Treatment Of Type Research Articles

Infertility treatment and offspring blood pressure-a systematic review and meta-analysis.

Studies have inconsistently observed that children conceived by IVF or ICSI have higher blood pressure compared to children not conceived by these ARTs. The aim was to perform a systematic review and meta-analysis of blood pressure measures of offspring conceived by ART and those conceived naturally. Resolving the suspicion of ART as a risk factor of higher blood pressure, and therefore of heart disease, has public health and clinical implications. A biomedical librarian searched the Embase, PubMed, and Web of Science databases. Searches were limited to records published in English since 1978. Grey literature was searched. Inclusion criteria were humans born via infertility treatment (vs no treatment) who underwent a blood pressure assessment. Exclusion criteria were non-human participants, non-quantitative studies, absence of a control group, and specialty populations (e.g. cancer patients only). Two reviewers independently screened each record's title and abstract and full text using Covidence, extracted data using Excel, and assessed bias using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for cohort studies. Of 5082 records identified, 79 were included in the systematic review and 36 were included in the meta-analysis of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in ART and non-ART groups. Overall, 34 reports including 40 effect sizes from 25 unique cohorts, compared blood pressure between ART (N = 5229) and non-ART (N = 8509, reference) groups with no covariate adjustment. No standardized mean differences (SMD) in SBP (0.06 per SD of mmHg, 95% CI = -0.05, 0.18) or DBP (0.11, 95% CI = -0.04, 0.25) by treatment were found, but the heterogeneity was considerable (I2=76% for SBP and 87% for DBP). Adjusted analyses were presented in 12 reports, representing 28 effect sizes from 21 unique cohorts (N = 2242 treatment vs N = 37590 non-treatment). Studies adjusted for varied covariates including maternal (e.g. age, education, body mass index, smoking, pregnancy complications), child (e.g. sex, age, physical activity, BMI, height), and birth characteristics (e.g. birth weight and gestational age). Adjusted results similarly showed no SMD for SBP (-0.03, 95% CI = -0.13, 0.08) or DBP (0.02, 95% CI = -0.12, 0.16), though heterogeneity remained high (I2 = 64% and 86%). Funnel plots indicated a slight publication bias, but the trim and fill approach suggested no missing studies. Removal of five studies which adjusted for birth outcomes (potentially over-adjusting for mediators) made no material difference. Type of treatment (e.g. IVF vs ICSI), period effects by birth year (≤2000 vs >2000), offspring age group (<8, 8-14, 15+), or study location (e.g. Europe) did not modify the results. In conclusion, conception by ART was not associated with offspring blood pressure in a meta-analysis, although considerable heterogeneity was observed. Given the increasing number of children born using ART, perpetuating a difference in blood pressure would mean unnecessary risk screening for many children/adults on a population level. At a clinical level, couples considering these reproductive technologies have some reassurance that there is no evidence of strong vascular 'programming' due to the techniques used. PROSPERO No. CRD42022374232.

Effect of telemedicine interventions on weight loss: A systematic review and meta-analysis.

Obesity and its associated health challenges represent a pressing global concern. Telemedicine interventions offer a promising solution for effective weight loss support. This study examines the impact of telemedicine interventions on weight loss support. We conducted a search of PubMed, Scopus, and Web of Science, starting from their inception. Both researchers systematically selected articles and extracted data using a designated data collection form. To assess the risk of bias in the included studies, we employed the Mixed Methods Appraisal Tool. Publication bias was evaluated through funnel plots and Egger's and Begg's tests. Utilizing the gathered data, we computed the standardized mean differences (Hedges's g) between the treatment and control groups. We estimated heterogeneity variance using the Q test and I2 statistic. The analysis was carried out using Stata 17.0. Out of a total of 2626 retrieved articles, 30 studies were included in the analysis. Telemedicine interventions can cause weight loss in people (Hedges's g = 0.09, 95% CI: -0.13, 0.39; p-value < 0.001). The type of telemedicine intervention and target population were a significant moderator of the heterogeneity between studies (p < 0.05). This study highlights the potential of telemedicine interventions as valuable tools in weight loss programs. Embracing these technologies can enhance the effectiveness of weight management strategies for diverse populations.

