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As humanity reaches the 5.0 industrial revolution, education plays a critical role in boosting the quality of human resources. This paper reports bibliometric research on emerging TiP during 1993-2022 in the educational field to analyse its development on any level of education during the last three decades. This study employed a Scopus database. The findings are that the trend of TiP publication in educational fields has tended to increase every year during the past three decades and conference paper became the most published document type, the USA is the country which produces the most publications; "Students" being the most occurrences keyword and total link strength. The publication of the TiP is ranked to the Quartile 1, which implies that a publication with the cited performance is a publication with credibility because the publisher has a good reputation. Researchers can find the topics most relevant to other metadata sources such as Web of Science, Publish, and Perish.

Objective: Schools are important settings for health promotion. In schools, children and adolescents can be reached regardless of their social background, which represents a unique opportunity for promoting health. Several studies have demonstrated the importance of school leadership in initiating and sustaining health promotion; however, efforts to systematically review the influence of school leadership on school health promotion are still lacking. Hence, this paper analyses empirical studies published in scientific journals on school leadership and health promotion in schools. Design: Systematic literature review. Method: Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a review was conducted using two main databases: Web of Science and Scopus, which retrieved 51 eligible articles. Results: The review of these articles resulted in the identification of seven main themes -- school leaders' health; attitudes, knowledge and behaviour; accountability; support from school leaders; shared leadership approaches; capacity building and parent engagement. Conclusion: This systematic literature review expands the literature by highlighting the school leadership factors that promote school health promotion in Oceania, Europe, North America, South America, Africa and Asia continents. Future systematic literature reviews could explore studies and different aspects of health promotion by teachers, especially in the Asian context.

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This study aims to describe Facebook users' beliefs toward physical distancing measures implemented during the Coronavirus disease (COVID-19) pandemic using the key constructs of the health belief model. A combination of rule-based filtering and manual classification methods was used to classify user comments on COVID-19 Facebook posts of three public health authorities: Centers for Disease Control and Prevention of the United States, Public Health England, and Ministry of Health, Singapore. A total of 104,304 comments were analyzed for posts published between 1 January, 2020, and 31 March, 2020, along with COVID-19 cases and deaths count data from the three countries. Findings indicate that the perceived benefits of physical distancing measures (n = 3,463; 3.3%) was three times higher than perceived barriers (n = 1,062; 1.0%). Perceived susceptibility to COVID-19 (n = 2,934; 2.8%) was higher compared with perceived severity (n = 2,081; 2.0%). Although susceptibility aspects of physical distancing were discussed more often at the start of the year, mentions on the benefits of intervention emerged stronger toward the end of the analysis period, highlighting the shift in beliefs. The health belief model is useful for understanding Facebook users' beliefs at a basic level, and it provides a scope for further improvement.

To test whether adoption differentially benefited adopted youth's behavioral health, 243 female American youth who were adopted from China were compared with 234 non-adopted American peers, and 955 non-adopted Chinese peers living in China on four composite scales: School Problems, Internalizing Problems, Attention-Deficit/Hyperactivity Disorder (ADHD), and Personal Adjustment. The adopted youth were from high socioeconomic status (SES) families, while the two comparison groups were from average SES families. Self-report data were collected with the third edition of the Behavior Assessment System for Children (BASC-3). Effect sizes showed that the adopted youth outperformed their non-adopted American and Chinese peers. Latent mean comparison using Mplus 8 showed that, controlling for age difference, the adopted youth's advantages over the comparison groups in some subscales dissipated. These findings were explained with possible compensating effects afforded by growing up in high SES adoptive environment, as well as on children's differential susceptibility to the benefit of intervention.

Purpose: This paper aims to provide an overview of the origins of bansho, how it has developed to be an indispensable practice in Japan and its influence on countries outside Japan. The integration of bansho into lesson study (LS) will also be presented. Design/methodology/approach: This paper draws on the vast literature on bansho from both in and outside Japan to illustrate the points mentioned above. Findings: Recapitulation on the history of chalkboard and bansho in different eras in Japan illustrated its endurance towards the test of time, geographical space and functions. While bansho remains a constant presence in LS research, there has not been any work that outlines how bansho is integrated into the LS cycle. Thus, a guideline on how bansho can be incorporated in the LS cycle is provided. Originality/value: A comprehensive overview of bansho allows educators and researchers outside Japan to move beyond the know-how and know-what of bansho; it would serve as an invaluable source to understand the core concepts underlying this classroom practice, thus avoiding the mere adaptation of bansho superficial aspects. This study also provides precise instruction on how bansho can be integrated into each step of the LS cycle, which will guide teachers and researchers in the future implementation of LS.

