Ideal Approach Research Articles

Direct C–H arylation vs Stille polymerization: Rational design, synthesis, and systematic examinations of π-conjugated polymers for organic solar cells

Direct C–H arylation (DA) polymerization, often known as DArP, is an emerging protocol to the synthesis of π-functional polymers that has garnered a lot of attention due to its virtues of requiring a minimum number of synthetic steps and producing a simpler byproduct. However, the regioselectivity of the C–H bonds is significantly less effective in the DArP-derived polymers, which is one of the reasons why only a small number of these polymers exhibit photovoltaic characteristics that are equal to counterparts generated via Stille coupling. In this work, a low-defect π-polymer PBDTF-TPD (DA) is facilely obtained via DArP between 4,8-bis(5-(2-ethylhexyl)-4-fluorothiophen-2-yl)benzo[1,2-b:4,5-b']-dithiophene (BDTF) and thieno [3,4-c]pyrrole-4,6-dione (TPD) that possesses regioselective π-C−H bonds toward arylation. As a result, DArP-derived PBDTF-TPD (DA) and Stille-derived PBDTF-TPD (St) share the similar opto-electrochemical properties, photovoltaic performance, and morphology, indicating that DArP polymerization leads to defined structures with minimal branching defects. Specifically, this study demonstrates that the (PCE = 8.91%) of a rationally designed monomer for DArP using an ideal approach is equivalent to that of the Stille-derived analogue PBDTF-TPD (St, PCE = 9.57%).

A Comparison of Short-Term Outcomes after Surgical Treatment of Multilevel Degenerative Cervical Myelopathy in the Geriatric Patient Population: An Analysis of the National Surgical Quality Improvement Program Database 2010-2020.

Retrospective review of the American College of Surgeons-National Surgical Quality Improvement Program database from 2010 to 2020. To compare the short-term complication rates of anterior cervical decompression and fusion (ACDF), posterior cervical laminoplasty (LP), and posterior cervical laminectomy and fusion (PCF) in a geriatric population. The geriatric population in the United States has increased significantly. Degenerative cervical myelopathy (DCM) is caused by cervical spinal stenosis, and its prevalence increases with age. Therefore, the incidence of multilevel DCM requiring surgical intervention is likely to increase. ACDF, LP, and PCF are the most commonly used surgical techniques for treating multilevel DCM. However, there is uncertainty regarding the optimal surgical technique for the decompression of DCM in geriatric patients. Patients aged 65 years who had undergone either multilevel ACDF, LP, or PCF for the treatment of DCM were analyzed. Additional analysis was performed by standardizing the data for the American Society of Anesthesiologists classification scores and preoperative functional status. A total of 23,129 patients were identified. Patients with ACDF were younger, more often female, and preoperatively healthier than those in the other two groups. The estimated postoperative mortality and morbidity, mean operation time, and length of hospital stay were the lowest for ACDF, second lowest for LP, and highest for PCF. The readmission and reoperation rates were comparable between ACDF and LP; however, both were significantly lower than PCF. PCF is associated with the highest risk of mortality, morbidity, unplanned reoperation, and unplanned readmission in the short-term postoperative period in patients aged 65 years. In contrast, ACDF carries the lowest risk. However, some disease-specific factors may require posterior treatment. For these cases, LP should be included in the preoperative discussion when determining the ideal surgical approach for geriatric patients.

Abstract IA006: Friend or foe: Reevaluating the therapeutic potential of monocytes and tumor-associated macrophages in ovarian cancer

