Search

Background:. Brief alcohol interventions use patient-provider communication to promote alcohol cessation. We characterized the receipt of this intervention in chronic liver disease (CLD). Methods:. We surveyed patients with CLD for weekly drinking patterns and examined associations with patient-provider communication receipt. Results:. Among 840 participants, 82.1% and 56.5% reported ≥1 standard drink weekly and excessive alcohol consumption, respectively. Patient-provider communication was lower in noncirrhotic (adjusted odds ratio:0.34, 95% CI: 0.22–0.54) and nonalcohol-associated CLD (adjusted odds ratio: 0.22, 95% CI: 0.15–0.34) among individuals drinking ≥1 standard drink weekly, and similarly in noncirrhotic CLD (adjusted odds ratio: 0.45, 95% CI: 0.21–0.95) among those with excessive drinking. Conclusions:. Brief alcohol interventions are underutilized in noncirrhotic and nonalcohol-associated CLD.

Background: Mortality is high for severe alcohol-associated hepatitis (AH). Corticosteroids are the standard of care for patients without contraindications. Recent data showed that interleukin-1β receptor antagonist anakinra attenuated inflammation and liver damage. We designed a multicenter, double-blind, randomized controlled trial to assess the safety and efficacy of anakinra compared to prednisone. Methods: Patients meeting the clinical and biochemical criteria for severe AH with MELD scores between 20 and 35 were recruited at eight clinical sites. Eligible patients enrolled in the study were randomized to anakinra, 100 mg subcutaneous injection for 14 days, plus zinc sulfate 220 mg for 90 days, vs. prednisone 40 mg PO daily for 30 days. Matching placebos for anakinra, zinc, and prednisone were provided to mask the treatment. Participants were followed for 180 days. The primary outcome was overall survival at 90 days. An unadjusted log-rank test was used to compare the survival of the two treatments in the first 90 days. Between July 10, 2020, and March 4, 2022, we screened 1082 patients with severe AH, and 147 eligible patients were enrolled and randomized. The average baseline MELD score was 25 [range 20–35], Maddrey discriminant function (MDF) was 59.4 [range 20.2–197.5]. The mean aspartate transaminase (AST)-to-alanine transaminase (ALT) ratio was 3.5. The baseline characteristics were not statistically different between the two treatment groups. Conclusions: The study provided a direct comparison of the survival benefits and safety profiles of anakinra plus zinc vs. prednisone in patients with severe AH.

Background. Alcohol-associated liver disease (ALD) is the leading indication for liver transplantation (LT) in the United States. Alcohol use disorder relapse can lead to graft failure and the need for liver retransplantation (re-LT). Despite the rising incidence of LT for ALD, the practice of re-LT for recurrent ALD is not well understood. We aimed to define the practice of re-LT for recurrent ALD during the last 20 y. Methods. Using the US national transplant registry, adults who underwent re-LT for recurrent ALD were compared with LT recipients who died from recurrent ALD and propensity score–matched re-LT recipients with non-ALD indications. All groups had at least 1-y survival of their primary graft. Kaplan-Meier analysis was used to calculate 1- and 5-y survivals. Results. Between 2000 and 2020, 74 re-LTs were performed for recurrent ALD (1.0% of all re-LTs). There was an increase in recurrent ALD re-LT practice from 2017 to 2020 versus 2014 to 2016 (20 versus 2). At the time of re-LT, patients with recurrent ALD had a significant decrease in body mass index (median 25.1 versus 28.8 kg/m2; P

Background. The 2013 HIV Organ Policy Equity Act has increased liver transplantation (LT) in HIV+ patients; however, transplant centers may remain reluctant to perform LT in HIV/hepatitis C virus (HCV)-coinfected patients due to inferior outcomes. We aimed to assess how direct-acting antivirals (DAAs) have impacted HIV+/HCV+-coinfected LT recipient outcomes. Methods. national data including 70 125 adult LT recipients between 2008 and 2019 were analyzed. Kaplan-Meier survival analysis and Cox proportional hazards model were used to analyze outcomes. Results. LT for HIV+ individuals increased in the DAA era from 28 in 2014 to 64 in 2019 (23 had HIV+/HCV+ coinfection). In the pre-DAA era, HIV+/HCV+-coinfected LT recipients had an increased risk of graft failure compared with HIV−/HCV−-uninfected LT recipients (hazard ratio [HR], 1.85; P

