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We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3–7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric. [ABSTRACT FROM AUTHOR]

Context: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult . Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. Design: Cross-sectional study . Methods.· The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis . Floor and ceiling effects (< 15%) were also assessed. Results : Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1 -factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. Conclusions : Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS- TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the validity of the Physical Activity Questionnaire for Older Children (PAQ-C) to assess the moderate- to vigorous-intensity physical activity (MVPA) level of children and adolescents diagnosed with HIV and propose cut-points, with accelerometer measures as the reference method. Method: Children and adolescents, aged 8–14 years (mean age = 12.21 y, SD = 2.09), diagnosed with HIV by vertical transmission, participated in the study. MVPA was investigated through the PAQ-C and triaxial accelerometer (ActiGraph GT3X+). Receiver operating characteristic curve and sensitivity and specificity values were used to identify a cut-point for PAQ-C to distinguish participants meeting MVPA guidelines. Results: Fifty-six children and adolescents participated in the study. Among those, 16 met MVPA guidelines. The PAQ-C score was significantly related to accelerometry-derived MVPA (ρ =.506, P <.001). The PAQ-C score cut-point of 2.151 (sensitivity = 0.625, specificity = 0.875) was able to discriminate between those who met MVPA guidelines and those that did not (area under the curve = 0.751, 95% confidence interval, 0.616–0.886). Conclusion: The PAQ-C was useful to investigate MVPA among children and adolescents diagnosed with HIV and to identify those who meet MVPA guidelines. [ABSTRACT FROM AUTHOR]

Background: Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER. Methods: Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4–16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires. Results: Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low. Conclusions : The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms. [ABSTRACT FROM AUTHOR]

Objective: The early identification and diagnosis of transplant-associated thrombotic microangiopathy (TA-TMA) are essential yet difficult in patients underwent hematopoietic stem cell transplantation (HSCT). To develop an evidence-based, nurse-leading early warning model for TA-TMA, and implement the healthcare quality review and improvement project. Methods: This study was a mixed-methods, before-and-after study. The early warning model was developed based on quality evidence from literature search. The healthcare quality review and improvement project mainly included baseline investigation of nurse, improvement action and effectiveness evaluation. The awareness and knowledge of early parameter of TA-TMA among nurses and the prognosis of patients underwent HSCT were compared before and after the improvement. Results: A total of 1 guideline, 1 evidence synthesis, 4 expert consensuses, 10 literature reviews, 2 diagnostic studies, and 9 case series were included in the best evidence. The early warning model including warning period, high-risk characteristics and early manifestation of TA-TMA was developed. The improvement action, including staff training and assessment, suspected TA-TMA identification and patient education, was implemented. The awareness and knowledge rate of early parameter of TA-TMA among nurses significantly improved after improvement action (100% vs. 26.7%, P < 0.001). The incidence of TA-TMA was similar among patients underwent HSCT before and after improvement action (2.8% vs. 1.2%, P = 0.643), while no fall event occurred after improvement action (0 vs. 1.2%, P < 0.001). Conclusion: The evidence-based early warning model and healthcare quality improvement project could enhance the awareness and knowledge of TA-TMA among healthcare providers and might improve the prognosis of patients diagnosed with TA-TMA. [ABSTRACT FROM AUTHOR]

Background: Postoperative urinary retention (POUR) is a common complication of anorectal surgery. This study was to determine the incidence of POUR in anorectal surgery for benign anorectal diseases, identify its risk factors, and establish a nomogram for prediction of POUR. Methods: A nested case–control study was conducted. The clinical data of patients were collected, and the incidence of POUR was analyzed. Univariate analysis was used to identify the risk factors associated with POUR, and multivariate logistic regression analysis was used to determine independent risk factors for POUR. A nomogram for the preoperative prediction of POUR using a logistic regression model was developed (n = 609). Results: The incidence of POUR after anorectal surgery for benign anorectal diseases was 19.05%. The independent risk factors for POUR were: female (P = 0.007); male with benign prostatic hyperplasia (BPH) (P = 0.001); postoperative visual analogue scale (VAS) score > 6 (P = 0.002); patient-controlled epidural analgesia (PCEA) (P = 0.016); and a surgery time > 30 min (P = 0.039). In the nomogram, BPH is the most important factor affecting the occurrence of POUR, followed by a postoperative VAS score > 6, PCEA, surgery time > 30 min, and sex has the least influence. Conclusion: For patients undergoing anorectal surgery for benign anorectal diseases, preventive measures can be taken to reduce the risk of POUR, taking into account the following risk factors: female or male with BPH, severe postoperative pain, PCEA, and surgery time > 30 min. Furthermore, we developed and validated an easy-to-use nomogram for preoperative prediction of POUR in anorectal surgery for benign anorectal diseases. Trial registration: China Clinical Trial Registry: ChiCTR2000039684, 05/11/2020. [ABSTRACT FROM AUTHOR]

Background: Due to the significant increase in the prevalence of food-related diseases, the value that physicians place on nutritional advice may have implications for patient treatment. The objective of this study was to evaluate the perception of the importance of nutritional intervention among physicians in the Universidad San Francisco de Quito's (USFQ) healthcare system. Methods: This cross-sectional study employed a telephone survey administered to a subset of all medical doctors (MDs) working in the healthcare system clinics of USFQ between 2021 and 2022. Study participants were recruited through voluntary response sample from a complete list of 253 MD. The single time questionnaire consisted of a 22-item validated survey in which attitudes, self-perceived capacity, and knowledge about nutrition ofmedical doctors were evaluated. Data was analyzed using descriptive statistics, two-sided t test, bivariate associations and linear and logistic regressions. Results: 136 MDs completed the survey yielding a response rate of 54%. Our analysis grouped participants into clinical (CE) and non-clinical specialties, hereafter referred to as surgical MDs. While a higher percentage of physicians in CE are confident in their ability to provide examples of recommended food portions based on national or international guidelines, 1 in 10 do not know how to use and interpret BMI or waist circumference, and around 1 in 3 do not know how many calories there are in one gram of fat, protein, or carbohydrates, and their basic metabolic functions. Almost all survey participants believe MDs can have an impact on the eating behavior of a patient if time is used to discuss the problem, however, almost half of survey participants believe nutrition counseling is not an effective use of time. Conclusion: It is important to explore the perceptions and self-confidence of physicians around nutrition related issues. Our results demonstrated that nearly 1 in 4 surgical MDs do not feel capable of recognizing nutritional risk in patients, which highlights the essentiality of physicians having an updated understanding of basic nutrition principles. Future research should examine how commonly MDs refer patients to nutritionists/dietitians, as well as strategies for improving physician knowledge on basic nutrition concepts. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a prevalent psychiatric disorder that affects 1% of the global population. Schizophrenia frequently begins in late adolescence or early adulthood, causing significant educational, social, and economic costs for people and society. Functional neuroimaging research on schizophrenia physiopathology has been beneficial. Arterial spin labelling (ASL) is one of functional magnetic resonance imaging (fMRI) technologies that assess brain function without radiation. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Arterial spin labelling (ASL) is one of the functional magnetic resonance imaging (fMRI) technologies that assess the brain function without radiation hazards. ASL uses magnetic resonance (MR) imaging to quantify tissue-level brain perfusion non-invasively. Many publications were performed on role of different advanced MRI techniques in schizophrenia, but our study insisted on the added value of combined ASL and MRS over the conventional MRI in schizophrenic Egyptian population sample. Aim of the work: The purpose of this work was to evaluate the added value of combined ASL-perfusion MRI and MRS in schizophrenic patients. Methods: This prospective case–control study was carried out on two groups: First group was 30 patients who were diagnosed clinically as schizophrenic patients, and second group was 20 healthy volunteers as a control group for comparison in the period from August 2021 till July 2022. Results: The majority of newly diagnosed cases had significant higher positive symptoms than chronic cases. According to arterial spin labelling (ASL) data, rCBF was noticed to be reduced in anterior cingulate, frontal lobe, and parietal lobe of both patients' subgroups but more significant in chronically ill patients. Convergent results of decreased rCBF were also found in the parietal lobe and occipital lobe. Magnetic resonance spectroscopic analysis showed that NAA was decreased in the anterior cingulate cortex, thalami and basal ganglia of the newly diagnosed cases more than chronic cases. The ASL-MRI perfusion accurately detected the hypo-perfusion of different brain regions with sensitivity 100%, specificity 66.67%, positive predictive value 96.43%, negative predictive value 100%, and accuracy 96.67%, while MR spectroscopy showed sensitivity 100%, specificity 33.33%, positive predictive value 93.10%, negative predictive value 100%, and accuracy 93.33% in evaluation of changes of brain metabolites. Conclusion: ASL is a promising functional MRI technique that can produce together with MRS quantitative information about the metabolites of different brain regions. The ASL-MRI appears as a reliable non-invasive technique to measure cerebral blood flow and identify decreased rCBF without any contrast administration, and it could be repeatable which helps in early diagnosis as well as follow-up of the progression of the disease. [ABSTRACT FROM AUTHOR]

