Epithelioid sarcoma are rare malignant mesenchymal tumors that affect mostly young males in the distal part of extremities. They are frequently treated initially with incomplete resection because of their clinically slow-growing benign pattern. Heterogeneity in pathological presentation of epithelioid leads to frequent misdiagnosis that affects survival. This report describes the clinical course and management of a 58-year-old man who presented with epithelioid sarcoma in the shoulder girdle. The case was misdiagnosed initially as a benign lesion and then, at the local recurrence, as a carcinoma. The patient is free of recurrence and metastases 4 years after a large resection of the axillary lymph recurrence sacrificing the axillary vein followed by radiation.

Opportunities for Trauma-Informed Medical Care in Cystic FibrosisTo the Editor:People living with Cystic Fibrosis (PwCF) face a lifetime of potentially traumatic medical experiences. These experiences can range from invasive medical treatments (e.g. venipuncture, nasogastric tube placement) to daily illness-related events (e.g. illness related bullying). These experiences place PwCF at high risk for a type of posttraumatic stress called Medical Traumatic Stress (MTS)[1]. With the growing recognition of the high prevalence and impact of MTS, we anticipate that cystic fibrosis care teams may soon be tasked with integrating trauma-informed medical care into their clinical practices. CF care teams are well poised to prevent and screen for MTS because they 1) create the environment for many illness-related experiences; 2) have established workflows for mental health screening; and, in many cases, 3) have trusting relationships with PwCF and their families. Here, we seek to highlight the opportunities for implementing trauma-informed medical care within the cystic fibrosis-specific context.MTS is defined as the psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences[2]. MTS is common in PwCF – 55% of these youth report experiencing potentially traumatic medical experiences and 30% report MTS symptoms[1]. MTS symptoms have the potential to impact medical care, health outcomes and quality of life[3].While highly effective modulator therapies may decrease the frequency and severity of medical care, PwCF have identified these therapies as an additional source of potentially traumatic experiences[4]. New potentially traumatic medical experiences in modulator-eligible PwCF can include lost sense of purpose as their identity shifts from a “sick” person to a “well” person; survivor guilt from benefiting from therapies not available to others; and financial distress as they face planning for a longer than anticipated life expectancy [4]. The challenge of navigating the healthcare system, such as advocating with care teams and insurance companies, has been identified as potentially traumatic by PwCF, particularly those who are modulator-ineligible[4].A trauma-informed approach to medical care may be helpful for cystic fibrosis care teams to mitigate MTS. The Pediatric Psychosocial Preventive Health Model (PPPHM) provides a framework for tiered implementation of trauma-informed medical care[5]. It includes recommendations for universal practices gauged towards all children and families, targeted approaches for those at high risk of developing MTS, and treatment for those with severe, escalating, or persistent MTS symptoms (Figure 1).Universal MTS interventions for PwCF include prevention and screening. Preventive interventions can include MTS awareness education for all PwCF, family members of PwCF and cystic fibrosis care team members. This education can highlight approaches to modifying potentially traumatic medical experiences and identifying MTS symptoms that indicate the need for further support. Universal systems interventions may also include the implementation of workflows to minimize the traumatic potential of healthcare experiences (e.g. workflows to minimize needle distress with comfort positioning, numbing cream, and distraction as part of standard care. Care teams can also integrate shared decision-making processes to optimize patient perception of control and implement systems that facilitate communication between cystic fibrosis care team and PwCF.While annual mental health screening for depression and anxiety is the current recommendation for all PwCF, healthcare providers should consider integrating routine MTS screening into their practice. Screening workflows can include screening for patient risk factors and MTS symptoms, as well as family member symptoms of MTS. Currently, there are no screening tools designed to specifically capture the cystic fibrosis experience of MTS; however, acute stress screeners such as the Acute Stress Checklist for Children can aid in the identification of MTS, thereby guiding providers on who to refer for further mental health assessments or support. One common concern regarding screening for MTS is managing the burden of time as well as supporting those PwCF who screen at-risk. Thus, in planning for MTS screening, teams ought to consider the time required for screening, appropriate training for those performing the screening, and the development of a clear workflow for management and referrals. While these barriers require a thoughtful approach to processes and care, the benefits outweigh the consequences of not screening. MTS is present for many regardless of if screening occurs and screening allows the medical team to optimize overall healthcare.The second tier of the PPPHM recommends targeted approaches to MTS for those with risk factors or early symptoms. Possible MTS risk factors in PwCF include parent posttraumatic stress disorder, high daily medication burden, and emergency room and intensive care [1]. Interventions for PwCF who have MTS risk factors or early symptoms may include increasing support during potentially traumatic medical experiences (e.g. having a child life expert prepare a patient before a procedure); altering the medical care plan when possible (e.g. minimizing daily medication burden); educating family members on what to say to PwCF before, during, and after potentially traumatic medical experiences; and integrating patient-specific resilience factors into individualized coping and support plans. In some cases, brief therapeutic psychological interventions may help address specific symptoms (e.g., targeted CBT needle phobia interventions, behavioral sleep interventions, brief psychoeducation interventions).The third tier of the PPPHM recommends treatment for MTS symptoms that impact medical care or impair daily functions. PwCF with significant MTS symptoms should be referred to a mental health provider with expertise in the treatment of trauma symptoms. Ideally, the provider should have familiarity with chronic medical conditions, and, ideally, cystic fibrosis specifically. While we do not yet have evidence-based MTS-specific interventions for PwCF, approaches may include cognitive behavioral techniques such as restructuring of hospital-related thoughts, behavioral activation, or trauma-focused cognitive behavioral therapy. Mental health providers could also collaborate with families and cystic fibrosis care teams to develop an individualized plan for minimizing re-traumatization and reducing the impact of MTS on medical care and quality of life.In summary, given the substantial impact that MTS can have on PwCF, cystic fibrosis care teams should consider integrating trauma-informed approaches into the medical care of PwCF to optimize overall health (including mental health). Comprehensive approaches to MTS mitigation in PwCF include 1) universal awareness, prevention, and screening, 2) targeted interventions for those at high risk, and 3) individualized MTS treatment administered by mental health professionals. To optimize cystic fibrosis care with attention to MTS, future research should prioritize more definitive identification of MTS risk factors, the development of validated cystic fibrosis-specific MTS screening tools, the creation and dissemination of evidence-based MTS prevention programs, and the development of evidence-based MTS mental health interventions tailored to PwCF.Figure 1: Application of the Pediatric Psychosocial Preventative Health Model to Cystic Fibrosis. Adapted with permission from the Center for Healthcare Delivery Science at Nemours Children’s Health System 2018-2019. All rights reserved[5].

