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Purpose: We investigated the effects of manipulating running velocity and hypoxic exposure on vastus lateralis muscle oxygenation levels during treadmill running. Methods: Eleven trained male distance runners performed 7 randomized runs at different velocities (8, 10, 12, 14, 16, 18, and 20 km·h−1), each lasting 45 seconds on an instrumented treadmill in normoxia (fraction of inspired oxygen [FiO2] = 20.9%), moderate hypoxia (FiO2 = 16.1%), high hypoxia (FiO2 = 14.1%), and severe hypoxia (FiO2 = 13.0%). Continuous assessment of Tissue Saturation Index (TSI) in the vastus lateralis muscle was conducted using near-infrared spectroscopy. Subsequently, changes in TSI (ΔTSI) data over the final 20 seconds of each run were compared between velocities and conditions. Results: There was a significant velocity × condition interaction for ΔTSI% (P <.001, η p 2 =.19), with a smaller ΔTSI% decline in normoxia compared with high hypoxia and severe hypoxia at 8 km·h−1 (g = 1.30 and 1.91, respectively), 10 km·h−1 (g = 0.75 and 1.43, respectively), and 12 km·h−1 (g = 1.47 and 1.95, respectively) (pooled values for all conditions: P <.037). The ΔTSI% decline increased with each subsequent velocity increment from 8 km·h−1 (−9.2% [3.7%]) to 20 km·h−1 (−22.5% [4.1%]) irrespective of hypoxia severity (pooled values for all conditions: P <.048). Conclusions: Running at slower velocities in conjunction with high and severe hypoxia reduces vastus lateralis muscle oxygenation levels. Muscle ΔTSI% proves to be a sensitive indicator, underscoring the potential use of near-infrared spectroscopy as a reference index of internal load during treadmill runs. [ABSTRACT FROM AUTHOR]

Objectives: There is relatively scarce data regarding the association between primary hyperparathyroidism (PHPT) and incident diabetes in large population‐based longitudinal studies. We aimed to evaluate the risk of incident diabetes in individuals with and without PHPT and investigate the association between serum calcium concentrations and the risk of incident diabetes in patients with PHPT. Methods: We included 2749 PHPT patients and 13,745 age, sex and index year matched non‐PHPT individuals during 2000–2019. We used Cox regression models to compare the risk of incident diabetes in individuals with and without PHPT, and the risk of incident diabetes in PHPT patients with serum calcium concentration above and below the median value. The association between serum calcium concentrations and the risk of incident diabetes was examined by restricted cubic spline analyses in patients with PHPT. Results: During a median follow‐up time of 5.17 years (IQR 2.17, 9.58), 433 patients (15.75%) with PHPT and 2110 individuals (15.35%) without PHPT developed diabetes, respectively. Patients with PHPT had a higher incidence rate of diabetes compared to non‐PHPT individuals (27.60 [95% CI 25.00, 30.30] vs. 23.90 [95% CI 22.80, 24.90] per 1000 person‐years, log‐rank test p =.007]. Crude Cox regression model showed PHPT was associated with a 15% higher risk of incident diabetes (HR 1.15, 95%CI 1.04, 1.28). In patients with PHPT, a 44% higher risk of incident diabetes was found in patients with serum calcium concentrations above the median value (2.63 mmol/L), compared to those below the median value (HR 1.44, 95%CI 1.08, 1.90). Restricted cubic spline analyses confirmed a positive linear association between serum calcium concentrations and the risk of incident diabetes in those with PHPT (p‐value for nonlinear =.751) Conclusions: Patients with PHPT had a higher risk of incident diabetes compared to non‐PHPT individuals. A positive linear association was found between serum calcium concentrations and the risk of incident diabetes in patients with PHPT. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a sexual rehabilitation program, SEXHAB, in improving sexual functioning, reducing sexual distress, and enhancing marital satisfaction for women after gynecological cancer treatment. Methods: This is a randomized controlled trial that included 150 women newly diagnosed with gynecological cancer from three public hospitals in Hong Kong. Participants were randomly assigned to the intervention group (n = 78) to receive the SEXHAB or to an attention control group (n = 72) to receive attention. The SEXHAB comprises four individual‐ or couple‐based sessions with three major components: information provision, cognitive‐behavioral therapy and counseling using motivational interviewing skills. The outcomes were measured at baseline (T0), upon completion of the program (T1) and 12‐month post‐treatment (T2). Semi‐structured interviews were also conducted with the SEXHAB group participants to explore their experiences with and opinions toward the program. Results: At both follow‐ups, there were no statistically significant differences between groups in improving sexual functioning, sexual distress and marital satisfaction. Nevertheless, participants in the SEXHAB group reported their partners having significantly greater sexual interest at T1 (76% vs. 52%, rate ratio: 1.46, 95% CI: 1.07 to 1.99, p = 0.024) and T2 (74% vs. 48%, rate ratio: 1.55, 95% CI: 1.11 to 2.10, p = 0.014). From the qualitative interviews, the interviewees who resumed sexual activity reported positive experiences in rebuilding sexuality and intimacy. Conclusions: Despite the quantitative results are negative, the qualitative findings suggest potential benefits of the SEXHAB for women resuming sexual activities after treatment for gynecological cancer. Further studies with longer intervention period and follow‐ups are needed to confirm the intervention effects. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate expert practitioners' approaches to conducting a first sport psychology session with individual clients as there is sparse empirical literature on this topic. Nine expert Certified Mental Performance Consultants completed a semistructured interview where they discussed experiences conducting a first meeting with an athlete. Primary objectives included establishing the relationship, setting guidelines and expectations, understanding the client's background, identifying presenting concerns, and formulating the treatment plan and building skills. Building rapport was an aspect used to establish the relationship while discussing confidentiality was utilized to set guidelines. Important strategies employed to increase the perceived benefits to services included conveying the consulting approach and philosophy. Lessons learned centered around doing too much and not appreciating individual differences of clients. Findings show expert consultants aim to achieve similar broad objectives in the first session and provide a basis for best practices in this area. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of a multimodal couple-based sexual health intervention for premenopausal women treated for breast cancer and their partners to provide personalised psychosexual care, and to understand participants' experience of, and adherence to, the intervention. Methods: This is an assessor-blinded, randomised controlled trial. Premenopausal women treated for breast cancer (N = 160) and their partners will be recruited. Dyads will be randomised into an intervention (n = 80) or attention control (n = 80) group. The intervention group will receive the multimodal couple-based sexual health intervention over eight weeks. The intervention comprises five face-to-face and virtual individual couple counselling sessions combined with online reading, a chat-based discussion forum, and telephone calls. The intervention is based on level I-II evidence and a robust theoretical framework. The attention control group will receive usual care plus telephone calls comprising general greetings and reminders to complete follow-up surveys. Sexual adjustment, relationship quality and quality of life will be measured at baseline, after completion of the intervention, three months and six months post-intervention. The project will adhere to the CONSORT-EHEALTH checklist. Qualitative interviews will explore the participants' experience of, and adherence to, the intervention. Discussion: This study will provide the first pragmatic evidence of the effectiveness of a multimodal couple-coping intervention to support premenopausal women and their partners to improve sexuality, relationship quality and quality of life after treatment for breast cancer. Implications for the profession and /or patient care: Sexual health is a neglected area in clinical practice, for patients and partners. The ever-growing population of women treated for breast cancer at younger age has created a more pressing need for the development of tailored sexual health interventions. If effective, this intervention could be incorporated into routine cancer care to provide better support and care for this patient population to enhance sexual health, intimacy and overall well-being. Trial registration: ISRCTN35481498; prospectively registered on 08/05/2023. [ABSTRACT FROM AUTHOR]