Abstract The hostile tumor microenvironment in ovarian cancer is an active deterrent to the efficacy of immunotherapeutic agents such as immune checkpoint inhibitors, Chimeric Antigen Receptor (CAR) T-cells, and Bispecific T-cell Engagers (BiTEs). Tumor-associated macrophages (TAMs) and Myeloid-Derived Suppressor Cells (MDSCs) have been shown to promote an immunosuppressive metabolic and cytokine tumor microenvironment that is detrimental to cytotoxic effector T-cell activity in ovarian cancer. These immunosuppressive cells are also associated with poor prognostic outcomes. The ideal approach to modulating TAMs and MDSCs is unknown. Data from preclinical models support reprogramming these cells to a more inflammatory phenotype or removing them from the tumor microenvironment entirely. However, neither approach has translated to clinical benefits. We have previously demonstrated that CAR-T cells modified to secrete IL-18 exerted their therapeutic effects partly via polarization of bone marrow macrophages towards an M1 phenotype. We also found that the depletion of TAMs improved CAR-T cell efficiency, even when these CAR-T cells were co-modified to secrete IL-12. Because of the propensity for monocytes to be recruited to the ovarian cancer tumor microenvironment, we evaluated the efficacy of monocytes genetically modified to secrete BiTEs. First, we designed and evaluated BiTEs that recognize the retained portion of MUC16 (Muc16-ecto) and CD3+ T-cells and showed that these BiTEs were efficacious in vitro and in vivo in a xenograft model of ovarian cancer. We validated that monocytes transduced to secrete Muc16-specific BiTEs (Mono-BiTEs) could effectively lyse tumor cells in vitro and suppress xenograft ovarian cancer cells in vivo. Adding IFN-alpha and IFN-gamma to Mono-BiTEs significantly improved Mono-BiTEs antitumor efficacy over BiTE therapy or unmodified monocyte therapy alone. Adoptive cell therapy with genetically engineered autologous monocytes could provide an alternative approach to reprograming or eliminating myeloid-derived cells in ovarian cancer. Citation Format: Oladapo Yeku. Friend or foe: Reevaluating the therapeutic potential of monocytes and tumor-associated macrophages in ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference on Ovarian Cancer; 2023 Oct 5-7; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_2):Abstract nr IA006.

Assessing immunogenicity of CRISPR-NCas9 engineered strain against porcine epidemic diarrhea virus

Porcine epidemic diarrhea (PED) caused by porcine epidemic diarrhea virus (PEDV), is an acute and highly infectious disease, resulting in substantial economic losses in the pig industry. Given that PEDV primarily infects the mucosal surfaces of the intestinal tract, it is crucial to improve the mucosal immunity to prevent viral invasion. Lactic acid bacteria (LAB) oral vaccines offer unique advantages and potential applications in combatting mucosal infectious diseases, making them an ideal approach for controlling PED outbreaks. However, traditional LAB oral vaccines use plasmids for exogenous protein expression and antibiotic genes as selection markers. Antibiotic genes can be diffused through transposition, transfer, or homologous recombination, resulting in the generation of drug-resistant strains. To overcome these issues, genome-editing technology has been developed to achieve gene expression in LAB genomes. In this study, we used the CRISPR-NCas9 system to integrate the PEDV S1 gene into the genome of alanine racemase-deficient Lactobacillus paracasei △Alr HLJ-27 (L. paracasei △Alr HLJ-27) at the thymidylate synthase (thyA) site, generating a strain, S1/△Alr HLJ-27. We conducted immunization assays in mice and piglets to evaluate the level of immune response and evaluated its protective effect against PEDV through challenge tests in piglets. Oral administration of the strain S1/△Alr HLJ-27 in mice and piglets elicited mucosal, humoral, and cellular immune responses. The strain also exhibited a certain level of resistance against PEDV infection in piglets. These results demonstrate the potential of S1/△Alr HLJ-27 as an oral vaccine candidate for PEDV control.Key points• A strain S1/△Alr HLJ-27 was constructed as the candidate for an oral vaccine.• Immunogenicity response and challenge test was carried out to analyze the ability of the strain.• The strain S1/△Alr HLJ-27 could provide protection for piglets to a certain extent.

