BACKGROUND: Ehlers-Danlos syndrome (EDS) is a rare inherited connective tissue disease characterized by hyperextensibility of the skin and joints and tissue fragility of the skin and blood vessels, Vascular EDS is the most severe form of EDS, with abnormal arterial fragility. There have been no reports of breast cancer occurring in patients with vascular EDS. Here, we report here a very rare case of breast cancer in a patient with vascular EDS.
METHODS: A 46-year-old woman with vascular EDS underwent partial left mastectomy and sentinel lymph node biopsy for left breast cancer (cStage 0) detected by medical examination. The final pathological diagnosis was invasive ductal carcinoma of the breast (pStage IA) [hormone receptor-positive, HER2 score 2 equivocal (FISH-positive), Ki-67LI 18%, luminal-HER2 type]. BluePrint was submitted as an aid in determining the postoperative treatment strategy, BluePrint Molecular Subtype HER2-type. However, the 10-year breast cancer mortality risk using Predict was low (5%). After consultation with the patient, the decision was made to administer postoperative radiation to the preserved breast along with hormone therapy only. There was no delay in postoperative wound healing, and the patient was free of metastatic recurrence for 9 months after surgery.
CONCLUSIONS: We performed surgery, postoperative radiotherapy, and hormonal therapy in a breast cancer patient with vascular EDS without major complications.

This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.

UNASSIGNED: Blueprint provides a base for assessment by assigning proportionate weightage to various content areas and helps the paper setter to construct a uniform and valid assessment. This study aimed to design and validate a blueprint for theory in Community Medicine as per the new curriculum for Medical Undergraduates in India.
UNASSIGNED: Blueprint in community medicine was designed by assigning impact score (I) and frequency score (F) for the competencies. Blueprint was validated using the Content Validity Index (CVI), and inter-rater agreement for subject experts using Fleiss\' kappa statistics was calculated. Feedback from faculty and students was obtained afterward to assess the postimplementation response.
UNASSIGNED: Blueprint was designed by an expert group where impact score and frequency score were assigned to 146 competencies in the theory of Community Medicine. In Delphi survey I, 63.2% of subject experts responded, while in Delphi survey II, a response rate of 58.3% was achieved. Value of the Fleiss\' Kappa test for an inter-rater agreement was 0.68, i.e. \"substantial agreement,\" while CVI among the raters came out to be 0.86, i.e. overall valid assessment. Feedback of faculty (n = 11) suggested that the blueprint was helpful and standardized the paper setting, whereas feedback from students (n = 138) depicted that it helped in preparing for exams, and they would recommend it to other students.
UNASSIGNED: Validated blueprint by consensus of subject experts has impact score and frequency score along with topic-wise distribution of marks for the convenience of faculty and its utility is well proven among learners too.

BACKGROUND:  Competency-based medical education is followed by most of the medical schools in India. Health universities are changing their question paper pattern and practical assessment pattern to ensure valid and reliable evaluation of student learning but assessment of entire curriculum competencies is a difficult task to achieve. Assessment blueprinting can provide a guiding map for balanced and rational assessment. It ensures similar exam content from year to year (over- or under-representing a topic can be avoided). The assessment blueprint provides ideas of appropriate formats for the knowledge/skills being assessed. The study aims to observe facilitators\' perceptions and develop an assessment blueprint for the anatomy curriculum.
METHODS:  This educational mixed-method study was conducted in the Department of Anatomy of All India Institute of Medical Sciences, Jodhpur, India. Perceptions of 13 facilitators of the Anatomy Department about assessment blueprinting were observed on a five-point Likert scale. Topics of the lower limb were identified based on the Undergraduate Curriculum Volume-1 document provided by the National Medical Council of the Government of India. Weightage to each topic was given on the basis of anatomical importance and clinical significance at the undergraduate level. Marks for the topic as per relative weightage were calculated. The blueprint was prepared and validated by the subject expert of the institute. An example question paper template was prepared as per the assessment blueprint.
RESULTS:  In the present study, all 13 (100%) participants agreed that there is a need for a valid assessment framework to maintain the reliability of assessment, 11 (85%) participants agreed that an assessment blueprint can provide a valid tool for assessment, and 10 (77%) participants agreed that assessments are not planned as per learning domain requirement, and planning of assessment as per blueprint requires more time and resource. Of the participants, eight (62%) agreed that all topics or competencies are not included while setting the question paper. The blueprint for assessment of the lower limb provided an idea of high-weightage and low-weightage topics and the suitable types of questions for these topics.
CONCLUSIONS: Assessment is the key element of competency-based medical education. For a complete, valid, and reliable assessment, a blueprint for assessment is the need of the hour. Assessment blueprinting in this study showed that the anterior thigh region, hip joint, knee joint, and vascular and nerve supply of the lower limb are topics with maximum weightage for the lower limb in the medical anatomy undergraduate curriculum. It can help in reducing under or over-representation of content. With the help of a blueprint, the examiners can assess the majority of content without any intentional or unintentional bias.

The release of the plans of the 3D-printed Liberator firearm sparked a wave of new designs from creators worldwide, resulting in an extensive collection of 3D-printed firearm plans, in particular blueprints, and parts available for almost unrestricted download on the internet. Identifying and categorizing the diverse range of 3D-printed firearms and components pose a challenge due to the abundance of designs available. Between 2021 and April 2023, data was collected on over 2,100 3D-printed firearm plans. While blueprints of fully 3D-printed firearms initially dominated the scene, hybrid designs and parts kit completions / conversions (PKC) have gained popularity for their improved reliability and performance. The now highly networked community offers considerable support with detailed instructions and procedures, providing precise guidance for construction. This systematic classification, grouping and structuration of the recorded data on the Clear Web supported the identification of patterns of the main threat trends related to 3D-printed firearms.

