Individual Subjects Research Articles

Fructose biphosphate aldolase: A new cassava allergen

BackgroundFood allergy has considerably increased in recent years and this situation has been aggravated mainly by the consumption of more processed and complex foods, since minor or potentially allergenic foods are not required to be labeled. Manihot esculenta (cassava) is a widely consumed food in South America, Africa, and Asia and can be used in the production of flour and starch, as well as several other products. This root can cause allergic reactions with symptoms ranging from mild to severe. MethodsThus, the aim of this study was the characterization of the immunogenic cassava proteins responsible for sensitizing patients allergic to it. Using a 2D-SDS-PAGE based proteomic approach, six proteins were identified, including Fructose Bisphosphate Aldolase (FBA). Recombinant FBA was produced in Expi293 cells and evaluated by immunoblotting with the serum of 10 individual study subjects. ResultsOur results showed six cassava IgE-reactive proteins. From those, recombinant fructose bisphosphate aldolase (FBA) showed a positivity of 80% among tested sera, proving to be a highly sensitizing protein. ConclusionThe recombinant FBA molecule obtained in this study can be important for in vivo diagnostic assays, by producing more accurate results, and for desensitization protocols, in which the use of the isolated molecule produces more precise results by avoiding secondary sensitization. Trial registrationAll patients signed a consent form approved by the internal ethics committee CAPPesq, Comissão de Ética para Análise de Projetos de Pesquisa do HC FMUSP (CAAE: 10420619.6.0000.0068).

Alterations in Intratumoral Immune Response before and during Early-On Nivolumab Treatment for Unresectable Advanced or Recurrent Gastric Cancer

We investigated the tumor immune response in gastric cancer patients receiving third-line nivolumab monotherapy to identify immune-related biomarkers for better patient selection. Nineteen patients (10 males, median age 67 years) who received nivolumab as a third- or later-line therapy were enrolled. We analyzed the tumor immune response in durable clinical benefit (DCB) and non-DCB patients. Pre-treatment and early-on-treatment tumor transcriptomes were examined, and gene expression profiles, immunograms, and T cell receptor (TCR) repertoire were analyzed. DCB was observed in 15.8% of patients, with comparable secondary endpoints (ORR; objective response rate, OS; overall survival, PFS; progression-free survival) to previous trials. The immunograms of individual subjects displayed no significant changes before or early in the treatment, except for the regulatory T cell (Treg) score. Moreover, there were no consistent alterations observed among cases experiencing DCB. The intratumoral immune response was suppressed by previous treatments in most third- or later-line nivolumab recipients. TCR repertoire analysis revealed newly emerged clonotypes in early-on-treatment tumors, but clonal replacement did not impact efficacy. High T cell/Treg ratios and a low UV-radiation-response gene signature were linked to DCB and treatment response. This study emphasizes the tumor immune response’s importance in nivolumab efficacy for gastric cancer. High T cell/Treg ratios and specific gene expression signatures show promise as potential biomarkers for treatment response. The tumor-infiltrating immune response was compromised by prior treatments in third-line therapy, implying that, to enhance immunotherapeutic outcomes, commencing treatment at an earlier stage might be preferable. Larger cohort validation is crucial to optimize immune-checkpoint inhibitors in gastric cancer treatment.

Beyond Neoliberal Presentism: An Eco-Temporality for the Anthropocene

Abstract: In this paper, we examine the relationship between neoliberal presentist temporality and the climate-environmental crisis, arguing for the necessity of envisioning a new “eco-temporality”. The deconstruction of the modern concept of progress in postmodern thought and postcolonial studies is considered, making a case for the undesirability of its complete abandonment – since a progressive temporality retains a role in enabling political change and long-term vision. To capture the connection between politics and temporality we develop the concept of “political temporality”, which we define as the schema of interaction between the social representation of time and what is perceived as politically feasible in each community at a given time. Furthermore, we analyse the most prominent features of neoliberal temporality (structural presentism, the public/private distinction, individual subjects, and philosophy of history), sketching an account of how each of them impacts ecological and climate politics. Finally, to envision a new, Anthropocene-friendly “regime of historicity”, we lay down two basic conditions that an “eco-temporality” should satisfy. In the last two sections, we sketch a new (multi)temporal model that is meant to be apt for the Anthropocene, drawing on Ernst Bloch’s concepts of “multiversum” and “contemporaneity of non-contemporaneous elements” (Bloch, 1970, 1991).