Background: Alterations in the bacteria, such as the periodontal bacteria, might be considered potential risk factors for nonalcoholic fatty liver disease (NAFLD). Most studies analyzing this association have focused mainly on a specific periodontal bacteria (Porphyromonas gingivalis) and have involved relatively small study populations (tens or hundreds of individuals). To address this gap, a sizable, nationally representative adult population was utilized to investigate the association between the incidence of NAFLD and high serum IgG antibodies for 19 periodontal bacteria. Methods: To explore this association, data from the Third National Health and Nutrition Examination Survey (NHANES III)—which provides a cross-sectional representation of the noninstitutionalized U.S. population, encompassing 33,994 individuals—were analyzed. Participants aged 40 years and above with data on NAFLD—determined by the gold standard of ultrasound examination (USON)—as well as comprehensive records of serum IgG antibodies against periodontal bacteria, were included, resulting in a final analysis subset of 6,330 individuals. Results: Using a cluster analysis based on the Socransky classification scheme for oral microorganisms, antibody titers for the 19 bacteria were grouped into four clusters—Red-Green, Orange-Blue, Yellow-Orange, and Orange-Red. When these clusters, as well as individual antibody relationships with NAFLD, were examined, the adjusted odds ratios (ORs) ranged from 0.958 [95% confidence interval (CI): 0.916, 1.003] to 1.021 [95% CI: 0.987, 1.055]. This indicated that no statistically significant associations were found (P > 0.05), underscoring the absence of a meaningful link. Conclusions: In summary, it was discovered that there is currently no evidence to correlate serum antibodies to periodontal pathogens with NAFLD in the nationally representative NHANES III. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatocellular carcinoma is the most common type of liver cancer and is often seen in people with chronic liver diseases. For patients with hepatocellular carcinoma who cannot receive surgery, other treatments include atezolizumab plus bevacizumab, sorafenib, or lenvatinib. We compared the length of life among 1874 United States veterans who received these therapies, both in the overall population of patients and in groups by race/ethnicity. The results showed that the risk of death was 30% lower with atezolizumab plus bevacizumab compared with sorafenib, and 26% lower compared with lenvatinib. These trends were consistent across White, Black, and Hispanic patients. Thus, patients who received atezolizumab plus bevacizumab had improved survival outcomes compared with those treated with sorafenib or lenvatinib, regardless of race or ethnicity. Background/Objectives: This study evaluated comparative overall survival (OS) of United States veterans with unresectable hepatocellular carcinoma (uHCC) receiving first-line (1L) atezolizumab plus bevacizumab vs. sorafenib or lenvatinib, overall and across racial and ethnic groups. Methods: In this retrospective study, patients with uHCC who initiated atezolizumab plus bevacizumab (post-2020) or sorafenib or lenvatinib (post-2018) were identified from the Veterans Health Administration National Corporate Data Warehouse (1 January 2017–31 December 2022). Patient characteristics were evaluated in the year prior to 1L treatment initiation. Kaplan–Meier and multivariable Cox regression methods were used to compare OS starting from treatment between cohorts, both overall and by race and ethnicity. Results: Among the 1874 patients included, 405 (21.6%) received 1L atezolizumab plus bevacizumab, 1016 (54.2%) received sorafenib, and 453 (24.2%) received lenvatinib, with a median follow-up time of 8.5, 7.6, and 8.2 months, respectively. Overall, patients receiving atezolizumab plus bevacizumab had longer unadjusted median OS (12.8 [95% CI: 10.6, 17.1] months) than patients receiving sorafenib (8.0 [7.1, 8.6] months) or lenvatinib (9.5 [7.8, 11.4] months; both log-rank p < 0.001). After adjustment, atezolizumab plus bevacizumab was associated with a reduced risk of death by 30% vs. sorafenib (adjusted HR: 0.70 [95% CI: 0.60, 0.82]) and by 26% vs. lenvatinib (0.74 [0.62, 0.88]; both p < 0.001). OS trends in the White, Black, and Hispanic patient cohorts were consistent with that of the overall population. Conclusions: Atezolizumab plus bevacizumab was associated with improved survival outcomes compared with sorafenib and lenvatinib in patients with uHCC, both overall and across racial and ethnic subgroups. [ABSTRACT FROM AUTHOR]

Derived from the Expectancy-Value Theory (EVT) model, cost has drawn scholarly interest for being predicative of avoidance motivation. The study is an effort to develop and validate an instrument to measure students' perceived costs in physical education. Through literature review and student interviews, a draft of 39 items under seven domains was developed for content validation. A total of 29 items were sent to collect psychometric evidence from two samples of 6th to 8th grade middle school students, age 11 to 15. Exploratory factor analyses (EFA) were applied on the first sample and yielded a three-factor construct to measure social costs (six items), physical costs (five items), and loss of valuable alternatives (five items). with item loadings ranging from.48 to.73. Following confirmatory factor analysis (CFA) applied on the second student sample confirmed the construct with satisfactory fitting indexes. [ABSTRACT FROM AUTHOR]

The synergy, or lack thereof, between large-scale and classroom assessment has been fiercely debated in both academic and policy spheres for decades around the world. This paper seeks to explicate how different countries are utilizing large-scale testing and test results at the classroom level. Through country profiles, this paper analyzes contemporary developments on the tensions and synergies between large-scale assessment and classroom teaching, learning, and assessment observed across seven international jurisdictions: United States, Canada, Australia, England, Germany, Finland, and Singapore. The paper concludes with an analysis of international trends leading to a synthesis of root causes contributing to the current limited uptake of large-scale assessment results at classroom levels.

The purpose of this study was to examine and compare the creative musical identities of pre-service music education students in the United States and Singapore. The Creative Identity in Music (CIM) measure was utilized with both US and Singapore pre-service music teacher populations (n = 274). Items of the CIM relate to music-making activities often associated with creativity in music education in the literature, including composition, improvisation and popular music performance. Results suggest, similar to findings of previous research, that while both populations are similar in their degree of creative music-making self-efficacy and are similarly willing to allow for creativity in the classroom, Singaporean pre-service music teachers value the areas of creative identity and the use of popular music listening/performing within the learning environment to a significantly greater extent (p < 0.0001) than their US counterparts.

The purpose of this study was to investigate participant involvement in community wind bands through the lens of organizational theory to inform the music education profession about community wind bands as an "expressive" voluntary association with potential for lifelong participation. Twenty-eight informants were drawn from three community wind bands in the United States and four community wind bands in Singapore. Overall, responses between U.S. and Singapore informants shared many commonalities. Informants from both countries desired musical opportunities that aligned with their interests (incentives and commitment), viewed their participation as defined largely by the ensemble-conductor relationship (formal structures), and preferred rehearsing and performing under the direction of a competent and respectful conductor (leadership and authority). The diversity of bands from which informants were drawn points to the importance of an environment that supports a range of interests for lifelong participation.