Ultra-sensitive fluorescent immunoassay based on bright AIE nanoparticle for biomarkers detection and quantification

Fluorescence immunoassay (FIA) is one of the most immunoassay diagnosis methods in clinic for biomarker quantification in recent years. The development of reliable FIA strategy with high-sensitivity, large-rang and outstanding efficiency for biomarkers rapid diagnosis, especially in complicated samples, is still a great challenge. Herein, an ultra-sensitive FIA combined with magnetic separation was established to achieve efficient point-of-care diagnosis in quantitative behavior based on bright aggregation-induced emission nanoparticles (AIE NPs). By utilizing swelling method, AIE NPs with controllable size, relatively high luminescence efficiency and large Stokes shift were prepared, moreover, the obtained NPs also exhibit narrow size distribution and well-defined spherical morphology. Stability studies prove that AIE NPs not only possess quite high photostability, but also present good resistance towards harsh acid-alkaline steadily. By using AIE NPs as the reporter, a reliable and efficient FIA sensor was successfully constructed. The precise detection of C-reaction protein (CRP) antigen was acquired with the linear range of 0.5 ng·mL−1 ∼ 1000 ng·mL−1 and the limit of detection (LOD) of 0.35 ng·mL−1, which is comparative with the conventional chemiluminescence immunoassays. Moreover, the whole detection operation could be accomplished within 10 min, which is relatively rapid and desirable for point-of-care diagnosis. In addition, this strategy also presented excellent specificity towards CRP antigens among various inflammatory antigens. These results confirm that AIE NPs-based FIA strategy provides an ideal and reliable approach for precise and quantitive biosensing of in vitro diagnostics.

A Hydrogen Evolution Catalyst [Co2O2] Metallacycle Enables Regioselective Allene C(sp2)‐H Functionalization

AbstractSelective functionalization of allenic C(sp2)‐H is an ideal approach to upgrading simple allenes to synthetically useful allenes, albeit suffering from challenges associated with inert reactivity and inferior selectivity. Inspired by energy chemistry, a catalytic hydrogen evolution reaction (HER) strategy was leveraged to selectively activate weakly acidic allene C(sp2)‐H bonds in a reductive mode. An array of [Co2O2] metallacycle complexes were readily devised starting from amino acids, and they were demonstrated as robust HER catalysts, which would selectively break allenic C(sp2)‐H bonds to release hydrogen. With the newly developed HER catalyst, regioselective electrochemical functionalization of allenic C(sp2)‐H with alcoholic α C(sp3)‐H was unprecedentedly achieved. This strategy features excellent regioselectivity, unconventional chemoselectivity, good functional‐group tolerance (62 examples), and mild conditions. Mechanism experiments revealed a reactive hydroxy‐coordinated cobalt(II) species in the reaction. Density functional theory (DFT) calculations were also conducted to rationalize the regioselectivity observed in the reaction.

ROS-Responsive Poly(α-l-lysine)-Based Nanoparticles Loaded with Doxycycline Combat Oxidative Stress and Bacterial Infection.

Bacterial pneumonia is one of the major threats in clinical practice, and the reactive oxygen species (ROS) generated at the infection site can exacerbate the damage. Currently, conventional antibiotic therapies have low utilization, and their excessive use can result in substantial toxicity. Nanocarrier systems provide an ideal approach for treating bacterial infection by facilitating more efficient utilization of antibiotics. In this study, the ROS-responsive amphiphilic nanoparticles (NPs) are developed and used to encapsulate the antibiotic doxycycline (DOXY) to achieve antibacterial and antioxidant functionalities. The NPs are prepared from poly(α-l-lysine) (α-PLL) and phenylboronic acid pinacol ester simultaneously conjugated carbonyldiimidazole (abbreviated as CDIPB). The phenylboronic acid ester groups on CDIPB could react with excessive ROS to suppress oxidative damage at the infection site. The ROS-responsive degradation of CDIPB also facilitates the rapid release of internal DOXY, effectively killing the accumulated bacteria. Additionally, in vitro cell experiments demonstrate the good biocompatibility of the NPs. These results suggest that the ROS-responsive amphiphilic nanoparticles can serve as a novel nanoplatform for the treatment of bacterial pneumonia.

Dimethyloxallyl glycine-loaded mesoporous bioactive glass/poly(D,L-lactide) composite scaffolds with ultrasound stimulation for promoting bone repair.

