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Purpose This manuscript reports on the occurrence of early and frequent erythrocytosis in advanced hepatocellular carcinoma (HCC) patients treated with lenvatinib. Methods A cohort of 23 patients with advanced HCC, treated with this antiangiogenic drug for at least one month, was retrospectively analyzed. Results These patients (82.7% men, median age 58.3, cirrhosis in 60.8%) were treated between October 2019 and September 2020 with lenvatinib, as first-line systemic therapy for 82.6% of them. For 20 patients (87%), an early and significant increase in hemoglobin (Hb) level, up to 1.41 g/dL (p 16.5 g/dL), 7 were treated with low-dose aspirin for primary thromboprophylaxis and 2 needed phlebotomy. None underwent thromboembolic complications. A significant Hb decrease was observed after treatment discontinuation (p Conclusion This report documents the frequent occurrence of erythrocytosis during lenvatinib treatment for advanced HCC, likely secondary to EPO secretion by tumor cells through the antiangiogenic activity levatinib. An early and close monitoring of hematologic parameters is, thus, recommended, together with thromboprophylaxis by low-dose aspirin and phlebotomy in case of symptomatic erythrocytosis.

People with an immigrant background can be affected by stereotypes and discrimination. As adolescence is an important developmental stage, this study investigated whether adolescents hold (negative) implicit attitudes towards people with Turkish immigrant background and whether adolescents differ in the extent of attitudes. Additionally, the relevance of perceived discrimination, identification with culture of residence, motivation to act without predjudice, and quality and quantity of contact to people with Turkish immigrant background for the extent of implicit attitudes was analysed. Analyses are based on 244 adolescents (60.7% female, 1.6% diverse; 13.1% with Turkish immigrant background, 16.8% with immigrant background other than Turkish) who participated in an online study. An implicit association test revealed that negative implicit attitudes towards people with a Turkish immigrant background were present among adolescents. Unlike adolescents with a Turkish immigrant background, adolescents without immigrant background and with immigrant background other than Turkish hold negative implicit attitudes on average. For the total sample, it was found that low perceived discrimination was related to negative implicit attitudes. The results are discussed with respect to substantive and methodological aspects. Implications for research and practice are derived.

Introduction Maternal and child health (MCH) services are critical for vulnerable populations. Workforce shortages, poor retention, and gaps in necessary trainings impede the capacity of public health systems to address needs. This manuscript characterizes the current MCH workforce, MCH program applicants and graduates, and describe findings within a national context to devise elements of a recruitment and retention strategy. Methods Data were obtained for public health program applicants, first-destination employment outcomes, and worker perceptions and demographics. Data were stratified according to the MCH and total public health workforce and by local, state, and national totals. Data were characterized by degree type, discipline, demographics, and employment outcomes. Results MCH staff constitute 11% of the state and local governmental public health workforce. MCH staff are approximately as diverse, have higher educational attainment, and are more likely to hold nursing degrees than the rest of the public health workforce. Yet, just 14% of MCH staff hold any type of public health degree. The MCH pipeline from academia appears modestly sized, with approximately 5% of applicants between 2017 and 2021 applying to a MCH master’s degree. Discussion The MCH workforce has a lower proportion of formal training or degrees in public health, though trends seem to indicate improvements. However, it is critical that a multi-faceted recruitment and retention strategy be coordinated by a broad range of stakeholders. These efforts will serve to improve the capability and capacity of the public health system to address critical needs of increasingly diverse MCH populations. Significance In order to modernize and reimagine the academic-public health pipeline, it is critical to better understand how many applicants and graduates exist within Maternal and Child Health programs across the US, and their characteristics. This manuscript connects that information with the most recently available public health workforce information on demographics, workplace perceptions, and intent to leave among staff at state and local health departments. Data presented in this paper allow the most comprehensive characterization of the MCH academia->practice pipeline to-date, identifies a fundamental disconnect in those career pathways, and offers options to repair that break.

