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Background: Immunotherapy has revolutionized cancer treatment. Recent studies have suggested that the efficacy of immunotherapy can be further enhanced by the influence of gut microbiota. In this study, we aimed to investigate the impact of bacteria on the effectiveness of cancer immunotherapy by combining analysis of clinical samples with validation in animal models. Methods: In order to characterize the diversity and composition of microbiota and its relationship with response to immune checkpoint inhibitors (ICIs), 16S ribosomal RNA (rRNA) and GC–MS sequencing was performed on 71 stool samples from patients with advanced non‐small cell lung cancer (NSCLC) prior to treatment with immune checkpoint blockade (ICB). Furthermore, fecal microbiota transplantation (FMT) was performed from different patients into mice and a subcutaneous tumor model established using the Lewis lung cancer cell line to evaluate the therapeutic effect of PD‐1 on mice with varying gut microbiota. Results: The results demonstrated a significant association between elevated gut microbiota diversity and response to treatment with ICIs, p < 0.05. Faecalibacterium was markedly increased in the gut microbiota of responders (R), accompanied by increased short‐chain fatty acid (SCFA) levels, especially butanoic acid, acetic acid and hexanoic acid, p < 0.05. Additionally, FMT from R and nonresponders (NR) could promote an anticancer effect and reduce the expression of Ki‐67 cells in tumors in mice, p < 0.05. Moreover, R and NR FMT did not alter PD‐L1 expression in the tumor tissues of mice, p > 0.05. The diversity of gut microbiota consistently correlated with an optimistic prognosis in NSCLC patients with immunotherapy, which could be functionally mediated by SCFAs. Conclusion: The findings of the present study indicated that the diversity of gut microbiota and SCFAs is related to the efficacy of immunotherapy. FMT can effectively delay tumor progression, and enhance the effect of immunotherapy, thus providing evidence for improving the efficacy of immunotherapy in NSCLC patients. [ABSTRACT FROM AUTHOR]

Background: 'PD Warrior' (PDW) is a popular exercise programme for Parkinson disease; however, there are no published studies on the outcomes of the programme. Aims: To investigate short‐term functional and quality of life (QoL) outcomes after the PDW 10‐week programme in a pilot study of individuals with early Parkinson Disease (PD). Methods: Twenty individuals with PD (Hoehn & Yahr 1–3) attending a hospital outpatient clinic were recruited into the PDW 10‐week programme, comprising a weekly 1‐h supervised class complemented by an individualised daily home exercise programme. Participants had the following assessments at baseline and after completion of the programme: Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS‐UPDRS) Part III, timed up‐and‐go (TUG), 10‐m walk test (10mWT), 6‐min walking test (6MWT), balance tests, fine motor skills, 7‐day Parkinson KinetiGraph (PKG) and PDQ‐39 QoL scale. Results: Seventeen individuals completed the programme. Significant improvements were observed in MDS‐UPDRS motor score (P = 0.019, d = 0.68, MCID 7); 6MWT distance (P < 0.001, d = 1.16); walking time during motor or cognitive dual tasking (P = 0.006, d = 0.77; P = 0.005, d = 0.79, respectively); and the PDQ‐39 emotional well‐being subdomain (P = 0.009; MCID 4.2); as well as improvements trending to significance in bradykinesia (P = 0.025, d = 0.73), 10mWT walking time (P = 0.023, d = 0.61) and borderline improvement in balance (P = 0.056, d = 0.50). Conclusions: The outcomes of this study support the efficacy of the PDW programme in individuals with early PD and provide justification for future trials and investigation of its effects. [ABSTRACT FROM AUTHOR]

Objective: Prominent theories of binge‐eating (BE) maintenance highlight dietary restriction as a key precipitant of BE episodes. Consequently, treatment approaches for eating disorders (including binge‐eating disorder; BED) seek to reduce dietary restriction in order to improve BE symptoms. The present study tested the hypothesis that dietary restriction promotes BE among 112 individuals with BED. Methods: Participants completed a 7‐day ecological momentary assessment (EMA) protocol before and after completing 17 weeks of either Integrative Cognitive‐Affective Therapy or guided self‐help cognitive behavioral therapy. Analyses examined whether dietary restriction on 1 day of the baseline EMA protocol predicted risk for BE later that same day, and on the following day. Changes in dietary restriction over the course of treatment were also evaluated as a predictor of change in BE from pre‐treatment to post‐treatment. Baseline dietary restraint was examined as a moderator of the above associations. Results: Dietary restriction did not predict BE later the same day, and changes in restriction were not related to changes in BE across treatment, regardless of baseline dietary restraint levels. Restriction on 1 day did predict increased BE risk on the following day for individuals with higher levels of dietary restraint, but not those with lower levels. Discussion: These findings challenge the assumption that dietary restriction maintains BE among all individuals with BED. Rather, results suggest that dietary restriction may be largely unrelated to BE maintenance in this population, and that reducing dietary restriction generally does not have the intended effect on BE frequency. [ABSTRACT FROM AUTHOR]

Background: Stroke profoundly affects quality of life (QOL), including loss of employment, reduced social activity, shrinking social networks and low mood. Dysgraphia (impaired writing) is a common symptom of aphasia yet is rarely targeted in rehabilitation. Recent technological advances might challenge this, since much communication is now conducted digitally through writing. The rehabilitation of writing may therefore help to address the wider consequences of stroke and aphasia. Aims: Can assistive technology (AT) training for people with dysgraphia: (1) improve written output, and are gains achieved only with AT? (2) improve reading comprehension scores, and are gains achieved only with AT? and (3) affect social participation, mood or QOL Methods and Procedures: Design A mixed‐methods, repeated measures, small group study design was adopted (qualitative outcomes will be reported elsewhere). Participants: Recruited from community settings, for example, Stroke Association communication support groups. Inclusion criteria: over 18 years old, aphasia due to stroke, acquired dysgraphia, writing more impaired than speech, fluent English prior to stroke, access to computer and Internet. Exclusion criteria: currently receiving speech and language therapy, significant cognitive impairment, neuromuscular/motor‐speech impairments/structural abnormalities, developmental dyslexia, uncorrected visual/auditory impairments. Procedures: Screening and diagnostic assessments at time T1 (first baseline). Outcome measures at T1; repeated at T2 (second baseline), T3 (end of intervention), T4 (3‐month follow up). Social participation assessment and cognitive monitoring at T2, T3, T4. Intervention: Seven–ten hours individual therapy weekly and additional email support. Participants were trained to operate Dragon NaturallySpeaking (speech to text package) and ClaroRead (read writing aloud). Outcome measures were administered on pen and paper (control) and on computer, with AT enabled only at T3, T4. Outcomes and Results: Computer narrative writing was significantly improved by AT training (Friedman's χ2 (3) = 8.27, p = 0.041), indicating a compensatory effect of AT. Though reading comprehension significantly improved in the computer condition (Friedman's χ2 (3) = 21.07, p = 0.001), gains could not be attributed to the AT. Gains were achieved only when measures were administered on the keyboard, with AT enabled. Thus, a compensatory rather than remediatory effect was suggested. Social network size significantly increased; there were no significant changes in mood/QOL. Individual success rates varied. Conclusion and Implications: The customisable AT training was acceptable to participants and resulted in significantly improved narrative writing. Compensatory AT interventions are a useful adjunct to remediatory writing interventions and may particularly support functional writing. WHAT THIS PAPER ADDS: What is already known on this subject: Writing is rarely spared in aphasia and may present as the most impaired communication modality. Yet, people with aphasia report that writing is seldom included in their rehabilitation. Many communication activities are now conducted digitally through writing, therefore rehabilitation of this is more important than ever before. This study sought to address whether an assistive technology (AT) software package can improve writing and whether any changes were compensatory or remediatory. What this study adds to existing knowledge: This group study found that AT training led to gains in written discourse and social network in people with aphasia and dysgraphia. Gains were not replicated in handwritten tasks, suggesting this was a compensatory therapeutic approach. What are the clinical implications of this work?: AT programs such as this may present speech and language therapists with a practical, pragmatic adjunct to writing or typing therapy, particularly for clients with chronic, intractable impairments for whom remediatory therapy may have a low chance of success. [ABSTRACT FROM AUTHOR]