Nikel Cobalt layered double hydroxides (NiCo LDHs) have emerged as ideal electrode materials for supercapacitor due to their high specific surface area and excellent cycling stability. Morphology control plays a unique role in regulating the performance of NiCo LDHs, but there are rare reports to regulate the morphology during energy storage. Herein, the morphology of NiCo-LDHs electrode is optimized for enhancing energy storage by simple activation process with different t concentrations of the electrolyte. During the activation process, electrochemical morphology reconstructed occurs on the electrode surface. With2 M KOH electrolyte the NiCo-LDH electrode transforms from nanosheets to nanoflower, which aids in reducing the distance of ion transport. The reconstructed NiCo-LDH (NiCo-LDH-2) exhibits an ultra-high specific capacitance of 5428 F g-1 at a current density of 1 A g-1, outperforming most of NiCo LDHs. Even at a high current density of 10 A g-1, the capacitance retention rate remains above 77.6% after 1000 charge-discharge cycles. The strategy proposed in the study, which involves concentration-controlled morphology optimization for energy storage enhancement, holds great practical significance for the field of supercapacitors.

A document by Carla Rodriguez-Watson. Click on the document to view its contents.

Trajectory similarity computation is very important for trajectory data mining. It is applied into many trajectory mining tasks, including trajectory clustering, trajectory classification and trajectory search etc. So efficient trajectory similarity computation method is very useful for improving trajectory mining result. Nowadays many trajectory similarity computation methods have been proposed. But these methods don't take the outline feature of long trajectory into consideration. Thus a new trajectory similarity computation method is proposed in this paper. This method not only takes the long-term dependence feature of long trajectory into consideration, but also considers the outline feature of long trajectory. The proposed method employs GAT-based transformer to extract long-term dependence feature from long trajectory. And it applies Convolutional Neural Network to extract outline feature from long trajectory.

