Search Results (5,520)

Background: Chordoma is a rare bone cancer with limited treatment options. Clinical trials are crucial for developing effective therapies, but their success depends on including diverse patient populations. The objective of this study was to systematically evaluate the reporting of racial, ethnic, and socioeconomic diversity in United States clinical trials exploring treatment for chordoma. Methods: A literature search was conducted through PubMed/Medline, Cochrane, Epistemonikos, and ClinicalTrials.gov databases for published US chordoma trials up until 19 August 2024. The data collected included trial characteristics and racial and ethnic data, as well as socioeconomic indicators when available. Methodological Index for Non-Randomized Studies (MINORS) and Revised Cochrane Risk-of-Bias Tool for Randomized Trials (RoB2) analyses were adopted to assess the methodological quality. The N-1 Chi-squared (χ²) test was implemented to compare the reported racial and ethnic data with the most recent US Census Bureau data. Results: Five trials involving 111 patients (median age: 63 years; 34% female) were included. Four studies (80%) were single-arm non-randomized studies with one study (25%) having a high methodological quality and three (75%) having a moderate quality based on the MINORS analysis. Most patients (91%, n = 82) were White/Caucasian, representing a proportion which was significantly higher than the reported 75% in the US population (p = 0.0005). Black/African American patients (2%, n = 2) were significantly underrepresented compared to the 14% in the US population (p = 0.0015). Regarding ethnicity, Hispanic/Latino patients (7%, n = 6) were significantly underrepresented compared to the 20% in the US population (p = 0.0021). No measures of socioeconomic status were reported. Conclusions: This systematic review highlighted the need for improved racial and ethnic diversity in chordoma trials and the better reporting of socioeconomic data. The underrepresentation of minority groups may obscure potential disparities in disease incidence, treatment access, and clinical outcomes. Full article

Financial inclusion can boost wealth, health, and quality of life. However, few studies have examined how women’s participation in community-based financial inclusion opportunities, such as village saving and loan groups (VSLGs), relates to household food security. Using program data from central Mozambique, this study examined whether low-income women’s participation in VSLGs directly increases household food availability, as well as indirectly through increased asset ownership. Employing a post-test-only comparison group quasi-experimental design, the study sampled 205 female VSLG participants and non-participants from three sub-villages in Mozambique’s Sofala province. Structural equation modeling (SEM) results indicated that low-income women’s participation in VSLGs is directly associated with a reduction in household hunger score (β = −0.21, p < 0.01), as well as indirectly associated through the mediating role of household assets ([Sobel indirect effect] = −0.06, p = 0.05). The VSLG participants showed a significant increase in household asset ownership compared to non-VSLG participants (β = 0.15, p < 0.05). Further, increased asset ownership significantly correlated with a lower probability of household hunger (β = −0.30, p < 0.01). The results suggest that community-based financial inclusion approaches could improve the availability of food through asset building among Mozambique’s low-income women. The study offers a potential strategy for policymakers and development experts to utilize community approaches to financial inclusion to improve rural and low-income women’s livelihoods. Full article

Background/Objectives: Sleep disturbances are prevalent among pediatric cancer survivors (PCSs) and their caregivers, often leading to poorer dietary choices and reduced physical activity. Additionally, the sleep quality and health behaviors of parents and children can affect each other. This study examined bi-directional associations between PCSs and their parents’ sleep quality and health-related behaviors. Methods: 127 parent–child dyads enrolled in a behavioral intervention for pediatric cancer survivors (Mage = 11.04; 53.2% female) and their families completed the Patient Sleep Quality Inventory (PSQI) and USDA Parent or Child Food and Activity Questionnaire (FAQ). Two actor–partner interdependence models, using multi-level modeling and adjusting for relevant confounds, estimated the bidirectional associations between the parent–child dyad’s sleep quality and composite food and physical activity quality. Results: After controlling for partner BMI and actor and partner age, the effect of children’s PSQI scores on parent’s FAQ scores was statistically significant (β = −0.23, p = 0.036). Poorer sleep quality in children was associated with worse physical activity and dietary behaviors in parents. Second, after adjusting for race, a significant partner effect for parents’ FAQ scores on children’s PSQI scores was shown—greater parental food and physical activity quality was associated with better sleep quality in PCS (β = −0.20, p = 0.041). Conclusions: Better food and activity quality for parents is linked to improved sleep quality for children, while children’s poor sleep quality is associated with lower food and activity quality in parents. The findings highlight the prospective value of systems-focused clinical interventions to manage sleep quality and promote positive health behaviors among PCS. Full article

