In the pursuit of equitable diabetes care, international knowledge exchange (iKE) serves as a crucial mechanism for narrowing the gaps in quality within and between countries. Little is known about the process of quality measurement exchange among stakeholders from high-income countries (HICs), low- and middle-income countries (LMICs), and international organizations. This study aims to analyze recent international exchanges of quality measures in diabetes care and propose a framework for enhancing quality, focusing on LMICs. Employing a realist evaluation methodology, we conducted database searches for peer-reviewed articles, international organizations' documents, and country-level reports. Semi-structured online interviews were conducted with corresponding authors. Synthesis was achieved using the Two-Communities theory. The study encompassed 98 articles and reports from 44 countries and regions, supplemented by in-depth interviews with 13 informants. We delineate a framework for iKE of quality measures, highlighting three key approaches: "pull," "push," and "exchange." Researchers in HICs and LMICs utilize knowledge from other countries, adapting to local contexts through various processes. International organizations such as the World Health Organization and the International Diabetes Federation play pivotal roles in developing and disseminating measurement tools. "Exchange" processes expedite sharing, especially in LMICs, empowering local stakeholders. Global inequities in quality measurement underscore the need for collaborative efforts to address the Inverse Care Law. Finally, a realist framework was developed to guide stakeholders in identifying relevant iKE initiatives, facilitating gradual improvements in quality measurement. Balancing measurement burden with clinical care while strengthening primary care capacity and data systems is crucial for advancing equitable diabetes care globally.

Although suicide bereavement is highly distressing and is associated with an increased risk of suicidal behaviors and mental and physical health impairments, those bereaved by suicide encounter difficulties accessing support. Digital resources offer new forms of support for bereaved people. However, digital resources dedicated to those bereaved by suicide are still limited.

We recently reported factors leading to different severity of ruminal pH drop in primiparous cows fed the same diet during transition and early lactation. The present study evaluates the effects of those severities on performance and several blood and balance parameters in the same 24 primiparous cows from 3 wk before calving until week 10 in lactation. The dietary concentrate was increased for all cows from 32 before calving to 60% dry matter (DM) basis over the first week in lactation, resulting in a diet with 40% non-fiber carbohydrates (NFC), and 14.4% physically effective fiber [peNDF > 8]. Ruminal pH was monitored with indwelling systems in all cows during the study; then several indices of duration and magnitude of pH change were used as indicators of the severity of ruminal pH drop. Accordingly, as reported in the companion paper, the cows were classified as either higher pH drop (HIGH; n = 9), moderate (MOD; n = 9), or lower (LOW; n = 6) severity of pH drop. In the present report, body weight, body condition score, and back fat thickness decreased but rumen mucosa thickness increased after calving in all cows (P < 0.05). Post-partum daily energy intake in HIGH was greater (P < 0.05) than in the other categories. In addition, there were 5.6 kg extra of energy-corrected milk in HIGH (P < 0.05). Independent of the severity of pH drop, blood glucose, non-esterified fatty acids, beta-hydroxybutyrate, bilirubin, and cortisol were higher, whereas triglycerides, total protein, globulin, albumin, urea nitrogen, cholesterol, calcium, and phosphorous were lower at calving (P < 0.05). Blood cholesterol was greater in HIGH than the other pH categories (P < 0.05); insulin and reproductive variables were not affected by the severity of the pH drop. Overall, primiparous cows fed the same diet showed different severity of ruminal pH drop, but the individual variation in ruminal pH depression was not related to a negative impact on milk yield, energy balance, or blood metabolites during the study. This indicates that the impact of low ruminal pH on the animals may depend not only on the severity of the pH drop (average of 403 min/d of pH < 5.8 over 13 wk) but also on diet characteristics. Specifically, drops of ruminal pH can be tolerated by primiparous cows during the first 10 wk in milk consuming a diet containing 40% NFC and 14.4% peNDF > 8. It would be worth studying the severity of ruminal pH drop in a larger sample size during the entire lactation and if the severity is sustained on the next lactation.