The limited literature and increasing interest in studies on cardiac electrophysiology, explicitly focusing on cardiac ion channelopathies and sudden cardiac death (SCD) in diverse populations, has prompted a comprehensive examination of existing research. Our review specifically targets Hispanic/Latino and Indigenous populations, which are often underrepresented in healthcare studies. This review encompasses investigations into genetic variants, epidemiology, etiologies, and clinical risk factors associated with arrhythmias in these demographic groups. The review explores the Hispanic paradox, a phenomenon linking healthcare outcomes to socioeconomic factors within Hispanic communities in the United States. Furthermore, it discusses studies exemplifying this observation in the context of arrhythmias and ion channelopathies in Hispanic populations. Current research also sheds light on disparities in overall healthcare quality in Indigenous populations. The available yet limited literature underscores the pressing need for more extensive and comprehensive research on cardiac ion channelopathies in Hispanic/Latino and Indigenous populations. Specifically, additional studies are essential to fully characterize pathogenic genetic variants, identify population-specific risk factors, and address health disparities to enhance the detection, prevention, and management of arrhythmias and SCD in these demographic groups.

Ocean warming has led to significant changes for marine zooplankton. Modelling responses to climate change assume that zooplankton respond uniformly with little adaptation (niche conservatism). Oceanic barriers, local adaptation and genetic variation in cosmopolitan species could drive niche divergence between same species populations. We assess niche divergence among 325 globally distributed species across the five main ocean basins. There were 487 diverged niches out of 1124 ocean basin comparisons. The proportion of diverged niches varied both across and within phyla. Calanoida (133 of 325 species) were used to test the likelihood of niche divergence between same species population across environmental gradients. Niche divergence was more likely to occur in species that occupy colder waters and in shallower depths. Niche divergence was more likely for larger ominivore-herbivores than smaller sized carnivores. This study demonstrates adaptive potential across environmental-niche gradients, which must be considered when modelling population responses to climate change.

Global environmental changes are predicted to lead to warmer average temperatures and more extreme weather events thereby affecting wildlife population dynamics by altering demographic processes. Extreme weather events can reduce food resources and mortality, but the contribution of such events to demographic processes are poorly understood. Estimates of season-specific survival probabilities are crucial for understanding mechanisms underlying annual mortality. However, only few studies have investigated survival at sufficient temporal resolution to assess the contribution of extreme weather events. Here, we analysed biweekly survival probabilities of 307 radio-tracked juvenile little owls (Athene noctua) from fledging to their first breeding attempt in the following spring. Biweekly survival probabilities were lowest during the first weeks after fledging in summer and increased over autumn to winter. The duration of snow cover in winter had a strong negative effect on survival probability, while being well fed during the nestling stage increased survival during the first weeks after fledging and ultimately led to a larger proportion of birds surviving the first year. Overall annual survival probability over the first year varied by 34.3 % between 0.117 (95 % credible interval 0.052 – 0.223) and 0.178 (0.097 – 0.293) depending on the severity of the winter, and up to 0.233 (0.127 – 0.373) for well-fed fledglings. The season with the lowest survival was the post-fledging period (0.508; 0.428 – 0.594) in years with mild winters, and the winter in years with extensive snow cover (0.481; 0.337 – 0.626). We therefore show that extreme weather events reduced the proportion of first-year survivors. Increasingly warmer winters with less snow cover may therefore increase annual survival probability of juvenile little owls in central Europe, but environmental changes reducing food supply during the nestling period can have similarly large effects on annual juvenile survival and therefore the viability of populations.