Curriculum content mapping of the Chinese National Biology Curriculum Standards for middle school: an analysis from the OECD Education 2030 perspective

Curriculum standards are a critical component of a nation’s educational system and directly impact talent development and overall national development. Most studies on curriculum standards focus on a single competency. This study aims to understand the extent to which the competencies outlined in the OECD 2030-oriented learning framework are reflected in China’s compulsory education biology curriculum as a whole and within individual content subjects. In this study, we conducted a content analysis of China’s National Biology Curriculum Standards (Grades 7–9). The result shows that the standards cover 20 of the 28 competencies, focusing on foundational literacies, transformative competencies and competency development. We found that certain competencies, such as Action, Literacy, and Problem-solving, were emphasized across content subjects, while other competencies were uniquely emphasized within specific content subjects. This study provides a comprehensive view of China’s National Biology Curriculum Standards (Grades 7–9) from the perspective of future literacy development and can inform efforts to reform the curriculum.

A Comparative Assessment of Acceptance of Different Types of Functional Appliances.

Background Modern clinical orthodontics' functional appliances, a well-established modality of treatment, exhibit an amazing diversity of design. Clinical findings show that people have difficulty adjusting to these devices due to their size and unfixed positioning inside the mouth and that patient adaptation may vary based on the type of orthodontic functional appliance employed. Despite the fact that they appear to inflict more pain and soreness than, for example, removable plates, the effects of various orthodontic functional appliances on patients' acclimation have not yet been researched. Aim The current study's goal was to assess how different functional appliances' shapes and designs affected patients' willingness to accept them. Materials and methods About 20 adult volunteers (10 males and 10 females, age 18-32 years) with marked Class II division 1 malocclusion and not familiar with orthodontic appliances were selected as test subjects. Impressions for working casts were taken, and construction bites were prepared for the fabrication of eight functional appliances of various designs for each individual test subject. These appliances had eight design variations. There were three tests: one for speech effects, one for initial acceptance, and one for final acceptance after wearing different scales. Results Overall, the correlation between the quality of speech and pronunciation after wearing the appliance and the type of functional appliance was statistically significant. The quality of speech and pronunciation after wearing the appliance was maximum infrequency range 1 (FR1), while it was minimum in the medium-size activator. The difference was statistically significant(p=0.001). Overall, the correlation between the comfort and acceptability of functional appliances after wearing them and the type of functional appliance was statistically significant. The acceptance of functional appliances after wearing was maximum in FR1, while it was minimum in the medium-size activator. The difference was statistically significant(p=0.001). Overall, the correlation between the type of functional appliance and initial acceptance was significant statistically, with the maximum initial acceptance in medium-sized activators and the minimum initial acceptance in small bionators(p=0.001). Conclusion The study's findings show that patient acceptance of various kinds of functional appliances varies significantly.

Crucial Role of Foxp3 Gene Expression and Mutation in Systemic Lupus Erythematosus, Inferred from Computational and Experimental Approaches.