Objective: Recent studies have suggested a critical role for toll-like receptor 4 (TLR4) in the development of alcoholic liver disease. As TLR4 is widely expressed throughout the body, it is unclear which TLR4-expressing cell types contribute to alcohol-induced liver damage. Methods: We selectively ablated TLR4 in hepatocytes and myeloid cells. Male mice were fed a liquid diet containing either 5% alcohol or pair-fed a control diet for 4 weeks to examine chronic alcohol intake-induced liver damage and inflammation. In addition, mice were administered a single oral gavage of alcohol to investigate acute alcohol drinking-associated liver injury. Results: We found that selective hepatocyte TLR4 deletion protected mice from chronic alcohol-induced liver injury and fatty liver. This result was in part due to decreased expression of endogenous lipogenic genes and enhanced expression of genes involved in fatty acid oxidation. In addition, mice lacking hepatocyte TLR4 exhibited reduced mRNA expression of inflammatory genes in white adipose tissue. Furthermore, in an acute alcohol binge model, hepatocyte TLR4 deficient mice had significantly decreased plasma alanine transaminase (ALT) levels and attenuated hepatic triglyceride content compared to their alcohol-gavaged control mice. In contrast, deleting TLR4 in myeloid cells did not affect the development of chronic-alcohol induced fatty liver, despite the finding that mice lacking myeloid cell TLR4 had significantly reduced circulating ALT concentrations. Conclusions: These findings suggest that hepatocyte TLR4 plays an important role in regulating alcohol-induced liver damage and fatty liver disease. Keywords: Alcoholic fatty liver disease, Toll-like receptor 4, Hepatocyte, Myeloid cell, Liver injury, Inflammation

Background: More than two million U.S. families receive home visiting services each year, yet little is known about the content and process of home visit interventions. Home visit observations are a recommended tool to address this gap in knowledge, but guidance regarding how much observation time is needed to provide a trustworthy picture of home visits is not available. Objective: This study estimated the length of observation needed to provide a reliable description of the content and process of home visits delivered through an Early Head Start (EHS) home-based program. Methods: Observations of 555 home visits involving 88 families and 17 home visitors were coded with the Home Visit Observation Form--Revised (HVOF-R). The HVOF-R describes the proportions of time spent among several subcategories within each of three major categories: Primary Interaction Partners, Content of Interactions, and Nature of the Home Visitor's Interactions. The psychometric theory of test reliability guided use of bootstrap resampling and the Spearman-Brown prediction formula to estimate the duration of observation necessary to achieve conventional psychometric standards of reliability (r = 0.90 and r = 0.80). Results: Results showed that 40-60 min of a home visit observation yields a reliable estimate of the proportion of time spent on most key features of home visits, especially those behaviors observed most frequently, including interactions among the home visitor, parent, and/or child. Conclusion: Fairly brief observations yield reliable description of home visit activities, and use of observation is recommended to guide program implementation efforts and enhance program quality.

This study incorporated institutional characteristics (e.g., Carnegie type, selectivity) and resource allocations (e.g., instructional expenditures, student affairs expenditures) into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocating academic financial resources to optimize graduation rates

Shoreline position (e.g., beach width) is a critical component of flooding and overtopping forecasts but difficult to predict accurately. We model beach width changes with a supervised machine learning (ML) approach informed by equilibrium principles. The time history of wave energy anomalies that force equilibrium models is used as an ML input feature. The sweeping simplifying equilibrium model assumptions relating beach width change to anomalies are replaced with data‐based ML results. Supervised learning regression methods including linear, support vector, decision trees, and ensemble regressors are tested. Observations for model training and testing includes weekly to quarterly beach elevation surveys spanning approximately 500 m alongshore and 8 years at two beaches, each supplemented with several months of ∼100 sub‐weekly surveys. These beaches, with different sediment types (sand vs. sand‐cobble mix), both widen in summer in response to the seasonal wave climate, in agreement with a generic equilibrium model. Differences in backshore erodability contribute to differing beach responses in the stormiest (El Niño) year that are reproduced by a simple extra trees regression model but not by the equilibrium model. With sufficiently extensive training data, the ML model outperforms equilibrium by providing flexibility and complexity in the response to wave forcing. The present ML and equilibrium models both fail to simulate a uniquely stunted beach recovery unlike other recoveries in the training data. Plain Language Summary: Beach elevation surveys are compared at two beaches in San Diego County. Both beaches narrow during winter as large wave events transport sand offshore and widen during summer as gentle waves move sand onshore. The seasonality of such beaches has been characterized by simple models that primarily rely on wave energy relative to an average state to predict beach width changes, known as equilibrium models. Here, we highlight some of the limitations of equilibrium models, such as a tendency to over predict winter erosion at a beach backed by non‐erodible infrastructure. We demonstrate that machine learning models, when trained with sufficient observations, can predict beach width changes more accurately than equilibrium models. Key Points: The Equilibrium‐informed extra tree (ET) regression machine learning model uses input features of only wave history, inspired by equilibrium conceptsWith sufficient training, ET outperforms a widely used equilibrium model [ABSTRACT FROM AUTHOR]

