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PurposeThe study aims to determine the contributions of universal school-based educational programs to the current and future worldwide youth mental health condition.Design/methodology/approachA systematic search was conducted in accordance with the PRISMA 2020 guidelines. Academic education and health databases including ERIC, Education Database, APA PsycInfo, APA PsycArticles, Psychology Database, and PubMed were used. Characteristics and outcomes of educational interventions developed in school settings and education potential for mental health promotion were examined.FindingsUniversal school-based mental health educational programs positively affect preadolescents and adolescents. The study review provided further insight into educational programs' characteristics and identified two primary curricula foci: mental health education and development of resiliency traits and skills.Originality/valueResearch on mental health promotion using a pedagogical approach is rare as most studies focus on mental health symptomatology and psychotherapy techniques training.

Anti-BRAF/EGFR therapy was recently approved for the treatment of metastatic BRAF V600E colorectal cancer (mCRC BRAF-V600E ). However, a large fraction of patients do not respond, underscoring the need to identify molecular determinants of treatment response. Using whole-exome sequencing in a discovery cohort of patients with mCRC BRAF-V600E treated with anti-BRAF/EGFR therapy, we found that inactivating mutations in RNF43 , a negative regulator of WNT, predict improved response rates and survival outcomes in patients with microsatellite-stable (MSS) tumors. Analysis of an independent validation cohort confirmed the relevance of RNF43 mutations to predicting clinical benefit (72.7% versus 30.8%; P  = 0.03), as well as longer progression-free survival (hazard ratio (HR), 0.30; 95% confidence interval (CI), 0.12–0.75; P  = 0.01) and overall survival (HR, 0.26; 95% CI, 0.10–0.71; P  = 0.008), in patients with MSS- RNF43 mutated versus MSS- RNF43 wild-type tumors. Microsatellite-instable tumors invariably carried a wild-type-like RNF43 genotype encoding p.G659fs and presented an intermediate response profile. We found no association of RNF43 mutations with patient outcomes in a control cohort of patients with MSS-mCRC BRAF-V600E tumors not exposed to anti-BRAF targeted therapies. Overall, our findings suggest a cross-talk between the MAPK and WNT pathways that may modulate the antitumor activity of anti-BRAF/EGFR therapy and uncover predictive biomarkers to optimize the clinical management of these patients. The presence of inactivating mutations in RNF43 , a negative regulator of WNT, in tumor cells predicts improved response rates and survival outcomes in patients with metastatic BRAF V600E colorectal cancer treated with anti-BRAF/EGFR therapy.

Calculations of annual energy productions of wind farms are normally very computing demanding as they require simulations of the wind flow field inside the wind farms for a range of ambient wind conditions and directions. Although there exists many advanced computing tools for atmospheric flows, which, in principle, cope with all flow situations, most wind power developers rely their work on simplified engineering models based on analytical approaches and superposition of the flow behind a single row of wind turbines. An alternative to wake modeling is the fully developed wind farm array boundary layer model, which assumes that the wind farm is so large, that the wind field inside the wind farm is in equilibrium with the flow field of the ambient atmospheric boundary layer. Such a model was recently further developed by the authors using a simple correction for coping with finite-sized wind farms. The purpose of the present work is to extend further the finiteness correction formula and validate the model by comparing results to actual production data and to results from other simulation models, such as the Jensen, Gaussian and TurbOPark engineering models. In spite of the simplicity of the proposed model, it outperforms the other models, achieving results within 5% accuracy as compared with full-scale data from existing wind farms.

ObjectiveDescribe characteristics, treatment patterns and clinical outcomes of patients with small-cell lung cancer (SCLC).DesignRetrospective chart review study defining several cohorts: (1) limited-stage disease (LD) SCLC initiating 1L therapy (1 L LD-SCLC), (2) extensive-stage disease (ED) SCLC initiating 1L therapy (1L ED-SCLC) and (3) patients initiating 2L therapy.Setting39 physicians (medical oncologists, thoracic oncologists and/or pulmonologists) from France, Italy and the UK.ParticipantsPatients >18 years of age with a confirmed diagnosis of LD-SCLC or ED-SCLC and a full oncology medical history. Patients included initiated a 1L (2013–2015) or 2L (2013–2016) treatment (chemotherapy and/or radiotherapy—RT).Primary and secondary outcome measuresOverall survival (OS) and progression-free survival (PFS).Results231 patients in 1L LD-SCLC, 308 in 1L ED-SCLC and 225 with relapse/refractory SCLC initiating 2L treatment were included. The proportion of men was higher across all groups (56.8% to 68.5%) and mean age at time of diagnosis was 66.0 and 65.4 years in 1L LD-SCLC and 2L ED-SCLC cohorts. The majority of patients in LD-SCLC 1L group received chemotherapy with RT (76.2%). Patients initiating 2L therapy predominantly received chemotherapy alone (79.6%).Median OS in 1 L patients was 17.3 months in LD-SCLC and 8.8 months in ED-SCLC. Median PFS was 11.6 months in LD-SCLC and 6.1 months in ED-SCLC patients. Median OS in patients initiating 2L treatment was 6.6 months. OS from start of 2L treatment was lower in patients initially diagnosed with ED (5.1 months) than in patients initially diagnosed with LD (9.3 months) (p<0.0001). OS and PFS were assessed from the start of 1L or 2L therapy, depending on the cohort.ConclusionsDespite the availability of a high number of treatments and combinations, the prognosis of SCLC is still unsatisfactory, especially for those patients diagnosed with ED-SCLC, indicating high unmet need in this patient population.