The impaired suppressive function of regulatory T cells is well-understood in systemic lupus erythematosus. This is likely due to changes in Foxp3 expression that are crucial for regulatory T-cell stability and function. There are a few reports on the correlation between the Foxp3 altered expression level and single-nucleotide polymorphisms within the Foxp3 locus. Moreover, some studies showed the importance of Foxp3 expression in the same diseases. Therefore, to explore the possible effects of single-nucleotide polymorphisms, here, we evaluated the association of IVS9+459/rs2280883 (T>C) and -2383/rs3761549 (C>T) Foxp3 polymorphisms with systemic lupus erythematosus. Moreover, through machine-learning and deep-learning methods, we assessed the connection of the expression level of the gene with the disease. Single-nucleotide polymorphisms of Foxp3 (IVS9+459/rs2280883 (T>C) and -2383/rs3761549 (C>T)) were, respectively, genotyped using allele-specific PCR and direct sequencing and polymerase chain reaction-restriction fragment length polymorphism, in 199 systemic lupus erythematosus patients and 206 healthy age- and sex-matched controls. The Statistical Package for the Social Sciences version 19 and Fisher's exact and chi-square tests were used to analyze the data. Moreover, six machine-learning models and two sequential deep-learning models were designed to classify patients from normal people in the E-MTAB-11191 dataset through the expression level of Foxp3 and its correlated genes. The allele and genotype frequencies of both polymorphisms in question were found to be significantly associated with an increased risk of systemic lupus erythematosus. Furthermore, both of the two single-nucleotide polymorphisms were associated with some systemic-lupus-erythematosus-related risk factors. Three SVM models and the logistic regression model showed an 81% accuracy in classification problems. In addition, the first deep-learning model showed an 83% and 89% accuracy for the training and validation data, respectively, while the second model had an 85% and 79% accuracy for the training and validation datasets. In this study, we are prompted to represent the predisposing loci for systemic lupus erythematosus pathogenesis and strived to provide evidence-based support to the application of machine learning for the identification of systemic lupus erythematosus. It is predicted that the recruiting of machine-learning algorithms with the simultaneous measurement of the applied single nucleotide polymorphisms will increased the diagnostic accuracy of systemic lupus erythematosus, which will be very helpful in providing sufficient predictive value about individual subjects with systemic lupus erythematosus.

Perinatal Outcome in High-Risk & Severe-Risk Pregnancy- A Study in a Tertiary Care Hospital

Introduction: High-risk & severe-risk pregnancies are characterized by increased risks of complications for both the mother and the fetus, which can result from several factors such as maternal age, medical situations, lifestyle habits, and previous pregnancies. These complications are a major concern, mostly in developing countries like Bangladesh, where maternal and infant mortality rates remain high. Maternal complications associated with high-risk and severe-risk pregnancies may include maternal death, severe bleeding, sepsis, and hypertensive disorders, while fetal complications may include preterm delivery, fetal growth restriction, and stillbirth. The objective of this study was to investigate the perinatal outcomes of high-risk and severe-risk pregnancies. Methods: This prospective purposive study was carried out on the admitted patients in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2007 to December 2007. Total hundreds of risk groups pregnant women (N=100) were enrolled in the study among them eighty-five (n=85) scoring 3-6 included as high risk pregnancy and fifteen (n=15) scoring 7 or more included as severe-risk pregnancy. All relevant data were recorded for each individual study subject on predesigned data collection sheet. All collected data were compiled and analyzed by computer-based statistical software (Instat). Chi-square tests were performed to compare the prevalence of study variables where, p < 0.05 considered the level of significance with 95%CI. Ethical clearance of this study was obtained from the Institutional Review Board (IRB) of BSMMU, Dhaka, Bangladesh. Results: In the high-risk group (n=85), around one-fourth of the patients (22,25.9%) and in a severe- risk group (n=15), one patient (1,6.7%) underwent vaginal delivery, Caesarean section was done in sixty-three patients (63,74.1%) in high-risk pregnant women and fourteen patients (14,93.3%) in severe-risk pregnant women respectively. The distribution of risk group and mode of delivery is statistically highly significant (P <0.001). Out of sixty-three patients (n1=63), nineteen (19, 30.2%) were required to be delivered by caesarean section for fetal distress and fifteen (15, 30.16%) were malpresentation. Out of forty-one patients (n2=14), the most common indications were a history of previous caesarean section with multiple risk factors in eight patients (8, 57.1%). Birth asphyxia was present in nine neonates (9, 13.6%) in a high-risk group (n = 65) and a severe- risk group (n2=14), and birth asphyxia was present in five neonates (5, 35.7%). Based on the outcome, in high-risk pregnancy (n=85), four neonates (4, 4.5%) died and in severe-risk pregnancy (n=15), one (1, 6.3%) died. Conclusion: The study found various obstetric complications and outcomes associated with high-risk and severe-risk pregnancies. The results indicated a significantly higher proportion of caesarean sections performed in severe-risk pregnancies compared to high-risk pregnancies. Moreover, the overall outcome was favorable, with only five neonatal deaths reported among the one hundred maternal risk groups.