We identified gaps in safe food handling practices that may be placing older adults at increased risk of food-borne illness. A convenience sample of 1,019 older adults completed the Food Safety Behavior Questionnaire. Majority groups among participants were those who were female, those who were White, and those who were widowed. Participants had lower adherences to safe practices related to temperature control, attention to sell-by/use-by dates on food packages, and cross-contamination. Adherences were significantly (p < 0.05) influenced by gender, race/ethnicity, age, marital status, and education. Our findings suggest the need for older adult-focused safe food handling education related to temperature control, product selection practices, and cross-contamination. [Additional support for this research was provided by the U.S. Department of Agriculture Supplemental Nutrition Assistance Program, in collaboration with the Iowa Department of Public Health and Iowa State University Extension and Outreach.]

Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18–80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated. [ABSTRACT FROM AUTHOR]

Urinary tract infections are a common diagnosis in dogs presenting to veterinary practice. Veterinarians often treat suspected infections empirically, either in the absence of culture and susceptibility testing results or whilst waiting for them. This study aimed to identify the bacteria most frequently isolated from canine urinary samples and their antimicrobial susceptibility patterns in South East Queensland (SEQ) to help guide responsible empirical antimicrobial prescription by the veterinary community in this geographical location. Cumulative antibiograms were generated from the results of 1284 culture‐positive urinary samples in SEQ, obtained from a commercial veterinary laboratory over a 5‐year period. Escherichia coli was the most commonly isolated bacterial species (43%), followed by Staphylococcus spp. (23%), Proteus spp. (21%) and Enterococcus spp. (10%). Of the six most common isolates, 97% had susceptibility to at least one low‐importance antimicrobial. Susceptibility to the low‐importance and first‐line antimicrobial recommendation, amoxicillin, was 81% for E. coli and 24% for Staphylococcus spp. Susceptibility of both E. coli and Staphylococcus spp. to medium‐importance and commonly recommended empirical antimicrobials, trimethoprim sulphonamides and amoxicillin–clavulanic acid was ≥85% and >92% for high‐importance antimicrobials enrofloxacin and ceftiofur. Of the E. coli and Staphylococcus spp. isolates, 8.8% and 4%, respectively, were considered multidrug resistant. There was no increase in resistance to antimicrobials detected over the study period. Susceptibilities suggest low‐ and medium‐importance antimicrobials remain acceptable first‐line empirical treatments. However, this should be continually assessed and updated using local surveillance data. [ABSTRACT FROM AUTHOR]

In a cluster-randomized study, we investigate the impact of an argument-based approach to teaching science in elementary school on science learning and critical thinking skills. Forty-eight schools participated in the study, with data on 9,963 students across the 2 years of the intervention. Annual standardized tests assessing science content knowledge were used to evaluate the effect of the intervention on science using a hierarchical linear model. To assess critical thinking abilities, scores for the Cornell Critical Thinking instrument were assessed for the 2,353 students in fifth grade using a multilevel model. While no statistically significant gains were found for science content, there was statistically significant evidence that the intervention was associated with an improvement in critical thinking scores (p < 0.05, ES = 0.167). In particular, the strongest gains were for students in the following groups: individual education plan, free and reduced price lunch, and English language learners.

Multiple regression was performed on four dependent variables derived from the results of a student survey measuring attitudes about student leadership: (a) leadership is important to the student, (b) the student considers himself or herself to be a leader, (c) leadership will be important to the student after college, and (d) leaders need to be able to work in teams or groups. Each of 10 independent variables was a significant predictor of one or more dependent variables. (Contains 7 tables.)

This study incorporated institutional characteristics (e.g., Carnegie type, selectivity) and resource allocations (e.g., instructional expenditures, student affairs expenditures) into a statistical model to predict undergraduate graduation rates. Instructional expenditures, library expenditures, and a number of institutional classification variables were significant predictors of graduation rates. Based on these results, recommendations as well as warranted cautions are included about allocating academic financial resources to optimize graduation rates. (Contains 5 tables and 2 notes.)

