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ABSTRACT Aim To design and validate the Flipped‐Learning Assessment Scale; a tool for assessing students' experience of flipped learning. Background Frequently, university students are introduced to new content during lectures. In contrast, active learning activities, such as Flipped Learning, are designed as an instructional method to engages students in the learning process. Design Cross‐sectional descriptive study. Methods A cross‐sectional study was carried out in three phases ((1) item selection, rephrasing and translation; (2) content analysis through expert panel and (3) confirmatory factor analysis). The final version of the scale was piloted on a sufficient sample of undergraduate student nurses from three Spanish universities. Results A total of 455 students completed the questionnaire; 373 women and 82 men. The total Cronbach's alpha value for the complete instrument was 0.893. Cronbach alpha for each separate dimension ranged between 0.660 and 0.897. Goodness‐of‐fit values were acceptable, implying that the model was validated. Conclusion The flipped learning approach has become increasingly popular in academic settings. Evaluating the students' flipped learning experience is important to analyse aspects such as acceptability and effectiveness of this methodology. The Flipped‐Learning Assessment Scale is a valid and reliable tool for analysing students' experience of flipped learning. Impact Flipped learning has been a useful pedagogical model very for cultivating student skills in problem‐solving, critical thinking, teamwork and self‐active learning in nursing education. A key issues, such as student satisfaction, has been explored further before implementing this teaching and learning methodology. Patient or Public Contribution None.

Abstract Introduction Kazakhstan has one of the fastest‐growing HIV epidemics in the world, with increasing rates among adolescents and young adults (AYA). Innovative strategies are needed to increase HIV testing uptake and decrease HIV stigma among AYA. Citizen science, defined as the active engagement of the general public in scientific research tasks, promotes and facilitates community engagement throughout the research process. This citizen science study used crowdsourcing to engage AYA in Kazakhstan to develop a digital intervention to reduce HIV stigma and promote HIV self‐testing. Our objectives in this paper are to describe the approach used, its feasibility and acceptability, and AYA motivations for and lessons learned collaborating on the study. Methods From October 2021 to July 2022, in collaboration with a Community Collaborative Research Board and a Youth Advisory Board, we developed an open call requesting multimedia submissions to reduce HIV testing stigma. Eligible submissions were separated by age group (13−19 or 20−29 years) and judged by a panel composed of AYA (n = 23), healthcare professionals (n = 12), and representatives from the local government and non‐governmental organizations (n = 17). Each entry was reviewed by at least four judges and ranked on a 5‐point scale. The top 20 open call contestants were asked to submit self‐recordings sharing their motivation for and experience participating in the contest and lessons learned. Descriptive statistics were calculated for quantitative data. Qualitative data were coded using open coding. Results We received 96 submissions from 77 youth across Kazakhstan. Roughly, three‐quarters (n = 75/96) of entries met judging eligibility criteria. Of the eligible entries, over half (n = 39/75) scored 3.5 or higher on a 5‐point scale (70.0%). The most frequent types of entries were video (n = 36/96, 37.5%), image (n = 28/96, 29.2%) and text (n = 24/96, 25.0%). AYA's primary motivations for collaborating on the study included a desire to improve society and help youth. The main challenges included creating content to address complex information using simple language, finding reliable information online and technological limitations. Conclusions Crowdsourcing was feasible and highly acceptable among AYA in Kazakhstan. Citizen science approaches hold great promise for addressing the increasingly complex health and social challenges facing communities today.

Abstract Present‐day convergence between Caribbean and North American plates is accommodated by subduction zones, major active thrusts and strike‐slip faults, which are probably the source of the historical large earthquakes on Hispaniola. However, little is known of their geometric and kinematic characteristics, slip rates and seismic activity over time. This information is important to understand the active tectonics in Hispaniola, but it is also crucial to estimate the seismic hazard in the region. Here we show that a relatively constant NE‐directed shortening controlled the geometry and kinematics of main active faults in southern central Hispaniola, as well as the evolution of the Quaternary stress regime. This evolution included a pre‐Early Pleistocene D1 event of NE‐trending compression, which gave rise to the large‐scale fold and thrust structure in the Cordillera Central, Peralta Belt, Sierra Martín García and San Juan‐Azua basin. This was followed by a near pure strike‐slip D2 stress regime, partitioned into the N‐S to NE‐SW transverse Ocoa‐Bonao‐La Guácara and Beata Ridge fault zones, as well as subordinate structures in related sub‐parallel deformation corridors. Shift to D2 strike‐slip deformation was related to indentation of the Beata Ridge in southern Hispaniola from the Early to Middle Pleistocene and continues today. D2 was locally coeval by a more heterogeneous and geographically localized D3 extensional deformation. Defined seismotectonic fault zones divide the region into a set of simplified seismogenic zones as starting point for a seismic hazard modeling. Highest peak ground acceleration values computed in the Ocoa Bay establish a very high seismic hazard.

