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The dramatic expansion of internet communication tools has led to the increased use of temporary online groups to solve problems, provide services, or produce new knowledge. However, many of these groups need help to collaborate effectively. The rapid development of new tools and collaboration forms requires ongoing experimentation to develop and test new ways to support this novel form of teamwork. Building on research demonstrating the use of nudges to shape behavior, we report the results of an experiment to nudge teamwork in 168 temporary online groups randomly assigned to one of four different nudge treatments. Each nudge was designed to spur one of three targeted collaborative processes (collaborator skill use, effective task strategy, and the level of collective effort) demonstrated to enhance collective intelligence in extant research. Our results support the basic notion that digitally nudging collaborative processes can improve collective intelligence. However, to our surprise, a couple of nudges had unintended negative effects and ultimately decreased collective intelligence. We discuss our results using structured speculation to systematically consider the conditions under which we would or would not expect the same patterns to materialize in order to clearly articulate directions for future research. [ABSTRACT FROM AUTHOR]

Background: Risk for colorectal cancer may accumulate through multiple environmental factors. Understanding their effects, along with genetics, age, and family history, could allow improvements in clinical decisions for screening protocols. We aimed to extend the previous work by recalibrating an environmental risk score (e-Score) for colorectal cancer among a sample of US veteran participants of the Million Veteran Program. Methods: Demographic, lifestyle, and colorectal cancer data from 2011 to 2022 were abstracted from survey responses and health records of 227,504 male Million Veteran Program participants. Weighting for each environmental factor's effect size was recalculated using Veterans Affairs training data to create a recalibrated e-Score. This recalibrated score was compared with the original weighted e-Score in a validation sample of 113,752 (n cases = 590). Nested multiple logistic regression models tested associations between quintiles for recalibrated and original e-Scores. Likelihood ratio tests were used to compare model performance. Results: Age (P < 0.0001), education (P < 0.0001), diabetes (P < 0.0001), physical activity (P < 0.0001), smoking (P < 0.0001), NSAID use (P < 0.0001), calcium (P = 0.015), folate (P = 0.020), and fruit consumption (P = 0.019) were significantly different between colorectal cancer case and control groups. In the validation sample, the recalibrated e-Score model significantly improved the base model performance (P < 0.001), but the original e-Score model did not (P = 0.07). The recalibrated e-Score model quintile 5 was associated with significantly higher odds for colorectal cancer compared with quintile 1 (Q5 vs. Q1: 1.79; 95% CI, 1.38-2.33). Conclusions: Multiple environmental factors and the recalibrated e-Score quintiles were significantly associated with colorectal cancer cases. Impact: A recalibrated, veteran-specific e-Score could be used to help personalize colorectal cancer screening and prevention strategies. [ABSTRACT FROM AUTHOR]

This article provides an overview and introduction to ChatGPT that can be used in higher education settings to help professors and students explore the capabilities of Artificial Intelligence (AI) while acquainting themselves with the popular ChatGPT interface. The article offers a demonstration of ChatGPT, including prompts to generate substantive exchanges and questions that introduce users to the technology while also allowing the technology to introduce itself to users. Several applications and examples that illustrate the potential for ChatGPT to enhance classroom dialogues are highlighted. [ABSTRACT FROM AUTHOR]

Electrodiagnostic studies can identify evidence of sensory and motor axonal loss (AL) in carpal tunnel syndrome (CTS) patients. However, the impact of sensory and motor AL on outcomes following carpal tunnel release (CTR) remains unclear. We hypothesize that patients with no evidence of sensory and motor AL will experience greater improvement following CTR compared to those with evidence of AL. Patients undergoing open and endoscopic CTR by four fellowship-trained orthopedic hand surgeons were identified. Sensory and motor AL were identified using preoperative electromyography and nerve conduction studies. Patients completed the following before surgery and 3-month postoperative patient-reported outcomes: Patient-Reported Outcomes Measurement Information System Upper Extremity (UE) and Pain Interference (PI) as well as Disabilities of the Arm, Shoulder, and Hand (Quick DASH [QD]). Preoperative and postoperative scores, changes in scores, and rates of achieving the minimally clinically important difference (MCID) were compared between patients with and without sensory and motor AL. One hundred and seventy-five patients were included. Of these, 91 exhibited sensory AL and 98 exhibited motor AL. Demographic matched analysis of patients with and without sensory AL showed no differences in before surgery, after surgery, difference, or proportion meeting MCID for UE, PI, or QD. Matched analysis revealed no difference in preoperative PROMs between patients with and without motor AL. Patients with motor AL had increased postoperative UE (better function), decreased postoperative PI (less PI) and QD (less disability), increased changes in PI and QD, as well as a greater proportion meeting MCID for QD compared to those without motor AL. There was no difference in post-CTR improvement between patients with and without sensory AL. However, contrary to our hypothesis, motor AL patients experienced greater postoperative improvement according to QD. These findings suggest surgery should be recommended for severe CTS patients with evidence of AL. These results can better inform physicians and patients as they discuss expectations of CTR outcomes. Prognosis II. [ABSTRACT FROM AUTHOR]

