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BackgroundChronic gastroduodenal disorders including, chronic nausea and vomiting syndrome, gastroparesis, and functional dyspepsia, are challenging to diagnose and manage. The diagnostic and treatment pathways for these disorders are complex, costly and overlap substantially; however, experiences of this pathway have not been thoroughly investigated. This study therefore aimed to explore clinician and patient perspectives on the current clinical pathway.MethodsSemi-structured interviews were conducted between June 2020 and June 2022 with 11 patients with chronic nausea and vomiting syndrome alone (based on Rome IV criteria) and nine gastroenterologists who treat these conditions. Interviews were recorded, transcribed, and thematically analyzed using a reflexive, iterative, inductive approach. Five key patient themes were identified: (1) the impacts of their chronic gastroduodenal symptoms, (2) the complexity of the clinical journey, (3) their interactions with healthcare providers, (4) the need for advocacy, and (5) their experience of treatments. Five key clinician themes were also identified: (1) these conditions were seen as clinically complex, (2) there is an uncertain and variable clinical pathway, (3) the nuance of investigations, (4) these conditions were difficult to therapeutically manage, and (5) there are barriers to developing a therapeutic relationship.ConclusionFindings indicate that both patients and clinicians are dissatisfied with the current clinical care pathways for nausea and vomiting syndromes. Recommendations included the development of more clinically relevant and discriminant tests, standardization of the diagnostic journey, and the adoption of a multidisciplinary approach to diagnosis and treatment.

The reliable supply of safe drinking water is vital for the health of human populations. Despite this, there is no consistent nationwide spatial dataset of water distribution zones (WDZ) for Aotearoa New Zealand (A-NZ). The purpose of this data article is to describe the development and validation of a consistent nationwide dataset of WDZ across A-NZ. We obtained spatial data from all 67 district and city councils through: 1) information requests between 2021 and 2023; 2) the Ministry of Health and; 3) the Institute of Environmental Science and Research. Data were modified to improve the spatial accuracy of the WDZ using auxiliary data on the building footprints (Land Information New Zealand) and the drinking water reticulation (WSP & councils). We estimated the population served by each WDZ through spatial linking to meshblock-level data provided by Statistics New Zealand (meshblocks are the smallest administrative geographic unit in A-NZ). The dataset will be useful to provide insights into the extent of the publicly-owned drinking water assets in A-NZ and is essential for the accurate exposure assessment in epidemiological research investigating the impact of drinking water quality on human health.

ObjectivesResearch examining decision-making in sports has predominantly used experimental approaches that fail to provide a holistic understanding of the various factors that impact the decision-making process. The current study aimed to explore the decision-making processes of Senior (expert) and Academy (near-expert) Gaelic Football players using a focus group approach.MethodsFour focus groups were conducted; two with Senior players (n = 5; n = 6) and two with U17 Academy players (n = 5; n = 6). In each focus group, short video clips of Senior Gaelic football games were played, and the action was paused at key moments. The group then discussed the options available to the player in possession, the decision they would make in that situation, and importantly, what factors influenced the final decision. Thematic analysis was used to identify themes that emerged from the focus groups.Results and discussionFour primary themes emerged that affected the decision-making process. Three themes were related to information sources, namely, pre-match context (coach tactics and instructions, match importance, and opposition status), current match context (score and time remaining), and visual information (player positioning and field space, and visual search strategy), and the fourth theme related to individual differences (self-efficacy, risk propensity, perceived pressure, physical characteristics, action capabilities, fatigue) that moderated the decision-making process. Compared to the near-expert Academy players, the expert Senior players displayed a more sophisticated understanding of the various sources of information and were able to integrate them in a more complex manner to make projections regarding future scenarios. For both groups, the decision-making process was moderated by individual differences. A schematic has been developed based on the study findings in an attempt to illustrate the hypothesized decision-making process.