Background The use of fidaxomicin is recommended as first-line therapy for all patients with Clostridioides difficile infection (CDI). However, real-world studies have shown conflicting evidence of superiority. Methods We conducted a retrospective single-center study of patients diagnosed with CDI between 2011 and 2021. A primary composite outcome of clinical failure, 30-day relapse, or CDI-related death was used. A multivariable cause-specific Cox proportional hazards model was used to evaluate fidaxomicin compared to vancomycin in preventing the composite outcome. A separate model was fit on a subset of patients with C. difficile ribotypes adjusting for ribotype. Results There were 598 patients included, of whom 84 received fidaxomicin. The primary outcome occurred in 8 (9.5%) in the fidaxomicin group compared to 111 (21.6%) in the vancomycin group. The adjusted multivariable model showed fidaxomicin was associated with 63% reduction in the risk of the composite outcome compared to vancomycin (hazard ratio [HR] = 0.37; 95% confidence interval [CI],.17–.80). In the 337 patients with ribotype data after adjusting for ribotype 027, the results showing superiority of fidaxomicin were maintained (HR = 0.19; 95% CI,.05–.77). Conclusions In the treatment of CDI, we showed that real-world use of fidaxomicin is associated with lower risk of a composite end point of treatment failure. [ABSTRACT FROM AUTHOR]

Limited by the energy gap law, purely organic materials with efficient near‐infrared room temperature phosphorescence are rare and difficult to achieve. Additionally, the exciton transition process among different emitting species in host–guest phosphorescent materials remains elusive, presenting a significant academic challenge. Herein, using a modular nonbonding orbital‐π bridge‐nonbonding orbital (n‐π‐n) molecular design strategy, we develop a series of heavy atom‐free phosphors. Systematic modification of the π‐conjugated cores enables the construction of a library with tunable near‐infrared phosphorescence from 655 to 710 nm. These phosphors exhibit excellent performance under ambient conditions when dispersed into a 4‐bromobenzophenone host matrix, achieving an extended lifetime of 11.25 ms and a maximum phosphorescence efficiency of 4.2 %. Notably, by eliminating the interference from host phosphorescence, the exciton transition process in hybrid materials can be visualized under various excitation conditions. Spectroscopic analysis reveals that the improved phosphorescent performance of the guest originates from the triplet‐triplet energy transfer of abundant triplet excitons generated independently by the host, rather than from enhanced intersystem crossing efficiency between the guest singlet state and the host triplet state. The findings provide in‐depth insights into constructing novel near‐infrared phosphors and exploring emission mechanisms of host–guest materials. [ABSTRACT FROM AUTHOR]

This study investigates the impacts of urban‐induced anthropogenic heat (AH) and surface roughness on Tropical Cyclone (TC) Victor (1997) using the Weather Research and Forecasting Model. TC Victor originated in the South China Sea and made landfall over the Greater Bay Area (GBA) megacity. The storm was characterized by slow movement, a weakly organized structure, and a small size. Three parallel experiments were conducted in the following setups: "Nourban," where urban areas in the GBA were replaced by croplands, "AH0" ("AH300"), in which the diurnal maximum AH was set to 0 (300 W/m2) in urban locations. The urbanization effect during the landfall period results in a notable reduction in both the Power Dissipation Index and Integrated Kinetic Energy of the storm. A Lagrangian particle dispersion model further demonstrates that from 33 to 17 hr prelandfall, the entrainment of AH‐affected warm airflow into the TC's circulation leads to a decrease in both the convective available potential energy and surface latent heat flux in the western quadrant of the TC, thus weakening the cyclone's intensity. Furthermore, from 12 hr prelandfall to 8 hr postlandfall, there is an intense influx of AH‐affected airflow into the TC's primary circulation, resulting in a decrease in relative humidity and a stronger asymmetrical structure, declining the TC intensity. Concurrently, urban surface roughness contributes to a decrease in postlandfall storm intensity through frictional energy dissipation. This study underscores the critical role of AH and urban roughness in modulating TC intensity for storms with specific characteristics, emphasizing the need for deeper insights into urban‐TC dynamics. Plain Language Summary: This study looks at how heat from cities and the roughness of urban surfaces affect a tropical storm named Victor that happened in 1997. Victor originated in the South China Sea and hit the Greater Bay Area, a highly urbanized region. It moved slowly, was weakly organized, and was relatively small. We used a computer model called the Weather Research and Forecasting Model to simulate the storm. We performed three simulations: one where we imagined the city was just farmland, another where we did not add any extra heat from the city, and third where we added a lot of heat as sensible heat flux from the surface of the city. We found that when the storm passed over the city, it became weaker. This weakening was due to the warm air from the city getting absorbed into the storm, which changed the storm's energy and made it less stable. At the same time, the roughness of the city's surface also helped to weaken the storm because of the friction. Our research highlights how city heat and surface roughness are important in changing the strength of storms like Victor. Key Points: Numerical modeling results indicate that urbanization can decrease the intensity of tropical cyclone (TC) Victor (1997) in south ChinaUrban surface roughness effect decreases postlandfall storm intensity through frictional energy dissipationThe entrainment of AH‐affected warm airflow decreases TC's relative humidity, resulting in decreased prelandfall storm intensity [ABSTRACT FROM AUTHOR]

