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Abstract Physical exercise is a potential intervention for enhancing cognitive function across the lifespan. However, while studies employing long-term exercise interventions consistently show positive effects on cognition, studies using single acute bouts have produced mixed results. Here, a systematic review and meta-analysis was conducted to determine the impact of acute exercise on cognitive task performance in healthy young adults. A Bayesian hierarchical model quantified probabilistic evidence for a modulatory relationship by synthesizing 651 effect sizes from 113 studies from PsychInfo and Google Scholar representing 4,390 participants. Publication bias was mitigated using the trim-and-fill method. Acute exercise was found to have a small beneficial effect on cognition (g = 0.13 ± 0.04; BF = 3.67) and decrease reaction time. A meta-analysis restricted to executive function tasks revealed improvements in working memory and inhibition. Meta-analytic estimates were consistent across multiple priors and likelihood functions. Physical activities were categorized based on exercise type (e.g., cycling) because many activities have aerobic and anaerobic components, but this approach may limit comparison to studies that categorize activities based on metabolic demands. The current study provides an updated synthesis of the existing literature and insights into the robustness of acute exercise-induced effects on cognition. Funding provided by the United States Army Research Office.

Ocean Accounts, aligned with the UN System of Environmental Economic Accounting – Environmental Accounting (SEEA EA), bring together economic, social and environmental information in a coherent and standardised manner. Ecosystem extent is a structure to understand environmental assets and uses a basic spatial unit to facilitate the classification and measurement of ecosystems by type. This study tested the impact of grid size and method of designation per grid cell for Marine Basic Spatial Units (MBSU), using Saleh Bay, Indonesia as a case study. The extent of mangrove, seagrass and coral reefs were previously delineated in 2021 for ocean accounting activities. This study tested grids with two different cell sizes (10 x 10 m2 and 25 x 25 m2) and two different methods of designation, namely: (i) dominance (extent-based) and (ii) hierarchy (criteria-based) methods. The results indicated that a larger grid size is related to higher error in estimating both total area per ecosystem and spatial configuration within the study area. The dominance method produced more accurate results than the hierarchy method, although, when considering computational trade-offs, a larger grid size and the hierarchy method observed a much lower computational cost. These results demonstrate the need to carefully consider grid size and method when designating basic spatial units for accounting activities, as they impact linked accounting tables and, in turn, have implications when providing information for management and policy.

Abstract Climate change is intensifying extreme weather events, including marine heatwaves, which are prolonged periods of anomalously high sea surface temperature that pose a novel threat to aquatic animals. Tropical animals may be especially vulnerable to marine heatwaves because they are adapted to a narrow temperature range. If these animals cannot acclimate to marine heatwaves, the extreme heat could impair their behavior and fitness. Here, we investigated how marine heatwave conditions affected the performance and thermal tolerance of a tropical predatory fish, arceye hawkfish (Paracirrhites arcatus), across two seasons in Moorea, French Polynesia. We found that the fish’s daily activities, including recovery from burst swimming and digestion, were more energetically costly in fish exposed to marine heatwave conditions across both seasons, while their aerobic capacity remained the same. Given their constrained energy budget, these rising costs associated with warming may impact how hawkfish prioritize activities. Additionally, hawkfish that were exposed to hotter temperatures exhibited cardiac plasticity by increasing their maximum heart rate but were still operating within a few degrees of their thermal limits. With more frequent and intense heatwaves, hawkfish, and other tropical fishes must rapidly acclimate, or they may suffer physiological consequences that alter their role in the ecosystem.

Abstract CD19‐targeted chimeric antigen receptor T‐cell (CAR‐T) immunotherapy has transformed the management of relapsed/refractory large B‐cell lymphoma (LBCL), yet durable remissions are observed in less than half of treated patients. The tumor microenvironment (TME) is a key and understudied factor impacting CD19 CAR‐T therapy outcomes. Using NanoString nCounter transcriptome profiling (n = 24) and multiplex immunohistochemistry (mIHC, n = 15), we studied the TME in pretreatment biopsies from patients with LBCL undergoing CD19 CAR‐T therapy. Patients who achieved complete response (CR) after CAR‐T therapy demonstrated higher expression of genes associated with T‐cell trafficking and function, whereas those who did not achieve CR had higher expression of genes associated with macrophages and T‐cell dysfunction. Distinct patterns of immune infiltration and fibrosis in the TME were associated with CAR‐T therapy outcomes, and these findings were corroborated using artificial intelligence‐assisted image analyses. Patients who achieved CR had a lower proportion of the biopsy occupied by an interspersed immune infiltrate and a higher proportion of hypocellular/fibrotic regions. Furthermore, mIHC revealed lower density of CD4+ T cells and higher densities of both macrophages and tumor cells expressing PD‐L1 in non‐CR patients. Spatial analysis revealed that PD‐1+ T cells were in close proximity to PD‐L1+ macrophages or PD‐L1+ tumor cells in patients who did not compared to those who did achieve CR after CAR‐T therapy. These findings suggest that morphologic patterns in the TME and engagement of the PD‐1/PD‐L1 axis in pretreatment biopsies may impact CD19 CAR‐T immunotherapy response in patients with LBCL.

