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Introduction Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries’ targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence.Areas Covered During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations.Expert Opinion Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.

Retention and underrepresentation of diverse ethnic groups have been and continue to be problematic in the science, technology, engineering, and mathematics (STEM) disciplines in the United States. One foundational course that is required for all STEM majors is general chemistry. One way to increase retention and diversity in STEM majors is by targeting students' social-psychological beliefs about their academic success through the implementation of social-psychological interventions. These short impactful exercises aim to change students' thoughts, feelings, and beliefs about their academic success and affective characteristics. In this exploratory study, we designed and implemented two chemistry specific growth-mindset modules (GMMs) in two first-year chemistry courses (general chemistry 1 (GC1) and general chemistry 2 (GC2)) at a Hispanic-Serving Institution (HSI). Students worked on the GMMs asynchronously at two specific time points throughout the semester. Using a mixed-methods approach, we assessed students': (1) changes in mindset beliefs, chemistry self-efficacy (CSE), and chemistry performance, (2) perceptions towards failures and challenges, and (3) perceptions on growth-mindset modules (GMM) after participation in GMMs. Overall, GC2 students shifted towards a growth mindset and away from a fixed mindset, with small to medium effect sizes detected. No statistically significant changes in GC1 students' mindsets were detected throughout the study period. For both courses, students increased in CSE by the end of semester. Furthermore, GC1 students who participated in any portion of the GMM intervention achieved higher scores on the ACS exam compared to those who didn't participate. Additionally, students' written responses highlighted an improved attitudinal change towards failures and challenges after participating in GMMs. For both courses, over 95% of the students agreed that the GMMs were valuable, over 95% students indicated they developed more positive attitudes and perspectives towards challenges, and over 96% students believed they could learn challenging topics with effort, determination, and persistence. While these results show differences in performance, CSE, mindset scores, and attitudinal change after participation in GMMs, it is also important to acknowledge that self-selection into the study may be one of the factors for explaining such differences. Results and implications for practice are discussed.

The performance of the multi-robot wireless-based networks is investigated in this paper. Particularly, we derive the outage probability (OP) and potential throughput (PT) of the worst terminal in the closed-form expressions under two scenarios, with and without direct transmission from the centre robot to all terminal robots. The considered system is complicated since it involves many random variables (RVs) and they are correlated owing to the common link from the central robot to the relay one. To overcome such correlations, our approach is to first derive the performance of the considered metric condition on the correlated link, we then take the average over the common link. Numerical results based on the Monte-Carlo method are given to verify the accuracy of the derived framework as well as to identify the behaviors of two metrics with respect to some key parameters such as the transmit power at both central and immediate robots.

In this paper a very compact design of a dual-band band pass filter (D-BPF) using dual composite right-/left-handed (D-CRLH) and open-loop ring (OLR) resonators is presented. To overcome the frequency ratio limitations of D-CLRH resonators technique, the D-BPF design combines D-CRLH and OLR resonators to finally perform a D-BPF. The filter covers the 2.6 and 3.5 GHz spectrums for 4G and 5G applications, respectively. The reported D-BPF is designed and optimized using ADS software, and is implemented on a Rogers RO5880 substrate with a relative dielectric constant of 2.2 and thickness of 0.787 mm. The overall compact size is 8×8×0.787 mm^3. To our knowledge, this design is considered as the most compact and smallest size dual-bandpass filters.

IntroductionThe aim of this study was to evaluate the impact of the thoracic robotic approach in a high-volume center regarding procedures and clinical outcomes after 1,000 procedures.MethodsIn a single-center subset of the Epithor® database, a prospective cohort database of French thoracic surgery, we analyzed procedural characteristics and clinical outcomes from February 2014 to April 2023. A surgical technique for lung surgery was conducted with a four-arm closed chest with the port access approach and vascular sewing and knotting were preferred over stapling. Statistical analysis was performed using the Chi-2 test for discontinuous variables and the Mann–Whitney–Wilcoxon test for continuous variables. Tests were considered significant for a p-value

Abstract Viral clearance, antibody response and the mutagenic effect of molnupiravir has not been elucidated in at-risk populations. Non-hospitalised participants within 5 days of SARS-CoV-2 symptoms randomised to receive molnupiravir (n = 253) or Usual Care (n = 324) were recruited to study viral and antibody dynamics and the effect of molnupiravir on viral whole genome sequence from 1437 viral genomes. Molnupiravir accelerates viral load decline, but virus is detectable by Day 5 in most cases. At Day 14 (9 days post-treatment), molnupiravir is associated with significantly higher viral persistence and significantly lower anti-SARS-CoV-2 spike antibody titres compared to Usual Care. Serial sequencing reveals increased mutagenesis with molnupiravir treatment. Persistence of detectable viral RNA at Day 14 in the molnupiravir group is associated with higher transition mutations following treatment cessation. Viral viability at Day 14 is similar in both groups with post-molnupiravir treated samples cultured up to 9 days post cessation of treatment. The current 5-day molnupiravir course is too short. Longer courses should be tested to reduce the risk of potentially transmissible molnupiravir-mutated variants being generated. Trial registration: ISRCTN30448031