Background and objective: The EV-302 trial found that the combination of enfortumab vedotin (EV) with pembrolizumab significantly improved survival for patients with metastatic urothelial carcinoma (mUC). However, given the high cost of the drugs, there is a need to assess its value by considering both efficacy and cost. This study assessed the cost-effectiveness of EV plus pembrolizumab as a first-line treatment for patients with mUC from the perspective of U.S. payers. Methods: A Markov model was developed to compare the lifetime costs and effectiveness of EV in combination with pembrolizumab with chemotherapy in the treatment of mUC patients from U.S. payer perspective. Life-years (LYs), quality-adjusted LYs (QALYs), and lifetime costs were estimated. One-way, twoway and probabilistic sensitivity analyses were conducted to evaluate model uncertainty. Additionally, subgroup analyses were performed. Results: Compared to chemotherapy, the combination of EV and pembrolizumab provided an additional 2.10 LYs and 1.72 QALYs, at an incremental cost of $962,240.8 per patient. The incremental cost-effectiveness ratio (ICER) is $558,973 per QALY. Subgroup analysis indicated that patients ineligible for cisplatin treatment had a lower ICER compared to those who were eligible for cisplatin. Conclusions: From the perspective of US payers, at a willingness-to-pay threshold of $150,000 per QALY, the combination of EV and pembrolizumab is estimated to not be cost-effective compared to traditional chemotherapy in the first-line treatment of mUC patients. [ABSTRACT FROM AUTHOR]

Background: Residency programs are required to incorporate simulation into their training program. Ideally, simulation provides a safe environment for a trainee to be exposed to both common and challenging clinical scenarios. The purpose of this review is to detail the current state of the most commonly used laparoscopic, endoscopic, and robotic surgery simulation programs in general surgery residency education, including resources required for successful implementation and benchmarks for evaluation. Materials and methods: Members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Resident and Fellow Task Force (RAFT) Committee performed a literature review using PubMed and training websites. Information regarding the components of the most commonly used laparoscopic, endoscopic, and/or robotic simulation curriculum, including both formal and informal benchmarks for evaluating training competence, were collected. Results: Laparoscopic simulation revolves around the Fundamentals of Laparoscopic Surgery (FLS). Proficiency-based as well as virtual simulation have been utilized for FLS training curricula. Challenges include less direct translation to the technical complexities that can arise in laparoscopic surgery. Endoscopic simulation focuses on the Fundamentals of Endoscopic Surgery. There are virtual reality simulation platforms that can be used for skills assessment and training. Challenges include simulator types and access, as well as structured mentoring and feedback. Robotic simulation training curricula have not been standardized. Simulation includes one primary technology, which can be prohibitive based on cost and requirements for onboarding. Conclusions: While surgical simulation seems to be a fundamental and integrated part of surgical training, it requires a significant number of resources, which can be daunting for residency training programs. Regardless of the barriers outlined, the need for surgical simulation in laparoscopy, endoscopy, and robotics at surgical education training programs is clear. [ABSTRACT FROM AUTHOR]

The American Heart Association (AHA) recently redefined cardiovascular health (CVH) with the introduction of Life's Essential 8 (LE8), which encompasses eight areas (diet, physical activity, nicotine exposure, sleep duration body mass index, non-HDL cholesterol, blood glucose, and blood pressure). This study aimed to explore the relationships between both the aggregate and individual CVH metrics, as defined by Life's Essential 8, and cognitive function in older adults in the United States. This cross-sectional, population-based study analyzed data from the National Health and Nutrition Examination Survey conducted between 2011 and 2014, focusing on individuals aged 60 years and older. CVH was categorized as low (0–49), moderate (50–79), or high (80–100). Cognitive function was assessed through the CERAD tests, Animal Fluency test, and Digit Symbol Substitution test. Multivariable logistic models and restricted cubic spline models were employed to investigate these associations. This study included a total of 2279 older adults in the United States. Only 11% of adults achieved a high total CVH score, while 12% had a low score. After further adjustment for potential confounding factors, higher LE8 scores were significantly associated with higher scores on CERAD: delayed recall score (0.02[0.01, 0.03]; P < 0.001), CERAD: total score (3 recall trials) (0.04[0.02, 0.06]; P < 0.001), animal fluency: total score (0.09[0.05, 0.12]; P < 0.001), and digit symbol: score (0.29[0.18, 0.41]; P < 0.001), demonstrating a linear dose–response relationship. Similar patterns were also observed in the associations between health behavior and health factor scores with cognitive function tests. LE8 scores exhibited positive linear associations with cognitive function. Maintaining better levels of CVH may be associated with higher levels of cognitive function in older Americans, but further research is needed to confirm the causal and temporal relationships between LE8 and cognitive function. [ABSTRACT FROM AUTHOR]

Introduction: Malignant brain tumors are malignancies which are known for their low survival rates. Despite advancements in treatments in the last decade, the disparities in malignant brain cancer mortality among the US population remain unclear. Methods: We analyzed death certificate data from the US CDC WONDER from 1999 to 2020 to determine the longitudinal trends of malignant brain tumor mortality. Malignant brain tumor (ICD-10 C71.0–71.9) was listed as the underlying cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated by standardizing the AAMR to the year 2000 US population. Results: From 1999 to 2020, there were 306,375 deaths due to malignant brain tumors. The AAMR decreased from 5.57 (95% CI, 5.47–5.67) per 100,000 individuals in 1999 to 5.40 (95% CI, 5.31–5.48) per 100,000 individuals in 2020, with an annual percent decrease of −0.05 (95% CI, −0.22, 0.12). Whites had the highest AAMR (6.05 [95% CI, 6.02–6.07] per 100,000 individuals), followed by Hispanics (3.70 [95% CI, 3.64–3.76]) per 100,000 individuals, blacks (3.09 [95% CI, 3.04–3.14] per 100,000 individuals), American Indians (2.82 [95% CI, 2.64–3.00] per 100,000 individuals), and Asians (2.44 [95% CI, 2.38–2.50] per 100,000 individuals). The highest AAMRs were reported in the Midwest region (5.58 [95% CI, 5.54–5.62] per 100,000 individuals) and the rural regions (5.66 [95% CI, 5.61–5.71] per 100,000 individuals). Conclusions: Our study highlights the mortality disparity among different races, geographic regions, and urbanization levels. The findings underscore the importance of addressing the disparities in malignant brain tumors that existed among males, white individuals, and rural populations. [ABSTRACT FROM AUTHOR]