Effects of Physical and Mind-body Exercise on Sleep Quality in Individuals With Diabetes Mellitus: A Systematic Review and Meta-analysis.

Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus. Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed. Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust. Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.

Malaysian occupational therapists’ perspectives on sensory-based intervention for children with autism spectrum disorder: A focus group discussion

ABSTRACT This study explores Malaysian occupational therapists’ perspectives on implementing sensory-based intervention for children with autism spectrum disorder, addressing the high prevalence of sensory processing disorder in this population. Despite sensory-based intervention’s common usage globally, its implementation and associated challenges remain inadequately documented. The research employed a qualitative approach, conducting two focus group discussions with 14 experienced occupational therapists. Thematic analysis using ATLAS.ti software revealed eight themes: intervention approaches, implementation references, common activities, implementation structure, strategies, intervention types, evaluation methods, and challenges encountered. The findings emphasize the importance of personalized intervention strategies to meet the diverse sensory needs of children with autism spectrum disorder. The study highlights the necessity for developing comprehensive guidelines for effective sensory-based intervention implementation and underscores the need for individualized approaches. The study’s findings provide a contextual overview of sensory-based intervention in addressing sensory processing disorder among children with autism spectrum disorder. This research may inform the development of evidence-based guidelines and protocols for sensory interventions in occupational therapy practice, ultimately improving the quality of care for children with autism spectrum disorder.

The effects of peer-assisted learning on rhythmic and melodic sight-reading in a middle school chorus

The purpose of this study was to investigate the ways that children engage in collaborative processes with adults and their peers in music sight-reading skill acquisition in a middle school chorus in the Southeastern United States. Intact groups of sixth-, seventh-, and eighth-grade choruses were assessed on melodic and rhythmic sight-reading using a quasi-experimental pretest/posttest non-equivalent control group design. The instruments to evaluate melodic and rhythmic sight-reading included an adapted version of the Vocal Sight-Reading Inventory and a researcher-developed Rhythmic Skills Hierarchy. A comparison of the effectiveness of three learning models on rhythmic and melodic sight-reading achievement occurred: teacher-only and two types of peer-assisted learning. Three Analyses of Covariance (ANCOVAs) compared differences between groups on adjusted posttest scores. There were significant differences between the teacher-only (T-O) and the symmetrical peer-assisted learning (SPAL) groups when compared to the asymmetrical peer-assisted learning group (APAL). The T-O and SPAL treatment types were effective learning models for melodic sight-reading achievement but with nonsignificant results on rhythmic sight-reading. Symmetrical peer-assisted learning strategies are a suggested practice as a complement to teacher-directed instruction.

Scoping review of anticancer drug utilization in lung cancer patients at the end of life.

This scoping review aims to deepen the understanding of end-of-life anticancer drug use in lung cancer patients, a disease marked by high mortality and symptom burden. Insight into unique end-of-life treatment patterns is crucial for improving the appropriateness of cancer care for these patients. Comprehensive searches were carried out in Medline and Embase to find articles on the utilization of anticancer drugs in the end of life of lung cancer patients. We identified 68 publications, highlighting the methodological characteristics of studies including the timing of the research, disease condition, treatment regimen, type of treatment, and features of the treatment. We outlined the frequency of anticancer drug use throughout different end-of-life periods. This review provides a comprehensive overview of primary studies exploring end-of-life treatments in lung cancer patients. Methodological inconsistencies pose many challenges, revealing a notable proportion of patients experiencing potential overtreatment, warranting more standardized research methods for robust evaluations.

