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Pearl culture in Fiji relies on a supply of pearl oysters obtained through the strategic deployment of spat collectors. Although the design and deployment of spat collectors aim to maximize the recruitment of pearl oysters (Pinctada and Pterin spp.), this activity incidentally captures many other bivalves as bycatch. This study explored whether tropical rock oysters (specifically Magallana bilineata and Saecostrea spp.) were present and sufficiently abundant as bycatch from pearl oyster spat collectors, to support additional commercial opportunities. The results showed that the absolute (0.7 [+ or -] 2.1 spat collector-1) and proportional (2.9% of all bivalves) abundance of these taxa was very low, which would limit oyster harvest in meaningful quantities. Although the prospect of creating additional revenue streams from bycatch could be seen as an incentive to on-grow and sell tropical rock oysters despite their low abundance, it is argued that greater benefit would come from prioritizing activities related to pearl oysters and associated downstream products such as mabe pearl, shellcraft, and pearl-meat production. Ultimately, existing spat collection activities within the cultured pearl sector did not have the anticipated potential to support supplemental aquaculture of tropical rock oysters. KEY WORDS: Fiji, spat collection, fouling, bycatch, tropical rock oyster, Saecostrea, Magallana bilineata, INTRODUCTION Tropical rock oysters are excellent candidates for aquaculture (Angell 1986, Nowland et al. 2020). They are consumed almost everywhere they occur (M unro 1994, Kinch et al. 2019a, Simard [...]

We present an exploratory research based on an online questionnaire to better understand the French trainers’ beliefs on problems and computing from grades 1 to 3 of primary school. We explain the French context of the new 2016 curriculum and of the 2018 report on mathematics teaching that motivates the content and the interest of the questionnaire. The results show trainers’ heterogeneity although some beliefs are dominant. A cluster analysis proposes three trainer’s types that could help to organize the training on teaching of problems and computing. This research could go on with paragons’ semi-directed interviews.

Abstract Intertidal mudflats colonized by sediment-dwelling microphytobenthos deliver a wide range of ecosystem services. Here we simulate the response of microphytobenthos, located on a temperate tidal mudflat along the French Atlantic coast in Northwestern Europe, exposed to changes in light, temperature, and sea level conditions predicted by the Intergovernmental Panel on Climate Change. Without sea level rise, microphytobenthos benefit from the balancing effect of net primary production fluctuations, experiencing an increase in winter and a decrease in summer. Under the worst emissions scenario, microphytobenthos bloom up to 14 days earlier in spring and 5 days later in fall, thereby extending the low-level microphytobenthos biomass period by an additional 3 weeks in summer. Sea level rise reduces light exposure leading to a pronounced decline in microphytobenthos under the medium-low emissions and worst emissions scenarios. We provide evidence that the anticipated warmer climate and sea level rise will have an impact on microphytobenthos, potentially triggering cascading effects across the entire food web and disrupting ecosystem services.

IntroductionPublic health concerns over the impact of social media use (SMU) on adolescent health are growing. We investigated the relationship between SMU and sleep health in adolescents in Canada aged 11 to 17 years. MethodsData from the 2017–2018 Health Behaviour in School-aged Children study were available for 12 557 participants (55.2% female). SMU was categorized by frequency of use (non-active, active and intense) and the presence of addiction-like symptoms (problematic). Mixed effects logistic regression models identified associations between SMU and seven sleep health indicators (insomnia symptoms, daytime wakefulness problems, screen time before bed, meeting sleep duration recommendations, sleep variability and late bedtime on school and non-school days). ResultsCompared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group. ConclusionCompared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group.

IntroductionLes effets de l’utilisation des médias sociaux sur la santé des adolescents soulèvent de plus en plus de préoccupations en matière de santé publique. Nous avons exploré la relation entre cette utilisation et la santé du sommeil chez les adolescents du Canada de 11 à 17 ans. MéthodologieDes données de l’Enquête sur les comportements de santé des jeunes d’âge scolaire de 2017-2018 étaient disponibles pour 12 557 participants (dont 55,2 % de sexe féminin). Des catégories d’utilisation des médias sociaux ont été établies en fonction de la fréquence (utilisation non active, active ou intensive) et de la présence de symptômes évoquant une dépendance (utilisation problématique). Des modèles de régression logistique à effets mixtes ont révélé des associations entre l’utilisation des médias sociaux et sept indicateurs de la santé du sommeil (symptômes d’insomnie, somnolence diurne, utilisation d’un écran avant de se coucher, respect des recommandations sur la durée du sommeil, variabilité du sommeil, heure de coucher tardive les jours d’école et heure de coucher tardive les jours de repos). RésultatsComparativement à une utilisation active des médias sociaux, une utilisation non active a été associée à de meilleurs résultats des indicateurs de la santé du sommeil, sauf en ce qui concerne les symptômes d’insomnie. Une utilisation intensive des médias sociaux a été associée à un risque accru d’indicateurs défavorables de la santé du sommeil (rapport de cotes ajusté [RCa] de 1,09 à 2,24) et une utilisation problématique a été associée au RCa le plus élevé (1,67 à 3,24). Les associations avec une utilisation problématique des médias sociaux étaient plus marquées chez les filles que chez les garçons, en particulier en ce qui concerne l’heure de coucher tardive les jours d’école (RCa = 3,74 vs 1,84) et les jours de repos (RCa = 4,13 vs 2,18). Les associations entre l’utilisation des médias sociaux et les résultats en matière de sommeil ne variaient pas selon la tranche d’âge. ConclusionUne utilisation intensive et une utilisation problématique des médias sociaux ont été associées à un risque accru de troubles du sommeil chez les adolescents du Canada, avec des associations plus marquées chez les filles que chez les garçons. D’autres recherches doivent être menées pour éclaircir les mécanismes à l’origine des associations entre l’utilisation des médias sociaux et le sommeil, de manière à orienter les recommandations en matière de santé publique.