BACKGROUND: Aldosterone-producing adenomas (APAs) are a common cause of primary aldosteronism that can lead to cardiovascular complications if left untreated. Machine learning-based bioinformatics approaches have emerged as powerful tools for identifying potential disease markers, gaining widespread recognition in biomedical research. We aimed to use machine learning to discover novel biomarkers of APAs to identify new pathophysiological mechanisms. METHODS: We applied 2 machine learning algorithms to published RNA sequencing data to identify APA feature genes. Validation was performed using APA tissue samples, spatial transcriptomics, pig adrenal glands, and in vitro assays in a human adrenocortical cell line. RESULTS: Machine learning identified ATP2A3 as a key feature gene in APA, and its upregulation in APAs compared with the adjacent cortex was confirmed by spatial transcriptomics. In human adrenocortical cells, angiotensin II treatment increased ATP2A3 gene expression 9.15-fold. Silencing ATP2A3 decreased basal CYP11B2 expression and aldosterone secretion by 3.51-fold and 1.46-fold, respectively, and by 1.77-fold and 1.94-fold under angiotensin II stimulation. Dietary sodium restriction in pigs significantly increased ATP2A3 mRNA and protein levels. Spatial transcriptomics showed that APA cells exhibited higher ATP2A3 gene expression compared with all other adrenal cell types. The suppressive effect of ATP2A3 silencing on CYP11B2 expression was further enhanced by Ca2+ inhibitors. CONCLUSIONS: The ATP2A3 gene is highly expressed in APA and is a key regulator of CYP11B2 expression and aldosterone production. [ABSTRACT FROM AUTHOR]

In vitro studies indicate that kidney transplantation from gene-edited pigs in which expression of all 3 of the known glycan xenoantigens has been deleted may be more challenging in nonhuman primates (NHPs) than it will be in human recipients. Furthermore, pig-to-human xenotransplantation offers several other advantages—(1) the patient can communicate with the surgical team; (2) recipient microbiological monitoring and environment will be clinical-grade; and (3) sophisticated graft monitoring and imaging techniques, (4) therapeutic interventions, eg, dialysis, plasmapheresis, and (5) intensive care can be deployed that are not easily available in NHP laboratory models. We suggest, therefore, that progress to develop safe, informative human clinical trials will be accelerated if pilot clinical cases are initiated. The selection of patients for kidney xenotransplantation can include those who are at high risk of dying imminently, for example, those experiencing increasing vascular access challenges with no realistic alternative therapy available, and those who have been accepted onto the waitlist for an allograft, but who are unlikely ever to receive one. Patients with an increased risk of dying include those with (1) age above 60 years, (2) blood groups O or B, and (3) diabetic nephropathy. UNOS data indicate that an average of 25 patients on the kidney waitlist in the United States die or are removed from the list every day (ie, >9000 each year). Given the improved xenograft survival observed in preclinical studies, we suggest that it is time to plan a small pilot clinical trial for healthy dialysis patients who understand the risks and potential benefits of kidney xenotransplantation. [ABSTRACT FROM AUTHOR]

Baseball is one of the most popular sports among youth athletes in the United States, and among these players, pitchers are at a particularly high risk of sustaining an injury. Overuse of the arm from repetitive pitching is a common mechanism for injury. Despite the attention that overuse injury has received, little is known regarding the mechanism that leads to elbow injury. This study aims to determine the effect of increasing pitch count on elbow flexion at ball release in a youth pitching cohort. The authors hypothesize that elbow flexion would increase as pitch count increases. Study subjects included volunteers from youth baseball players from local teams and public advertisements. Retroreflective markers attached to bony landmarks were placed on the players according to International Shoulder Group recommendations. Pitchers threw an indoor simulated game. Three-dimensional marker trajectories were collected using a 12-camera optical motion capture system, and ball velocity was captured using a radar gun. Voluntary maximal isometric strength of the internal and external rotators was evaluated before and after pitching. Paired 2-tailed t tests were performed to determine if a significant change occurred between the fresh and fatigued sets. Twelve adolescent male pitchers were recruited. Eleven of 12 pitchers completed the prescribed 6 sets of 15 pitches, culminating in a 90-pitch simulated game. The ball speed in the second set was found to be the highest in all pitchers and was considered the "peak set" (P =.021), whereas ball speed was the slowest in the sixth set of pitches and was therefore considered the "fatigue set" (P =.001). There was a moderate but statistically significant inverse correlation between elbow flexion at ball release and maximum internal rotation velocity (P =.005). Elbow flexion at ball release was also significantly positively correlated with shoulder abduction at ball release (P =.004). Elbow flexion at ball release was not significantly correlated with ball velocity (P =.108). In a simulated game laboratory setting, increasing pitch count was associated with increasing elbow flexion angle at ball release in youth baseball pitchers. These findings demonstrate that pitching with fatigue may cause biomechanical changes that have been associated with increased rates of elbow injury in the adult throwing population. Further investigation on the association between elbow flexion angle and elbow injury in the youth baseball population is needed. [ABSTRACT FROM AUTHOR]