7288 A Preclinical Mouse Model of Gender-Affirming Hormone Therapy: Metabolic and Behavioral Outcomes

Abstract Disclosure: A. Yasrebi: None. K. Otersen: None. O. Groh: None. E. Guthman: None. I. Shmarakov: None. S. Campbell: None. T.A. Roepke: None. The long-term metabolic effects of gender-affirming hormone therapy (GAHT) is largely unknown, in part, due to the lack of properly designed preclinical animal models. Here we propose a rodent study design, beyond the classical endocrine model of gonadectomy and steroid treatment, to accurately reflect the reality of the trans experience. Specifically, trans women do not all seek or undergo orchidectomy (ORX) instead take estrogen supplementation along with an androgen blocker such as finasteride. In this study, 40 WT C57 male mice were divided into 4 groups of 10 mice - 1) intact with oil vehicle, 2) intact with estradiol benzoate (EB, 150 μg/kg/d) and finasteride (F, 0.25 mg/kg/d), 3) ORX with oil; and ORX with EB (150 μg/kg/d). Each mouse was dosed daily for 8 weeks while on a standard chow diet. Mice were pair housed and food intake and body weight were collected weekly prior to behavioral (open field, elevated plus, Y-maze) and metabolic (body composition, metabolic rates, activity, tolerance testing) phenotyping. Intact mice treated with EB+F exhibited less avoidance behaviors, potentially due to differences in movement, with no differences between treatments in the Y-maze. Cumulatively, Intact:EB+F gained less weight than Intact:oil (3.4 ± 0.4 g vs 5.3 ± 0.4 g), while ORX:oil mice gained less than ORX:EB (2.2 ± 0.5 g vs 5.5 ± 0.7 g). These interactive effects were due to differences in the gain of fat or lean mass between ORX and intact and lower cumulative food intake in ORX:oil mice (136 ± 3.8 g vs Intact:oil: 159 ± 4.9 g; Intact:EB+F: 167 ± 6.1 g; ORX:EB: 171 ± 3.4 g). Metabolic assessments found that Intact:EB+F exhibited elevated V.O2, V.CO2, and heat production in the light and dark cycle compared to Intact:oil, while ORX:EB only exhibited elevated heat production compared to ORX:oil. Similarly, Intact:EB+F and ORX:EB moved more than their counterparts during the dark cycle; however, only Intact:EB+F exhibited elevated wheel running. Tolerance tests (i.p.) found that glucose clearance was augmented in ORX:EB mice while insulin-induced glucose clearance was lower in Intact:EB+F compared to Intact:oil but modestly elevated by EB in ORX mice. These data, along with suppressed fasting blood glucose in ORX:EB mice, suggest that glucose homeostasis is differentially modulated by GAHT paradigms in mice. Analysis of hypothalamic, hepatic, adipose, and intestinal gene expression is currently underway. Collectively, these data, generated by using a translationally-relevant preclinical animal model, are the first to establish that metabolism is differentially affected by both steroid treatments and ORX and suggesting that the long-term metabolic effects of GAHT are dependent on the type of treatment. The underlying mechanisms and sites of action remain to be investigated. Presentation: 6/3/2024

Enhanced Transcription of Human Endogenous Retroviruses and TRIM28 Downregulation in Patients with Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) includes patients affected by Crohn's disease or ulcerative colitis. IBD is thought to be a chronic immune-mediated disease, but its origin remains elusive, and this limits new therapeutic approaches. Human endogenous retroviruses (HERVs) originate from ancestral infections and represent 8% of the human genome. HERVs are no longer infectious, but some retroviral sequences can be activated, and their aberrant expressions have been implicated in inflammatory and autoimmune disorders. HERV transcription is regulated by TRIM28 and SETDB1, which are also directly involved in epigenetic processes and modulation of the immune response. Using a PCR real-time Taqman amplification assay, we assessed, for the first time, the transcription levels of pol genes of HERV-H, -K, and -W families of env genes of syncytin 1 (SYN1), SYN2, and HERV-W, as well as of TRIM28 and SETDB1 in the whole blood of 48 patients with Crohn's disease (CD), 20 with ulcerative colitis (UC), and in healthy controls (HC) of comparable age. The transcriptional levels of HERV-H-pol (p = 0.0003) and HERV-K-pol (p = 0.001) were significantly higher in IBD patients compared with HC, with no differences between patients with CD and UC. No significant differences were found for the remaining HERVs between IBD patients and HC. The transcript levels of TRIM28 were significantly downregulated in IBD patients (p < 0.001), without differences between CD and UC, while the SETDB1 levels were preserved. The enhanced transcription of HERV-H-pol and HERV-K-pol, as well as the impaired activation of TRIM28, were not influenced by clinical disease activity and type of treatment. The overexpression of HERVs and impaired transcription of TRIM28 in patients affected by CD or UC suggest that they might be the main actors in the pathophysiology of IBD, opening the way to innovative targeted interventions.