Objective In 2019, the EULAR/American College of Rheumatology developed classification criteria for systemic lupus erythematosus (SLE). A positive correlation between summary score at diagnosis and SLE disease activity at five years has been noted in adult patients with lupus, but little is known among the pediatric population. We evaluated the prognostic value of higher summary scores and number of extrarenal domains at diagnosis (low/moderate number [1–5] vs high number [6–9]) to renal outcomes after one year of treatment in pediatric patients with lupus nephritis (LN). Methods This retrospective, single‐center cohort study included 74 pediatric patients with LN. Published pediatric renal response definitions were used for our outcome measure (no, partial, and complete response). Descriptive statistics were reported, and an ordinal logistic regression estimated adjusted odds ratios (ORs) for renal response including 95% confidence intervals (CIs). Results Patients with high extrarenal domains had OR 1.47 (95% CI 0.55–2.91) of having a complete renal response compared to patients with low/moderate domains. Patients with a summary score

Cooking at home is associated with health benefits, and 10- and 11-year-old children are capable of participating in meal preparation. However, opportunities for children to cook at home have declined. This study aimed to identify determinants of the frequency and the intention to cook at home in fifth graders using the Theory of Planned Behavior as a framework with quantitative methodology. A total of 241 participants across five elementary schools of the Chaudière-Appalaches region (Quebec, Canada) took part in this correlational study. Data were collected via a self-administered questionnaire based on the Theory of Planned Behavior. Regression analyses led to the identification of determinants of frequency and intention to cook at home. More than two-thirds of participants (69%) declared having cooked at home in the past 7 days. Intention was the only significant variable explaining 18% of the variance for frequency. Intention was determined by perceived behavioral control, attitude, descriptive norms, subjective norms, perceived barriers, being a girl, and normative beliefs, which explain 74% of the variance. Whereas other studies aiming at better understanding children's involvement in meal preparation at home focused on self-efficacy for cooking, this study highlights other behavioral determinants. For example, support from parents appears to be crucial to promote this behavior in this age group. Future research and interventions should be oriented toward determinants such as subjective norms and normative beliefs, and focus on children's autonomy.

Abstract While the efficacy of GpIIb–IIIa-inhibitors during primary PCI (pPCI) for ST-elevated myocardial infarction (STEMI) has previously been demonstrated, its ongoing role and safety in combination with newer P2Y12-inhibitors is unclear. We therefore sought to compare outcomes between two centers with divergent approaches to the use of GpIIbIIIa antagonists in pPCI. We performed a retrospective chart review of all-comer STEMI patients treated with pPCI at two high-volume Montreal academic tertiary care centers. One center tended to use GpIIb–IIIa-inhibitors up-front in a large proportion of patients (liberal strategy) and the other preferring a bail-out approach (conservative strategy). Baseline patient characteristics and procedural data were compared between the two groups. The main efficacy outcome was rate of no-reflow/slow-reflow and the main safety outcome was BARC ≥ 2 bleeding events. A total of 459 patients were included, of whom 167 (36.5%) were exposed to a GpIIb–IIIa-antagonist. There was a significant overall difference in use of GpIIb–IIIa-antagonist between the two centers (60.5% vs. 16.1%, p