This chapter puts forth a model of student-success-focused policy development at small colleges that elucidates the role of the institutional research (IR) professional, highlighting how the breadth of roles and responsibilities that IR professionals serve at these institutions intersect with traditional training and background.

This study investigated the role of a new paradigm in teaching large introductory, fundamental engineering mechanics (IFEM) courses that combined student-centered learning pedagogies and supplemental learning resources. Demographic characteristics in this study included a total of 405 students, of whom 347 (85.7%) are males and 58 are (14.3%) females. The students' majors included aerospace engineering, agricultural engineering, civil engineering, construction engineering, industrial engineering, materials engineering, and mechanical engineering. Results of this study, as tested using an independent samples t-test, validated using a nonparametric independent samples test, and a general linear multivariate model analysis, indicated overwhelmingly that there is a difference between a class taught passively using the teacher-centered pedagogy and a class taught actively using student-centered pedagogy. The principal focus of this work was to determine if the new paradigm was successful in improving student understanding of the course concepts in statics of engineering using student-centered pedagogies in large classes. After evaluating the effects of several variables on students' academic success, the results may provide important information for both faculty members and researchers and present a convincing argument to faculty members interested in academic reform but hesitant to abandon conventional teaching practices. By promoting a new paradigm, the potential for improving understanding of engineering fundamentals on a larger scale may be realized.

In the past ten years, engineering classrooms have seen an exponential growth in the use of technology, more than during any other previous decade. Unprecedented advancements, such as the advent of innovative gadgets and fundamental instructional alterations in engineering classrooms, have introduced changes in both teaching and learning. Student learning in introductory, fundamental engineering mechanics (IFEM) courses, such as statics of engineering, mechanics of materials, dynamics, and mechanics of fluids, as in any other class, is influenced by the experiences students go through in the classroom. Thus, bold new methodologies that connect science to life using student-centered approaches and scaffolding pedagogies need to be emphasized more in the learning process. This study is aimed to gain insight into the role of student-centered teaching, particularly the implementation of scaffolding pedagogies into IFEM courses. This study also attempts to contribute to the current national conversation in engineering education of the need to change its landscape--from passive learning to active learning. Demographic characteristics in this study included a total of 3,592 students, of whom 3,160 (88.0%) are males and 432 (12.0%) are females, over a period of six years, from 2007 to 2013. The students' majors included aerospace engineering, agricultural engineering, civil engineering, construction engineering, industrial engineering, materials engineering, and mechanical engineering. Results of the study, as tested using a general linear univariate model analysis, indicated that overwhelmingly the type of class in statics of engineering is a significant predictor of student "downstream" performance in tests measuring their knowledge of mechanics of materials. There is a statistically significant difference in students' performance in mechanics of materials depending on whether they were taught passively using the teacher-centered pedagogy or taught actively using the student-centered pedagogy in statics of engineering. Mechanics of materials is commonly the next immediate course, or a downstream course, following statics of engineering. [Cover title varies: "Scaffolding in Introductory Engineering Courses."]

With the aim of summarizing years of research comparing pedagogies for second/foreign language teaching supported with computer technology and pedagogy not-supported by computer technology, a meta-analysis was conducted of empirical research investigating language outcomes. Thirty-seven studies yielding 52 effect sizes were included, following a search of literature from 1970 to 2006 and screening of studies based on stated criteria. The differences in research designs required subdivision of studies, but overall results favored the technology-supported pedagogy, with a small, but positive and statistically significant effect size. Second/foreign language instruction supported by computer technology was found to be at least as effective as instruction without technology, and in studies using rigorous research designs the CALL groups outperformed the non-CALL groups. The analyses of instructional conditions, characteristics of participants, and conditions of the research design did not provide reliable results because of the small number of effect sizes representing each group. The meta-analysis results provide an empirically-based response to the questions of whether or not technology-supported pedagogies enhance language learning, and the process of conducting the meta-analysis pointed to areas in research methodology that would benefit from attention in future research.