Authors used an andragogy framework to help undergraduate allied health students better understand social determinants of health (SDOH) using a photo essay assignment. The study examined students’ perceptions of SDOH in various communities, description of health outcomes associated with their chosen SDOH, and lessons learned and suggestions to improve the assignment for future cohorts. Data were extracted from photo essays from 2019–2021 and entered in Microsoft Excel and Word for data analysis after course completion. Conventional qualitative content analysis was used to analyze student evaluation data from open-ended questions. Data were extracted from 53 student essays from 2019 to 2021. Most photo essays described communities in South Carolina (n = 42, 79.2%), urban areas (n = 37, 69.8%), or intermediary SDOH (75.5%). Several themes emerged concerning lessons learned (awareness and empathy are key to addressing SDOH), health equity (collaboration is necessary to provide resources, especially for underserved populations), and constructive feedback for the instructor (more time to discuss SDOH and assignment with peers and instructor). Faculty must work with students to think about more upstream factors like policy and cultural and societal values. Collecting evaluation data, specifically lessons learned and constructive feedback for faculty, can help faculty continuously improve course topics and assignments. Following a transparency framework can support student success and help faculty become effective leaders in the classroom while teaching subjects like SDOH and social justice.

Zusammenfassung Hintergrund In Schlaganfallnetzwerken verlegen Kliniken, die selbst keine endovaskuläre Thrombektomie (EVT) durchführen (hier: Primärkliniken), Patient*innen für diese Therapie in spezialisierte Schlaganfallzentren. Zur Verbesserung des Zugangs und des Managements der EVT muss der Fokus der Forschung nicht nur auf den spezialisierten Zentren, sondern auch auf den vorangehenden Prozessen in den Primärkliniken liegen. Fragestellung Wie stellen sich die Schlaganfallbehandlungspfade in verschiedenen Primärkliniken dar und was wird in diesen Pfaden als Vor- und Nachteil gesehen? Methoden Im Rahmen einer qualitativen multizentrischen Studie in drei Primärkliniken eines Schlaganfallnetzwerkes wurde die Versorgung von Schlaganfallpatient*innen mithilfe von nichtteilnehmenden Beobachtungen und 15 leitfadengestützten Interviews mit Beschäftigten unterschiedlicher Professionen erfasst und analysiert. Ergebnisse Innerhalb der Schlaganfallbehandlungspfade wurden folgende Aspekte als vorteilhaft berichtet: (1) eine strukturierte und persönliche Ankündigung von Schlaganfallpatient*innen in der Primärklinik durch den Rettungsdienst, (2) ein effizienter Ablauf des Telekonsils, (3) die Notfallverlegung zur EVT durch die gleichen Rettungsdienstmitarbeitenden der Primärzuweisung und (4) die Integration von externen Neurolog*innen in klinikinterne Strukturen. Diskussion Die Studie liefert einen Einblick in die z. T. unterschiedlichen Schlaganfallbehandlungspfade drei verschiedener Primärkliniken eines Schlaganfallnetzwerkes. Aus den Ergebnissen lassen sich Verbesserungspotenziale auch für andere Kliniken ableiten. Allerdings ist diese Studie zu klein, um verlässliche Aussagen über deren Wirksamkeit zu geben. Zukünftige Studien sollten daher untersuchen, ob Implementierungen der hier erarbeiteten Empfehlungen tatsächlich zu Verbesserungen führen bzw. unter welchen Bedingungen diese erfolgreich sind. Zur Sicherstellung der Patientenzentrierung sollte dabei auch die Perspektive von Betroffenen und Angehörigen miteinbezogen werden.

This research was partly funded by Huawei Technologies Oy (Finland) Co. Ltd. A limited liability company headquartered in Helsinki, Finland., Background Technological advances have recently made possible the estimation of maximal oxygen consumption (VO2max) by consumer wearables. However, the validity of such estimations has not been systematically summarized using metaanalytic methods and there are no standards guiding the validation protocols. Objective The aim was to (1) quantitatively summarize previous studies investigating the validity of the VO2max estimated by consumer wearables and (2) provide best-practice recommendations for future validation studies. Methods First, we conducted a systematic review and meta-analysis of studies validating the estimation of VO2max by wearables. Second, based on the state of knowledge (derived from the systematic review) combined with the expert discussion between the members of the Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) consortium, we provided a set of best-practice recommendations for validation protocols. Results Fourteen validation studies were included in the systematic review and meta-analysis. Meta-analysis results revealed that wearables using resting condition information in their algorithms significantly overestimated VO2max (bias 2.17 ml·kg−1·min−1; limits of agreement − 13.07 to 17.41 ml·kg−1·min−1), while devices using exercise-based information in their algorithms showed a lower systematic and random error (bias − 0.09 ml·kg−1·min−1; limits of agreement − 9.92 to 9.74 ml·kg−1·min−1). The INTERLIVE consortium proposed six key domains to be considered for validating wearable devices estimating VO2max, concerning the following: the target population, reference standard, index measure, testing conditions, data processing, and statistical analysis. Conclusions Our meta-analysis suggests that the estimations of VO2max by wearables that use exercise-based algorithms provide higher accuracy than those based on resting conditions. The exercise-based estimation seems to be optimal for measuring VO2max at the population level, yet the estimation error at the individual level is large, and, therefore, for sport/ clinical purposes these methods still need improvement. The INTERLIVE network hereby provides best-practice recommendations to be used in future protocols to move towards a more accurate, transparent and comparable validation of VO2max derived from wearables., Huawei Technologies