Background: Human epidermal growth factor receptor 2 (HER2) plays an important role in the progression of multiple solid tumors and induces resistance to epidermal growth factor receptor (EGFR) target treatment. However, the expression status and the clinical significance of HER2 in oral squamous cell carcinoma (OSCC) is still controversial. Pyrotinib (PYR) is a promising novel EGFR/HER2 dual inhibitor, whose efficacy in OSCC has not been determined. Methods: 57 locally advanced de novo OSCC patients were included in this study to investigate the relationship between the HER2 expression levels and the prognosis by the tissue microarray analysis (TMA). In vitro and in vivo experiments were performed to retrieve the efficacy of PYR in OSCC. The main downstream of HER2 was evaluated by western blotting in OSCC cell lines and xenograft tumors to explore the potential mechanism of PYR. Results: This study revealed the primary tumor of OSCC had higher HER2 expression levels. Patients with HER2 overexpression had poor overall survival (P < 0.014) and poor disease free survival (P < 0.042). In vitro, PYR suppressed the proliferation, colony formation and migration of OSCC cells. It also promoted apoptosis of OSCC cells and induced cell cycle arrest. Furthermore, PYR was able to inhibit the occurrence and development of OSCC effectively in vivo. Western blotting revealed that PYR suppressed OSCC by inhibiting the phosphorylation of HER2, AKT and ERK. Conclusions: This study exhibited the anti-OSCC effects of PYR in vitro and in vivo, and demonstrated PYR inhibited OSCC cells by inducing apoptosis via the HER2/ AKT and ERK pathway. The result of this study also indicated locally advanced OSCC patients might benefit from HER2 assay and EGFR/HER2 dual inhibit treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Assigning trauma team activation (TTA) levels for trauma patients is a classification task that machine learning models can help optimize. However, performance is dependent on the "ground-truth" labels used for training. Our purpose was to investigate 2 ground truths, the Cribari matrix and the Need for Trauma Intervention (NFTI), for labeling training data. STUDY DESIGN: Data were retrospectively collected from the institutional trauma registry and electronic medical record, including all pediatric patients (age <18 years) who triggered a TTA (January 2014 to December 2021). Three ground truths were used to label training data: (1) Cribari (Injury Severity Score >15 = full activation), (2) NFTI (positive for any of 6 criteria = full activation), and (3) the union of Cribari+NFTI (either positive = full activation). RESULTS: Of 1,366 patients triaged by trained staff, 143 (10.47%) were considered undertriaged using Cribari, 210 (15.37%) using NFTI, and 273 (19.99%) using Cribari+NFTI. NFTI and Cribari+NFTI were more sensitive to undertriage in patients with penetrating mechanisms of injury (p = 0.006), specifically stab wounds (p = 0.014), compared with Cribari, but Cribari indicated overtriage in more patients who required prehospital airway management (p < 0.001), CPR (p = 0.017), and who had mean lower Glasgow Coma Scale scores on presentation (p < 0.001). The mortality rate was higher in the Cribari overtriage group (7.14%, n = 9) compared with NFTI and Cribari+NFTI (0.00%, n = 0, p = 0.005). CONCLUSIONS: To prioritize patient safety, Cribari+NFTI appears best for training a machine learning algorithm to predict the TTA level. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite the increase in firearm injury observed across the country, significant gaps remain relevant to our understanding of how firearm exposure translates to injury. Using acoustic gunshot detection and a collaborative hospital and law enforcement firearm injury database, we sought to identify the relationship between firearm discharge and injury over time. STUDY DESIGN: From 2018 to 2021, instances of firearm discharge captured via acoustic detection in 6 square miles of Louisville, KY, were merged with data from the collaborative firearm injury database. Key outcomes included the total number of rounds fired, injury and fatality rates per round, and the percentage of rounds discharged from automatic weapons and high-capacity magazines. RESULTS: During the study period, 54,397 rounds of ammunition were discharged resulting in 914 injuries, 435 hospital admissions, 2,442 hospital days, 155 emergent operations, and 180 fatalities. For each round of ammunition fired, the risk of injury and fatality was 1.7% and 0.3%, respectively. The total number of rounds fired per month nearly tripled (614 vs 1,623, p < 0.001) leading to increased injury (15 vs 37, p < 0.001) and fatality (3 vs 7, p < 0.001). The percentage of rounds fired from automatic weapons (0 vs 6.8%, p < 0.001) and high-capacity magazines (7.6 vs 28.9%, p < 0.001) increased over time. CONCLUSIONS: The increased burden of firearm injury is related to an overall increase in firearm exposure as measured by the total number of rounds discharged. High-capacity magazines and automatic weaponry are being used with increasing frequency in urban America. [ABSTRACT FROM AUTHOR]

BACKGROUND: Federal regulations require a history and physical (H&P) update performed 30 days or less before a planned procedure. We evaluated the use and burdens of H&P update visits by determining impact on operative management, suitability for telehealth, and visit time and travel burden. STUDY DESIGN: We identified H&P update visits performed in our health system during 2019 for 8 surgical specialties. As available, up to 50 visits per specialty were randomly selected. Primary outcomes were interval changes in history, examination, or operative plan between the initial and updated H&P notes, and visit suitability for telehealth, as determined by 2 independent physician reviewers. Clinic time was captured, and round-trip driving time and distance between patients' home and clinic ZIP codes were estimated. RESULTS: We identified 8,683 visits and 362 were randomly selected for review. Documented changes were most commonly identified in histories (60.8%), but rarely in physical examinations (11.9%) and operative plans (11.6%). Of 362 visits, 359 (99.2%) visits were considered suitable for telehealth. Median clinic time was 52 minutes (interquartile range 33.8 to 78), driving time was 55.6 minutes (interquartile range 35.5 to 85.5), and driving distance was 20.2 miles (interquartile range 8.5 to 38.4). At the health system level, patients spent an estimated aggregate 7,000 hours (including 4,046 hours of waiting room and travel time) and drove 142,273 miles to attend in-person H&P update visits in 2019. CONCLUSIONS: Given their minimal impact on operative management, regulatory requirements for in-person H&P updates should be reconsidered. Flexibility in update timing and modality might help defray the substantial burdens these visits impose on patients. [ABSTRACT FROM AUTHOR]

Introduction: With a surge in the prevalence of coronavirus disease-2019 (COVID-19) in Beijing starting in October 2022, hospitalisation rates increased markedly. This study aimed to evaluate factors associated with in-hospital mortality in patients with COVID-19. Methods: Using data from hospitalised patients, sex-based differences in clinical characteristics, in-hospital management, and in-hospital mortality among patients diagnosed with COVID-19 were evaluated. Predictive factors associated with mortality in 1,091 patients admitted to the Beijing Anzhen Hospital (Beijing, China) for COVID-19 between October 2022 and January 2023 were also evaluated. Results: Data from 1,091 patients hospitalised with COVID-19 were included in the analysis. In-hospital mortality rates for male and female patients were 14.9% and 10.4%, respectively. Multifactorial logistic analysis indicated that lymphocyte percentage (LYM%) (odds ratio [OR] 0.863, 95% confidence interval [CI] 0.805–0.925; p < 0.001), uric acid (OR 1.004, 95% CI: 1.002–1.006; p = 0.001), and high-sensitivity C-reactive protein (OR 1.094, 95% CI: 1.012–1.183; p = 0.024) levels were independently associated with COVID-19-related in-hospital mortality. Among female patients, multifactorial analysis revealed that LYM% (OR 0.856, 95% CI: 0.796–0.920; p < 0.001), older age (OR 1.061, 95% CI: 1.020–1.103; p = 0.003), obesity (OR 2.590, 95% CI: 1.131–5.931; p = 0.024), and a high high-sensitivity troponin I level (OR 2.602, 95% CI: 1.157–5.853; p = 0.021) were risk factors for in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, including area under the ROC curve, showed that the efficacy of LYM% in predicting in-hospital death was 0.800 (sensitivity, 63.2%; specificity, 83.2%) in male patients and 0.815 (sensitivity, 87.5%; specificity, 64.4%) in female patients. Conclusion: LYM% is a consistent predictor of in-hospital mortality for both sexes. Older age and markers of systemic inflammation, myocardial injury, and metabolic dysregulation are also associated with a high mortality risk. These findings may help identify patients who require closer monitoring and tailored interventions to improve outcomes. [ABSTRACT FROM AUTHOR]