Background: Despite positive outcomes in controlled trials, organizations have been slow to adopt health literacy practices. The purpose of the Communicate to CARE (Clear Communication, Achieve Understanding with Teach-Back, Receptive to our patient family needs, Empathetic care delivery) study was to use theories and strategies from implementation science to scale up health literacy practices in a pediatric Ears, Nose, and Throat (ENT) clinic. Brief Description of Activity: Expanding on previous efforts that simply reflected on barriers, the CARE team identified barriers within the local context pre-implementation to select strategies to directly address barriers during health literacy implementation. The RE-AIM framework was used to evaluate the reach, effectiveness, adoption, implementation, and maintenance of health literacy practices. Implementation: Over 18 months, the CARE team delivered multiple implementation strategies, including external facilitator, microlessons, preparing champions, audit and feedback, local consensus discussions, and small test of change. We tailored health literacy practices to clinic team roles to accommodate the clinic workflow. Results: ENT team mean ratings on acceptability, appropriateness, and feasibility remained >4 indicating a high likelihood of successful implementation. Caregiver always ratings significantly increased from baseline to 12 months for easy-to-understand medication instructions (74%–96%), test results (54%–96%), know what to do if had questions (89%–96%), and encouraged to talk about health problems (76%–90%). Caregiver ratings dropped slightly at 18 months, indicating a need for booster training. While one third of caregivers reported Teach-Back practice across all time periods, the ENT team reported increased practice from baseline (42%), 6 (61%) and 12 months (70%). Lessons Learned: Over the first 12 months, the external facilitator delivered implementation strategies with weekly contact, tapering contact over the final 6 months. The local champion became engaged in the CARE study through a quality improvement project with meaningful outcomes for the clinic and an incentivization program for scholarly endeavors. Lunch and learn sessions helped build relationships between the CARE and ENT team to discuss and problem solve issues. The 5-item CAHPS health literacy composite proved to be sensitive to changes during implementation of health literacy practices. Integrating these items into standard follow up surveys with patients and families would help realize the return on investment for health literacy implementation. [HLRP: Health Literacy Research and Practice. 2024;8(3):e166–e174.]

Purpose: An effective didactic curriculum is a cornerstone for a successful residency program, as it is the basis upon which residents acquire the necessary knowledge and perspective to provide high-quality, evidence-based care. Here we describe our success in creating a standardized curriculum in clinical radiation oncology – one that was well-received and led to significantly improved performance on the national in-service examination. Methods and Materials: One-hundred and fifty topics were outlined in accordance with the American Board of Radiology; to accommodate this breadth of material, didactic frequency was increased from biweekly to daily. As a clinical correlate to these sessions, a teaching library of over 100 real-world cases was compiled for individual learning. Finally, comprehensive dosimetric constraints were compiled to aid residents in radiation therapy plan evaluation. To evaluate these curricular changes, anonymous questionnaires were provided to all residents and faculty, and de-identified resident clinical performance from the annual in-service examination was analyzed. Results: Before the introduction of the standardized curriculum, the mean clinical percentage on the in-service examination was 46%, equivalent to the 17th percentile. Within 2 years of implementation of the new curriculum, both the mean percentage and percentile were significantly improved, with the mean percentage correct at 69.3% and the mean percentile at the 59th percentile (P < .001 and P = .034, respectively). Feedback showed the curriculum to be well-received and used frequently outside of standard didactic hours. Conclusions: This is the first report of the creation of a standardized curriculum and outcomes in radiation oncology. Although there are certainly developmental challenges, addressing these barriers creates an education model that effectively imparts knowledge, fosters multidisciplinary thinking, and prepares residents for the diverse challenges of clinical practice. We present our institutional experience with the intent of publishing this curriculum on a national platform in the coming years.

Purpose: Pediatric low-grade tectal gliomas are rare, indolent tumors of the brain stem. We reviewed outcomes of pediatric patients who received a diagnosis of low-grade tectal gliomas and report dosimetric parameters for those receiving radiation therapy (RT). Methods and Materials: We retrospectively reviewed all pediatric patients (age

Ecosystem Accounting provides a framework to measure and value relationships amongst ecosystems, society and the economy. The accounts measure ecosystem extent, condition and services, providing the means to identify and internalise ecological degradation, as well as understanding the risks and dependencies of economic activities on the environment and tracking progress towards sustainable development. The OSPAR Convention, which concerns the protection of the Marine Environment for the North-East Atlantic, has committed to accounting for natural capital and ecosystem services, where the UN System of Environmental Economic Accounting – Ecosystem Accounting (SEEA EA) provides an international accounting standard for guidance in compiling accounts. Here, we describe the first attempt in compiling accounts aligned with SEEA EA at a Regional Sea scale. We: (i) identified existing open access data, (ii) produced accounts for selected ecosystems and valued their services and asset value and (iii) identified challenges and lessons learned. For ecosystem services, we measured fish provisioning, carbon sequestration and outdoor recreation from coastal and marine environments across OSPAR contracting parties. The exercise identified lack of fitting data at regional level, spatially-explicit linkages and harmonisation need to be overcome to further expand accounts. This work represents an initial step to progress on ecosystem accounting and demonstrates that even with limited data and incomplete time-series, accounts can start being compiled to identify data gaps and prioritising next steps.

