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We seek to guide design, development, and adoption of Renewable Assignments by testing ways learners can contribute to Open Educational Resources (OER). We design, test, and iterate four assignment structures to this end. Testing was completed in an upper-division undergraduate endocrinology course, taught emergency remote due to COVID-19. Using mixed methods: surveys, focus groups, and iterations, we assessed assignment structures and created design guidance for renewable assignments and open pedagogy. We find that in a remote course, these assignments were effective in advancing learning goals. Both students and teachers favored their inclusion in the course. Analysis revealed six design principles to maximize effectiveness of renewable assignments and courses, and empowering teachers and learners to contribute to open knowledge. These principles also provide insight to praxis related to theories of open pedagogy, scaffolding, peer interaction, and active learning.

This study aimed to identify factors, particularly positive parenting styles, associated with unmet dental needs, defined as no dental visit for the past 12 months, in children with developmental disabilities (DD). Participants included 263 primary caregivers of children with DD. Children exposed to less positive parenting styles were more than two times (aOR, 2.19, 95%CI, 1.12-4.32) more likely to have unmet dental needs. Children who were male (aOR, 1.88, 95%CI, 1.04-3.41), aged < 4 years (aOR, 2.95, 95%CI, 1.2-7.27) or aged [greater than or equal to] 11 years (aOR, 2.65, 95%CI, 1.25-5.64), had higher illness severity (aOR, 2.04, 95%CI, 1.09-3.81), had primary caregivers with less than or equal to high school education (aOR, 2.45, 95%CI, 1.13-5.30) were also more likely to have unmet dental needs.

: Introduction: Men who have sex with men (MSM), especially those living with HIV, are at an increased risk of anal cancer. The prevalence and incidence of its precursor, anal high‐grade squamous intraepithelial lesions (HSILs), among MSM who started antiretroviral therapy during acute HIV acquisition are yet to be explored. Methods: Participants in an acute HIV acquisition cohort in Bangkok, Thailand, who agreed to take part in this study, were enrolled. All participants were diagnosed and started antiretroviral therapy during acute HIV acquisition. Human papillomavirus (HPV) genotyping and high‐resolution anoscopy, followed by anal biopsy as indicated, were done at baseline and 6‐monthly visits. Results: A total of 89 MSM and four transgender women were included in the analyses. Median age at enrolment was 26 years. Baseline prevalence of histologic anal HSIL was 11.8%. With a total of 147.0 person‐years of follow‐up, the incidence of initial histologic anal HSIL was 19.7 per 100 person‐years. Factors associated with incident anal HSIL were anal HPV 16 (adjusted hazards ratio [aHR] 4.33, 95% CI 1.03–18.18), anal HPV 18/45 (aHR 6.82, 95% CI 1.57–29.51), other anal high‐risk HPV (aHR 4.23, 95% CI 1.27–14.14), syphilis infection (aHR 4.67, 95% CI 1.10–19.90) and CD4 count Conclusions: With antiretroviral therapy initiation during acute HIV acquisition, we found the prevalence of anal HSIL among cisgender men and transgender women who have sex with men to be similar to those without HIV. Subsequent anal HSIL incidence, although lower than that of those with chronic HIV acquisition, was still higher than that of those without HIV. Screening for and management of anal HSIL should be a crucial part of long‐term HIV care for all MSM., INTRODUCTION Anal cancer is a rising concern for people living with HIV. The incidence of anal cancer among men who have sex with men (MSM) with HIV was 85 per [...]

This paper explored the authors' concerns about students enrolled in their introductory accounting course. Anecdotal evidence suggested that students struggle with basic arithmetic concepts that underlie basic business transactions even though their math placement and ACT scores are high. A survey of 125 students in a first accounting course was conducted in the spring of 2010 to assess the basic arithmetical skills. The results indicated that the ACT scores and math placement tests do not reveal weakness in basic arithmetic. We find that faculty and students will experience frustration due to the impaired arithmetic ability. By taking for granted that students possess basic skills in arithmetic faculty will exclude exercises from the curriculum that will build the kind of arithmetic abilities students need to think on their feet about basic business transactions. We conclude by arguing that making curricular accommodations to cope with the deficit in arithmetic is not in the student's best interest. A competitive advantage for students can be created by addressing the deficit head on rather than adjusting the curriculum to work around the problem.