Objective To develop the optimal US scanning protocol for the diagnosis of calcium pyrophosphate crystal deposition (CPPD) disease. Methods In this cross-sectional study, consecutive patients with a crystal-proven diagnosis of CPPD disease, and age-, sex-matched disease controls with a negative synovial fluid analysis were prospectively enrolled in two Italian Institutions. Four rheumatologists, blinded to patients' clinical details, performed US examinations using a standardized scanning protocol including 20 joints (shoulders, elbows, wrists, metacarpophalangeal joints from second to fifth fingers, hips, knees, ankles). CPPD was identified as presence/absence, according to the OMERACT definitions. Reduced US scanning protocols were developed by selecting the most informative joints to be imaged by US using the LASSO technique. Patients were randomly divided into training and validation sets. Their diagnostic accuracy was tested comparing the area under the receiver operating characteristic curves. Results The number of participants enrolled was 204: 102 with CPPD disease and 102 disease controls [age, mean (s. d.): 71.3 (12.0) vs 71.1 (13.5) years; female: 62.8% vs 57.8%]. The median number of joints with US evidence of CPPD was 5 [interquartile range (IQR): 4–7] and 0 (IQR: 0–1) in patients with CPPD disease and controls, respectively (P  < 0.01). The detection of CPPD in ≥2 joints using a reduced scanning protocol (bilateral assessment of knees, wrists and hips) showed a sensitivity of 96.7% (95% CI: 82.8, 99.9) and a specificity of 100 (95% CI: 88.8, 100.0) for the diagnosis of CPPD disease and had good feasibility [mean (s. d.): 12.5 (5.3) min]. Conclusion Bilateral US assessment of knees, wrists and hips had excellent accuracy and good feasibility for the diagnosis of CPPD disease. [ABSTRACT FROM AUTHOR]

Safe and effective vaccines have been developed that protect against high-risk strains of HPV, but uptake is relatively low. We previously identified factors such as sexual attitudes and HPV knowledge that impact the intent of Christian parents to vaccinate their children against HPV. We hypothesized that culturally specific interventions in the form of short videos would be effective at improving HPV vaccine intentions and attitudes. We made three short educational videos, one with a Christian focus, one informational about HPV, and one control. Videos were distributed electronically with accompanying surveys, and responses were measured before and after watching a randomly selected video. The religious-focused and educational interventions significantly (p < 0.0001, p = 0.0015) improved intentions towards HPV vaccination. The religiously-focused video also significantly diminished the belief that the HPV vaccine is unnecessary because of a family's values (p = 0.014). Parents significantly credited both interventions with improving their intent to vaccinate their children against HPV (p < 0.001 for both). These results suggest that culturally focused educational interventions are effective at influencing vaccine intentions and attitudes, even when those are based on religious or cultural feelings. Highly specific interventions are likely to be necessary for optimal improvement in vaccine hesitancy. [ABSTRACT FROM AUTHOR]

This study aims to examine changes in body image (BI) over time and factors related to BI among patients with prostate cancer who receive hormone therapy (HT). A cross-sectional design and longitudinal design were utilized. Patients with prostate cancer who received HT were recruited from the urology outpatient departments in two hospitals in Taiwan between August 2017 and December 2020. Cross-sectional data were collected from 177 patients who had started HT for prostate cancer. Longitudinal data were collected from 34 newly diagnosed patients before receiving HT and at 1, 3, 6, and 12 months after HT. The variables measured included hormonal symptoms and distress, self-efficacy, and BI. The results showed that BI dissatisfaction ranged from 6.1% to 17.2%. Hormonal symptoms and distress (e.g. lack of vitality) were correlated with BI dissatisfaction. Education on the side effects of HT and coping strategies can be provided to patients to prevent BI dissatisfaction. [ABSTRACT FROM AUTHOR]

Background High-risk human papillomavirus (HR-HPV) is a known cause of cervical cancer (CC). Latvia has a high incidence of CC compared with the average incidence in the European Union. This study aims to fill the data gap on the HR-HPV burden in Latvia, providing information on its prevalence and associated factors. Methods The cross-sectional study was conducted from February 2021 to April 2022. Participants 25–70 years old visiting a general practitioner (general population) or those referred to a colposcopy clinic with changes in their cervical cytology (colposcopy population) collected vaginal self-sample and completed a paper-based questionnaire. Samples were analyzed with Cobas 6800 System (Roche) for HPV16, HPV18 and other HR-HPV (HPV31/33/35/39/45/51/52/56/58/59/66/68). Descriptive statistics for categorical variables were performed. The Chi-square test was used to determine for the statistical significance of differences in the proportions of the dependent variable between subgroups of the independent variable. Univariate and multivariate binary logistic regression were used to identify factors associated with positive HR-HPV status. Results were considered statistically significant at P  < 0.05. Results A total of 1274 participants provided a valid sample. The prevalence of any HR-HPV infection was 66.8% in the colposcopy group and 11.0% in the general population. Factors associated with positive HR-HPV status were marital status single/divorced/widowed (vs. married/cohabiting) [adjusted OR (aOR) 2.6; P  = 0.003], higher number of lifetime sex partners [aOR 5.1 (P  < 0.001) and 4.0 (P  = 0.001)] for six or more and three to five partners in the general population; in the colposcopy group, the statistical significance remained only for Latvian ethnicity (vs. other) (aOR 1.8; P  = 0.008) and current smoking (vs. never) (aOR 1.9; P  = 0.01). Conclusion We documented a comparison to European Union HR-HPV infection burden in Latvia. Any HR-HPV positivity was significantly associated with sexual and other health behavior. [ABSTRACT FROM AUTHOR]

Purpose: Response times (RTs) are commonly used in studying language acquisition. However, previous research utilizing RT in the context of language has largely overlooked the intra-individual variability (IIV) of RTs, which could hold significant information about the processes underlying language acquisition. Method: We explored the association between language abilities and RT variability in visuomotor tasks using two data sets from previously published studies. The participants were 7- to 10-year-old children (n = 77). Results: Our results suggest that increased variability in RTs is associated with weaker language abilities. Specifically, this within-participant variability in visuomotor RTs, especially the proportion of unusually slow responses, predicted language abilities better than mean RTs, a factor often linked to language skills in past research. Conclusions: Based on our findings, we introduce the IIV hypothesis in explaining individual differences in language development. According to our hypothesis, inconsistency in the timing of cognitive processes, reflected by increased IIV in RTs, degrades learning different aspects of language, and results in individual differences in language abilities. Future studies should further examine the relationship between IIV and language abilities, and test the extent to which the possible relationship is causal. [ABSTRACT FROM AUTHOR]