Background: According to European Centre for Disease Prevention and Control (ECDC) reports, women and migrants are more likely to have delayed HIV diagnosis (CD4 <350 cells/mm3). As a follow‐up to a previously published systematic review revealing a range of barriers to HIV testing among migrant women, the aim of the present study was to identify barriers to HIV testing from the perspective of service providers and to formulate possible interventions to improve access to HIV healthcare among migrants in Europe, with an emphasis on migrant women. Methods: Between November 2021 and February 2022 an online survey, consisting of 20 questions, was forwarded to 178 stakeholders and non‐governmental organizations (NGOs) working with migrant populations in 33 countries from the World Health Organization (WHO) European region. Results: Forty‐three responses from 14 countries were analysed. Most respondents (70%) judged migrants' access to healthcare as worse than that for the resident native population. Only 2/11 prevention interventions were available to all in at least 50% of participating countries. The three main barriers to accessing healthcare for migrant women and reasons for late HIV diagnosis among migrant women were stigma and discrimination, language barriers, and cultural barriers. Conclusions: Many HIV prevention interventions are not free of charge for all within Europe. The results of this survey show that migrant women face many barriers to accessing healthcare and that these might contribute to late HIV diagnosis. Simplification of access to free healthcare for all, more awareness raising about HIV screening and prevention among migrant women, and more migrant‐focused outreach programmes are suggested to improve migrant women's access to HIV healthcare in Europe. [ABSTRACT FROM AUTHOR]

Background: There has been a significant increase in scientific investigations of the hearing‐dementia association among the research on potentially modifiable risk factors for cognitive impairment. We tested two clinical questions. Analysis 1: does persistent hearing aid (HA) use decrease the decline in cognitive function caused by ageing? Analysis 2: does cognitive function at the time of HA fitting predict future persistent HA use? Methods: This case–control study performed at two referral centres reported data obtained over a 4.5‐year period. We recruited a group of patients with cognitive decline, aged 65 or older with or without hearing loss. The intervention consisted of the use of HAs. The primary outcome measures were adherence to continuous HA use and cognitive function measured using the Japanese version of the Mini‐Mental State Examination Test and the Reading Cognitive Test Kyoto. Results: Eighteen HA users and 18 controls were included in the first analysis. HA use was associated with a deceleration of cognitive decline 12 months later. In the second analysis, 11 participants with good adherence to HA use were compared with 12 participants who showed poor adherence to HA use. Among the variables employed in this study, cognitive function measured using the Reading Cognitive Test Kyoto was significantly lower in participants with poor adherence to HA. Conclusions: HA use in cognitively impaired individuals with hearing loss can slow age‐related cognitive decline. Cognitively impaired people with hearing loss who fail to commit to HA use tend to have lower cognitive measurement scores before HA fitting. HA use is generally more challenging as people age and their cognitive abilities decline. Therefore, it is desirable that HAs be used when hearing loss and dementia are in their early stages. [ABSTRACT FROM AUTHOR]

Aim: To evaluate patients' satisfaction levels with primary healthcare services and providers in Jordan and assess differences in patients' satisfaction in relation to sociodemographic factors and accessibility to primary healthcare. Design: A descriptive cross‐sectional design was used in this study. Sampling: A convenient sampling technique was utilized. Measures: A 34‐item survey instrument was adopted and distributed to patients in nine primary healthcare centers in Amman in the period between October and December 2022. Results: A total of 225 patients completed the survey. The mean total score for patient satisfaction with primary healthcare services was 25.22 (SD = 4.13). There were significant differences in satisfaction with services in terms of educational level, visitation reason, mode of transportation, availability of parking, and suitably designed for patients with disabilities. Furthermore, the mean total score for patient satisfaction with primary healthcare providers was 22.85 (SD = 5.86). There were significant differences in relation to visitation reason, mode of transportation, and parking space availability. Conclusion: It is important to improve patient satisfaction in primary healthcare facilities, and the Ministry of Health should implement policies for improving the quality of services provided by primary healthcare. [ABSTRACT FROM AUTHOR]

Background and aims: Total abstinence has historically been the goal of treatment for substance use disorders; however, there is a growing recognition of the health benefits associated with reduced use as a harm reduction measure in stimulant use disorders treatment. We aimed to assess the validity of reduced stimulant use as an outcome measure in randomized controlled trials (RCTs) of pharmacological interventions for stimulant use disorder. Design: We conducted a secondary analysis of a pooled dataset of 13 RCTs. Setting and participants: Participants were individuals seeking treatment for cocaine or methamphetamine use disorders (N = 2062) in a wide range of treatment facilities in the United States. Measurements We validated reduced stimulant use against a set of clinical indicators drawn from harmonized measurements, including severity of problems caused by drug use, comorbid depression, global severity of substance use and improvement, severity of drug‐seeking behavior, craving and high‐risk behaviors, all assessed at the end of the trial, as well as follow‐up urine toxicology. A series of mixed effect regression models was conducted to validate reduction in frequency of use against no reduction in use and abstinence. Findings More participants reduced frequency of primary drug use than achieved abstinence (18.0% vs. 14.2%, respectively). Reduced use was significantly associated with decreases in craving for the primary drug [60.1%, 95% confidence interval (CI) = 54.3%–64.7%], drug seeking behaviors (41.0%, 95% CI = 36.6%–45.7%), depression severity (39.9%, 95% CI = 30.9%–48.3%), as well as multiple measures of global improvement in psychosocial functioning and severity of drug‐related problems, albeit less strongly so than abstinence. Moreover, reduced use was associated with sustained clinical benefit at follow‐up, as confirmed by negative urine tests (adjusted odds ratio compared with those with no reduction in use: 0.50, 95% CI = 0.35–0.71). Conclusion: Reduced frequency of stimulant use appears to be associated with meaningful improvement in various clinical indicators of recovery. Assessment of reduced use, in addition to abstinence, could broaden the scope of outcomes measured in randomized controlled trials of stimulant use disorders and facilitate the development of more diverse treatment approaches. [ABSTRACT FROM AUTHOR]

Objective: This clinical study aimed to evaluate the effect of virtual reality (VR) technology on anxiety and pain levels in patients undergoing gingivectomy and gingivoplasty procedures. Materials and Methods: The patients were randomized into test (surgery with VR glasses) and control (surgery without VR glasses) groups. Before the surgery, the anxiety level was measured using the modified dental anxiety scale (MDAS), and anticipated pain (AP) was measured by a visual analog scale (VAS). Immediately after the surgery, the pain and discomfort associated with the surgery (VASP), procedure time (T), and time perception (TP) were evaluated. The patients in the test group were requested to assess the immersion (VASI), satisfaction (VASS), perception of reduced anxiety (VASA), and perceived control (VASC). One week after surgery, MDAS was applied to all patients. Results: This trial was conducted with 41 female and 17 male subjects with a mean age of 29.69 ± 12.32. There were no significant differences between the groups in terms of age, sex, preoperative MDAS, or AP. After surgery, MDAS, VASP, T, and TP failed to differ significantly between the groups. The subject age was positively correlated with VASI, VASS, VASA, and VASC (r = 0.60, p = 0.00; r = 0.44, p = 0.02; r = 0.46, p = 0.02; r = 0.50, p = 0.01, respectively) and negatively correlated with VASP (r = 0.47, p = 0.04). Conclusions: VR application did not affect anxiety and pain levels in patients undergoing periodontal surgery. More studies are needed to evaluate VR distraction in periodontal surgeries with diverse age samples and video options. Clinical Significance: VR does not affect anxiety and pain levels during gingivectomy and gingivoplasty surgeries in the young adult population. It should be evaluated in older age groups. Trial registration ClinicalTrials.gov Identifier: NCT06092177. [ABSTRACT FROM AUTHOR]

Background: Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School‐based caries prevention can increase access to care and reduce health inequities. Disruptions in school‐based care due to pandemic control policies may result in children losing access to their primary dental care option. Methods: The CariedAway project was a school‐based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low‐income, minority students. Program operations were suspended for 2 years due to the COVID‐19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. Results: A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow‐up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. Conclusion: There are considerable unmet dental needs in high‐risk children that may be further exacerbated by a lack of access to care during disease outbreaks. [ABSTRACT FROM AUTHOR]