Linguistic modality acts in existential semiotics: the epistemological turn from “being-in-the-world” awareness to “lived-through-world” experience

Abstract Against the background of deliberations about the conception of worldhood as developed in existential semiotics on the basis of linguistic modality acts, this paper proposes merging mundane and transcendentalist phenomenology with epistemology as a theory of knowledge, in general, that alludes to pragmatic sources of human knowledge about the world, in particular. From the epistemological perspective, the reality of the human “life-world” is considered not only as a static position of the individual subject’s being-in-the-world, but also as his/her/its experience of living-the-world or things-of-the-world. Against the background of epistemology, defined in terms of ontological and gnoseological assessments pertaining to the knowledge of how things exist and how they are cognitively accessible, and epistemology as an activity of acquiring knowledge about an object of cognition, the author puts forward a hypothetical deductive scaffold of the linguistically and phenomenologically rooted documentary epistemology of practice, which refers to the practicing researchers’ knowledge as a set of texts created for the purposes of communicating in the first person about the awareness of lived word-ness and lived sign-ness of the transmedial and multimodal means and ways of how the world is perceived.

Multi-task learning for joint weakly-supervised segmentation and aortic arch anomaly classification in fetal cardiac MRI

Congenital Heart Disease (CHD) is a group of cardiac malformations present already during fetal life, representing the prevailing category of birth defects globally. Our aim in this study is to aid 3D fetal vessel topology visualisation in aortic arch anomalies, a group which encompasses a range of conditions with significant anatomical heterogeneity. We present a multi-task framework for automated multi-class fetal vessel segmentation from 3D black blood T2w MRI and anomaly classification. Our training data consists of binary manual segmentation masks of the cardiac vessels’ region in individual subjects and fully-labelled anomaly-specific population atlases. Our framework combines deep learning label propagation using VoxelMorph with 3D Attention U-Net segmentation and DenseNet121 anomaly classification. We target 11 cardiac vessels and three distinct aortic arch anomalies, including double aortic arch, right aortic arch, and suspected coarctation of the aorta. We incorporate an anomaly classifier into our segmentation pipeline, delivering a multi-task framework with the primary motivation of correcting topological inaccuracies of the segmentation. The hypothesis is that the multi-task approach will encourage the segmenter network to learn anomaly-specific features. As a secondary motivation, an automated diagnosis tool may have the potential to enhance diagnostic confidence in a decision support setting. Our results showcase that our proposed training strategy significantly outperforms label propagation and a network trained exclusively on propagated labels. Our classifier outperforms a classifier trained exclusively on T2w volume images, with an average balanced accuracy of 0.99 (0.01) after joint training. Adding a classifier improves the anatomical and topological accuracy of all correctly classified double aortic arch subjects.<br>Our code is available at <a href='https://github.com/SVRTK/MASC-multi-task-segmentation-and-classification'>https://github.com/SVRTK/MASC-multi-task-segmentation-and-classification</a>

Possibilistic distribution distance metric: a robust domain adaptation learning method.

The affective Brain-Computer Interface (aBCI) systems, which achieve predictions for individual subjects through training on multiple subjects, often cannot achieve satisfactory results due to the differences in Electroencephalogram (EEG) patterns between subjects. One tried to use Subject-specific classifiers, but there was a lack of sufficient labeled data. To solve this problem, Domain Adaptation (DA) has recently received widespread attention in the field of EEG-based emotion recognition. Domain adaptation (DA) learning aims to solve the problem of inconsistent distributions between training and test datasets and has received extensive attention. Most existing methods use Maximum Mean Discrepancy (MMD) or its variants to minimize the problem of domain distribution inconsistency. However, noisy data in the domain can lead to significant drift in domain means, which can affect the adaptability performance of learning methods based on MMD and its variants to some extent. Therefore, we propose a robust domain adaptation learning method with possibilistic distribution distance measure. Firstly, the traditional MMD criterion is transformed into a novel possibilistic clustering model to weaken the influence of noisy data, thereby constructing a robust possibilistic distribution distance metric (P-DDM) criterion. Then the robust effectiveness of domain distribution alignment is further improved by a fuzzy entropy regularization term. The proposed P-DDM is in theory proved which be an upper bound of the traditional distribution distance measure method MMD criterion under certain conditions. Therefore, minimizing P-DDM can effectively optimize the MMD objective. Secondly, based on the P-DDM criterion, a robust domain adaptation classifier based on P-DDM (C-PDDM) is proposed, which adopts the Laplacian matrix to preserve the geometric consistency of instances in the source domain and target domain for improving the label propagation performance. At the same time, by maximizing the use of source domain discriminative information to minimize domain discrimination error, the generalization performance of the learning model is further improved. Finally, a large number of experiments and analyses on multiple EEG datasets (i.e., SEED and SEED-IV) show that the proposed method has superior or comparable robustness performance (i.e., has increased by around 10%) in most cases.