This study aims to assess the pollution levels and sources of heavy metals (Al, Mn, Co, Ni, Sc and V) and radionuclides (Th and U) in sediments of Lékié Watershed in Cameroon. Surface sediment samples were collected from 14 stations across different areas of the Lékié Watershed. The heavy metal and radionuclide analysis on sediments were carried out and pollution indices such as enrichment factor (EF), contamination factor (CF), degree of contamination (DC), pollution load index (PLI), potential ecological risk assessment and multivariate statistical methods were utilized to evaluate the degree of contamination and estimate the source of metals in the sediments of Lékié Watershed. The results show that the mean concentrations are lower than those of the upper continental crust (UCC) reference values except those of Mn, Co, Ni, and V. The values of EF varied from moderate to severe enrichments (from 4 to 44). The contamination factor (1 < CF < 3), potential ecological risk ( 1, indicating pollution. The application of multivariate analysis to these metallic elements reveals contaminations attributed to anthropogenic activities, including the release of domestic, artisanal mining, and industrial effluents, as well as natural sources originating from the leaching of local surrounding soils and geological factors. To mitigate more pollution in this watershed which is closed from urbanization, it is crucial for local authorities to implement wastewater treatment measures.

BackgroundPeritoneal carcinomatosis is a particularly rare presentation of prostate cancer. Here we report a rare clinical case of surgically identified peritoneal carcinomatosis at the time of a planned robotic prostatectomy in a patient with a history of prostatic urethral lift procedure.Case presentationA 72-year-old man, with a history of urinary retention managed with tamsulosin, presented to his local urologist. Prostatic urethral lift procedures were performed for symptom management. After a definitive uptrend in his prostate-specific antigen (PSA) values, a biopsy was obtained, which demonstrated prostate adenocarcinoma. On presurgical multidisciplinary review, it was presumed that he had very high-risk localized prostate cancer. However, upon initiation of robotically assisted laparoscopic radical prostatectomy (RALP), he was noted to have numerous punctate white plaques on the peritoneum; biopsy of these lesions confirmed metastatic disease—for which the patient was starting on triple therapy per the PEACE-1 trial. The PSA level responded appropriately, decreasing from 16.8 to 0.08. Genetic testing was performed and returned negative for any clinically significant mutations.ConclusionOur patient, diagnosed with peritoneal carcinomatosis during a planned RALP, highlights the importance of vigilant laparoscopic exam prior to this prostatectomy. Multidisciplinary discussion is crucial for individualized and optimal treatment planning.

In this research, the effect of acai pulp on the physicochemical, sensory quality, and antioxidant capacity of a type II yogurt sweetened with Stevia was evaluated. A completely randomized experimental design with a factorial arrangement was proposed, the factor under study corresponded to the concentrations of 5, 10 and 15% of acai pulp. Three replicates per formulation trial were established respectively. The Tukey test was used for the physicochemical and antioxidant capacity variables, while the KruskalWallis test was used for the sensory profile. A significant difference was determined in the study variables and the following results were obtained: pH 3.78 -3.79; °Brix 6.53 –7.03%; acidity 0.90 –1.02%; density 1,036 –1,039 g/ml; total solids 11.93 –12.05%; viscosity of 291.67 –382.67 mPa.s; protein 2.43 –2.49%; fat 1.27 –1.57%; total phenols 635.80 –2002.04 mg EAG/mL; antioxidant capacity 0.55 –1.84 μmol EQ Trolox/mL; the test with the best sensory acceptance was A3 (15% acai pulp) which obtained a significant difference in the flavor and texture attribute, in addition, it presented better values in colorimetry in terms of Lightness 74.87, saturation 2.47 and tone 19.30. Except for the protein content, all the treatments presented microbiological and physicochemical quality within the requirements of the INEN 2395 standard, on the other hand, the proposed hypothesis was accepted since all the evaluated parameters varied significantly in the proposed formulations. Yogurt with acai pulp can be considered a food with potential functional compounds for the benefit of the consumer.

Coasts lie at the interface between terrestrial and marine environments, where complex interrelationships and feedbacks between environmental, social and economic factors provide a challenge for decision-making. The knowledge and data needed to link and measure these multiple domains are often highly fragmented and incoherent. Ocean Accounting provides a means to organise relevant ocean data into a common framework, grounded in existing international statistical standards for national and environmental-economic accounting. Here, we test Ocean Accounting within Lake Illawarra, New South Wales (Australia), compiling accounts for the years between 2010 and 2020, inclusive, to measure the extent of coastal vegetation (mangrove, tidal marsh and seagrass) and associated ecosystem services flows (climate change mitigation, eutrophication mitigation) in physical and monetary terms and associated production and employment within sectors of the ocean economy. The accounts show an increase in mangroves by 2 ha and a decrease in seagrass of 80 ha. A net increase was observed in the amount of carbon, nitrogen and phosphorus sequestered across coastal vegetation, due to the expansion of mangroves. Alongside changes in ecosystem extent, a 2-fold increase in full-time ocean-related employment was observed. Fisheries catch also showed significant variation over the 10-year period, where dependencies were observed between commercial species with seagrass and tidal marsh. The relationships and measures derived from accounts provide a cohesive and integrated understanding to provide information for the management and standardised ecosystem service assessments.