Conclusion: This predictive model shows that leg girth and gender are significant predictors of tibial nerve depth in a healthy cohort. However, its clinical utility remains preliminary and requires external validation in larger, diverse, and pathology-specific populations to confirm broader applicability in clinical settings.

Summary Hydroxytyrosol (HT) is one of the most powerful dietary antioxidants with numerous applications in different areas, including cosmetics, nutraceuticals and food. In the present work, heterologous hydroxylase complex HpaBC from Escherichia coli was integrated into the Saccharomyces cerevisiae genome in multiple copies. HT productivity was increased by redirecting the metabolic flux towards tyrosol synthesis to avoid exogenous tyrosol or tyrosine supplementation. After evaluating the potential of our selected strain as an HT producer from glucose, we adjusted the medium composition for HT production. The combination of the selected modifications in our engineered strain, combined with culture conditions optimization, resulted in a titre of approximately 375 mg l−1 of HT obtained from shake‐flask fermentation using a minimal synthetic‐defined medium with 160 g l−1 glucose as the sole carbon source. To the best of our knowledge, this is the highest HT concentration produced by an engineered S. cerevisiae strain.

Abstract Cavities used for avian reproduction in spring often host other organisms for roosting during winter, which should affect their microclimatic conditions and, then, the patterns of emergence of nest‐dwelling ectoparasites of birds and successful parasitism. To prove these cascade effects, we experimentally blocked the entrance of half of nest boxes previously used for reproduction by hoopoes (Upupa epops), recorded temperature and humidity during the fall–winter period, and evaluated abundance, emergence of ectoparasitic flies (Carnus hemapterus), and intensity of parasitism in hoopoe nestlings growing in open and blocked nest boxes the next spring. As expected, experimental treatment as well as the occupancy of open nest boxes by rodents (i.e., mainly dormice [Eliomys quercinus]) affected temperature and humidity, but did not predict the onset or duration of Carnus emergence. Moreover, flies were more abundant in open nest boxes and, among them, those occupied by dormice showed the lowest abundance. Finally, hoopoe nestlings developing in nest boxes blocked during winter experienced lower intensity of ectoparasitism than those in open nest boxes. These hitherto undescribed cryptic effects of overwinter occupants of nest cavities on subsequent emergence and viability of nest‐dwelling ectoparasites would profoundly impact on the interaction with their avian hosts.

Abstract Hypertension in obese and overweight patients is associated with an elevated resting metabolic rate (RMR). The aim of this study was to determine whether RMR is reduced in hypertensive patients treated with angiotensin‐converting enzyme inhibitors (ACEI) and blockers (ARB). The RMR was determined by indirect calorimetry in 174 volunteers; 93 (46.5 %) were hypertensive, of which 16 men and 13 women were treated with ACEI/ARB, while 30 men and 19 women with untreated hypertension served as a control group. Treated and untreated hypertensives had similar age, BMI, physical activity, and cardiorespiratory fitness. The RMR normalized to the lean body mass (LBM) was 15% higher in the untreated than ACEI/ARB‐treated hypertensive women (p = .003). After accounting for LBM, whole‐body fat mass, age, the double product (heart rate x systolic blood pressure), and the distance walked per day, the RMR was 2.9% lower in the patients taking ACEI/ARB (p = .26, treatment x sex interaction p = .005). LBM, age, and the double product explained 78% of the variability in RMR (R2 = 0.78, p

Abstract Sepsis is a major cause of mortality among hospitalized patients worldwide. Shorter time to administration of broad‐spectrum antibiotics is associated with improved outcomes, but early recognition of sepsis remains a major challenge. In a two‐center cohort study with prospective sample collection from 1400 adult patients in emergency departments suspected of sepsis, we sought to determine the diagnostic and prognostic capabilities of a machine‐learning algorithm based on clinical data and a set of uncommonly measured biomarkers. Specifically, we demonstrate that a machine‐learning model developed using this dataset outputs a score with not only diagnostic capability but also prognostic power with respect to hospital length of stay (LOS), 30‐day mortality, and 3‐day inpatient re‐admission both in our entire testing cohort and various subpopulations. The area under the receiver operating curve (AUROC) for diagnosis of sepsis was 0.83. Predicted risk scores for patients with septic shock were higher compared with patients with sepsis but without shock (p