Introduction: Bone tissue engineering is considered the ideal approach for bone repair. Mesoporous bioactive glass (MBG) possesses the characteristics of high drug-loading capacity and bioactivity. Low-intensity pulsed ultrasound contributes to promoting fracture healing and bone defect repair, and dimethyloxalyl glycine (DMOG) is a small molecular inhibitor that can suppress prolyl hydroxylase, reducing the degradation of hypoxia-inducible factor. Methods: In this study, we proposed to prepare DMOG-loaded MBG/poly(D,L-lactide) composite scaffolds (DMOG-MBG/PDLLA) for promoting bone repair. The effects of ultrasound stimulation and DMOG release on the cell responses of rat bone marrow mesenchymal stem cells (BMSCs) and human umbilical vein endothelial cells (HUVECs) and bone repair in vivo were investigated. Results and Discussion: The results showed that both ultrasound stimulation and DMOG release could promote the proliferation, adhesion and differentiation of BMSCs and HUVECs, respectively. After the implantation of scaffolds in rat cranial bone defect model for 8 weeks, the results indicated that the combined ultrasound stimulation and DMOG release contributed to the highest ability for promoting bone repair. Hence, the DMOG-MBG/PDLLA scaffolds with ultrasound stimulation are promising for application in bone repair.

Pre-Segmented Down-Sampling Accelerates Graph Neural Network-Based 3D Object Detection in Autonomous Driving.

Graph neural networks (GNNs) have been proven to be an ideal approach to deal with irregular point clouds, but involve massive computations for searching neighboring points in the graph, which limits their application in large-scale LiDAR point cloud processing. Down-sampling is a straightforward and indispensable step in current GNN-based 3D detectors to reduce the computational burden of the model, but the commonly used down-sampling methods cannot distinguish the categories of the LiDAR points, which leads to an inability to effectively improve the computational efficiency of the GNN models without affecting their detection accuracy. In this paper, we propose (1) a LiDAR point cloud pre-segmented down-sampling (PSD) method that can selectively reduce background points while preserving the foreground object points during the process, greatly improving the computational efficiency of the model without affecting its 3D detection accuracy. (2) A lightweight GNN-based 3D detector that can extract point features and detect objects from the raw down-sampled LiDAR point cloud directly without any pre-transformation. We test the proposed model on the KITTI 3D Object Detection Benchmark, and the results demonstrate its effectiveness and efficiency for autonomous driving 3D object detection.

Distal Junctional Failures in Degenerative Thoracolumbar Hyperkyphosis.

Degenerative thoracolumbar hyperkyphosis (DTH) is a disease that negatively affects individual health and requires surgical intervention, yet the ideal surgical approach and complications, especially distal junctional failures (DJF), remain poorly understood. This study aims to investigate DJF in DTH and to identify the risk factors for DJF so that we can improve surgical decision-making, and advance our knowledge in the field of spinal surgery to enhance patient outcomes. This study retrospectively reviewed 78 cases (late osteoporotic vertebral compression fracture [OVCF], 51; Scheuermann's kyphosis [SK], 17; and degenerative disc diseases [DDD], 10) who underwent corrective surgery in our institute from 2008 to 2019. Clinical outcomes were assessed using health-related quality of life (HRQOL) measures, including the visual analogue scale (VAS) scores for back and leg pain, the Oswestry disability index (ODI), and the Japanese Orthopaedic Association (JOA) scoring system. Multiple radiographic parameters, such as global kyphosis (GK) and thoracolumbar kyphosis (TLK), were assessed to determine radiographic outcomes. Multivariate logistic regression analysis was employed to identify the risk factors associated with DJF. HRQOL improved, and GK, TLK decreased at the final follow-up, with a correction rate of 67.7% and 68.5%, respectively. DJF was found in 13 of 78 cases (16.7%), two cases had wedging in the disc (L3-4) below the instrumentation, one case had a fracture of the lowest instrumented vertebrae (LIV), one case had osteoporotic fracture below the fixation, nine cases had pull-out or loosening of the screws at the LIV and three cases (23.1%) required revision surgery. The DJF group had older age, lower computed tomography Hounsfield unit (CT HU), longer follow-up, more blood loss, greater preoperative sagittal vertical axis (SVA), and poorer postoperative JOA and VAS scores (back). The change in TLK level was larger in the non-DJF group. Post-sagittal stable vertebrae (SSV) moved cranially compared with pre-SSV. Age, CT HU, length of follow-up, estimated blood loss, and preoperative SVA were independent risk factors for DJF. We recommend fixation of the two vertebrae below the apex vertebrae for DTH to minimize surgical trauma.

