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Precision-based percutaneous coronary intervention (PCI) integrates contemporary strategies across the pre-, intra-, and post-procedural phases to improve outcomes and minimize complications. Emerging evidence underscores the value of these strategies in reducing adverse events and improving procedural efficiency. While artificial intelligence and pharmacogenomics hold long-term promise for enhancing personalization, their clinical utility in PCI remains in the early stages of development.

The use of online platforms for pediatric healthcare research is timely, given the current pandemic. These platforms facilitate trial efficiency integration including electronic consent, randomization, collection of patient/family survey data, delivery of an intervention, and basic data analysis. We created an online digital platform for a multicenter study that delivered an intervention for sleep disorders to parents of children with autism spectrum disorder (ASD). An advisory parent group provided input. Participants were randomized to receive either a sleep education pamphlet only or the sleep education pamphlet plus three quick-tips sheets and two videos that reinforced the material in the pamphlet (multimedia materials). Three measures - Family Inventory of Sleep Habits (FISH), Children's Sleep Habits Questionnaire modified for ASD (CSHQ-ASD), and Parenting Sense of Competence (PSOC) - were completed before and after 12 weeks of sleep education. Enrollment exceeded recruitment goals. Trial efficiency was improved, especially in data entry and automatic notification of participants related to survey completion. Most families commented favorably on the study. While study measures did not improve with treatment in either group (pamphlet or multimedia materials), parents reporting an improvement of ≥3 points in the FISH score showed a significantly improved change in the total CSHQ ( = 0.038). Our study demonstrates the feasibility of using online research delivery platforms to support studies in ASD, and more broadly, pediatric clinical and translational research. Online platforms may increase participant inclusion in enrollment and increase convenience and safety for participants and study personnel.

Peer nominations and teacher ratings were used to examine age and sex differences in behaviors associated with perceived coolness during middle childhood. Participants were 470 students in Grades 1, 3, and 5. Participants nominated peers whom they perceived as cool; separate scores were calculated for samesex coolness and cross-sex coolness (i.e., cool nominations received from samesex and cross-sex classmates, respectively). Teachers reported on children's prosocial and aggressive behavior. Behavior–coolness associations differed by (a) sex of the target child, (b) age of the target child, and (c) sex of the perceiving child. Most notably, aggressive behavior positively predicted cross-sex coolness for girls (not boys) and for students in Grades 3 and 5 (not Grade 1). Results underscore the value of disaggregating peer nominations by sex. Discussion builds upon the literature on perceived coolness and popularity, which has drawn disproportionately from adolescent samples.

This study examined whether ethnic segregation is concurrently (fall) and prospectively (fall to spring) associated with social status among 4th- and 5th-grade African American and European American children (n = 713, ages 9–11 years). Segregation measures were (a) same-ethnicity favoritism in peer affiliations and (b) cross-ethnicity dislike. Social status measures were same- and cross-ethnicity peer nominations of acceptance, rejection, and cool. Among African Americans, fall segregation predicted declines in cross-ethnicity (European American) acceptance and same-ethnicity rejection, and increases in same-ethnicity acceptance and perceived coolness. For European American children, fall segregation predicted declines in cross-ethnicity (African American) acceptance and increases in cross-ethnicity rejection. Results indicate that segregation induces asymmetric changes in social status for African American and European American children.

Person-centered analyses of achievement goals have been scarce in studies of elementary school children. In this investigation, the authors examined the natural combinations of achievement goals (mastery, performance-approach, performance-avoidance) among 3rd grade students (N = 195) and how clusters differed in self-, teacher-, and peer-reported adjustment variables. Cluster analysis revealed four groups of students: mastery (above average in mastery goals, below average in performance-approach and performance-avoidance goals), multi-goal (above average in all three goals), avoidant (above average in performance-avoidance goals, below average in mastery and performance-approach goals), and low motivation (below average in all three goals). Clusters differed in self-reported academic self-efficacy and perceptions of teacher support, teacher-reported academic competence, and peer nominations of social status. Mastery students had the most adaptive profiles; low motivation, the least adaptive. Avoidant boys had more maladaptive profiles than avoidant girls.

This longitudinal study inquired into African American (n = 402) and European American (n = 311) children’s patterns of peer group segregation, cross-ethnicity dislike, and social status in 4th and 5th grade classrooms. Primary study questions asked whether ethnic segregation is concurrently (i.e., Fall) and/or prospectively (i.e., Fall to Spring) associated with social preference and perceived popularity as viewed by same- and cross-ethnicity classmates. African Americans, as compared to European Americans, had more segregated peer groups yet evidenced less cross-ethnicity dislike. Compelling evidence indicated that (a) segregation has social costs and social benefits for both ethnic groups and (b) segregation is a mechanism for change in social status. In the Fall, African American children’s segregation was positively associated with same-ethnicity social preference and perceived popularity and with cross-ethnicity perceived popularity, but was negatively associated with cross-ethnicity social preference; European American children’s segregation was positively associated with same-ethnicity social preference but was negatively associated with cross-ethnicity social preference and perceived popularity. Moreover, for African American children, Fall segregation predicted increases in same-ethnicity social preference and perceived popularity and in cross-ethnicity perceived popularity, but predicted declines in cross-ethnicity social preference. For European American children, Fall segregation predicted declines in cross-ethnicity social preference, but was unrelated to changes in other status constructs. Discussion elaborates on processes of intergroup relations and the complexities of fostering positive cross-ethnicity relationships in elementary classrooms.

