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Values such as peace, mutual understanding, and solidarity have long been subsidiary to the aim of pursuing competition and revenue through the internationalization of higher education (HE). With the full-scale Russian invasion of Ukraine in February 2022, higher education institutions demonstrated strong support for peace and solidarity. Yet, the extent to which we are witnessing a return to an international politics rationale driving HE internationalization remains unclear. Using Canada and Germany as case studies, this paper compares how international conflict impacts HE internationalization practices from a host institution perspective. The developed theoretical framework connects HE crisis literature with novel approaches to HE institutions in global geopolitics. Data were analyzed through critical policy analysis, focusing on university presidents' statements and institutional press releases. The key finding suggests the dominance of the logic of appropriateness whereby a geopolitical rationale governs institutional responses in a context where widely shared democratic values are under attack.

Background: African American men (AAM) have persistently had the highest incidence and mortality rates for prostate cancer (PrCa) in the United States. Considering that current guidelines recommend the practice of shared decision-making to determine whether or not to undergo a Prostate-Specific Antigen (PSA) test for the early detection of PrCa, this study focuses on the identification of key factors influencing AAM decisions regarding having or not having PSA screenings. Methods: Cross-sectional study of 152 AAM who completed study surveys. Statistical analysis included frequencies, means, and distributions and methods to test for differences in knowledge confidence, satisfaction and, self-efficacy when making decisions. Results: 94% of participants would get a PSA test if offered, only 57% knew that the PSA test is a blood test. Participants who reported having had a PSA test before the baseline had significantly higher mean scores than their counterparts in the knowledge about the definition of the PSA and biopsy exams (p = 0.04), and in the confidence (p = 0.005) and efficacy (p = 0.002) scales when making PSA screening decisions. Older participants were more likely to have had a PSA test (p < 0.0001) and to intend to screen (p = 0.0441). Conclusions: Significant differences in the satisfaction scale by clinical site (p < 0.001) may underscore the influence of clinicians’ practices in participants’ satisfaction with their decisions. Results suggest that patients’ experience of care has the potential to positively influence PSA screening. It is our call that type of health insurance, knowledge about PrCa and PSA, and having had a PSA test in the past, as well as the patient’s characteristics (age, race and family history of PrCa) be considered when discussing with patients the harms/benefits of PSA screening and their preferences to have or not have the PSA test.

There are unique challenges that arise from participating in remote clinical trials. Broadly, findings suggest that participants enrolled in digital intervention trials are more likely to disengage or prematurely dropout than participants in face-to-face trials. Thus, optimizing contact with participants via video-conferencing platforms to build rapport and encourage commitment to the study is critical. Still, challenges with video-conferencing visits can pose challenges. Some of these challenges include a lack of clarity about study requirements, difficulties demonstrating staff engagement and building rapport, and the technical challenges of using video-conferencing software. These challenges can affect participant retention, study validity, and the willingness of underserved groups to participate in research. In the context of a remote randomized clinical trial evaluating a digital intervention for prenatal insomnia, we discuss strategies used to counteract these challenges, including the use of virtual orientation sessions, and practical recommendations to improve staff engagement with participants. These findings are relevant to research teams conducting remote clinical trials, especially those seeking to recruit and retain participants from populations currently and historically underrepresented in research.

Introduction Although there has been a significant and steady increase nationwide in the number of physician assistant/associate (PA) and nurse practitioner (NP) postgraduate residency/fellowship programs, there remains a paucity of research related to the level of operational support available in many of these programs to facilitate specialty training. Therefore, the primary aim of this study is to conduct a national survey to gather foundational data regarding advanced practice provider (APP) postgraduate fellowship/residency operational support and program director total compensation data in the United States. Methodology A descriptive cross-sectional survey consisting of 27 questions was distributed via email to 336 postgraduate NP, PA, joint NP/PA, and certified nurse-midwifery residency/fellowship programs between November 2023 and December 2023. Frequency tables and descriptive statistics were used to summarize the survey data. Additionally, Spearman's rank correlation coefficients were performed to determine the relationship between the dependent variables and the independent variable. Results There was a statistically significant positive relationship between the organization values the postgraduate program and having sufficient administrative time (rs = 0.342, p < 0.001), having adequate support staff (rs = 0.340, p < 0.001), and being fairly compensated (rs = 0.356, p < 0.001) for program roles and responsibilities. Moreover, slightly less than half of respondents reported having adequate support staff and sufficient administrative time to address program responsibilities. Only 50% of respondents believed they were fairly compensated for their position. Respondents moderately agreed that their organization values the postgraduate training program (M = 4.00, SD = 1.00). Conclusions The results of this study highlight the perceptions of postgraduate program directors regarding adequate administrative support and resources to facilitate specialty-specific training for NPs and PAs. Further research is warranted to evaluate the level of operational support needed to develop and sustain postgraduate APP residency/fellowship training programs now and in the future.