Shifts in global climate patterns can alter animal behavior, including movement and space use. The southwestern United States of America is currently undergoing a period of megadrought, which can have profound consequences on small ectothermic organisms like box turtles. We radiotracked eight adult ornate box turtles (Terrapene ornata) in eastern New Mexico from September 2019 to July 2022, when the environmental conditions transitioned from a dry season with low cumulative precipitation in 2020 to high cumulative precipitation in 2021, followed by a regression to exceptional drought conditions that culminated with a high-intensity wildfire in early 2022. Turtles exhibited greater mean daily movement and were more active in 2021 in comparison to 2020 and 2022. Turtles were least active in 2022, while mean daily movement was comparative to 2020. All turtles in our study exhibited homing behavior after the wildfire, but individual responses varied. While some turtles initially moved out of the burned area and returned within a month, others remained inactive within a small portion of the burned area. The greatest movement was documented in one female turtle following the wildfire, whose home range expanded to seven times the average maximum annual home range size observed among other turtles. Overall, this is the first documentation of T. ornata response to highly altered habitat after high-severity wildfire. Full article

Very virulent plus Marek’s disease virus (vv+MDV) induces severe immunosuppression in commercial chickens. In this study, we evaluated how three Gallid alphaherpesvirus 2 (GaHV-2) vaccines (CVI-988, rMd5-BAC∆Meq, and CVI-LTR) protected against two negative outcomes of vv+MDV infection: (1) reduced viability and frequency of immune cells in the spleen and (2) decreased efficacy of the CEO (chicken embryo origin) vaccine against infectious laryngotracheitis challenge. At 25 days post-infection with vv+MDV 686, all vaccines are protected against the reduced viability of splenocytes. However, there were differences in the frequency of splenic immunophenotypes among groups. Compared to the uninfected control, the frequency of B cells was reduced in the CVI-988/686 group but not in the rMd5-BAC∆Meq/686 and CVI-LTR/686 groups. T cell subset frequencies showed no difference between the negative controls and CVI-988/686; however, there was a reduction in activated CD4+ T cells in the rMd5-BAC∆Meq/686 group and in activated CD4+, activated CD8+, and γδ+ T cells in the CVI-LTR/686 group. We also demonstrated that the three vaccines protected against MDV-induced tumors, but only rMd5-BAC∆Meq and CVI-LTR protected against the negative impact of vv+MDV 648A strain on CEO vaccine efficacy. Our findings demonstrate important differences in the biology and/or mechanisms of protection of these vaccines. Full article

This study presents new, knitted fabrics that combine woven and knitted structures to better control compression garments. This can be achieved by incorporating inlay yarns that utilize a woven configuration within knitted fabrics. As a result, this structure enhances the fabric’s functionality. Central to the research is the development and evaluation of various prototypes of arm sleeves using nylon–spandex, specifically engineered to apply the desired pressure on arms. The sleeves were knitted using different base structures including single jersey, single pique, 1 × 1 mock rib, and 2 × 2 mock rib, with and without inlays. A commercial sleeve was added as a reference. According to the protocol, the applied pressure of each sleeve was measured at three different points on the dominant arm of 12 healthy females. Stretch properties of arm sleeves were examined using an elongation tester. The thickness and weight of fabrics were evaluated as well. Also, the results of surveys—featuring four questions about the ease of motion, softness, thermal sensation, and overall comfort—were statistically analyzed. The analysis showed that the commercial and 2 × 2 mock rib sleeves were the most comfortable, creating pleasant subjective wearing sensations. The findings showed that the fabric’s tensile properties were significantly changed by the inclusion of inlay yarns in the weft and warp directions. According to survey results, 1 × 1 mock rib and 1 × 1 mock rib with inlay negatively affected subjective wearing sensations, while exerting the highest pressure on the subject’s arm. This is associated with the fabric’s compressive structure which directly contributes to the increased thickness and weight of the fabric. Full article