Background: The United States faces a growing challenge with over 6.5 million people living with dementia (PLwD). PLwD and their caregivers struggle with cognitive, functional, behavioral, and psychosocial issues. As dementia care shifts to home settings, caregivers receive inadequate support but bear increasing responsibilities, leading to higher healthcare costs. In response, the Centers for Medicare & Medicaid Services (CMS) introduced the Guiding an Improving Dementia Experience (GUIDE) Model. The study explores the real‐world implementation of the Cedars‐Sinai C.A.R.E.S. Program, a pragmatic dementia care model, detailing its recruitment process and initial outcomes. Methods: The Cedars‐Sinai C.A.R.E.S. Program was integrated into the Epic electronic health record system and focused on proactive patient identification, engagement, interdisciplinary collaboration, care transitions, and ongoing care management. Eligible patients with a dementia diagnosis were identified through electronic health record and invited to join the program. Nurse practitioners with specialized training in dementia care performed comprehensive assessments using the CEDARS‐6 tool, leading to personalized care plans developed in consultation with primary care providers. Patients benefited from a multidisciplinary team and support from care navigators. Results: Of the 781 eligible patients identified, 431 were enrolled in the C.A.R.E.S. Program. Enrollees were racially diverse, with lower caregiver strain and patient behavioral and psychological symptoms of dementia (BPSD) severity compared to other programs dementia care programs. Healthcare utilization, including hospitalizations, emergency department (ED) admissions, and urgent care visits showed a downward trend over time. Completion of advanced directives and Physician Order of Life‐Sustaining Treatment (POLST) increased after enrollment. Conclusion: The Cedars‐Sinai C.A.R.E.S. Program offers a promising approach to dementia care. Its real‐world implementation demonstrates the feasibility of enrolling a diverse population and achieving positive outcomes for PLwD and their caregivers, supporting the goals of national dementia care initiatives. [ABSTRACT FROM AUTHOR]

Background Many persons living with dementias (PLWD) prefer to remain at home as long as possible, and days spent at home (DAH)—defined as the time an individual spends outside of healthcare facilities—has emerged as a person-centred outcome measure in this population. We examined the association between DAH and functional status and health among PLWD. Methods Utilizing a nationally representative cohort of individuals age 65 and older in the United States with dementia from the 2010–2018 Health and Retirement Study (HRS), we assessed the relationship between an ordinal categorical DAH variable and number of activities of daily living (ADLs) (range 0–10; 10 being independent), mobility (0–5; 5 being mobile), and self-rated health (SRH) (0–4; 4 being excellent), controlling for patient characteristics. DAH was defined as the number of self-reported days spent outside a hospital or nursing home in the time between survey waves, typically 730 days. Results We identified 3002 participants (4192 observations, average 1.4 observations per participant). The mean DAH was 704.4 days (SD 10.8 days) and 64.9% spent all days at home (i.e. 730 days). A 2-week decrease in DAH was associated with a lower ADL score by 0.32 points (95% confidence internal [CI]: 0.24–0.40, P -for-trend<0.001), a lower mobility score by 0.18 points (95% CI: 0.13–0.22, P -for-trend<0.001), and a lower SRH by 0.05 points (95% CI: 0.02–0.08, P -for-trend<0.001). Conclusion We demonstrate that DAH is positively associated with important patient-reported outcomes among the dementia population, strengthening the argument for considering DAH as a meaningful outcome measure for PLWD. [ABSTRACT FROM AUTHOR]

The article shares how trauma can have effect on the academic performance of unaccompanied migrant youth (UMY). Topics mentioned include the role of schools in creating supportive environment for UMY, the impact of intergenerational trauma on UMY, the author's experience of clinical practice with UMY, and some strategies to integrate trauma-informed approaches.

Inconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the prevalence of secondhand cigarette smoke (SHS) and secondhand e-cigarette aerosol (SHA) exposure by sexual identity using U.S. national data. Topics include exposure to smoke and aerosol indoors/outdoors and study covariates by sexual identity and results of multivariable logistic regression models on each outcome.

Singapore's strong performance in international benchmarking studies--Trends in International Mathematics and Science Study (TIMSS) and Programme for International Student Assessment (PISA)--poses a conundrum to researchers who view Singapore's pedagogy as characterized by the teaching of facts and procedures, and lacking in constructivist learning principles. In this paper, we examine the impact of different curriculum innovations on critical thinking as measured by the Watson-Glaser Critical Thinking Assessment-UK (WGCTA-UK). This includes two innovations that are subject-specific and short-term, one that strongly infuses the arts into the curriculum throughout the whole course of study, and the innovation of the Integrated Programme (IP) which allows academically stronger students to skip the GCE "O" Levels and enter directly into the next level of education, with the time previously allocated to exam preparation now spent on greater breadth in the academic and non-academic curriculum. This paper takes the sociocultural approach to investigate the contexts, process, and outcomes, reports the state of critical thinking, and sheds light on how critical thinking is being promoted. Through our analysis, we find support for the claim that only curriculum that is rigorously designed to foster critical thinking competencies will reap the intended student outcome.

The purpose of the study was to investigate how university band students' (non--music majors) motivational goal orientations toward band and academics differ across participants from Singapore (n = 200) and the United States (n = 227) and examine how they relate to a suite of adaptive dispositions (i.e., flow, grit, and commitment) relevant for 21st-century learning. Data were gathered via a self-report questionnaire that measured achievement goal orientations toward academic major, individual and collective goal orientations toward band, flow during rehearsals, grit while practicing, and commitment to band. An unexpected lack of cross-cultural differences was found, with participants from both cultural groups reporting higher levels of motivation toward their major academic field compared to band, indicating that achievement domain rather than culture accounted for differences in motivational goal orientations. Results also suggest that the optimal motivational profile to cultivate in large ensemble is a combination of individual mastery-approach and collective performance-approach goals.