The hydroaminomethylation of alkenes using CO and H proceeds efficiently in the presence of a heterogeneous Co-N/C catalyst with highly dispersed metal centers. Various secondary and tertiary amines can be effectively synthesized from cyclic and linear aliphatic alkenes using this specific material. The active sites of the optimal catalyst result from the synergistic effect of atomically dispersed Co sites with their surrounding N atoms, and the high surface area as well as structural defects of the NC support. The broad applicability (>54 examples), including pharmaceutically relevant molecules, together with the high activity and reusability, underline the general applicability of this catalytic system.

The development of improved and less costly catalysts for dehydrogenation of formic acid (HCOOH) is of general interest for renewable energy technologies involving hydrogen storage and release. Theoretical calculations reveal that ruthenium (Ru) nanoparticles supported on nitrogen-doped carbon should be appropriate catalysts for such transformations. It is predicted that nitrogen doping significantly decreases the formation of CO, but at the same time increases CO tolerance of the catalysts. To prove these hypotheses heterogeneous ruthenium catalysts supported on porous nitrogen-doped carbon (Rux/CN) with hierarchical structure were synthesized using carbon nitride (CN) as template and phenanthroline (Phen) as ligand. Experimental tests in HCOOH dehydrogenation revealed that the optimal catalyst Ru7/CN exhibited good thermal stability at 140 °C and a high turnover frequency (TOF >1300 h), which is more than one order of magnitude higher than that of the commercial Ru5/C catalyst.

Among the most investigated hypotheses for a radiobiological explanation of the mechanism behind the FLASH effect in ultra-high dose rate radiotherapy, intertrack recombination between particle tracks arriving at a close spatiotemporal distance has been suggested. In the present work, we examine these conditions for different beam qualities and energies, defining the limits of both space and time where a non-negligible chemical effect is expected. To this purpose the TRAX-CHEM chemical track structure Monte Carlo code has been extended to handle several particle tracks at the same time, separated by pre-defined spatial and temporal distances. We analyzed the yields of different radicals as compared to the non-interacting track conditions and we evaluated the difference. We find a negligible role of intertrack for spatial distances larger than 1 μm, while for temporal distances up to μs, a non-negligible interaction is observed especially at higher LET. In addition, we emphasize the non-monotonic behavior of some relative yield as a function of the time separation, in particular of H2O2, due to the onset of a different reaction involving solvated electrons besides well-known OH· recombination.

The interaction between basic science epilepsy researchers and clinical epileptologists is a longstanding issue. Efforts to provide opportunities for a dialogue between preclinical and clinical epilepsy professionals are crucial to reduce the knowledge gap between them and improve the translational success of neurobiology-based research. The International League Against Epilepsy (ILAE) Research and Innovation Task Force circulated a survey to investigate the need for an update on new clinical epilepsy concepts within the basic science community. The 336 respondents included basic scientists (BS), preclinical scientists (PCSs), and/or clinical scientists (CSs). The majority of the 237 BSs/PCSs were engaged in preclinical studies in translational epilepsy research and declared translational research as a priority research interest. Fewer respondents from low-middle-income countries than from upper-middle or high-income countries (40.7% vs 65%) considered translational research a critical aspect of their research. A broad understanding of both clinical and neurobiological aspects of epilepsy was declared by 48% of BSs/PCSs; 96% of CSs declared a superficial knowledge of neurobiology of epilepsy. Most BSs/PCSs were aware that epilepsy is a complex condition that should be investigated with the help of clinical epileptologists, even though concerns were expressed on the relationship with clinicians. A focused training program on emerging clinical epileptological aspects tailored for BSs/PCSs was recommended by 81% of the participants; the majority of respondents preferred either 1- or 2-week in-presence tutoring or continuous online training coordinated by ILAE at the regional/national level. The survey also underscored the value of educational programs on neurobiology of epilepsy targeting CSs and low-middle-income countries (LMIC) investigators.