Rhodococcus equi causes pyogranulomatous pneumonia in foals and immunocompromised people. Despite decades of research efforts, no vaccine is available against this common cause of disease and death in foals. The purpose of this narrative review was to summarize the current understanding of interactions between R. equi and the host innate immune system, to describe features of the immune response that are associated with resistance or susceptibility to R. equi infection, and help guide strategies for developing novel approaches for preventing R. equi infections. Virulence of R. equi in foals has been attributed to the virulence associated protein A which allows intracellular survival in macrophages by preventing acidification of R. equi-containing vacuole. Additionally, foal susceptibility to R. equi infection is associated with immaturity and naivety of innate and adaptive immune systems, while adult horses with fully functional immune system are resistant to pneumonia. Specific interaction between R. equi and innate immune cells can result in bacterial survival or death; learning how to manipulate these responses to control infection is critical to prevent pneumonia in foals. Administration of live vaccines and stimulation of innate immune responses appears to improve foals’ immune response and has the potential to overcome the challenges of foal active vaccination and elicit protection against pneumonia.

Letter to the Editor

I aimed to better understand the community ecology of sympatric birdlife in subtropical South East Queensland, Australia using patterns of temporal species co-occurrence and principles from network theory. In line with expectation, a hierarchical clustering analysis showed that dates that were successive were joined by the shortest branch lengths because of similar patterns of observed bird species. The only date sampled in the Southern hemisphere Autumn was awarded its own branch in the tree, indicating these observations were relatively distinct. Estimates of total observed bird biomass were substantively higher in the Autumn sample. Ranking each species on its average pairwise correlation to the other 87 species in the set shows that, unsurprisingly, raptors (such as Whistling Kites, Haliastur splenurus) tend to be the most negatively correlated (hypergeometric enrichment statistic P = 0.00029) indicating their presence is inhibitory to other avian species. On the other hand, Silvereyes (Zosterops lateralis) possess the highest number of total connections, the highest radiality (or ‘network influence’) metric within the inferred co-occurrence network and have the second highest average positive correlation to all other bird species in the set (+0.32). Collectively, this means Silvereyes can be seen as an indicators whose presence indicates an enhanced likelihood of observing a diversity of other bird species. Network clustering analysis detects a large module of positively connected bird species within the overall structure (dominated by non-threatening diminutive species as Z. lateralis, Little Friarbirds Philomon citreogularis and Red Backed Fairy Wrens Malurus melanocephalus), whereas all but one of the raptors sit on the periphery. The use of the PCIT network reconstruction algorithm is demonstrated for the first time in community ecology.

Spontaneous Raman spectroscopy is a well-established diagnostic tool, allowing for the identification of all Raman active species with a single measurement. Yet, it may suffer from low signal intensity and fluorescent background. In contrast, coherent anti-Stokes Raman scattering (CARS) offers laser-like signals, but the traditional approach lacks the multiplex capability of spontaneous Raman spectroscopy. We present an ultrabroadband CARS setup which aims at exciting the full spectrum (300 - 3700 cm -1) of biological molecules. A dual-output optical parametric amplifier provides a ~7 fs pump/Stokes and a ~ 700 fs probe pulse. CARS spectra of DMSO, ethanol and methanol show great agreement with spontaneous Raman spectroscopy and superiority in fluorescent environments. The spectral resolution proves sufficient to differentiate between the complex spectra of L-proline and hydroxyproline. Moreover, decay constants in the sub picosecond range are determined for individual Raman transitions, providing an additional approach for sample characterization.

Hybridization affects the spatial and temporal patterns of morphological and genetic variation, shaping species evolution. Asclepias speciosa and A. syriaca provide an excellent system for uncovering how these patterns are generated. The ranges of A. speciosa and A. syriaca overlap on the North American Great Plains, and multiple intermediates are observed in this contact zone, consistent with hybridization. However, other processes, such as preservation of ancestral polymorphism or selective pressure imposed by environmental clines, could explain the presence of morphological intermediates. In this study, we characterized patterns of variation within and between A. speciosa and A. syriaca using morphological and genetic data to validate the hybrid origin of intermediates, evaluate the impact of hybridization on the parental species, and reconstruct the demographic history of hybridization events. We demonstrate that hybridization best explains the occurrence of large numbers of morphologically intermediate individuals in the contact zone and document bidirectional and asymmetric genetic introgression. We discover that the timing of secondary contact is relatively recent, coinciding with rapid range shifts during the Pleistocene. Our findings provide new insights into the dynamics of hybridization on the North American Great Plains, the setting for numerous contact zones between taxa affiliated with eastern and western biotas.