Abstract Located in northern Dominican Republic, the Early Cretaceous Rio Boba mafic‐ultramafic plutonic sequence constitutes a lower crust section of the Caribbean island arc, made up by gabbroic rocks and subordinate pyroxenite. Modal compositions, mineral chemistry, whole‐rock compositions and thermobarometric calculations indicate that pyroxenites and gabbronorites represent a cumulate sequence formed by fractionation of tholeiitic magmas with initially very low H2O content in the lower crust of the arc (0.6–0.8 GPa). Melts evolved along a simplified crystallization sequence of olivine → pyroxenes → plagioclase → Fe‐Ti oxides. The magmatic evolution of the Rio Boba sequence and associated supra‐crustal Puerca Gorda metavolcanic rocks is multi‐stage and involves the generation of magmas from melting of different sources in a supra‐subduction zone setting. The first stage included the formation of a highly depleted substrate as result of decompressional melting of a refractory mantle source, represented by a cumulate sequence of LREE‐depleted island arc tholeiitic (IAT) and boninitic gabbronorites and pyroxenites. The second stage involved volumetrically subordinate cumulate troctolites and gabbros, which are not penetratively deformed. The mantle source was refractory and enriched by a LILE‐rich hydrous fluid derived from a subducting slab and/or overlying sediments, and possibly by a LREE‐rich melt. The third stage is recorded in the upper crust of the arc by the Puerca Gorda “normal” IAT protoliths, which are derived from an N‐MORB mantle source enriched with a strong subduction component. This magmatic evolution has implications for unraveling the processes responsible for subduction initiation and subsequent building of the Caribbean island arc.

Abstract Sepsis induces a myopathy characterized by loss of muscle mass and weakness. Septic patients undergo prolonged periods of limb muscle disuse due to bed rest. The contribution of limb muscle disuse to the myopathy phenotype remains poorly described. To characterize sepsis‐induced myopathy with hindlimb disuse, we combined the classic sepsis model via cecal ligation and puncture (CLP) with the disuse model of hindlimb suspension (HLS) in mice. Male C57bl/6j mice underwent CLP or SHAM surgeries. Four days after surgeries, mice underwent HLS or normal ambulation (NA) for 7 days. Soleus (SOL) and extensor digitorum longus (EDL) were dissected for in vitro muscle mechanics, morphological, and histological assessments. In SOL muscles, both CLP+NA and SHAM+HLS conditions elicited ~20% reduction in specific force (p

Abstract Heart disease remains the number one killer of women in the US. Nonetheless, studies in women and female animal models continue to be underrepresented in cardiac research. Hypertrophic cardiomyopathy (HCM), the most commonly inherited cardiac disorder, has been tied to sarcomeric protein variants in both sexes. Among the susceptible genes, TNNC1—encoding cardiac troponin C (cTnC)—causes a substantial HCM phenotype in mice. Mice bearing an HCM‐associated cTnC‐A8V point mutation exhibited a significant decrease in stroke volume and left ventricular diameter and volume. Importantly, isovolumetric contraction time was significantly higher for female HCM mice. We utilized a transcriptomic approach to investigate the basis underlying the sexual dimorphism observed in the cardiac physiology of adult male and female HCM mice. RNA sequencing revealed several altered canonical pathways within the HCM mice versus WT groups including an increase in eukaryotic initiation factor 2 signaling, integrin‐linked kinase signaling, actin nucleation by actin‐related protein‐Wiskott‐Aldrich syndrome family protein complex, regulation of actin‐based motility by Rho kinase, vitamin D receptor/retinoid X receptor activation, and glutathione redox reaction pathways. In contrast, valine degradation, tricarboxylic acid cycle II, methionine degradation, and inositol phosphate compound pathways were notably down‐regulated in HCM mice. These down‐regulated pathways may be reduced in response to altered energetics in the hypertrophied hearts and may represent conservation of energy as the heart is compensating to meet increased contractile demands. HCM male versus female mice followed similar trends of the canonical pathways altered between HCM and WT. In addition, seven of the differentially expressed genes in both WT and HCM male versus female comparisons swapped directions in fold‐change between the sexes. These findings suggest a sexually‐dimorphic HCM phenotype due to a sarcomeric mutation and pinpoint several key targetable pathways and genes that may provide the means to alleviate the more severe decline in female cardiac function.