A Model for Judicial Leadership: Community Responses to Juvenile Substance Abuse

Outlines the Reclaiming Futures initiative, which brings juvenile courts and systems of care together under judges' leadership in a team effort toward systemic change. Offers lessons learned, guidance, and recommendations for starting similar projects

GADA titer-related risk for organ-specific autoimmunity in LADA subjects subdivided according to gender (NIRAD study 6).

CONTEXT: Latent autoimmune diabetes in adults (LADA) includes a heterogeneous population wherein, based on glutamic acid decarboxylase antibody (GADA) titer, different subgroups of subjects can be identified. OBJECTIVE: The aim of the present study was to evaluate GADA titer-related risk for β-cell and other organ-specific autoimmunity in LADA subjects. METHODS: Adult-onset autoimmune diabetes subjects (n=236) and type 2 diabetes (T2DM) subjects (n=450) were characterized for protein tyrosine phosphatase (IA-2IC and IA-2(256-760)), zinc transporter 8 (ZnT8), thyroid peroxidase, (TPO), steroid 21-hydroxylase (21-OH), tissue transglutaminase (tTG), and antiparietal cell (APC) antibodies. RESULTS: High GADA titer compared to low GADA titer showed a significantly higher prevalence of IA-2IC, IA-2(256-760), ZnT8, TPO, and APC antibodies (P≤0.04 for all comparison). 21-OH antibodies were detected in 3.4% of high GADA titer. A significant decreasing trend was observed from high GADA to low GADA and to T2DM subjects for IA-2(256-760), ZnT8, TPO, tTG, and APC antibodies (P for trend≤0.001). TPO was the only antibody showing a different prevalence between gender; low GADA titer and T2DM female patients had a higher frequency of TPO antibody compared to males (P=0.0004 and P=0.0006, respectively), where the presence of high GADA titer conferred an odds ratio of 8.6 for TPO compared to low GADA titer. After subdividing high and low GADA titer subjects according to the number of antibodies, we observed that 73.3% of high GADA titer subjects were positive for at least one or more antibodies, compared to 38.3% of low GADA titer (P<0.0001). CONCLUSIONS: In LADA subjects, high GADA titer was associated with a profile of more severe autoimmunity and, in male gender, specifically predisposed to thyroid autoimmunity. A regular screening for other antibodies is recommended in LADA patients according to GADA titer and gender

Low-Protein Diets in Diabetic Chronic Kidney Disease (CKD) Patients: Are They Feasible and Worth the Effort?

Low-protein diets (LPDs) are often considered as contraindicated in diabetic patients, and are seldom studied. The aim of this observational study was to provide new data on this issue. It involved 149 diabetic and 300 non-diabetic patients who followed a LPD, with a personalized approach aimed at moderate protein restriction (0.6 g/day). Survival analysis was performed according to Kaplan–Meier, and multivariate analysis with Cox model. Diabetic versus non-diabetic patients were of similar age (median 70 years) and creatinine levels at the start of the diet (2.78 mg/dL vs. 2.80 mg/dL). There was higher prevalence of nephrotic proteinuria in diabetic patients (27.52% vs. 13.67%, p = 0.002) as well as comorbidity (median Charlson index 8 vs. 6 p = 0.002). Patient survival was lower in diabetic patients, but differences levelled off considering only cases with Charlson index &gt; 7, the only relevant covariate in Cox analysis. Dialysis-free survival was superimposable in the setting of good compliance (Mitch formula: 0.47 g/kg/day in both groups): about 50% of the cases remained dialysis-free 2 years after the first finding of e-GFR (estimated glomerular filtration rate) &lt; 15 mL/min, and 1 year after reaching e-GFR &lt; 10 mL/min. In patients with type 2 diabetes, higher proteinuria was associated with mortality and initiation of dialysis. In conclusion, moderately restricted LPDs allow similar results in diabetic and non non-diabetic patients with similar comorbidity