For more than two decades, nanoparticles have attracted a great deal of attention from researchers and developers. When properly designed, vectorized nanoparticles represent high-value-added tools with potentially invaluable properties in a number of areas, including biology, biotechnology, and medicine owing to their exceptional physico-chemical properties, especially resulting from their high surface area, high loading capacity, and nanoscale size. Smart design and building of nanoparticles through appropriate surface chemistry and functionalization provide a material that possesses multifunctional capabilities, able to specifically interact with a selected target, release a compound in a controlled and sustained way, and overcome, if desired, biological barriers such as the blood–brain barrier or lung barriers of interest. Unique constructions have thus opened up original and innovative possibilities in biotechnological and biomedical fields such as imaging, biosensors, rapid diagnostics, drug delivery, medical implants, and tissue engineering. This article briefly describes the main types of nanoparticles that have been developed and their advantages and disadvantages depending on the intended application, and highlights some remarkable results achieved recently in the biomedical field. Certain dangers or fears regarding their use in human and animal therapy or for users have been mentioned. Finally, conclusions and future perspectives are provided.

AIMS: We aimed to explore atrial fibrillation (AF)-induced productivity losses in working-age atrial fibrillation patients and to estimate atrial fibrillation-related indirect costs. METHODS: Between 2014 and 2017, the Swiss Atrial Fibrillation prospective cohort study (Swiss-AF) enrolled 217 working-age patients with documented atrial fibrillation. Self-reported changes in professional activity and the reasons thereof were descriptively analysed over 8 years of follow-up or until patients reached the retirement age. Results were put into perspective, and indirect costs were planned to be estimated, through comparison with a general population-based, age-, sex- and year-matched comparison sample from the Swiss labour force survey (SLFS). RESULTS: Of 217 analysed Swiss-AF patients, 14.7% reported a professional activity change (9.2% stop, 5.5% reduction) due to atrial fibrillation before the end of observation. Of those working at enrolment (n = 157), 3.8% had a subsequent professional activity change due to atrial fibrillation, 11.6% due to other reasons. Patients were more likely to report an impact of atrial fibrillation on professional activity if they had had atrial fibrillation longer and were closer to the retirement age. Slightly fewer Swiss-AF patients were employed (75%) than in the comparison sample (77%). For those working however, the degree of employment was higher (88% vs 83%). Lack of differences between the Swiss-AF patients and the comparison sample indicated no relevant indirect costs of atrial fibrillation due to lost productivity. CONCLUSION: Only a minority of atrial fibrillation patients reported a negative impact of atrial fibrillation on their professional activity. Professional activity changes due to other reasons were reported more frequently. Compared with the general population, atrial fibrillation did not cause distinct differences.

Introduction Total pelvic exenteration (TPE) for clinical T4b colorectal cancer (CRC) is associated with significant morbidity. Short (0-30 days)- and intermediate (31-90 days)-term temporal analysis of complication onset is not well described, yet needed, to better counsel patients considering TPE. Methods A retrospective cohort study of consecutive patients with primary or recurrent clinical T4b pelvic CRC undergoing open TPE between 2014 and 2023 was conducted. Clinicopathologic variables were collected for each patient. Postoperative morbidity was classified according to the Clavien-Dindo (CD) grade system and stratified by time of onset within 90 days of surgery. Pearson’s Chi-square test, Fisher’s Exact test, and the Mann-Whitney U test were used to compare primary vs recurrent patient groups, and logistic regression assessed predictors of postoperative morbidity. Statistical analysis was performed using R with two-sided significance set at

This paper presents a comparison of different route choice models for cyclists. The data includes approx. 3,700 cycling trajectories. The network is derived based on the Open-Street-Map that contains street-level attribute information. We estimate two path-based and one link-based models. We present descriptive statistics, model results, resulting indicators, and compare different validation approaches. The results reveal important differences across the models, especially in context of applications and policy-making.