Background: The use of intracytoplasmic sperm injection (ICSI) currently extends beyond male factor infertility, notably replacing conventional in vitro fertilisation (IVF) in scenarios like limited oocyte availability, where it is used as a precaution against complete fertilisation failure. While existing studies on the use of conventional IVF in such situations provide some reassurance, the available evidence is somewhat insufficient and ICSI is commonly used. Aims: To evaluate whether conventional IVF can be a feasible option when only one oocyte is retrieved. Materials and Methods: A retrospective study was performed to evaluate the fertilisation rate with conventional IVF in women retrieving only one oocyte and whose partner had normal semen. The study aimed at evaluating whether the fertilisation rate was aligned with the threshold indicated by recognized IVF laboratory performance indicators (Vienna Consensus). Clinical pregnancy and live birth rates were secondary outcomes. Results: Out of 304 cycles with a single oocyte inseminated with conventional IVF, 209 achieved normal fertilisation and 82 did not. Thirteen had no mature oocytes. The fertilisation rate was 69% (95% CI: 63–74%) and increased to 72% (95% CI: 66–77%) when immature oocytes were excluded. The fertilisation rate surpassed the minimum competency threshold of the Vienna Consensus (60%), even if below the benchmark value (75%). Clinical pregnancy and live birth rates per oocyte retrieval were 10% and 8%, respectively. Univariate and multivariate analyses failed to identify any predictive factor of fertilisation. Conclusion: Conventional IVF with one oocyte met Vienna Consensus standards even if it fell short of higher benchmarks. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is one of the most common complications of diabetes worldwide. The aim of this study was to assess the prevalence of DR in hospitalized patients with type 2 diabetes (T2DM) in Tibet and to identify risk factors that may influence the occurrence of DR. Methods: This was a cross-sectional study conducted in a third-class hospital in the Tibet Autonomous Region. The prevalence of DR in hospitalized patients with T2DM was measured. Univariate and multivariate logistic regression, restricted cubic spline (RCS) analysis and receiver-operating characteristic curve analysis were used to investigate the risk factors for DR. Results: The prevalence of DR was 29.3%. The duration of diabetes; concentrations of 25-OH-VitD3, hemoglobin, fasting insulin, alanine aminotransferase, total bilirubin, and creatinine; and HOMA-IR were significantly different between DR patients and non-DR patients (all P < 0.05). Univariate and multivariate logistic regression revealed that a longer duration of diabetes and lower 25-OH-VitD3 levels were associated with increased DR risk. RCS analysis suggested overall positive associations of the duration of diabetes and 25-OH-VitD3 concentrations with DR risk (P nonlinearity < 0.05). The turning points for the duration of diabetes and 25-OH-VitD3 concentrations were 5.1 years and 10.6 ng/mL, respectively. The sensitivity, specificity, and area under the receiver-operating characteristic curve for the combination of the duration of diabetes and 25-OH-VitD3 levels were 79.4%, 69.4% and 0.764, respectively. Conclusions: Given the high prevalence of DR in hospitalized patients with T2DM in Tibet, vitamin D supplementation seems to be important in the prevention of DR to some degree. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe and compare the proportion of patients classified as an emergency department (ED) mental health presentation under different definitions, including the Australian Institute of Health and Welfare (AIHW) definition. Methods: This retrospective cohort study enrolled all patients that presented to the EDs of a multi-centre Victorian health service between 1 January 2020 and 30 June 2023. Varying definitions of a mental health presentation were applied to each ED attendance, applying the current AIHW definition (using selected diagnosis codes), broader diagnosis-based coding, the presenting complaint recorded at triage and whether the patient was seen by or referred to the emergency psychiatric service (EPS). The proportion of all ED presentations meeting each definition and any overlap between definitions were calculated. The agreement between each definition and the AIHW definition was evaluated using Kappa's coefficient. Results: There were 813,078 presentations to ED of which 34,248 (4.2%) met the AIHW definition for a mental health presentation. Throughout the study, 45,376 (5.6%) patients were seen and/or referred to EPS, and 36,160 (4.4%) patients were allocated a mental health presenting complaint by triage staff. There was moderate interrater agreement between these definitions, with a kappa statistic (95% confidence interval) between the AIHW definition and a mental health presenting complaint recorded at triage of 0.58 (0.58–0.59) and between the AIHW definition and review by EPS of 0.58 (0.57–0.58). Conclusions: The AIHW definition is a conservative measure of ED mental health presentations and may underestimate emergency psychiatry workload in Australian EDs. What is known about this topic? It is unknown whether the Australian Institute of Health and Welfare (AIHW) definition of an emergency department (ED) mental health presentation definition accurately reflects ED mental health workload. What does this paper add? The AIHW definition appears to underestimate the clinical workload related to ED mental health presentations. There is moderate agreement between the AIHW definition and mental health presentations classified according to complaint recorded at triage, or whether the patient is reviewed by psychiatry services. What are the implications for practitioners? Accurate measurement of emergency psychiatry workload should not rely on the AIHW definition alone. [ABSTRACT FROM AUTHOR]

This pilot randomized controlled trial tested the potential efficacy of a brief internet-based, passive psychoeducation intervention, Free From Abuse, in promoting healthy relationships among young adults. Participants aged 18 to 24 years were randomly assigned to an intervention treatment (n = 71) or a placebo control condition (n = 77). Participants in the treatment arm had a larger increase in recognition of abusive behavior and reduction in domestic violence myth acceptance scores than participants in the control arm postintervention and after one week. This study provides preliminary evidence that brief internet-based passive psychoeducation is potentially useful in promoting healthy relationships among young adults. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health. Current diagnostic methods based on glucose tolerance tests have limitations for early detection. tRNA‐derived small RNAs (tsRNAs) have emerged as potential molecular regulators in various diseases, including metabolic disorders. However, the diagnostic value of tsRNAs in plasma for early GDM or postpartum remains unclear. Methods: This longitudinal study profiled the expression of tsRNAs across different gestational stages and postpartum in women with GDM (n = 40) and healthy control gestational women (HCs, n = 40). High‐throughput small RNA sequencing identified candidate tsRNAs, which were then validated and correlated with clinical biochemical markers such as fasting blood glucose (FBG), HOMA‐IR, and GHbA1c. Results: tRF‐1:32‐Val‐AAC‐1‐M6, tRF‐1:31‐Glu‐CTC‐1‐M2, and tRF‐1:30‐Gly‐CCC‐1‐M4 were consistently upregulated in the GDM group compared to HCs during the second trimester (p < 0.05). Only tRF‐1:31‐Glu‐CTC‐1‐M2 was highly expressed during the first trimester, and tRF‐1:30‐Gly‐CCC‐1‐M4 increased during postpartum. tRF‐1:31‐Glu‐CTC‐1‐M2 showed a significant correlation with FBG levels in the first trimester (R = 0.317, p = 0.047). The expression of tRF‐1:30‐Gly‐CCC‐1‐M4 was significantly correlated with HOMA‐IR (r = 0.65, p < 0.001) and GHBA1c (r = 0.33, p = 0.037) during postpartum. A joint diagnostic model incorporating tsRNAs expression and clinical markers demonstrated enhanced predictive power for GDM (ROC AUC = 0.768). Conclusion: Our results revealed distinct expression patterns of specific tsRNAs in GDM, showcasing their correlation with key metabolic parameters. This underscores their promising role as biomarkers for early prediction and diagnosis of GDM. The integration of tRFs into a composite biomarker panel holds the potential to improve clinical outcomes by enabling personalized risk assessment and targeted interventions. [ABSTRACT FROM AUTHOR]

Background: The advancement of laparoscopic technology has broadened the application of laparoscopic pancreaticoduodenectomy (LPD) for treating pancreatic head and ampullary tumors. Despite its benefits, postoperative pancreatic fistula (POPF) and postpancreatectomy hemorrhage (PPH) remain significant complications. Ligamentum teres hepatis wrapping around the gastroduodenal artery (GDA) stump show limitations in reducing POPF and PPH. Methods: This study retrospectively analyzed patients undergoing LPD from January 2016 to October 2023, We compared the effectiveness of the two-parts wrapping (the ligamentum teres hepatis wrapping of the gastroduodenal artery stump and the omentum flap wrapping of the pancreatojejunal anastomosis) and ligamentum teres hepatis wrapping around the gastroduodenal artery (GDA) in reducing postoperative pancreatic fistula (POPF) and postpancreatectomy hemorrhage (PPH), using propensity score matching for the analysis. Results: A total of 172 patients were analyzed, showing that the two-parts wrapping group significantly reduced the rates of overall and severe complications, POPF, and PPH compared to ligamentum teres hepatis wrapping around the GDA group. Specifically, the study found lower rates of grade B/C POPF and no instances of PPH in the two-parts wrapping group, alongside shorter postoperative hospital stays and drainage removal times. These benefits were particularly notable in patients with soft pancreatic textures and pancreatic duct diameters of < 3 mm. Conclusion: The two-parts wrapping technique significantly reduce the risks of POPF and PPH in LPD, offering a promising approach for patients with soft pancreas and pancreatic duct diameter of < 3 mm. [ABSTRACT FROM AUTHOR]

