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A Simplified, Regional Lung Ultrasound Score for Surfactant Administration in Neonatal RDS: A Prospective Observational Study
No full textBACKGROUND: A total lung ultrasound score (tLUS) is a validated tool to describe parenchymal aeration, evaluate neonatal respiratory distress syndrome (RDS) progression and guide early surfactant replacement. tLUS derives from regional scores (rLUS) from predefined ultrasound views. RESEARCH QUESTION: This paper explores the relative contribution of rLUS to tLUS and their predictive power of surfactant need for RDS, individually and with additional variables. STUDY DESIGN AND METHODS: This was a secondary analysis of multicenter, prospective, observational study. Preterm neonates with RDS were stabilized on nCPAP. Within 2 h of life, we calculated a tLUS (range 0-18) by summing 6 rLUS (using a 0-3 scale on midclavicular, anterior and posterior axillary line views) and the oxygen saturation/inspired oxygen fraction ratio (SatO2/FiO2). The administration of surfactant by a physician masked to the ultrasound results was used as reference test. RESULTS: We enrolled 175 preterm infants. A midclavicular (MC) score ≥ 2 was an early marker of aeration heterogeneity. Prognostic accuracy for surfactant need was high for the left MC score (AUC: 0.86 with sensitivity 0.79 and specificity 0.90) and the right MC score (AUC 0.87 with sensitivity 0.74 and specificity 0.93; optimal Youden cut-off = 2). A combined left + right MC score lead to an AUC: 0.90 (sensitivity 0.82. specificity 0.89; optimal Youden cut-off = 3). A prediction model including gestational age, SatO2/FiO2 and the combined MC score had an AUC 0.95. INTERPRETATION: rLUS are not always uniformly distributed in early RDS. The combined MC score is a simplified rapid and accurate predictor of surfactant replacement (alone or in combination with noninvasive variables) reducing stressful manipulations in first hours of life for preterm neonates
Cognitive processes are robust to early environmental conditions in two lizard species
No full textAnimals must acquire new information through learning to adjust their behavior adaptively. However, learning ability can be constrained by conditions experienced during early development, when the brain is especially susceptible to environmental conditions. For example, temperature can result in phenotypically plastic adjustments to growth, metabolism, and learning in ectotherms. In vertebrates, thermal conditions can increase the production of glucocorticoid (GCs) - 'stress' hormones. Maternal GCs can be transmitted to offspring during development, potentially impacting their learning abilities. GCs and thermal environments are, therefore, predicted to have interactive effects on the development of learning in ectotherms. Here, we investigated the combined effects of prenatal corticosterone (CORT) - the main GC in reptiles-and incubation temperature on associative learning using two species of lizards, Lampropholis delicata and L. guichenoti. We manipulated CORT levels and temperature in a 2 × 2 factorial design, and then subjected juveniles to a color-associative learning task. We predicted that elevated CORT and low temperatures would impair associative learning. However, both species showed similar learning rates independently of treatment. Our results suggest that these two species may have evolved mechanisms to maintain learning performance despite prenatal challenges. We also found that color affected decision-making in both species. Overall, we observed a non-learned preference towards blue, underscoring the need to carefully select the color used in cognitive tests involving visual stimuli
Considerations in the development of an mHealth approach to increase cervical screening participation in primary care in Victoria, Australia