Indigenous populations have remained resilient in maintaining their unique culture and values, despite facing centuries of colonial oppression. With many discriminatory policies continuing to disempower Indigenous peoples, First Nations communities have been reported to experience a higher level of cardiovascular disease (CVD)-related mortality, compared to that in the general population. Many of the risk factors contributing to the burden of CVD have been attributed to the impact of colonization and the ongoing dismissal of Indigenous knowledge. Despite Indigenous peoples recognizing the value of addressing their mental, physical, spiritual, and emotional well-being in balanced totality, current health services focus predominantly on the promotion of Western biomedicine. To begin to move toward reconciliation, a better understanding of how Indigenous health is defined within different cultural worldviews is needed. The objective of this scoping review was to explore the various Western and/or Indigenous strategies used for the prevention of CVD and the management of heart health and wellness in Indigenous communities in Canada. In this review, a total of 3316 articles were identified, and only 21 articles met the eligibility criteria. Three major themes emerged, as follows: (i) valuing of the emotional domain of health through cultural safety; (ii) community is at the core of empowering health outcomes; and (iii) bridging of cultures through partnership and mutual learning. Most studies recognized the importance of community engagement to develop heart health strategies that integrate traditional languages and cultures. However, to move toward the delivery of culturally safe care, health systems need to rebuild their relationship with Indigenous peoples. Résumé: Les populations autochtones ont toujours fait preuve de résilience dans le maintien de leurs cultures et de leurs valeurs uniques, malgré des siècles d’oppression coloniale. En raison des nombreuses politiques discriminatoires qui continuent de priver les peuples autochtones de certains pouvoirs, on rapporte que les communautés des Premières Nations ont un taux de mortalité liée aux maladies cardiovasculaires (MCV) supérieur à celui observé dans la population générale. De nombreux facteurs de risque qui contribuent au fardeau des MCV ont été attribués aux répercussions de la colonisation et au rejet continu du savoir autochtone. Malgré le fait que les peuples autochtones reconnaissent l’avantage de prendre soin de leur bien-être mental, physique, spirituel et émotionnel dans une intégralité équilibrée, les services de santé actuels sont essentiellement axés sur la promotion de la biomédecine occidentale. Afin de commencer à nous diriger vers la réconciliation, nous devons mieux comprendre la façon dont les peuples autochtones définissent la santé au sein de différentes visions culturelles du monde. L’objectif de cette étude de portée était d’explorer les diverses stratégies occidentales ou autochtones de prévention des MCV et de prise en charge de la santé et du bien-être cardiaques chez les communautés autochtones du Canada. Dans le cadre de cette étude, 3 316 articles ont été recensés, et seulement 21 d’entre eux répondaient aux critères de sélection. Trois principaux thèmes ont été dégagés, soit : (i) la sécurité culturelle permet de mettre en avant l’importance du domaine émotionnel de la santé; (ii) la communauté est au centre de l’autonomie en matière de devenir de la santé; et (iii) le lien entre les cultures doit se faire au moyen de partenariats et d’apprentissages mutuels. La plupart des études reconnaissaient l’importance de l’engagement communautaire pour mettre au point des stratégies relatives à la santé du cœur qui intègrent les langues et les cultures traditionnelles. Toutefois, afin de passer à la prestation de soins respectueux des cultures, les systèmes de santé doivent reconstruire leur relation avec les peuples autochtones.

This paper details the design, development, and evaluation of VulcanH, a computerized maintenance management system (CMMS) specialized in preventive maintenance (PM) and predictive maintenance (PdM) management for underground mobile mining equipment. Further, it aims to expand knowledge on trust in automation (TiA) for PdM as well as contribute to the literature on explainability requirements of a PdM-capable artificial intelligence (AI). This study adopted an empirical approach through the execution of user tests with nine maintenance experts from five East-Canadian mines and implemented the User Experience Questionnaire Plus (UEQ+) and the Reliance Intentions Scale (RIS) to evaluate usability and TiA, respectively. It was found that the usability and efficiency of VulcanH were satisfactory for expert users and encouraged the gradual transition from PM to PdM practices. Quantitative and qualitative results documented participants’ willingness to rely on PdM predictions as long as suitable explanations are provided. Graphical explanations covering the full spectrum of the derived data were preferred. Due to the prototypical nature of VulcanH, certain relevant aspects of maintenance planning were not considered. Researchers are encouraged to include these notions in the evaluation of future CMMS proposals. This paper suggests a harmonious integration of both preventive and predictive maintenance practices in the mining industry. It may also guide future research in PdM to select an analytical algorithm capable of supplying adequate and causal justifications for informed decision making. This study fulfills an identified need to adopt a user-centered approach in the development of CMMSs in the mining industry. Hence, both researchers and industry stakeholders may benefit from the findings.

Most sturgeon populations are imperilled and living in fragmented rivers. Here, we studied namew (lake sturgeon Acipenser fulvescens), fish important to Ililiwak (Moose Cree Peoples), in the North French River: a free-flowing, intact river in Kit Aski Nahnuun (the Moose Cree Homeland) in northern Ontario, Canada. This study was co-created alongside members of Moose Cree First Nation and used acoustic telemetry to passively track 20 tagged namew over 6 yr (2016-2022). Namew occupied the entire monitored river reach: about 45 km. Namew used 2 overwintering areas and occupied more overall river sections during spring and summer (out of 6 total seasons often used by Ililiwak). We did not detect namew moving upstream or downstream during freeze-up and winter. Generally, namew showed the greatest acceleration and travelled the longest distances during spring and summer, and they occupied shallower water during summer at lower water levels and deepest waters during freeze-up. We found an interaction between season and diurnal period, where namew occupied shallower depths and had higher acceleration at dawn and night relative to morning and afternoon in most seasons; dusk behaviour was variable among seasons. However, this pattern was absent in spring, when namew showed no diurnal pattern in acceleration and were in shallower water during morning and afternoon. Diurnal patterns were less pronounced, but detectable, during ice-affected seasons. This river provides year-round habitat for namew, and our data reveal distinct patterns of namew occupancy, movement, and behaviour in a free-flowing, intact river. Our work is an example of successfully co-creating research that addresses both scientific and community priorities.

