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Studies of human lung development have focused on epithelial and mesenchymal cell types and function, but much less is known about the developing lung immune cells, even though the airways are a major site of mucosal immunity after birth. An unanswered question is whether tissue-resident immune cells play a role in shaping the tissue as it develops in utero. Here, we profiled human embryonic and fetal lung immune cells using scRNA-seq, smFISH, and immunohistochemistry. At the embryonic stage, we observed an early wave of innate immune cells, including innate lymphoid cells, natural killer cells, myeloid cells, and lineage progenitors. By the canalicular stage, we detected naive T lymphocytes expressing high levels of cytotoxicity genes and the presence of mature B lymphocytes, including B-1 cells. Our analysis suggests that fetal lungs provide a niche for full B cell maturation. Given the presence and diversity of immune cells during development, we also investigated their possible effect on epithelial maturation. We found that IL-1β drives epithelial progenitor exit from self-renewal and differentiation to basal cells in vitro. In vivo, IL-1β-producing myeloid cells were found throughout the lung and adjacent to epithelial tips, suggesting that immune cells may direct human lung epithelial development.

The aim of this study was to explore home-school collaboration in the areas of assessment, placement, and Individual Education Plan (IEP) development for children identified with disabilities or special educational needs (SEN) in Macao. Despite the noted benefits of parent-school partnerships from prior research, minimal research has been conducted from the perspective of parents of children with SEN to examine whether these partnerships materialize in the context of Macao. Participants included 115 parents of school-aged children diagnosed with SEN. They provided demographic information and completed a 36-item questionnaire derived from two validated instruments. The research identified a range of factors which hinder parental involvement in decision-making and in the inclusion of children with SEN in optimal ways in Macao schools. Parents indicated they were not receiving relevant information and assessment feedback from the teachers; they were minimally involved in the IEP process, and their children were not receiving one-to-one support, regardless of the type of placement. Parents also underlined issues related to the timing of assessment procedures. Parents of children attending special classes in regular schools voiced more satisfaction with support provision than parents of children following the full inclusion model. Recommendations about how services could be improved for greater parental involvement are discussed.

This study examined responses from 508 full-time teachers working in inclusive schools in Macao (SAR). The intention was to understand the teachers' perceptions about their roles and how they responded to inclusive practices in their school. Teachers' perceived levels of emotional exhaustion and cognitive work engagement were assessed in relation to several professional competencies (self-efficacy with using inclusive instruction, collaborating with parents and paraprofessionals, and managing disruptive behaviours), as well as the organisational variable of role understanding. Regression analysis showed that teachers' self-efficacy with using inclusive instruction was found to be the most powerful negative predictor of emotional exhaustion; while self-efficacy for managing disruptive behaviours was a positive predictor of teachers' cognitive work engagement. Teachers' level of understanding of their role and that of their schools was a negative predictor of emotional exhaustion and a positive predictor of cognitive work engagement. Moreover, it further confirmed that the concept of co-existence between work engagement and burnout can be applied to inclusive teachers. Results were interpreted in relation to management in inclusive schools in Macao and were followed by a discussion on the implications of enhancing inclusive education.

The human bronchial epithelium is composed of multiple distinct cell types that cooperate to defend against environmental insults. While studies have shown that smoking alters bronchial epithelial function and morphology, its precise effects on specific cell types and overall tissue composition are unclear. We used single-cell RNA sequencing to profile bronchial epithelial cells from six never and six current smokers. Unsupervised analyses led to the characterization of a set of toxin metabolism genes that localized to smoker ciliated cells, tissue remodeling associated with a loss of club cells and extensive goblet cell hyperplasia, and a previously unidentified peri-goblet epithelial subpopulation in smokers who expressed a marker of bronchial premalignant lesions. Our data demonstrate that smoke exposure drives a complex landscape of cellular alterations that may prime the human bronchial epithelium for disease.