Objective: The tapering of biologic disease‐modifying antirheumatic drug (b‐DMARD) therapy for patients with rheumatoid arthritis (RA) in stable remission is frequently undertaken, but specific guidance on how to successfully taper is lacking. The objective of this study is to identify predictors of flare in patients in stable b‐DMARD–induced clinical remission, who did or did not follow structured b‐DMARD tapering. Methods: Patients with RA receiving b‐DMARD treatment who had achieved sustained remission according to a Disease Activity Score in 28 joints using the C‐reactive protein level (DAS28‐CRP) <2.6 for ≥6 months were offered tapering. Clinical, ultrasound (US) (total power Doppler [PD]/grayscale abnormalities), CD4+ T cell subsets, and patient‐reported outcomes (PROs) were collected at inclusion. The primary endpoint was the occurrence of flare (loss of DAS28‐CRP remission) over 12 months. Logistic regression analyses identified predictors of flare. Dichotomization into high/low‐risk groups was based on 80% specificity using the area under the receiving operator curve (AUROC). Results: Of 63 patients choosing tapering, 23 (37%) flared compared with 12 of 60 (20%) on stable treatment (P = 0.043). All patients who flared regained remission upon reinstating treatment. In the tapering group, flare was associated with lower regulatory T cell (Treg) (P < 0.0001) and higher CRP levels (P < 0.0001), erythrocyte sedimentation rate (P < 0.035), and inflammation‐related cells (IRCs) (P = 0.054); stepwise modeling selected Tregs (odds ratio [OR] = 0.350, P = 0.004), IRCs (OR = 1.871, P = 0.007), and CRP level (OR = 1.577, P = 0.004) with 81.7% accuracy and AUROC = 0.890. In the continued therapy group, modeling retained the tender joint count, total PD, and visual analog scale pain score, with 82.1% accuracy and AUROC = 0.899. Most patients in the study were considered low risk of flare (80 of 123 patients [65%]). Only 5 of 37 (13.5%) of the low‐risk patients who tapered flared, which was notable compared with the continued therapy group (20% flare). Conclusion: Flare on tapering b‐DMARDs was predicted by lower Tregs and elevated inflammation biomarkers (IRCs/CRP level); flare on continued b‐DMARDs was associated with raised pain parameters and US inflammation. Knowledge of these biomarkers should improve outcomes by targeted selection for tapering, and by increased monitoring of those on continued therapy predicted to flare. [ABSTRACT FROM AUTHOR]

Ecologists and evolutionary biologists are regularly tasked with the comparison of binary data across groups. There is, however, some discussion in the biostatistics literature about the best methodology for the analysis of data comprising binary explanatory and response variables forming a 2 × 2 contingency table.We assess several methodologies for the analysis of 2 × 2 contingency tables using a simulation scheme of different sample sizes with outcomes evenly or unevenly distributed between groups. Specifically, we assess the commonly recommended logistic (generalised linear model [GLM]) regression analysis, the classical Pearson chi‐squared test and four conventional alternatives (Yates' correction, Fisher's exact, exact unconditional and mid‐p), as well as the widely discouraged linear model (LM) regression.We found that both LM and GLM analyses provided unbiased estimates of the difference in proportions between groups. LM and GLM analyses also provided accurate standard errors and confidence intervals when the experimental design was balanced. When the experimental design was unbalanced, sample size was small, and one of the two groups had a probability close to 1 or 0, LM analysis could substantially over‐ or under‐represent statistical uncertainty. For null hypothesis significance testing, the performance of the chi‐squared test and LM analysis were almost identical. Across all scenarios, both had high power to detect non‐null effects and reject false positives. By contrast, the GLM analysis was underpowered when using z‐based p‐values, in particular when one of the two groups had a probability near 1 or 0. The GLM using the LRT had better power to detect non‐null results.Our simulation results suggest that, wherever a chi‐squared test would be recommended, a linear regression is a suitable alternative for the analysis of 2 × 2 contingency table data. When researchers opt for more sophisticated procedures, we provide R functions to calculate the standard error of a difference between two probabilities from a Bernoulli GLM output using the delta method. We also explore approaches to compliment GLM analysis of 2 × 2 contingency tables with credible intervals on the probability scale. These additional operations should support researchers to make valid assessments of both statistical and practical significances. [ABSTRACT FROM AUTHOR]

Summary: Finding similar scientific workflow modules that can substitute essential components of the privacy workflows from public repositories to create a personalized workflow is growing in popularity. This is a cost‐effective and error‐free strategy for the scientific community. Currently, module alignment approaches heavily depend on syntactic information such as modules' names and types. However, the contextual semantic information of modules, which encompasses inputs, outputs, and datalinks connecting modules, can also convey their functions. Unfortunately, this information is scarcely utilized during the module alignment process. In this work, we propose a module alignment method based on neighbor information for scientific workflow (MANSOR). Specifically, we present a rule‐based attribute similarity computation approach for calculating initial module‐pair similarity in two workflows. The relation similarity is then employed to iteratively fine‐tune the matching degree with uncertainty of module pairs by considering the contextual semantics until reaching a steady state. After pairwise comparison of workflows, the module alignment results are determined based on their module‐pair similarity. Experimental results on the human‐curated corpus of ratings indicate that MANSOR outperforms the existing state‐of‐the‐art approaches with statistical significance. [ABSTRACT FROM AUTHOR]

Background: Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low‐level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied. Aim: To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH. Design: This prospective, parallel‐arm control, randomized, triple‐blind clinical trial included children aged 7–12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p <.05). The chi‐squared test was used to determine the effect of PBMT on categorical outcomes. Results: The no‐pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate‐to‐high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p =.235, p =.143). Conclusions: Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH. [ABSTRACT FROM AUTHOR]

Using panel data from Indonesia, this paper analyzes short and long‐term drivers of nutritional conditions among children aged 0–15 years. I estimate a Mundlak model in order to better account for the relatively larger "between" variation that is found in the data, and to control for endogeneity biases that may arise due to the correlation of unobserved heterogeneity and observed explanatory variables. As results suggest, children with older, more experienced mothers, and those breastfed, exhibit improved height outcomes, aligning with existing research on breastfeeding's positive health effects. While prior research emphasized the importance of maternal education, this study reveals that, once accounting for father's education, the long‐term effect of the mother's education loses statistical significance. Finally, the findings of this study suggest that household wealth and access to adequate sanitation facilities strongly affect short ‐and long‐run improvements in children anthropometric outcomes. [ABSTRACT FROM AUTHOR]

Mismatch negativity (MMN) is an auditory event‐related response reflecting the pre‐attentive detection of novel stimuli and is a biomarker of cortical dysfunction in schizophrenia (SZ). MMN to pitch (pMMN) and to duration (dMMN) deviant stimuli are impaired in chronic SZ, but it is less clear if MMN is reduced in first‐episode SZ, with inconsistent findings in scalp‐level EEG studies. Here, we investigated the neural generators of pMMN and dMMN with MEG recordings in 26 first‐episode schizophrenia spectrum (FEsz) and 26 matched healthy controls (C). We projected MEG inverse solutions into precise functionally meaningful auditory cortex areas. MEG‐derived MMN sources were in bilateral primary auditory cortex (A1) and belt areas. In A1, pMMN FEsz reduction showed a trend towards statistical significance (F(1,50) = 3.31; p =.07), and dMMN was reduced in FEsz (F(1,50) = 4.11; p =.04). Hypothesis‐driven comparisons at each hemisphere revealed dMMN reduction in FEsz occurred in the left (t(56) = 2.23; p =.03; d =.61) but not right (t(56) = 1.02; p =.31; d =.28) hemisphere, with a moderate effect size. The added precision of MEG source solution with high‐resolution MRI and parcellation of A1 may be requisite to detect the emerging pathophysiology and indicates a critical role for left hemisphere pathology at psychosis onset. However, the moderate effect size in left A1, albeit larger than reported in scalp MMN meta‐analyses, casts doubt on the clinical utility of MMN for differential diagnosis, as a majority of patients will overlap with the healthy individual's distribution. [ABSTRACT FROM AUTHOR]

Background: Alcohol use contributes to the national burden of morbidity and mortality in the United States. Arrest, as a unique form of criminal justice system involvement, may be related to alcohol use from adolescence to adulthood. This study investigates the relationship between arrest and alcohol use across race/ethnicity-gender (R/E-G) status (e.g., Black, Latinx, and White men and women) as youth age. Methods: Data from 17 waves (1997-2015) of the National Longitudinal Survey of Youth, 1997 cohort (N = 8901) were used to explore how variation in R/E-G moderates the relationship between arrest history and alcohol use trajectories from 13 to 30 years old. Multilevel zero-inflated Poisson and Poisson regression were used to assess R/E-G variation in the relationship between arrest history and days of alcohol consumption, drinks per drinking occasion, and days of binge drinking after accounting for covariates, including incarceration. Results: The findings indicate that an arrest history is associated with alcohol use, and these results varied by R/E-G status, age, and alcohol use outcome. Those with an arrest history reported more days of drinking than their counterparts without an arrest; yet, the magnitude and direction of average drinks per occasion and binge drinking days varied by R/E-G status and age. Paradoxically, Black men, Black women, and Latinx men with an arrest history reported fewer days of binge drinking as they aged than their counterparts without an arrest. Conclusions: A history of arrest is important for alcohol use from adolescence to adulthood and varies by R/E-G status, age, and alcohol use outcome. This work confirms previous scholarship showing that arrest and alcohol use are socially patterned and R/E-G status is an essential consideration in understanding the relationship. Future work should include additional identities and health behaviors and the consequences related to alcohol use outcomes. [ABSTRACT FROM AUTHOR]