Pleiotropic beneficial cardiometabolic actions of a high-purity eicosapentaenoic acid product in high cardiovascular risk individuals.

The ideal approach to the secondary dyslipidemia goal of lowering triglycerides (TG) is not well established. The available ω-3 fatty acid products differ from each other in composition and content. The purpose of the present study was to investigate the effect of a highly purified eicosapentaenoic acid (EPA) formulation on cardiometabolic biomarkers in high cardiovascular (CV) risk patients. The study included 226 subjects with high TG and ≥1 of the following CV risk factors: arterial hypertension, diabetes mellitus, ultrasound-documented atheromatosis, peripheral artery disease, previous myocardial infarction, or ischemic stroke. Participants received 2 g EPA twice daily for 3 months, along with typical nutritional counseling. Cardiometabolic hematological parameters (TG, low-density lipoprotein [LDL], high-density lipoprotein [HDL], non-HDL, total cholesterol [TChol], apolipoprotein A1 [Apo A1], apolipoprotein B [Apo B], glucose, glycated hemoglobin [HbA1c], and C-reactive protein [CRP]) were measured at baseline and at 3 months. The mean patients' age was 61.1 ± 1.4 years and the mean baseline TG was 2.97 ± 0.15 mmol/L. Apart from Apo A1, all other biomarkers significantly (p < 0.05) improved at 3 months, regardless of sex (except Apo B) and age: TG 1.75 ± 0.09 versus 2.97 ± 0.15 mmol/L, LDL 2.46 ± 0.08 versus 3.05 ± 0.13 mmol/L, HDL 1.22 ± 0.03 versus 1.11 ± 0.03 mmol/L, non-HDL 3.29 ± 0.10 versus 4.14 ± 0.16 mmol/L, TChol 4.55 ± 0.10 versus 5.15 ± 0.13 mmol/L, Apo A1 26.8 ± 9.3 versus 22.5 ± 8.6 μmol/L, Apo B 1.25 ± 0.23 versus 1.29 ± 0.23 μmol/L, glucose 5.66 ± 0.11 versus 5.99 ± 0.17 mmol/L, HbA1c 5.83 ± 0.1 versus 5.97 ± 0.1% and CRP 1.92 ± 0.2 versus 5.26 ± 2.8 mg/L. In conclusion, adding highly purified EPA product (4 g daily) on nutritional counseling leads to a significant TG reduction. In addition, this treatment appears to have pleiotropic beneficial cardiometabolic actions.

Comparative Analysis of Autophagy and Apoptosis in Disc Degeneration: Understanding the Dynamics of Temporary-Compression-Induced Early Autophagy and Sustained-Compression-Triggered Apoptosis.