7626 Endocrine Adverse Reactions Of Tyrosine Kinase Inhibitors In Combination With Immune Checkpoint Inhibitors: A Retrospective Analysis Using The US FDA Adverse Event Reporting System

Abstract Disclosure: W. Shao: None. D. Lu: None. K. Yang: None. Y. Gao: None. J. Zhang: None. Y. Zhang: None. Background: Tyrosine kinase inhibitor (TKI) and immune checkpoint inhibitor (ICI) have been recognized to cause multiple endocrine adverse reactions (EARs). However, the combination therapy-associated EARs is still unclear. We aimed to evaluate the clinical characteristics and prognosis of EARs induced by TKI, ICI and TKI+ICI therapy. Methods: Using the US FDA Adverse Event Reporting System, 938464 cases of all adverse events, adult patients, related to the three types of treatments from January 2001 to September 2023 were identified. A total of 22275 cases were EARs and divided into TKI (n=9181), ICI (n=11363) and TKI+ICI group (n=1731). Results: The incidence of EARs was the highest in TKI+ICI group (9.1%), followed by ICI (7.7%), and TKI group (1.2%) (P &amp;lt; 0.05). Among patients with EARs, the proportions of female and Asian patients were significantly greater in TKI+ICI group than in the other groups (P&amp;lt;0.05 for all). TKI+ICI group had a larger proportion of elderly patients compared with TKI group. The most common type of EARs in TKI+ICI group was thyroid dysfunction (TD) (67.5%), followed by glucose metabolism disorder (GMD) (14.0%). Compared with TKI group, TKI+ICI group displayed a higher risk of TD (OR 3.247, 95% CI [2.849-3.701]), pituitary dysfunction (PD) (OR 6.199, 95% CI [4.534-8.474]), and primary adrenal insufficiency (PAI) (OR 4.178, 95% CI [3.470-5.031]), while the risk of GMD was lower (OR 0.136, 95% CI [0.115-0.161]). Compared with ICI group, an increasing trend of TD (OR 2.640, 95% CI [2.328-2.995]) was found in TKI+ICI group, while a lower risk of GMD (OR 0.388, 95% CI [0.328-0.459]) and PD (OR 0.312, 95% CI [0.255-0.383]) was observed in TKI+ICI group. Hypothyroidism and diabetes mellitus were the main types of TD and GMD in all three groups. Patients with polyendocrine glands involvement accounted for the largest proportion in ICI group (11.4%), followed by TKI +ICI (7.9%), and TKI group (2.3%) (P&amp;lt;0.05). In TKI+ICI group, elderly patients, Asians, melanoma patients were more likely to experience multi-glandular EARs. In terms of prognosis, TKI+ICI group presented a higher risk of hospitalization compared to TKI (OR 2.201, 95% CI [1.943-2.492]) and ICI group (OR 1.282, 95%CI [1.139-1.442]). However, the mortality risk of TKI+ICI group was significantly lower (OR 0.717, 95% CI [0.588-0.874]) than TKI group, and there was no significant difference compared to ICI group. Moreover, there was no difference in mortality between patients with polyendocrine and single endocrine gland involvement. Conclusions: EARs were more common in TKI+ICI therapy. The distribution of EARs in different glands varied among combination therapy and monotherapy. Combination therapy associated EARs did not increase the risk of mortality. Key words: Tyrosine kinase inhibitors, Immune checkpoint inhibitors, Combination therapy, Endocrine adverse reactions, Prognosis Presentation: 6/3/2024

Differences in motivational dynamics between experienced cyclists and untrained participants during an incremental endurance exercise task