Objective: Sjögren's disease (SjD) has a strong sex bias, suggesting an association with sex hormones. Male SjD represents a distinct subset of the disease, but the pathogenic mechanisms of male SjD is poorly characterized. The aim of this study is to identify initiating events related to the development of gland hypofunction and autoimmunity in male SjD patients. Materials and methods: Human minor salivary glands were transcriptomically analyzed with microarrays to detect differentially expressed genes in male SjD patients. Identified genes were tested on their involvement in the disease using conditional transgenic mice and gene‐overexpressing cells. Results: GPR78, an orphan G protein–coupled receptor, was overexpressed in the salivary glands of male SjD patients compared with male healthy controls and female SjD patients. Male GPR78 transgenic mice developed salivary gland hypofunction with increased epithelial apoptosis, which was not seen in control or female transgenic mice. In cell culture, GPR78 overexpression decreased lysosomal integrity, leading to caspase‐dependent apoptotic cell death. GPR78‐induced cell death in vitro was inhibited by treatment with estradiol. Conclusion: GPR78 overexpression can induce apoptosis and salivary gland hypofunction in male mice through lysosomal dysfunction and increased caspase‐dependent apoptosis in salivary gland epithelium, which may drive disease in humans. [ABSTRACT FROM AUTHOR]

Introduction: The optimal slow pathway (SP) ablation site in cases with an inferiorly located His bundle (HIS) remains unclear. Methods and Results: In 45 patients with atrioventricular nodal reentrant tachycardia, the relationship between the HIS location and successful SP ablation site was assessed in electroanatomical maps. We assessed the location of the SP ablation site relative to the bottom of the coronary sinus ostium in the superior‐to‐inferior (SPSI), anterior‐to‐posterior (SPAP), and right‐to‐left (SPRL) directions. The HIS location was assessed in the same manner. The HIS location in the superior‐to‐inferior direction (HISSI), SPSI, SPAP, and SPRL were 17.7 ± 6.4, 1.7 ± 6.4, 13.6 ± 12.3, and −1.0 ± 13.0 mm, respectively. The HISSI was positively correlated with SPSI (R2 = 0.62; P <.01) and SPAP (R2 = 0.22; P <.01), whereas it was not correlated with SPRL (R2 = 0.01; P =.65). The distance between the HIS and SP ablation site was 17.7 ± 6.4 mm and was not affected by the location of HIS. The ratio of the amplitudes of atrial and ventricular potential recorded at the SP ablation site did not differ between the high HIS group (HISSI ≥ 13 mm) and low HIS group (HISSI < 13 mm) (0.10 ± 0.06 vs. 0.10 ± 0.06; P =.38). Conclusion: In cases with an inferiorly located HIS, SP ablation should be performed at a lower and more posterior site than in typical cases. [ABSTRACT FROM AUTHOR]

Aim: To determine how the nighttime sleep patterns of older adults in a long‐term care facility vary according to cognitive function and participation in daytime activities. Methods: This observational study was conducted with older adults aged ≥65 years who are residents of a long‐term care facility. Nighttime sleep was monitored using a non‐wearable sleep monitor for 8 weeks. Based on the Mini‐Mental State Examination scores for assessment of cognitive function, participants were classified into non‐dementia, mild‐to‐moderate dementia, and severe dementia groups. The Mann–Whitney U test and Kruskal–Wallis test were used to analyze the data. Results: Twenty three older adults were included in this study. Sleep onset latency was significantly longer in the severe dementia group than in the non‐dementia (p =.027) and mild‐to‐moderate dementia (p =.041) groups. Sleep efficiency was significantly lower in the severe dementia group than in the mild‐to‐moderate dementia group (p =.003), whereas wakefulness after sleep onset was significantly longer in the severe dementia group than in the mild‐to‐moderate dementia group (p =.011). The number of days spent engaging in recreational activities was <50%, whereas those spent taking a nap was >60% in all older adults. Older adults with mild‐to‐moderate dementia had better sleep and participated in more daytime activities than those with severe or no dementia. Moreover, bathing in a bathtub improved sleep onset latency. Conclusions: This study demonstrates that participation in daytime activities and bathing in a bathtub affect nighttime sleep in older adults. [ABSTRACT FROM AUTHOR]

Background: Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. Objectives: This network meta‐analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma. Methods: We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point. Results: At the Weeks 4, 8, and 12 and the last follow‐up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8. Conclusions: Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration. [ABSTRACT FROM AUTHOR]

Background: The mental health of patients with temporomandibular disorder or other jaw dysfunction is a primary concern in clinical practice, but the extent of these symptoms in this patient subset is not yet well understood. Objectives: This cross‐sectional study aimed to compare the mental health and jaw function between patients with anterior disc displacement with reduction (ADDWR) and healthy individuals. Methods: In total, 170 patients with ADDWR and 163 healthy participants enrolled in this study from March 2020 to December 2021. All participants completed a single assessment, including a pain rating and several questionnaires to assess jaw dysfunction, depression, and anxiety. All scores and the grade distribution of somatization, depression and anxiety were analysed between groups. Results: Significant differences were found in measures of pain, jaw function and somatization; the ADDWR group had significantly higher pain and functional jaw limitations than the healthy group. The grade distribution of somatic symptoms also differed between groups: the distribution of patients who reported mild and above scores in the ADDWR group was significantly higher than that of the healthy group. Depression and anxiety scores or grade distributions were not significantly different by group. Conclusion: The jaw function of patients seeking treatment for ADDWR was lower than that of non‐TMD individuals. They did not show high anxiety and depression symptoms, but their somatic symptoms were more apparent. [ABSTRACT FROM AUTHOR]

To analyse the risk factors and healing factors of pharyngocutaneous fistula (PCF) in patients with laryngeal cancer after total laryngectomy, and to explore the relevant epidemiology. A retrospective analysis was conducted on laryngeal cancer patients who underwent total laryngectomy in our hospital from January 2010 to December 2022. The 349 patients included in the study were divided into a PCF group of 79 and a non‐PCF group of 270. Perform one‐way analysis of variance and multivariate logistic analysis on various data of patients included in the statistics, and analyse the risk factors and healing factors of PCF. Smoking, history of radiation therapy for laryngeal cancer, history of chemotherapy for laryngeal cancer, tumour location (larynx, pharynx, oesophagus), preoperative albumin, postoperative proteinaemia, <99 haemoglobin, postoperative haemoglobin, postoperative C‐reactive protein (CRP) level are the risk factors for PCF. Also, radiation therapy and postoperative proteinaemia were the main reasons for preventing PCF healing. Smoking history, laryngeal cancer, radiation therapy, albumin, haemoglobin and CRP are risk factors for postoperative PCF after total laryngectomy, while radiation therapy and postoperative hypoalbuminaemia are key factors affecting PCF healing. [ABSTRACT FROM AUTHOR]

The size and shape of niche spaces or trait spaces are often analysed using hypervolumes estimated from data. The hypervolume R package has previously supported such analyses via descriptive but not inferential statistics. This gap has limited the use of hypothesis testing and confidence intervals when comparing or analysing hypervolumes.We introduce a new version of this R package that provides nonparametric methods for resampling, building confidence intervals and testing hypotheses. These new methods can be used to reduce the bias and variance of analyses, and well as provide statistical significance for hypervolume analysis.We illustrate usage on real datasets for the climate niche of tree species and the functional diversity of penguin species. We analyse the size and overlap of the respective niche or trait spaces.These statistical inference methods improve the interpretability and robustness of hypervolume analyses. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF). We aim to evaluate the association between RA and AF, and other clinical outcomes. We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until September 10, 2023. Primary clinical outcomes were AF. Secondary outcomes were acute coronary syndrome (ACS), stroke, and all-cause mortality (ACM). A total of 4 679 930 patients were included in the analysis, with 81 677 patients in the RA group and 4 493 993 patients in the nonrheumatoid arthritis (NRA) group. The mean age of the patients was 57.2 years. Pooled analysis of primary outcomes shows that RA groups of patients had a significantly higher risk of AF (odds ratios [OR], 1.53; 95% confidence interval [CI]: [1.16-2.03], p < .001) compared with NRA groups. Secondary Outcomes show that the RA group of patients had significantly higher odds of ACS (OR, 1.39; 95% CI: [1.26-1.52], p < .001), and ACM (OR, 1.19; 95% CI: [1.03-1.37], p = .02) compared with the NRA groups. However, the likelihood of stroke (OR, 1.02; 95% CI: [0.94-1.11], p = .61) was comparable between both groups of patients. Our study shows that RA groups of patients are at increased risk of having AF, ACS, and ACM. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine the relationship between older adults' health literacy and their psychological well‐being and the role of worry about future unmet needs for medical care in mediating this relationship. Methods: We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single‐item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well‐being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks. Results: Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well‐being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker‐Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi‐square test = 50.96, P = 0.321). Conclusions: The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults. Geriatr Gerontol Int 2024; 24: 202–207. [ABSTRACT FROM AUTHOR]