The purpose of this study was to investigate the initiation of autophagy activation and apoptosis in nucleus pulposus cells under temporary compression (TC) and sustained compression (SC) to identify ideal research approaches in intervertebral disc degeneration. Various techniques were used: radiography (X-ray), magnetic resonance imaging (MRI), transmission electron microscope (TEM), H&E staining, Masson's trichrome staining, immunohistochemistry (IHC) (LC3, beclin-1, and cleaved caspase-3), and real-time polymerase chain reaction (RT-qPCR) for autophagy-related (beclin-1, LC3, and P62) and apoptosis-related (caspase-3 and PARP) gene expression analysis. X-ray and MRI revealed varying degrees of disc degeneration, ranging from moderate to severe in both groups. The severity was directly linked to compression duration, with SC resulting in notably severe central NP cell degeneration. Surprisingly, TC also caused similar, though less severe, degeneration. Elevated expression of LC3 and beclin-1 was identified after 6 weeks, but it notably declined after 12 weeks. Central NP cells in both groups exhibited increased expression of cleaved caspase-3 that was positively correlated with the duration of SC. TC showed fewer apoptotic markers compared to SC. LC3, beclin-1, and P62 mRNA expression peaked after 6 weeks and declined after 12 weeks in both groups. Cleaved caspase-3 and PARP expression peaked in SC, positively correlating with longer compression duration, while TC showed lower levels of apoptosis gene expression. Furthermore, TEM results revealed different events of the autophagic degradation process after 2 weeks of compression. TCmay be ideal for studying early triggered autophagy-mediated degeneration, while SC may be ideal for studying late or slower-triggered apoptosis-mediated degeneration.

ENDOMETRIOSIS AND FERTILITY -NATURAL CONCEPTION FOLLOWING MULTIPLE SURGERIES FOR ENDOMETRIOSIS

The association between endometriosis and infertility is well established and treatment is challenging. It is a chronic and debilitating disease with multiple pathophysiologic mechanisms. Treatment involves both surgical/medical interventions and ART for those with infertility.&#x0D; Evidence on the ideal approach is inadequate and guidelines vary. The patient’s symptomatology, age, fertility desires and prior surgical interventions are important factors to consider. Fertility preservation is paramount.&#x0D; We present an interesting case of a nulliparous patient who over four years has had recurrent ovarian endometriosis, underwent four laparoscopic surgical/medical interventions, and ultimately achieved a natural conception.&#x0D; Case&#x0D; A 32-year-old female presented in 2019 with symptoms of endometriosis confirmed on pelvic ultrasound. Laparoscopy, the gold standard was performed and the histology confirmed endometriosis. Postoperatively, she was on medical management to control symptoms. However, seven months later, she presented with worsening symptoms despite being on Leuprolide and later Visanne. Ultrasound showed recurrent ovarian endometriosis and uterine fibroids. A Laparoscopic myomectomy, adhesiolysis, and excision of ovarian endometriosis were done. She was then on Visanne but 6 months later her symptoms returned. A scan showed recurrent left ovarian endometriosis and she underwent laparoscopic excision. Her symptoms improved. Two years later she presented with worsening symptoms. A repeat ultrasound scan showed ovarian endometriosis. With a desire to conceive, laparoscopic excision of endometriosis, Adhesiolysis, and chromopertubation were performed. She conceived spontaneously four months later and is currently in her second trimester. &#x0D; &#x0D; Conclusion&#x0D; Treatment for endometriosis is an enigma and has to be individualized. Shared decision-making is important and repeated surgical/medical interventions with fertility preservation are a plausible approach for those keen on child-bearing.

PERK modulation, with GSK2606414, Sephin1 or salubrinal, failed to produce therapeutic benefits in the SOD1G93A mouse model of ALS.

Amyotrophic lateral sclerosis (ALS) has been linked to overactivity of the protein kinase RNA-like ER kinase (PERK) branch of the unfolded protein response (UPR) pathway, both in ALS patients and mouse models. However, attempts to pharmacologically modulate PERK for therapeutic benefit have yielded inconsistent and often conflicting results. This study sought to address these discrepancies by comprehensively evaluating three commonly used, CNS-penetrant, PERK modulators (GSK2606414, salubrinal, and Sephin1) in the same experimental models, with the goal of assessing the viability of targeting the PERK pathway as a therapeutic strategy for ALS. To achieve this goal, a tunicamycin-challenge assay was developed using wild-type mice to monitor changes in liver UPR gene expression in response to PERK pathway modulation. Subsequently, multiple dosing regimens of each PERK modulator were tested in standardized, well-powered, gender-matched, and litter-matched survival efficacy studies using the SOD1G93A mouse model of ALS. The alpha-2-adrenergic receptor agonist clonidine was also tested to elucidate the results obtained from the Sephin1, and of the previously reported guanabenz studies, by comparing the effects of presence or absence of α-2 agonism. The results revealed that targeting PERK may not be an ideal approach for ALS treatment. Inhibiting PERK with GSK2606414 or activating it with salubrinal did not confer therapeutic benefits. While Sephin1 showed some promising therapeutic effects, it appears that these outcomes were mediated through PERK-independent mechanisms. Clonidine also produced some favorable therapeutic effects, which were unexpected and not linked to the UPR. In conclusion, this study highlights the challenges of pharmacologically targeting PERK for therapeutic purposes in the SOD1G93A mouse model and suggests that exploring other targets within, and outside, the UPR may be more promising avenues for ALS treatment.