QGIS AND OPEN DATA CUBE APPLICATIONS FOR LOCAL CLIMATE ZONES ANALYSIS LEVERAGING PRISMA HYPERSPECTRAL SATELLITE DATA

Climate change poses a significant threat to humans and biodiversity, impacting various aspects of livelihoods, infrastructure, and ecosystems. Understanding climate change and its interaction with the environment is crucial for achieving Sustainable Development Goals. Local Climate Zones (LCZ) play a key role in comprehending climate change by categorizing urban areas also based on their thermal characteristics. This study presents prototype open-source software tools developed to integrate ground and satellite data for LCZ analysis in the Metropolitan City of Milan (Northern Italy). These tools consist of a QGIS plugin to access and preprocess ground-based meteorological sensor data and a client-server platform, based on the Open Data Cube and Docker technologies, for the exploitation of multispectral and hyperspectral satellite data in LCZ mapping and analysis. The tools’ architecture, data retrieval methods, and analysis capabilities are described in detail. The QGIS plugin facilitates the access and preprocessing of ground-based sensor data within the user-friendly QGIS environment. The platform enables seamless ground-sensor and satellite data management and analysis, using Jupyter Notebooks as an interface to support programmatic operations on the data. The proposed tools provide a framework for studying climate change and its local impacts on urban environments, with the potential of empowering users to effectively analyze and mitigate its effects

Reliability of programmed death ligand 1 (PD-L1) tumor proportion score (TPS) on cytological smears in advanced non-small cell lung cancer: a prospective validation study

Introduction: Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assessment is mandatory for the single agent pembrolizumab treatment of patients with advanced non-small cell lung cancer (NSCLC). PD-L1 testing has been validated and is currently certified only on formalin-fixed paraffin-embedded materials but not on cytological smears. Unfortunately, a significant proportion of patients, having only cytological material available, cannot be tested for PD-L1 and treated with pembrolizumab. In this study, we aimed to validate PD-L1 IHC on cytological smears prospectively by comparing clone SP263 staining in 150 paired histological samples and cytological smears of NSCLC patients. Methods: We prospectively enrolled 150 consecutive advanced NSCLC patients. The clone SP263 was selected as, in a previous study of our group, it showed higher accuracy compared with clones 28-8 and 22-C3, with good cyto-histological agreement using a cut-off of 50%. For cyto-histological concordance, we calculated the kappa coefficient using two different cut-offs according to the percentage of PD-L1 positive neoplastic cells (&lt;1%, 1–49% and ⩾50%; &lt;50%, ⩾50%). Results: The overall agreement between histological samples and cytological smears was moderate (kappa = 0.537). However, when the cyto-histological concordance was calculated using the cut-off of 50%, the agreement was good (kappa = 0.740). With the same cut-off, and assuming as gold-standard the results on formalin-fixed paraffin-embedded materials, PD-L1 evaluation on smears showed specificity and negative predictive values of 98.1% and 93.9%, respectively. Conclusion: Cytological smears can be used in routine clinical practice for PD-L1 assessment with a cut-off of 50%, expanding the potential pool of NSCLC patients as candidates for first-line single agent pembrolizumab therapy

Polaronic optical absorption in electron-doped and hole-doped cuprates

Polaronic features similar to those previously observed in the photoinduced spectra of cuprates have been detected in the reflectivity spectra of chemically doped parent compounds of high-critical-temperature superconductors, both $n$-type and $p$-type. In Nd$_2$CuO$_{4-y}$ these features, whose intensities depend both on doping and temperature, include local vibrational modes in the far infrared and a broad band centered at $\sim$ 1000 cm$^{-1}$. The latter band is produced by the overtones of two (or three) local modes and is well described in terms of a small-polaron model, with a binding energy of about 500 cm$^{-1}$. Most of the above infrared features are shown to survive in the metallic phase of Nd$_{2-x}$Ce$_x$Cu0$_{4-y}$, Bi$_2$Sr$_2$CuO$_6$, and YBa$_2$Cu$_3$O$_{7-y}$, where they appear as extra-Drude peaks. The occurrence of polarons is attributed to local modes strongly coupled to carriers, as shown by a comparison with tunneling results.Comment: File latex, 31 p., submitted to Physical Review B. Figures may be faxed upon reques