Background: Endoscopic balloon dilation (EBD) is a safe and effective treatment for Crohn's disease (CD)-associated strictures. However, serial EBDs have rarely been reported. This study aimed to evaluate the efficacy and safety of serial EBDs for treating CD-associated duodenal strictures compared with intermittent EBDs. Methods: Patients with CD-associated duodenal strictures who underwent EBD were recruited. The clinical data, stricture characteristics, number of EBDs, dilation diameter, complications, surgical interventions, and follow-up periods were recorded. Patients were divided into a serial dilation group and an intermittent dilation group to analyze the differences in safety and efficacy. Results: Forty-five patients with duodenal CD-associated strictures underwent a total of 139 dilations. A total of 23 patients in the serial dilation group underwent 72 dilations, for a median of 3 (range 3 ~ 4) dilations per patient, and 22 patients in the intermittent dilation group underwent 67 dilations, for a median of 3 (range 1 ~ 6) dilations per patient. Technical success was achieved in 97.84% (136/139) of the patients. During the follow-up period, three patients in the intermittent dilation group underwent surgery, and the total clinical efficacy was 93.33% (42/45). No difference in safety or short-term efficacy was noted between the two groups, but serial EBDs exhibited significantly greater clinical efficacy between 6 months and 2 years. No significant difference in recurrence-free survival was observed, but the median longest recurrence-free survival and recurrence-free survival after the last EBD in the serial dilation group were 693 days (range 298 ~ 1381) and 815 days (range 502 ~ 1235), respectively, which were significantly longer than the 415 days (range 35 ~ 1493) and 291 days (range 34 ~ 1493) in the intermittent dilation group (p = 0.013 and p = 0.000, respectively). At the last follow-up, the mean diameter of the duodenal lumen was 1.17 ± 0.07 cm in the serial dilation group, which was greater than the 1.11 ± 0.10 cm in the intermittent dilation group (p = 0.018). We also found that the Simple Endoscopic Score for Crohn's Disease was associated with an increased risk of surgical intervention (HR 2.377, 95% CI 1.125–5.020; p = 0.023) and recurrence at 6 months after the last EBD (HR 0.698, 95% CI 0.511–0.953; p = 0.024), as assessed by univariate analysis. Conclusions: Compared to the intermittent EBDs, serial EBDs for duodenal CD-associated strictures exhibit greater clinical efficacy within two years and could delay stricture recurrence. We suggest that serial EBDs can be a novel option for endoscopic treatment of duodenal CD-associated strictures. [ABSTRACT FROM AUTHOR]

Background: The optimal approach for the safe implementation and education of robotic pancreaticoduodenectomy (RPD) remains unclear. Prolonged operation time may cause surgeon fatigue and result in perioperative complications. To solve this issue, our department adopted task division by the console surgeon turnover between resection and reconstruction in 2022. Methods: This study retrospectively investigated consecutive patients who underwent RPD from November 2009 (initial introduction of RPD) to December 2023. The analysis excluded patients who underwent concomitant resection of other organs. The cases performed by a single console surgeon (single approach) were compared with those performed by two or more console surgeons (multiple approach). Results: This study analyzed 85 consecutive RPD cases, including 51 with the single approach and 34 with the multiple approach. The operation time was significantly shorter (832 vs. 618 min, p < 0.001), and the postoperative major complication was less frequent (45% vs. 12%, p = 0.003) in the multiple approach group, although less experienced surgeons performed the multiple approach (number of RPD experiences: 19 cases vs. 5 cases, p < 0.001). The console surgeon turnover between the resection and reconstruction resulted in a safe pancreatojejunostomy performed by the less experienced surgeon (number of pancreatic reconstruction experiences: 6.5 vs. 14 cases, p = 0.010). Surgeons who started RPD with a multiple approach observed a reduction in surgical time and a lower incidence of complications earlier than those who started with a single approach. Conclusion: Task division during the early introduction phase of RPD using the multiple approach demonstrated potential contributions to improved surgical outcomes and enhanced educational benefits. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing sleeve gastrectomy (SG) experience transformative changes in eating-related experiences that include eating-related symptoms, emotions, and habits. Long-term assessment of these endpoints with rigorous patient-reported outcome measures (PROMs) is limited. We assessed patients undergoing SG with the Body-Q Eating Module PROMs. Methods: All patients evaluated at the Emory Bariatric Center were given the Body-Q Eating Modules questionnaire at preoperative/postoperative clinic visits. Rasch scores and prevalence of relevant endpoints were assessed across six time-points of interest: preoperatively, post-operative months 0–6, 7–12, 12–24, 24–36, and over 36. Student's t-test and Chi-square test were used for analysis. Results: Overall, 1,352 questionnaires were completed pre-operatively and 493 postoperatively. Survey compliance was 81%. Compared to the pre-operative group, the post-operative group had lower BMI (39.7 vs. 46.4, p < 0.001) and higher age (46.3 vs. 44.9, p = 0.019). Beginning one year after SG, patients experience more frequent eating-related pain, nausea and constipation compared to pre-operative baseline (p < 0.05). They also more frequently experience eating-related regurgitation and dumping syndrome-related symptoms beginning post-operative year two (p < 0.05). In the first year after SG, patients more rarely feel eating-related embarrassment, guilt, and disappointment compared to pre-operative baseline (p < 0.05). These improvements disappear one year after SG, after which patients more frequently experience feeling out of control, unhappy, like a failure, disappointed, and guilty (p < 0.05). In the first year after SG, patients experience an increased frequency in positive eating behaviors (ate healthy foods, showed self-control, stopped before full; (p < 0.05). Only two eating-related behavior improvements persist long-term: feeling in control and eating the right amount (p < 0.05). Conclusions: Patients undergoing SG may experience more frequent eating-related symptoms, distress, and behavior in the long-term. These findings can enhance the pre-operative informed consent and guide development of a more tailored approach to postoperative clinical management such as more frequent visits with the dietician. [ABSTRACT FROM AUTHOR]

Background: Missed early gastric cancer (MEGC) is prevalent during esophagogastroduodenoscopy (EGD), which is the first-line recommended strategy for detecting early gastric cancer (EGC). Hence, we explored the risk factors for MEGC and different types of MEGC, based on the endoscopic resected population. Methods: This retrospective, case–control study was conducted at Nanjing Drum Tower Hospital (NJDTH). We included patients who were diagnosed with EGC during screening EGD, underwent endoscopic resection, and were confirmed by postoperative pathology at the NJDTH from January 2014 to December 2021, and classified them into different types according to the different root causes of misses. Univariable, multivariable, subgroup and propensity score analyses were used to explore the risk factors for MEGC and different types of MEGC. Results: A total of 447 patients, comprising 345 with initially detected early gastric cancer (IDEGC) and 102 with MEGC, were included in this study. Larger size (≥ 1 cm) (OR 0.45, 95% CI 0.27–0.74, P = 0.002) and invasion depth of submucosa (OR 0.26, 95% CI 0.10–0.69, P = 0.007) were negatively associated with MEGC. Use of sedation (OR 0.32, 95% CI 0.20–0.52, P < 0.001) and longer observation time (OR 0.60, 95% CI 0.37–0.96, P = 0.034) exhibited protective effect on MEGC. Conclusions: Smaller and more superficial EGC lesions are more susceptible to misdiagnosis. The use of sedation and prolonged observation time during EGD could help reduce the occurrence of MEGC. [ABSTRACT FROM AUTHOR]

Background: Despite evidence of benefits on postoperative outcomes, minimally invasive liver surgery (MILS) had a very low diffusion up to 2014, and recent evolution is unknown. Our aim was to analyze the recent diffusion and adoption of MILS and compare the trends in indications, extent of resection, and institutional practice with open liver surgery (OLS). Methods: We analyzed the French nationwide, exhaustive cohort of all patients undergoing a liver resection in France between January 1, 2013 and December 31, 2022. Average annual percentage changes (AAPC) in the incidence of MILS and OLS were compared using mixed-effects log-linear regression models. Time trends were analyzed in terms of extent of resection, indication, and institutional practice. Results: MILS represented 25.2% of 74,671 liver resections and year incidence doubled from 16.5% in 2013 to 35.4% in 2022. The highest AAPC were observed among major liver resections [+ 22.2% (19.5; 24.9) per year], primary [+ 10.2% (8.5; 12.0) per year], and secondary malignant tumors [+ 9.9% (8.2; 11.6) per year]. The highest increase in MILS was observed in university hospitals [+ 14.7% (7.7; 22.2) per year] performing 48.8% of MILS and in very high-volume (> 150 procedures/year) hospitals [+ 12.1% (9.0; 15.3) per year] performing 19.7% of MILS. OLS AAPC decreased for all indications and institutions and accelerated over time from – 1.8% (– 3.9; – 0.3) per year in 2013–2018 to – 5.9% (– 7.9; – 3.9) per year in 2018–2022 (p = 0.013). Conclusions: This is the first reported trend reversal between MILS and OLS. MILS has considerably increased at a national scale, crossing the 20% tipping point of adoption rate as defined by the IDEAL framework. [ABSTRACT FROM AUTHOR]