Repair of DNA double strand breaks (DSBs) is integral to preserving genomic integrity. Therefore, defining the mechanisms underlying DSB repair will enhance our understanding of how defects in these pathways contribute to human disease and could lead to the discovery of new approaches for therapeutic intervention. Here, we established a panel of HaloTagged DNA damage response factors in U2OS cells which enables concentration-dependent protein labeling by fluorescent HaloTag ligands. Genomic insertion of HaloTag at the endogenous loci of these repair factors preserves expression levels and proteins retain proper subcellular localization, foci-forming ability, and functionally support DSB repair. We systematically analyzed total cellular protein abundance, measured recruitment kinetics to laser-induced DNA damage sites, and defined the diffusion dynamics and chromatin binding characteristics by live-cell single-molecule imaging. Our work demonstrates that the Shieldin complex, a critical factor in end-joining, does not exist in a preassembled state and that relative accumulation of these factors at DSBs occurs with different kinetics. Additionally, live-cell single-molecule imaging revealed the constitutive interaction between MDC1 and chromatin mediated by its PST repeat domain. Altogether, our studies demonstrate the utility of single-molecule imaging to provide mechanistic insights into DNA repair, which will serve as a powerful resource for characterizing the biophysical properties of DNA repair factors in living cells.

Background: Telehealth-facilitated models of palliative care are a patient-focused way to deliver specialist care in or closer to home for people with a life-limiting illness. Telehealth can increase access to palliative care and support people experiencing symptoms of advanced disease in their own home, reducing the discomfort of travel. This retrospective cohort study examines the activity and outcomes of a regional telehealth-facilitated palliative care service to (i) describe which patients are most likely to use telehealth; and (ii) explore possible impacts of telehealth on patient outcomes including place of death, timely access to care, responsiveness to urgent needs and pain management. Methods: Analysis of service activity data (patient demographics, care modality, consultation frequency) and Palliative Care Outcomes Collaborative data registry (place of death, timely access to palliative care, responsiveness to urgent needs as measured by time in unstable phase, pain management) were undertaken. Outcomes were compared between patients who had no videoconsultations (n = 683) and those who had one or more videoconsultations (n = 524). Results: Compared to people who had no videoconsultations, those who had at least one appointment via video were: more than twice as likely to die at home and spent a shorter amount of time in the unstable phase of palliation. Mixed results were found regarding timely access to palliative care. There was no significant difference in pain management between consultation modes. Conclusion: Telehealth-facilitated palliative care has multiple benefits, including the increased likelihood of fulfilling someone's wish to die at home, often their preferred place of death. [ABSTRACT FROM AUTHOR]

Freshmen often encounter significant challenges in adapting to the complexity of university-level mathematics and independent learning. These challenges necessitate the development of strong self-regulated learning (SRL) skills to successfully navigate the demands of higher education. Building on mindset theory, this study explores how mathematical mindset-oriented interventions can support freshmen's mathematics learning during their transition to higher education mathematics, particularly in an online setting. This mixed-methods study involved 306 freshmen, who participated in an online calculus tutorial program, with 118 engaged in the mindset intervention and 188 serving as controls. The intervention significantly altered the students' perceptions of mathematics and improved their SRL strategies. Quantitative data were analyzed using descriptive statistics, ANOVA, t -tests, and Structural Equation Modeling to examine the relationships between mathematical mindset, SRL, and academic achievement. Qualitative data from semi-structured interviews with 18 students were thematically analyzed to provide deeper insights into students' experiences and mindset development. Students with a mathematical mindset demonstrated enhanced SRL strategies and superior mathematical achievement. However, the fact that some students with a fixed mindset also achieved high levels of mathematical success points to the intervention's complex influence on academic confidence and achievement. These findings highlight the need for ongoing research into the mathematical growth mindset at the tertiary level and for adapting educational strategies to the changing dynamics of online education and diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Developing the capacity to monitor species diversity worldwide is of great importance in halting biodiversity loss. To this end, remote sensing plays a unique role. In this study, we evaluate the potential of Global Ecosystem Dynamics Investigation (GEDI) data, combined with conventional satellite optical imagery and climate reanalysis data, to predict in situ alpha diversity (Species richness, Simpson index, and Shannon index) among tree species. Data from Sentinel-2 optical imagery, ERA-5 climate data, SRTM-DEM imagery, and simulated GEDI data were selected for the characterization of diversity in four study areas. The integration of ancillary data can improve biodiversity metrics predictions. Random Forest (RF) regression models were suitable for estimating tree species diversity indices from remote sensing variables. From these models, we generated diversity index maps for the entire Cerrado using all GEDI data available in orbit. For all models, the structural metric Foliage Height Diversity (FHD) was selected; the Renormalized Difference Vegetation Index (RDVI) was also selected in all species diversity models. For the Shannon model, two GEDI variables were selected. Overall, the models indicated performances for species diversity ranging from (R2 = 0.24 to 0.56). In terms of RMSE%, the Shannon model had the lowest value among the diversity indices (31.98%). Our results suggested that the developed models are valuable tools for assessing species diversity in tropical savanna ecosystems, although each model can be chosen based on the objectives of a given study, the target amount of performance/error, and the availability of data. [ABSTRACT FROM AUTHOR]