Chimp Haven is a sanctuary for chimpanzees retired from biomedical research, rescued from the pet trade, or re-homed after other organizations could no longer care for them. To provide optimal care for over 300 chimpanzees, Chimp Haven’s animal care team includes experts in behavioral science, veterinary treatment, and husbandry practices. To aid these teams in making routine welfare management decisions, a system of behavioral metrics provides objective data to guide decisions and track outcomes. Chimp Haven has built and piloted seven behavioral metric protocols over the past 5 years to provide staff with an objective and comprehensive picture of the chimpanzees’ behavioral welfare. The data from behavioral observations, staff surveys, and routine staff documentation are analyzed and processed through Google Forms, ZooMonitor, Microsoft Power Bi, Microsoft Excel, and R. Each metric assists staff in making data-based decisions regarding the management of captive chimpanzees related to abnormal behavior, hair loss, wounding, social relationships, positive reinforcement training and overall wellness. In this article, we explore examples of each metric and how they have been utilized to monitor and make decisions for both social groups of chimpanzees as well as individuals. These metrics can be collected and shared easily in an understandable format, which may provide an important framework for others to follow to enable the tracking of welfare for other sanctuaries, non-human primates, as well as other species.

Plastic debris within marine environments is an issue of global concern, leading to commitments at international, regional, and national scales to remove plastics from the environment and prevent further entry. The United Nations (UN) created a global framework of 17 Sustainable Development Goals (SDGs), with several goals to advance the environmental dimension of sustainable development, with global and country progress tracked by targets and their indicators. Countries voluntarily report their progress on the basis of guidance provided by the UN on what data is needed. SDG 14, Life Below Water, contains one target to significantly reduce marine pollution, with specific mention of plastic debris. To date, however, national information on plastic debris has been sparse, although citizen science projects have been collecting data at a spatial and temporal coverage relevant to SDG reporting. This paper provides an overview to clarify the data requirements for reporting on the SDG indicator of plastic debris density and the complex process in which data for SDGs is requested from and provided by countries. We then explore the potential for citizen science to assist countries in filling evidence gaps, through providing data on plastic pollution. We focus on the sub-indicator for beach debris, which accounts for most citizen science projects collecting data on plastic pollution. Then, we unpack the opportunities and challenges of augmenting SDG reporting with information gathered from citizen science communities. Lastly, we recommend ways for citizen science communities and governments to synergize efforts monitoring plastics to inform pathways for preventing and reducing such pollution ending up in our marine environments.

A glicose é uma importante fonte de energia para todos os seres vivos, sem distinção. Dessa forma, o presente trabalho teve como objetivo avaliar o incremento na curva glicêmica após a profilaxia dentária, comprovando sua eficiência. Foram utilizados 8 (oito) animais, hígidos, do Centro de Equoterapia da APAE Colatina/ES. Os animais do experimento, com peso médio de 369kg e idade de 10,3 anos, nunca haviam passado por avaliação odontológica e nem profilaxia dentária. Foram coletadas amostras de sangue antes da realização da profilaxia, tanto com avaliação laboratorial quanto com o uso do glicosímetro. Após a realização do procedimento odontológico foi feito nova coleta de sangue para avaliar a influência da profilaxia dentária neste parâmetro estudado. Com o estudo pudemos concluir que a profilaxia dentária em equinos aumenta os níveis de glicose no sangue, quando são avaliados em laboratório.

Politicians are skilled language users who deploy words strategically and pay close attention to the emotions that those words evoke. We examined the emotional characteristics of over 92 million words spoken by Canadian Members of Parliament between 2006 and 2021. The analysis brought together the Warriner, Kuperman, and Brysbaert (Behav. Res., 2013, 45, 1191–1207) database of valence (positivity) ratings for English and the Canadian Hansard, which contains a transcription of parliamentary speech. Results revealed that the positivity of words used by politicians in parliament was significantly related to both political and social variables. Politicians increased the positivity of their language after the onset of the COVID-19 crisis. Within the time of the crisis, word positivity was linked statistically to month-by-month case counts, indicating a very fine-grained sensitivity to social realities. Our analysis also revealed a fine-grained sensitivity of word valence to political realities. As expected, parties in power used more positive language than those in opposition. In addition, our analysis revealed that individual parties have characteristic levels of word positivity and that those levels change in accordance with political changes as specific as whether or not the party in power holds a majority of seats in parliament. These findings suggest that the emotional properties of words used by Members of Parliament are reliably indexed to sociopolitical dynamics. The findings also suggest that the methodology of linking individual word ratings to Hansard Documents (which are used to document Parliamentary activities in over 25 countries) can provide a key tool for the understanding of specific crises such as the COVID-19 global pandemic as well as more general social and political trends across countries and languages.