This paper reports findings of a mixed methods study examining private school teachers' perceptions of efficacy in dealing with the challenges presented by inclusive education in Macao. This is highly pertinent after the Government invited consultation to propose changes to amendments of the Decree Law of 1996 concerning the education of students with Special Education Needs (SEN) which will likely see private schools being required to accept these students in the future. Within the context of teacher preparedness for inclusive education, the study found that a number of teachers felt that they were not at all prepared to teach students with SEN. Whilst some teachers suggested that they lacked skills and knowledge in teaching in inclusive classrooms, some felt overwhelmed with the challenges. The teachers proposed that they would need to know how to provide instructional adaptations and modifications to support students with SEN. Implications for continuous development of teacher training and education are discussed within the context of improving teacher efficacy and how private school teachers could better respond to the challenges of inclusive education in Macao.

Despite decades of literature on (de)hydration in healthy individuals, many unanswered questions remain. To outline research and policy priorities, it is fundamental to recognize the literature trends on (de)hydration and identify current research gaps, which herein we aimed to pinpoint. From a representative sample of 180 (de)hydration studies with 4350 individuals, we found that research is mainly limited to small-scale laboratory-based sample sizes, with high variability in demographics (sex, age, and level of competition); to non-ecological (highly simulated and controlled) conditions; and with a focus on recreationally active male adults (e.g., Tier 1, non-athletes). The laboratory-simulated environments are limiting factors underpinning the need to better translate scientific research into field studies. Although, consistently, dehydration is defined as the loss of 2% of body weight, the hydration status is estimated using a very heterogeneous range of parameters. Water is the most researched hydration fluid, followed by alcoholic beverages with added carbohydrates (CHO). The current research still overlooks beverages supplemented with proteins, amino acids (AA), and glycerol. Future research should invest more effort in "real-world" studies with larger and more heterogeneous cohorts, exploring the entire available spectrum of fluids while addressing hydration outcomes more harmoniously. [ABSTRACT FROM AUTHOR]

In Macao, the government has initiated a debate regarding revisions in the Decree Law in order to promote a more inclusive schooling system. In this Special Administrative Region of China, inclusive education is one of three possible types of special education that are likely be legislated in the future. The way the teachers perceive the different aspects related to inclusive education, namely the principles, concepts and law, is essential for its full implementation. The aim of this study is to understand teachers' perceptions about the proposed amendments in the consultation document for changes in the special education regime. In particular, we focus on teachers' acceptance of the recommended role of parents, the proposed placement models and expectations for teacher training. A mixed-methods approach with a survey of a sample of 500 teachers in private schools and interviews to a sub-sample of 20 provide the data. While agreeing in principle with the majority of the proposed changes in the Decree Law, there were several reservations made by the teachers, especially regarding the extent of parental choice, placement decisions and teacher training. Recommendations to continue the pathway for a more inclusive education system in Macao and for further research are made.