Chamber Attention Network (CAN): Towards interpretable diagnosis of pulmonary artery hypertension using echocardiography

Introduction:Accurate identification of pulmonary arterial hypertension (PAH) in primary care and rural areas can be a challenging task. However, recent advancements in computer vision offer the potential for automated systems to detect PAH from echocardiography. Objectives:Our aim was to develop a precise and efficient diagnostic model for PAH tailored to the unique requirements of intelligent diagnosis, especially in challenging locales like high-altitude regions. Methods:We proposed the Chamber Attention Network (CAN) for PAH identification from echocardiographic images, trained on a dataset comprising 13,912 individual subjects. A convolutional neural network (CNN) for view classification was used to select the clinically relevant apical four chamber (A4C) and parasternal long axis (PLAX) views for PAH diagnosis. To assess the importance of different heart chambers in PAH diagnosis, we developed a novel Chamber Attention Module. Results:The experimental results demonstrated that: 1) The substantial correspondence between our obtained chamber attention vector and clinical expertise suggested that our model was highly interpretable, potentially uncovering diagnostic insights overlooked by the clinical community. 2) The proposed CAN model exhibited superior image-level accuracy and faster convergence on the internal validation dataset compared to the other four models. Furthermore, our CAN model outperformed the others on the external test dataset, with image-level accuracies of 82.53% and 83.32% for A4C and PLAX, respectively. 3) Implementation of the voting strategy notably enhanced the positive predictive value (PPV) and negative predictive value (NPV) of individual-level classification results, enhancing the reliability of our classification outcomes. Conclusions:These findings indicate that CAN is a feasible technique for AI-assisted PAH diagnosis, providing new insights into cardiac structural changes observed in echocardiography.

Sur la crise psychique : considération inactuelle

ObjectivesAs the concept of crisis has permeated all disciplinary fields, it has become less intelligible. This phenomenon is also valid in psychiatry, on account of the usage of the concept in relation with different realities. Thus, our present case study takes interest in what the psychic crisis is, so as to clarify how it appears for individual subjects through its various manifestations, whose heterogeneity has an undeniable clinical interest. MethodologyIn an attempt to provide a granular definition of the psychic crisis, we will first put forth a historical and etymological study. Then, based on a system of psychoanalytical references supplied with contributions from philosophy and particularly from phenomenology, we will address in what way any psychic crisis comes as a critical reaction to an encounter with the real, which appears as a discontinuity, an event for the subject. ResultsWe theorize that the internal disruption caused by the psychic crisis phenomenon, which tears apart the subject's representations, stems from its unique operating mode by means of the language use to interact with the surrounding world. The subject going through a crisis, and accompanied by health care professionals, will be guided to a decision that aims at creating a new livable mode following the downfall of their former objective certainty. DebateHence, we believe any psychic crisis unravels the subject as a being to themselves. However, such an epiphany is not harmless, which is why the health care professional plays an even greater role in this instance. Running counter to current practices, the health care professional must not hinder the psychic crisis when it arises, but, instead, make space for any uniquely subjective creation that is likely to come forth. ConclusionWe advocate for the emergence of a new mode of being, of dealing with the world, while facilitating the subject's fashioning of their own dynamic narrative, of the crisis they are going through. We believe, indeed, that such are the ethical prerequisites of care, with regard to the psychic crisis.

The Use of Punishment as a Way to Relization Political Goals in International Relations (Theoretical Study)

The problem of the application of punishment to realization political goals in international relations is considered. The author characterizes the social institution of punishment, indicates its place and role in the structure of social relations. The political and legal component of punishment is analyzed in the context of unilateral sanctions of some sovereign states against others. The main forms and content of the influence of political goals on the institution of international legal sanctionspunishments are determined. The author’s vision of such specific phenomena as “self-punishment” and “political engagement” is substantiated. An algorithm for identifying the political bias of decisions on the imposition of international legal penalties, as well as possible ways to develop an adequate response to them from the “punished” subjects (target states) is formulated. The empirical base of the study includes materials on the application of punishments by individual and collective subjects of international relations against the Russian Federation, including the geopolitical consequences of the relevant sanctions decisions.

