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Objective. Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. Methods. On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Results. Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69 to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; [I.sup.2] = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Conclusion. Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. Impact. This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia. Keywords: Pain, Pelvic Floor Pain, Physical Agent Modalities, Physical Therapy, Vulvodynia, Introduction Vulvodynia is a chronic clinical condition of unknown etiology characterized by vulvar pain for at least 3 months without other dermatological or gynecological disorders according to the International Society [...]

Une femme de 28 ans enceinte de 35 semaines et 5 jours s'est presentee a l'unite de triage en obstetrique en raison d'une diminution aigue des mouvements fetaux dans les [...]

A 28-year-old woman presented to the obstetric triage unit at 35 + 5 weeks' gestation with an acute decrease in fetal movements during the previous 12-hour period. A previous pregnancy [...]

Of Jade and Dragons. By Amber Chen. June 2024. 480p. Viking, $20.99 (9780593622759); paper, $11.50 (9780593692905). Gr. 7-12. Aihui Ying jumps off of cliffs and turns fans into weapons in [...]

Immortal Dark. By Tigest Girma. Sept. 2024. 432p. Little, Brown, $19.99 (9780316570381); paper, $11.99 (9780316570398). Gr. 10-12. Following the disappearance of her sister, Kidan is hurtling through life with the [...]

The Dividing Sky. By Jill Tew. Oct. 2024. 352P. Random/Joy Revolution, $19.99 (9780593710357). Gr. 8-12. LifeCorp: buying out entire nations to bring vigorously applied capitalism to people everywhere. Adrian, abandoned [...]

Medici Heist. By Caitlin Schneiderhan. Aug. 2024. 432P. Feiwel and Friends, $20.99 (9781250907189). Gr. 9-12. Revenge is a dish best shared with good company, and it also helps to have [...]

* The Dark We Know. By Wen-yi Lee. Aug. 2024. 336p. Zando/Gillian Flynn, $19.99 (9781638930587); e-book, $10.99 (9781638930501). Gr. 9-12. The mountain sings, and children die. Isadora Chang has always [...]

The Great Cool Ranch Dorito in the Sky. By Josh Galarza. July 2024. 320p. Holt, $19.99 (9781250907714). Gr. 10-12. Brett copes with his adoptive mother's terminal cancer by hiding his [...]

Cursed Boys and Broken Hearts By Adam Sass. July 2024. 352p. Viking, $19.99 (9780593464816); paper, $12 (9780593692912). Gr. 9-12. As a heartbroken, closeted 13-year-old, Grant Rossi wished his romantic woes [...]

Queerceanera. By Alex Crespo. May 2024. 304p. HarperTeen, $19.99 (9780063257405). Gr. 9-12. Queerceanera (noun): a coming-of-age party for a young queer person, irrespective of gender (according to the Zoida family). [...]

Liar's Test. By Ambelin Kwaymullina. May 2024. 272p. Knopf, $19.99 (9780593571781). Gr. 7-12. A captive within the temple of the colonizers' sun god, Treesinger Bell Silverleaf believes that her ability […]

Dead Girls Talking. By Megan Cooley Peterson. June 2024. 288p. Holiday, $19.99 (9780823457014); e-book, $11.99 (9780823459186). Gr. 9-12. When she trips over a dead body in the woods on her [...]

To the Editor PFAS is an emerging contaminant, so I read with interest the article 'PFAS Contamination and Residential Property Values' (Winter 2022, 26-50) by Orell C. Anderson, MAI, Chris [...]

High-efficacy disease-modifying therapies have been proven to slow disability accrual in adults with relapsing–remitting multiple sclerosis. However, their impact on disability worsening in paediatric-onset multiple sclerosis, particularly during the early phases, is not well understood. We evaluated how high-efficacy therapies influence transitions across five disability states, ranging from minimal disability to gait impairment and secondary progressive multiple sclerosis, in people with paediatric-onset multiple sclerosis.

* GONG, Chloe. Foul Heart Huntsman. 560p. (Foul Lady Fortune: Bk. 2). S. & S./ McElderry. Sept. 2023. Tr $21.99. ISBN 9781665905619. Gr 9 Up--Following the devastating standoff at the [...]

