 79% (95% CI: 65–95) at 6 and 12 months post-MSCs infusion.ConclusionIn our study, the most frequent indication of MSCs was refractory aGVHD (43.3%). Response rates were high (OR 83%) and safety profile was good.

Nanocarrier - Mediated Salinomycin Delivery Induces Apoptosis and Alters EMT Phenomenon in Prostate Adenocarcinoma.

Salinomycin (Sal) has been recently discovered as a novel chemotherapeutic agent against various cancers including prostate cancer which is one of the most commonly diagnosed cancers affecting male populations worldwide. Herein we designed salinomycin nanocarrier (Sal-NPs) to extend its systemic circulation and to increase its anticancer potential. Prepared nanoform showed high encapsulation and sustained release profile for salinomycin. The present study elucidated the cytotoxicity and mechanism of apoptotic cell death of Sal-NPs against prostate cancer both in vitro and in vivo. At all measured concentrations, Sal-NPs showed more significant cytotoxicity to DU145 and PC3 cells than Sal alone. This effect was mediated by apoptosis, as confirmed by ROS generation, loss of MMP and cell cycle arrest at the G1 phase in both cells. Sal-NPs efficiently inhibited migration of PC3 and DU145 cells via effectively downregulating the epithelial mesenchymal transition. Also, the results confirmed that Sal-NPs can effectively inhibit the induction of Prostate adenocarcinoma in male Wistar rats. Sal-NPs treatment exhibited a decrease in tumour sizes, a reduction in prostate weight, and an increase in body weight, which suggests that Sal-NPs is more effective than salinomycin alone. Our results suggest that the molecular mechanism underlying the Sal-NPs anticancer effect may lead to the development of a potential therapeutic strategy for treating prostate adenocarcinoma.

Damp and mould—the big picture. How do we tackle the damp and mould crisis in social housing: lessons from the UK

The tragic death of 2-year-old Awaab Ishak, from extensive and prolonged exposure to damp and mould that had not been dealt with by the social landlord who owned the property, and other high profile news stories, have alerted social landlords to the damp and mould crisis in social rented homes across England. This paper discusses the findings from a 24-h knowledge exchange “Think Tank”, attended by representatives from social housing providers, charities, professional bodies, and residents from across England, to discuss how to tackle damp and mould in social housing. The event was made up of short informal presentations and group discussions in order to share good practice and develop a cross-sector understanding of damp and mould, its impacts, and how it can be tackled holistically. The event highlighted that damp and mould should firstly be seen as a building problem and that residents’ “lifestyles” should not be blamed. Tackling damp and mould should not be seen as the responsibility of one individual or department, all stakeholders need to work together to tackle the problem, ensuring tenants’ wellbeing is at the centre of every decision. Finally, damp and mould cannot be tacked in silo. Social landlords are facing a number of other major challenges, including the cost-of-living crisis, new building safety regulations, and the urgent need to decarbonise their stock. Landlords must think creatively in order to tackle these problems together and consider the big picture to ensure we are not walking towards the next housing tragedy. This paper brings together a wider contextual understanding of how the damp and mould crisis has developed in the UK, the impacts of damp and mould on residents’ physical and mental wellbeing, and the Think Tank findings, to suggest policy and practical recommendations for tackling the problem holistically.

Pre-Operative Group and Save in Elective and Emergency Laparoscopic Cholecystectomy: Necessity, Cost-Effectiveness, and Own Experience