Total shoulder arthroplasty is performed by orthopedic surgeons with various fellowship training backgrounds. Whether surgeons performing shoulder arthroplasty with different types of fellowship training have differing rates of complications and reoperation remains unknown. The PearlDiver Mariner database was retrospectively queried from the years 2010 to 2022. Patients undergoing shoulder arthroplasty were selected using the CPT code 23472. Those undergoing revision arthroplasty and those with a history of fracture, infection, or malignancy were excluded. Fellowship was determined and verified via online search. Only surgeons who performed a minimum of 10 cases were selected; and PearlDiver was queried using their provider ID codes. Primary outcome measures included 90-day, 1-year, and 5-year rates of complication and reoperation. A Bonferroni correction was utilized in which the significance threshold was set at P ≤.00023. In total, 150,385 patients met the inclusion criteria and were included in the study. Analysis of surgical trends revealed that Sports Medicine and Shoulder and Elbow fellowship-trained surgeons are performing an increasing percentage of all shoulder arthroplasty over time, with each cohort exhibiting an 11.3% and 4.2% increase from 2010 to 2022, respectively. The geographic region with the highest proportion of cases performed by Sports Medicine surgeons was the West, while the Northeast has the highest proportion of cases performed by Shoulder and Elbow surgeons. Shoulder and Elbow surgeons operated on patients that were significantly younger and had fewer comorbidities. Both Shoulder and Elbow and Sports Medicine surgeons had lower rates of postoperative complications at 90 days, 1 year, and 5 years in comparison to surgeons who completed another type of fellowship or no fellowship. Across each time point, the rates of individual complications between Sports Medicine and Shoulder and Elbow were comparable, but the pooled complication rate was lowest in the Shoulder and Elbow cohort. Surgeons who have completed either a Sports Medicine or Shoulder and Elbow fellowship are performing an increasing proportion of shoulder arthroplasty over time. Sports Medicine and Shoulder and Elbow-trained surgeons have significantly lower complication rates at 90 days, 1 year, and 5 years postoperatively. The individual complication rates between Sports Medicine and Shoulder and Elbow are comparable, but Shoulder and Elbow have the lowest pooled complication rates overall. [ABSTRACT FROM AUTHOR]

Patients with peripheral artery disease (PAD) undergo lower extremity revascularization (LER) for symptomatic relief or limb salvage. Despite LER, patients remain at increased risk of platelet-mediated complications, such as major adverse cardiac and limb events (MACLEs). Platelet activity is associated with cardiovascular events, yet little is known about the dynamic nature of platelet activity over time. We, therefore, investigated the change in platelet activity over time and its association with long-term cardiovascular risk. Patients with PAD undergoing LER were enrolled into the multicenter, prospective Platelet Activity and Cardiovascular Events study. Platelet aggregation was assessed by light transmission aggregometry to submaximal epinephrine (0.4 μmol/L) immediately before LER, and on postoperative day 1 or 2 (POD1 or POD2) and 30 (POD30). A hyperreactive platelet phenotype was defined as >60% aggregation. Patients were followed longitudinally for MACLEs, defined as the composite of death, myocardial infarction, stroke, major lower extremity amputation, or acute limb ischemia leading to reintervention. Among 287 patients undergoing LER, the mean age was 70 ± 11 years, 33% were female, 61% were White, and 89% were on baseline antiplatelet therapy. Platelet aggregation to submaximal epinephrine induced a bimodal response; 15.5%, 16.8%, and 16.4% of patients demonstrated a hyperreactive platelet phenotype at baseline, POD1, and POD30, respectively. Platelet aggregation increased by 18.5% (P =.001) from baseline to POD1, which subsequently returned to baseline at POD30. After a median follow-up of 19 months, MACLEs occurred in 165 patients (57%). After adjustment for demographics, clinical risk factors, procedure type, and antiplatelet therapy, platelet hyperreactivity at POD1 was associated with a significant hazard of long-term MACLE (adjusted hazard ratio, 4.61; 95% confidence interval, 2.08-10.20; P <.001). Among patients with severe PAD, platelet activity increases after LER. Platelet hyperreactivity to submaximal epinephrine on POD1 is associated with long-term MACLE. Platelet activity after LER may represent a modifiable biomarker associated with excess cardiovascular risk. [ABSTRACT FROM AUTHOR]