Vascular rings are arterial malformations that lead to the compression of the trachea and/or esophagus. While "tight" rings often produce symptoms and require surgery, "loose" rings rarely produce symptoms. Given advances in fetal echocardiography, this diagnosis is now more often made prenatally. This poses a new conundrum in the management of asymptomatic patients, leading to practice variation and creating a target for clinical system improvement. Hence, we conducted this survey aiming to demonstrate the practice variation existing in current evaluation and management of these patients. An anonymous web-based survey was distributed to several listservs for pediatric cardiologists and pediatric cardiothoracic surgeons. Survey questions targeted respondent practice characteristics, testing obtained, and indications for testing or surgical referral. In total 61 responses were received, predominantly from pediatric cardiologists (95%) in the United States (97%). About 60% of clinicians reported frequently diagnosing patients with vascular rings by fetal echocardiogram, with only about 20% diagnosing them frequently on evaluation of symptoms. Computed tomography angiography and echocardiogram were the most common imaging modalities employed. Most clinicians obtained cross-sectional imaging at the time of diagnosis and referred to surgery once patients had at least occasional symptoms. Respondents demonstrated a low degree of agreement (Krippendorf's alpha 0.48). Few statistically significant patterns were identified between respondents based on their practice characteristics. This study identified significant variation between clinicians regarding the evaluation and management of vascular rings. Further research or expert opinions may help to standardize practice, saving costs and improving the quality of care for affected patients. [ABSTRACT FROM AUTHOR]

Background: Epstein–Barr virus (EBV)‐associated post‐transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis. Methods: The prospective, multicenter, study enrolled 944 children (≤21 years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre‐transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis. Results: The uni−/multivariable competing risk analyses revealed the combination of EBV‐seropositive donor and EBV‐naïve recipient (D+R−) was a significant risk factor for PTLD development (sub‐hazard ratio: 2.79 [1.34–5.78], p =.006) and EBV DNAemia (2.65 [1.72–4.09], p <.001). Patients with D+R− were significantly more associated with monomorphic/polymorphic PTLD than those with the other combinations (p =.02). Patients with monomorphic/polymorphic PTLD (n = 21) had significantly more EBV DNAemia than non‐PTLD patients (p <.001) and an earlier clinical presentation of PTLD than patients with hyperplasias (p <.001), within 6‐month post‐transplant. Among non‐liver transplant recipients, monomorphic/polymorphic PTLD were significantly more frequent than hyperplasias in patients ≥5 years of age at transplant (p =.01). Conclusions: D+R− is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic/polymorphic PTLD. Intensive follow‐up of EBV viral load within 6‐month post‐transplant, especially for patients with D+R− and/or non‐liver transplant recipients ≥5 years of age at transplant, may help detect monomorphic/polymorphic PTLD early in pediatric transplant. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio) and Type 2 diabetes mellitus (T2DM) in US adults, using National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2018. Methods: This study explored the connection between NHHR and T2DM by analyzing a sample reflecting the adult population of the United States (n = 10,420; NHANES 2007–2018). NHHR was characterized as the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol. T2DM was defined based on clinical guidelines. This research used multivariable logistic models to examine the connection between NHHR and T2DM. Additionally, it included subgroup and interaction analyses to assess variations among different groups. Generalized additive models, smooth curve fitting, and threshold effect analysis were also employed to analyze the data further. Results: The study included 10,420 subjects, with 2160 diagnosed with T2DM and 8260 without. The weighted multivariate logistic regression model indicated an 8% higher probability of T2DM for each unit increase in NHHR (OR: 1.08, 95% CI: 1.01–1.15) after accounting for all covariates. Subgroup analysis outcomes were uniform across various categories, demonstrating a significant positive relationship between NHHR and T2DM. Interaction tests showed that the positive link between NHHR and T2DM remained consistent regardless of age, body mass index, smoking status, moderate recreational activities, hypertension, or stroke history, with all interaction P-values exceeding 0.05. However, participants' sex appeared to affect the magnitude of the connection between NHHR and T2DM (interaction P-value < 0.05). Also, a nonlinear association between NHHR and T2DM was discovered, featuring an inflection point at 1.50. Conclusions: Our study suggests that an increase in NHHR may be correlated with a heightened likelihood of developing T2DM. Consequently, NHHR could potentially serve as a marker for estimating the probability of T2DM development. [ABSTRACT FROM AUTHOR]

The article discusses the mental health challenges faced by international students in the United States, emphasizing the need for culturally responsive support systems . It explores reasons behind these challenges, including acculturative stress, social isolation, and anxieties related to academic performance and immigration status.

Introduction: Cancer represents a significant global public health concern. In recent years, the incidence of cancer has been on the rise worldwide due to various factors, including diet, environment, and an aging population. Simultaneously, advancements in tumor molecular biology and genomics have led to a shift from systemic chemotherapy focused on disease sites and morphopathology towards precise targeted therapy for driver gene mutations. Therefore, we propose a comprehensive review aimed at exploring the research hotspots and directions in the field of Kirsten rat sarcoma viral oncogene homolog (KRAS)-mutant cancers over the past decade, providing valuable insights for cancer treatment strategies. Specifically, we aim to present an intellectual landscape using data obtained from the Web of Science (WoS) regarding KRAS mutation. Methods: Bibliometrix, VOSviewer, CiteSpace, and HistCite were employed to conduct scientometric analyses on national publications, influential authors, highly cited articles, frequent keywords, etc. Results: A total of 16,609 publications met the screening criteria and exhibited a consistent annual growth trend overall. Among 102 countries/regions, the United States occupied the vast majority share of the published volume. The journal Oncotarget had the highest circulation among all scientific publications. Moreover, the most seminal articles in this field primarily focus on biology and targeted therapies, with overcoming drug resistance being identified as a future research direction. Conclusion: The findings of the thematic analysis indicate that KRAS mutation in lung cancer, the prognosis following B-Raf proto-oncogene, serine/threonine kinase (BRAF) or rat sarcoma (RAS) mutations, and anti-epidermal growth factor receptor (EGFR)-related lung cancer are the significant hotspots in the given field. Considering the significant advancements made in direct targeting drugs like sotorasib, it is anticipated that interest in cancers associated with KRAS mutations will remain steadfast. [ABSTRACT FROM AUTHOR]