The matriculation, retention, and graduation of students is a critical and ongoing effort in undergraduate engineering education. Implementing measures is vital in increasing student motivation to continue pursuing engineering and is especially important for individuals from low-income and academically talented students. At the University of Illinois at Chicago, our NSF Scholarships in Science, Technology, Engineering, and Mathematics Program includes students from all six departments in the College of Engineering and includes multiple implementations such as a summer bridge program, faculty mentoring, and a service-learning project. Here, we define and implement a longitudinal Industry Mentorship (IM) program structure. While the implementation of this program is still ongoing, we present here the basic structure of the IM program, the rationale for the structure, and some preliminary results of implementation.

ObjectiveThe authors investigated associations between rates of contact with individuals in distress during field visits by mobile crisis teams and client and referral source characteristics.MethodsIn this retrospective observational study of an urban mobile crisis program, call logs (N=2,581) were coded for whether an attempted field visit resulted in a client evaluation. Logistic regression analyses examined potential associations with client age, gender, race-ethnicity, primary language, living situation, insurance, and referral source.ResultsContact was made with 77% of adults and 97% of children referred to mobile crisis teams. Field visit contact rates differed by age. Unsuccessful visits were more likely when the referral source was from institutional settings than from individuals.ConclusionsApproximately one-quarter of attempted field visits with adults by an urban mobile crisis team were not completed, particularly among referrals from institutional settings. As mobile crisis services proliferate, field visit contact rate could be a key performance metric for these critical services.

Colorectal cancer, developing from malignant transformation of the distal gut epithelium, is the second leading cause of cancer death in the United States. We present a gentleman in his 60s who was diagnosed with colorectal cancer during a routine screening colonoscopy with no evidence of distant metastasis on subsequent staging with positron emission tomography and computed tomography (PET-CT). The outside rectal MR (magnetic resonance) imaging report localized a mass to the upper rectum. Review of the MRI at an institutional, Multidisciplinary Tumor Board designated the tumor as “rectosigmoid,” straddling the rectosigmoid junction at the level of the “sigmoid take-off” (STO) or alternatively at the level of the last sigmoid artery take-off (SAT) at the origin of the superior rectal artery. The anatomic differentiation between upper rectal and lower sigmoid colon cancers carries clinical importance which is highlighted in this case report and brief literature review. Optimal anatomic localization of colorectal cancers helps direct the clinical team to tailor an individualized patient care plan.

Background:. The lateral supramalleolar flap is a useful local flap for defects around the lateral malleolus. However, this flap is classically harvested subfascially, which requires superficial peroneal nerve (SPN) transection with loss of dorsal foot sensation and potential for chronic pain. We explore whether suprafascial harvest with nerve preservation results in a viable flap. Methods:. Clinical cases include five patients who presented with a soft tissue defect at the lateral malleolar area. The etiologies included traumatic, decubitus, and chronic wounds. The suprafascial lateral supramalleolar flap was performed to reconstruct the defect while preserving the SPN. Results:. Four flaps and one flap were performed as one-stage operation and delayed fashion, respectively. All flaps survived without complications. The SPN was identified and preserved in all cases. Postoperatively, the sensory distribution of the SPN was maintained in all patients. Conclusion:. The lateral supramalleolar flap can be safely raised in the suprafascial plane, sparing the SPN.