Marc Simard,1– 4 Elham Rahme,5 Marjolaine Dubé,1 Véronique Boiteau,1 Denis Talbot,2,3 Miceline Mésidor,2,3 Yohann Moanahere Chiu,1,4,6 Caroline Sirois1,3,4,6 1Institut national de santé publique du Québec, Québec, QC, Canada; 2Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada; 3Centre de recherche du CHU de Québec, Québec, QC, Canada; 4VITAM-Centre de recherche en santé durable, Québec, QC, Canada; 5Department of Medicine, Division of Clinical Epidemiology, McGill University, and Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC, Canada; 6Faculty of de Pharmacy, Université Laval, Québec, QC, CanadaCorrespondence: Marc Simard, Institut national de santé publique du Québec, 945, Wolfe, 5e étage, Québec, QC, G1V 5B3, Canada, Tel +1 418 650 5115 #5522, Fax +1 418 643 5099, Email marc.simard@inspq.qc.caPurpose: To identify multimorbidity trajectories among older adults and to compare their health outcome predictive performance with that of cross-sectional multimorbidity thresholds (eg, ≥ 2 chronic conditions (CCs)).Patients and Methods: We performed a population-based longitudinal study with a random sample of 99,411 individuals aged > 65 years on April 1, 2019. Using health administrative data, we calculated for each individual the yearly CCs number from 2010 to 2019 and constructed the trajectories with latent class growth analysis. We used logistic regression to determine the increase in predictive capacity (c-statistic) of multimorbidity trajectories and traditional cross-sectional indicators (≥ 2, ≥ 3, or ≥ 4 CCs, assessed in April 2019) over that of a baseline model (including age, sex, and deprivation). We predicted 1-year mortality, hospitalization, polypharmacy, and frequent general practitioner, specialist, or emergency department visits.Results: We identified eight multimorbidity trajectories, each representing between 3% and 25% of the population. These trajectories exhibited trends of increasing, stable, or decreasing number of CCs. When predicting mortality, the 95% CI for the increase in the c-statistic for multimorbidity trajectories [0.032– 0.044] overlapped with that of the ≥ 3 indicator [0.037– 0.050]. Similar results were observed when predicting other health outcomes and with other cross-sectional indicators.Conclusion: Multimorbidity trajectories displayed comparable health outcome predictive capacity to those of traditional cross-sectional multimorbidity indicators. Given its ease of calculation, continued use of traditional multimorbidity thresholds remains relevant for population-based multimorbidity surveillance and clinical practice.Keywords: multimorbidity, trajectories, prevalence, health outcome prediction, population-based

Abstract Background Health administrative databases play a crucial role in population-level multimorbidity surveillance. Determining the appropriate retrospective or lookback period (LP) for observing prevalent and newly diagnosed diseases in administrative data presents challenge in estimating multimorbidity prevalence and predicting health outcome. The aim of this population-based study was to assess the impact of LP on multimorbidity prevalence and health outcomes prediction across three multimorbidity definitions, three lists of diseases used for multimorbidity assessment, and six health outcomes. Methods We conducted a population-based study including all individuals ages > 65 years on April 1st, 2019, in Québec, Canada. We considered three lists of diseases labeled according to the number of chronic conditions it considered: (1) L60 included 60 chronic conditions from the International Classification of Diseases (ICD); (2) L20 included a core of 20 chronic conditions; and (3) L31 included 31 chronic conditions from the Charlson and Elixhauser indices. For each list, we: (1) measured multimorbidity prevalence for three multimorbidity definitions (at least two [MM2+], three [MM3+] or four (MM4+) chronic conditions); and (2) evaluated capacity (c-statistic) to predict 1-year outcomes (mortality, hospitalisation, polypharmacy, and general practitioner, specialist, or emergency department visits) using LPs ranging from 1 to 20 years. Results Increase in multimorbidity prevalence decelerated after 5–10 years (e.g., MM2+, L31: LP = 1y: 14%, LP = 10y: 58%, LP = 20y: 69%). Within the 5–10 years LP range, predictive performance was better for L20 than L60 (e.g., LP = 7y, mortality, MM3+: L20 [0.798;95%CI:0.797-0.800] vs. L60 [0.779; 95%CI:0.777–0.781]) and typically better for MM3 + and MM4 + definitions (e.g., LP = 7y, mortality, L60: MM4+ [0.788;95%CI:0.786–0.790] vs. MM2+ [0.768;95%CI:0.766–0.770]). Conclusions In our databases, ten years of data was required for stable estimation of multimorbidity prevalence. Within that range, the L20 and multimorbidity definitions MM3 + or MM4 + reached maximal predictive performance.