District administrator perspectives of current and ideal approaches to identifying and supporting student social, emotional, and behavioral needs

IntroductionLeadership support has been identified as a key facilitator to successful implementation of school-based initiatives. School leadership contributions to student academic success and school reform have been documented, but less work has focused on the effects of leadership on school mental health initiatives such as social, emotional, and behavioral (SEB) screening. Few studies have investigated administrator knowledge and support for SEB screening or compared their current and ideal approaches to SEB screening, both of which are important to informing directions for implementation supports.MethodsUsing a nationally representative sample of U.S. public school districts, we investigated tensions between school district administrators’ (n = 1,330) current and ideal approaches to SEB screening within the current study. We fit binomial and multinomial logistic regression models to determine predictors of positive, negative, or no tensions based on the administrators’ current approach to SEB screening, administrators’ beliefs about the role of schools in student SEB concerns, and district demographics.ResultsNearly half of administrators (46.7%) reported using an approach to SEB screening that was not their ideal approach. Higher beliefs scores commonly predicted administrator desire for more proactive approaches, whereas district characteristics yielded varied results.DiscussionResults call for targeted next steps, including implementation supports, funding, and knowledge building aligned with administrator and district characteristics.

Comparison of evaluation methods for improving the usability of a Spanish mHealth tool

ObjectiveMobile health (mHealth) technology is now widely used across health conditions and populations. The rigorous development of these tools has yielded improved health outcomes, yet the ideal approach for developing mHealth tools continues to evolve, indicating the need for rigorous usability evaluation methods. This study compares two usability evaluation methods – cognitive interviews and usability assessments employing a think-aloud approach – for adapting an evidence-based mHealth tool from English into Spanish. MethodsWe conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City, NY, and La Romana, Dominican Republic. The Health IT Usability Evaluation Model (Health-ITUEM) was used to guide the analysis of qualitative data collected from each method. ResultsParticipants (N = 40) averaged 43 years old (SD = 12.26; range 20–79), identified primarily Hispanic/Latino (92.5 %), and resided in La Romana (50 %) or New York City (50 %). Both usability evaluation methods yielded similar findings, highlighting learnability and information needs as crucial components of participant feedback for the mHealth application. Cognitive interviews captured participants' perspectives on the app's interface and design. On the other hand, results from usability assessments offered insights into participants' competency while interacting with the mHealth tool. ConclusionFindings from this study highlight the contributions and limitations of including cognitive interviews and task-based usability assessments using a think-aloud approach in mHealth usability testing. Future research should employ a multi-method approach, incorporating complementary usability evaluation methods and engaging participants in multiple assessments. Using complementary usability evaluation methods may provide a more comprehensive understanding of the usability and participant experience aspects of a mHealth tool compared to using a single usability evaluation method.

Self-Care Management, Patient Education, and Nursing Support in Patients with Diabetes and Hypertension

Diabetes and related complications such as hypertension are considered major public health issues throughout the world as they are the most important causes of death and disability and cause huge economic implications for both patients and the public health system. Sufficient management of these complications along with novel patient education and self-care strategies are documented as ideal approaches able to postpone the onset of morbidity and disability and thereby delay the onset of preventable costs. However, contradictions regarding the efficacy of the studied self-care strategies are mentioned, thereby the current study aimed to review self-care strategies as a preventive approach to disease management and improving clinical outcomes in patients with diabetes and hypertension. The findings revealed that self-care through patient education with nursing support can improve medication adherence and lifestyle. However, clinical outcomes have revealed relative inconsistencies that require further studies.