OBJECTIVE: To evaluate whether sleep apnea or insomnia among pregnant people is associated with increased risk for adverse infant outcomes. DESIGN: Retrospective cohort study SETTING: California PARTICIPANTS: The sample included singleton live births. Sleep apnea and insomnia were defined based on ICD-9 and -10 codes. A referent group was selected using exact propensity score matching on maternal characteristics, obstetric factors, and infant factors among individuals without a sleep disorder. MEASUREMENTS: Adverse infant outcomes were obtained from birth certificate, hospital discharge, and death records (eg, Apgar scores, neonatal intensive care unit (NICU) stay, infant death, long birth stay, etc.). Logistic regression was used to calculate odds of an adverse infant outcome by sleep disorder type. RESULTS: Propensity-score matched controls were identified for 69.9% of the 3371 sleep apnea cases and 68.8% of the 3213 insomnia cases. Compared to the propensity-matched referent group, individuals with a diagnosis of sleep apnea (n = 2357) had infants who were more likely to have any adverse outcome, low 1-min Apgar scores, NICU stay, and an emergency room visit in the first year of life. Infants born to mothers with a diagnosis of insomnia (n = 2212) were at increased risk of few negative outcomes relative to the propensity matched referent group, with the exception of an emergency room visit. CONCLUSIONS: In unadjusted analyses, infants born to individuals with a diagnosis of sleep apnea or insomnia were at increased risk of several adverse outcomes. These were attenuated when using propensity score matching, suggesting these associations were driven by other comorbidities.

Poor prenatal sleep quality is associated with increased risk for depressive symptoms but may go undetected in brief, busy prenatal care visits. Among non-depressed pregnant participants, we evaluated whether 1) the endorsement of sleep disturbance on a depression questionnaire predicted postpartum depressive symptoms, 2) the strength of these associations was higher than other somatic symptoms of pregnancy and depression (i.e., fatigue, appetite disturbance), and 3) the endorsement of prenatal sleep disturbance varied by participant characteristics. In this retrospective cohort study, participants had a live birth and completed Patient Health Questionnaire (PHQ-9) during pregnancy and within 8 weeks postpartum between 2012 and 2017. Participants who were non-depressed during pregnancy (PHQ-9 < 10) were included (n = 3619). We operationalized sleep disturbance, fatigue, and appetite disturbance as endorsement of item 3, 4, and 5 on the PHQ-9, respectively, and postpartum depressive symptoms as PHQ-9 total score ≥ 10. Participant characteristic variables included age, race, ethnicity, parity, gestational age at delivery, and preterm birth. Prenatal sleep disturbance was associated with higher odds of postpartum depressive symptoms (aORs 1.9, 95% CI 1.2-3.1 for first trimester; 3.7, 95% CI 1.5-11.5 for second trimester; 3.4, 95% CI 1.9-6.8 for third trimester). Fatigue and appetite disturbance in the first and third trimesters were associated with higher odds of postpartum depressive symptoms. Sleep disturbance varied by race during the first and second trimesters (p < 0.05) and was highest among Black or African American participants (61.8-65.1%). A routinely administered single-item measure of sleep disturbance could identify otherwise lower-risk pregnant individuals who may benefit from depression prevention efforts.

PURPOSE: This study (1) assessed the psychometric properties of a pregnancy-related COVID worry scale, (2) explored variations in pregnancy-related COVID worry over the course of the pandemic, and (3) examined associations between pregnancy-related COVID worry and depressive symptom severity, and evaluated sleep disturbance as a mediator. METHODS: Data were drawn from an ongoing randomized trial comparing the effectiveness of two enhanced forms of prenatal care. The current analysis includes baseline pre-randomization data collected from participants who enrolled November 2020-November 2021 (n = 201). Participants were pregnant individuals with low income and primarily Latinx. RESULTS: Our 7-item scale was valid and reliable for assessing pregnancy-related COVID worry. Pregnancy-related COVID worry did not vary significantly by any participant characteristic or pandemic stage. Pregnancy-related COVID worry was significantly associated with depressive symptom severity in multivariate analysis (p = .002). For each unit increase on the 10-point pregnancy-related COVID worry scale, the odds of mild-to-severe depression increased by 16% (odds ratio = 1.16, 95% confidence interval 1.02-1.32, p = .02), holding all other variables constant. Sleep disturbance mediated the pregnancy-related COVID worry-depressive symptom relationship (48% of the total effect mediated). CONCLUSIONS: Worry about how COVID may impact their baby, birth, and postpartum experiences was associated with higher depressive symptom severity, partly through its effect on sleep. These findings suggest that interventions related to improving sleep quality among perinatal populations may reduce depressive symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT04154423, Engaging Mothers & Babies; Reimagining Antenatal Care for Everyone (EMBRACE) Study.