BackgroundA breast cancer diagnosis is a highly stressful experience that affects patients' mental health. The study's main objective was to compare the level of anticipative anxiety and depression in patients prepared for their first dose of chemotherapy for breast cancer with virtual reality vs. a standard psychoeducational intervention.MethodsThe study was single-center, comparative, and randomized and included a group that received four sessions with virtual reality and another that received four sessions of regular psychoeducational intervention based on mindfulness.Results133 patients with a mean age of 49 SD 11.6; range 30–82) were included. Both groups showed a decrease in anxiety and depression with the Anxiety and Depression Scale, higher in the experimental group with significant differences. At three months, a more notable decrease in the Emotional Discomfort Detection Scale was observed in the experimental group, with significant differences. The fighting spirit and cognitive avoidance increased assessed with the MINI-MAC coping scale, higher in the experimental group, with significant differences in all evaluations.ConclusionA psychoeducational intervention protocol using virtual reality can improve anticipatory anxiety, depression, and emotional distress in breast cancer patients who must start chemotherapy.

This reflection paper presents a consolidated view of EFPIA on the need for principles for good practice in the generation and use of non-interventional studies (NIS), including overarching principles such as the registration of hypothesis evaluating treatment effect (HETE) studies. We first define NIS and the important adjacencies to clinical trials and relationship with real-world evidence (RWE). We then outline the principles for good practice with respect to appropriate research design, study protocol, fit-for-purpose variables and data quality, analytical methods, bias reduction, transparency in conduct and use, privacy management and ethics review. We conclude with recommendations for action for the research community to promote trust and credibility in the use of NIS.

Night shift work, exposure to light at night (ALAN) and circadian disruption may increase the risk of hormone-dependent cancers. We evaluated the association of exposure to ALAN during sleeping time with breast and prostate cancer in a population based multicase-control study (MCC-Spain), among subjects who had never worked at night. We evaluated chronotype, a characteristic that may relate to adaptation to light at night. We enrolled 1,219 breast cancer cases, 1,385 female controls, 623 prostate cancer cases, and 879 male controls from 11 Spanish regions in 2008-2013. Indoor ALAN information was obtained through questionnaires. Outdoor ALAN was analyzed using images from the International Space Station (ISS) available for Barcelona and Madrid for 2012-2013, including data of remotely sensed upward light intensity and blue light spectrum information for each geocoded longest residence of each MCC-Spain subject. Among Barcelona and Madrid participants with information on both indoor and outdoor ALAN, exposure to outdoor ALAN in the blue light spectrum was associated with breast cancer [adjusted odds ratio (OR) for highest vs. lowest tertile, OR=1.47; 95% CI: 1.00, 2.17] and prostate cancer (OR=2.05; 95% CI: 1.38, 3.03). In contrast, those exposed to the highest versus lowest intensity of outdoor ALAN were more likely to be controls than cases, particularly for prostate cancer. Compared with those who reported sleeping in total darkness, men who slept in \"quite illuminated\" bedrooms had a higher risk of prostate cancer (OR=2.79; 95% CI: 1.55, 5.04), whereas women had a slightly lower risk of breast cancer (OR=0.77; 95% CI: 0.39, 1.51). Both prostate and breast cancer were associated with high estimated exposure to outdoor ALAN in the blue-enriched light spectrum. https://doi.org/10.1289/EHP1837.

In this retrospective study, critically ill patients with community-acquired pneumonia frequently received empiric anti-methicillin-resistant Staphylococcus aureus (MRSA) and antipseudomonal antibiotics despite having few or no guidelines-endorsed risk factors. De-escalation of anti-MRSA therapy was quicker, likely aided by MRSA polymerase chain reaction assays.

Despite major advances in the treatment of metastatic colorectal cancer (mCRC), the survival rate remains very poor. This study aims at exploring the prognostic value of RAS‐mutant allele fraction (MAF) in plasma in mCRC. Forty‐seven plasma samples from 37 RAS‐mutated patients with nonresectable metastases were tested for RAS in circulating tumor DNA using BEAMing before first‐ and/or second‐line treatment. RAS MAF was correlated with several clinical parameters (number of metastatic sites, hepatic volume, carcinoembryonic antigen, CA19‐9 levels, primary site location, and treatment line) and clinical outcome [progression‐free survival (PFS) and overall survival (OS)]. An independent cohort of 32 patients from the CAPRI‐GOIM trial was assessed for clinical outcome based on plasma baseline MAF. RAS MAF analysis at baseline revealed a significant correlation with longer OS [Hazard ratios (HR) = 3.514; P = 0.00066]. Patients with lower MAF also showed a tendency to longer PFS, although not statistically significant. Multivariate analysis showed RAS MAFs as an independent prognostic factor in both OS (HR = 2.73; P = 0.006) and first‐line PFS (HR = 3.74; P = 0.049). Tumor response to treatment in patients with higher MAF was progression disease (P = 0.007). Patients with low MAFs at baseline in the CAPRI‐GOIM group also showed better OS [HR = 3.84; 95% confidence intervals (CI) 1.5–9.6; P = 0.004] and better PFS (HR = 2.5; 95% CI: 1.07–5.62; P = 0.033). This minimally invasive test may help in adding an independent factor to better estimate outcomes before initiating treatment. Further prospective studies using MAF as a stratification factor could further validate its utility in clinical practice. Therapy selection in first‐line treatment of metastatic colorectal cancer (mCRC) depends on tumor RAS mutation status. The use of liquid biopsy, with reported concordance rates between tissue and plasma of around 90%, is an emerging alternative to detect RAS mutations. Beyond mutation status, data support that RAS mutant allele fractions in plasma have independent prognostic value for mCRC survival.