Objective Data on ANCA-associated vasculitis (AAV) induced by anti-thyroid drugs (ATD) are scarce. We aimed to describe the characteristics and outcome of these patients in comparison to primary AAV. Methods We performed a retrospective multicentre study including patients with ATD-induced AAV. We focused on ATD-induced microscopic polyangiitis (MPA) and compared them with primary MPA by matching each case with four controls by gender and year of diagnosis. Results Forty-five patients with ATD-induced AAV of whom 24 MPA were included. ANCA were positive in 44 patients (98%), including myeloperoxidase (MPO)-ANCA in 21 (47%), proteinase 3 (PR3)-ANCA in six (13%), and double positive MPO- and PR3-ANCA in 15 (33%). Main clinical manifestations were skin involvement (64%), arthralgia (51%) and glomerulonephritis (20%). ATD was discontinued in 98% of cases, allowing vasculitis remission in seven (16%). All the remaining patients achieved remission after glucocorticoids, in combination with rituximab in 11 (30%) or cyclophosphamide in four (11%). ATD were reintroduced in seven cases (16%) without any subsequent relapse. Compared with 96 matched primary MPA, ATD-induced MPA were younger at diagnosis (48 vs 65 years, P  < 0.001), had more frequent cutaneous involvement (54 vs 25%, P  = 0.007), but less frequent kidney (38 vs 73%, P  = 0.02), and a lower risk of relapse (adjusted HR 0.07; 95% CI 0.01, 0.65, P  = 0.019). Conclusion ATD-induced AAV were mainly MPA with MPO-ANCA, but double MPO- and PR3-ANCA positivity was frequent. The most common manifestations were skin and musculoskeletal manifestations. ATD-induced MPA were less severe and showed a lower risk of relapse than primary MPA. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the leading cause of mortality associated with diabetes, which is characterized by chronic hyperglycemia. Low-carbohydrate diet has gained popularity as an intervention in patients with type 2 diabetes mellitus, acting to improve glycemic profile and serum lipids. In its turn, exercise in hypoxia induces specific adaptations, mostly modulated via hypoxia-induced transcription factor signaling cascade, which increases with exposure to altitude, and promotes angiogenesis, glycogen supply, glucose tolerance, and raises GLUT-4 expression. Aim: Given that hyperglycemia decreases HIF-1α and it is better controlled when following a low-carbohydrate diet, this study aims to examine the hypothesis that a combination of both low-carbohydrate diet and chronic exercise in hypoxia in type 2 diabetes mellitus is associated with improved glycemic control and cardiovascular parameters, whose protocol is described. Methods: Patients with type 2 diabetes mellitus (n = 48) will be recruited and randomized into one of the three groups: (a) Control group: Control diet (low-fat and moderate-carbohydrate diet) + exercise in normoxia; (2) exercise in hypoxia group: Control diet + exercise in hypoxia; (3) intervention group: Low-carbohydrate diet (low-carbohydrate and high-fat diet) + exercise in hypoxia. Before and after 8 weeks of interventions, cardiopulmonary tests (Bruce protocol), body composition and blood pressure will be evaluated. Blood samples will be collected to measure hypoxia-induced transcription factor, C-reactive protein, glycemic and lipid profiles. Summary: This will be the first trial to examine the isolated and combined effect of chronic exercise in hypoxia and low-carbohydrate diet in type 2 diabetes mellitus. This trial will help to fill a significant research gap, guide future research and contribute to the combined nutrition and exercise approach to type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The molecular alterations that occur in cells before cancer is manifest are largely uncharted. Lung carcinoma in situ (CIS) lesions are the pre-invasive precursor to squamous cell carcinoma. Although microscopically identical, their future is in equipoise, with half progressing to invasive cancer and half regressing or remaining static. The cellular basis of this clinical observation is unknown. Here, we profile the genomic, transcriptomic, and epigenomic landscape of CIS in a unique patient cohort with longitudinally monitored pre-invasive disease. Predictive modeling identifies which lesions will progress with remarkable accuracy. We identify progression-specific methylation changes on a background of widespread heterogeneity, alongside a strong chromosomal instability signature. We observed mutations and copy number changes characteristic of cancer and chart their emergence, offering a window into early carcinogenesis. We anticipate that this new understanding of cancer precursor biology will improve early detection, reduce overtreatment, and foster preventative therapies targeting early clonal events in lung cancer. A multi-omics survey of progressive compared to regressive carcinoma in situ lesions provides a molecular map of early lung cancer development., Author(s): Vitor H. Teixeira [sup.1] , Christodoulos P. Pipinikas [sup.1] [sup.2] , Adam Pennycuick [sup.1] , Henry Lee-Six [sup.3] , Deepak Chandrasekharan [sup.1] , Jennifer Beane [sup.4] , Tiffany J. [...]

A correction is presented to the article "Eight Weeks of Intermittent Exercise in Hypoxia, With or Without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults With Type 2 Diabetes," which appeared in the 2024 issue of the magazine.