The integrated application of rapid and accurate topological analysis with state estimation is crucial for ensuring the reliability, stability, and efficiency of power systems. In response to this need, this paper proposed an innovative approach to constructing a spatiotemporal “Power Grid One Graph” model using a graph database and achieving fast topological analysis and state estimation. Firstly, a spatiotemporal power grid model was constructed by combining grid topology with temporally dynamic updates of the power grid telemetric and telesignalling. Subsequently, based on the graph model and employing entity mapping, the spatiotemporal node-breaker graph model was generated. Building upon this model, the topological error identification was executed, and a fast topological analysis optimization algorithm considering the functionality of components was utilized to create the corresponding dynamic bus-branch graph model, facilitating graph-based state estimation. Finally, the proposed method on a real power grid system was validated, and the application and performance enhancement of the spatiotemporal power grid model considering topological changes were explored. The introduced method provides theoretical and practical support for the digital transformation of power systems and the developing of digital twin power grids.

Background: No studies have deeply examined the transmission patterns of H1N1pdm09 in Anhui Province, China. Methods: We conducted a genome-wide analysis of 162 historical epidemic strains in Anhui Province, China to understand the transmission patterns, incoming and outgoing events, and evolutionary dynamics of the strains. Results: Our study showed that the number of recent infections was higher in 2018-2023 compared to previous years. Compared to the global strain sequences, the clade production times were all delayed in Anhui Province, China, suggesting that Anhui is an introduced region in the global transmission chain. The NA fragments had higher dN/dS values than the HA fragments. The circulation pattern of the strain in Anhui Province, China was mainly from central to northern, followed by northern to central and central to southern. Central Anhui was the transmission center of H1N1pdm09 in Anhui Province, China. Calculation of transmission events for the whole country showed that the main source of the epidemic strain in Anhui Province was East China, but the national epidemic of the H1N1pdm09 strain in 2023 appeared to originate from Anhui Province, China. Conclusion: The above results emphasize the focus of influenza prevention and control in Anhui Province, China, as well as the importance of sharing information about epidemics between different provinces.

The Penninic and Subpenninic nappe stack of the Tauern Window (TW) in the European Alps was formed by collision between Europe (Subpenninic) and the Adria margin (Austroalpine), and finally exhumed by the northward push of the Dolomites Indenter in the Miocene. In this study, we kinematically restore a cross-section along the trace of the Brenner Base Tunnel, concentrating mainly on the Subpenninic (Venediger duplex; VD). We integrate zircon fission-track data (ZFT) as a temporal constraint for the termination of viscous deformation and test different geothermal gradients (GG). P-T-t data are used to define (i) the depth of brittle-viscous transition (ca. 300°C) and (ii) pre-indenter depth. First, we displace the VD down along the Sub-Tauern ramp below the 300°C isotherm. To that time, a GG of 50°C/km prevailed. ZFT ages reveal that viscous folding of the VD terminated at ca. 17 ± 2 Ma. Unfolding of the VD, while conserving surface area, yield that the model is extended by ca. 70 km (i.e. thus equaling indenter shortening), which means that the VD was not affected by W-E extension or lateral extrusion. Reconstruction of the hanging-wall nappes (Austroalpine and Penninic nappes) above the restored VD reveals that the total pre-indenter thickness of their northern limbs was 35–50% more than it is today. We interpret this as tectonic thinning, which was mainly caused by the Brenner normal fault. Our model shows that tectonic processes can explain the exhumation of the western TW; erosional denudation seems to play only a minor part.

Omega bands are mesoscale auroral structures emerging as eastward moving sinusoidal undulations well within the closed field line region of the auroral oval. While associated with geomagnetic activity, neither specific conditions of their appearance nor their causes are well understood. We perform a superposed epoch analysis of OMNI and SuperMAG measurements taken during 28 omega band events recorded by auroral all-sky imager (ASI) observations from 2006-2013 to identify their solar wind drivers. We find local enhancements in the solar wind flow speed, magnetic field, pressure, and proton density at the onset of the omega band observation. In the magnetosphere-ionosphere, we see enhancements in the ring current, partial ring current, and auroral electrojets. These features are consistent with geomagnetic activity caused by stream interaction regions (SIRs). 19 of our events overlap with SIRs from published event catalogs. Our findings suggest that omega bands are driven by SIR-like events.