Background: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these. Method: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality. Results: 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4–2), (OR = 4.7, 95% CI 3.1–7.6)], female gender [(OR = 1.8, 95% CI 1.4–2.3), (OR = 1.9, 95% CI 1.3–2.9)], shock on admission [(OR = 2.1, 95% CI 1.7–2.7), (OR = 4.8, 95% CI 3.2–7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9–3.2), (OR = 3.9), 95% CI 2.7–5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1–1.6], but not mortality. Conclusions: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality. [ABSTRACT FROM AUTHOR]

Cyber dating abuse (CDA) concerns the use of digital technology to control, monitor, and hurt one's intimate partner. CDA can have profound detrimental outcomes, such as mental health problems. As such, it is important to identify intrapersonal factors that may explain these behaviors. Previous research suggests that one such factor is the personality cluster of Dark Triad traits (DTT), comprising Machiavellianism, narcissism, and psychopathy. Additionally, DTT and CDA perpetration have both been linked to poor self-control ability, but these relationships have not yet been tested together in one model. As such, the present study examines if individuals' poor self-control ability mediates the relationship between the DTT and CDA perpetration. To test these associations, we conducted a survey study among a representative sample of Belgian adults (n = 1,144; M age = 47.66 years; 51.3% female). Findings from correlation analyses revealed that all three DTT were individually associated with CDA perpetration, such that higher scores on these traits corresponded with more CDA perpetration. Additionally, pathway analyses from structural equation modeling revealed that individuals' poor self-control ability fully explained the relationship between Machiavellianism and narcissism and CDA perpetration, and partially explained the relationship between psychopathy and CDA perpetration. As our findings suggest that self-control plays an instrumental role in explaining why individuals control and monitor their partner via digital technology, prevention and intervention efforts should seek ways to improve individuals' self-control ability in situations that may trigger such harmful interpersonal behaviors, particularly among individuals who exhibit Dark Triad personality traits. [ABSTRACT FROM AUTHOR]

Policing domestic violence (DV) poses significant challenges in China due to cultural, legal, and organizational complexities. Policing DV in China favors mediation over assertive interventions, complicating law enforcement's role. While previous research has focused on coercive interventions by Chinese police, there is limited information on non-coercive, supportive approaches. This study investigates the relationship between police officers' knowledge and training regarding the Anti-DV law and their willingness to provide supportive services to DV victims in China. It also considers various individual and organizational factors. The data used in this study are derived from the Policing DV in China project, with a sample of 1,353 respondents who had experience dealing with DV cases within the past 3 years. The study focuses on three dependent variables representing supportive approaches to DV cases: Referral, Counseling, and Protection orders. Independent variables include officers' knowledge of the Anti-DV law and agency training. Control variables include the use of body-worn cameras (BWC) and attitudes toward Violence Tolerance, Male Dominance, and Gender Equality. Additionally, demographic variables, working environment, length of service, and police rank are considered. The analytical approach involves a three-step strategy, incorporating descriptive, bivariate analyses, and regression analyses. The results are interpreted using odds ratios and average marginal effects, and statistical software such as SPSS by IBM and R by Open-Source Model is utilized for data analysis. Key findings indicate that more than half of the officers referred intimate partner violence survivors to shelters and assisted victims in filing protection orders. Counseling practices varied across provinces and between male and female officers. Agency training and the use of BWC were positively associated with non-coercive and supportive approaches, while knowledge of the DV Act, male dominance score, and gender equality score did not predict the use of such approaches. Demographic characteristics, including police rank, length of service, and province of employment, influenced the utilization of non-coercive and supportive approaches. This study examines the challenges faced by Chinese police officers when responding to DV cases and their willingness to provide supportive interventions. The study highlights the complexities surrounding the initiation of protection orders due to officers' legal knowledge and discretion. The study emphasizes the importance of police support in addressing DV in China and the role of agency training in promoting non-coercive responses. It highlights regional variations in police support and underscores the need for addressing disparities in service provision across different provinces. [ABSTRACT FROM AUTHOR]

The objectives of the present analyses are to examine the frequency, nature, and correlates of nonfatal gun use in incidents of conflict between adult children and their parents, to which police were summoned. A cross-sectional study design was used with all cases of domestic violence to which police were called between adult children and their parents, in Philadelphia, PA, in 2013 (N = 6,248). Data were drawn from forms required to be completed by police when responding to domestic violence calls for assistance. A series of multivariate logistic regression models were estimated. Of the 6,248 incidents, 5,486 involved no weapon, 522 involved a bodily weapon, 190 involved a non-gun external weapon, and 50 involved a gun. Guns were most often used to threaten victims (66%), with guns less often fired (6%) or used to pistol whip victims (4%). Compared to incidents involving a bodily weapon, when guns were involved, offenders were less likely to have pushed, grabbed, or punched the victim and victims were less likely to have visible injuries; however, offenders were more likely to have threatened victims and victims were more likely to be observed as frightened. Police officers intervened similarly to incidents involving guns vs. bodily weapons. This is the first study we are aware of to focus on nonfatal gun use between family members who are not intimate partners, with the results extending much of what is known regarding nonfatal gun use among intimate partners to nonfatal gun use among adult children and parents. [ABSTRACT FROM AUTHOR]

While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older Black adults. Data were from 3,191 Black adults ages 51+ in the 2008–2016 waves of the Health and Retirement Study to examine associations among neighborhood characteristics, psychosocial resilience (sense of purpose, mastery, and social support), and cognitive functioning among Black adults. Multilevel linear regression models assessed direct effects of neighborhood characteristics and psychosocial resources on cognitive functioning. We then tested whether psychosocial resources moderated the association between neighborhood characteristics and cognitive functioning. Mean levels of cognitive functioning, sense of purpose, social support, and mastery were significantly related to neighborhood disorder and discohesion. Regression results showed that levels of neighborhood disorder and high discohesion were significantly associated with cognitive functioning. Sense of purpose was positively associated with cognitive functioning, net of neighborhood characteristics. However, only social support moderated the association between neighborhood discohesion and cognition. These findings demonstrate the importance of examining psychosocial and contextual risk and resilience resources among midlife and older Black adults. This work may inform the development of cognitive behavioral interventions aimed at increasing sense of purpose to promote and enhance cognitive resiliency among Black adults. Altogether, this work may have implications for policy aimed at advancing cognitive health equity. [ABSTRACT FROM AUTHOR]

Students with mental health needs, behavioral support needs, and/or emotional disturbance can engage in internalizing behaviors, externalizing behaviors, or both. Preservice and induction phase elementary general education teachers are reported to have limited education in providing evidence-based behavior management strategies, especially for students who engage in internalizing and/or externalizing behaviors. There is little understanding as to the differences in elementary general education teachers' knowledge, application, and self-efficacy in applying evidence-based behavior management strategies between preservice teachers, first-year teachers, second-year teachers, and third-year teachers. The purpose of this preliminary secondary data analysis was to examine differences in U.S. elementary general education teacher knowledge, application, and self-efficacy in evidence-based behavior management strategies from preservice to induction phase teaching. Results indicated third-year teachers had significantly less behavior management knowledge than preservice teachers. All other results were nonsignificant; however, there were practical differences when comparing the four groups on the knowledge and application measures. Implications for findings indicate the need for induction programs to focus on evidence-based behavior management strategies to support the development of behavior management for induction phase elementary education teachers as they progress through their first 3 years of teaching. [ABSTRACT FROM AUTHOR]

Data on attaining indicators of early speech, language, and literacy development, notably phonological awareness, among children with visual impairments (VI) are limited. This U.S. study utilized the National Survey of Children's Health (NSCH), 2016–2020, to observe the distinctive population of children with VI and speech, language, and literacy needs. Chi-square bivariate and multivariable logistic regression analyses established differences between children ages 3 to 5 years with VI (n = 186) and without VI (n = 25,354). Significant differences included lower parental education and higher rates of family poverty for children with VI. Significantly fewer children with VI had attained early phonological awareness (identifying initial sounds in words and word rhyming). Nearly three times more children with VI had been diagnosed with a speech or language disorder. Findings affirm that interventions address speech, language, and literacy development among children with VI, including explicit phonological awareness. Communication disorders research based on population health databases can inform evidence-based practice. [ABSTRACT FROM AUTHOR]