Organizations play a central role in replicating societal inequalities. Despite theories of gendered and racialized organizations, evidence of unequal outcomes, and research on proposed mechanisms, we have few intersectional analyses demonstrating how the promotion process varies by race and gender across job levels in actual organizations. In this first-ever analysis of advancement in a U.S. firm by gender, race, and job, we run random effects logistic regression models on five years of novel longitudinal data from the software engineering workforce of a U.S.-based technology company. Results show intersectional performance-reward bias in patterns that help maintain the racialized gendered hierarchy so commonly observed in organizations: White men overrepresented at the top, women of color overrepresented at the bottom, and in the technology sector, men of Asian descent overrepresented in midlevel technical jobs and White women overrepresented in midlevel management positions. Findings suggest monitoring promotions by gender, race, and position to make visible biases that continue to impede workplace equity.

BackgroundAdvances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources.MethodsEmploying an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness.Expected resultsAnticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases.DiscussionBy focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

How household-level data from censuses and surveys are analyzed to study household structure is an issue that has received little attention. The present study proposes a new methodological approach to address this gap. Specifically, we introduce the idea of the household configuration as a mathematical representation of observations from the household roster that uses the tools of sequence analysis to study relationships between household members. This "household configuration approach" is statistically efficient, captures the heterogeneity of family forms in a population, and is computationally simple. An application to Canadian census data for Indigenous and non-Indigenous peoples shows that our approach can yield interesting insights into household structure, otherwise not readily obtained.

Climate change has resulted in a widespread increase in primary productivity in northern regions. This “greening” can alter terrestrial ecosystems dynamics and trigger positive climate feedbacks but often exhibits spatial heterogeneity. Few studies have focused on the differential responses of plant functional groups to warming as a potential driver of heterogeneity in greening rates. Our objective was to determine whether climate–growth relationships are species-specific, and whether they can explain the heterogeneity of the subarctic greening rates. We compared climate–growth relationships and associations to normalized difference vegetation index (NDVI) of the dominant tree (Picea mariana) and shrub (Betula glandulosa) species at two locations in the forest–tundra ecotone in Nunavik (Québec, Canada). Correlation coefficients of the climate–growth relationship varied between species and locations, being higher for P. mariana and at the northernmost location. The lower association between NDVI and P. mariana radial growth at the northernmost location appeared to be compensated by a stronger association between NDVI and B. glandulosa radial growth. Our results show that response to climate varies spatially and between species, both of which could potentially be used to explain the heterogeneity of subarctic greening rates. This improved understanding of the species-specific response to climate change will help predict forthcoming changes in primary productivity and their potential positive feedback on climate change.

Background: In patients with anterior ST-elevation myocardial infarction (STEMI) and new-onset antero-apical wall motion abnormalities (WMAs), whether the rate of prophylaxis against left ventricular thrombus and outcomes differ between men and women is unknown. Methods: A multicentre retrospective cohort study of patients with STEMI and new-onset antero-apical WMAs treated with primary percutaneous coronary intervention was conducted. Patients with an established indication of oral anticoagulation (OAC) were excluded. The rates of triple therapy (double antiplatelet therapy + OAC) at discharge were compared for women vs men. The rates of net adverse clinical events, a composite of mortality, myocardial infarction, stroke or transient ischemic attack, systemic thromboembolism or Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding at 6 months were compared across sex using a multivariate logistic regression model. Results: A total of 1664 patients were included in the primary analysis, of whom 402 (24.2%) were women and 1262 (75.8%) were men. A total of 138 women (34.3%) and 489 men (38.7%) received a triple therapy prescription at discharge (P = 0.11). At 6 months, 33 women (8.2%) and 96 men (7.6%) experienced a net adverse clinical event (adjusted odds ratio 0.82; 95% confidence interval 0.49-1.37). No difference occurred in the risk of bleeding events and ischemic events between men and women, when these were analyzed separately. Conclusions: The rates of OAC prescription for left ventricular thrombus prophylaxis and clinical outcomes at 6 months were similar in women and men following anterior STEMI with new-onset antero-apical WMAs. Résumé: Contexte: On ignore si le taux de prophylaxie contre le thrombus ventriculaire gauche et les résultats thérapeutiques diffèrent entre les hommes et les femmes qui ont subi un infarctus du myocarde avec élévation du segment ST (STEMI) antérieur et ont des anomalies du mouvement pariétal (AMP) antéroapical d’apparition récente. Méthodes: Nous avons mené une étude de cohorte rétrospective multicentrique auprès de patients qui ont subi un STEMI et ont des AMP d’apparition récente traitées par une intervention coronarienne percutanée primaire. Nous avons exclu les patients chez lesquels il existait une indication établie à l’anticoagulation orale (ACO). Nous avons comparé les taux de trithérapie (bithérapie antiplaquettaire + ACO) à la sortie de l’hôpital entre les femmes et les hommes. Nous avons comparé les taux d’événements indésirables cliniques nets, le critère composite de mortalité, d’infarctus du myocarde, d’accident vasculaire cérébral ou d’accident ischémique transitoire, la thromboembolie systémique ou l’hémorragie de type 3 ou 5 selon le Bleeding Academic Research Consortium (BARC) après 6 mois entre les sexes au moyen du modèle de régression logistique multivariée. Résultats: Au sein des 1 664 patients de l’analyse principale, 402 (24,2 %) étaient des femmes et 1262 (75,8 %) étaient des hommes. Un total de 138 femmes (34,3 %) et de 489 hommes (38,7 %) ont reçu une ordonnance de trithérapie à la sortie de l’hôpital (P = 0,11). Après 6 mois, 33 femmes (8,2 %) et 96 hommes (7,6 %) ont subi un événement indésirable net (rapport de cotes ajusté 0,82 ; intervalle de confiance à 95 % 0,49-1,37). Aucune différence n’a été notée dans le risque d’événements hémorragiques et d’événements ischémiques entre les hommes et les femmes lorsque ces événements étaient analysés séparément. Conclusions: Les taux d’ordonnances d’ACO en prophylaxie du thrombus ventriculaire gauche et les résultats cliniques après 6 mois étaient similaires entre les femmes et les hommes à la suite du STEMI antérieur et des AMP antéroapicale d’apparition récente.