PurposeThe conflict between the desire to reduce effort during exercise and the performance goal of the exercise task contributes to explaining endurance exercise performance. However, whether the trajectories of these two motivational responses systematically differ across individuals with different characteristics is poorly understood. The present study examined whether changes in desire to reduce effort and performance goal value across moderate, heavy, and severe exercise intensity domains differed between cyclists and untrained, but active participants. MethodsFifty participants (14 cyclists and 36 untrained) completed an incremental step test on a cycle ergometer, in which work rate was increased by 25 W every 4 min until voluntary exhaustion. Desire to reduce effort, performance goal value, and blood lactate concentration (for determination of exercise intensity domains) were measured every 4 min and the data were analysed using multilevel modelling. ResultsDesire to reduce effort increased quicker for untrained participants in the moderate exercise intensity domain (b = 1.66, p < .001) and across the whole trial (b = 1.64, p < .001), compared to cyclists (b = .69, and b = 1.14, respectively, both p < .001). Untrained participants reported similar performance goal value at the beginning of the trial (b = 16.02, p < .001), compared to cyclists (b = 17.25, p < .001). Beyond moderate intensities, the performance goal value decreased significantly for the untrained participants (b = −.70, p < .001) but significantly increased for cyclists (b = .45, p = .01). This pattern was also observed when focusing solely on the severe intensity domain (cyclists: b = .90, p < .001; untrained: b = −.84, p < .001). ConclusionThere are distinct differences in the desire to reduce effort and performance goal value between cyclists and untrained athletes. Identifying these systematic differences enhances the credibility of the desire-goal conflict framework in explaining endurance performance and provides insight into the type and timing of interventions that might be successful in improving performance.

Analysis of the Impact of Treatments Stimulating Branching on the Quality of Maiden Apple Trees

Nursery material intended for establishing intensive apple orchards should be characterised by a dominant and straight leader with an appropriate number of shoots that develop at the right height and are regularly spaced along the leader. The use of well-branched trees can lead to fruiting in the first year after planting. However, many apple varieties have difficulty forming lateral shoots due to strong apical dominance. The aim of the study was to assess the effectiveness of treatments stimulating the branching of maiden apple trees of the ‘Gloster’ variety. The research was carried out in 2017–2019 at a private nursery farm located in eastern Poland. The studied trees were subjected to a mechanical branching stimulation treatment, which consisted of pinching off 4–5 of the youngest leaves located below the growth cone, and chemical branching stimulation treatments, which consisted of applying growth regulator mixtures in the form of an aqueous solution, i.e., BA+GA3 and BA+GA4+7. The conducted studies showed that the type of branching-stimulating treatment had a significant effect on the height and trunk diameter of the maiden trees, the number of lateral shoots, the average length of one shoot and the sum of the lengths of all sylleptic shoots. The maiden trees treated with BA+GA3 were characterised by the best quality among the analysed combinations. Maiden apple trees treated with BA+GA3 were the tallest (2017—167.7 cm; 2018—175.3 cm; 2019—164.4 cm), produced the largest number of shoots (2017—6.5 pcs; 2018—6.8 pcs; 2019—6.3 pcs) and had the largest sum of lateral shoot lengths (2017—148.0 cm; 2018—155.4 cm; 2019—140.6 cm) among the evaluated combinations. The number of treatments and the concentration of applied growth regulators had a significant effect on the structure of the crown of the maiden apple trees of the ‘Gloster’ cultivar.

8265 Premature Ovarian Insufficiency in Pediatric Cancer Patients: a 10-Year Rady Children's Hospital Experience

Abstract Disclosure: M. Robinson: None. L. Meller: None. M.E. Patterson: None. Objective: To highlight the occurrence of premature ovarian insufficiency in cancer patients treated at a children’s hospital and to determine which patient characteristics or treatment modalities are associated with ovarian failure and subsequent recovery of ovarian function. Study design: A retrospective chart review. Setting: Rady Children’s Hospital San Diego. Subjects and Methods: Between August 2011 and August 2021, the cases of 36 patients with cancer and ovarian failure were reviewed. Data collected included type of cancer, age at diagnosis, types of chemotherapy used in treatment, whether a bone marrow transplant or radiation was part of the treatment plan, peak FSH value and age when this occurred, peak AMH value, whether GnRHa treatment was used, type of hormone replacement therapy used, and whether there was recovery of ovarian function. Results: The most common type of cancer identified in this group of patients was acute lymphoblastic leukemia (ALL) (13, 36.1%). The mean age of diagnosis was 8.5 ± 4.3 years and the mean age of peak FSH value was 12.6 ± 2.8 years. Nearly all patients (97.2%) were treated with alkylating agents as part of their chemotherapy regimen and 72.2% received some form of radiation. Most patients (26, 72.2%) also received some form of hormone therapy, most commonly transdermal hormone therapy (13, 36.1%) or oral contraceptive pill (10, 27.8%), and 15.8% of patients were treated with the GnRHa Lupron. Fertility planning was offered or discussed in 36.1% of patients. Ten patients (27.8%) were noted to have some degree of recovery in their ovarian function. Age at diagnosis and type of cancer treatment were significant predictors of recovery in multivariate regression modeling. Specifically, each year older in age was associated with a 30% decrease in odds of recovery (OR: 0.7, CI: 0.5-0.95, P = 0.035), and treatment with an alkylating agent without transplant was associated with a 3-fold increase in odds of recovery (OR: 3, CI:2.7-564, P = 0.007). Conclusion: This retrospective review demonstrates that, while uncommon, POI can occur in pediatric cancer survivors, emphasizing the importance of educating patients on the potential long-term effects of cancer treatment and routine surveillance for these complications. This study also confirmed that recovery of ovarian function is possible in these patients, especially when diagnosed at a younger age, so continued monitoring is essential. Presentation: 6/3/2024