Purpose Immune checkpoint inhibitors (ICIs) have significantly improved the survival of patients with cancer and provided long-term durable benefit. However, ICI-treated patients develop a range of toxicities known as immune-related adverse events (irAEs), which could compromise clinical benefits from these treatments. As the incidence and spectrum of irAEs differs across cancer types and ICI agents, it is imperative to characterize the incidence and spectrum of irAEs in a pan-cancer cohort to aid clinical management. Design We queried >400 000 trials registered at ClinicalTrials.gov and retrieved a comprehensive pan-cancer database of 71 087 ICI-treated participants from 19 cancer types and 7 ICI agents. We performed data harmonization and cleaning of these trial results into 293 harmonized adverse event categories using Medical Dictionary for Regulatory Activities. Results We developed irAExplorer (https://irae.tanlab.org), an interactive database that focuses on adverse events in patients administered with ICIs from big data mining. irAExplorer encompasses 71 087 distinct clinical trial participants from 343 clinical trials across 19 cancer types with well-annotated ICI treatment regimens and harmonized adverse event categories. We demonstrated a few of the irAE analyses through irAExplorer and highlighted some associations between treatment- or cancer-specific irAEs. Conclusion The irAExplorer is a user-friendly resource that offers exploration, validation, and discovery of treatment- or cancer-specific irAEs across pan-cancer cohorts. We envision that irAExplorer can serve as a valuable resource to cross-validate users' internal datasets to increase the robustness of their findings. [ABSTRACT FROM AUTHOR]

Using the revised bioecological model, we examined whether three broad factors predict adolescents' nonacademic media use, with the exception of TV: (a) process factors that highlight a child's fundamental and proximal interactional activities (e.g., eating meals together); (b) person factors (e.g., age, sex, ethnicity); and (c) contextual factors that delineate a child's immediate physical and social environments (such as family, school, and community). By analyzing a nationally representative cohort (N = 22,454) of U.S. parents/primary caregivers who completed surveys regarding their children, we identified specific process-person-contextual factors that predict adolescents' nonacademic screen time. Factors that positively predict screen time include, e.g., age, sex, ethnicity, BMI, anxiety. Those that negatively predict screen time include, e.g., sleep, physical activity, father's physical health, mother's mental health, eating meals together, sharing ideas with parents, the child's active participation in school activities and community service, school safety, and emotional support for parents. Further, we found one age-related developmental process; the beneficial impact of meal sharing on media use was more pronounced in younger adolescents. This underscores the importance of exploring not only individual characteristics but also the broader process and contextual factors that shape adolescents' nonacademic media use. Prior research on adolescents' screen time primarily examined risk or protective factors at the individual level. In contrast, understanding the nuanced interplay among individual, familial, and broader contextual factors in shaping nonacademic media consumption is limited. We identified a comprehensive but understudied group of process, personal, and contextual factors and their intricate interactions that are pivotal in adolescents' media use. We also made critical theoretical contributions regarding family functioning in the promotion of healthy media practices. Our results have important implications for effective and holistic interventions that support healthy media-use practices in adolescents. These include the promotion of adolescents' self-regulatory skills, healthy family lifestyles at home, and diverse activities at school and within the community. [ABSTRACT FROM AUTHOR]

There is little research on the relationship between phthalates exposure and sleep problems in adult females, with existing studies only assessing the association between exposure to individual phthalates with sleep problems. We aimed to analyse the relationship between phthalates and sleep problems in 1366 US females aged 20 years and older from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) by age stratification. Multivariate logistic regression showed that the fourth quartile of MECPP increased the risk of sleep problems in females aged 20–39 compared with the reference quartile (OR: 1.87, 95% CI: 1.14, 3.08). The WQS index was significantly associated with the sleep problems in females aged 20–39. In the BKMR, a positive overall trend between the mixture and sleep problems in females aged 20–39. In this study, we concluded that phthalates might increase the risk of sleep problems in females aged 20–39. [ABSTRACT FROM AUTHOR]

Background & Aims: Following the classification of metabolic dysfunction‐associated fatty liver disease (MAFLD), non‐alcoholic fatty liver disease (NAFLD) has recently been redefined again as metabolic dysfunction‐associated steatotic liver disease (MASLD). However, the distinctions in characteristics and mortality outcomes between NAFLD, MAFLD and MASLD remain unclear. Methods: We analysed data from 7519 participants in the third National Health and Nutrition Examination Surveys of United States (US) and their linked mortality until 2019. Survey weight‐adjusted multivariable Cox proportional model was used to study the mortality over three terms. Results: The prevalence of NAFLD, MAFLD and MASLD was 18.5%, 19.3% and 20.8%, respectively. Most individuals with NAFLD (94.5%) or MAFLD (100%) can be classified as MASLD, while a relatively low percentage of those with MASLD were also diagnosed with either NAFLD (84.1%) or MAFLD (92.7%). During a median follow‐up of 26.9 years, both MAFLD and MASLD were associated with increased risk of all‐cause mortality (adjusted hazard ratio [aHR] 1.18, 95% CI 1.04–1.33 and 1.19, 1.06–1.34, respectively), this association was mainly observed in NAFLD−/MASLD+ subgroups. NAFLD was not associated with all‐cause mortality. However, all three terms were associated with an increased risk of all‐cause mortality in individuals with advanced fibrosis (aHR: 1.71–1.81). Subgroup analyses showed that higher risk of all‐cause mortality for both MAFLD and MASLD were observed among older adults (≥65 year), non‐Hispanic whites and those without diabetes. Conclusions: Both MASLD and MALFD were linked to higher all‐cause mortality risk, but MASLD identified a greater number of individuals compared to MAFLD. [ABSTRACT FROM AUTHOR]

The present study examined how access to home and school IT resources impacted student mathematics achievement. Data comprised 144,395 secondary school students from 7,308 schools in 22 developed economies who participated in the Programme for International Student Assessment (PISA) 2012. Results of hierarchical linear modelling showed that after controlling for student and school covariates, student achievement benefited from their access to home IT resources (main effect), and from the access to both home IT resources and highly educated mothers (interactive effect). Furthermore, IT resource shortages in school had a detrimental impact on student achievement (main effect), and the shortage accentuated the negative effects of school shortage in qualified teachers on achievement (interactive effect). Lastly, the results showed that students with less home academic and cultural resources were more impacted by IT resource access when compared to peers from advantaged families.