Background: - Alcohol-induced pro-inflammatory activation might influence cellular and synaptic pathology, thus contributing to the behavioral phenotypes associated with alcohol use disorders. In the present study, the possible anti-inflammatory properties of N-[(4-trifluoromethyl)-benzyl]4-methoxybutyramide (GET73), a promising therapeutic agent for alcohol use disorder treatment, were evaluated in primary cultures of rat cortical microglia. Methods: - Primary cultures of cerebral cortex microglial cells were treated with 100 ng/ml lipopolysaccharide (LPS; 8 h, 37 °C) or 75 mM ethanol (EtOH; 4 days, 37 °C) alone or in the presence of GET73 (1–30 µM). At the end of the incubation period, multiparametric quantification of cytokines/chemokines was performed by using the xMAP technology and Luminex platform. Furthermore, cultured microglial cell viability following the treatment with EtOH and GET73, alone or in combination, has been measured by a colorimetric assay (i.e. MTT assay). Results: - GET73 (10 and 30 µM) partially or fully prevented the LPS-induced increase of IL-6, IL-1β, RANTES/CCL5 protein and MCP-1/CCL2 levels. On the contrary, GET73 failed to attenuate the TNF-α level increase induced by LPS. Furthermore, GET73 treatment (10–30 µM) significantly attenuated or prevented the EtOH-induced increase of TNF-α, IL-6, IL-1β and MCP-1/CCL2 levels. Finally, at all the concentrations tested (1–30 µM), the GET73 treatment did not alter the EtOH-induced reduction of microglial cell viability. Conclusions: - The current results provide the first in vitro evidence of GET73 protective properties against EtOH-induced neuroinflammation. These data add more information on the complex and multifactorial profile of action of the compound, further supporting the significance of developing GET73 as a therapeutic tool for the treatment of individuals with alcohol use disorders.

Introduction: It is unclear which patients with non-traumatic (spontaneous) intracerebral haemorrhage (ICH) are at risk of developing acute symptomatic seizures (provoked seizures occurring within the first week after stroke onset; early seizures, ES) and whether ES predispose to the occurrence of remote symptomatic seizures (unprovoked seizures occurring more than 1 week after stroke; post-stroke epilepsy, PSE) and long-term mortality.Patients and Methods: In the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) we examined the risk of ES and whether they predict the occurrence of PSE and all-cause mortality in a cohort of patients with first-ever spontaneous ICH and no previous history of epilepsy, consecutively hospitalized in 12 Italian neurological centers from 2002 to 2014.Results: Among 2570 patients (mean age, 73.4 ± 12.5 years; males, 55.4%) 228 (8.9%) had acute ES (183 (7.1%) short seizures and 45 (1.8%) status epilepticus (SE)). Lobar location of the hematoma (OR, 1.49; 95% CI, 1.06–2.08) was independently associated with the occurrence of ES. Of the 2,037 patients who were followed-up (median follow-up time, 68.0 months (25th–75th percentile, 77.0)), 155 (7.6%) developed PSE. ES (aHR, 2.34; 95% CI, 1.42–3.85), especially when presenting as short seizures (aHR, 2.35; 95% CI, 1.38–4.00) were associated to PSE occurrence. Unlike short seizures, SE was an independent predictor of all-cause mortality (aHR, 1.50; 95% CI, 1.005–2.26).Discussion and Conclusion: The long-term risk of PSE and death after an ICH vary according to ES subtype. This might have implications for the design of future clinical trials targeting post-ICH epileptic seizures.

We demonstrate a design for a high-performance $2 \times 2$ splitter meeting the essential requirements of broadband coupling, support for arbitrary coupling ratio, ultra low-loss, high fabrication tolerance, and a compact footprint. This is achieved based on a rigorous coupled mode theory analysis of the broadband response of the bent directional coupler (DC) and by demonstrating a full coupling model, with measured broadband values of 0.4, 0.5, 0.6, and 0.7. As a benchmark, we demonstrate a 0.5:0.5 splitter that significantly reduces coupling variation from 0.391 in the traditional DC to just 0.051 over an 80 nm wavelength span. This represents a remarkable 7.67 times reduction in coupling variation. Further, newly-invented low-loss bends were used in the proposed design leading to an ultra low-loss design with negligible excess loss ($\mathrm{0.003 \pm 0.013 \ dB}$). The proposed 0.5:0.5 silicon strip waveguide-based design is tolerant and shows consistently low coupling variation over a full 300 mm wafer showcasing a maximum cross coupling variation of 0.112 over 80 nm wavelength range, at the extreme edge of the wafer. Futhermore, we augmented the wafer mapping with a waveguide width fabrication tolerance study, confirming the tolerance of the device with a mere 0.061 maximum coupling variation with a waveguide width deviation of $\pm 20$ nm over 80 nm wavelength range. These specs make the proposed splitter an attractive component for practical applications with mass production.