Abstract 11 — Development of a Novel Treg Activator KINE-101 for a New Treatment Option for Rheumatoid Arthritis

Background KINE-101, a novel synthetic nonapeptide, is being developed for the treatment of rheumatoid arthritis with a distinctive mode of action. A study using a collagen-induced arthritis (CIA) mouse model showed that KINE-101 suppressed cartilage damage through inhibiting osteoclastogenesis. KINE-101 showed its therapeutic effects in suppressing auto-immune responses by activating Regulatory T cells (Tregs), a specialized subpopulation of T cells, in in-vivo studies using mouse models of RA. Following the in-vivo studies, the phase 1 clinical study for KINE-101 was conducted to assess the safety and tolerability in healthy subjects in the US. Methods Total 40 healthy subjects were enrolled to assign in 5 cohorts. Each cohort included 8 subjects composed of 6 active and 2 placebo treatment. The subjects of first 4 cohorts were administrated with 10, 30, 100, 300 mg of KINE-101 by intravenous (IV) infusion as single ascending doses (SAD), and the Cohort 5 subjects were subcutaneously (SC) injected with 96.8 mg of KINE-101. Results Except for 2 subjects in placebo group, all subjects completed the study. All the randomized subjects were included in the safety evaluation. No deaths, SAEs (Serious Adverse Events), or AEs (Adverse Events) leading to discontinuation were reported during the study periods. While total 9 TEAEs (Treatment-Emergent Adverse Events) were reported, all were assessed as mild. It included 3 headaches, 1 catheter site edema, 1 contusion and 1 nasal congestion in the treatment group, and 1 catheter site pain, 1 oral contusion and 1 COVID-19 infection in the placebo group. Oral contusion and COVID-19 occurred in the same subject, and all the other events were singular TEAEs reported in individual subjects. No injection site reactions were reported and no clinically significant changes in any laboratory values were noted. In terms of pharmacokinetic (PK) profile, KINE-101 was observed in the blood samples during and up to 5 minutes after infusion. Conclusion In the phase I clinical study, Treg activator KINE-101 demonstrated a favorable safety and tolerability profile. The most common AEs were headaches reported in 3 subjects, but all were mild and transient events. As typically seen in peptide drugs, KINE-101 has a short half-life. However, given that KINE-101 uses Treg as a proxy to exerts anti-inflammatory effects, its pharmacodynamic (PD) activity is likely to last longer. The next stage for KINE-101 will proceed to oral formulation and the Phase 2 clinical study in RA patients.

Personal comfort models in long-term monitoring using physiological data from wearable sensors

Personal Comfort Models (PCMs) propose a new approach for human-centric comfort studies overcoming the one-size-fits-all of the conventional models. This research addresses the development of PCMs based on a seven-month long-term monitoring campaign including continuous environmental and physiological data collection through wearables and daily survey submission about subjects’ sensations. To tackle the influence of subjects’ environmental exposure history, time series of environmental data of different durations were used to predict individuals’ perception via Machine Learning models with Support Vector Machine and Random Forest methods. The accuracy and F1-score values of seven different PCMs were confronted for each subject and for the whole group (nine people). The number of datapoints per subject and their answers’ consistency during time affected the models’ accuracy, and the inclusion of physiological signals improved the models’ performance. When considering the whole dataset, the comfort model accuracy decreases supporting that individual subjectivity have an important impact in the environmental perception prediction.