The clinical management of people with multidrug-resistant (MDR) human immunodeficiency virus (HIV) remains challenging despite continued development of antiretroviral agents. A 58-year-old male individual with MDR HIV and Kaposi sarcoma (KS) was treated with a new antiretroviral regimen consisting of anti-CD4 domain 1 antibody UB-421 and capsid inhibitor lenacapavir. The individual experienced delayed but sustained suppression of plasma viremia and a substantial increase in the CD4 T cell count. A longitudinal examination of plasma HIV and infectious isolates showed no evidence of viral evolution or the emergence of UB-421- or lenacapavir-resistant viruses. The individual received three cycles of liposomal doxorubicin and five doses of anti-programmed cell death protein 1 (PD-1) monoclonal antibody pembrolizumab that resulted in improvement in KS with flattening of lesions. Our data demonstrate that combination therapy with UB-421 could provide sustained virologic suppression in people harboring MDR HIV with limited therapeutic alternatives.

Increasing droughts adversely affect grasslands, diminishing the availability and quality of forages for ruminants. We have recently shown that mixed ensiling of drought-impaired grass (DIG) with sugar beet pulp (SBP) improved the conservation and feed value of silage. The application of silage additives may further improve the ruminal degradability, which may thereby shape the fermentation and microbiome in the rumen when those silages are tested as part of dairy diets. Therefore, we performed a long-term in vitro nutritional evaluation of diets containing 50% (DM basis) of mixed silages from DIG and SBP, ensiled either with no additive (T_CON) or with anaerobic fungi culture supernatant (25% in DM; T_AF), mixed ruminal fluid (10% in DM; T_RF) or lactic acid bacteria (1% in FM; T_LAB). The data showed a high degradability of all diets (e.g., > 70% for organic matter), though without differences in nutrient degradabilities among treatments (p > 0.05). Fermentation characteristics, such as ruminal pH, short-chain fatty acid profile, and gas production were only marginally affected by the treatments. Isobutyric acid proportion was higher in T_CON than in T_AF (p = 0.01), whereas isovaleric acid proportion was lower in T_LAB than in T_RF (p = 0.01). The analysis of the bacterial community revealed similar diversity and structure across all treatments in both the liquid and solid fraction. Noteworthy, Lactobacillus was among the predominant genera in the liquid fraction, which may have derived from the mixed silages. In conclusion, mixed silages from DIG and SBP as part of a 50% concentrate diet showed high ruminal degradability, but no beneficial impact by the tested silage additives was observed. Hence, under these conditions, their application appears not justified. Our results warrant further in vivo verification, whereby it would be of interest to determine the impact of the applied silage additives in forage-based diets (e.g., > 50% silage in diet DM) in future research.

Sexual assault (SA) is unfortunately common in U.S. college campuses. Friends are central to the social context of college women, and thus to the context of SA, and thus may play a key role in SA prevention. The objective of the present study was to provide a preliminary test of a novel friend-based motivational intervention (FMI) that encourages and prepares friends to work together to reduce SA risk.

One of the most important surgical steps during thyroidectomy is the safe ligation of vessels. In fact, it is crucial to avoid postoperative bleeding and nerves' injury. The "clamp and tie" technique was first introduced in the 19th century. Since then, a lot of other techniques have been adopted to facilitate the safe ligation and sectioning of thyroidal vessels; however, one of the most relevant advances is the introduction of energy-based devices (EBDs), which occurred three decades ago.