Objective To investigate (1) the UK-wide inactivated influenza vaccine (IIV) uptake in adults with inflammatory bowel disease (IBD), (2) the association between vaccination against influenza and IBD flare and (3) the effectiveness of IIV in preventing morbidity and mortality.Design Data for adults with IBD diagnosed before the 1 September 2018 were extracted from the Clinical Practice Research Datalink Gold. We calculated the proportion of people vaccinated against seasonal influenza in the 2018–2019 influenza cycle. To investigate vaccine effectiveness, we calculated the propensity score (PS) for vaccination and conducted Cox proportional hazard regression with inverse-probability treatment weighting on PS. We employed self-controlled case series analysis to investigate the association between vaccination and IBD flare.Results Data for 13 631 people with IBD (50.4% male, mean age 52.9 years) were included. Fifty percent were vaccinated during the influenza cycle, while 32.1% were vaccinated on time, that is, before the seasonal influenza virus circulated in the community. IIV was associated with reduced all-cause mortality (aHR (95% CI): 0.73 (0.55,0.97) but not hospitalisation for pneumonia (aHR (95% CI) 0.52 (0.20–1.37), including in the influenza active period (aHR (95% CI) 0.48 (0.18–1.27)). Administration of the IIV was not associated with IBD flare.Conclusion The uptake of influenza vaccine was low in people with IBD, and the majority were not vaccinated before influenza virus circulated in the community. Vaccination with the IIV was not associated with IBD flare. These findings add to the evidence to promote vaccination against influenza in people with IBD.

Amino acid restriction induces cellular stress and cells often respond via the induction of autophagy. Autophagy or ‘self-eating’ enables the recycling of proteins and provides the essential amino acids needed for cell survival. Of the naturally occurring amino acids, methionine restriction has pleiotropic effects on cells because methionine also contributes to the intracellular methyl pools required for epigenetic controls as well as polyamine biosynthesis. In this report, we describe the chemical synthesis of four diastereomers of a methionine depletion agent and demonstrate how controlled methionine efflux from cells significantly reduces intracellular methionine, S-adenosylmethionine (SAM), S-adenosyl homocysteine (SAH), and polyamine levels. We also demonstrate that human pancreatic cancer cells respond via a lipid signaling pathway to induce autophagy. The methionine depletion agent causes the large amino acid transporter 1 (LAT1) to preferentially work in reverse and export the cell’s methionine (and leucine) stores. The four diastereomers of the lead methionine/leucine depletion agent were synthesized and evaluated for their ability to (a) efflux 3H-leucine from cells, (b) dock to LAT1 in silico, (c) modulate intracellular SAM, SAH, and phosphatidylethanolamine (PE) pools, and (d) induce the formation of the autophagy-associated LC3-II marker. The ability to modulate the intracellular concentration of methionine regardless of exogenous methionine supply provides new molecular tools to better understand cancer response pathways. This information can then be used to design improved therapeutics that target downstream methionine-dependent processes like polyamines.

The 1RXS J034231.8+121622 system consists of an M dwarf primary and a directly imaged low-mass stellar companion. We use high-resolution spectroscopic data from Keck/KPIC to estimate the objects' atmospheric parameters and radial velocities (RVs). Using PHOENIX stellar models, we find that the primary has a temperature of 3460 ± 50 K and a metallicity of 0.16 ± 0.04, while the secondary has a temperature of 2510 ± 50 K and a metallicity of ${0.13}_{-0.11}^{+0.12}$ . Recent work suggests this system is associated with the Hyades, giving it an older age than previous estimates. Both metallicities agree with current Hyades [Fe/H] measurements (0.11–0.21). Using stellar evolutionary models, we obtain significantly higher masses for the objects, 0.30 ± 0.15 M _⊙ and 0.08 ± 0.01 M _⊙ (84 ± 11 M _Jup ), respectively. Using the RVs and a new astrometry point from Keck/NIRC2, we find that the system is likely an edge-on, moderately eccentric ( ${0.41}_{-0.08}^{+0.27}$ ) configuration. We also estimate the C/O ratio of both objects using custom grid models, obtaining 0.42 ± 0.10 (primary) and 0.55 ± 0.10 (companion). From these results, we confirm that this system most likely went through a binary star formation process in the Hyades. The significant changes in this system's parameters since its discovery highlight the importance of high-resolution spectroscopy for both orbital and atmospheric characterization of directly imaged companions.