Introduction: Among high tuberculosis (TB) and HIV burden countries in Asia, tuberculosis preventive therapy (TPT) in people living with HIV (PLWH) has been underutilized despite its proven benefits independent of antiretroviral therapy (ART). Therefore, we determined the incidence of active TB and mortality among 9179 adult PLWH who attended and received ART from 15 tertiary care hospitals across Thailand. Methods: A retrospective study was conducted in 2018 using follow-up data from 1999 to 2018. The primary endpoint was incident TB disease after ART initiation. Factors associated with TB incidence were analysed using competing risk regression. The Kaplan-Meier method was used to estimate mortality after ART initiation. Results: During a median of 5.1 years of ART (IQR 2.2-9.5 years), 442 (4.8%) PLWH developed TB (TB/HIV), giving an over-all incidence of 750 (95% CI 683-823) per 100,000 persons-year of follow up (PYFU). In multivariate analysis, lower CD4 at ART initiation ([less than or equal to]100 cells/[mm.sup.3], adjusted sub-distribution hazard ratio [aSHR]: 2.08, 95% CI, 1.47-2.92; 101-200 cells/[mm.sup.3], aSHR: 2.21, 95% CI, 1.54-3.16; 201-350 cells/[mm.sup.3], aSHR: 1.59, 95% CI, 1.11-2.28 vs. >350 cells/[mm.sup.3]), male sex (aSHR: 1.40, 95% CI, 1.11-1.78), lower body weight ( Conclusions: In this high TB burden country, TB incidence was remarkably high during the first few years after ART initiation and thereafter decreased significantly. Rapid ART initiation and appropriate TPT can be potential key interventions to tackle the TB epidemic and reduce mortality among PLWH in TB/HIV high burden settings. Keywords: antiretroviral therapy; Asia; HIV; incident tuberculosis; latent TB infection; Thailand, 1 | INTRODUCTION Despite the availability of effective antiretroviral therapy (ART), tuberculosis (TB) remains the leading cause of morbidity and mortality among people living with human immunodeficiency virus (PLWH). The [...]

Carbon-based molecules are of universal importance for a huge variety of chemical and biological processes. The complication of the structure of such molecules proceeds via the bonding of carbon atoms. An efficient mechanism for such reactions proceeds via cross-coupling, related to the association of bond-terminating counter-ions. Here, an uncommon version of such a process is investigated, with at least some ions bound in the system noncovalently and/or switching the bonding mode in due course. The analyzed sample reactions involve a single C-C bond formation in environmentally relevant halocarbon species and involve alkali–halide ion-pair components. A consistent ab initio computational study predicts the related energy barriers to alter significantly in the presence of the ion pair. Different channels are checked, with the carbon–halogen bond cleavage preceding or following the actual C-C bonding and with the counter-ions located closely or farther apart. The relative heights of the corresponding energy barriers are found to be switched by the ion pair. The above results suggest a possibility of facilitating such reactions without expensive catalysts. [ABSTRACT FROM AUTHOR]

Objective: Oblique lumbar interbody fusion (OLIF), performed using a retroperitoneal approach, can lead to complications related to the approach, such as lumbar sympathetic chain injury (LSCI). Although LSCI is a common complication of OLIF, its reported incidence varies across studies due to an absence of specific diagnostic criteria. Moreover, research on the risk factors of postoperative sympathetic chain injuries after OLIF remains limited. Therefore, this study aimed to describe the incidence, and identify independent risk factors for LSCI, in patients with degenerative lumbar spinal diseases who underwent OLIF. Methods: Between October 2020 and August 2023, a retrospective review was conducted at our institute on 200 patients who underwent OLIF at 1 to 4 consecutive spinal levels (L1–5) for degenerative spinal diseases including spinal stenosis, spondylolisthesis, degenerative scoliosis. We excluded those with infections, trauma, tumors, and lower extremity edema/warmth due to other causes. The patients were categorized into 2 groups: those with and without LSCI symptoms. Demographic data, operative data, and pre- and postoperative parameters were evaluated for their association with LSCI using a univariate logistic regression model. Variables with a p-value <0.1 in the univariate analysis were included in a multivariate model to identify the independent risk factors. Results: Thirty-five of 200 patients (17.5%) developed LSCI symptoms after OLIF. Multivariate logistic regression analysis indicated that prolonged retraction time, particularly exceeding 31.5 miniutes, remained an independent risk factor (adjusted odds ratio, 12.59; p<0.001). Conclusion: This study demonstrated that prolonged retraction time was an independent risk factor for LSCI following OLIF, particularly when it exceeded 31.5 minutes. Protecting the lumbar sympathetic chain during surgery and minimizing retraction time are crucial to avoiding LSCI following OLIF. [ABSTRACT FROM AUTHOR]