Background: Elevated brain levels of kynurenic acid (KYNA), a metabolite in the kynurenine pathway, are associated with cognitive dysfunctions, which are nowadays often considered as fundamental characteristics of several psychopathologies; however, the role of KYNA in mental illnesses, such as schizophrenia, is not fully elucidated. This study aimed to assess KYNA levels in the prefrontal cortex (PFC) of rats prenatally treated with methylazoxymethanol (MAM) acetate, i.e., a well-validated neurodevelopmental animal model of schizophrenia. The effects of an early pharmacological modulation of the endogenous cannabinoid system were also evaluated. Methods: Pregnant Sprague-Dawley rats were treated with MAM (22 mg/kg, ip) or its vehicle at gestational day 17. Male offspring were treated with the cannabinoid CB1 receptor antagonist/inverse agonist AM251 (0.5 mg/kg/day, ip) or with the typical antipsychotic haloperidol (0.6 mg/kg/day, ip) from postnatal day (PND) 19 to PND39. The locomotor activity and cognitive performance were assessed in the novel object recognition test and the open field test in adulthood. KYNA levels in the PFC of prenatally MAM-treated rats were also assessed. Results: A significant cognitive impairment was observed in prenatally MAM-treated rats (p< 0.01), which was associated with enhanced PFC KYNA levels (p< 0.05). The peripubertal AM251, but not haloperidol, treatment ameliorated the cognitive deficit (p< 0.05), by normalizing the PFC KYNA content in MAM rats. Conclusions: The present findings suggest that the cognitive deficit observed in MAM rats may be related to enhanced PFC KYNA levels which could be, in turn, mediated by the activation of cannabinoid CB1 receptor. These results further support the modulation of brain KYNA levels as a potential therapeutic strategy to ameliorate the cognitive dysfunctions in schizophrenia.

In this article, we present a feedback approach to the design of an attack mitigation policy for directed acyclic graph (DAG)-based distributed ledgers. We develop a model to analyze the behavior of the ledger under the so-called Tips Inflation Attack, which endangers the liveness of transactions, and we design a control strategy to counteract this attack strategy. The efficacy of this approach is showcased through a theoretical analysis, in the form of two theorems about the stability properties of the ledger with and without the controller, and extensive Monte Carlo simulations of an agent-based model of the distributed ledger.

* LE, Vanessa. The Last Bloodcarver. 384p. (The Last Bloodcarver Duology: Bk. 1). Roaring Brook. Mar. 2024. Tr $19.99. ISBN 9781250881526. Gr 7 Up--As the last practitioner of the Yarongese [...]

The development of new anticounterfeiting solutions is a constant challenge and involves several research fields. Much interest is currently devoted to systems that are impossible to clone, based on the physical unclonable function (PUF) paradigm. In this work, a new strategy based on electrospinning and electrospraying of dye-doped polymeric materials is presented for the manufacturing of flexible free-standing films that embed simultaneously different PUF keys. The proposed films can be used to fabricate novel anticounterfeiting labels having three encryption levels: (i) a map of fluorescent polymer droplets, with random positions on a dense yarn of polymer nanofibers, (ii) a characteristic fluorescence spectrum for each label, and (iii) the unique speckle patterns that every label produces when illuminated with coherent laser light shaped in different wavefronts. The intrinsic uniqueness introduced by the manufacturing process encodes enough complexity into the optical anticounterfeiting tag to generate thousands of cryptographic keys. The simple and cheap fabrication process as well as multilevel authentication makes such colored polymeric unclonable tags a practical solution in the secure protection of goods in our daily life.

Accurate knowledge of right ventricular (RV) volumes and ejection fraction is fundamental to providing optimal care for pediatric patients with congenital and acquired heart disease, as well as pulmonary hypertension. Traditionally, these volumes have been measured using cardiac magnetic resonance because of its accuracy, reproducibility, and freedom from geometric assumptions. More recently, an increasing number of studies have described the measurement of RV volumes using three-dimensional (3D) echocardiography. In addition, volumes by 3D echocardiography have also been used for outcome research studies in congenital heart surgery. Importantly, 3D echocardiographic acquisitions can be obtained over a small number of cardiac cycles, do not require general anesthesia, and are less costly than CMR. The ease and safety of the 3D echocardiographic acquisitions allow serial studies in the same patient. Moreover, the studies can be performed in various locations, including the intensive care unit, catheterization laboratory, and general clinic. Because of these advantages, 3D echocardiography is ideal for serial evaluation of the same patient. Despite these potential advantages, 3D echocardiography has not become a standard practice in children with congenital and acquired heart conditions. In this report, the authors review the literature on the feasibility, reproducibility, and accuracy of 3D echocardiography in pediatric patients. In addition, the authors investigate the advantages and limitations of 3D echocardiography in RV quantification and offer a pathway for its potential to become a standard practice in the assessment, planning, and follow-up of congenital and acquired heart disease.