Abstract: Allogeneic hematopoietic cell transplantation (allo-HCT) is offered to selected patients after chimeric antigen receptor–modified T-cell (CAR-T) therapy. Lymphodepleting chemotherapy and CAR-T therapy have immunosuppressive and immunomodulatory effects that could alter the safety profile of subsequent allo-HCT. We reviewed our experience with 32 adults (acute lymphoblastic leukemia [ALL], n = 19; B-cell non-Hodgkin lymphoma [NHL]/chronic lymphocytic leukemia [CLL], n = 13) who received an allo-HCT after CAR-T therapy, with a focus on posttransplant toxicities. Myeloablative conditioning (MAC) was used in 74% of ALL patients and 39% of NHL/CLL patients. The median time from CAR-T therapy to allo-HCT was 72 days in ALL patients and 122 days in NHL/CLL patients. Cumulative incidences of grade 3-4 acute graft-versus-host disease (GVHD) and chronic GVHD were 25% and 10%, respectively. All patients had neutrophil recovery (median, 18.5 days) and all but 3 had platelet recovery (median, 12 days). Twenty-two percent had viral or systemic fungal infection within 100 days after allo-HCT. The 100-day and 1-year cumulative incidences of NRM were 16% and 21%, respectively, for ALL patients and 15% and 33%, respectively, for NHL/CLL patients. In ALL patients, later utilization of allo-HCT after CAR-T therapy was associated with higher mortality. In NHL/CLL patients, MAC was associated with higher mortality. Toxicities did not exceed the expected incidences in this high-risk population.

Abstract Objective Several controversial findings have been reported on treatment outcomes for diabetic stroke patients that received thrombolysis therapy in the hospital. We determined whether the association between telestroke technology, thrombolysis therapy and clinical risk factors in diabetic acute ischemic stroke may result in the inclusion or exclusion or more diabetic ischemic stroke patients for thrombolysis therapy. Methods Retrospective data that comprises of a total of 3202 acute ischemic stroke patients from a regional stroke registry that contained telestroke and non telestroke patients with a primary diagnosis of acute ischemic stroke of which 312 were identified as diabetic stroke patients were used in this study. Multivariate logistic regression models were used to determine the associated pre-clinical risk factors, and demographics associated with recombinant tissue plasminogen activator (rtPA) therapy in a subset of diabetic acute ischemic stroke patients in the telestroke and non-telestroke settings. Results In the telestroke, only higher International Normalized Ratio (INR) [odds ratio, OR = 0.063 (0.003–1.347, 95% confidence interval (CI)] was associated with exclusion from thrombolysis. Direct admission [OR, 3.141 (1–9.867), 95% CI] and telestroke [OR, 4.87 (1.834–12.928), 95% CI] were independent predictors in the inclusion for thrombolysis therapy. In the non telestroke, older age (> 80 years) [(OR), 0.955 (0.922–0.989), 95% CI], higher blood glucose level [OR, 0.994 (0.99–0.999); 95% CI], higher INR [OR, 0.113 (0.014–0.944); 95% CI], and renal insufficiency [OR, 0.163 (0.033–0.791); 95% CI] were associated with exclusion while higher NIH stroke scale [OR, 1.068 (1.009–1.13); 95% CI] was associated with inclusion for thrombolysis in the non telestroke. Conclusion The non-telestroke setting admitted more diabetic stroke patients to the hospital, but more were excluded from thrombolysis therapy when compared with the telestroke setting. Measures to improve clinical risk factors that excluded more diabetic ischemic stroke patients in the non telestroke will improve the use of thrombolysis in the treatment of diabetic acute ischemic stroke patients.

Abstract Background In acute ischemic stroke patients, telestroke technology provides sustainable approaches to improve the use of thrombolysis therapy. How this is achieved as it relates to inclusion or exclusion of clinical risk factors for thrombolysis is not fully understood. We investigated this in a population of hypertensive stroke patients. Methods Structured data from a regional stroke registry that contained telestroke and non telestroke patients with a primary diagnosis of acute ischemic stroke with history of hypertension were collected between January 2014 and June 2016. Clinical risk factors associated with inclusion or exclusion for recombinant tissue plasminogen activator (rtPA) in the telestroke and non telestroke were identified using multiple regression analysis. Associations between variables and rtPA in the regression models were determined using variance inflation factors while the fitness of each model was determined using the ROC curve to predict the power of each logistic regression model. Results The non telestroke admitted more patients (62% vs 38%), when compared with the telestroke. Although the telestroke admitted fewer patients, it excluded 11% and administered thrombolysis therapy to 89% of stroke patients with hypertension. In the non telestroke group, adjusted odd ratios showed significant associations of NIH stroke scale score (OR = 1.059, 95% CI, 1.025–1.093, P

We sought to move beyond single word and sentence processing experiments in order to examine textual effects on the processing of compound words in English. We developed minimal texts (sentences pairs that together constitute a story) that had neutral, semantic or lexical relations between the last word of the first sentence and the second word of the second sentence (which was always a compound noun). This generated minimal text triplets that differed only in the last word of the first sentence (e.g., “She walked down to the path/river/water. The waterfall roared in the distance”). Four experiments were conducted with a total 143 native speakers of English. Experiment 1 employed a Modified Maze Task to identify cross-sentence effects on compound processing. Sentence pairs with lexical links differed from those with semantic links, which, in turn differed from neutral pairs, providing evidence of cross-sentence influence on compound processing. In Experiments 2a, 2b, and 2c, we examined compound production using typing tasks. Results indicated that morphological effects found in single word typing persisted in text typing. In addition, constituent priming effects on typing were seen in both single word typing and sentence typing. Finally, morphological effects were correlated with overall story ratings. We thus conclude that morphological effects are not restricted to single word processing, but rather reflect the dynamics of real-world language processing.