Biological age, which reflects the physiological state of an individual, offers a better predictive value than chronological age for age-related diseases and mortality. Nonetheless, determining accurate functional features of biological age remains challenging due to the multifactorial nature of aging. Here, we established a unique mouse cohort comprising 1576 male and female outbred SWISS mice subjected or not to high-fat, high-sucrose diet to investigate multiorgan/system biological aging throughout adulthood. Comprehensive functional and biological phenotyping at ages of 6, 12, 18, and 24 months revealed notable sex-specific disparities in longitudinal locomotion patterns and multifunctional aging parameters. Topological data analysis enabled the identification of functionally similar mouse clusters irrespective of chronological age. Moreover, our study pinpointed critical functional markers of biological aging such as muscle function, anxiety characteristics, urinary patterns, reticulocyte maturation, cardiac remodeling and function, and metabolic alterations, underscoring muscle function as an early indicator of biological age in male mice.

several experimental findings and epidemiological observations indicated that aspirin/acetylsalicylic acid (ASA) may be endowed with anticancer effects against a variety of human malignancies, including thyroid carcinomas. Among these, undifferentiated/anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal human cancers, refractory to all currently available therapies. we here evaluated in a preclinical setting the effects of ASA on a panel of three ATC-derived cell lines: the CAL-62, the 8305C, and the 8505C. the data obtained demonstrated the ability of ASA to inhibit, in a dose- and time-dependent manner, the proliferation of all ATC cell lines investigated, with IC values comprised between 2.0 and 4.3 mM. Cell growth was restrained with the same efficacy when the ASA treatment was applied to three-dimensional soft-agar cultures. In addition, ASA significantly reduced migration and invasion in two of the three ATC cell lines. We finally investigated the effects of ASA on the MAPK and PI3K/Akt signaling pathways, which are often altered in ATC. The results showed that the phosphorylation status of the Akt1/2/3 kinases was significantly reduced following ASA treatment, while ERK1/2 phosphorylation was either unaffected or slightly upregulated. our findings support epidemiological evidence on the anticancer potential of ASA. On this basis, further investigations should be carried out to assess the usefulness of ASA as adjuvant therapy in patients affected by ATC.

An innovative solution that overcomes the long-standing inherently low efficiency in -heterocyclic carbene-catalyzed aerobic oxidation of aldehydes is reported. This solution included the design and synthesis of a novel polymerized catalyst and the utilization of a flow reactor. The unprecedentedly high efficiency achieved via this protocol makes it synthetically applicable. A total turnover number (TON) of 26,300 was achieved based on recycling experiments (runs). The highest TON in a single run could be up to 2475 with a turnover frequency (TOF) of 208 h, far superior to its traditional counterpart, in which a typical TON ranges from 20 to 100 with a TOF of less than 10 h. The catalyst has been recycled over 50 times and is still fully active. The success was attributed to the discovery of hidden reactivity, which was observed for the first time as an autoacceleration in the reaction rate during kinetic investigations. The research also provided concrete evidence supporting the conclusion that radical intermediates played crucial roles in the catalytic cycle by having a determinative impact on the overall reaction rate.

Increasing emissions of carbon dioxide into the atmosphere due to the use of fossil fuels and ongoing deforestation are affecting the global climate. To reach the Paris climate agreement, in the coming decades low emission technologies must be developed, which allow for carbon removal on a Gt per year-scale. In this regard, we propose the electrochemical conversion of carbon dioxide to oxalic acid as a potentially viable pathway for large scale CO utilization and storage. Combined with water oxidation, in principle this transformation does not need stoichiometric amounts of co-reagents and minimize the necessary electrons for the reduction of carbon dioxide.

Mild cognitive impairment (MCI) poses significant challenges in early diagnosis and timely intervention. Underdiagnosis, coupled with the economic and social burden of dementia, necessitates more precise detection methods. Machine learning (ML) algorithms show promise in managing complex data for MCI and dementia prediction.

