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An animal's diet breadth is a central aspect of its life history, yet the factors determining why some species have narrow dietary breadths (specialists) and others have broad dietary breadths (generalists) remain poorly understood. This challenge is pronounced in herbivorous insects due to incomplete host plant data across many taxa and regions. Here, we develop and validate machine learning models to predict pollen diet breadth in bees, using a bee phylogeny and occurrence data for 682 bee species native to the United States, aiming to better understand key drivers. We found that pollen specialist bees made an average of 72.9% of their visits to host plants and could be predicted with high accuracy (mean 94%). Our models predicted generalist bee species, which made up a minority of the species in our dataset, with lower accuracy (mean 70%). The models tested on spatially and phylogenetically blocked data revealed that the most informative predictors of diet breadth are plant phylogenetic diversity, bee species' geographic range, and regional abundance. Our findings also confirm that range size is predictive of diet breadth and that both male and female specialist bees mostly visit their host plants. Overall, our results suggest we can use visitation data to predict specialist bee species in regions and for taxonomic groups where diet breadth is unknown, though predicting generalists may be more challenging. These methods can thus enhance our understanding of plant-pollinator interactions, leading to improved conservation outcomes and a better understanding of the pollination services bees provide.

Purpose: This study contributes to the science of teaching reading and vocabulary by illustrating how a ubiquitous classroom practice – read alouds – can be enhanced by structured supplements. This experimental study examines whether and to what extent providing structured supplements can improve student comprehension outcomes by helping teachers foster discussions about academic vocabulary that support schema transfer as students make connections between known and new topics. Method: A total of 80 third-grade teachers and their students (N = 965; 32% Black, 31% Hispanic, 25% white, 9 Asian, 48% Male) were randomly assigned to treatment or control conditions. Treatment students received a single social studies read aloud on the story of Apollo 11 with structured supplements while control students received the same read aloud story but without structured supplements. Students were from linguistically, economically, and ethnically diverse backgrounds. Results: Effect sizes from hierarchical linear models indicated that students in the treatment condition outperformed students in the control condition on four measures of domain-specific reading comprehension: recall (ES =.17), near-transfer (ES =.17), mid-transfer (ES =.18), and content comprehension (ES =.18). Further exploratory analyses using structural equation modeling revealed that teacher language scaffolds – that is, temporary dialogic supports in which teachers went above and beyond the intervention script – explained 66% of the treatment effect on domain-specific reading comprehension. Conclusion: Results from this study suggest that read alouds, when enhanced with structured supplements designed to facilitate schema transfer, can increase the amount of academic vocabulary teachers use during classroom instruction and improve their students' ability to comprehend disciplinary texts. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is associated with significant human and financial costs, particularly among vulnerable populations like older adults living in long-term care homes (LTCHs). Urinary tract infection (UTI) is the leading indication for antibiotic use in this population, with some estimates suggesting that up to 70% of these prescriptions may be avoidable. Objective: The purpose of this study is to develop and test novel behavioural science-informed antimicrobial stewardship (AMS) quality improvement strategies in Canadian LTCHs, which aim to decrease unnecessary testing and treatment for residents who lack the minimum clinical signs and symptoms of UTI. Intervention: The quality improvement strategy is a two-pronged approach that includes 1) targeted education for essential care providers (family and friends of LTCH residents) about UTI and benefits of AMS, which strives to outline a positive role for this group in UTI management, and 2) monthly feedback to LTCH staff on their facility's urine culture ordering rates. Outcomes: The protocol was piloted in a single LTCH; a process evaluation of the pilot implementation served to refine the research protocol, which is being implemented in eight LTCHs across Canada using an eight-month stepped wedge randomized cluster design. Conclusion: This protocol represents a behavioural science-informed intervention to improve AMS across LTCHs. If successful, this model of care could be scalable across Canadian LTCHs, offering an inclusive approach that aims to empower clinicians, non-regulated healthcare staff, residents and their family and friends to improve health outcomes as antibiotic stewards. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the following: (1) the frequency of axial spondyloarthritis (axSpA) according to extra‐articular presentation and HLA‐B27 status, (2) clinical and imaging features that distinguish axSpA from non‐axSpA, and (3) the impact of magnetic resonance imaging (MRI) on diagnosis and classification of axSpA. Methods: The Screening for Axial Spondyloarthritis in Psoriasis, Iritis, and Colitis (SASPIC) study enrolled patients in two multicenter cohorts. Consecutive patients with undiagnosed chronic back pain attending dermatology, ophthalmology, and gastroenterology clinics with psoriasis (PsO), acute anterior uveitis (AAU), or inflammatory bowel disease (IBD) were referred to a local rheumatologist with special expertise in axSpA for a structured diagnostic evaluation. The primary outcome was the proportion of patients diagnosed with axSpA by the final global evaluation. Results: Frequency of axSpA was 46.7%, 61.6%, and 46.8% in patients in SASPIC‐1 (n = 212) and 23.5%, 57.9%, and 23.3% in patients in SASPIC‐2 (n = 151) with PsO, AAU, or IBD, respectively. Among those who were B27 positive, axSpA was diagnosed in 70%, 74.5%, and 66.7% of patients in SASPIC‐1 and in 71.4%, 87.8%, and 55.6% of patients in SASPIC‐2 with PsO, AAU, or IBD, respectively. All musculoskeletal clinical features were nondiscriminatory. MRI was indicative of axSpA in 60% to 80% of patients and MRI in all patients (SASPIC‐2) versus on‐demand (SASPIC‐1) led to 25% fewer diagnoses of axSpA in patients who were HLA‐B27 negative with PsO or IBD. Performance of the Assessment of SpondyloArthritis International Society classification criteria was greater with routine MRI (SASPIC‐2), though sensitivity was lower than previously reported. Conclusion: Optimal management of patients presenting with PsO, AAU, IBD, and undiagnosed chronic back pain should include referral to a rheumatologist. Conducting MRI in all patients enhances diagnostic accuracy. [ABSTRACT FROM AUTHOR]