Abstract Background Acute kidney injury is a common disorder that is associated with significant morbidity and mortality. Point-of-care ultrasonography (PoCUS) is an imaging modality performed at the bedside and is used to assess for obstructive causes of acute kidney injury. Little is known about the test characteristics of PoCUS in patients with acute kidney injury. Objective Our primary objective was to describe the test characteristics of PoCUS for the detection of hydronephrosis in patients presenting with acute kidney injury at our centre. Our secondary objective was to describe the current rate of use of PoCUS for this indication. Results In total, 7873 patients were identified between June 1, 2019 and April 30, 2021, with 4611 meeting inclusion criteria. Of these, 94 patients (2%) underwent PoCUS, and 65 patients underwent both PoCUS and reference standard, for a total of 124 kidneys included in our diagnostic accuracy analysis. The prevalence of hydronephrosis in our cohort was 33% (95% CI 25–41%). PoCUS had a sensitivity of 85% (95% CI 71–94%) and specificity of 78% (95% CI 68–87%) for the detection of hydronephrosis. Conclusion We describe the test characteristics of PoCUS for the detection of hydronephrosis in a cohort of patients with acute kidney injury. The low uptake of this test presents an opportunity for quality improvement work to increase its use for this indication.

Background: Type I myocardial infarction (T1MI) or type II myocardial infarction (T2MI) have different underlying mechanisms; however, in the setting of cardiogenic shock (CS), it is not understood if patients experience resultantly different outcomes. The objective of this study was to determine clinical features, biomarker patterns, and outcomes in these subgroups. Methods: Patients from the CAPITAL-DOREMI trial presenting with acute myocardial infarction-associated CS (n = 103) were classified as T1MI (n = 61) or T2MI (n = 42). The primary endpoint was a composite of all-cause in-hospital mortality, cardiac arrest, the need for mechanical circulatory support, or initiation of renal replacement therapy at 30 days. Secondary endpoints were evaluated as individual components of the primary endpoint. Results: Patients with T1MI CS did not have a higher incidence of the primary composite endpoint compared with T2MI CS (adjusted hazard ratio [HR], 1.63; 95% confidence interval [CI], 0.96-2.77; P = 0.07). Cardiac biomarkers including troponin I (P < 0.001), and creatine kinase levels (P = 0.001) were elevated in patients with T1MI CS compared with T2MI. Furthermore, patients with T1MI CS presented with decreased urine output (P = 0.01) compared with T2MI. Predictors of T2MI CS included nonischemic ventricular dysfunction (P = 0.002), atrial fibrillation (P = 0.02), and chronic obstructive pulmonary disease (P = 0.002). Conclusions: There were no differences in adverse clinical outcomes between patients with T1MI and T2MI CS, although the events were numerically increased, and the sample size was small. Overall, this study provides a hypothesis-generating analysis regarding the clinical and biochemical outcomes in T1MI vs T2MI CS. Résumé: Introduction: L’infarctus du myocarde de type 1 (IMT1) et l’infarctus du myocarde de type 2 (IMT2) ont des mécanismes sous-jacents différents. Toutefois, dans le contexte du choc cardiogénique (CC), nous ignorons si les patients ont donc des résultats cliniques différents. Les objectifs de la présente étude étaient de déterminer les caractéristiques cliniques, les profils des biomarqueurs et les résultats cliniques dans ces sous-groupes. Méthodes: Les patients de l’essai CAPITAL-DOREMI qui présentaient un CC associé à un infarctus aigu du myocarde (n = 103) étaient classifiés dans le sous-groupe IMT1 (n = 61) ou dans le sous-groupe IMT2 (n = 42). Le critère de jugement principal était un critère composite qui regroupait la mortalité à l’hôpital toutes causes confondues, l’arrêt cardiaque, la nécessité d’une assistance circulatoire mécanique ou l’amorce d’une thérapie de remplacement rénal dans les 30 jours. Les critères secondaires étaient évalués en fonction des composantes individuelles du critère de jugement principal. Résultats: Les patients qui avaient un CC-IMT1 n’avaient pas une plus grande fréquence de survenue du critère de jugement principal composite que les patients qui avaient un CC-IMT2 (rapport de risque [RR] ajusté, 1,63 ; intervalle de confiance [IC] à 95 %, 0,96-2,77 ; P = 0,07). Les biomarqueurs cardiaques dont les concentrations de la troponine I (P < 0,001) et de la créatine kinase (P = 0,001) étaient élevées chez les patients qui avaient un CC-IMT1, mais non chez les patients qui avaient un CC-IMT2. De plus, les patients qui avaient eu un CC-IMT1 avaient une diurèse réduite (P = 0,01), mais non les patients qui avaient un CC-IMT2. Les prédicteurs du CC-IMT2 étaient la dysfonction ventriculaire non ischémique (P = 0,002), la fibrillation auriculaire (P = 0,02) et la maladie pulmonaire obstructive chronique (P = 0,002). Conclusions: Il n’y avait aucune différence dans les résultats cliniques défavorables entre les patients qui avaient un CC-IMT1 et les patients qui avaient un CC-IMT2, bien que les événements aient augmenté en nombre, et que la taille de l’échantillon était petite. Dans l’ensemble, cette étude fournit une analyse de génération d’hypothèses quant aux résultats cliniques et biochimiques du CC-IMT1 vs du CC-IMT2.