Background: Laparoscopic cholecystectomy is associated with a high safety profile. This study seeks to quantify the incidence of blood transfusion in both the elective and emergency settings, examine related patient outcomes, and investigate selection criteria for pre-operative Group and Save (G&amp;S) sampling. Methods: A prospective multi-centre observational study was conducted to investigate patients undergoing either elective or emergency laparoscopic cholecystectomy in the UK between January 2020 and May 2021. Multivariate logistical regression models were used to identify patient factors associated with the risk of transfusion and explore outcomes linked to pre-operative G&amp;S sampling. Results: This study comprised 959 patients, with 631 (65.8%) undergoing elective cholecystectomy and 328 (34.2%) undergoing emergency surgery. The median age was 48 years (range: 35–59), with 724 (75.5%) of the patients being female. Only five patients (0.5%) required blood transfusions, receiving an average of three units, with the first unit administered approximately six hours post-operatively. Among these cases, three patients (60%) had underlying haematological conditions. In adjusted models, male gender was significantly associated with the need for a blood transfusion (OR 11.31, p = 0.013), while the presence of a pre-operative Group and Save sample did not demonstrate any positive impact on patient outcomes. Conclusions: The incidence of blood transfusion following laparoscopic cholecystectomy is very low. Male gender and haematological conditions may present as independent risk factors. Pre-operative G&amp;S sampling did not yield any positive impact on patient outcomes and could be safely excluded in both elective and emergency cases, although certain population subsets will warrant further consideration.

Catheter-Directed Ionic Liquid Embolic Agent for Rapid Portal Vein Embolization, Segmentectomy, and Bile Duct Ablation.

Embolic materials currently in use for portal vein embolization (PVE) do not treat the tumor, which poses a risk for tumor progression during the interval between PVE and surgical resection. Here, is developed an ionic-liquid-based embolic material (LEAD) for portal vein embolization, liver ablation, and drug delivery. LEAD is optimized and characterized for diffusivity, X-ray visibility, and cytotoxicity. In the porcine renal embolization model, LEAD delivered from the main renal artery reached vasculature down to 10 microns with uniform tissue ablation and delivery of small and large therapeutics. In non-survival and survival porcine experiments, successful PVE is achieved in minutes, leading to the expected chemical segmentectomy, and delivery of a large protein drug (i.e., Nivolumab) with LEAD. In cholangiocarcinoma mouse tumor models and in ex vivo human tumors, LEAD consistently achieved an effective ablation and wide drug distribution. Furthermore, various strains of drug-resistant patient-derived bacteria showed significant susceptibility to LEAD, suggesting that LEAD may also prevent infectious complications resulting from tissue ablation. With its capabilities to embolize, ablate, and deliver therapeutics, ease of use, and a high safety profile demonstrated in animal studies, LEAD offers a potential alternative to tumor ablation with or without PVE for FLR growth.

Designing a High Gain Rectangular Microstrip Patch Antenna Working at 3 GHz for RADAR

This study presents the design and analysis of a microstrip patch antenna optimized for radar applications operating at a frequency of 3 GHz. The antenna is designed to meet the requirements of radar systems, offering characteristics such as high gain, low profile, and broad bandwidth. The design process involves simulation using electromagnetic simulation software to achieve the desired antenna performance parameters. Various antenna parameters, including substrate material selection, patch dimensions, feeding techniques, and impedance matching networks, are carefully optimized to enhance antenna performance. The proposed antenna design is expected to exhibit excellent radiation characteristics, making it suitable for radar applications requiring reliable and efficient communication at 3 GHz frequency. This antenna designed for operating at 3 GHz, type Rogers Ultralam1217 (tm) with dielectric constant, ∈r= 2.2 tanδ (0.0009) and thickness of h = 1.6mm. The antennas are simulated using Ansys HFSS software. The performance is evaluated in terms of return loss, gain, and directivity and is deemed to be compatible with simulations.

Cardiovascular Risk Profile in Master Paralympic Athletes, a High-Risk Undertreated Population: A Cross-Sectional Longitudinal Study.