While Search Engine Optimisation seeks to enhance PageRankings, some methods are not approved or condoned by browser developers. To understand the risks faced by suicidal gamblers in the online environment, 2 studies examined the behaviour of an online search engine. A series of Google searches in 2021 used key terms such as 'suicide' and 'gambling' that might be employed by a suicidal gambler. During these searches browser 'hits' included opportunities to gamble. Webpages (N = 200) offered to a potentially suicidal gambler were primarily categorised as: other suicides (20%), treatment providers (8.5%), online casinos (7%); politics (22%), academic (23.5%). From a Google search providing 1,090 hits, the links to 113 online casinos were classified as a function of Domain Name hijacking, Metatag Stuffing, Error 404, and presence of Malware. There were significant relationships between the size of the businesses whose Domain Names were hijacked, and the presence of Malware. The deliberate use by webpage designers of the word 'suicide' to attract customers to online casinos appears inappropriate and ethically questionable. [ABSTRACT FROM AUTHOR]

Limited by the energy gap law, purely organic materials with efficient near‐infrared room temperature phosphorescence are rare and difficult to achieve. Additionally, the exciton transition process among different emitting species in host–guest phosphorescent materials remains elusive, presenting a significant academic challenge. Herein, using a modular nonbonding orbital‐π bridge‐nonbonding orbital (n‐π‐n) molecular design strategy, we develop a series of heavy atom‐free phosphors. Systematic modification of the π‐conjugated cores enables the construction of a library with tunable near‐infrared phosphorescence from 655 to 710 nm. These phosphors exhibit excellent performance under ambient conditions when dispersed into a 4‐bromobenzophenone host matrix, achieving an extended lifetime of 11.25 ms and a maximum phosphorescence efficiency of 4.2 %. Notably, by eliminating the interference from host phosphorescence, the exciton transition process in hybrid materials can be visualized under various excitation conditions. Spectroscopic analysis reveals that the improved phosphorescent performance of the guest originates from the triplet‐triplet energy transfer of abundant triplet excitons generated independently by the host, rather than from enhanced intersystem crossing efficiency between the guest singlet state and the host triplet state. The findings provide in‐depth insights into constructing novel near‐infrared phosphors and exploring emission mechanisms of host–guest materials. [ABSTRACT FROM AUTHOR]

Introduction: Continuity and coordination‐of‐care for childhood cancer survivors with multiple chronic conditions are understudied but critical for appropriate follow‐up care. Methods: From April through June 2022, 800 Childhood Cancer Survivor Study participants with two or more chronic conditions (one or more severe/life‐threatening/disabling) were emailed the "Patient Perceived Continuity‐of‐Care from Multiple Clinicians" survey. The survey asked about survivors' main (takes care of most health care) and coordinating (ensures follow‐up) provider, produced three care‐coordination summary scores (main provider, across multiple providers, patient–provider partnership), and included six discontinuity indicators (e.g., having to organize own care). Discontinuity (yes/no) was defined as poor care on one or more discontinuity item. Chi‐square tests assessed associations between discontinuity and sociodemographics. Modified Poisson regression models estimated prevalence ratios (PRs) for discontinuity risk associated with the specialty and number of years seeing the main and coordinating provider, and PRs associated with better scores on the three care‐coordination summary measures. Inverse probability weights adjusted for survey non‐participation. Results: A total of 377 (47%) survivors responded (mean age 48 years, 68% female, 89% non‐Hispanic White, 78% privately insured, 74% ≥college graduate); 147/373 (39%) reported discontinuity. Younger survivors were more likely to report discontinuity (chi‐square p =.02). Seeing the main provider ≤3 years was associated with more prevalent discontinuity (PR; 95%CI) (1.17; 1.02‐1.34 vs ≥ 10 years). Cancer specialist main providers were associated with less prevalent discontinuity (0.81; 0.66–0.99 vs. primary care). Better scores on all three care‐coordination summary measures were associated with less prevalent discontinuity: main provider (0.73; 0.64–0.83), across multiple providers (0.81; 0.78–0.83), patient–provider partnership (0.85; 0.80–0.89). Conclusions: Care discontinuity among childhood cancer survivors is prevalent and requires intervention. Childhood cancer survivors with multiple chronic conditions require care from a variety of providers, but the coordination and continuity of their care is understudied. Among Childhood Cancer Survivor Study participants with two or more chronic conditions (with at least one severe/life‐threatening/disabling), nearly 40% reported discontinuity in their care. [ABSTRACT FROM AUTHOR]

The primary and secondary fragmentation dynamics of iodobenzene following its ionization at 120 eV were determined using three-dimensional velocity map imaging and covariance analysis. Site-selective iodine 4d ionization was used to populate a range of excited polycationic parent states, which primarily broke apart at the carbon-iodine bond to produce I+ with phenyl or phenyl-like cations (C n H x + or C n H x 2 + , with n = 1 – 6 and x = 1 – 5). The molecular products were produced with varying degrees of internal excitation and dehydrogenation, leading to stable and unstable outcomes. This further allowed the secondary dynamics of C 6 H x 2 + intermediates to be distinguished using native-frame covariance analysis, which isolated these processes in their own centre-of-mass reference frames. The mass resolution of the imaging mass spectrometer used for these measurements enabled the primary and secondary reaction channels to be specified at the level of individual hydrogen atoms, demonstrating the ability of covariance analysis to comprehensively measure the competing fragmentation channels of aryl cations, including those involving intermediate steps. [ABSTRACT FROM AUTHOR]