Objectives: The herbs in Tao Hong Si Wu Decoction (THSWD) are beneficial in the treatment of cognitive impairment. However, the underlying mechanisms of THSWD in treating diabetes‐associated cognitive dysfunction (DACD) are not entirely explored. This study is aimed to investigate the therapeutic effects of THSWD in DACD model rats and the underlying mechanism. Methods: Ultra‐high‐phase liquid chromatography was employed to identify the main compounds contained in the THSWD extract. DACD rat model was induced by feeding with a high‐sugar and high‐fat diet and injecting streptozotocin (35 mg/kg). DACD rats were gavaged with THSWD for 1 week. The learning and memory abilities of the rats were measured by using the Morris water maze. Western blotting was used to detect the changes in DACD rat targets. Statistical methods were used to evaluate the correlation between proteins. Results: The results show that THSWD effectively reduced the escape latency, hippocampal neuron damage, glycosylated hemoglobin, type A1C, and blood lipid levels in DACD rats. Furthermore, DACD rats showed significantly increased amyloid precursor protein, β‐secretase, Aβ1−40, Aβ1−42, Tau phosphorylation, and advanced glycation end products (AGEs) expression. However, THSWD treatment can reverse this phenomenon. Conclusions: THSWD can improve the learning and memory abilities of DACD rats by inhibiting the expression of AEGs‐AGE receptors pathway, which provides an experimental basis for the clinical application of THSWD. In addition, the experiment combines pharmacological and statistical methods, which offers a new perspective for the study of Chinese herbal medicine. Key points: Tao Hong Si Wu Decoction (THSWD) can improve the learning and memory abilities of diabetes‐associated cognitive dysfunction (DACD) rats.Reduced Aβ content was associated with more favorable cognitive abilities.The advanced glycation end products (AGEs)‐AGE receptors (RAGE) pathway may be a key pathway for THSWD to alleviate symptoms in DACD rats and exert therapeutic effects. [ABSTRACT FROM AUTHOR]

Background: Negative urgency (NU), the tendency to act rashly during negative emotional states, is a robust risk factor for alcohol misuse that is posited to function in part through alcohol‐related cognitions. Nonetheless, relatively little research has examined mood‐based fluctuations in such cognitions, which could help to explain how the trait of NU translates to impulsive alcohol‐related behaviors. We examined how NU impacted several alcohol cognitions (positive/negative alcohol expectancies, positive/negative alcohol valuations, and alcohol craving for positive/negative emotional reinforcement) before and after negative, neutral, or positive mood inductions. We hypothesized that NU would predict greater and more favorable endorsement of alcohol and its effects following negative (vs. positive or neutral) mood induction. Methods: Participants (N = 428) were southern‐midwestern college students recruited for an online experiment. Following the provision of consent, participants rated NU and preinduction alcohol cognitions, and were then randomly assigned to one of three (negative, neutral, or positive) mood inductions; subsequently, postinduction alcohol‐cognition ratings were immediately obtained. We conducted six robust multilevel linear models (one per DV) examining NU's influence on within‐person changes in alcohol cognitions across each mood induction. Results: No three‐way interactions were identified and only one two‐way interaction involving NU was identified. There were main effects across mood induction conditions and time points for NU predicting greater endorsement of positive and negative alcohol outcome expectancies, and greater alcohol craving for positive and negative emotional reinforcement. Conclusions: Greater NU predicts greater perceived likelihood of alcohol's effects, alongside greater desire for mood improvement from alcohol. The absence of three‐way interactive effects indicates NU's influence on mood‐dependent fluctuations in alcohol cognitions may manifest over longer timescales (e.g., months and years), involve alternative cognitive processes (e.g., drinking motives and implicit alcohol cognitions), and apply more broadly to desires for mood improvement than purely negative emotional reinforcement. [ABSTRACT FROM AUTHOR]

Background: The mechanism of typical slow‐fast atrioventricular nodal re‐entrant tachycardia (AVNRT) and its anatomical and electrophysiological circuit inside the right atrium (RA) and Koch's Triangle (KT) are not well known. Objective: To identify the potentials of the compact AV node and inferior extensions and to perform accurate mapping of the RA and KT in sinus rhythm (SR) and during AVNRT, to define the tachycardia circuit. Methods: Consecutive patients with typical AVNRT were enrolled in 12 Italian centers and underwent mapping and ablation by means of a basket catheter with small electrode spacing for ultrahigh‐density mapping and a modified signal‐filtering toolset to record the potentials of the AV nodal structures. Results: Forty‐five consecutive cases of successful ablation of typical slow‐fast AVNRT were included. The mean SR cycle length (CL) was 784.1 ± 6 ms and the mean tachycardia CL was 361.2 ± 54 ms. The AV node potential had a significantly shorter duration and higher amplitude in sinus rhythm than during tachycardia (60 ± 40 ms vs. 160 ± 40 ms, p <.001 and 0.3 ± 0.2 mV vs. 0.09 ± 0.12 mV, p <.001, respectively). The nodal potential duration extension was 169.4 ± 31 ms, resulting in a time‐window coverage of 47.6 ± 9%. The recording of AV nodal structure potentials enabled us to obtain 100% coverage of the tachycardia CL during slow‐fast AVNRT. Conclusion: Detailed recording of the potentials of nodal structures is possible by means of multipolar catheters for ultrahigh‐density mapping, allowing 100% of the AVNRT CL to be covered. These results also have clinical implications for the ablation of right‐septal and para‐septal arrhythmias. [ABSTRACT FROM AUTHOR]

This paper provides estimates of local employment multipliers from large, publicly subsidized firms. We use a synthetic control weighted difference‐in‐difference estimation procedure that matches treated areas with comparison areas to generate local employment multiplier estimates. We show that local employment multiplier estimates have a high degree of uncertainty, with a wide range of point estimates (both positive and negative) and varying degrees of statistical significance. There is a concentration of positive employment multipliers from manufacturing facilities, but little correlation between estimated multipliers and subsidy value. We demonstrate that our approach produces drastically different results than a traditional difference‐in‐difference approach. [ABSTRACT FROM AUTHOR]

The physicochemical diversity of the structurally related aromatic probe drugs, used together in a drug cocktail to assess metabolic and transport phenotypes, require optimized analytical procedures for simultaneous quantification. The analytical conditions can greatly influence the analyte selectivity, retention, stability, and ultimately the robustness of the method. The aim of this study was to assess the selectivity of the structurally related ionizable analytes between the commonly used C18 column chemistry and an alternative biphenyl column chemistry as well as the influence of changes in the analytical conditions on method robustness using liquid chromatography‐tandem mass spectrometry. A repeated measure two‐factor analysis of variance with Geisser‐Greenhouse correction was used to determine statistical significance. The results showed that a biphenyl stationary phase in combination with methanol as the organic eluent, could provide improved resolution and analyte selectivity. Changes in analytical conditions caused statistically significant variation in the retention behavior, selectivity, column efficiency, and sensitivity of the analytes of interest The robustness experiment confirmed the importance of controlling analytical conditions to ensure the reproducibility and reliability of the quantitative method. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis is a serious health problem among women of reproductive age, with pelvic pain and infertility. Given the limited success of current treatments, this study explores Neroli oil (N.O.) effects on inflammation, oxidation, angiogenesis, and tissue remodeling implicated in endometriosis. Materials and Methods: Albino Wistar female rats were used to simulate an endometriosis model. Groups were established for comparison: a control, an endometriosis model, a N.O.‐treated group, and a N.O.‐treated group postendometriosis induction. The study focused on Tumor necrosis factor‐alpha (TNF‐α), Interleukin 6, Interleukin 8, vascular endothelial growth factor (VEGF), myeloperoxidase, Matrix metalloproteinase‐1 (MMP‐1), nitric oxide, superoxide dismutase, catalase, and anti‐mullerian hormone values, as well as histopathological evaluations of endometriotic foci. Results: AMH values showed a significant increase in the endometriosis group treated with N.O. compared with the endometriosis group (p < 0,01).A statistically significant decrease was found in MMP‐1 level in the endometriosis group that underwent N.O. (p < 0.001). Increased CAT (p < 0.0001) and decrease in nitric oxide (p < 0.01) are found in N.O.‐treated endometriosis group. TNF‐α levels in the endometriosis group showed a statistically significant increase in the endometriosis group when compared with the control and sham group (p < 0.001, p < 0.01 respectively). In our study, a statistically significant increase was observed in VEGF levels (p < 0.001) in endometriosis group and significant decrease in the N.O. administered endometriosis model group. Groups treated with N.O. showed decreased inflammation and congestion scores. Histopathological assessments demonstrated reduced inflammation and tissue remodeling signs in endometriotic foci. Conclusion: This study highlights the potential of N.O. in the treatment of endometriosis, owing to its anti‐inflammatory, antioxidant, and antiangiogenic properties that can disrupt chronic processes. Our findings lend support to utilization of herbal remedies for the management of endometriosis, thereby emphasizing the necessity for additional comprehensive investigations in the future. [ABSTRACT FROM AUTHOR]