Quantifying basal area in terms of diameter classes is important for informing forest management decisions. It is commonly derived from stand diameter distributions using field measurements, LiDAR, and a distribution function. This study compares alternative methods for directly estimating basal area in three tree diameter classes that are relevant to timber operations and wildlife habitat planning in southern United States pine forests. Specifically, linear modeling, ensemble linear modeling (ELM) and ensemble general additive modeling (EGAM) were compared. The results showed that the EGAM method provided the highest r-squared values and the lowest RMSE, and the ELM method provided good interpretability and 30 times faster processing than the EGAM method. Both ensemble methods produced a spatially explicit standard error estimate output without additional steps, unlike the single linear model. In general, the estimation results of this study were comparable or improved over prior studies' estimates of basal area by tree diameter class. [ABSTRACT FROM AUTHOR]

As digital devices become ubiquitous in learning contexts, they have become the main source of distraction that leads to distractive multitasking. This underscores the growing importance of self-regulated learning as a means of combating distraction and persisting in learning. This study aims to bridge the perspectives of self-regulation and distractive multitasking in academic settings to gain a comprehensive understanding of how distractions from various sources induce multitasking and how students employ self-regulation strategies to manage distractions during class time. A framework was constructed to explore internal and external distractions that account for distractive multitasking and self-regulation strategies for coping with distractions. A mixed-method design was adopted to collect data from three Chinese universities. The results show that distractive multitasking can be induced by cognitive, emotional, and behavioral conditions and external factors concerning physical, social, and technological contexts. Further, students' multitasking behaviors and implementation of self-regulated learning strategies are changeable depending on their motivation and the perceived value of the ongoing course. Our study also illuminates a range of self-regulated learning strategies that involve minimizing distractions during the planning phase and monitoring and combating distractions during class. [ABSTRACT FROM AUTHOR]

Landscape-oriented approaches in archaeology have moved beyond site-based research to interpret how people have engaged with, modified, and constructed the environment and how the legacies of these activities continue to influence land use. In the Maya Lowlands, landscape archaeology is related to the analysis of settlement patterns, households, agricultural intensification, and water management. The increasing availability of LiDAR data has revolutionized the mapping of archaeological landscapes under vegetation, especially in tropical environments like the Maya Lowlands, but researchers still emphasize site-oriented settlement densities and infrastructure. Furthermore, the accessibility of drone-based LiDAR platforms has the potential to collect data across several seasons or years to facilitate change detection. In this paper, we compare three LiDAR datasets collected from 2018 to 2023, using both occupied and unoccupied airborne systems. The landscape surrounding the archaeological site of El Infiernito, Chiapas, Mexico near the Classic period (AD 250–800) dynastic capital of Piedras Negras, Guatemala was selected to compare these LiDAR datasets in the context of prior, extensive ground-based fieldwork. These data were used to interpret the built environment, land use, hydrology, landscapes of movement, and other infrastructure constructed and modified by several communities beginning in the Late Preclassic period (400 BC–AD 250) to the present. When used alongside systematic survey and ground verification, the combination of several LiDAR platforms to collect data across different seasons at El Infiernito enhanced the understanding of the spatial distribution of archaeological sites and features across the karst landscape. [ABSTRACT FROM AUTHOR]