MET inhibitors have demonstrated efficacy in treating patients with non-small cell lung cancer (NSCLC) harboring METex14 skipping alterations. Advancements in spatial profiling technologies have unveiled the complex dynamics of the tumor microenvironment (TME), a crucial factor in cancer progression and therapeutic response.This study uses spatial profiling to investigate the effects of the MET inhibitor tepotinib on the TME in a case of locally advanced NSCLC with a METex14 skipping alteration. A patient with resectable stage IIIB NSCLC, unresponsive to neoadjuvant platinum-based chemotherapy, received tepotinib following the detection of a METex14 skipping alteration. Paired pre- and post-treatment biopsies were subjected to GeoMx Digital Spatial Profiling using the Cancer Transcriptome Atlas and immune-related protein panels to evaluate shifts in the immune TME.Tepotinib administration allowed for a successful lobectomy and a pathological downstaging to stage IA1. The TME was transformed from an immunosuppressive to a more permissive state, with upregulation of antigen-presenting and pro-inflammatory immune cells. Moreover, a marked decrease in immune checkpoint molecules, including PD-L1, was noted. Spatial profiling identified discrete immune-enriched clusters, indicating the role of tepotinib in modulating immune cell trafficking and function. Tepotinib appears to remodel the immune TME in a patient with METex14 skipping NSCLC, possibly increasing responsiveness to immunotherapy.Our study supports the integration of genetic profiling into the management of early and locally advanced NSCLC to guide personalized, targeted interventions. These findings underscore the need to further evaluate combinations of MET inhibitors and immunotherapies.

This study aimed to examine the evolution of test anxiety during the transition to secondary school, a challenging period that includes a set of contextual factors that could potentially increase students' test anxiety. In addition, to further understand the contribution of different individual factors that might increase the susceptibility to test anxiety during this transition, the study examined the role of motivation, achievement, internalizing behaviors and gender in the development of test anxiety. A total of 478 French-speaking students (231 boys, 247 girls) were followed during their transition to secondary school. Latent growth analysis revealed an overall stable trajectory of test anxiety during the transition to secondary school. However, internalizing behaviors and gender moderated the trajectory over time. Additionally, high initial levels of internalizing behaviors, as well as lower grades in mathematics, were associated with initial levels of test anxiety, as measured at the end of elementary school.