Objective: This cross‐sectional study investigated the association of periodontitis with the metabolic status and hepatic function in pregnant women. Materials and Methods: Full‐mouth periodontal conditions, metabolic profiles, and hepatic function were assessed in 219 self‐reported healthy pregnant females. The association of periodontal status with the systemic parameters was evaluated by parametric and non‐parametric tests, and multivariate logistic regression analysis. Results: Overall, periodontal status was positively associated with the metabolic profiles and hepatic function test results. The subjects with periodontitis exhibited higher levels of body mass index (BMI) (p < 0.01) and serum aspartate transaminase (AST) (p < 0.05), elevated diastolic blood pressure (DBP) (p < 0.05), and lower levels of high‐density lipoprotein cholesterol (p < 0.05) than those of the counterparts. The periodontitis severity was strongly correlated with BMI and AST levels, and the extent of periodontal inflammation was related to DBP (p < 0.01). The periodontitis patients at 34–36 gestational weeks showed higher blood pressure and AST levels than those of non‐periodontitis subjects (p < 0.05). Conclusion: Our findings on the notable links of periodontitis to concurrent metabolic disorders and abnormal liver function in pregnant women highlight the need of proactive integration of regular periodontal screening and healthcare in maternal programs for promoting optimal health and wellbeing of mothers‐to‐be and newborns. [ABSTRACT FROM AUTHOR]

Objective(s): Several guidelines exist to inform best‐practice management of community‐dwelling fallers. This study aimed to outline a pragmatic approach to developing an audit tool for guideline‐based care of falls and provide an overview of current practice. Methods: An audit tool to determine compliance with guideline‐based care was developed with an allied health and physiotherapy focus, utilising the Australian Commission on Safety and Quality in Health‐Care Guidelines for Preventing Falls and Harm from Falls in Older People (2009) and Queensland State Government 'Stay on your Feet' guidelines. A retrospective audit of medical records was completed in July 2020 of community‐dwelling people aged 65 years and over with a fall‐related emergency department (ED) presentation in a medium‐sized metropolitan hospital in Australia. Data were compared between patients admitted to hospital and those discharged home from the ED. Results: Ninety‐three patients were included: 68 were discharged home from ED and 25 were admitted to hospital. There was a significant difference in receiving an allied health review (p <.001) between admitted patients (96%) and those who discharged home from ED (68%). The Clinical Frailty Scale was only completed for 23% of patients. Physiotherapy quality‐of‐care (n = 46 patients) was variable, with poor completion of physical outcome measures (7%) and fall education (4%). However, assessment of mobility was routinely completed (94%), and most patients were referred to an appropriate community service (66%). Conclusions: Adherence to guideline‐based care of community‐dwelling fallers is inconsistent. Improvements are required in the consistency of risk stratification, comprehensive physical assessment and patient education. [ABSTRACT FROM AUTHOR]

Does nursing directed education have any impact on severity of symptoms and quality of life among BPH patients? This study aims to develop a nurse‐directed education program, to assess and compare the effectiveness of the program on symptoms‐severity and quality of life among BPH patients. BPH, one of the most common causes of Lower Urinary Tract Symptoms (LUTS) in elderly men, is caused by a combination of prostate proliferation and lower urinary tract obstruction. A cross‐sectional study conducted by Divmehar Kaur et al. 2020 at Rajindra Hospital, Patiala, Punjab concluded that BPH patients' quality of life is negatively affected by LUTS associated with BPH (p ≤ 0.001). Also, a field study conducted by Özcan et al. in Turkey concluded that subjects' BPH‐QLS ratings varied statistically significantly (p 0.05) depending on the age, educational attainment, the occurrence of micturition issues, and whether they had ever applied to a medical facility. Then another descriptive study, correlational‐type carried by Pinto et al. in 2014 in Singapore found that patients with BPH had a poor health‐related quality of life and suffered significantly from their psychological wellbeing. And a RCT conducted in Korea by Jung et al. in 2011 with the aim of examining the benefits of tai chi on patients with benign prostatic hypertrophy's (BPH's) lower urinary tract symptoms (LUTSs) and quality of life (QoL) found that tai chi group's change in overall QoL score was more notable (t = 3.06; p = 0.005) and it demonstrated significant improvements. A quasi‐experimental study was conducted among the BPH patients visiting the Urology OPD of AIIMS Jodhpur. Data were collected from 10 BPH patients (5 in each group) using a purposive sampling technique from those over 40 years diagnosed with BPH for the last 6 months after taking informed consent, excluding those being advised for surgery. Self‐structured sociodemographic and clinical variables tool, International Prostate Symptom Score (IPSS), and 12‐item Short Form Survey (SF‐12) were administered. Statistical analysis was performed by employing the SPSS version 23. Chi‐square and Mann–Whitney U tests were used. It was seen that there was a significant difference (p‐value < 0.05) concerning the IPSS‐QOL Index (p‐value = 0.008) of symptoms‐severity (IPSS) and PCS‐12 (p‐value = 0.009) of quality of life scale (SF‐12) between control and experimental groups after 4th‐week post‐intervention (nurse‐directed education program). Findings from this study will help reinforce designing a cost‐effective care delivery system in the care of BPH patients. This program is a novel approach to improving preventive, curative, and rehabilitative services to BPH patients in India. [ABSTRACT FROM AUTHOR]

Aim: To explore the mediating role of psychological capital between authentic leadership and innovative behaviour among Chinese nurses. Design: A cross‐sectional study. Methods: In December 2021, online surveys were delivered among nurses from 37 hospitals in Anhui Province by convenience sampling approach. The data was collected using the Chinese version of the Authentic Leadership Questionnaire, Nurse Psychological Capital Questionnaire and Nurse Innovative Behaviour Scale. The structural equation model and bootstrap test examined the mediating role of psychological capital between authentic leadership and innovative behaviour. Results: 3495 Chinese nurses from 37 Anhui Province hospitals participated in this study. The mean item score of authentic leadership was 3.25 (SD 0.83), psychological capital was 4.85 (SD 0.89), and innovative behaviour was 2.82 (SD 0.84). Authentic leadership perceived by nurses, psychological capital, and innovative behaviour were statistically significant and positively correlated with each other (r = 0.524 ~ 0.806, p < 0.01). Psychological capital significantly mediated the association between authentic leadership and innovative behaviour (β = 0.449, p < 0.001), and its mediating effect accounted for 76.75% of the total effect. Conclusion: Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' psychological capital and innovation behaviour. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the factors that influence the level of flourishing among nursing students. Design: Cross‐sectional study. Methods: A multistage sampling technique was used to recruit 328 undergraduate nursing students from a nursing college. Data were collected from February to June 2023 using the Global Flourishing Study (GFS) questionnaire, which assesses six domains of flourishing and their determinants. To ensure reliability and validity, a pilot study was conducted and a thorough validation process was employed. Results: The Flourishing Index ranged from 24.0 to 100.0, with an average score of 74.2 (SD = 14.8). Well‐being, disposition and behaviour, as well as external factors, correlated strongly positively with the Flourishing Index (r = 0.741, r = 0.565, r = 0.596, all p < 0.001). The Flourishing level was significantly negatively correlated with religion (r = −0.381, p < 0.001). Married participants had a significantly negative association with flourishing (p = 0.009). Disposition and behaviour were significantly and positively associated with flourishing (p = 0.017). The regression model had goodness of fit (R2 = 0.628) and was significant overall (F = 108.703, p = 0.001). The Flourishing model was established based on well‐being, external factors, religion, disposition and behaviour, and marital status. Conclusion: Positive correlations between flourishing and well‐being, disposition and external factors suggest areas of improvement. Conversely, the negative association with religion emphasizes the necessity of culturally sensitive approaches. Future studies with larger and more diverse samples, as well as additional variables, are crucial to obtain a deeper understanding of the factors that influence flourishing among nursing students in Saudi Arabia. [ABSTRACT FROM AUTHOR]