Two fenestrindane‐based porous nanographenes containing four polyaromatic macrocycles in a highly twisted, basically S4–symmetric conformation were synthesized and characterized by NMR spectroscopy and mass spectrometry. Stepwise π‐extension at the periphery of the fenestrindane core by a sequence of eightfold Suzuki‐Miyaura cross‐coupling, fourfold Scholl cyclodehydrogenation and another eightfold Suzuki‐Miyaura reaction affords the porous nanographene precursors in good yields. In the last step, fourfold intramolecular Yamamoto coupling generates the porous nanographenes in 17‐18 %‐yield. Their optical and electronic properties were studied by UV/Vis and fluorescence spectroscopy and cyclic voltammetry. DFT calculations revealed structural details of the macrocycles. The surprisingly weak binding of these porous structures with chloride ions (K≈10 M−1) is attributed to their highly twisted conformation. The title compounds represent the first porous nanographenes based on the [5.5.5.5]fenestrane motif and, at the same time, they consist of a fenestrane‐like polyarylene network. [ABSTRACT FROM AUTHOR]

Background: Unstructured play has also been found effective on promoting positive emotions and emotional competence among children and adolescents with special educational needs (SEN). Unstructured Outdoor Play coupled with Mindfulness-based Interventions via 'Supporting Wellness in E-Child Learning Environments' (SWELE) program can foster the mental health and wellbeing of children and adolescents with SEN. Currently there is a lack of the unstructured play with mindfulness-based interventions in the special schools in Hong Kong. Thus, aim of the SWELE program is to examine the effects of unstructured play with mindfulness-based interventions—(SWELE) program combining unstructured outdoor play activities with mindfulness-based interventions to promote mental wellbeing among SEN children and adolescents. Methods: This 16-week SWELE program focuses on combining unstructured outdoor play activities with mindfulness-based interventions to promote mental wellbeing among children and adolescents with SEN. Training workshops for schoolteachers, school principals, parents and student mental health ambassadors in each special school together with a 16-week SWELE program and each last 45–60 min. Unstructured play allows students the freedom to explore, create and discover without predetermined rules or guidelines. Outdoor unstructured play activities include naturally run, jump and move on a playground, riding a bike, climbing trees, playing tag, playing with blocks, colour, water play, and boxes. A convergent parallel mixed-methods design both with a quantitative measure using a single group pre- and post-tests quasi-experiment behavioural observational method to preliminarily evaluate the impact of SWELE Program on SEN children's and adolescents' mental wellbeing; and with a qualitative design to conduct eight focus group discussions including schoolteachers, school principals, parents, SEN students, school nurses from six selected special groups and to explore their perceptions and experiences after participated the SWELE program. Discussion: The purpose of this protocol is to examine the effects of a 16-week SWELE program on the mood, anxiety level, social skills and playfulness behaviours among children and adolescents with SEN in the special schools in Hong Kong. From the evaluation and observation, the pre-set aim and objectives on the improvement of mental wellbeing in children and adolescents with SEN can be confirmed. Trial registration: ClinicalTrial.gov, NCT06112483. Registered on 31 October 2023. [ABSTRACT FROM AUTHOR]

Objective: To describe the barriers to and facilitators of implementing and delivering virtual hospital (VH) services, and evidence and practice gaps where further research and policy changes are needed to drive continuous improvement. Study design: Qualitative descriptive study. Setting, participants: Online semi‐structured interviews and a focus group were conducted between July 2022 and April 2023 with doctors, nurses and leadership staff involved in VH services at three sites in New South Wales, Australia. Main outcome measures: Barriers to and facilitators of implementing and delivering VH services in sites with differing operating structures and levels of maturity, and evidence and practice gaps relating to VH services. Results: A total of 22 individuals took part in the study. Barriers, facilitators, and evidence and practice gaps emerged within five major themes: scope and structure of VH services; development and implementation of VH models of care; delivery of VH models of care; evaluation of VHs and VH models of care; and sustainment and scalability of VH services. Facilitators of VH success included hybrid approaches to care, partnerships with external services, and skills of the VH workforce. Barriers and gaps in evidence and practice included technical challenges, the need to define the role of VH services, the need to evaluate the tangible impact of VH care models and technologies, and the need to develop funding models that support VH care delivery. Participants also highlighted the perceived impacts and benefits of VH services on the workforce (within and beyond the VH setting), consumers, and the health care system. Conclusions: Our findings can help inform the development of new VH services and the improvement of existing VH services. As VH services become more mainstream, gaps in evidence and practice must be addressed by future research and policy changes to maximise the benefits. [ABSTRACT FROM AUTHOR]

Objectives: To identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics). Design: Qualitative study using a modified nominal group technique. Setting: Online semi‐structured interviews and workshops held in November 2022 and February 2023. Participants: Health workers involved in delivering virtual care in two metropolitan local health districts and one specialty statewide network, and people who had received care from these sites, were recruited using passive snowball sampling. Research and academic staff from a tertiary institution were also invited to participate. Main outcome measures: Priorities to support a translational research agenda for virtual care. Results: Twenty‐five individuals participated including 18 innovation deliverers, two innovation recipients and five implementation facilitators. Stakeholders identified several key priorities for developing virtual care models and for sustaining and scaling virtual care services. These included demonstrating the economic and societal value of virtual care, developing a common framework to support evaluation and comparison of virtual care services, ensuring virtual care services integrate acute and primary care, and defining which models of care are most appropriate for virtual care delivery. Conclusion: As the health system recalibrates with the return of in‐person care, there is a growing need to demonstrate the value of virtual care models to patients, the health system, and society at large. Demonstrating this value while also demonstrating improvements to health outcomes will future‐proof virtual care, enabling it to be used to address broader challenges of health care delivery. In addition, sustaining virtual care will depend on robust operational structures and workforce training and education. As services evolve, research and development priorities must be revisited to ensure that translational research aligns with stakeholder interests. [ABSTRACT FROM AUTHOR]