No full textBackground: Short message service (SMS) messages are an effective means of delivering health interventions, including promoting cancer screening. SMS offers opportunities to remind people about cervical screening and promote the self-collection option available in Australia’s National Cervical Screening Program. This research aimed to explore the acceptability of SMS reminders sent by general practices to eligible patients promoting the option of self-collection for cervical screening. Methods: We conducted a cross-sectional survey (n = 221) with women and people with a cervix, and focus group discussions (n = 5) with women aged ≥50 years (n = 7), regional/rural residents (n = 6) and bicultural health educators (n = 10) in Victoria, Australia. We examined awareness of self-collection, current receipt and acceptability of health promotion SMSs, and preferences for SMS content promoting cervical screening. Results: Most survey respondents (83%) found SMS reminders for cervical screening acceptable, stating a preference for their first name (71%) and clinic’s name (58%) to be included. Focus group participants had varying awareness of self-collection, with concerns about accuracy, sample collection and accessibility. Clear communication about clinician- and self- collection options was considered crucial. Most participants were hesitant to click embedded links. SMS acceptability may be affected by limited knowledge of self-collection, accessibility for people with disabilities, differing English or digital literacy, and privacy concerns. Conclusion: SMS messages appear to be an appropriate way to raise awareness about the choice of self-collection, but SMS may not be suitable as a population-based strategy. Leveraging general practitioner endorsement through SMS may improve participation, particularly for people who may prefer self-collection, but are unaware of this optio
Power Relations in Co-Production: The Roles of NGOs in Co-Producing Urban Greenspaces in Beijing
No full text© 2025 Luquan LiangThe co-production of urban greenspaces (UGS) is widely acknowledged as a participatory approach that enhances environmental justice and social inclusion. Although China’s planning remains top-down in structure, recent years have witnessed a growing involvement of non-governmental organizations (NGOs) in UGS planning, indicating a shift toward collaborative governance practices. However, NGOs’ involvement in co-production remains tightly regulated and constrained by the state control, which shapes NGOs’ strategies and influences the co-production outcomes. Existing urban co-production literature remains aspirational and methodological, focusing on the benefits of co-production while overlooking why many co-production initiatives fail to achieve empowerment and equity. A key gap in co-production research is its limited attention to power dynamics, particularly how power structures shape decision-making processes and outcomes.
This study addresses this gap by integrating Lukes’ three-dimensional power theory with Ostrom’s Institutional Analysis and Development (IAD) framework to examine the NGO-government power relations in the co-production of UGS in Beijing. This study analyzes six co-production cases in Beijing, including Olympic Forest Park, Wenyu River Park, Sha River Park, Honglingjin Park, Jiahui Lake Park, and Nanyuan Forestry Park. Data were mainly collected through in-depth interviews with 58 participants, including government officials, NGO staffs, urban planners, citizens, and other stakeholders who engaged in UGS co-production in Beijing, supplemented by non-participant observations, participant observations, and document analysis.
The findings reveal that the visible, hidden, and invisible power play a crucial role in shaping co-production processes and outcomes. The risk-averse government officials maintain control through resource allocation, agenda-setting, selective NGO inclusion, information control, and delayed actions. They shape public discourse, emphasizing recreational functions of UGS over ecological concerns. They reinforce the perception that government expertise is superior and frame NGOs and citizens as passive beneficiaries rather than active co-producers. Despite these constraints, NGOs managed to partially break government control by using supervisory, networking, and advocacy power to create limited decision-making space, increase transparency, and introduce ecological concerns into UGS development. Through embedded and silent strategies, NGOs achieved procedural and recognitional improvements such as increased dialogue, small gains in responsiveness, and unacknowledged influence on UGS planning and management, while failing to shift agenda-setting power or redistribute authority. These limitations stem from the government’s overarching governance framework, which confines NGO participation to non-threatening domains and restricts their ability to influence UGS governance.