We aimed to assess the quality and reliability of pressure injury‐related videos uploaded on YouTube, analyse the sources and contents, and examine the correlation between video parameters. We searched YouTube using two keywords, "pressure ulcer" and "pressure sore", on August 20, 2022. We sorted the videos according to their number of views and included the top 100 videos for each keyword. The quality of videos was assessed using the Global Quality Scale (GQS), while their reliability was evaluated by the modified DISCERN (mDISCERN) tool. In addition, we evaluated the videos in which content was included, analysed the correlations and differences between GQS, mDISCERN, and video parameters. We initially found a total of 100 videos for each keyword and finally included and analysed 77 videos. The mean scores for the mDISCERN and GQS were 2.35 ± 0.98 and 3.09 ± 0.99, respectively. Both GQS and mDISCERN showed statistically significant correlations with each other (rho = 0.54, p < 0.0001*) and with the length of the videos, respectively (rho = 0.36, p = 0.001*), (rho = 0.29, p = 0.01*). Of the videos created by physicians, 8 (57.1%) included content related to treatment, while of the videos created by nonphysician health personnel, 22 (57.9%) included content related to prevention. Analysing whether there were differences in video parameters based on the sources, we observed significant differences between sources in GQS (p < 0.0001*), mDISCERN (p < 0.0001*), and video length (p = 0.001*). In the post‐hoc analysis, videos uploaded by physicians or nonphysician health personnel showed higher quality and reliability than videos uploaded by other sources. Therefore, the results of this study could be useful for healthcare providers, as well as patients and caregivers, to search for high‐quality and reliable YouTube videos related to pressure injury. [ABSTRACT FROM AUTHOR]

Introduction: Hypothermia is a well‐recognised finding in trauma patients, which can occur even in warmer climates. It is an independent predictor of increased morbidity and mortality. It is associated with pre‐hospital intubation, although the reasons for this are likely to be multifactorial. Core temperature drop after induction of anaesthesia is a well‐known phenomenon in the context of elective surgery, and the mechanisms of this are well established. Methods: We conducted a prospective observational study to examine the behaviour of core temperature in patients undergoing pre‐hospital anaesthesia for traumatic injuries. Results: Between 2017 and 2021 data were collected on 48 patients. The data from 40 of these were included in the final analysis. Discussion: Our data do not show a decrease in the core temperatures of patients who receive pre‐hospital anaesthesia, unlike patients who are anaesthetised without pre‐warming, in operating theatres. The lack of a change could relate to patient, anaesthetic or environmental factors. [ABSTRACT FROM AUTHOR]

Objectives: To examine trends in incidence and mortality and evaluate overall survival (OS) of oral cancer in Singapore between 1968 and 2017. Methods: All diagnosed oral cancers by anatomical sites and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore. The trend of age‐standardized incidence rate (ASIR) and mortality rate (ASMR) (per 100 000 person‐years) of the lip, oral cavity and salivary gland cancers were evaluated by Prais‐Winsten regressions for each ethnicity and gender. Kaplan–Meier curves were performed to evaluate the OS by anatomical sites in each age group by ethnicity and sex. Results: Overall, 49, 3494 and 1066 people were diagnosed, and 28, 2310 and 476 died from lip, oral cavity and salivary gland cancers, respectively. The oral cavity cancer ASIR and ASMR reduced from 3.07 (1968–1972) to 2.01(2008–2012) and from 2.06 (1978–1982) to 1.21 (2013–2017) per 100 000 person‐years, respectively, with both highest in Indians throughout the whole period. Male:Female ratio ranged from 3.43 (1973–1977) to 1.75 (2013–2017) and from 3.41 (1978–1982) to 2.40 (2013–2017) for ASIR and ASMR, respectively. However, both salivary gland cancer ASIR and ASMR increased from 0.50 (1968–1972) to 0.80 (2008–2012) and from 0.18 (1968–1982) to 0.42 (1988–1992) per 100 000 person‐years, respectively, with both higher in males since 1993. Oral cavity cancer ASIR decreased for males aged ≥60, and Indian females ≥25, but increased among Chinese females aged ≥60. Oral cavity cancer ASMR decreased among Chinese aged 25–59, and among Malay males and Indian females. Salivary gland cancer ASIR increased among Chinese males aged ≥60 and Malay males aged 25–59; while ASMR increased among Chinese males aged ≥60. The median OS for oral cavity, lip and salivary gland cancers were 3.0, 9.3 and 18.1 years, respectively, with females surviving longer than males. Conclusions: Singapore has experienced a decline in the incidence and mortality of lip, oral cancer, an increase in in the incidence and mortality of salivary gland cancer, with an increase in the median overall survival rate. Monitoring the magnitude of oral cancer burden and the demographic, and temporal variations is necessary for tailoring health planning and setting priorities for future clinical care and research. [ABSTRACT FROM AUTHOR]

Summary: Effect sizes from previously reported trials are often used to determine the meaningful change in weight in childhood obesity prevention interventions because information on clinically meaningful differences is lacking. Estimates from previous trials may be influenced by statistical significance; therefore, it is important that they have a low risk of type 1 error. A systematic review and meta‐analysis were conducted to report on the design of child obesity prevention randomized controlled trials and effectiveness according to risk of type 1 error. Eighty‐four randomized controlled trials were identified. A large range of assumptions were applied in the sample size calculations. The most common primary outcome was BMI, with detectable effect size differences used in sample size calculations ranging from 0.25 kg/m2 (followed up at 2 years) to 1.1 kg/m2 (at 9 months) and BMI z‐score ranging from 0.1 (at 4 years) to 0.67 (at 3 years). There was no consistent relationship between low risk of type 1 error and reports of higher or lower effectiveness. Further clarity of the size of a meaningful difference in weight in childhood obesity prevention trials is required to support evaluation design and decision‐making for intervention and policy. Type 1 error risk does not appear to impact effect sizes in a consistent direction. [ABSTRACT FROM AUTHOR]

Summary: This paper reviews the effectiveness of four types of front‐of‐pack nutrition labels (FoPLs) in influencing calorie purchases. The four FoPL types are poised for unified implementation across European countries. Further, this study extends its analysis to evaluate the impacts of the voluntary adoption of these FoPLs within 27 EU nations. Nutri‐Score displays higher potential for yielding positive health and economic outcomes, compared with other FoPLs. Across EU countries, Nutri‐Score is projected to avert nearly two million cases of non‐communicable diseases, in total, between 2023 and 2050. Keyhole demonstrates effects of a similar magnitude but with no statistical significance. Nutri‐Repere shows smaller impacts, while Nutri‐Couleurs has non‐significant effects. Nutri‐Score is projected to significantly lower annual healthcare spending by 0.05%, whereas the other labels have negligible impacts. By reducing cases of disease, FoPLs have the potential to improve employment and work productivity. Nutri‐Score surpasses the other labels with an estimated annual gain of 10.6 full‐time equivalent workers per 100,000 individuals of working age across EU countries. In all, mandatory implementation of any of the four labels would lead to greater effects than those obtained with a voluntary implementation, providing evidence to inform legislation proposal for an EU‐wide nutrition labelling system. [ABSTRACT FROM AUTHOR]

Background: Even though monitoring and control enactment are key aspects of self‐regulated learning (SRL), Adaptive learning technologies (ALTs) may reduce the need for learners to monitor and control their learning. Personalized dashboards are effective in supporting learners' monitoring and can potentially support control behaviour. Allowing learners to enact control over their learning process, seems to hold potential for increasing their motivation. Objectives: Therefore, this study's aim was to investigate the relation between control enactment and motivation. We examined how learners enacted control while learning with an ALT with personalized dashboards and examined the relation between learners' enactment of control and their motivation. Methods: Seventy‐eight primary school learners (Grade 5) participated. During the lesson, learners worked on mathematics in the ALT and concurrently were shown personalized visualizations that supported monitoring and enacting control over their learning process. Learners could enact control to change problems' difficulty to easy, medium, or hard. Motivation was measured before and after learning. Results: The SEM analyses showed that how learners enacted control was related to their motivation. Choosing difficult problems was related to more enjoyment and competence while choosing easy problems related to more pressure and tension. Learners who complied with the suggested difficulty level experienced less choice, but also less pressure/tension and more enjoyment and competence. Conclusions: These results provide avenues to account for broader learner characteristics like SRL and motivation to optimize learning. This way, hybrid systems in which control enactment is a shared responsibility of the system and learner, can be improved to support SRL development. Lay Description: What is currently known: Monitor and control enactment are key aspects of self‐regulated learning (SRL).Adaptive learning technologies may reduce the need for learners to monitor and control their learning.Personalized dashboards support learners' monitoring behaviour and can potentially also support control enactment.Enactment of control could positively affect learners' motivation. What does this paper add: There is a large variation in how learners enact control and whether they comply with the scaffold.Learners who chose more difficult problems experienced more enjoyment, while learners choosing easy problems, experienced more pressure.Learners complied with the scaffold, experienced less choice, but also less pressure and more enjoyment.This study provides avenues to account for broader learner characteristics like SRL and motivation to optimize learning. Practical implications: Support control enactment by actively involve learners in choice during the learning process.Offer monitor and enactment in conjunction, as learners can only make well‐founded choices if they can monitor their learning process.Intrinsically and extrinsically motivated learners showed different choice patterns and learning experience.It is important to have an understanding and monitoring of learners' motivation. [ABSTRACT FROM AUTHOR]