The study explored the influence of work experience on adult part-time students' academic success as defined by their cumulative grade point average. The sample consisted of 614 part-time students from four polytechnic institutions in Malaysia. The study identified six factors to measure the perceived influence of work experiences--positive belief, negative belief, intrinsic motivation, learning orientation, deep learning approach, and surface learning approach. The results indicated that lower academic success was associated with higher negative belief, lower intrinsic motivation and adopting surface learning approach. Students with a deeper learning approach, greater intrinsic motivation, and greater learning orientation tended to perceive higher positive belief. In contrast, students who favored surface learning approaches were more likely to perceive negatively the impact of work experiences on their academic learning. The best-fitted path model demonstrated students' academic success was affected negatively by negative belief and weakly by intrinsic motivation. Other factors did not have significant direct effects on students' academic success. These findings suggest that the success of adult part-time students does not rely on their positive attitude alone, but also could depend on the effectiveness of the classroom environment, teaching and learning strategies, and assessment methods.

A central challenge for higher education today is to understand the diversity and complexity of nontraditional students' life experiences and how these factors influence their academic success. To better understand these issues, this study explored the role of demographic characteristics and employment variables in predicting the academic success of part-time students at four polytechnic institutes in Malaysia. Demographic characteristics studied included respondent's age, gender, marital status, number of children, parent's educational level, and financial resources. Employment variables assessed were number of years working, job relatedness to the program, job satisfaction, and monthly salary. A total of 614 part-time students completed the survey. Results indicated that being an older student, being female, paying for their own education, and having high job satisfaction were statistically significant predictors of part-time students' academic success. Understanding the effects of demographic characteristics and employment variables on students' academic success might help administrators and educators to develop teaching and learning processes, support services, and policies to enhance part-time students' academic success.

Purpose: The purpose of this paper is to examine college and university dining services administrators' (CUDSAs) intention to adopt sustainable practices. Design/methodology/approach: The theory of planned behavior (TPB) including constructs of subjective norm (SN), attitude, perceived behavior control, and personal norm (PN), formed the theoretical framework. A web-based questionnaire was developed, pretested, and distributed to 535 CUDSAs in the USA. Findings: Results indicated that SN (pressure from others) had the most influence on CUDSAs' intention to adopt sustainable practices, followed by attitude and PN. Including the PN construct in the TPB model reduced unexplained variance by 33.48 percent. Research limitations/implications: Limitations of this research are generalizability of results due to use of a sample of US members of a professional organization (National Association of College and University Food Services) and low response rate. Practical implications: Results suggest that pressure from college administrators and students has the greatest impact on CUDSAs' decisions to adopt sustainable practices. Originality/value: The question of why some university dining operations are models for sustainability and others have few sustainable practices has not been explored. The dining services' director plays a key role in determining sustainability efforts for that operation. This research explored factors influencing a director's intention to adopt sustainable practices. (Contains 6 tables and 2 figures.)

Enrollment in STEM majors has improved recently, but there continues to be concern over students' retention in those majors, especially women and minority students. The purpose of this study is to develop an integrated understanding of how multiple predictor variables affect student degree attainment, and to ascertain how those variables' impact is moderated by whether students are in STEM or non-STEM majors. Six-year cohort retention/graduation outcomes are predicted for all students in STEM and non-STEM majors, and separately adjusting for whether students remain in, or shift into or away from, STEM majors. Long-term retention/graduation is predicted significantly by cumulative grade point average, financial need, aid (work-study, loan, and gift), gender, ethnicity, years living on campus, high school rank, ACT composite, out-of-state residence, and STEM status. For students starting out in non-STEM majors, six-year graduation/retention also is predicted significantly by learning community participation and whether the student switches to a STEM major. (Contains 4 tables.)

Perceptions of student satisfaction living in special Fresh Start residence halls were collected (N = 1,160, 40% female, 11% minority, 72% freshmen). Satisfaction was influenced by out-of-state residency, satisfaction with two residence staff positions, and Fresh Start policies, as well as house comfort interaction factors and living in a suite or a renovated residence hall.

The extent to which community colleges in 10 Midwest states relied on 12 current funds revenue sources between 1990 and 2000 is presented in this study. Four models of funding were identified and evaluated. All models generated revenue in excess of the change in the Higher Education Price Index (HEPI), a measure of inflation over the period studied. Implications for practice are discussed.

Linear models of two of the most salient motivations for undergraduates to attend college--learning (intrinsic) and enhanced post-graduation earnings (extrinsic)--are estimated from a sample of 2,199 respondents to the 2000 Cooperative Institutional Research Program (CIRP) survey of first-year students, supplemented by institutional records. Model results, using composite variables derived from exploratory factor analysis, emphasize that women are more motivated to attend college to learn than men. Implications are drawn regarding student development and higher education administration, focusing on the need to use different teaching approaches for students with different goals. (Contains 1 table.)