Vaccines are indispensable for the control and prevention of influenza, but there are several challenges to efficacy. Some individuals respond poorly to vaccination, and virus variation makes targeting optimal antigens difficult. Broadly neutralizing antibodies are one solution, but they have their own pitfalls, including limited cross-reactivity to both influenza A and B strains and the need for repeated injections. Now, Laursen et al. have developed multidomain antibodies with breadth and potency. Administered intranasally to mice with an adeno-associated virus vector, the antibodies provided durable and continuous protection from a panoply of influenza strains. Science , this issue p. 598 Llama nanobodies can be used to generate comprehensive and long-lasting flu protection. Broadly neutralizing antibodies against highly variable pathogens have stimulated the design of vaccines and therapeutics. We report the use of diverse camelid single-domain antibodies to influenza virus hemagglutinin to generate multidomain antibodies with impressive breadth and potency. Multidomain antibody MD3606 protects mice against influenza A and B infection when administered intravenously or expressed locally from a recombinant adeno-associated virus vector. Crystal and single-particle electron microscopy structures of these antibodies with hemagglutinins from influenza A and B viruses reveal binding to highly conserved epitopes. Collectively, our findings demonstrate that multidomain antibodies targeting multiple epitopes exhibit enhanced virus cross-reactivity and potency. In combination with adeno-associated virus–mediated gene delivery, they may provide an effective strategy to prevent infection with influenza virus and other highly variable pathogens.

The capability of electronic cigarette devices (e-cigs) to deliver nicotine is key to their potential to replace combustible cigarettes. We compared nicotine delivery and subjective effects associated with the use of two classes of e-cigarettes and cigarettes. 14 e-cigarette users were instructed to vape their own e-cigarette device every 20 seconds for 10 minutes while blood was drawn at 1, 2, 4, 6, 8, 10,12, and 15 minutes after initiating vaping. Users rated withdrawal symptoms and side effects before and after vaping. E-cigarette devices were classified as first-generation (same size as cigarette, no activation button) or advanced (larger than cigarette with an activation button). Separately, 10 cigarette smokers completed a similar protocol. Fisher's Exact Test and two-sided t-tests were used as appropriate to determine differences in outcomes between first-generation e-cigarette users, advanced e-cigarette users, and smokers. Compared to first-generation devices, advanced devices were associated with greater serum nicotine Cmax (ng/ml) (11.5 v. 2.8, p = 0.0231) and greater nicotine boost (ng/ml) (10.8 v. 1.8, p = 0.0177). Overall, e-cigarettes users experienced a significant reduction in withdrawal and craving, although there were no significant differences between users of first-generation and advanced devices. Comparing e-cigarettes overall to cigarettes, cigarettes were associated with greater Cmax (25.9 v. 9.0, p = 0.0043) and greater nicotine boost (21.0 v. 8.2, p = 0.0128). Advanced e-cigarettes delivered significantly more nicotine than first-generation devices but less than combustible cigarettes. Overall, e-cigarette use was associated with a reduction in withdrawal and craving with no reported side effects. The wide variation in nicotine absorption from different e-cigarette devices should be considered in studies of e-cigarettes for smoking cessation.

Acute severe ulcerative colitis (ASC) is a potentially life-threatening disease. We aimed to formulate guidelines for managing ASC in children based on systematic review of the literature and robust consensus process. This manuscript is a product of a joint effort of the ECCO (European Crohn's and Colitis Organization), the Pediatric Porto Inflammatory Bowel Disease (IBD) Working group of ESPGHAN (European Society of Pediatric Gastroenterology, Hepatology, and Nutrition) and ESPGHAN. A group of 19 experts in pediatric IBD participated in an iterative consensus process including two face-to-face meetings. A total of 17 predefined questions were addressed by working subgroups based on a systematic review of the literature. The recommendations and practice points were eventually endorsed with a consensus rate of at least 95% regarding: definitions, initial evaluation, standard therapy, timing of second-line therapy, the role of endoscopic evaluation and heparin prophylaxis, how to administer second-line medical therapy, how to assess response, surgical considerations, and discharge recommendations. A management flowchart is presented based on daily scoring of the Pediatric Ulcerative Colitis Activity Index (PUCAI), along with 28 formal recommendations and 34 practice points. These guidelines provide clinically useful points to guide the management of ASC in children. Taken together, the recommendations offer a standardized protocol that allows effective monitoring of disease progress and timely treatment escalation when needed.

A typical police lineup contains a photo of one suspect (who is innocent in a target-absent lineup and guilty in a target-present lineup) plus photos of five or more fillers who are known to be innocent. To create a fair lineup in which the suspect does not stand out, two filler selection methods are commonly used. In the first, fillers are selected if they are similar in appearance to the suspect. In the second, fillers are selected if they possess facial features included in the witness’s description of the culprit (e.g., “20-y-old white male”). The police sometimes use a combination of the two methods by selecting description-matched fillers whose appearance is also similar to that of the suspect in the lineup. Decades of research on which approach is better remains unsettled. Here, we tested a counterintuitive prediction made by a formal model based on signal detection theory: From a pool of acceptable description-matched photos, selecting fillers whose appearance is otherwise dissimilar to the suspect should increase the hit rate without affecting the false-alarm rate (increasing discriminability). In Experiment 1, we confirmed this prediction using a standard mock-crime paradigm. In Experiment 2, the effect on discriminability was reversed (as also predicted by the model) when fillers were matched on similarity to the perpetrator in both target-present and target-absent lineups. These findings suggest that signal-detection theory offers a useful theoretical framework for understanding eyewitness identification decisions made from a police lineup.