Even after adopting various measures, recent years have witnessed a surge in environment‐related issues such as pollution and climate change. These issues have been considered anthropogenic, and it is a well‐received notion that changing human behaviour is crucial for sustainable development. Promoting pro‐environmental behaviour (PEB) requires understanding of associations among relevant factors; the present study aimed to explore the same among a few less‐explored constructs, which, along with other factors, may significantly explain pro‐environmental behaviour. The study examined the direct relationship of PEB with ecological intelligence (EI) and self‐transcendent values. Also, it explored the mediating effects of implementation‐intentions and the moderating effect of the "new ecological paradigm" (NEP) on PEB. The data were obtained from 400 adult participants using a set of standardized questionnaires. The results showed significant direct and indirect associations among EI, self‐transcendent values, implementation‐intentions, the NEP and PEB. Implementation‐intentions significantly mediated the relationship of EI and values with PEB, and the mediation was moderated by the NEP. Individuals low on EI but endorsing the NEP showed implementation‐intentions similar to those with high EI. Knowledge of the interplay among these factors can be utilized to design interventions for promoting PEB. [ABSTRACT FROM AUTHOR]

The main objective of most clinical trials is to estimate the effect of some treatment compared to a control condition. We define the signal‐to‐noise ratio (SNR) as the ratio of the true treatment effect to the SE of its estimate. In a previous publication in this journal, we estimated the distribution of the SNR among the clinical trials in the Cochrane Database of Systematic Reviews (CDSR). We found that the SNR is often low, which implies that the power against the true effect is also low in many trials. Here we use the fact that the CDSR is a collection of meta‐analyses to quantitatively assess the consequences. Among trials that have reached statistical significance we find considerable overoptimism of the usual unbiased estimator and under‐coverage of the associated confidence interval. Previously, we have proposed a novel shrinkage estimator to address this "winner's curse." We compare the performance of our shrinkage estimator to the usual unbiased estimator in terms of the root mean squared error, the coverage and the bias of the magnitude. We find superior performance of the shrinkage estimator both conditionally and unconditionally on statistical significance. [ABSTRACT FROM AUTHOR]

Background: Transthoracic echocardiography (TTE) plays a key role in the initial work‐up of myocarditis where the identification of pathologic structural and functional changes may assist in its diagnosis and management. The aim of this systematic review was to appraise the evidence for the utility of echocardiographic parameters of cardiac structure and function in the diagnosis of myocarditis in adult populations. Methods: A systematic literature search of medical databases was performed using PRISMA principles to identify all relevant studies assessing TTE parameters in adult patients with myocarditis (1995–2020; English only; PROSPERO registration CRD42021243598). Data for a range of structural and functional TTE parameters were individually extracted and those with low heterogeneity were then meta‐analyzed using a random‐effects model for effect size, and assessed through standardized mean difference (SMD). Results: Available data from six studies (with a pooled total of 269 myocarditis patients and 240 controls) revealed that myocarditis can be reliably differentiated from healthy controls using echocardiographic measures of left ventricular (LV) size and systolic function, in particular LV end‐diastolic diameter, LV ejection fraction (LVEF) and LV global longitudinal strain (LV‐GLS) (p ≤.01 for all). LV‐GLS demonstrated the highest overall effect size, followed by LVEF and LVEDD (SMD: |0.46–1.98|). Two studies also demonstrated that impairment in LV‐GLS was associated with adverse cardiovascular outcomes in this population, irrespective of LVEF. Conclusions: LV‐GLS demonstrated the greatest overall effect size and therefore ability to differentiate myocarditis populations from healthy controls. GLS was also shown to be a predictor of adverse cardiovascular outcomes, in this population. Hightlights: What is already known on this subject? Myocarditis is a disease process that is often a diagnosis of exclusion, as it frequently mimics other acute cardiac pathologies.Transthoracic echocardiography is traditionally the initial imaging modality used for noninvasive structural assessment in populations with myocarditis. What might this study add? This study demonstrates that left ventricular (LV) global longitudinal strain, LV ejection fraction and LV end‐diastolic diameter can differentiate between myocarditis patients and healthy controls.LV‐GLS demonstrated the greatest overall effect size when comparing these two populations, in comparison to the other measures. How might this impact on clinical practice? This study demonstrates that assessment of myocardial deformation indices allows for sensitive discrimination between myocarditis patients from healthy controls.Routine assessment of LV‐GLS may serve as an important diagnostic tool in the acute care setting. [ABSTRACT FROM AUTHOR]

Introduction: Patients in emergency departments (EDs) constitute a diverse population with multiple health‐related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines the interaction effect of depression, posttraumatic stress disorder (PTSD), impulsivity, drug use, adverse childhood experiences (ACEs), at‐risk drinking, and having a hazardous drinker partner with gender on mutual physical IPV in an urban ED sample. Methods: Research assistants surveyed 1037 married, cohabiting, or partnered patients in face‐to‐face interviews (87% response rate) regarding IPV exposure, alcohol and drug use, psychological distress, ACEs, and other sociodemographic features. IPV was measured with the Revised Conflict Tactics Scale. Interaction effects were examined in multinomial and logistic models. Results: Results showed a significant interaction of gender and PTSD (odds ratio [OR] 3.06, 95% CI 1.21–7.23, p < 0.05) for mutual IPV. Regarding main effects, there were also statistically significant positive associations between mutual physical IPV and at‐risk drinking (OR 1.73, 95% CI 1.07–2.77, p < 0.05), having a hazardous drinker partner (OR 2.19, 95% CI 1.35–3.55, p < 0.01), illicit drug use (OR 2.09, 95% CI 1.18–3.71, p < 0.01), ACEs (OR 1.23, 95% CI 1.06–1.42, p < 0.01), days of cannabis use past in the 12 months (OR 1.003, 95% CI 1.002–1.005, p < 0.001), and impulsivity (OR 2.04, 95% CI 1.29–3.22, p < 0.01). Conclusions: IPV risk assessment in EDs will be more effective if implemented with attention to patients' gender and the presence of various and diverse other risk factors, especially PTSD. [ABSTRACT FROM AUTHOR]

Motivated by the puzzling null impact of high‐frequency‐based jumps on future volatility, this paper exploits the rich information content in high‐frequency jump intensity with a mark structure under the heterogeneous autoregressive framework. Our proposed model shows that harnessing jump intensity information from the marked Hawkes process leads to significantly superior in‐sample fit and out‐of‐sample forecasting accuracy. In addition to statistical significance evidence, we also illustrate the economic significance in terms of trading efficiency. Our findings hold for a variety of competing models and under different market conditions, underlying the robustness of our results. [ABSTRACT FROM AUTHOR]

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While triple inhalation therapy is commonly employed in the treatment of chronic obstructive pulmonary disease (COPD), limited knowledge exists regarding its impact on the healing of minor wounds and integrity of the epidermis. This study investigated the impact of combining triple inhalation therapy with double bronchodilators on the aforementioned parameters in patients with stable COPD. A cross‐sectional study was conducted in Changzhou, China, from March 2022 to October 2023, involving 540 patients who had received the diagnosis of stable COPD. Combined therapy participation requirements stipulated a minimum of 6 months of uninterrupted treatment. Dermatological examinations, demographic data and clinical records were utilized to collect information regarding the elasticity, moisture content and duration of wound healing. The research revealed that there were no statistically significant differences in demographic and clinical characteristics between the groups that received triple inhalation alone and triple inhalation in combination with double bronchodilators (p > 0.05). Nevertheless, the combined therapy group demonstrated shorter duration since receiving a diagnosis of COPD (p < 0.05). It is noteworthy to remark that the combined therapy group exhibited significantly higher skin moisture content and shorter interval for wound recovery when compared with the group that only received triple inhalation (p < 0.05). Lung function measurements in combined therapy group indicated enhanced Forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity ratio, as well as a reduction in COPD exacerbations. Nevertheless, no statistically significant distinction in skin elasticity was observed among the groups (p > 0.05). The supplementary application of triple inhalation therapy and double bronchodilators in stable COPD patients not only improved respiratory outcomes but also positively impacted skin health, specifically by promoting wound healing and augmenting moisture levels. These results highlighted the possible benefits of implementing a holistic treatment approach in COPD, suggesting that incorporating these therapies could offer additional advantages to the epidermis. [ABSTRACT FROM AUTHOR]