Objectives:. The recent conflicting data on the mortality benefit of neuromuscular blocking agents in acute respiratory distress syndrome and the potential adverse effects of continuous neuromuscular blocking agent necessitates that these medications should be used judiciously with dose reduction in mind. The aims of the study were to improve the process of care by provider education of neuromuscular blocking agent titration and monitoring and to determine the impact of clinical endpoint based neuromuscular blocking agent titration protocol. Design:. We conducted a proof-of-concept historically controlled study of protocol-based intervention standardizing paralytic monitoring and titration using clinical variables. Education of the protocol was provided to ICU staff via bedside teaching and workshops. The primary outcomes were the time to reach goal paralysis and cumulative neuromuscular blocking agent dose. Secondary outcomes included maintenance of deeper sedation (Richmond Agitation and Sedation Scale –5) prior to neuromuscular blocking agent initiation, total time on mechanical ventilation, length of stay, and mortality. Setting:. Medical ICU at a quaternary academic hospital between March 2019 and June 2020. Patients:. Adult severe acute respiratory distress syndrome (Pao2/Fio2

Background: Partial face composite allotransplantation poses a unique aesthetic challenge. Namely, partial face transplants need to resemble the patient’s native skin. The degree of resemblance considered acceptable is a prominent variable and may depend on the gender and underlying skin tone of the recipient. The primary aim of this study was to investigate the degree of skin tone matching deemed aesthetically tolerable, recipient gender, and recipient skin tone. Two populations were queried: (1) the general public and (2) plastic surgeons. Few studies have investigated this topic from either of these standpoints. A secondary aim was to determine whether participant characteristics such as demographics, skin color, and history of having had facial surgery impacted their perceptions. Methods: This was a cross-sectional investigation of perceptions on skin tone matching. Participants from the general public were recruited through Amazon Mechanical Turk and surgeons were recruited through the American Council of Academic Plastic Surgeons. Participants were queried for aesthetic preferences using frontal face photos from age-standardized models. Skin tones of transplanted segments were varied using the Munsell color scale via Adobe Photoshop (Adobe Inc., San Jose, CA). Results: In total, 550 lay participants from Amazon Mechanical Turk and 21 plastic surgeons provided complete survey responses. On average, plastic surgeons tolerated a lesser degree of skin tone discordance than the lay public: 87% of lay participants and 33% of plastic surgeons believed a change of 4 hues was acceptable (p=0.02). Additionally, all survey respondents tolerated less of a degree of skin tone discrepancy on female faces when compared to male faces (mean difference tolerated: 2 hues for females, 4 hues for males). Participants tended to tolerate less skin tone discrepancy in subjects with similar skin tones as their own (mean difference tolerated: 2 hues for own versus 4 hues for different skin tones, p=0.04). Conclusion: This study highlighted the intensely- subjective nature of aesthetic preferences surrounding skin tone matching on the face, which varied by demographics and between surgeons versus the lay public. Surgeons should ensure that they truly elicit their patients’ preferences, especially given that our results demonstrated a greater tolerance for discrepancies among the lay public compared to plastic surgeons. Procuring a graft for facial allotransplantation is challenging; understanding what level of skin tone discrepancy is tolerable to the recipient can help surgeons improve patient satisfaction and may also lessen time-to-transplant by enlarging the potential donor pool for this type of transplant.

Abstract Background Clinical risk factors related to not administering thrombolysis to acute ischemic stroke patients with incidence dyslipidemia is not clear. This issue was investigated in telestroke and non-telestroke settings. Methods We analyzed retrospective data collected from a stroke registry to compare exclusion risk factors in the telestroke and non-telestroke. We performed multivariate analysis was performed to identify risk factors that may result in exclusion from rtPA. Variance inflation factors were used to examine multicollinearity and significant interactions between independent variables in the model, while Hosmer-Lemeshow test, Cox & Snell were used to determine the fitness of the regression models. Results A greater number of patients with acute ischemic stroke with incidence dyslipidemia were treated in the non-telestroke (285) when compared with the telestroke network (187). Although non-telestroke admitted more patients than the telestroke, the telestroke treated more patients with rtPA (89.30%) and excluded less (10.70%), while the non-telestroke excluded from rtPA (61.40%). In the non-telestroke, age (adjusted OR, 0.965; 95% CI, 0.942–0.99), blood glucose level (adjusted OR, 0.995; 95% CI, 0.99–0.999), international normalized ratio (adjusted OR, 0.154; 95% CI, 0.031–0.78),congestive heart failure(CHF) (adjusted OR, 0.318; 95% CI, 0.109–0.928), previous stroke (adjusted OR, 0.405; 95% CI, 0.2–0.821) and renal insufficiency (adjusted OR, 0.179; 95% CI, 0.035–0.908) were all directly linked to exclusion from rtPA. In the telestroke, only body mass index (adjusted OR, 0.911; 95% CI, 0.832–0.997) significantly excluded acute ischemic stroke patients with incidence dyslipidemia from thrombolysis therapy. Conclusion Despite having more patients with acute ischemic stroke that present incidence dyslipidemia, the non-telestroke patients had more clinical risk factors that excluded more patients from rtPA when compared with telestroke. Future studies should focus on how identified clinical risk factors can be managed to improve the use of rtPA in the non-telestroke setting. Moreover, the optimization of the risk-benefit ratio of rtPA by the telestroke technology can be advanced to the non-telestroke setting to improve the use of thrombolysis therapy.