OBJECTIVE: There has been increasing awareness of perinatal health and organisation of maternal and child health care in the Netherlands as a result of poor perinatal outcomes. Vulnerable women have a higher risk of these poor perinatal outcomes and also have a higher chance of receiving less adequate care. Therefore, within a consortium, embracing 100 organisations among professionals, educators, researchers, and policymakers, a joint aim was defined to support maternal and child health care professionals and social care professionals in providing adequate, integrated care for vulnerable pregnant women.
METHODS: Within the consortium, vulnerability is defined as the presence of psychopathology, psychosocial problems, and/or substance use, combined with a lack of individual and/or social resources. Three studies focussing on population characteristics, organisation of care and knowledge, skills, and attitudes of professionals regarding vulnerable pregnant women, were carried out. Outcomes were discussed in three field consultations.
RESULTS: The outcomes of the studies, followed by the field consultations, resulted in a blueprint that was subsequently adapted to local operational care pathways in seven obstetric collaborations (organisational structures that consist of obstetricians of a single hospital and collaborating midwifery practices) and their collaborative partners. We conducted 12 interviews to evaluate the adaptation of the blueprint to local operational care pathways and its\' embedding into the obstetric collaborations.
CONCLUSIONS: Practice-based research resulted in a blueprint tailored to the needs of maternal and child health care professionals and social care professionals and providing structure and uniformity to integrated care provision for vulnerable pregnant women.

The present work reviews the main challenges regarding adaptation of urban drainage networks to climate change by comparing 32 case studies from 29 articles, published between 2003 and 2020. The aim is to: (i) identify the state-of-the-art scientific approaches of adaptation of urban drainage networks to climate change; (ii) assess whether or not these approaches incorporated monetization of the adaptation practices and the associated costs/benefits; and (iii) define a novel approach (Blueprint) for the future development and assessment of urban drainage network adaptation to climate change and other drivers. First, the motivation is provided that makes urban drainage adaptation a globally relevant issue. Second, the main impacts of climate change on precipitation, flooding and urban drainage systems are discussed. Then, current practices are described. Finally, a blueprint for an integrated urban adaptation framework to climate change and other drivers is proposed. Our research indicated that future quantity and quality of urban runoff is not widely addressed in the scientific literature. The Storm Water Management Model is the most widely used software in modeling adaptation options. Solutions such as plans of maintenance and rehabilitation, public awareness, flood forecasting and warning, mobility measures and insurance measures are not widely reflected in the literature. Uncertainties of climate projections and bias correction methods are still significant, and uncertainties of socio-economic scenarios, hydrologic and hydrodynamic models, and adaptation options are not fully addressed. Finally, environmental cost and benefits associated with the ecosystem services provided by the adaptation options are not fully addressed.

We celebrate the 10th anniversary of the launch of the HUPO Human Proteome Project (HPP) and its major milestone of confident detection of at least one protein from each of 90% of the predicted protein-coding genes, based on the output of the entire proteomics community. The Human Genome Project reached a similar decadal milestone 20 years ago. The HPP has engaged proteomics teams around the world, strongly influenced data-sharing, enhanced quality assurance, and issued stringent guidelines for claims of detecting previously \"missing proteins.\" This invited perspective complements papers on \"A High-Stringency Blueprint of the Human Proteome\" and \"The Human Proteome Reaches a Major Milestone\" in special issues of Nature Communications and Journal of Proteome Research, respectively, released in conjunction with the October 2020 virtual HUPO Congress and its celebration of the 10th anniversary of the HUPO HPP.

While native proteins cover diverse structural spaces and achieve various biological events, not many of them can directly serve human needs. One reason is that the native proteins usually contain idiosyncrasies evolved for their native functions but disfavoring engineering requirements. To overcome this issue, one strategy is to create de novo proteins which are designed to possess improved stability, high environmental tolerance, and enhanced engineering potential. Compared to other protein engineering strategies, in silico design of de novo proteins has significantly expanded the protein structural and sequence spaces, reduced wet lab workload, and incorporated engineered features in a guided and efficient manner. In the Baker laboratory we have been applying a design pipeline that uses the blueprint builder to design different folds of de novo proteins, and have successfully obtained libraries of de novo proteins with improved stability and engineering potential. In this article, we will use the design of de novo β-barrel proteins as an example to describe the principles and basic procedures of the blueprint builder-based design pipeline. © 2020 Wiley Periodicals LLC. Basic Protocol 1: The construction of blueprints Alternate Protocol: Build blueprints based on existing protein .pdb files Basic Protocol 2: De novo protein design pipeline using the blueprint builder.

Pandemics are a significant stress test for a country\'s economic, political and health systems. An effective pandemic response demands a multi-pronged and multi-layered approach, comprising surveillance, containment, border control, as well as various social and community measures. In the wake of the novel coronavirus disease 2019 (COVID-19) pandemic, which has now infected more than 7 million people worldwide, strict quarantine measures are a commonplace, and a third of the world\'s population have now gone into some form of lockdown. With the exception of border control, all these response measures involve the contributions of family physicians and general practitioners (GPs) in one way or another. Primary care physicians form and lead the primary care network, which in turn forms the backbone of any healthcare system. Being the first point of contact for a significant proportion of patients, primary care physicians play an essential strategic function in the fight against disease, both during peacetime and in the event of a public health crisis. In this commentary, we examine and propose some of the key roles that they play in a pandemic, drawing examples from the current COVID-19 pandemic and past experiences. COVID-19 has showed us that the world is grossly unprepared for a pandemic, both in terms of our global management and the structure of our current primary health care systems, and this should provide the impetus for us to improve.