BackgroundMindfulness-based cognitive therapy (MBCT) is an effective group intervention for reducing rates of depression relapse. However, about one-third of graduates experience relapse within 1 year of completing the course.ObjectiveThe current study aimed to explore the need and strategies for additional support following the MBCT course.MethodsWe conducted 4 focus groups via videoconferencing, two with MBCT graduates (n = 9 in each group) and two with MBCT teachers (n = 9; n = 7). We explored participants' perceived need for and interest in MBCT programming beyond the core program and ways to optimize the long-term benefits of MBCT. We conducted thematic content analysis to identify patterns in transcribed focus group sessions. Through an iterative process, multiple researchers developed a codebook, independently coded the transcripts, and derived themes.ResultsParticipants said the MBCT course is highly valued and was, for some, "life changing." Participants also described challenges with maintaining MBCT practices and sustaining benefits after the course despite using a range of approaches (ie, community and alumni-based meditation groups, mobile applications, taking the MBCT course a second time) to maintain mindfulness and meditative practice. One participant described finishing the MBCT course as feeling like "falling off a cliff." Both MBCT graduates and teachers were enthusiastic about the prospect of additional support following MBCT in the form of a maintenance program.ConclusionSome MBCT graduates experienced difficulty maintaining practice of the skills they learned in the course. This is not surprising given that maintained behavior change is challenging and difficulty sustaining mindfulness practice after a mindfulness-based intervention is not specific to MBCT. Participants shared that additional support following the MBCT program is desired. Therefore, creating an MBCT maintenance program may help MBCT graduates maintain practice and sustain benefits longer-term, thereby decreasing risk for depression relapse.

PurposePerinatal depression is the most common complication of pregnancy and childbirth, and it is associated with adverse consequences. The United States Preventive Services Task Force (USPSTF) recommends that pregnant and postpartum (i.e., perinatal) individuals at risk for depression be referred for therapy or counseling interventions; however, it is unclear to what extent this recommendation has been implemented.MethodsPregnant individuals were recruited via advertisements on a pregnancy app and a separate study on sleep. Respondents completed the initial screening questions to determine their risk for perinatal depression, defined as self-reported history of depression; recent stressors; history of emotional, sexual, or physical abuse; mild depressive symptoms; anxiety symptoms; single; diabetes diagnosis; or unwanted pregnancy. Eligible respondents reported their providers' recommendations for preventing depression, and their utilization of interventions to prevent depression (n = 303).ResultsFewer than 15% of participants reported that a provider referred them for therapy or counseling to prevent depression; recommendations included cognitive behavioral therapy (4%), interpersonal psychotherapy (2.3%), mindfulness-based cognitive therapy (4.3%), or other/unknown (6.6%). Approximately 12% reported that a provider recommended medication to prevent depression. Provider referral rates varied by risk factor, but not by patient demographics. Nearly 20% of participants reported using therapy or counseling to prevent depression, and nearly 13% reported using medication to prevent depression.ConclusionsWe explore potential factors affecting the uptake of the USPSTF recommendation and underscore the importance of preventing perinatal depression.

BackgroundThe excess incidence and mortality due to prostate cancer that impacts African American men constitutes the largest of all cancer disparities. Patient navigation is a patient-centered healthcare system intervention to eliminate barriers to timely, high-quality care across the cancer continuum and improves health outcomes among vulnerable patients. However, little is known regarding the extent to which navigation programs include cultural humility to address prostate cancer disparities among African American men. We present a scoping review protocol of an in-depth examination of navigation programs in prostate cancer care-including navigation activities/procedures, training, and management-with a special focus on cultural context and humility for African American men to achieve health equity.MethodsWe will conduct comprehensive searches of the literature in PubMed, Embase, Web of Science, and CINAHL Complete, using keywords and index terms (Mesh and Emtree) within the three main themes: prostate cancer, patient navigation, and African American men. We will also conduct a search of the gray literature, hand-searching, and reviewing references of included papers and conference abstracts. In a two-phase approach, two authors will independently screen titles and abstracts, and full-text based on inclusion/exclusion criteria. All study designs will be included that present detailed data about the elements of navigation programs, including intervention content, navigator training, and/or management. Data will be extracted from included studies, and review findings will be synthesized and summarized.DiscussionA scoping review focused on cultural humility in patient navigation within the context of eliminating disparities in PCa care among African American men does not yet exist. This review will synthesize existing evidence of patient navigation programs for African American prostate cancer patients and the inclusion of cultural humility. Results will inform the development and implementation of future programs to meet the unique needs of vulnerable prostate cancer patients in safety net settings.Systematic review registrationPROSPERO 2021 CRD42021221412.