Background and Purpose: School leader has an effect on teachers in divergent ways. If school leader wants their teachers to be successful and satisfied, he or she must have the potential to prompt work conditions that build up teachers’ psychological empowerment. Main aim of our research was to empirically test the relations between teachers’ perceptions of school leaders’ empowering behaviours and all dimensions of psychological empowerment (meaning, competence, self-determination and impact). Design/Methodology/Approach: We tested four hypotheses in one structural model by using structural equation modelling (SEM). The quantitative data was collected through an online survey on a sample of 525 primary school teachers in Slovenia by using two already validated questionnaires, The School Leader Empowering Behaviours (SLEB) and Psychological Empowerment Questionnaire (PEQ). Results: Findings show that teachers’ perceptions of school leaders’ empowering behaviours are positively and statistically significantly related to all dimensions of psychological empowerment (meaning, competence, self-determination and impact). Conclusion: Knowledge of psychological empowerment can be beneficial for school leaders, because with this comprehension they can strengthen apprehension and potential in exercising empowering behaviours towards their teachers to maximize their psychological empowerment.

Background and Purpose: Online activities are present in almost every aspect of people’s daily lives. Online purchases are also increasing each year and therefore it is important to investigate what influences online purchase intentions. Online purchase intentions are among everything else, influenced by the fear of identity theft and perceived risk. Design/Methodology/Approach: The online survey was conducted among 190 participants from Slovenia. The relations between the constructs of fear of financial losses, fear of reputational damage, perceived risk and online purchase intention were investigated. Results: The research showed that the relations between the constructs of fear of financial losses, fear of reputational damage, perceived risk are positive and the relation between the constructs of perceived risk and online purchase intention were negative. All of the relations were statistically significant. Conclusion: Understanding the impact of fear of identity theft and perceived risk on online purchase intention can be helpful for online sellers, because with these findings they can manage this fear and perceived risk to increase online purchase intention and address the risks accordingly. Online sellers should therefore regard new findings from the field of online sales. If an online store wants to have success in sales, they should consider all sides of customers’ desires as well as their restraints.

Titanium (Ti) is a non-essential metal element. TiO2 is used predominantly in the form of micro and nanoparticles in consumer products, including cosmetics and food. Because of its excellent biocompatibility, the trade-pure titan and its alloys are widely used as an alternative to certain metals in invasive medicine, surgery, dental medicine. Contemporary data concerning the sources of exposure to titanium, immune reactions to Ti alloys, current knowledge and perspectives of diagnosis of sensitization or allergic reactions to titanium are discussed. Conclusion: TiO2 is much more stable than pure Ti and alloys used in the implants, that should be taken into account when conducting research and analysing the results. The evidence of possible toxic effects is insufficient. It is difficult to assess the frequency of Ti allergy due to the uncertainty of diagnostic methods, but it is believed that it is very low. This is supported by the evidence that Ti and TiO2 (often as NP) doesn’t penetrate through the healthy skin. Skin patch testing with currently available formulations of Ti and TiO2 has no significant value in clinical practice, and currently, it is assumed that there is no reliable method for diagnosis Ti allergy. The functional analysis of cytokine release and investigation of genetic characteristics could be useful for individual risk assessment in dental implantology. Such studies may also help to investigate separately early and late implant loss, as well as to develop new diagnostic tools.

The mental foramen is a clinically important landmark for several clinical dental procedures. The aim of this study is to assess the anatomic position of the mental foramen (MF) in panoramic radiographs of a Brazilian population. The sample consisted of 2,100 panoramic radiographs, obtained from 8,600 clinical files from the School of Dentistry at the Universidade Federal do Paraná. Two calibrated examiners investigated the MF according to the classification of Tebo and Telford, which locates the right and left MF into 6 different positions in relation to the apex of the adjacent teeth. Results: The MFs were similarly distributed between the apices of the mandibular premolars (class III) and below the apex of the mandibular second premolar (class IV). More specifically, on the right side 41.8% (n = 878) of the MFs were classified as class III, while 47.52% (n = 998) were classified as class IV. On the left side 42.47% (n = 892) were classified as class III, while 47.38% (n = 995) were classified as class IV. The results indicate that MFs are often located adjacent to the apex of the mandibular second premolar. However, slight variations may occur in the positioning of the MF to the mesial direction. Clinicians and surgeons must be aware of the position of the MF and its potential variations prior to anaesthetics and surgical procedures in the mandible.

Background and Purpose: Organizations should implement new findings from the field of human resource management. If an organization wants to have successful and effective employees, they should be satisfied with all aspects of work and at the same time they should be feel commitment towards an organization. To have a full insight in employees, organizations have to take care of psychological side of employees, which manifests in psychological empowerment.