Technological developments have allowed helicopter airborne laser scanning (HALS) to produce high-density point clouds below the forest canopy. We present a tree stem classification method that combines linear shape detection and model-based clustering, using four discrete methods to estimate stem diameter. Stem horizontal size was estimated every 25 cm below the living crown, and a cubic spline was used to estimate where there were gaps. Individual stem diameter at breast height (DBH) was estimated for 77% of field-measured trees. The root mean square error (RMSE) of DBH estimates was 7–12 cm using stem circle fitting. Adapting the approach to use an existing stem taper model reduced the RMSE of estimates (<1 cm). In contrast, estimates that were produced from a previously existing DBH estimation method (PREV) could be achieved for 100% of stems (DBH RMSE 6 cm), but only after location-specific error was corrected. The stem classification method required comparatively little development of statistical models to provide estimates, which ultimately had a similar level of accuracy (RMSE < 1 cm) to PREV. HALS datasets can measure broad-scale forest plantations and reduce field efforts and should be considered an important tool for aiding in inventory creation and decision-making within forest management. Full article

Introduction: Patients with metastatic melanoma to the lung typically have poor outcomes. Although a pulmonary metastasectomy for selected patients has been shown to improve survival, the role of surgical resection following the introduction of immunotherapy for metastatic melanoma is unknown. The objective of this study was to determine predictors of survival for patients with melanoma metastatic to the lung in the era of immunotherapy. Methods: In this retrospective study, data from the National Cancer Database were abstracted for patients with melanoma lung metastases. The overall survival was evaluated using Kaplan–Meier and Cox proportional hazard analysis, adjusting for previously described risk factors for mortality. Patients with concomitant metastases to organs other than the lung were excluded from the study. Results: A total of 625 patients with lung metastases at the time of a skin melanoma diagnosis were identified. A total of 280 patients underwent a pulmonary metastasectomy, 267 received immunotherapy, and 78 were treated with both a metastasectomy and immunotherapy. During a median follow-up time of 34.6 months [IQR: 14.2, 75.9], a metastasectomy was found to offer significantly improved survival compared to immunotherapy alone. No difference was noted between a metastasectomy and a combination of a metastasectomy and immunotherapy in the adjusted Cox proportional hazard model. Conclusions: When statistical models were adjusted for risk factors, a metastasectomy maintained a significant survival advantage compared to immunotherapy. The addition of immunotherapy to the treatment of patients treated with a pulmonary metastasectomy did not improve survival. Our findings support the role of surgery for patients with pulmonary metastatic melanoma. Full article

Understanding influential factors for fecal contamination in groundwater is critical for ensuring water safety and public health. The objective of this study is to identify key factors for fecal contamination of shallow tubewells using machine learning methods. Three methods, including recursive feature elimination (RFE) with XGBoost, Random Forest, and mutual information, were implemented to examine E. coli presence and concentration in 1495 tubewell water samples in Matlab, Bangladesh. For E. coli presence, climatic variables, including average rainfall and temperature over the 30, 15, and 7 days preceding sampling, as well as ambient temperature and rainfall on the sampling day, emerged as critical predictors. Land cover characteristics, such as the percentages of urban and agricultural areas within 100 m of a tubewell, were also significant. For E. coli concentration, land cover characteristics within 100 m, the number of hot and heavy-rain days in the 30 days preceding sampling, average rainfall and temperature in the 3 days preceding sampling, and ambient temperature on the sampling day were identified as key drivers. Random Forest and mutual information yielded results that were more similar to each other than to those of RFE with XGBoost. The findings highlight the interplay between climatic factors, land use, and population density in determining fecal contamination in shallow well water and demonstrate the power of machine learning algorithms in ranking these factors. Full article