Maintaining mitochondrial homeostasis is crucial for cell survival and organismal health, as evidenced by the links between mitochondrial dysfunction and various diseases, including Alzheimer's disease (AD). Here, we report that lncMtDloop, a non-coding RNA of unknown function encoded within the D-loop region of the mitochondrial genome, maintains mitochondrial RNA levels and function with age. lncMtDloop expression is decreased in the brains of both human AD patients and 3xTg AD mouse models. Furthermore, lncMtDloop binds to mitochondrial transcription factor A (TFAM), facilitates TFAM recruitment to mtDNA promoters, and increases mitochondrial transcription. To allow lncMtDloop transport into mitochondria via the PNPASE-dependent trafficking pathway, we fused the 3'UTR localization sequence of mitochondrial ribosomal protein S12 (MRPS12) to its terminal end, generating a specified stem-loop structure. Introducing this allotropic lncMtDloop into AD model mice significantly improved mitochondrial function and morphology, and ameliorated AD-like pathology and behavioral deficits of AD model mice. Taken together, these data provide insights into lncMtDloop as a regulator of mitochondrial transcription and its contribution to Alzheimer's pathogenesis Synopsis: lncMtDloop was recently identified as a noncoding RNA expressed in the brain and encoded in the mitochondria. This work characterizes how lncMtDloop functions in mitochondrial homeostasis and its implications for Alzheimer's disease (AD) pathology. RNA pull-down followed by mass spectrometry shows lncMtDloop interaction with mitochondrial transcription factor TFAM. lncMtDloop expression is lower in brains of human AD patients and in AD mouse model brains. Fusing a mitochondrial targeting sequence to the terminal end of lncMtDloop for gain-of-function studies results in lncMtDloop restoration in mitochondria of AD mouse-model brains. Expressing lncMtDloop in AD mouse models causes amelioration of AD-like pathology, of mitochondrial function and morphological abnormalities, and of behavioral deficits. By promoting TFAM binding to target DNA, the mitochondrial lncMtDloop regulates mitochondrial transcription and overall function, and ameliorates Alzheimer's disease pathology in model mice. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to assess the factors associated with pet owners' expectations for receiving antibiotics for their pet dogs and/or cats and the factors associated with pets (dogs and/or cats) receiving antibiotics during non-routine veterinary clinic consultations in Singapore. Methods: A cross-sectional study was conducted on consenting pet owners who attended 16 veterinary clinics in Singapore, between March and December 2023. An online survey measured participants' knowledge of antibiotic use, prior antibiotic use experience, expectation for antibiotics and receipt of antibiotics during the last non-routine clinic consultation for their pets. Multivariable logistic regression models were used to determine the factors associated with expectation of antibiotics and receipt of antibiotics. Results: Among the 821 pet owners, over one-in-four (27.5%) expected antibiotics. Owners with prior antibiotic use (adjusted OR 5.18, 95%CI 2.85–9.42) and poor knowledge of antibiotic use (adjusted OR 1.69, 95% CI 1.21–2.35) were 5 times and nearly 2 times as likely as owners without prior antibiotic use and those with good knowledge of antibiotic use respectively, to expect antibiotics for their pets. After adjusting for potential confounders, owners who expected antibiotics (adjusted OR 12.09, 95% CI 7.83–18.68) and had prior antibiotic use for their pets (adjusted OR 8.57, 95% CI 4.75–15.47) were more likely to receive antibiotics for their pets. Conclusion: Factors which significantly influenced expectation of antibiotics in pet owners included poor knowledge of antibiotic use and prior usage of antibiotics. This highlights the importance of effective communication by veterinarians to mitigate pet owners' expectations to address inappropriate antibiotic prescribing. [ABSTRACT FROM AUTHOR]

Background: Low-dose chest computed tomography (CT) is used for lung cancer screening, but can also detect coronary artery disease as coronary artery calcium. We sought to determine the prevalence and prognostic utility of coronary artery calcium in a population at high risk of cancer. Methods: We reviewed CT scans from consecutive participants screened for lung cancer between March 2017 and November 2018 as part of the Ontario Health Lung Cancer Screening Pilot for People at High Risk. We quantified coronary artery calcium using an estimated Agatston score. We identified the composite primary outcome of all-cause death and cardiovascular events using linked electronic medical record data from The Ottawa Hospital to December 2023. Results: Among 1486 people who underwent screening CT, coronary artery calcium was detected in 1232 (82.9%) and was extensive in 439 (29.5%). On multivariable analysis, extensive coronary artery calcium was associated with the composite primary outcome (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.35–3.38), all-cause death (HR 2.39, 95% CI 1.34–4.27), and cardiovascular events (HR 2.06, 95% CI 1.13–3.77). Extensive coronary artery calcium remained predictive of cardiovascular events after we adjusted for noncardiovascular death as a competing risk (HR 2.05, 95% CI 1.09–3.85). Interpretation: Among people undergoing low-dose chest CT for lung cancer screening, extensive coronary artery calcium was an independent predictor of all-cause death and cardiovascular events, even after adjustment for noncardiovascular death. The opportunity to identify and reduce risks from coronary artery disease may represent an additional benefit of lung cancer screening. [ABSTRACT FROM AUTHOR]

Background: To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the support and resources GPs need to manage urgent care patients in the community; assess the need for GP advice lines by primary care services in Australia; and identify the facilitators and barriers to adoption, and strategies to support the sustainability of GP advice lines. Methods: Qualitative study involving semi-structured interviews with GPs, hospital-based healthcare providers, consumers, and healthcare management, recruited via existing investigator networks and snowballing approach. The interviews were conducted between February and August 2023. Major themes were identified by an iterative and inductive thematic analysis. Results: We interviewed 16 participants (median age 50, IQR 38–59). Based on the aims of the study, three themes emerged: support and resources for GPs; motivation for GP advice lines; and factors influencing the uptake and sustainability of GP advice lines. Participants reported that better communication from hospital services with GPs is critical to ensure continuity of care between tertiary and primary settings. They also noted that GP advice lines can help increase capacity to manage urgent care patients in the community by providing timely decision-support to GPs. However, a reported barrier to the uptake and ongoing use of GP advice lines was the limited hours of the service. To sustain GP advice lines, participants highlighted a need to broaden the scope of the service beyond the pandemic, conduct rigorous evaluation on health outcomes, and further digitise the service so that a tiered level of support could be provided based on risk stratification. Conclusions: The benefits of GP advice lines are yet to be fully realised. With increasing technology sophistication, there remain opportunities to further digitise and optimise GP advice lines, whilst ensuring better integration within and across primary and tertiary care services. This is however dependent on continued financial and policy support from the government. [ABSTRACT FROM AUTHOR]