Background: Current evidence from epidemiologic studies suggested that phthalate metabolites might be associated with blood pressure (BP) changes. However, the special relationship between phthalate metabolites and BP changes in children has not been clearly elucidated in existing researches. Objectives: We investigated the links between phthalate metabolites and various BP parameters, including systolic/diastolic BP, mean arterial pressure (MAP), and the presence of hypertension. Methods: The population sample consisted of 1036 children aged 8 to 17 years from the 2013–2018 NHANES in the United States. High performance liquid chromatography-electrospray ionization-tandem mass spectrometry was used to measure urinary concentrations of 19 phthalate metabolites. Systolic/diastolic BP were derived from the average of three valid measurements, and MAP was calculated as (systolic BP + 2 × diastolic BP)/3. Hypertension was defined as mean systolic BP and/or diastolic BP that was ≥ 95th percentile for gender, age, and height reference. Linear regression, logistic regression, and weighted quantile sum (WQS) regression models were employed to assess the associations between phthalate exposure and systolic/diastolic BP, MAP, and hypertension. Results: Ten of 19 phthalate metabolites including MCNP, MCOP, MECPP, MBP, MCPP, MEP, MEHHP, MiBP, MEOHP, and MBzP had detection frequencies > 85% with samples more than 1000. MCNP, MCOP, MECPP, MBP, MCPP, MEHHP, MiBP, MEOHP, and MBzP were generally negatively associated with systolic/diastolic BP and MAP, but not protective factors for hypertension. These associations were not modified by age (8–12 and 13–17 years) or sex (boys and girls). The above-mentioned associations were further confirmed by the application of the WQS analysis, and MCOP was identified as the chemical with the highest weight. Conclusion: Phthalate metabolites were associated with modest reductions in systolic/diastolic BP, and MAP in children, while appeared not protective factors for hypertension. Given the inconsistent results among existing studies, our findings should be confirmed by other cohort studies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the relationship between drinking status and kidney stones occurrence among United States (US) adults who consume alcohol. Methods: We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES 2007–2018). Questionnaires yielded information on alcohol consumption and kidney health. Drinking status was categorized into four groups—former, mild, moderate, and heavy—based on alcohol consumption patterns. The aim was to explore the relationship between drinking status and the prevalence of kidney stones occurrence. For this analysis, we examined a group of individuals diagnosed with kidney stones. With survey weights applied, the total weight of the group was 185,690,415. Results: We used logistic regression to measure the relationship between drinking status and the likelihood of developing kidney stones. In a fully adjusted model, former drinkers were less likely to have previously experienced kidney stones (OR 0.762, 95% CI 0.595–0.977, P < 0.05). In subgroup analysis, heavy alcohol consumption was associated with a significantly reduced likelihood of kidney stones occurrence in various populations. The adjusted odds ratios (with 95% confidence intervals) of kidney stones risk for heavy alcohol consumption were 0.745 (0.566–0.981) for young individuals, 0.566 (0.342–0.939) for older individuals, 0.708 (0.510–0.981) for individuals of white race, 0.468 (0.269–0.817) for individuals with underweight/normal BMI, 0.192 (0.066–0.560) for widowed people, 0.538 (0.343–0.843) for smoking individuals, 0.749 (0.595–0.941) for individuals without a cancer history, and 0.724 (0.566–0.925) for individuals without a stroke history. Conclusions: In US adults who consume alcohol, a negative linear relationship is apparent between drinking status and the prevalence of kidney stones, with heavy drinking showing a lower prevalence compared to former drinkers. However, the causal relationship between drinking status and kidney stones requires further investigation in future research endeavors. [ABSTRACT FROM AUTHOR]

Background: Thromboembolic events related to invasive electrophysiology studies, while rare, can have devastating consequences. Use of systemic anticoagulation for a pediatric or adult‐congenital invasive electrophysiology study is recommended, however there is no established standard of practice in this population. Objective: To report on procedural practices for thromboembolism prophylaxis during invasive electrophysiology studies for pediatric patients and adults with congenital heart disease. Methods: An anonymous web‐based survey was sent to the members of the Pediatric and Congenital Electrophysiology Society. The survey focused on pre‐procedural, intra‐procedural, and post‐procedural thromboembolism prophylaxis practices during invasive electrophysiology studies. Significant practice variation was defined as <90% concordance among respondents. Results: Survey was completed by 73 members; 52 (71%) practicing in the United States, 65 (89%) practicing in an academic institution, and 14 (19%) in an institution that performs more than 200 invasive electrophysiology procedures annually. Responses showed significant variation in practice. Prior to an invasive electrophysiology procedure, 25% discontinue aspirin while 47% discontinue anticoagulants. Heparin is given for all procedures by 32%. When heparin is administered, the first dose is given by 32% after sheaths are placed, 42% after crossing into the systemic atrium, and 26% just prior to systemic‐side ablation. Most target an activated clotting time between 200–300 seconds. Post systemic‐side ablation, 58% do not initiate a heparin infusion. Post‐procedural oral agents were initiated on day of procedure by 34% of respondents and on post‐procedure day 1 by 53%. If treating with aspirin, 74% use low‐dose (3–5 mg/kg or 81 mg daily), and 68% treat for 4–6 weeks. Conclusion: There is significant variation in thromboembolism prophylaxis for invasive EP studies among pediatric and congenital electrophysiologists. Further studies are needed to optimize the management of thromboembolism prophylaxis in this population. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) is a prevalent complication of diabetes and the leading cause of end-stage renal disease. Recent evidence suggests that total flavonoids of Astragalus (TFA) has promising effects on diabetes; however, its influence on DKD and the underlying mechanism remains unclear. Methods: In this study, we induced the DKD model using streptozotocin (STZ) in male C57BL/6J mice and utilized glomerular endothelial cell (GEC) lines for in vitro investigations. We constructed a network pharmacology analysis to understand the mechanism of TFA in DKD. The mechanism of TFA action on DKD was investigated through Western blot analysis and multi-immunological methods. Results: Our findings revealed that TFA significantly reduced levels of urinary albumin (ALB). Network pharmacology and intracellular pathway experiments indicated the crucial involvement of the PI3K/AKT signaling pathway in mediating these effects. In vitro experiments showed that TFA can preserve the integrity of the glomerular filtration barrier by inhibiting the expression of inflammatory factors TNF-alpha and IL-8, reducing oxidative stress. Conclusion: Our findings demonstrated that TFA can ameliorates the progression of DKD by ameliorating renal fibrosis and preserving the integrity of the kidney filtration barrier. These results provide pharmacological evidence supporting the use of TFA in the treatment of kidney diseases. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The Society of Critical Care Medicine last published an intensivist definition in 1992. Subsequently, there have been many publications relating to intensivists. Our purpose is to assess how contemporary studies define intensivist physicians. DESIGN: Systematic search of PubMed, Embase, and Web of Science (2010- 2020) for publication titles with the terms intensivist, and critical care or intensive care physician, specialist, or consultant. We included studies focusing on adult U.S. intensivists and excluded non-data-driven reports, non-U.S. publications, and pediatric or neonatal ICU reports. We aggregated the study title intensivist nomenclatures and parsed Introduction and Method sections to discern the text used to define intensivists. Fourteen parameters were found and grouped into five definitional categories: A) No definition, B) Background training and certification, C) Works in ICU, D) Staffing, and E) Database related. Each study was re-evaluated against these parameters and grouped into three definitional classes (single, multiple, or no definition). The prevalence of each parameter is compared between groups using Fisher exact test. SETTING: U.S. adult ICUs and databases. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 657 studies, 105 (16%) met inclusion criteria. Within the study titles, 17 phrases were used to describe an intensivist; these were categorized as intensivist in 61 titles (58%), specialty intensivist in 30 titles (29%), and ICU/critical care physician in 14 titles (13%). Thirty-one studies (30%) used a single parameter (B-E) as their definition, 63 studies (60%) used more than one parameter (B-E) as their definition, and 11 studies (10%) had no definition (A). The most common parameter "Works in ICU" (C) in 52 studies (50%) was more likely to be used in conjunction with other parameters rather than as a standalone parameter (multiple parameters vs single-parameter studies; 73% vs 17%; p < 0.0001). CONCLUSIONS: There was no consistency of intensivist nomenclature or definitions in contemporary adult intensivist studies in the United States. [ABSTRACT FROM AUTHOR]