(S)-equol, the most influential metabolite of daidzein in vivo, has aroused great attention due to the excellent biological activities. Although existing studies have accomplished the construction of its heterologous synthetic pathway in the context of anaerobicity and inefficiency of natural strains, the low productivity of (S)-equol limits its industrial application. Here, rational design strategies based on decreasing the pocket steric hindrance and fine-tuning the pocket microenvironment to systematically redesign the binding pocket of enzyme were developed and processed to the rate-limiting enzyme DHDR in (S)-equol synthesis. After iterative combinatorial mutagenesis, an effective mutant S118G/T169A capable of significantly increasing (S)-equol yield was obtained. Computational analyses illustrated that the main reason of the increased activity relied on the decreased critical distance and more stable interacting conformation. Then, the reaction optimization was performed, and the recombinant Escherichia coli whole-cell biocatalyst harboring S118G/T169A enabled the efficient conversion of 2 mM daidzein to (S)-equol, achieving yields of 84.5%, which was 2.9 times higher than that of the parental strain expressing wide type DHDR. This study provides an effective idea and a feasible method for enzyme modification and whole-cell catalytic synthesis of (S)-equol, and will greatly accelerate the process of industrial production.

For decades the external globus pallidus (GPe) has been viewed as a passive way-station in the indirect pathway of the cortico-basal ganglia-thalamic (CBGT) circuit, sandwiched between striatal inputs and basal ganglia outputs. According to this model, one-way descending striatal signals in the indirect pathway amplify the suppression of downstream thalamic nuclei by inhibiting GPe activity. Here we revisit this assumption, in light of new and emerging work on the cellular complexity, connectivity, and functional role of the GPe in behavior. We show how, according to this new circuit-level logic, the GPe is ideally positioned for relaying ascending and descending control signals within the basal ganglia. Focusing on the problem of inhibitory control, we illustrate how this bidirectional flow of information allows for the integration of reactive and proactive control mechanisms during action selection. Taken together, this new evidence points to the GPe as being a central hub in the CBGT circuit, participating in bidirectional information flow and linking multifaceted control signals to regulate behavior.

Under the background of climate warming, the distribution pattern of snowpack in mountainous areas is naturally under the focus of attention, and the changes in the snowpack pattern in mountainous areas have important impacts on hydrological processes such as downstream river runoff, water supply, and so on. In this study, based on the MODIS day-by-day cloud-free snowpack area dataset, we analysed the process of stable snowpack formation and the final pattern of snowpack in spring and winter in two typical topographic regions, the hilly plateau and the alpine valley region, in the eastern part of the Tibetan Plateau, and constructed a model based on the Maximum Entropy Model (MEM) method for predicting the influencing factors of the stable snowpack. A model was constructed based on the maximum entropy model method to predict the factors influencing the stable snowpack, and the dominant factors of the stable snowpack in spring and winter in the watersheds of the two topographic regions were analysed. The main conclusions are as follows: (1) The snow ablation rate on the western Sichuan Plateau is different in winter and spring, and is greater in spring than in winter; there is also a difference in the snow ablation rate in different topographic regions, with a greater difference in the hilly plateau than in the high mountain valleys. (2) The distribution pattern of stable snow in the two major terrain areas of the Western Sichuan Plateau varies in seasons, and the spatial distribution area is relatively small, mostly showing a rising trend with increasing altitude. (3) The influence factors of stable snowpack in different terrain areas in different seasons are different, and elevation is the main factor influencing the distribution pattern of stable snowpack. The results of this paper have some reference value for the study of snow hydrology in the climatic context of the Western Sichuan Plateau.