Histomorphometry is an important technique in the evaluation of non‐traumatic osteonecrosis of the femoral head (ONFH). Quantification of empty lacunae and pyknotic cells on histological images is the most reliable measure of ONFH pathology, yet it is time and manpower consuming. This study focused on the application of artificial intelligence (AI) technology to tissue image evaluation. The aim of this study is to establish an automated cell counting platform using YOLOv8 as an object detection model on ONFH tissue images and to evaluate and validate its accuracy. From 30 ONFH model rabbits, 270 tissue images were prepared; based on evaluations by three researchers, ground truth labels were created to classify each cell in the image into two classes (osteocytes and empty lacunae) or three classes (osteocytes, pyknotic cells, and empty lacunae). Two and three classes were then annotated on each image. Transfer learning based on annotated data (80% for training and 20% for validation) was performed using YOLOv8n and YOLOv8x with different parameters. To evaluate the detection accuracy of the training model, the mean average precision (mAP (50)) and precision‐recall curve were identified. In addition, the reliability of cell counting by YOLOv8 relative to manual cell counting was evaluated by linear regression analysis using five histological images unused in previous experiments. The mAP (50) for the detection of empty lacunae was 0.868 for the YOLOv8n and 0.883 for the YOLOv8x. The mAP (50) for the three classes was 0.735 for the YOLOv8n model and 0.750 for the YOLOv8x model. The quantification of empty lacunae by automated cell counting obtained in the learning was highly correlated with the manual counting data. The development of an AI‐applied automated cell counting platform will significantly reduce the time and effort of manual cell counting in histological analysis. [ABSTRACT FROM AUTHOR]

Background and Objectives: Acute aortic dissection (AD) is a life-threatening condition in which early detection can significantly improve patient outcomes and survival. This study evaluates the clinical benefits of integrating a deep learning (DL)-based application for the automated detection and prioritization of AD on chest CT angiographies (CTAs) with a focus on the reduction in the scan-to-assessment time (STAT) and interpretation time (IT). Materials and Methods: This retrospective Multi-Reader Multi-Case (MRMC) study compared AD detection with and without artificial intelligence (AI) assistance. The ground truth was established by two U.S. board-certified radiologists, while three additional expert radiologists served as readers. Each reader assessed the same CTAs in two phases: assessment unaided by AI assistance (pre-AI arm) and, after a 1-month washout period, assessment aided by device outputs (post-AI arm). STAT and IT metrics were compared between the two arms. Results: This study included 285 CTAs (95 per reader, per arm) with a mean patient age of 58.5 years ±14.7 (SD), of which 52% were male and 37% had a prevalence of AD. AI assistance significantly reduced the STAT for detecting 33 true positive AD cases from 15.84 min (95% CI: 13.37–18.31 min) without AI to 5.07 min (95% CI: 4.23–5.91 min) with AI, representing a 68% reduction (p < 0.01). The IT also reduced significantly from 21.22 s (95% CI: 19.87–22.58 s) without AI to 14.17 s (95% CI: 13.39–14.95 s) with AI (p < 0.05). Conclusions: The integration of a DL-based algorithm for AD detection on chest CTAs significantly reduces both the STAT and IT. By prioritizing urgent cases, the AI-assisted approach outperforms the standard First-In, First-Out (FIFO) workflow. [ABSTRACT FROM AUTHOR]

Background: Myocarditis is a serious disease that has drawn increasing attention due to its association with COVID-19 and vaccination. This study investigates the epidemiology of myocarditis beyond the COVID-19 pandemic, including its incidence and outcomes over time. Methods: We analyzed the population-wide retrospective data from the Admitted-Patient-Data-Collection database of patients admitted to hospitals in New South Wales (NSW), Australia, with a diagnosis of myocarditis from 2001 to 2022. The incidence of myocarditis, changing classification of myocarditis over time, and complications of myocarditis over time were all calculated. Results: There were 4071 patients diagnosed with their first episode of myocarditis, with a median age of 42 years old, and 66% were male. The incidence of myocarditis in NSW has tripled over 20-years to 8.3 per-100,000-persons by 2022. Reactive myocarditis (i.e., myocarditis within 30-days of a respiratory or digestive illness) accounted for 38% of first presentations of myocarditis. Post COVID-19 myocarditis, a subset of reactive myocarditis, accounted for 42% of myocarditis admissions since the onset of the COVID-19 pandemic in Australia. Eight percent of patients had a background history of malignancy, and 6% had a history of autoimmune disease. In-hospital mortality was 4.5% during the entire study period but has been falling by 11% per year. During follow up, most readmissions for myocarditis occurred within 6-months; with 5.1% recurrence at 6-months compared to only 6.7% at 5-years. Conclusions: Myocarditis is an important condition with increasing incidence in Australia and with markedly changing characteristics in the pandemic and post pandemic era. [ABSTRACT FROM AUTHOR]

In hand trauma, the uninjured forearm has been touted as the ideal site for ectopic banking in digit/hand amputations. Here, we describe the temporary ectopic implantation and subsequent replantation of a partially amputated hand and highlight the "Three R's" – Recovery, Rehabilitation, and Revision over the first year of recovery. [ABSTRACT FROM AUTHOR]

Background: As the recognition of psychological factors in chronic illness management grows, this study examined the interplay of psychological traits – grit, self-efficacy, resilience, and nature-relatedness – and their collective impact on the Quality of Life (QoL) among patients with rheumatoid arthritis (RA) in Malaysia. Methods: A cross-sectional study was conducted among 222 patients with RA at a private hospital in Malaysia. Utilizing validated scales, including the Connor-Davidson Resilience Scale, Short Grit Scale, Nature Relatedness Scale, and Arthritis Self Efficacy Scale, data were collected. Pearson Product-moment Correlation analyses assessed the relationships between variables, and a multiple mediation analysis explored the mediating effects of resilience, grit, and self-efficacy on the relationship between nature-relatedness and QoL. Findings: Of the 222 participants (86% female, mean age = 56.03, S.D. = 13.42), the analysis revealed a significant mediating role of resilience in the relationship between nature-relatedness and QoL among RA patients (b = −.117, SE =.042, 95% BCa CI [−.208, –.046]). Although grit and self-efficacy positively correlated with QoL, they did not serve as significant mediators in the nature-relatedness – QoL relationship. This highlights the pivotal role of building a sense of resiliency among patients with RA. Interpretation: Individuals with RA are not only resilient in terms of their psychological traits such as grit, self-efficacy, and general resilience but also exhibit resilience in their connection and interaction with the natural environment (nature-relatedness). This holistic concept recognizes that fostering resilience in both psychological aspects and the context of one's environment is crucial for promoting overall well-being, particularly in the management of chronic illnesses like RA. It emphasizes the interconnectedness of psychological factors and environmental engagement in contributing to an individual's ability to cope and thrive despite health challenges. [ABSTRACT FROM AUTHOR]