By uncovering the role of power in shaping UGS co-production, this study contributes to provide new insights of understanding power relations in co-production theory. It reveals how the hidden and invisible power shape UGS co-production beyond visible power struggles in the formal decision-making arenas. Empirically, it uncovers how the governments as risk-averse officials control participation and manage narratives, while NGOs as silent influencers strategically promote procedural and recognitional justice under strong state control rather than focusing on distributive justice. By examining power inequalities in co-production, this study challenges normative and methodological perspectives, expanding the understanding of how power structures shape participation and UGS decision-making. Future research could explore governmental perspectives, conduct longitudinal studies, and incorporate social network analysis to assess NGO influence and power dynamics in UGS governance. Such work would deepen the understanding of how institutional constraints and long-term state-society relations shape the UGS co-production in China
INTERLINK-1: A Phase III, Randomized, Placebo-Controlled Study of Monalizumab plus Cetuximab in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma
No full textPURPOSE: Treatment options for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) after failure of immune checkpoint inhibitor treatment and platinum-based chemotherapy are limited. Preliminary data suggested that monalizumab plus cetuximab had clinical activity in R/M HNSCC. PATIENTS AND METHODS: INTERLINK-1 (NCT04590963) was a double-blind, phase III study. Participants with R/M HNSCC who had received immune checkpoint inhibitor therapy and progressed despite platinum-based chemotherapy were randomized 2:1 to monalizumab (750 mg, every 2 weeks) or placebo, plus cetuximab (400 mg/m2 loading dose, then 250 mg/m2, weekly). The primary endpoint was overall survival (OS) in participants with non-oropharyngeal cancer or human papillomavirus (HPV)-negative oropharyngeal cancer (HPV-unrelated analysis set). Secondary endpoints included progression-free survival and objective response rate. RESULTS: At data cutoff, 216 participants were randomized in the HPV-unrelated analysis set: 145 to monalizumab plus cetuximab and 71 to placebo plus cetuximab. Median OS was 8.8 months for monalizumab plus cetuximab versus 8.6 months for placebo plus cetuximab (HR, 1.00; 95% confidence interval, 0.66-1.54); median progression-free survival was 3.6 versus 3.8 months, respectively (HR, 1.11; 95% confidence interval, 0.79-1.57); and the objective response rate was 15.2% versus 23.9%, respectively. INTERLINK-1 was terminated after a preplanned interim analysis showed that futility criteria were met (predetermined futility HR >0.874). Grade 3/4 treatment-related adverse events were reported in 18.3% and 17.2% of participants treated in the monalizumab and placebo arms, respectively. CONCLUSIONS: Monalizumab plus cetuximab did not improve OS compared with placebo plus cetuximab. The safety profile of the combination was consistent with safety observations for cetuximab monotherapy
無: Paradox and Emptiness
No full textNothingness is a tantalizing concept. It appears in the thinking of many major philosophers—East and West—where it plays a profound role in their thinking concerning the nature of the world (that is, the beings that constitute it). However, nothingness is implicated in contradiction and paradox right from the start. It is something and, well, nothing. This essay has three themes. The first is the role of nothingness in Mahāyāna Buddhist philosophy. The second is the paradoxical nature of nothingness. The third is a mereological account of the nature of nothingness which does justice to the paradox. Though the themes are distinct, they are interconnected in important ways, as the essay will show
Identifying Human Settlements Vulnerability to Wildland-Urban Interface (WUI) Fire: A Review
No full textAbstract
The devastating impacts of Wildland-Urban Interface (WUI) fire events on residential buildings and their occupants have been recurring extreme events throughout human history. In the last 1.5 decades, the world has experienced a notable surge in the occurrence of large outdoor fires that resulted in significant impacts on the built environment. With population growth, climate change, and a lack of policy effort, there is a strong likelihood that the Wildland-Urban Interface (WUI) fire problem will worsen in the coming years. The purpose of this study is to review existing publications and literature on previous records of WUI fire events from various historical periods in countries around the world in order to identify shared physical characteristics of vulnerable features of human settlements that contribute to the loss of property and life of its occupants during a WUI fire. Previous studies regarding post-fire investigations indicate that the ways in which structures are exposed to and subsequently impacted by WUI fire may vary depending on the specific event. The review of relevant publications and literature shows that there are several physical human settlement features that are particularly vulnerable to fire, namely: roofs (eaves and gutters), timber decks, windows, and vents. Additionally, there were different strategies identified such as location and density management, consideration of appropriate building design and construction material, and management and maintenance of vegetation and other fuel sources to reduce the risk of WUI fire to human settlements. The limitation of this study lies in its reliance on existing publications, without accounting for different climatic and country variations
Direct‐to‐Angio Without Any Repeat Neuroimaging for Planned Endovascular Therapy in Patients Transferred From Remote Primary Stroke Centers: A Propensity‐Matched Study
No full textBackground
Repeat imaging when regional and remote patients with stroke arrive at a comprehensive stroke center can delay endovascular thrombectomy. We examined outcomes amongs patients transferred for endovascular therapy from nonmetropolitan primary stroke centers.