MGMT methylation and its prognostic significance in inoperable IDH-wildtype glioblastoma: the MGMT-GBM study

IntroductionThe methylation of the O6-Methylguanine-DNA Methyltransferase (MGMT) promoter is a valid biomarker for predicting response to therapy with alkylating agents and, independently, prognosis in IDH-wildtype(IDH-w) glioblastoma. We aim to study the impact of its methylation in overall survival of the unresectable IDH-w glioblastoma undergoing biopsy and systemic treatment.MethodsWe collected six-year retrospective (2017–2023) data at a quaternary neurosurgery center for patients undergoing biopsy as the only surgical procedure for an unresectable IDH wildtype glioblastoma. Data was collected from patient records including neuro-oncology multidisciplinary team meeting (MDT) documentation. Patients were grouped into categories according to different types of treatment received after biopsy (no treatment, chemotherapy (CT), radiotherapy (RT), chemoradiotherapy (CRT), chemoradiotherapy with adjuvant temozolomide (CRT with adjuvant TMZ), EORTC-NCIC protocol followed by second line treatment) and according to methylation status (unmethylated (< 5%), borderline methylated (5–15%) and strongly methylated (> 15%)). Survival analysis was performed.Results166 glioblastoma IDH wildtype patients were included in the study with mean age of 62.5 years (M: F = 1.5: 1). 70 (49.3%) patients had unmethylated MGMT status (< 5%), 29 (20.4%) patients had borderline methylated MGMT status (5–15%) and 43 (30.2%) patients had methylated MGMT status (> 15%). 36 (25.3%) patients did not receive any treatment post biopsy, 13 (9.1%) received CT only, 27 (19%) RT only, 12 (8.4%) CRT, 33 (23.2%) CRT with adjuvant TMZ, whereas 21 (14.7%) received EORTC-NCIC protocol along with second line treatment.In biopsy only group, there was no notable difference in survival outcomes among the different methylation statuses. For biopsy and any-other-form-of-treatment methylated groups showed a distinct trend of better survival compared to the borderline or unmethylated groups. Overall, methylated patients had better survival as compared to unmethylated or borderline groups.ConclusionMethylated MGMT status are predictors for better overall survival in unresectable IDH wildtype glioblastoma patients undergoing biopsy and treatment regardless of the treatment modality.

Are Membrane Bioreactors Really More Efficient in Removing Pharmaceutical Substances?—Variance Component Analysis Of Micropollutant Removal

This study evaluates the influence of micropollutant chemical characteristics on the removal of pharmaceutical substances through three different treatments: membrane bioreactor, full wastewater treatment with final filtration (WWTP), and secondary treatment through a conventional activated sludges system, operated in parallel at realistic sludge retention time (SRT) over three years and four sampling campaigns. Treated wastewater from the WWTP enters the local canal with a low dilution ratio. Therefore, the monitoring of water contamination is of particular interest for a reliable assessment of environmental risk. A total of 39 pharmaceutical substances were screened. While differences among the three types of treatments were found statistically not significant, data analysis performed through a generalized linear model showed that both the influent concentration and the physicochemical characteristics are strong predictors for the removal of micropollutant. SRT had no significance for the three types of treatment of this study. Finally, pharmaceuticals were divided into three major classes based on their influent concentration and removal. A canonical discriminant analysis was used to predict the removals and showed that the pharmaceuticals removal rates are strongly influenced by their hydrophobicity/hydrophilicity and enabled to predict their removal categories with high accuracy (i.e., 65% of correct predictions).