Board-certified dermatologists experience diverse practice gaps. Identify the top self-selected focused Practice Improvement (fPI) modules completed over time by board-certified dermatologists during the program's first 8 years. Cohort study of dermatologists certified by the American Board of Dermatology (ABD) completing fPI modules from 2016 to 2023. This descriptive analysis reports modules completed by topic, subspecialty, relevance, and self-reported changes to subsequent patient care related to modules. About 19,143 fPI modules were completed by 7378 unique ABD diplomates, representing 48.8% of all current ABD-certified dermatologists (n = 15,118). Modules were rated relevant by 18,917 participants (99%). Care gaps requiring improvement efforts and performance remeasurement occurred in 2919 (15.2%) completed modules. Acne and medication-related laboratory monitoring were popular topics requiring improvement. Diplomates reported care improvements resulting from completing modules in 8397 instances (43.9%), and improved patient outcomes in at least one patient 5310 times (27.7%). Finally, diplomates stated they would recommend fPI modules to peers 18,633 (97.3%) times. Dermatologists who started but did not complete modules would not have rated the module. Attribution bias on care impact is possible and potentially overestimated. The ABD fPI program is helping board-certified dermatologists identify and improve gaps in care with reported patient outcome improvements. [ABSTRACT FROM AUTHOR]

Respiratory rate (mean number of breaths per minute) and respiratory interval (mean time between breaths) can offer insight into a diving mammal's activity state, metabolic rate, behavior, and synchronization due to social cohesion. Also, respiratory rate can reflect an individual animal's health and has the potential to be an informative remotely assessed health metric for monitoring individual animal health in endangered whale species and populations such as southern resident killer whales (Orcinus orca). Using data collected from noninvasive, land-based theodolite tracking, we analyzed swimming speed and surfacing intervals (i.e., mean dive time or mean time between breaths) from 20,613 surfacings of 98 individuals from two populations of the fish-eating, resident killer whale ecotype, namely, one growing (northern resident) and one declining and endangered (southern resident) population. Focal animal sampling was used to measure behavior of individuals of known age and sex in various activity states. Our objective was to evaluate variability and generate normal ranges for respiratory intervals and swimming speeds for killer whales of the Northeast Pacific Ocean resident, fish-eating ecotype to identify baseline respiratory intervals. We found that median respiratory intervals for fish-eating killer whales were between 26 and 29 s for all activity states and that swimming speeds varied by activity state. Median swimming speeds were similar for foraging and traveling (1.6 and 1.7 m/s, respectively), but were significantly slower during resting (1.1 m/s) and social activity (1.3 m/s) states. Three southern resident killer whales in poor body condition (had body condition scores in the lowest 20th percentile of the population) swam at reduced speeds and had shorter median respiratory intervals than outwardly healthy whales of similar age and sex. Respiratory rates, respiratory intervals, and swimming speeds are valuable remotely sensed metrics of health for free-swimming killer whales, especially when combined with other metrics as is the standard in veterinary examinations. [ABSTRACT FROM AUTHOR]

Bacillary hemoglobinuria (BH) is an infectious disease, mostly affecting cattle, caused by Clostridium haemolyticum (C. novyi type D), with acute hepatic necrosis and intravascular hemolysis. Cattle are typically predisposed to BH by liver injury caused by Fasciola hepatica, although cases have been reported in cattle without evidence of this parasite. Here we describe a cluster of 14 BH cases from 7 counties in north-central to central Missouri submitted to a veterinary diagnostic laboratory between December 2020 and April 2023. Postmortem examination in all cases revealed hemoglobinuria and acute hepatic necrosis with large numbers of gram-positive bacilli with terminal-to-subterminal spores. Flukes, fluke ova, and/or fluke pigment consistent with Fascioloides magna were identified in 12 of 14 cases. Sequences of the nuclear ribosomal internal transcribed spacer 1 (ITS1) from one fluke had 100% identity to F. magna. C. novyi was detected by fluorescent antibody testing of liver impression smears (11 of 12 cases) and by immunohistochemistry of liver sections (7 of 7 cases). PCR on formalin-fixed, paraffin-embedded tissues amplified the C. haemolyticum beta toxin gene in each of the 7 cases tested. To our knowledge, a confirmed cluster of BH associated with F. magna has not been reported previously in cattle. [ABSTRACT FROM AUTHOR]

The article highlights the gaps and strengths in instructional approaches for developing word-level knowledge in adolescent learners.