Methods
In this prospective observational study patients who were transferred from remote nonmetropolitan hospitals with large vessel occlusion were recruited between 2020–2023. The control group was defined as patients with repeat neuroimaging at the comprehensive stroke center in the radiology/emergency department. Direct‐to‐angio (direct to angiography) included patients who proceeded directly to the angiography suite without any repeat neuroimaging or routine flat panel computed tomography. Logistic regression with propensity matching was performed to assess factors associated with 3‐month independent outcome (modified Rankin scale score 0–2). A secondary analysis was performed to assess factors associated with recanalization.
Results
Between June 2020 and February 2023, 227 patients with large vessel occlusion were transferred for endovascular clot retrieval. A total of 47 (26%) patients recanalized by time of arrival and 180 had persistent large vessel occlusion. Primary stroke centers were a median distance of 185 km from the comprehensive stroke center (interquartile range 130–256). After propensity matching 138 patients remained. Characteristics between direct‐to‐angio and control groups were similar with regard to age (68 versus 66), primary stroke centers National Institutes of Health Stroke Scale score (15 versus 13), and onset to referral (200 versus 246 min). Direct‐to‐angio increased independent functional outcome at 3 months (adjusted odds ratio, 2.2 [95% CI, 1.0–4.9]; P = 0.05). Direct‐to‐angio resulted in shorter door‐to arterial puncture time (43 versus 77 min, P<0.001) and a higher likelihood of receiving endovascular therapy (100% versus 65%, P<0.001).
Conclusion
In patients who have already received telestroke review at the primary stroke centers, our results suggest a direct‐to‐angio approach is likely to result in better outcomes
Protecting Cryptographic Code Against Spectre-RSB: (and, in Fact, All Known Spectre Variants)
No full textSpectre attacks void the guarantees of constant-time cryptographic code by leaking secrets during speculative execution. Recent research shows that such code can be protected from Spectre-v1 attacks with minimal overhead, but leaves open the question of protecting against other Spectre variants. In this work, we design, validate, implement, and verify a new approach to protect cryptographic code against all known classes of Spectre attacks, in particular Spectre-RSB. Our approach combines a new value-dependent information-flow type system that ensures that no secrets leak even under speculative execution and a compiler transformation that enables it on the generated low-level code. We first prove the soundness of the type system and the correctness of the compiler transformation using the Coq proof assistant. We then implement our approach in the Jasmin framework for high-assurance cryptography and demonstrate that the overhead incurred by all Spectre protections is below 2% for most cryptographic primitives and reaches only about 5--7% for the more complex post-quantum key-encapsulationkmechanism Kyber
Effect of chitosan nanoparticle filled methylcellulose coatings on the polycyclic aromatic hydrocarbon levels of deep-fried meatballs
No full textPolycyclic aromatic hydrocarbons (PAHs) are a group of carcinogens commonly found in deep-fried food products. The potential health risks of dietary exposure to PAHs are well recognized. Recent studies have shown that PAHs can penetrate into food through oil uptake, implying potential of edible coatings to reduce oil uptake and then PAHs level. This study investigated the effect of incorporation of 0.2/0.5% chitosan nanoparticles (CSNPs, w: v) into 0.8/0.5% methylcellulose (MC, w: v) for edible coating of meatballs to reduce the PAH levels under deep-frying condition at 190 °C for 5min. The results showed that the deep-fried meatballs coated with 0.5 % MC and CSNPs had the lowest moisture loss (25.87 %), oil uptake (1.29 %), lipid oxidation (0.54 mg MDA/kg) and PAH4 levels (0.73 ng/g). The results suggested that the incorporation of CSNPs into MC edible coating could be an effective method in reducing the PAHs levels and enhancing the quality and safety of deep-fried foods. Future study would incorporate CSNP-MC coatings with antioxidants to further enhance the quality and safety of deep-fried foods and their impacts on sensory properties