Objective: Oblique lateral interbody fusion (OLIF) is a minimally invasive procedure for stabilizing the spine and indirectly decompressing the neural elements. There is sparse data on unsatisfactory outcomes that require additional interventions (surgery or intervention) after OLIF. This study aimed to identify the causes, and risk factors of these reintervention. Methods: This was a single-center retrospective study of the patients who underwent the OLIF procedure from June 2016 to March 2023. Several clinical and radiographic parameters were studied. We also analyzed associations between several potential risk factors and the reintervention following OLIF. Results: A total of 231 patients were included. Over an average of 2.5 years of follow-up, 28 patients (12.1%) required a reintervention. Adjacent segment disease (ASD) was the most common cause of reintervention. The risk factors associated with reintervention were previous surgery (adjusted odds ratio [aOR], 4.44; 95% confidence interval [CI], 1.21–16.33; p=0.02) and high preoperative Oswestry Disability Index (ODI) scores (aOR, 1.04; 95% CI, 1.00–1.08; p=0.03). Although increasing the duration of follow-up was not statistically significant, the 95% CI was consistent with an increased risk of reintervention with longer follow-up (OR, 1.18; 95% CI, 0.94–1.50). Conclusion: This study showed that patients with prior lumbar surgery and high preoperative ODI scores were more likely to require additional intervention after the OLIF procedure. In addition, an increasing duration of follow-up was associated with an increased risk of reintervention. The most common reason for reintervention was ASD after OLIF. [ABSTRACT FROM AUTHOR]

Sofosbuvir/Velpatasvir (SOF/VEL) is a combination drug used for chronic hepatitis C (HCV) infection. However, limited information exists regarding the pharmacokinetics of SOF/VEL and its metabolites in hemodialysis patients. We conducted a prospective investigation of the pharmacokinetic parameters of SOF/VEL after a single dose of SOF/VEL (400/100 mg) on days with and without dialysis in 12 Thai hemodialysis patients with chronic HCV infection, who had been undergoing hemodialysis for a duration of 0.5–20 years. Blood samples were collected before dose (0) and 0.5, 1.0, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, and 12.0 h after dose. Dialysate samples were also collected before dose (0) and 1.0, 2.0, 3.0, and 4.0 h after dose. Plasma and dialysate samples were quantified for SOF and its metabolite, GS‐331007, and VEL concentrations using a fully validated LCMS technique. In addition, a preliminary efficacy study was conducted using the proposed SOF/VEL dose reduction regimen in all patients. No differences in SOF/VEL PK parameters between on‐ and off‐dialysis studies. On the contrary, GS‐331007 exhibited a 30% reduction in the area under the plasma concentration–time curve from time 0 to 24 h (AUC0‐24h) on dialysis days compared with non‐dialysis days (AUC0‐24h ratio 0.68 vs. 1.04, respectively). The dialysis clearance of SOF and GS‐331007 was 9.35 (8.72–15.11) and 8.89 (8.52–14.07) mL/min, respectively. Subsequently, an alternate‐day regimen of SOF/VEL (400/100 mg) was administered for 12 weeks, resulting in an undetectable plasma HCV viral load without side effects. Further clinical studies are warranted to validate the efficacy and safety of our proposed dose reduction regimen. [ABSTRACT FROM AUTHOR]