Abstract In recent years, synthetic aperture radar (SAR) interferometry (InSAR) has emerged as a valuable tool for measuring water level change (WLC) to study hydrodynamic processes in coastal wetlands. However, the highly dynamic wet atmosphere conditions common in these areas have a significant impact on InSAR observations, producing errors in the derived values. Standard methods for estimating atmospheric noise in InSAR time series lack the spatial or temporal resolution needed to adequately correct for wet tropospheric delays. In this study, we utilize the Independent Component Analysis (ICA) signal decomposition technique to identify the likely WLC signal and eliminate atmospheric noise in a time series derived from rapid repeat measurements made with the L‐band uninhabited aerial vehicle synthetic aperture radar airborne instrument. The method compares in‐situ water level measurements with the independent components (IC) to identify the ICA components corresponding to WLC. The signal‐to‐noise ratio between the WLC after the ICA‐based filtering and in situ water level gauges used for validation reaches 16 dB compared to an average of 2.6 dB before filtering. The excluded IC are used to generate maps showing a time series of likely atmospheric features. The identified features in the maps generally correspond to atmospheric features identifiable in Next Generation Weather Radar (NEXRAD) S‐band ground weather radar reflectivity maps collected during the SAR acquisitions. The method is sufficiently general to be applied to any InSAR‐derived surface displacement time series.

Downed woody debris is important for biodiversity, forest regeneration, and carbon, nutrient, and water cycling, and past studies have examined how the coarse fraction is affected by climate or harvesting. In a field study in Douglas-fir dominated forests, we expand existing knowledge by investigating the interacting effects of climate and harvesting on downed woody debris of all sizes. Across a 900-km long latitudinal gradient in British Columbia, we found that coarse woody debris (CWD, >7.5 cm diameter) in humid climates contained 700% greater carbon stocks, had 500% greater volume, and was more diverse than in arid climates. Pre- and post-harvest, small and fine woody debris comprised a higher proportion of total woody debris carbon stocks in arid than moist climates, especially after clearcutting and seed tree treatments. Harvesting generally decreased total CWD volume, but it was not depleted on any site. Harvesting substantially reduced the volume of large, highly decomposed CWD except at the two most arid sites, and losses of large CWD increased with increasing tree removal. These losses were accompanied by a pulse of fresh, small diameter CWD and SWD which are short-term organic nutrient sources but have less habitat value than larger pieces and contribute to fuel loads. Because CWD was less abundant in arid than humid mature forests, care must be taken on arid sites to avoid its depletion during harvesting, especially clearcutting, where future woody debris inputs will not occur for decades.

Throughout the Pacific Islands, shellcraft has begun to feature prominently in development intervention which aims to generate positive livelihood outcomes for coastal communities. This activity often involves the post-harvest processing of natural assets, namely shells and skeletal remains of marine taxa, into jewellery by individuals or small-sized enterprises. To foster participation in shellcraft, development intervention commonly involves gifting or subsidising physical assets. Yet knowledge of the natural (i.e., taxa) and physical (i.e., tools) assets required for shellcraft remains scant. An understanding of human dimensions in shellcraft pertaining to patterns in asset use, such as how tool ownership differentiates taxa utilised and products produced, is important for determining if access to a specific tool is necessary, or an encumbrance, for achieving a desired outcome. In this study, we identified tools used and variation in tool ownership among artisans engaged in shellcraft to afford an accurate and realistic understanding of the tools required to participate in this activity. We then evaluate how ownership of a specific tool or type of tool differentiates both taxa utilisation and product production for shellcraft. Results indicate ownership of neither all nor any specific tool was required to participate in shellcraft, with artisans typically owning a unique combination of tools. Furthermore, results identified that some specific tools were critical for affecting the attractiveness of utilising certain taxa or producing certain products. Implications of the significant relationships between specific tools and certain taxa or products are discussed in the context of development intervention and commonly articulated theories of change where shellcraft is linked to subsistence fishing, aquaculture, or tourism.

BackgroundWeb-based surveys can be effective data collection instruments; however, participation is notoriously low, particularly among professionals such as physicians. Few studies have explored the impact of varying amounts of monetary incentives on survey completion. ObjectiveThis study aims to conduct a randomized study to assess how different incentive amounts influenced survey participation among neurologists in the United States. MethodsWe distributed a web-based survey using standardized email text to 21,753 individuals randomly divided into 5 equal groups (≈4351 per group). In phase 1, each group was assigned to receive either nothing or a gift card for US $10, $20, $50, or $75, which was noted in the email subject and text. After 4 reminders, phase 2 began and each remaining individual was offered a US $75 gift card to complete the survey. We calculated and compared the proportions who completed the survey by phase 1 arm, both before and after the incentive change, using a chi-square test. As a secondary outcome, we also looked at survey participation as opposed to completion. ResultsFor the 20,820 emails delivered, 879 (4.2%) recipients completed the survey; of the 879 recipients, 622 (70.8%) were neurologists. Among the neurologists, most were male (412/622, 66.2%), White (430/622, 69.1%), non-Hispanic (592/622, 95.2%), graduates of American medical schools (465/622, 74.8%), and board certified (598/622, 96.1%). A total of 39.7% (247/622) completed their neurology residency more than 20 years ago, and 62.4% (388/622) practiced in an urban setting. For phase 1, the proportions of respondents completing the survey increased as the incentive amount increased (46/4185, 1.1%; 76/4165, 1.8%; 86/4160, 2.1%; 104/4162, 2.5%; and 119/4148, 2.9%, for US $0, $10, $20, $50, and $75, respectively; P