Parental representations of the child are linked to positive developmental outcomes in children, but the impact of prenatal representations on early social-emotional development, particularly from fathers, is less understood. This study explores how fathers' and mothers' prenatal representations within two-parent families are associated with early social-emotional development. Prenatal representations of fathers (n = 88) and mothers (n = 92) were assessed between 28 and 32 weeks of gestation using the Working Model of the Child Interview, categorizing them as balanced or nonbalanced. The children's (n = 97; 49.5% girls) social-emotional and behavioral problems and competencies were measured at 18 months using the Brief Infant-Toddler Social and Emotional Assessment. Balanced prenatal representations of both parents were related to higher social-emotional competence in toddlers. However, prenatal representations were not related to social-emotional and behavioral problems. The results highlight the benefits of balanced prenatal representations in promoting early social-emotional competence in children. [ABSTRACT FROM AUTHOR]

Objective Patients with severe preeclampsia (sPREX) face barriers to successful breastfeeding (BF), including an increased risk of maternal and newborn complications, prematurity, and low birth weight. Patients with early-onset sPREX (before 34 weeks' gestation) may be at even greater risk, yet there are little data available on factors associated with BF challenges in this population. We describe rates of BF initiation at hospital discharge and BF continuation at postpartum (PP) visit and identify factors associated with BF noninitiation and BF cessation among patients admitted with early-onset sPREX. Study Design Retrospective cohort study of women with sPREX admitted at less than 34 weeks' gestation to a single tertiary center (2013–2019). Demographic, antepartum, and delivery characteristics were evaluated. Factors associated with BF noninitiation at maternal discharge and with BF cessation at routine PP were assessed. Patients with intrauterine or neonatal demise and those missing BF data were excluded. Bivariate statistics were used to compare characteristics and Poisson regression was used to estimate relative risks (RR). Results Of 255 patients with early-onset sPREX, 228 (89.4%) had BF initiation at maternal hospital discharge. Initiation of BF occurred less frequently among patients with tobacco use in pregnancy (7.5 vs. 37.0%, χ2 , p < 0.001, RR: 0.69 [95% confidence interval, CI: 0.52–0.92]). At 6 weeks' PP, 159 of 199 (79.9%) patients had BF continuation. Maternal age under 20 years (1.9 vs. 17.5%, χ2 , p = 0.01, RR: 0.36 [95% CI: 0.14–0.91]) and experiencing maternal morbidity (25.2 vs. 45.0%, χ2 , p = 0.01, RR: 0.80 [95% CI: 0.66–0.96]) were associated with BF cessation at the PP visit. Conclusion Among patients with early sPREX, tobacco use in pregnancy was associated with noninitiation of BF at discharge, whereas young maternal age and maternal morbidity were associated with cessation of BF by routine PP visit. Further research is needed on how to support BF in this population, especially among patients with these associated factors. Key Points Tobacco use was associated with BF noninitiation in patients with early preeclampsia. Maternal age < 20 and maternal morbidity were associated with BF cessation by PP visit. BF support for patients with risk factors is important for BF success PP. [ABSTRACT FROM AUTHOR]

Objective Necrotizing enterocolitis (NEC) primarily affects preterm, especially small for gestational age (SGA), infants. This study was designed to (1) describe frequency and timing of NEC in SGA versus non-SGA infants and (2) assess whether NEC is independently associated with the severity of intrauterine growth failure. Study Design Retrospective cohort study of infants without severe congenital malformations born <33 weeks' gestational age (GA) carried out from 2009 to 2021. The frequency and time of NEC were compared between SGA and non-SGA infants. Multivariate logistic regression was used to assess whether NEC was independently associated with intrauterine growth restriction. Severe growth restriction was defined as birth weight Z -score < −2. Results Among 2,940 infants, the frequency of NEC was higher in SGA than in non-SGA infants (25/268 [9.3%] vs. 110/2,672 [4.1%], respectively, p < 0.001). NEC developed 2 weeks later in SGA than non-SGA infants. In multivariate analysis, the adjusted odds of NEC increased with extreme prematurity (<28 weeks' GA) and with severe but not moderate growth restriction. The adjusted odds of NEC increased with urinary tract infection or sepsis within a week prior to NEC, were lower in infants fed their mother's own milk until discharge, and did not change over five epochs. NEC was independently associated with antenatal steroid (ANS) exposure in infants with birth weight (BW) Z -score < 0. Conclusion NEC was more frequent in SGA than in non-SGA infants and developed 2 weeks later in SGA infants. NEC was independently associated with severe intrauterine growth failure and with ANS exposure in infants with BW Z -score < 0. Key Points We studied 2,940 infants <33 weeks' GA. We assessed NEC. NEC was more frequent in SGA infants. NEC occurred 2 weeks later in SGA infants. NEC was associated with severe growth restriction. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to determine which late-preterm (35–36 weeks' gestational age [GA]) and term neonates with early-onset hypoglycemia in the first 72 hours postnatal required a continuous glucose infusion to achieve and successfully maintain euglycemia. Study Design This is a retrospective cohort study of late preterm and term neonates born in 2010–2014 and admitted to the Mother-Baby Unit at Parkland Hospital who had laboratory-proven blood glucose concentration < 40 mg/dL (2.2 mmol/L) during the first 72 hours of life. Among the subgroup needing intravenous (IV) glucose infusion, we analyzed which factors predicted a maximum glucose infusion rate (GIR) ≥ 10 mg/kg/min. The entire cohort was randomly divided into a derivation cohort (n = 1,288) and a validation cohort (n = 1,298). Results In multivariate analysis, the need for IV glucose infusion was associated with small size for GA, low initial glucose concentration, early-onset infection, and other perinatal variables in both cohorts. A GIR ≥ 10 mg/kg / min was required in 14% of neonates with blood glucose value < 20 mg/dL during the first 3 hours of observation. The likelihood of a GIR ≥ 10 mg/kg/min was associated with lower initial blood glucose value and lower umbilical arterial pH. Conclusion Need for IV glucose infusion was associated with small size for GA, low initial glucose concentration, early-onset infection, and variables associated with perinatal hypoxia–asphyxia. The likelihood of a maximum GIR ≥ 10 mg/kg/min was greater in neonates with lower blood glucose value during the first 3 hours of observation and lower umbilical arterial pH. Key Points We studied 51,973 neonates ≥ 35 weeks' GA. We established a model predicting the need for IV glucose. We also predicted the need for a high rate of IV glucose. [ABSTRACT FROM AUTHOR]

Moral distress is recognized as a serious problem not only among healthcare providers, but also in the healthcare system in general. It is considered that moral distress in health care is defined as a phenomenon in which nurses know how to proceed ethically in certain situations but are constrained from acting. There are currently no studies conducted on moral distress among anesthesia and intensive care nurses in Latvia, but the moral distress scale has been adapted since beginning the research. Additionally, there have been no studies conducted in Latvia to analyze the correlations between the level of moral distress and burnout syndrome. The results of the conducted research confirmed H0 (null hypothesis), which suggests that there is no association between moral distress and burnout rates in nursing practitioners in anesthesiology and intensive care. The results of the study and a review of the existing literature suggest that there is a statistically significant relationship between moral distress rates and the rates of emotional exhaustion, as well as the rates of depersonalization. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Background: In scientific inquiry learning, students often have difficulties conducting hypothetical reasoning with multiple intertwined variables. Concept maps have a potential to facilitate complex thinking and reasoning. However, there is little investigation into the content of student‐constructed concept maps and its association with inquiry task performance. Objectives: This study explored students' concept mapping style and its association with task performance in computer‐based inquiry learning. Methods: An exploratory study was conducted with 80 Grade 11 students, who collaboratively constructed concept maps in a free style to support inquiry learning with a virtual ecosystem. Student‐constructed concept maps was analysed by firstly identifying different types of propositions formed in the maps and then determining the style of each concept map based on the dominant type of propositions in the map. Finally, the association between the concept map style and inquiry task performance was explored. Results and Conclusions: Two major concept map styles were identified: (1) knowledge‐oriented concept maps (KCMs) mainly representing problem‐related subject knowledge as a set of concepts and their relationships, and (2) problem‐oriented concept maps (PCMs) mainly representing problem situation as a sequence of changes and their causal relationships. Compared with those constructing KCMs, the students constructing PCMs formed higher‐quality propositions in their maps and performed better in hypothesising, reasoning, and drawing conclusions in the inquiry task. Implications: Besides KCMs, students in inquiry learning can be encouraged to construct PCMs to foster effective thinking and reasoning; that is, constructing a concept map to represent the problem situation as a sequence of changes and the causal relationships between the changes. Lay Description: What is currently known about the subject matter: Concept maps (CMs) can facilitate complex thinking and reasoning in inquiry learning.There is little investigation into the content of student‐constructed CMs.It is unknown how CM content might associate with inquiry task performance. What this paper adds: Students constructed two major styles of CMs in computer‐based inquiry learning.The two styles of CMs are problem‐oriented and knowledge‐oriented CMs.Students constructing problem‐oriented CMs performed better in the inquiry task. Implications for practitioners: Analysing student‐constructed CMs helps understand student thinking in inquiry.Students are encouraged to build problem‐oriented CMs in inquiry learning. [ABSTRACT FROM AUTHOR]