Telerehabilitation may stabilize the results of a previous phase 2 rehabilitation program through remote rehabilitation sessions. We evaluated a new telerehabilitation service (PV RehaTRAIN®) during its initial implementation, focusing on its usability both from the perspective of patients with musculoskeletal or oncological diseases and the interdisciplinary treatment team.

BackgroundThe majority of experimental approaches for cancer immunotherapy are tested against relatively small tumors in tumor-bearing mice, because in most cases advanced cancers are resistant to the treatments. In this study, we asked if even late-stage mouse tumors can be eradicated by a rationally designed combined radio-immunotherapy (CRI) regimen.MethodsCRI consisted of local radiotherapy, intratumoral IL-12, slow-release systemic IL-2 and anti- CTLA-4 antibody. Therapeutic effects of CRI against several weakly immunogenic and immunogenic mouse tumors including B78 melanoma, MC38 and CT26 colon carcinomas and 9464D neuroblastoma were evaluated. Immune cell depletion and flow cytometric analysis were performed to determine the mechanisms of the antitumor effects.ResultsTumors with volumes of 2,000 mm3 or larger were eradicated by CRI. Flow analyses of the tumors revealed reduction of T regulatory (Treg) cells and increase of CD8/Treg ratios following CRI. Rapid shrinkage of the treated tumors did not require T cells, whereas T cells were involved in the systemic effect against the distant tumors. Cured mice developed immunological memory.ConclusionsThese findings underscore that rationally designed combination immunotherapy regimens can be effective even against large, late-stage tumors.

Cochlear implant (CI) systems differ in terms of electrode design and signal processing. It is likely that patients fit with different implant systems will experience different percepts when presented speech via their implant. The sound quality of speech can be evaluated by asking single-sided-deaf (SSD) listeners fit with a cochlear implant (CI) to modify clean signals presented to their typically hearing ear to match the sound quality of signals presented to their CI ear. In this paper, we describe very close matches to CI sound quality, i.e., similarity ratings of 9.5 to 10 on a 10-point scale, by ten patients fit with a 28 mm electrode array and MED EL signal processing. The modifications required to make close approximations to CI sound quality fell into two groups: One consisted of a restricted frequency bandwidth and spectral smearing while a second was characterized by a wide bandwidth and no spectral smearing. Both sets of modifications were different from those found for patients with shorter electrode arrays who chose upshifts in voice pitch and formant frequencies to match CI sound quality. The data from matching-based metrics of CI sound quality document that speech sound-quality differs for patients fit with different CIs and among patients fit with the same CI.

To examine postpartum depressive symptom trajectories from birth to age 5 and their risk factors in a national sample of mothers of preterm and full-term infants. The racially and ethnically diverse sample comprised 11,320 maternal participants (Mage = 29; SD = 5.9) in the Environmental influences on Child Health Outcomes (ECHO) Program in the USA with data on newborn gestational age at birth (≥ 22 weeks) and maternal depression symptoms during the first 5 years following childbirth. Growth mixture models determined the number and trajectory of postpartum depression classes among women in the preterm and full-term groups, and we examined predictors of class membership. Five trajectories described depressive symptoms for both groups; however, notable differences were observed. One in 5 mothers of preterm infants developed clinically relevant depressive symptoms over time compared with 1 in 10 mothers of full-term infants. Among women who delivered preterm compared with those who delivered full-term, symptoms were more likely to increase over time and become severe when offspring were older. Distinct subgroups describe mothers depressive symptom trajectories through 5 years following childbirth. Mild to moderate depressive symptoms may onset or persist for many women beyond the initial postpartum period regardless of newborn gestational age at birth. For women with preterm infants, initially mild symptoms may increase to high levels of severity during the preschool and toddler years.