Psychoacoustic metrics and affective responses in indoor soundscapes: Implications for restorative soundscapes

This study investigates the links between psychoacoustic metrics and affective responses in indoor soundscapes, guided by the ISO/TS 12913 standard. Through the analysis of an indoor soundscapes dataset, we examine how various psychoacoustic metrics, namely sharpness (S), fluctuation strength (FS), and roughness (R), influence affective responses such as pleasant and eventful. Our research reveals that eventful and annoying soundscapes show higher values of (S), (FS), and (R). Conversely, pleasant soundscapes tend to show lower values in these metrics. The findings suggest that while these metrics can be effective in designing eventful soundscapes, they may be less useful for creating pleasant acoustic environments. This study contributes to the understanding of the applicability of current psychoacoustic metrics for the type of soundscape intervention and calls for the development of new psychoacoustic metrics to design restorative soundscapes that enhance well-being.

Rock Melon Crop Yield Prediction using Supervised Classification Machine Learning on Cloud Computing

Precision agriculture is a technology-driven approach to farmer to improve their crop yields and reduce costs. One of the major challenges facing farmers today is the lack of precise prediction which leads to decreased production and mismanagement of labour and resource. Precision technology is costly, and they only rely on manual observations which are less precise. Crop yield prediction systems on cloud computing can solve both problems by predicting the harvested fruit at earlier stages of farming and ease farmers to make decisions. In this study, we proposed a crop yield prediction system for farmers that utilizes cloud computing and machine learning techniques. The system uses data on the physical growth of the plant such as plant’s height at 15 and 30 days after transplant, type of pollination treatment, condition of the leaves, and their variety to predict the crop yield at the early stage. Logistic regression, k-nearest neighbour, and random forest classifier were used to compare the accuracy of the model. Our result shows that by using a random forest classifier, it can achieve an accuracy of 91% which is higher than logistic regression which is only 73% of accuracy, and k-nearest neighbour with 82% accuracy. The study highlights the potential of precision agriculture, cloud computing, and machine learning to revolutionize the way farmers manage their crops and increase their efficiency and productivity, even with the limited resources and hardware that many farmers have.

National biodiversity strategies under-utilize the potential for individual behavior change

Biodiversity conservation is increasingly recognized as a main challenge for the sustainability agenda. With humans at the epicenter of the biodiversity crisis, conserving nature requires changes in individual behavior. This study reveals gaps regarding the incorporation of behavior change into national biodiversity policy. A total of 1306 policy actions proposed by ten National Biodiversity Strategies and Action Plans (NBSAPs) from all world regions were coded for target actors, target behavior and responsible agents as well as the policy options, intervention types and behavioral determinants listed in the Behavior Change Wheel (BCW) framework. Results show that only 11 % (n=148) of the policy actions specified individual behaviors and 10 % mentioned individual actors to be targeted. Only 3 % (n=36) of the policy actions were specific about how interventions and policies could enable individual behavior change. Policy actions targeting individual behavior change were aimed mostly at increasing people’s capabilities (i.e., providing information) or providing opportunities (i.e., resources), and rarely addressed the motivation of individuals. More attention and specificity regarding behavior change and better incorporation of the behavioral sciences can improve the effectiveness of national biodiversity strategies.

Proactive Criminal Thinking and Criminal Identity in Adult Probationers Progressing Through a Day Reporting Program: What This Tells Us About Moral Identity

ABSTRACT This study sought answers to two questions: first, whether or not proactive criminal thinking and criminal identity decrease in justice-involved clients enrolled in a day reporting program (DRP) and second, whether these variables are reciprocally related. A group of 86 adult probationers (54 males, 32 females) completed proactive criminal thinking and criminal identity measures at the beginning of a DRP and again six months later. Results revealed a significant drop in proactive criminal thinking from Time 1 to Time 2, although criminal identity did not change. Also, while proactive criminal thinking predicted criminal identity and a change in criminal identity, criminal identity failed to predict proactive criminal thinking or a change in proactive criminal thinking. Based on these results, it is speculated that proactive criminal thinking is responsive to the types of interventions found in this particular DRP and may have the power to alter criminal identity.