Introduction: Media comparison studies examining the effectiveness of immersive virtual reality in education have yielded inconclusive findings, leaving the question of its impact on learning compared to conventional media unanswered. To address this issue, our study employs a novel approach that combines media comparison with an investigation on the influence of broader educational context. Methods: In the experiment, 262 students from two distinct types of lower secondary schools—comprehensive school and multi‐year gymnasium (a selective academic school)—participated. The students received a lesson on topography and contour line interpretation, using either an immersive virtual environment or a PowerPoint slideshow. A transfer test was carried out before, immediately after, and 1 month after the lesson to measure knowledge application. Results: The impact of the media (immersive virtual reality vs. PowerPoint slideshow) on learning outcomes was found to be minimal, with no clear advantage of one over the other in any experimental condition. In contrast, a significant influence on learning gains was observed due to school type. Multi‐year gymnasium students consistently outperformed comprehensive school students in the pre‐test and demonstrated greater learning gains, regardless of the learning media. Conclusion: The present study employs an innovative approach by integrating a comparative analysis of different media types with an investigation into the impact of learner characteristics. By including students from distinct types of schools, the study provides insights into the differential effects of immersive virtual reality in varied educational contexts. Lay Description: What is already known about this topic: Media comparison studies typically assess the effectiveness of immersive virtual reality as a learning medium in comparison to other instructional methods in education.The findings of these studies differ markedly.Numerous factors impact learning outcomes in an immersive virtual environment. What this paper adds: Recommendation that research in the field should explore not only if but also when and how IVR learning is effective.Evidence that learning achievements may not be affected by the medium used.Evidence that the type of school can significantly influence learning gains.Evidence that cognitive dispositions, such as spatial abilities, can be another factor that influence learning outcomes. Implications for practice: A technology‐centred approach alone does not allow for a proper evaluation of the learning gain potential of IVR, learner characteristics and broader educational context should also be taken into account.IVR as a learning medium may not be appropriate for all students and every educational setting.To ensure reliable evaluation of learning gains, it is necessary to align the content and format of the intervention in both learning mediums as closely as possible.Measuring learning gains not only immediately after the intervention but also with a significant time delay can contribute to a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between point‐of‐care β‐hydroxybutyrate (BHB) concentration and outcomes in adult patients without diabetes admitted through ED. Methods: This was a prospective study from 10 March to 2 July 2021. Admitted patients without diabetes had capillary BHB sampled in ED. Outcomes of length‐of‐stay (LOS), composite mortality/ICU admission rates and clinical severity scores (Quick Sepsis Organ Failure Assessment score/National Early Warning Score [qSOFA/NEWS]) were measured. BHB was assessed as a continuous variable and between those with BHB above and equal to 1.0 mmol/L and those below 1.0 mmol/L. Results: A total of 311 patients were included from 2377 admissions. Median length‐of‐stay was 4.1 days (IQR 2.1–9.8), 18 (5.8%) died and 37 (11.8%) were admitted to ICU. Median BHB was 0.2 mmol/L (IQR 0.1–0.4). Twenty‐five patients had BHB ≥1.0 mmol/L and five were >3.0 mmol/L. There was no significant difference in median LOS for patients with BHB ≥1.0 mmol/L compared to non‐ketotic patients, 5.3 days (IQR 2.2–7.5) versus 4.1 days, respectively (IQR 2.0–9.8) (P = 0.69). BHB did not correlate with LOS (Spearman ρ = 0.116, 95% confidence interval: 0.006–0.223). qSOFA and NEWS also did not differ between these cohorts. For those 25 patients with BHB ≥1.0 mmol/L, an infective/inflammatory diagnosis was present in 11 (44%), at least 2 days of fasting in 10 (40%) and ethanol intake >40 g within 48 h in 4 (16%). Conclusions: Routine BHB measurement in patients without diabetes does not add to clinical bedside assessment and use should be limited to when required to confirm a clinical impression. [ABSTRACT FROM AUTHOR]

Aim: To examine the positive motivational paths from perceived autonomy‐supportive leadership, and the negative motivational paths from perceived controlling leadership to satisfaction and frustration of basic psychological needs, work motivation, work performance, work engagement and somatic symptom burden among nurses using Self‐Determination Theory. Design: The study used a cross‐sectional design mapping nurses' perceptions of the various study variables through a survey. Methods: Nurses working in the municipal healthcare in Norway were recruited through an electronic questionnaire sent out via a link to their emails between 29th of August and 29th of September 2020. Of them, 219 nurses completed the questionnaire. Study hypotheses were tested using structural equation modelling. Results: Higher levels of perceived autonomy‐supportive leadership were associated with reduced levels of somatic symptom burden and increased levels of work performance and work engagement through the satisfaction of basic psychological needs and autonomous motivation, specifically identified regulation and intrinsic motivation. Perceptions of controlling leadership were associated with heightened levels of somatic symptom burden through basic psychological need frustration, amotivation and introjected motivation, along with lower levels of work engagement through need frustration and amotivation. Conclusion: This study underscores the positive motivational paths of perceived autonomy‐supportive leadership on nurses' work performance and wellbeing through the facilitation of basic psychological need satisfaction and autonomous motivation. Conversely, the study highlights negative motivational paths of perceived controlling leadership on reduced work engagement and heightened ill‐being through the basic psychological need frustration, controlled motivation and amotivation. Impact: This study provides insights and actionable recommendations for nurses and their leaders, emphasizing the significance of understanding the adverse impact associated with perceived controlling leadership. The findings underscore the importance of addressing these issues to mitigate detrimental effects on motivation and overall work functioning. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: It can be challenging to perform a second task at the same time as swallowing. Objective(s): The study aimed to investigate the effect of visual, auditory and motor dual‐tasking on swallowing and chewing function in healthy young adults. Method: Right‐handed healthy adults without any psychological and cognitive problems were included in the study. Swallowing was evaluated based on the dysphagia limit in different liquid textures such as water and nectar consistencies, and chewing was evaluated by the Test of Masticating and Swallowing Solids. For the second task, visual and auditory performance was assessed using reaction time, and the motor performance was assessed using a bilateral tapping task. Assessments were performed in two steps: baseline and dual‐task. For baseline, all evaluation methods were applied individually. After completing the baseline assessment, dual‐task assessment were carried out the following day. For dual‐task assessment, the swallowing and chewing tasks were performed simultaneously with visual, auditory and motor tasks. Results: Results showed a significant decrease in dysphagia limit in the nectar consistency, and significant increase in chewing time, visual reaction time and tapping rate (right–left) when compared to baseline and dual‐task conditions (χ2(3) = 9.61, p =.02; χ2(3) = 9.02, p =.02; χ2(3) = 28.09, p <.001; χ2(3) = 28.97, p <.001; χ2(3) = 21.56, p <.001, respectively). However, there were no differences in dysphagia limit in the water and auditory reaction time compared to baseline and dual‐task conditions (χ2(3) = 3.18, p =.36; χ2(3) = 2.56, p =.50, respectively). Conclusion: Results shedding light on how simultaneous dual tasks can influence swallowing and chewing. Dual‐tasking cause a decrease in both swallowing/chewing and the visual/motor performances. These results may provide valuable information for designing interventions or strategies aimed at improving or maintaining optimal swallowing and chewing during in various populations during daily life. [ABSTRACT FROM AUTHOR]

Context: In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population. Methods: A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions. Findings: Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people. Conclusions: The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of "folk devils" and from a public health perspective. [ABSTRACT FROM AUTHOR]