The editorial discusses the benefits of telerehabilitation as an alternative to center-based pulmonary rehabilitation for individuals with chronic respiratory diseases. A study comparing telerehabilitation and center-based programs found similar effectiveness in improving exercise capacity and quality of life, with telerehabilitation showing cost savings and a favorable internal rate of return. Telerehabilitation programs need to be further developed and assessed for cost-effectiveness to increase participation and provide sustainable healthcare solutions. The study highlights the importance of safe and effective telerehabilitation models tailored to local resources and healthcare environments. [Extracted from the article]

Background Meta‐analyses have suggested that the risk of cardiovascular disease events is significantly higher after a chronic obstructive pulmonary disease (COPD) exacerbation, but the populations at highest risk have not been well characterized to date. Methods and Results The authors analyzed the risk of atherosclerotic cardiovascular disease (ASCVD) hospitalizations after COPD hospitalization compared with before COPD hospitalization and patient factors associated with ASCVD hospitalizations after COPD hospitalization among 2 high‐risk patient cohorts. The primary outcome was risk of an ASCVD hospitalization composite outcome (myocardial infarction, coronary artery bypass graft, percutaneous coronary intervention, stroke, transient ischemic accident) after COPD hospitalization relative to before COPD hospitalization. Additional analyses evaluated for risk factors associated with the composite ASCVD hospitalization outcome. In the high‐risk primary prevention cohort, the hazard ratio (HR) estimate following adjustment for the composite ASCVD hospitalization outcome after COPD hospitalization versus before COPD hospitalization for 30 days was 0.74 (95% CI, 0.66–0.82; P≤0.0001); for 90 days, 0.69 (95% CI, 0.64–0.75; P≤0.0001); and for 1 year, 0.78 (95% CI, 0.73–0.82; P≤0.0001). In the secondary prevention cohort, the HR for 30‐day hospitalization was 1.15 (95% CI, 1.05–1.26; P=0.0036); 90‐day hospitalization, 1.08 (95% CI, 1.01–1.15; P=0.0178); and 1‐year hospitalization, 1.07 (95% CI, 1.02–1.11; P=0.0026). Among the 19 characteristics evaluated, hyperlipidemia and history of acute ASCVD event were associated with the highest risk of ASCVD events 1 year after COPD hospitalization in the high‐risk primary and secondary prevention cohorts. Conclusions The risk of ASCVD hospitalization was higher in patients with established ASCVD and lower among high‐risk patients without established ASCVD after‐COPD hospitalization relative to before hospitalization. We identified multiple risk factors for ASCVD hospitalization after COPD hospitalization.

Although cognitions have predicted COVID-19 protective behaviors in cancer populations, theory suggests that emotions may be more predictive of these behaviors. This study examined Health Belief Model (HBM) variables as correlates of COVID-19 protective behaviors in lung cancer patients and whether worry about COVID-19 was associated with these behaviors beyond the effects of HBM variables. From 2021 to 2022, 191 patients (62.3% female, mean age = 66 years, range = 34–91 years, mean time post-diagnosis = 2 years, range = 0.4–22 years) completed a one-time survey. Results of regression analyses showed that fewer perceived barriers to mask wearing were associated with greater mask wearing, and greater perceived severity of COVID-19 was associated with more social distancing. Higher levels of worry about COVID-19 were associated with greater mask wearing and social distancing above and beyond the effects of HBM variables. HBM variables and worry were unrelated to hand hygiene. Results are largely consistent with theory and suggest potential intervention targets. [ABSTRACT FROM AUTHOR]