Incidence and factors associated with mitral valve reoperation in patients undergoing surgery for mitral regurgitation: A nationwide cohort study

BackgroundWhen patients undergo surgery for mitral regurgitation, risk of reoperation is of concern. AimsTo examine the incidence and factors associated with mitral reoperation following surgery for mitral regurgitation according to type of surgery. MethodsPatients undergoing first-time surgery for mitral regurgitation, 1996–2021, were identified from nationwide registries. According to index surgery, the population was categorized into 1) mitral repair; 2) mechanical prostheses; 3) bioprostheses. Patients were followed from discharge with a maximum of 15 years of follow-up and cumulative incidence of reoperation was examined. Multivariable Cox analysis was used to examine factors associated with reoperation. ResultsWe identified 6958 patients: 4624 with mitral repair (72 % male, median age 66), 1250 with mechanical prosthesis (52 % male, median age 59), and 1084 with bioprosthesis (57 % male, median age 74). Cumulative incidence of reoperation was 7.3 % for repair (median 7.2 years follow-up), 6.1 % for mechanical prostheses (median 10.9 years follow-up), and 7.1 % for bioprostheses (median 4.5 years follow-up). Within first year, 22.6 % of reoperations were preceded by infective endocarditis. In long-term follow-up, bioprosthetic replacement was associated with a higher reoperation rate, while increasing age, male sex and mechanical prosthesis were associated with lower reoperation rate. ConclusionsIn patients operated for mitral regurgitation, reoperation was infrequent at approximately 7 % for all intervention types during a maximum of 15-year follow-up. In adjusted analysis, bioprosthetic replacement was associated with a higher rate of reoperation, while increasing age, male sex and mechanical prosthesis was associated with a lower rate of reoperation.

Emergent endovascular treatment versus medical treatment for acute large vessel occlusions with nondisabling symptoms.

The aim of this study is to analyze the effectiveness and safety of medical treatment (MT) versus endovascular treatment (EVT) in acute large vessel occlusion patients with mild nondisabling stroke symptoms. This study is a multicenter observational study in which data from patients at three stroke centers were prospectively obtained and retrospectively analyzed. Patients were included if they arrived for treatment within 6 h of stroke onset or last known well time and had a baseline National Institutes of Health Stroke Scale (NIHSS) score of ≤5. Primary outcome was modified Rankin Scale (mRS) score 0-2 at 90 days. Secondary outcomes included symptomatic intracranial hemorrhage (sICH), discharge NIHSS score, 90-day all-cause mortality and length of stay. Clinical outcomes were compared through a multivariable logistic regression after adjusting for age, treatment type admission and discharge NIHSS score, admission Alberta Stroke Program Early CT (ASPECT) score and length of stay. Of the 82 patients included in the study, 42 were in the EVT group and 40 were in the MT group. The groups were similar in age (MT:66, EVT:64 age; p = .62), gender (MT:55%, EVT:54.8%; male) admission NIHSS score (MT:2, EVT:3 points; p = .26), ASPECT score (MT:10, EVT:9; p = .15). While discharge NIHSS score was found to be statistically significant between the groups (MT:1, EVT:2; p = .04). There was no difference between the two groups in terms of 90-day mRS scores (MT:1, EVT:1, p = .86) and mortality rates (MT:4, EVT:4; p = .94). In unadjusted analysis, sICH rates were similar between the MT and EVT groups (MT 5%, EVT 7.1%, p = .52). Neurological intensive care unit length of stay (MT:5 days, EVT:2 days p < .001), inpatient clinic length of stay (MT:3, EVT:2 days p = .041), and total length of stay (MT:9 days, EVT:4 days p < .001) were significantly longer in the MT group. Our multicenter study demonstrated that MT with blood pressure augmentation and anticoagulation at hyperacute stage is an alternative option for emergency large vessel occlusion patients with nondisabling mild stroke symptoms.