The Use of Negative Pressure Therapy for the Treatment of Gunshot Wounds in a limited resource setting in Eastern part of the Democratic Republic of Congo: case series.Paul Munguakonkwa Budema 1,2, Jean de Dieu Tumusifu Manegabe 1,2, Gauthier Murhula Bahizire 1,2, Fabrice Cikomola Gulimwentuga 1,2, Georges Kuyigwa Toha 1,2, Olivier Mukuku 3, Zacharie Kibendelwa Tsongo 4, Theophile Barhwamire Kabesha 5, Stanislas Okitotsho Wembonyama 6.Department of Surgery, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo.Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.Institut Supérieur de Techniques Médicales de Lubumbashi, Lubumbashi, Democratic Republic of Congo.Faculty of Medecine, Université de Kisangani, Kisangani, Democratic Republic of Congo.Faculty of Medecine, Université Officielle de Bukavu, Bukavu, Democratic Republic of Congo.Faculty of Medecine, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo.Mails addressPaul Munguakonkwa Budema :paulbdma@yahoo.frJean de Dieu Tumusifu Manegabe :tumusifujeandedieu7@gmail.comGauthier Murhula Bahizire:b ahiziregauthierm@gmail.comFabrice Cikomola Gulimwentuga:cikomolafab@gmail.comGeorges Kuyigwa Toha:kuyigwa2002@yahoo.frOlivier Mukuku:oliviermukuku@yahoo.frZacharie Kibendelwa Tsongo:tsongo.kibendelwa@unikis.ac.cdTheophile Barhwamire Kabesha:thkabesha@gmail.comStanislas Okitotsho Wembonyama :wembostanislas@yahoo.fr

Background Although many people received the COVID-19 vaccine, shortly after the Chinese government announced that the three-year COVID-19 restrictions were being eased, the first large number of Omicron infections appeared in Beijing. In this study, we describe the epidemiological characteristics, clinical severity, and time-to-event distribution of patients infected with SARS-CoV-2 in Beijing Omicron outbreak, comparing those who received the booster vaccine with cases of full/partial vaccines. Methods In this epidemiological study, we collected epidemiological, clinical, laboratory, and clinical management data from the hospital information system (HIS) for 1495 cases using standardized forms. We also collected the illness onset time, diagnosis time, hospital admission time, and start and end times of each treatment. In addition, we collected the time of vaccination, inoculation times, and type of COVID-19 vaccination thorough the vaccination system. We described the epidemiological characteristics across vaccine inoculation doses, and estimated the risk of death, mechanical ventilation, and admission to the intensive care unit for patients admitted to hospital. We used the Kaplan–Meier method to estimate the survival rate and plot the survival curve, and the Cox proportional hazards model to assess the effect of covariates on survival time. Results Of the 1495 cases, 58.1% were male and 41.9% were female. The median ages in the non-vaccinated and vaccinated groups were 80 and 47 years, respectively. The elderly, people with underlying medical condition, and those with a lower BMI were less willing to be vaccinated ( p<0.05). Both the inactivated vaccine and adenovirus vaccine could reduce clinical severity and prolong survival time, and the protective effect of booster vaccination was the best. The clinical severity increased linearly from the booster vaccinated group to the full vaccinated group and non-vaccinated groups, and the death risk of COVID-19 cases without vaccination was the highest. Conclusion Booster vaccines of COVID-19 can provide greater protection against severe illness and death, and continuous monitoring and regular assessment are needed to minimize the risk of a recurrence of the pandemic.

A document by Timotej Šúri. Click on the document to view its contents.

Background: As adolescent suicide rates have increased, there has been a nationwide focus on legislation requiring school districts to create suicide prevention policies. There is a lack of tools to make a quantitative assessment of the quality and breadth of school-district suicide prevention policies. Thus, we developed a proof-of-concept instrument, the School District Suicide Policy Evaluation Tool (SDSPET). Methods: The SDSPET is derived from the “Model School District Policy on Suicide Prevention,” a document compiled by four nationally recognized suicide organizations. As a preliminary validation of the SDSPET, four independent raters used the SDSPET in a systematic analysis of suicide prevention policies for all school districts in Utah. Results: Inter-rater reliability was calculated to be 98.8% with intraclass correlation analysis. Analysis revealed a right-skewed distribution of policy scores, and a median total score was 2.25 out of 36 possible criteria. Conclusion: This proof-of-concept study demonstrates the utility of the SDSPET in quantifying the shortcomings of school-district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be beneficial to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school-aged children and adolescents.