Abstract 180: A Prospective, Single‐Center Study Appraising Aneurysm Embolization using the Balt Optima™ Coil System (APPLY Study)

Introduction Intracranial aneurysms, both ruptured and unruptured, pose a significant risk to the general population. Cases of unruptured intracranial aneurysms (UIA) are estimated to affect roughly 3% of the general population and aneurysmal subarachnoid hemorrhage (aSAH) have an incidence of 8 to 9 people per 100,000. With the advancement of endovascular coil devices, aneurysm embolization with coiling is becoming the more preferred treatment approach compared to craniotomy with microsurgical clipping. The purpose of this study was to assess the safety and efficacy of endovascular coiling using the novel Balt Optima™ Coil System. Methods This study was an investigator‐initiated, prospective, real‐world, single‐center, post‐market study conducted in Thousand Oaks, California. Between 2020 and 2023, thirty cerebral aneurysms were treated with at least 80% utilization of the Balt Optima™ Coil System. The subjects were followed for 6 months (‐4 months/+6 months). Data points were obtained at baseline, procedure, discharge or postoperative day 7, and 6 months follow‐up (‐4 months/+6 months). Primary outcomes were functional status recorded as modified Rankin scores (mRS) and radiographic occlusion rates documented as Raymond‐Roy scores. Serious adverse events including, but not limited to, groin hematoma, periprocedural stroke, intraoperative aneurysm rupture, coil herniation requiring stent placement, and mortality were recorded. Secondary outcomes included coil packing densities, minor complications, procedure duration, disposition after hospitalization, and antithrombotic medication adjustments. Results 30 intracranial aneurysms in 29 individual subjects were included in the study and were treated by a total of 4 neurointerventionalists with at least 80% use of the Balt Optima™ Coil System. One subject had two aneurysms which were treated at two separate occasions, and the subject was consented for both aneurysms to be included in the study. 60% of aneurysms were located along the right anterior circulation and vessels involved mirrored epidemiological data in the literature. 83% of subjects were female, and 50% of aneurysms presented as ruptured. All subjects had a baseline mRS 0‐2. 83% of aneurysms were treated with utilization of an assist device as well. At 6 months follow‐up (‐4 months/+6 months), 80% of subjects had mRS 0‐2. Of the 21 patients with 6 month (‐4 months/+6 months) follow‐up imaging, 15 (71%) had complete aneurysm occlusion (Raymond‐Roy score of 1) and 6 (29%) patients had residual aneurysm neck filling (Raymond‐Roy score of 2). One subject (3%) expired during the hospitalization due to complications unrelated to the aneurysm or coil system, and one subject (3%) was lost to follow‐up. One subject (3%) developed a groin hematoma, one subject (3%) had an intraoperative rupture with no significant clinical consequence, and two subjects (7%) experienced coil herniation requiring stent placement with no clinical sequelae. No subjects (0%) had periprocedural strokes. Conclusion This study demonstrates that the Balt Optima™ Coil System is safe and effective for endovascular treatment of both unruptured and ruptured intracranial aneurysms. Additional data is needed to validate these results and compare to other coil devices on the market.

에니어그램 2유형의 대인관계 어려움에 대한 인식 유형에 관한 연구

The purpose of this study is to investigate how Enneagram Type 2 perceives difficulties in interpersonal relationships. To achieve this goal, the Q-methodology, which is suitable for examining individual subjectivity, was used with a sample of 28 adults in their 20s to 60s who identify as Enneagram Type 2. Prior to conducting Q-sorting, a literature review and a preliminary survey were conducted to study the difficulties in interpersonal relationships experienced by Enneagram Type 2. The results were then analyzed using the Ken-Q Analysis Program. Five perception types were identified: Type I “I am not calculative, I just hope we understand each other's hearts well”, Type II “I'd rather suffer silently than express myself”, Type III “I hope we can all be happy while maintaining an appropriate distance”, Type IV “I might say things occasionally, but I feel embarrassed to reveal my innermost thoughts”, and Type V “I'll try to accommodate as much as possible, but I'm not sure if it's the best approach”. This study can provide foundational data that may contribute to the formation of healthy interpersonal relationships for individuals of Enneagram Type 2.