This study unveils the establishment of the United Kingdom-Netherlands Decomposition Experimental Research (UNDER) working group, marking a pioneering initiative in practical Forensic Taphonomy within the UK. Our primary objective was to craft a cohesive multidisciplinary framework, designed to ethically orchestrate, execute, and assess human decomposition. Concurrently, we aimed to amass data through human burials, fostering collaboration among diverse forensic experts across Europe. The compilation of data collected over the year, elucidates the comprehensive utilisation of cadavers through a multifaceted scientific methodology. This paper discusses the triumphs, challenges, and innovative solutions encountered during this undertaking, providing a blueprint for forthcoming European research in Forensic Taphonomy. Our efforts support the comparability of longitudinal studies and give strategies to address the challenges posed by the scarcity and diversity of human donors in forensic science. Moreover, we propose the adoption of a dynamic scientific research management framework, which includes thorough identification, measurement, analysis, and application of solutions. Emphasis is also placed on adeptly managing business processes to ensure sustained relevance in both research and other stakeholders. [ABSTRACT FROM AUTHOR]

Background: Scanning with low-dose computed tomography reduces lung cancer mortality by 20% among high-risk individuals. Despite its efficacy, the uptake of lung cancer screening (LCS) remains low. Our study aimed to estimate state-level and nationwide LCS rates among eligible individuals and to assess disparities in LCS uptake. Methods: Data for this study were obtained from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression models were used to model the associations between predictors and outcome variables and to examine LCS variability across states. Results: Of the 28,071 participants eligible for LCS, 17.24% underwent LCS. Participants ages 65 to 79 years were [OR, 1.75; 95% confidence interval (CI), 1.54-1.99] more likely to undergo LCS than their younger counterparts. Those who were female (OR, 0.83; 95% CI, 0.73-0.94); divorced, separated, or widowed (OR, 0.85; 95% CI, 0.74-0.98); without health insurance (OR, 0.34; 95% CI, 0.22-0.53); without a primary care provider (OR, 0.29; 95% CI, 0.19-0.44); and without chronic obstructive pulmonary disease or those who did not disclose their chronic obstructive pulmonary disease status (OR, 0.35; 95% CI, 0.31-0.40 and OR, 0.37; 95% CI, 0.19-0.73, respectively) were less likely to undergo LCS than their respective counterparts. LCS uptake also varied significantly across U.S. states. Conclusions: We observed a low uptake of LCS overall and significant variability in LCS uptake by sociodemographic and health-related factors, as well as by state of residence. Impact: The findings from this study have important implications for community health workers and healthcare clinicians and indicate the need to design effective interventions to increase LCS uptake, targeting specific subgroups of populations and particular U.S. states. [ABSTRACT FROM AUTHOR]

Background: Bicycle Motocross (BMX) has evolved to cater to different styles of riders, including Flatland, Street, Park, and Dirt. BMX culture is characterised by a unique framework of regulations, guidelines, and principles of which a subculture has a pronounced anti-establishment sentiment and embraced do-it-yourself (DIY) practices, contributing to its distinctive identity within the realm of sport. Formal organisations have emerged, leading to the legitimisation of BMX through events such as the Olympics. To the author's knowledge, this is the first attempt to identify and synthesise all academic publications on BMX and describe the emergence of this research. Methods: After adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) guidelines 940 studies were identified in the initial search and post screening 87 studies were included. Data was extracted to determine, among other things, the year of publication, methodology adopted, type of BMX and/or BMXers studied, discipline of the study, and focus of inquiry. No date limiter was applied to the search strategy. Results: We identified 87 BMX-related articles for analysis, published between 1982 to 2022. The majority of these studies were conducted within the disciplines of biomechanics and physiology/sports science with a primary focus on performance-enhancing techniques within BMX racing. Most studies have emerged from the UK, with both males and females as their gender sample, using quantitative methodology. Conclusions: This scoping review identified several trends in the history of BMX research. It also identified important gaps and possible avenues for future research to contribute to academic knowledge in this growing field. [ABSTRACT FROM AUTHOR]