Recently, European Society of Cardiology (ESC)validated aprediction model to estimate 10-year fatal and non-fatal cardiovascular disease risk (CVDR) in individuals (aged 40-60 years) without previous cardiovascular disease or diabetes(ESC-SCORE2)and to provide indications for treatment. At present, data describing the CVDR in Paralympic athletes (PAs) are scarce and inconsistent. Therefore,we sought to assess the prevalence of risk factors in PAs to estimate their CVDR through SCORE2. Weenrolled 99 PAs aged ≥40 y.o., who participated at 2012-2022 Paralympic Games, competing in 22 different sport disciplines classified according to sport type (power, skills, endurance and mixed) and disabilities: spinal cord injuries (SCI) and non-SCI. CVDR factors,anthropometric measurements and blood samples were collected. Among the 99 PAs (78% males, mean age 45.7±4.7 y.o.), 52.5% had SCI; 54% were dyslipidemic and 23% were smokers. According to ESC-SCORE2, 29% had high and 1% very-high CVDR. Women (compared to men) and endurance (compared to other sport) exhibited better CV profile. SCI showed no differences when compared with non-SCI for CVDR, excepted for a lower HDL and lower exercise performance.None of the dyslipidemic athlete was on pharmacologically treatment, despitethe altered lipid profile had already been detected at younger age. PAs are a selected population, presenting a high CV risk profile, with 30% showing either high or very-high CVDR according to ESC-SCORE2. Dyslipidemiawas the most common risk factor, underestimated and undertreated, emphasizing the need for specific preventive strategies in this special setting of athletes.

Understanding the mechanism of safety attitude mitigates the turnover intention novice nurses via the person-centred method: A theory-driven, deductive cross-sectional study.

Examine profiles of safety attitudes among novices and explore whether profiles moderate the occupational identity-turnover pathway. Novice nurses face unique challenges in adopting positive safety attitudes, which influence outcomes like turnover. However, past research found only average levels of safety attitudes among novices, ignoring possible heterogeneity. Exploring whether meaningful subgroups exist based on safety perspectives and factors shaping them can provide insights to improve safety attitudes and retention. This study was designed as a cross-sectional investigation. Data were collected through the distribution of questionnaires. Descriptive statistics were first conducted, followed by latent profile analysis. We then carried out univariate analysis and ordinal multinomial regression to explore the factors shaping the different profiles. Finally, we examine the moderating effect of nurses' safety attitudes with different latent profiles on the relationship between professional identification and turnover intention. A total of 816 novice nurses were included. Three profiles were identified: high, moderate and low safety attitudes - higher attitudes were associated with lower turnover intention. Interest in nursing, health status, identity and turnover predicted profile membership. Moderate profile had a stronger buffering effect on the identity-turnover link versus high profile. Multiple safety attitude profiles exist among novice nurses. Certain factors like interest in nursing and occupational identity are associated with more positive safety profiles. Targeting these factors could potentially improve safety attitudes and reduce turnover among novice nurses. The moderating effects suggest that tailored interventions matching specific subgroups may maximize impact. Assessing subgroup attitudes enables tailored training for novices' specific needs, nurturing continuous improvement. Supporting early career development and role identity may strengthen retention intentions.

Exploring heterogeneity in PTSD symptoms and associated predictors and outcomes in Afghanistan veterans: A latent profile analysis

ABSTRACT Research on posttraumatic stress symptoms (PTSS) typically focuses on diagnosis or symptom severity, however, this overlooks the variety of symptom patterns that exist. Latent profile analysis was used to explore PTSS profiles in a sample of Norwegian Afghanistan veterans (n = 4052, 91.7% males). Multinomial logistic regression analyses were conducted to examine predictors and outcomes associated with PTSS profile membership. Three profiles emerged: Low Symptoms profile (85%); High Numbing and Arousal profile (13%); and High Symptoms profile (2%). Being female, lower number of deployments, barriers to disclose war-related experiences, and higher number of potentially morally injurious events (PMIEs) were associated with belonging to the High Symptoms profile compared to the High Numbing and Arousal (Male gender: OR = 0.37, p < .05; Number of deployments: OR = 0.68, p < .05; Barriers to disclose: OR = 1.39, p < .001; PMIEs: OR = 1.15. p < .05), or Low Symptoms profile (Male gender: OR = 0.36, p < .05; Number of deployments: OR = 0.67, p < .01; Barriers to disclose: OR = 1.80, p < .001; PMIEs: OR = 1.32. p < .001). Participants in the High Symptoms profile had the highest probability of mental health service use (0.37) and endorsing suicidal ideation (0.38), compared to the two other profiles (p < .01). Participants in the High Numbing and Arousal profile had a higher probability of seeking professional mental health care (0.17), endorsing suicidal ideation (0.16), and reporting more suicide attempts compared to the Low Symptom profile (0.02 vs. 0.00, p < .001). These findings highlight the importance of considering the heterogeneity of PTSS profiles and understanding the predictors and responses of individuals who exhibit elevated PTSS symptoms.