Background: Current guidelines recommend adrenal venous sampling (AVS) for subtyping primary aldosteronism (PA). However, bilateral adrenal cannulation failure is common especially at low‐volume centers. The role of unilateral‐cannulating AVS in selecting patients for unilateral adrenalectomy is unclear. Methods: Fifty consecutive patients underwent AVS between 2009 and 2023 and thirty‐three (66%) underwent unilateral adrenalectomy. We defined unilateral PA (uPA) by the normalized plasma aldosterone and the aldosterone–renin ratio following unilateral adrenalectomy. We examined the effectiveness of unilateral‐cannulating AVS in identifying uPA. Results: 88%, 50%, and 48% of patients had the left, right, and bilateral adrenal veins successfully cannulated, respectively. Among patients with bilateral successful cannulation, a lateralization index (LI) > 4 provided a sensitivity of 100% and a positive predictive value (PPV) of 86.7% for uPA. Thresholds for the contralateral suppression index (CSI) and relative aldosterone secretion index (RASI) were derived from this subgroup and applied to the entire cohort. CSI <0.5 demonstrated a sensitivity of 76.5% and PPV of 92.9% for uPA, whereas RASI >2.4 showed a sensitivity of 85.0% and PPV of 94.4% for uPA. With CSI <0.5 or RASI >2.4 combined, a higher PPV (95.5%) was achieved when compared to computed tomography and iodocholesterol scintigraphy (86.2% and 62.5%, respectively). Conclusion: Despite unsuccessful bilateral cannulation, our study confirms that unilateral‐cannulating AVS can effectively select patients for unilateral adrenalectomy based on a combination of CSI or RASI criteria. [ABSTRACT FROM AUTHOR]

In Asia–Pacific region, hepatocellular carcinoma is a serious health threat attributing to over 600,000 deaths each year and account for over 70% of global cases. Clinically, the major unmet needs are recurrence after curative-intent surgery, liver transplantation or local ablation and disease progression in those with hepatocellular carcinoma not eligible for resection or failed locoregional therapy. In the recent few years, new targeted therapy and immune-checkpoint inhibitors have been registered as systemic therapy to address these issues. Notably, new forms of systemic therapy, either as first-line or second-line therapy for unresectable hepatocellular or those not eligible for locoregional therapy, are now available. New data is also emerging with the use of systemic therapy to prevent hepatocellular carcinoma recurrence after curative-intent resection or local ablation therapy and to retard disease progression after locoregional therapy. In the future, further implementation of immune-checkpoint inhibitors and other forms of immunotherapy are expected to bring a new paradigm to the management of hepatocellular carcinoma. New insight related to immune-related adverse events with the use of immunotherapy has allso enabled optimization of the therapeutic approach to patients with hepatocellular carcinoma. The purpose of this clinical practice guideline is to provide an up-to-date recommendation based on clinical evidence and experience from expert Asia–Pacific key opinion leaders in the field of hepatocellular carcinoma. Three key questions will be addressed, namely: (1) Which patients with hepatocellular carcinoma should be considered for systemic therapy? (2) Which systemic therapy should be used? (3) How should a patient planned for immune checkpoint-based systemic therapy be managed and monitored? [ABSTRACT FROM AUTHOR]

Purpose: There is limited evidence regarding body mass index (BMI) as an early marker of high-risk adenoma (HRA) at the time of screening colonoscopy. Because high-risk adenomas (HRA) can develop into colorectal cancer (CRC), BMI could serve as an important clinical predictor of future risk of CRC. Methods: We examined data from 1831 adults undergoing screening colonoscopy at the Forzani & MacPhail Colon Cancer Screening Center in Alberta, Canada. We fit multivariable logistic regression models to examine the association between BMI and HRA. Non-linear relationships for BMI on HRA were also evaluated using restricted cubic splines. Results: The mean BMI in patients with HRA was 28.2 kg/m2 compared to 27.4 kg/m2 in patients without adenomas (t test: p = 0.003). In the adjusted models, those with a BMI over 30 kg/m2 had 1.45 (95% CI 1.05–2.00) times the odds of HRA detected during colonoscopy compared to those with a BMI below 25 kg/m2. Examining BMI as continuous, the odds of HRA were 1.20 (95% CI 1.04–1.37) times higher for every 5 kg/m2 increase in BMI. Conclusion: The findings of this study suggest that excess body mass is associated with higher risk of HRA among a screening population and may be useful an early marker of future disease. [ABSTRACT FROM AUTHOR]

Approximately 5%–10% of fractures go on to delayed healing and nonunion, posing significant clinical, economic, and social challenges. Current treatment methods involving open bone harvesting and grafting are associated with considerable pain and potential morbidity at the donor site. Hence, there is growing interest in minimally invasive approaches such as bone marrow aspirate concentrate (BMAC), which contains mesenchymal stromal cells (MSCs), macrophages (Mφ), and T cells. However, the use of cultured or activated cells for treatment is not yet FDA‐approved in the United States, necessitating further exploration of optimal cell types and proportions for effective bone formation. As our understanding of osteoimmunology advances, it has become apparent that factors from anti‐inflammatory Mφ (M2) promote bone formation by MSCs. Additionally, M2 Mφ promote T helper 2 (Th2) cells and Treg cells, both of which enhance bone formation. In this study, we investigated the interactions among MSCs, Mφ, and T cells in bone formation and explored the potential of subsets of BMAC. Coculture experiments were conducted using primary MSCs, Mφ, and CD4+ T cells at specific ratios. Our results indicate that nonactivated T cells had no direct influence on osteogenesis by MSCs, while coculturing MSCs with Mφ and T cells at a ratio of 1:5:10 positively impacted bone formation. Furthermore, higher numbers of T cells led to increased M2 polarization and a higher proportion of Th2 cells in the early stages of coculture. These findings suggest the potential for enhancing bone formation by adjusting immune and mesenchymal cell ratios in BMAC. By understanding the interactions and effects of immune cells on bone formation, we can develop more effective strategies and protocols for treating bone defects and nonunions. Further studies are needed to investigate these interactions in vivo and explore additional factors influencing MSC‐based therapies. [ABSTRACT FROM AUTHOR]