KEPRAKTISAN ENSIKLOPEDIA FAMILI FABACEAE KEBUN RAYA BANUA UNTUK MELATIHKAN KETERAMPILAN BERPIKIR KRITIS MAHASISWA

Research development is research that aims to improve research that has been done before to improve the quality of learning materials. An encyclopedia is a type of learning material in the form of a book (a series of books) which compiles descriptions of various matters and is arranged alphabetically or according to the scientific environment. Generally, encyclopedias combine text with collaborative images in such a way that it is interesting. This study aims to describe the validity of the content, the practicality of the contents and the expectations and effectiveness of the expectations of the Fabaceae family encyclopedia. The research method used is the Tessmer design, which consists of: 1) self evaluation; 2) expert review; 3) one-to-one evaluation; 4) small group evaluations; The validation subjects included three experts, the individual test subjects were four students who were taking the phanerogamae course and the small group test subjects were four students who were taking the phanerogamae course. Data were obtained from research instruments on content validity, practicality of content, practicality of expectations, and effectiveness of expectations. The results of the study showed: 1) The validity of the contents of the encyclopedia was categorized as valid, namely 3.80, 2) the practicality of the contents was categorized as good, namely 3.82, and the practicality of expectations was categorized as very good, namely 85.71%, 3) The effectiveness of the expectations was categorized as very good, namely 88, 89%, so as to be able to train critical thinking skills. The Encyclopedia of the Fabaceae Family of the Banua Botanical Garden was declared valid including content, language and design. Practical because it has appeal and is easy to use so it gives a positive response (very good). Effective because it can train students' critical thinking skills.

Authentic STEM education through modelling: an international Delphi study

BackgroundThe literature asserts that science, technology, engineering, and mathematics (STEM) education needs to be authentic. Although models and modelling provide a basis from which to increase authenticity by bridging the STEM disciplines, the idea of authentic STEM education remains challenging to define. In response, the aim of this study is to identify consensus on significant elements of authentic STEM education through models and modelling. Views were gathered anonymously over three rounds of questions with an expert panel. Responses were subjected to a multimethod analysis that pursued identification, consensus, and stability in the panel’s revealed propositions and themes around authentic STEM education through modelling.ResultsThe panel reached high consensus concerning the potential of STEM education to support learning across traditional subject borders through authentic problem solving. The panel also consented that modelling is indispensable for achieving real-world relevance in STEM education, and that model-based integrated STEM education approaches provide opportunities for authentic problem solving. Furthermore, results showed that integrating individual STEM subjects during teaching, in terms of including disciplinary knowledge and skills, requires specialised competence. Here, technology and engineering subjects tended to implicitly underpin communicated teaching activities aimed at STEM integration.Conclusions and implicationsThe panellists stress that STEM disciplines should be taught collaboratively at the same time as they are not in favour of STEM as a subject of its own but rather as a cooperation that maintains the integrity of each individual subject. Many respondents mentioned integrated STEM projects that included modelling and engineering design, although they were not specifically labelled as engineering projects. Thus, real-world STEM education scenarios are often viewed as being primarily technology and engineering based. The panel responses also implicate a need for multiple definitions of authenticity for different educational levels because a great deal of uncertainty surrounding authenticity seems to originate from the concept implying different meanings for different STEM audiences. These international Delphi findings can potentially inform integrated STEM classroom interventions, teacher education development, educational resource and curriculum design.

Nonlinear connection between remnant cholesterol and stroke risk: evidence from the China health and retirement longitudinal study

ObjectiveThe evidence on the relationship between remnant cholesterol (RC) and stroke remains controversial. Therefore, this study aimed to explore the relationship between RC and stroke risk in a Chinese population of middle-aged and elderly individuals.MethodsThe present study included 10067 Chinese subjects of middle-aged and elderly individuals. The connection between RC and incident stroke was investigated using the multivariate Cox proportional hazards regression model, several sensitivity analyses, generalized additive models, and smoothed curve fitting.ResultsA total of 1180 participants with stroke were recorded during the follow-up period. The multivariate Cox proportional hazards regression model identified a positive connection between RC and stroke risk (hazard ratio (HR) = 1.087, 95% confidence interval (CI): 1.001–1.180). In addition, the current study discovered a nonlinear connection between RC and incident stroke, and the point of inflection for RC was 1.78 mmol/L. The risk of stroke increased by 25.1% with each unit increase in RC level when RC was < 1.78 mmol/L (HR:1.251, 95%CI: 1.089–1.437, P = 0.0015). The results were not affected by sensitivity tests.ConclusionThe current study showed a positive and nonlinear connection between RC and stroke risk in a middle-aged and elderly Chinese population. These findings provided new information to help researchers better understand the relationship between RC levels and incident stroke.