Adolescents’ Covitality Patterns: Relations with Student Demographic Characteristics and Proximal Academic and Mental Health Outcomes

AbstractIdentifying and promoting students’ social-emotional strengths is essential in building their mental health. Covitality, representing the co-occurrence of psychological strengths, is a helpful framework for characterizing students’ well-being. This study used latent profile analysis to identify adolescents’ (n = 11,217; 50.3% female, 37.8% male; grades 9 [33.7%], 10 [21.0%], 11 [28.9%], and 12 [16.5%]) covitality patterns across 12 social-emotional health domains. We investigated whether student demographic characteristics (i.e., sex, parent educational attainment, ethnic identification) were related to profile membership. We further examined profiles’ relations to students’ proximal academic and mental health outcomes, including self-reported grades, school connectedness, life satisfaction, and psychological distress. Four covitality profiles were identified—High, Moderate-High, Moderate-Low, and Low. Profile membership was statistically significantly related to students’ sex and socioeconomic circumstances but with small effect sizes. We identified consistent differences across covitality profiles on student self-reported proximal outcomes. Overall, students in profiles with higher covitality levels (High and Moderate-High) reported (a) higher grades, school connectedness, and life satisfaction and (b) less psychological distress, with students in the High profile reporting the most favorable outcomes. Assessing students’ strengths and providing interventions focused on building strengths across domains are recommended.

Bent ab interno needle goniotomy versus gonioscopy-assisted transluminal trabeculotomy in primary open-angle glaucoma: study protocol of a randomized clinical trial

BackgroundMinimally invasive glaucoma surgery (MIGS) is a new class of surgeries, which combines moderate to high success rates and a high safety profile. Bent Ab interno Needle Goniotomy (BANG) and Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) are two low-cost MIGS procedures that communicate the anterior chamber to Schlemm’s canal. Most of the available publications on MIGS are either case series or retrospective studies, with different study protocols. The aim of this manuscript is to describe a randomized clinical trial (RCT) protocol to compare the long-term intraocular pressure (IOP) control and the safety of both procedures in eyes with primary open-angle glaucoma.MethodsThis is a parallel, double-arm, single-masked RCT that includes pseudophakic primary open-angle glaucoma (POAG) eyes. After inclusion criteria, medications will be washed out to verify baseline IOP before surgery. Patients will be randomized to BANG or GATT using a sealed envelope. Follow-up visits will be 1, 7, 15, 30, 60, 90, 180, 330 and 360 days after surgery. On PO330, a new medication washout will be done. The main outcome is the IOP reduction following the procedures. Complimentary evaluation of functional and structural parameters, safety, and quality of life will be done after 30, 90, 180, and 360 days.DiscussionOur study was designed to compare the long-term efficacy and safety of two low-cost MIGS. Most of the published studies on this subject are case series or retrospective cohorts, with different study protocols, which included different types and severities of glaucomas, combined with cataract extraction. Our study only included mild to moderate POAG eyes, with previous successful cataract extraction. Moreover, it provides a standardized protocol that could be replicated in future studies investigating various types of MIGS. This would allow comparison between different techniques in terms of efficacy, safety, and patients’ quality of life.Trial registrationRetrospectively registered at the Registro Brasileiro de Ensaios Clínicos (ReBEC) platform RBR-268ms5y. Registered on July 29, 2023.The study was approved by the Ethics Committee of the University of Campinas, Brazil.