Background and purpose: Clinicians use the CTCAE scale to grade radiation dermatitis (RD) based on edema, erythema, and desquamation. The purpose of this study was to correlate the CTCAE scores with the severity of patient-reported symptoms using a skin symptom assessment (SSA) and the Radiation-Induced Skin Reaction Assessment Scale (RISRAS). Materials and methods: This is a secondary analysis of a randomized controlled trial involving 376 patients receiving Mepitel Film or standard-of-care for RD prophylaxis. The highest symptom categories for SSA and patient-component RISRAS assessments were selected from all time points, and a summary analysis and Spearman correlation coefficient was calculated for patients with CTCAE Grades 0, 1, 2, 3, and Grade 2/3, respectively. Analyses were conducted across all patients, within each treatment arm, and between arms in patients with only Grade 2 or 3 toxicity. Results: Weak correlations between CTCAE scores and all patient-reported skin symptoms were found across the entire cohort and each treatment arm (p < 0.05). Patients with Grade 2 (n = 72) and Grade 3 RD (n = 24) reported similar rates of patient-reported moderate-to-severe skin symptoms (11–72% vs 14–79%), with no significant difference in rates of individual moderate-to-severe symptom between these cohorts (p > 0.05). Between treatment arms, rates of patient-reported moderate-to-severe scores were similar for most symptoms. Conclusion: CTCAE RD scores are weakly correlated with patient-reported skin symptoms and cannot distinguish between patients with severe patient-reported outcomes. Clinicians should consider the limitations of CTCAE grading and incorporate patient-reported outcomes within clinical practice. [ABSTRACT FROM AUTHOR]

Automating the job hazard analysis (JHA) process is an urgent requirement in the construction safety management field due to limitations of the conventional process. The manual nature of conducting the JHA and the dynamic environment of construction sites make it necessary to perform the analysis before commencing the job and to then regularly update it in accordance with changes in the construction plans. With this in mind, this research aims to develop an automated approach to support safety personnel during the JHA process. In seeking to automate the JHA process, the nature of construction accidents, hazards and risk assessment needs to be studied in light of the theoretical knowledge on accident causation. Thus, this research was designed according to the constructive research approach to develop a job hazard analysis knowledge graph (JHAKG) to automate the JHA process. The JHAKG incorporated an ontology (O-JHAKG) built according to the systematic ontology development method, METHONTOLOGY, which formalises both explicit and implicit knowledge inherent in the JHA process. The data were imported to the JHAKG from an incident database using rule-based natural language processing (NLP) which helped to extract implicit information not evident in the traditional JHA document. The validation of the JHAKG was conducted in two stages: the first stage validated the information extraction process by calculating performance metrics, while the second stage validated the data population process and the JHAKG's reasoning capability. The overall research resulted in a comprehensive JHAKG with advanced inferencing capabilities which can assist safety personnel in effectively executing the JHA process. [ABSTRACT FROM AUTHOR]

External data (e.g., real‐world data (RWD) and historical data) have become more readily available. This has led to rapidly increasing interest in exploring and evaluating ways of utilizing external data to facilitate traditional clinical trials (TCT), especially for rare diseases with high unmet medical needs where a TCT would be impractical and/or unethical. In this article, we focus on hybrid studies that incorporate external data into randomized clinical trials to augment the control arm and explore a complex innovative design. A sequential adaptive design conducts multiple interim assessments to improve the accuracy of estimates of agreement between external data and current data. At each interim assessment, we apply the inverse probability weighted power prior (IPW‐PP) method to adaptively borrow information from external data to account for confounding and heterogeneity. The randomization ratio is dynamically adjusted during the interim assessment based on accumulatively augmented information to reduce the sample size of the current trial. Additionally, the proposed design can be extended to allow interim analyses for early efficacy/futility stopping, that is, early assessment of trial success or failure based on accumulated data, potentially reducing ineffective treatment exposure and unnecessary time and resources. The performance of the proposed method and design is evaluated via extensive simulation studies. The sequential adaptive design and IPW‐PP approach having desirable properties are implemented. [ABSTRACT FROM AUTHOR]

Summary: Sleepwear and bedding materials can affect sleep quality by influencing the skin and body temperature and thermal comfort. This review systematically evaluates the impact of sleepwear or bedding of different fibre types on sleep quality. A systematic search was conducted in six data bases plus Google Scholar and manual searches. Original articles that compared human sleep quality between at least two fibre types of bedding or sleepwear were included, resulting in nine eligible articles included in the review. The fibre types included cotton, polyester, wool, and blended materials for sleepwear; cotton, duck down, goose down, polyester and wool for duvet; and linen and a combination of cotton and polyester for bedding. The interplay between fibre materials and sleep quality is complex. Blended sleepwear demonstrated potential benefits for specific populations. Wool sleepwear showed benefits for sleep onset in adults (cool conditions) and in older adults (warm conditions). Linen bedsheets improved sleep quality under warm conditions in young adults. Goose down‐filled duvets increased slow‐wave sleep under cool conditions in young adults. However, a systematic comparison of fibre types is challenging due to the diverse nature of the studies evaluating sleep quality. Further research employing standardised methodologies with standard fibre samples in different populations and in different temperature conditions is imperative to elucidate comprehensively the effects of fibre choices on sleep quality. Despite the limitations and heterogeneity of the included studies, this analysis offers valuable insights for individuals seeking to optimise their sleep experiences and for manufacturers developing sleep‐related products. [ABSTRACT FROM AUTHOR]

Objective: Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation. Study Design: Survey and retrospective chart review. Setting: Tertiary care center. Methods: Emergency Medicine resident physicians completed an otologic skill self‐assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre‐ to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in‐person Otolaryngology consultation. Results: Forty‐six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (−13.6%), hemotympanum (−11.3%), and cerumen (−1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P <.01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in‐person Otolaryngology evaluation. Conclusion: Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e‐consultation model. [ABSTRACT FROM AUTHOR]

Background: The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. Methods: A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. Results: Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. Conclusions: Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women. [ABSTRACT FROM AUTHOR]