•Most (93%) of the females studied had very low levels of AMH at 1 to 2 years post-HCT.•Females undergoing RIC-HCT are more likely to have detectable AMH levels at 1 to 2 years post-HCT.•In males, total body irradiation dose ≥600 cGy is associated with the risk of gonadal failure at 1 to 2 years post-HCT.•For both males and females, older age at HCT was associated with increased risk of gonadal failure.

This Digest discusses engagement in alternative preparation to acquire a license to teach in U.S. public schools. Prospective teachers seek alternative programs for many reasons, including job change due to forced retirement or lack of interest; desire to contribute to society's wellbeing; and desire to use teaching skills learned elsewhere. Recent educational debate has centered on teacher knowledge. Education degree programs from the 1950s-1980s were deficient in content knowledge. However, alternative licensing candidates usually acquire knowledge of a particular area while studying for their bachelor's degree, and they have broad general content knowledge from core college programs. Alternative licensing requires successful completion of certain tests. The most widely used series in the United States is the PRAXIS. Because of increased demand for qualified teachers and lack of traditional bachelor's degree candidates, many teacher education institutions have modified traditional program offerings. A 1996 listing shows 328 alternative programs in 47 states, the District of Columbia, and two territories. Most teachers seek employment near where they reside, though moving to find employment has been simplified by the Interstate Contract, a mutual agreement by 38 states and the District of Columbia to recognize each other's licenses. Alternative preparation is closely watched by teacher education institutions, state departments of education, and educational researchers to examine whether it contributes to improving educational quality or further masks problems related to teacher quality. Overall, data present a mixed picture about the value of alternative paths. (Contains 25 references.) (SM)

While its name changed from the Signal Center of Excellence to the Cyber Center of Excellence (CCoE), the Signal Corps continues to remain both the heart and backbone of Fort [...]

This article aims to determine how quality of life (QoL) is defined and assessed in cases of severe craniofacial anomalies, as well as the impact such considerations may have on the treatment of a neonate with these conditions with respect to palliative neonatal care. Our literature review found insufficient evidence to suggest that craniofacial anomalies result in consistently poor QoL. Based on these findings and in line with the current acceptable standards for the ethical care of neonates, with the exception of rare cases, resuscitative efforts should always be performed on patients with isolated craniofacial anomalies, as demonstrated in the management of this reported patient.

The paper presents "The Big Game", a free training and gaming initiative on cybersecurity, digital awareness, and safe use of the Net and social networks, aimed at young people, carried out by the Cybersecurity National Lab of CINI (National Interuniversity Consortium for Informatics), under the sponsorship of the National Cybersecurity Agency - ACN. More than 30 thousand students have been involved so far, thanks also to the development of a network of high schools, which support these activities by accompanying their students in the different organized programs. [ABSTRACT FROM AUTHOR]

Graphical abstract: Left: Correlation of CEC and elemental analysis obtained from willow biochars produced at different pyrolysis temperatures. Right: Scanning electron micrographs at the same magnification (1 kX) of willow derived biochar at different pyrolysis temperatures (panel 1: 400 °C, panel 2: 550 °C and panel 3: 650 °C).

ATR is a key kinase in the DNA-damage response (DDR) that is synthetic lethal with several other DDR proteins, making it an attractive target for the treatment of genetically selected solid tumors. Herein we describe the discovery of a novel ATR inhibitor guided by a pharmacophore model to position a key hydrogen bond. Optimization was driven by potency and selectivity over the related kinase mTOR, resulting in the identification of camonsertib (RP-3500) with high potency and excellent ADME properties. Preclinical evaluation focused on the impact of camonsertib on myelosuppression, and an exploration of intermittent dosing schedules to allow recovery of the erythroid compartment and mitigate anemia. Camonsertib is currently undergoing clinical evaluation both as a single agent and in combination with talazoparib, olaparib, niraparib, lunresertib, or gemcitabine (NCT04497116, NCT04972110, NCT04855656). A preliminary recommended phase 2 dose for monotherapy was identified as 160 mg QD given 3 days/week.