Sexual minorities continue to face workplace discrimination, which leads to them experiencing concerns about disclosing their own sexual identities. Despite the benefits of disclosure, relatively little research has examined what organizational factors can work together to foster disclosure of a sexual minority identity. Across five experiments (N = 1662), we examined two main factors: diversity ideologies and information about diversity climate. Sexual minorities were more willing to disclose in organizations with diversity messages conveying that they value group differences (an identity‐conscious ideology) relative to those that downplay differences (an identity‐blind ideology). Identity‐conscious ideologies also increased belonging, perceptions of fair treatment and perceptions of LGBTQ+ representation. Despite expectations that contradictory evidence demonstrating a negative diversity climate might create mistrust and impede disclosure, the benefits of an identity‐conscious ideology persisted in the face of a negative diversity climate. These findings point to the complexities of facilitating visible sexual minority representation in many workplace environments. [ABSTRACT FROM AUTHOR]

Hate crimes, which stem from prejudiced attitudes, have a distributionally detrimental impact on societal stability. Although inter-group contacts are potentially an effective means for reducing prejudice and subsequently decreasing the number of hate crimes, scholars have recently recognized the possibility of negative contacts that might actually amplify prejudice. As a result, the question of whether intergroup contacts truly possess the ability to effectively decrease hate crime numbers remains inconclusive. In addition, prior contact research primarily relies on laboratory experiments because the establishment of intergroup contacts in a field setting is challenging. Examination of the effectiveness of intergroup contacts hence merits further investigation in a real-world setting. In this article, we propose that ride-hailing services, which naturally connect individuals from different backgrounds, offer an avenue to facilitate intergroup contacts in practice, which could potentially reduce prejudice and the volume of hate crimes. Leveraging the staggered introduction of this technology into counties in the United States, we conducted a series of analyses to empirically evaluate the contact effects in the open field. Our analysis reveals a notable decrease in the number of hate crimes (particularly a 5.75% reduction in racial hate crimes) after the introduction of ride-hailing services. These findings remained consistent across various robustness tests. Additional moderation analysis suggests that the increased interaction between different groups, facilitated by ride-hailing services, is the most likely explanation for the observed decrease in hate crimes. We further conducted an extensive survey involving real ride-hailing drivers and passengers. The results from our survey provide direct evidence that ride-hailing services create natural and constructive environments where positive interactions and mutual understanding can develop among diverse groups of people. This, in turn, helps mitigate prejudice and hate crimes within society, as observed in our analysis. This study not only extends the existing body of literature on contact theory but also sheds light on how modern technologies can play a pivotal role in curtailing hate crime, yielding both theoretical and practical implications. [ABSTRACT FROM AUTHOR]

Many eligible voters in the United States are not registered to vote, many registered voters do not vote, and physicians vote less often than the average citizen. This article describes the connection between voting and health, identifies some barriers to voting, and makes policy recommendations to support safe and accessible voting. During the past 2 decades, voter turnout in U.S. presidential elections has ranged from 51.7% to 66.9% of the eligible population. Low voter turnout rates and inequitable electoral institutions, such as gerrymandered districts, can skew policy decisions toward the preferences of a smaller group and further exclude individuals and communities who have been historically marginalized and excluded from decision-making processes. Voting and health are directly connected through the institution of policies by ballot initiative and the election of officials who incorporate health into their platforms. They are also indirectly connected, as civic participation connects persons to their community and empowers them with agency in decision making. In this position paper, the American College of Physicians seeks to inform physicians, medical students, and other health care professionals on the links between electoral processes and health; encourage civic participation; and offer policy recommendations to support safe and equitable access to electoral participation to advance health equity for both patients and health care professionals. [ABSTRACT FROM AUTHOR]