Brain tumor malignancy classification using improved VGG16 based on MRI images

This study introduces a method based on Magnetic Resonance Imaging (MRI) images and Convolutional Neural Networks (CNN) to categorize the malignancy of brain tumors. The major goal of this research is to develop an accurate and reliable model that aids in tumor early identification, leading to better patient outcomes. Specifically, first, the MRI images undergo preprocessing, which includes intensity normalization and random brightness and contrast adjustments for data augmentation. Next, the Visual Geometry Group (VGG16) model serves as a baseline, enhanced with flatten, dense, and dropout layers. Transfer learning is applied to leverage pre-trained features from VGG16, improving the generalization capability of model. A sizable collection of brain MRI pictures is used to train the model. The experimental outcomes on the MRI dataset illustrate the efficacy of the suggested model. The CNN-based approach achieves high accuracy in classifying brain tumor malignancy based on MRI images, indicating its potential in medical image analysis and its significance in early tumor detection and diagnosis. The proposed model serves as a valuable tool for healthcare professionals, aiding in well-informed decisions and providing an ideal medical approach for early detection of brain tumors. This research opens avenues for future work in medical imaging and deep learning, paving the way for improved treatment and diagnosis of brain tumors.

ChatGPT for Founding Teams: An Entrepreneurial Pedagogical Innovation

ChatGPT is taking the world and the education sector by storm. Many educators are still hesitant to integrate it within their curricula, owing to the limited practical and theoretical guidance on its applications, despite early conceptual studies advocating for its potential benefits. This pedagogical innovation applied an effectual logic to implement ChatGPT for a founding team activity within an entrepreneurship course. Composing a founding team is an inundating task in venture creation, with long-lasting consequences. So far, there is yet to be an ideal approach proposed in literature or observed in real-life for doing it. In this pedagogical innovation, three student teams with varying business ideas prompted ChatGPT using different keywords and levels of details, to get recommendations on essential team members, their roles and equity split. Each team presented their findings, and then the classroom engaged in a collective discussion. The students were surveyed afterwards to assess the reception and effectiveness of the intervention. Their feedback showed an overwhelming favoritism of ChatGPT, as a convenient and resourceful learning tool. The study establishes the potential value of ChatGPT as a heutagogical tool that supports student-centric entrepreneurial learning across educational institutions and the entrepreneurship ecosystem that extends to the venture creation process.

Bednar’s tumor at right shoulder in an adult male: a case report of a rare entity

Introduction and importance: Bednar tumor, a rare variant of dermatofibrosarcoma protuberans is a tumor with low malignant potential. Owing to limited studies, the pathogenesis and risk factor of this tumor are not clearly understood. The tumor extends from the epidermis to the dermal layers and even affects the surrounding bone. Here, the authors present a case of a 48-year-old male with a Bednar tumor, which was successfully managed by wide local excision and flap repair. Case presentation: Our patient presented to the hospital after the reappearance of mass, 6 years after the excision of the previously misdiagnosed lipoma. Vitals and systematic examination were normal. Local examination revealed an oval-shaped mass with a glistening surface on the right shoulder. The patient underwent wide excision and skin flap surgery for the treatment, and the diagnosis was confirmed through histopathological examination and immunohistochemistry for the CD34 marker. Clinical discussion: Bednar tumor is an infrequent skin tumor linked to genetic anomalies and is one of the rare variants [(&lt;0.1%) of skin tumors]. Diagnosis can be done by histopathological examination and CD34 marker positivity via immunohistochemistry. This tumor is mistaken for lipoma, leading to recurrent growth postexcision. The tumor demands a broader resection due to the high chances of reoccurrence. Although Mohs micrographic surgery is the ideal approach, its limited availability in resource-constrained settings prompts alternative strategies. Conclusion: This case highlights the challenges of diagnosis, the rarity of the condition, and the need for vigilant follow-up due to the tumor’s propensity for recurrence.