Introduction: Immune dysregulation persists in people with HIV (PWH) on antiretroviral therapy (ART) and may lead to accelerated vascular ageing and cardiovascular disease (CVD). While delayed time to initiation of ART has been linked to worse cardiovascular outcomes, the effect of ART initiation during acute infection on these outcomes is not well understood. Methods: Participants were enrolled from the SEARCH010/RV254 acute HIV (AHI) and HIV‐NAT chronic HIV (CHI) cohorts in Thailand. Participants with 6‐year follow‐up and viral suppression (viral load < 50 copies/μL) at follow‐up were included. Both unmatched cohorts and age and gender‐matched cohorts were analysed. Demographics, HIV laboratories, and cardiovascular risk factors from enrolment and 6‐year follow‐up were obtained from electronic records. Framingham Risk Score (FRS), vascular age (VA), vascular age deviation (VAD), and 10‐year atherosclerotic cardiovascular disease (ASCVD) risk were calculated from previously published equations. Vascular outcomes in AHI and CHI cohorts were compared, and univariable and multivariable linear regression analyses were used to investigate risk factors associated with worse vascular scores. Results: In all, 373 AHI participants and 608 CHI participants were identified. AHI participants were of younger age, had a higher prevalence of syphilis and a lower prevalence of prior hepatitis B, tuberculosis, diabetes, and hypertension. Higher CD4 T‐cell and lower CD8 T‐cell counts were seen in the AHI cohort at enrolment and 6‐year follow‐up. In all participants, the AHI cohort had a lower median FRS (p < 0.001) and VA (p < 0.001), but higher VAD (p < 0.001). However, in matched cohorts, no differences were found in FRS‐based outcomes. In all participants, higher VAD after 6 years of ART was associated with higher body mass index (p < 0.001) and higher CD4 count (p < 0.001), which persisted in multivariable analysis. When FRS components were analysed individually, CD4 count was associated only with male sex and cholesterol. Conclusions: We did not identify differences in FRS‐based vascular outcomes at 6 years in matched cohorts of participants who started ART during AHI versus CHI. We identified a correlation between higher CD4 count and worse FRS‐based vascular outcomes, which may be driven by underlying metabolic risk factors. Further study is needed to confirm these findings and evaluate underlying mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: The link between fatty liver diseases and cognitive impairment among people living with HIV (PLWH) remains unclear. We investigated the association of steatotic liver disease (SLD), advanced liver fibrosis and non‐alcoholic steatohepatitis (NASH) with significant activity and liver fibrosis with cognitive impairment in PLWH. Methods: Cognitive performance was assessed for PLWH aged ≥50 years on stable antiretroviral therapy (ART) with the Thai‐validated version of the Montreal Cognitive Assessment (MoCA), and a cut‐off of <25/30 was used to define cognitive impairment. SLD and NASH with significant activity and liver fibrosis were defined as having a controlled attenuation parameter value ≥248 dB/m and a FibroScan‐AST (FAST) score ≥0.67, respectively. Multivariable logistic regression was employed to investigate the association of cognitive impairment with SLD or NASH. Results: Of the 319 PLWH (63.3% male and 98% had HIV‐1 RNA ≤50 copies/mL) included, 74 (38%) had SLD. NASH with significant activity and liver fibrosis was present in 66 (20.1%) participants. Some 192 (60.2%) participants had cognitive impairment. In a multivariable analysis, NASH with significant activity and liver fibrosis was significantly associated with cognitive impairment (adjusted odds ratio [aOR] 2.01, 95% CI 1.02–3.98, p = 0.04), after adjusting for HIV‐related parameters, age, sex, body mass index, employment status, education, income level, smoking, alcohol use, diabetes mellitus, hypertension and HIV‐related parameters. The association of a lone diagnosis of SLD and cognitive impairment was not statistically significant. Conclusions: NASH with significant activity and liver fibrosis was associated with lower cognitive performance, even after controlling for demographics and HIV disease parameters. Additional research is needed to better understand the underlying mechanisms. [ABSTRACT FROM AUTHOR]