Middle school principals are essential to creating a successful learning environment. They should possess expertise in adolescent development, foster a diverse and equitable school community, and invest in teacher development. This review searched, organized, and analyzed the literature between 2019 and 2024 specifically regarding middle school principal preparation programs and leadership approaches. We sought to identify any alignment with the leadership and organization characteristics outlined in the Association of Middle Level Education’s The Successful Middle School: This We Believe framework The findings revealed a slight relationship between principal preparation programs and the leadership and organizational characteristics outlined by Bishop and Harrison. Our findings also revealed that many states lack specific credentialing requirements for middle school principals. To strengthen the field of middle school education, specifically principal preparation, further research will help educational leaders align their practices with middle school characteristics and advocate for the required credentials in this field. Full article

In this study, a single zirconium carbide (ZrC) nanoneedle structure oriented in the <100> direction was fabricated by a dual-beam focused ion beam (FIB-SEM) system, and its field emission characteristics and emission current stability were evaluated. Benefiting from controlled fabrication with real-time observation, the ZrC nanoneedle has a smooth surface and a tip with a radius of curvature smaller than 20 nm and a length greater than 2 μm. Due to its low work function and well-controlled morphology, the ZrC nanoneedle emitter, positioned in a high-vacuum chamber, was able to generate a single and collimated electron beam with a current of 1.2 nA at a turn-on voltage of 210 V, and the current increased to 100 nA when the applied voltage reached 325 V. After the treatment of the nanoneedle tip, the field emission exhibited a stable emission for 150 min with a fluctuation of 1.4% and an emission current density as high as 1.4 × 10¹⁰ A m⁻². This work presents an efficient and controllable method for fabricating nanostructures, and this method is applicable to the transition metal compound ZrC as a field emission emitter, demonstrating its potential as an electron source for electron-beam devices. Full article

Background: Chronic stress, characterized by sustained activation of physiological stress response systems, is a key risk factor for numerous health conditions. Allostatic load (AL), a biomarker of cumulative physiological stress, offers a quantitative measure of this burden. Lifestyle habits such as alcohol consumption and smoking, alongside environmental exposures to toxic metals like lead, cadmium, and mercury, were individually implicated in increasing AL. However, the combined impact of these lifestyle habits and environmental factors remains underexplored, particularly in populations facing co-occurring exposures. This study aims to investigate the joint effects of lifestyle habits and environmental factors on AL, using data from the NHANES 2017–2018 cycle. By employing linear regression and Bayesian Kernel Machine Regression (BKMR), we identify key predictors and explore interaction effects, providing new insights into how cumulative exposures contribute to chronic stress. Results from BKMR analysis underscore the importance of addressing combined exposures, particularly the synergistic effects of cadmium and alcohol consumption, in managing physiological stress. Methods: Descriptive statistics were calculated to summarize the dataset, and multivariate linear regression was performed to assess associations between exposures and AL. BKMR was employed to estimate exposure–response functions and posterior inclusion probabilities (PIPs), focusing on identifying key predictors of AL. Results: Descriptive analysis indicated that the mean levels of lead, cadmium, and mercury were 1.23 µg/dL, 0.49 µg/dL, and 1.37 µg/L, respectively. The mean allostatic load was 3.57. Linear regression indicated that alcohol consumption was significantly associated with increased AL (β = 0.0933; 95% CI [0.0369, 0.1497]; p = 0.001). Other exposures, including lead (β = −0.1056; 95% CI [−0.2518 to 0.0408]; p = 0.157), cadmium (β = −0.0001, 95% CI [−0.2037 to 0.2036], p = 0.999), mercury (β = −0.0149; 95% CI [−0.1175 to 0.0877]; p = 0.773), and smoking (β = 0.0129; 95% CI [−0.0086 to 0.0345]; p = 0.508), were not significant. BKMR analysis confirmed alcohol’s strong importance for AL, with a PIP of 0.9996, and highlighted a non-linear effect of cadmium (PIP = 0.7526). The interaction between alcohol and cadmium showed a stronger effect on AL at higher exposure levels. In contrast, lead, mercury, and smoking demonstrated minimal effects on AL. Conclusions: Alcohol consumption and cadmium exposure were identified as key contributors to increased allostatic load, while other exposures showed no significant associations. These findings emphasize the importance of addressing lifestyle habits and environmental factors in managing physiological stress. Full article