The efficiency of telestroke programs in improving the rates of recombinant tissue plasminogen activator (rtPA) in stroke patients has been reported. Previous studies have reported favorable treatment outcomes with the use of telestroke programs to improve the use of rtPA, but functional outcomes are not fully understood. This study investigated the effect of telestroke technology in the administration of rtPA and related functional outcomes associated with baseline clinical variables. Retrospective data of a telestroke registry were analyzed. Univariate analysis was used to compare demographic and clinical variables in the rtPA group and the no rtPA group and between the improved functional ambulation group and the no improvement group. A stepwise binary logistic regression identified factors associated with improved functional outcome in the total telestroke population and in the subset of the telestroke population who received rtPA. In adjusted analysis and elimination of any multicollinearity for patients who received rtPA in the telestroke setting, obesity (odds ratio [OR] = 2.138, 95% confidence interval [CI], 1.164-3.928, P

Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12–23, 54.7% male) underwent a nine-hour polysomnography (PSG), clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric Behavior Scale. Insomnia symptoms were defined as a self-report of difficulty falling and/or staying asleep and objective “short” sleep duration as a PSG total sleep time ≤7 h. A significant interaction showed that objective short sleep duration modified the association of insomnia symptoms with internalizing problems. Consistently, adolescents with insomnia symptoms and short sleep duration were characterized by depression, rumination, mood dysregulation and social isolation, while adolescents with insomnia symptoms and normal sleep duration were characterized by rule-breaking and aggressive behaviors and, to a lesser extent, rumination. These findings indicate that objective sleep duration is useful in differentiating behavioral profiles among adolescents with insomnia symptoms. The insomnia with objective short sleep duration phenotype is associated with an increased risk of depression earlier in the lifespan than previously believed.

Background: Reaching, grasping, and pulling behaviors are studied across species to investigate motor control and problem solving. String pulling is a distinct reaching and grasping behavior that is rapidly learned, requires bimanual coordination, is ethologically grounded, and has been applied across species and disease conditions., New Method: Here we describe the PANDA system (Pulling And Neural Data Analysis), a hardware and software system that integrates a continuous string loop connected to a rotary encoder, feeder, microcontroller, high-speed camera, and analysis software for the assessment and training of reaching, grasping, and pulling behaviors and synchronization with neural data., Results: We demonstrate this system in rats implanted with electrodes in motor cortex and hippocampus and show how it can be used to assess relationships between reaching, pulling, and grasping movements and single-unit and local-field activity. Furthermore, we found that automating the shaping procedure significantly improved performance over manual training, with rats pulling > 100 m during a 15-minute session., Comparison With Existing Methods: String-pulling is typically shaped by tying food reward to the string and visually scoring behavior. The system described here automates training, streamlines video assessment with deep learning, and automatically segments reaching movements into distinct reach/pull phases. No system, to our knowledge, exists for the automated shaping and assessment of this behavior., Conclusions: This system will be of general use to researchers investigating motor control, motivation, sensorimotor integration, and motor disorders such as Parkinson's disease and stroke., Competing Interests: Declaration of Competing Interest The authors do not have competing interests., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

This paper seeks to build on Carriere's (2022) work on the complex, pervasive, and dialogical nature of politics and extend this treatment to examine the politics of the transitional, liminal, and "in-between spaces." In particular, we analyze the theatrical nature of politics by examining how roads and streets become a "dynamic stage" (Valsiner, 2004, p. 2) where private and public policies enter into dynamic dialogical relationships. We distinguish between direct, direct but distanced, and indirect peripheral political participation and explore how roads and streets enable redundant and dramatic communicative processes that feed into the internalization/externalization meaning-making processes (Valsiner, 2014). Finally, we analyze the process of the emergence of roads and streets as a result of complex interactions between public policies, ordinances, and values. We extend this exploration to an illustrative case in Oahu, Hawai'i to demonstrate how streets become constructed and organized to provide affective guidance. We conclude by arguing that the absence of political messages or overt political actions does not mean the absence of politics - power dynamics are still at play in the liminal and transitional zones of human living., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Successful navigation depends critically upon two broad categories of spatial navigation strategies that include allocentric and egocentric reference frames, relying on external or internal spatial information, respectively. As with older adults, aged rats show robust impairments on a number of different spatial navigation tasks. There is some evidence that these navigation impairments are accompanied by a bias toward relying on egocentric over allocentric navigation strategies. To test the degree to which young and aged animals utilize these two navigation approaches, a novel behavioral arena was used in which rats are trained to traverse a circular track and to stop at a learned goal location that is fixed with respect to a panorama of visual cues projected onto the surrounding walls. By instantaneously rotating the cues, allocentric and egocentric reference frames were put in direct and immediate conflict and goal navigation performance was assessed with respect to how accurately young and aged animals were able to utilize the rotated cues. Behavioral data collected from nine young and eight aged animals revealed that both age groups were able to update their navigation performance following cue rotation. Contrary to what was expected, however, aged animals showed more accurate overall goal navigation performance, stronger allocentric strategy use, and more evident changes in behavior in response to cue rotation compared to younger animals. The young rats appeared to mix egocentric and allocentric strategies for ICR task solution. (PsycInfo Database Record (c) 2022 APA, all rights reserved).