Research results are often not easily accessible or readily digestible for decision-making by natural resource managers. This knowledge-action gap is due to various factors including the time lag between new knowledge generation and its transfer, lack of formal management structures, and institutional inertia to its uptake. Herein, we reflect on the Great Lakes Fishery Commission’s Science Transfer Program and its evolution from ‘Mode 1’ (i.e., scientists conduct research autonomously) toward ‘Mode 2’ (i.e., co-production of knowledge with practitioners) knowledge production to understand and overcome the knowledge-action gap. Six success factors and strategies and tactics used to achieve those factors were critical to the shift from Mode 1 to Mode 2: (1) dedicate funding and staff support; (2) obtain top-down commitment from organizational leadership; (3) break down silos; (4) build relationships through formal and informal interactions; (5) emphasize co-production in program and project implementation; and (6) obtain buy-in among relevant actors. By way of three project case studies, we highlight knowledge transfer approaches, products, and lessons learned. We anticipate this contribution will benefit those working on knowledge mobilization, particularly in boundary-spanning organizations, and those involved in resource program management, administration, and design; it is also intended for resource managers seeking to have their science and information needs met more effectively.

Ein qualitätsvoller Unterricht ist von zentraler Bedeutung sowohl für leistungsbezogene als auch für motivationale Lernergebnisse von Schülerinnen und Schülern. Die Motivierungsqualität des Unterrichts als eine bedeutsame Facette der Basisdimension konstruktive Unterstützung wurde bisher eher selten untersucht. Um die Bedeutung der wahrgenommenen Motivierungsqualität für motivationale Merkmale von Grundschulkindern zu erforschen, wurde basierend auf Angaben von Viertklässlerinnen und -klässlern (N = 187) analysiert, inwiefern die Motivierungsqualität des Mathematikunterrichts neben der Mathematiknote prädiktiv für die intrinsische Motivation und das Fähigkeitsselbstkonzept der Lernenden ist. Auch wurde geprüft, ob dem Kompetenzerleben der Lernenden eine vermittelnde Funktion zukommt. Die Ergebnisse zeigten, dass die wahrgenommene Motivierungsqualität neben der Mathematiknote ein bedeutsamer Prädiktor für beide motivationalen Merkmale war. Während das Kompetenzerleben die Zusammenhänge zwischen der Motivierungsqualität bzw. der Mathematiknote und dem Fähigkeitsselbstkonzept bedeutsam vermittelte, wurden die Zusammenhänge für die intrinsische Motivation der Schülerinnen und Schüler wiederum nicht mediiert. Resümierend werden die Befunde hinsichtlich möglicher Implikationen für zukünftige Forschung und Praxis diskutiert., Unterrichtswissenschaft;Bd 50. 2022, H. 1, S. 125-147

Real-time digital image point tracking feedback was used to control a servo-hydraulic load train during the loading of a Glass Fiber Reinforced Plastic (GFRP) cantilever beam. The loading pattern was defined in terms of two translational and one rotational in-plane degrees-of-freedom at a single control point on the beam. Tests were performed with both single-and multi degree-of-freedom controls, using independent and simultaneous control of the actuators, respectively. A reference control system was set up to transfer the displacements of three hydraulic actuators into a theoretical displacement of the control point using an assumption of rigidity. The discrepancies between this theoretical displacement and the actual displacement were addressed through three control configurations that used a linear transfer function, a feedback signal from the digital image point tracking using Proportional and Integral control, and a combination of these two. Performance was evaluated at frequencies ranging from 0.01 – 1 Hz. The combined implementation of the linear transfer function and digital image point tracking feedback showed the greatest improvement over the reference configuration, reducing the error between the desired and measured signal by 51–93%.