The differentiation/maturation trajectories of different blood cell types stemming from a CD34 common ancestor takes place in different biologically relevant multidimensional spaces. Here, we generated microRNA and cytokine profiles from highly purified populations of hematopoietic progenitors/precursors derived from cord blood hematopoietic stem/progenitor cells. MicroRNA and cytokine landscapes were then analyzed to find their mutual relationships under the hypothesis that the highly variable miRNome corresponds to the 'force field' driving the goal of a stable phenotype (here corresponding to the cytokine abundance pattern) typical of each cell kind. The high dimensionality and lack of linearity of the hematopoietic process pushed us to adopt a distance-geometry approach to compare different trajectories, while a complex network analysis was instrumental in revealing the fine structure of microRNA-cytokine relations. Importantly, the approach enabled us to identify a limited number of factors (represented either by microRNAs or cytokines) corresponding to crucial nodes responsible for connecting distinct interaction modules. Subtle changes in 'master nodes', keeping the connections between different regulatory networks, may therefore be crucial in influencing hematopoietic differentiation. These findings highlight the extremely interconnected network structures underlying hematopoiesis regulation and identify key factors in the microRNA/cytokine landscape that may be potentially crucial for influencing network stability.

: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient's quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. : Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). : On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27-0.72 and RR 0.47, CI 0.22-0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81-3.58; and RR 1.69, CI 1.23-2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). : Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution.

One of the most important surgical steps during thyroidectomy is the safe ligation of vessels. In fact, it is crucial to avoid postoperative bleeding and nerves' injury. The "clamp and tie" technique was first introduced in the 19th century. Since then, a lot of other techniques have been adopted to facilitate the safe ligation and sectioning of thyroidal vessels; however, one of the most relevant advances is the introduction of energy-based devices (EBDs), which occurred three decades ago.

Lung cancer remains the leading cause of death among cancer patients, and the five-year survival rate is less than 25%. However, () polymorphism rs140693 predicts the prognosis of lung cancer patients still needs further verification. Primary lung cancer patients ( = 839) were collected from two hospitals, genomic DNA was extracted from blood, and genotyping was performed using SNPcan technology. Kaplan-Meier technique and multivariate Cox proportional hazards model were used to analyze the prognosis association between and clinical characteristics. Significantly conferred a poorer prognosis was associated with the CT genotype (CT vs. CC; adjusted hazard ratio [HR] = 1.21, 95% CI: 1.03-1.43,  = 0.023) and dominant CT + TT genotype (CT + TT vs. CC; HR = 1.19, 95% CI: 1.02-1.39,  = 0.029) of polymorphism rs140693 for all lung cancer patients, compared with the CC genotype. Stratified analysis showed that polymorphism rs140693 CT and dominant CT + TT genotype conferred a significantly poorer prognosis in female and lung adenocarcinoma (ADC) cancer patients, compared with the CC genotype. Non-small cell lung cancer (NSCLC) patients with the CT genotype had a poorer prognosis than those with the CC genotype. Additionally, the allele T of small cell lung cancer (SCLC) patients compared with the allele C was associated with a poor prognosis, and the CT and recessive TT genotype of SCLC patients conferred a significantly poor prognosis. The polymorphism rs140693 is a significant prognostic genetic marker for predicting the prognosis of lung cancer patients.

The improvement of phenotyping methods is necessary for large-scale screening studies of wheat ( L.) drought tolerance. The objective of our research was to find out whether it is possible to use chlorophyll (Chl) fluorescence parameters instead of biochemical indicators of drought tolerance when screening wheat. We measured shoot biomass, gas exchange, as well as biochemical and Chl fluorescence indicators in 11 wheat genotypes grown under contrasting water supplies and differing in drought tolerance. The effect of drought on the traits was evaluated using the effect of size index. We made two independent rankings: one based on biochemical indicators and the other on Chl fluorescence parameters. The positions of the three genotypes with the highest comprehensive drought tolerance index in the two independent rankings coincided completely. It is concluded that Chl fluorescence methods are suitable for identifying soft wheat genotypes that differ significantly in their ability to activate cellular defense mechanisms.