Strawberries (Fragaria × ananassa) are highly valued for their colorful fruit and flavorful taste. Anthocyanins provide much of the red fruit color, and the flavor is highly affected by soluble sugars and non-volatile organic acids. These fruit composition parameters impact consumer decisions. In this study, strawberry fruits from 17 commercial cultivars and advanced selections were collected weekly from replicated trials at three locations in North Carolina. The relative effects of the location and germplasm on fruit composition were determined, including the soluble solid concentration (SSC), titratable acidity (Tacid), and total anthocyanin content (TAC). The breeding criteria of at least 8.0% SSC and 0.80% Tacid were met by eight and six genotypes, respectively and five of these met both criteria. The fruit TAC ranged from 24.0 to 45.7 mg pelargonidin-3-O-glucoside (P3G) equivalents/100 g FWT. P3G was the dominant pigment in all genotypes, followed by pelargonidin-3-O-rutinoside (P3R). As harvest dates advanced, pH, TAC, P3G, P3R, and pelargonidin-3-O-(6″-malonylglucoside) (P3MG) generally decreased, while Tacid, SSC, and cyanidin-3-O-glucoside (C3G) increased. Composition of field-grown strawberries in this mid-Atlantic location were more influenced by the genotype and harvest date than by the growing location. Full article

Meta-analysis aggregates information across related studies to provide more reliable statistical inference and has been a vital tool for assessing the safety and efficacy of many high-profile pharmaceutical products. A key challenge in conducting a meta-analysis is that the number of related studies is typically small. Applying classical methods that are asymptotic in the number of studies can compromise the validity of inference, particularly when heterogeneity across studies is present. Moreover, serious adverse events are often rare and can result in one or more studies with no events in at least one study arm. Practitioners remove studies in which no events have occurred in one or both arms or apply arbitrary continuity corrections (e.g., adding one event to arms with zero events) to stabilize or define effect estimates in such settings, which can further invalidate subsequent inference. To address these significant practical issues, we introduce an exact inference method for random effects meta-analysis of a treatment effect in the two-sample setting with rare events, which we coin “XRRmeta”. In contrast to existing methods, XRRmeta provides valid inference for meta-analysis in the presence of between-study heterogeneity and when the event rates, number of studies, and/or the within-study sample sizes are small. Extensive numerical studies indicate that XRRmeta does not yield overly conservative inference. We apply our proposed method to two real-data examples using our open-source R package. Full article

Additive manufacturing (AM) has revolutionized the design and production of complex geometries by offering unprecedented creative freedom over traditional manufacturing. Despite its growing prominence, AM lacks automated and standardized design rules tailored to specific AM processes, resulting in time-consuming and expert-dependent manual verification. To address these limitations, this research introduces a novel design for additive manufacturing (DfAM) framework consisting of two complementary models designed to automate the design process. The first model, based on a decision tree algorithm, evaluates part compliance with established AM design rules. A modified J48 classifier was implemented to enhance data mining accuracy by achieving a 91.25% classification performance accuracy. This model systematically assesses whether input part characteristics meet AM processing standards, thereby providing a robust tool for verifying design rules. The second model features an AM design rule engine developed with a Python-based graphical user interface (GUI). This engine generates specific recommendations for design adjustments based on part characteristics and machine compatibility, offering a user-friendly approach for identifying potential design issues and ensuring DfAM compliance. By linking part specifications to various AM techniques, this model supports both researchers and engineers in anticipating and mitigating design flaws. Overall, this research establishes a foundation for a comprehensive DfAM expert system. Full article