Help-seeking is an essential self-regulatory and metacognitive skill. In the online learning environment, much of the learning is self-directed and there are generally less opportunities to receive help in real time. The uses of email and discussion boards are the most common method of seeking help in these environments. The current study explored students' perceptions of the use of live chat technology for online academic help-seeking within higher education, with a focus on comparing online and blended learners' perspectives. Participants were 246 students who were studying psychology online (n = 91) or in blended learning (n = 155) environments. The live chat technology was well received by both groups, especially for its ability to provide instant, real-time, and convenient help. Live chat was particularly well received by online learners, who were more satisfied, felt more cared about by the teaching team, and would be more likely to recommend it to others than blended learners. Further, online learners reported that live chat gave them better access to staff, and felt that this feature was a good approximation for more traditional face-to-face conversations. As an online, synchronous, private help-seeking tool between student and teacher, these findings provide a strong endorsement for the use of live chat in higher education, particularly for online learners.

Self-regulated learning (SRL) is associated with increased academic achievement and improved learning outcomes for students. Thus, it is import to find ways to improve SRL, such as through training. Face-to-face training, discipline-dependent training, and paper-and-pencil diaries are limited in the number of students they can reach. The current randomised control study implemented discipline-independent online training and novel mobile-app based diaries and tested SRL motivation and perceived strategy use in 73 University students from mixed disciplines and study mode. Results showed that participants in the combined condition (training with diaries) improved more than other conditions. Specifically, they improved on SRL knowledge, metacognitive strategies, cognitive strategies (elaboration, organisation and critical thinking), and resources management strategies (time-management and effort regulation). The present study extends previous findings, showing that positive effects can be found for SRL when a discipline-independent approach is used coupled with online training and a mobile-app based daily diary.

Abstract Background Many Hodgkin lymphoma (HL) survivors are at increased risk of subsequent malignant neoplasms (SMN), including lung cancer, due to previous treatment for HL. Lung cancer screening (LCS) detects early-stage lung cancers in ever smokers but HL survivors without a heavy smoking history are ineligible for screening. There is a rationale to develop a targeted LCS. The aim of this study was to investigate levels of willingness to undergo LCS in HL survivors, and to identify the psycho-social factors associated with screening hesitancy. Methods A postal questionnaire was sent to 281 HL survivors registered in a long-term follow-up database and at increased risk of SMNs. Demographic, lung cancer risk factors, psycho-social and LCS belief variables were measured. Multivariable logistic regression analysis was performed to determine the factors associated with lung cancer screening hesitancy, defined as those who would ‘probably’ or ‘probably not’ participate. Results The response rate to the questionnaire was 58% (n = 165). Participants were more likely to be female, older and living in a less deprived area than non-participants. Uptake (at any time) of breast and bowel cancer screening among those previously invited was 99% and 77% respectively. 159 participants were at excess risk of lung cancer. The following results refer to these 159. Around half perceived themselves to be at greater risk of lung cancer than their peers. Only 6% were eligible for lung cancer screening pilots aimed at ever smokers in the UK. 98% indicated they would probably or definitely participate in LCS were it available. Psycho-social variables associated with LCS hesitancy on multivariable analysis were male gender (OR 5.94 CI 1.64–21.44, p

ABSTRACT Viruses have brought humanity many challenges: respiratory infection, cancer, neurological impairment and immunosuppression to name a few. Virology research over the last 60+ years has responded to reduce this disease burden with vaccines and antivirals. Despite this long history, the COVID-19 pandemic has brought unprecedented attention to the field of virology. Some of this attention is focused on concern about the safe conduct of research with human pathogens. A small but vocal group of individuals has seized upon these concerns – conflating legitimate questions about safely conducting virus-related research with uncertainties over the origins of SARS-CoV-2. The result has fueled public confusion and, in many instances, ill-informed condemnation of virology. With this article, we seek to promote a return to rational discourse. We explain the use of gain-of-function approaches in science, discuss the possible origins of SARS-CoV-2 and outline current regulatory structures that provide oversight for virological research in the United States. By offering our expertise, we – a broad group of working virologists – seek to aid policy makers in navigating these controversial issues. Balanced, evidence-based discourse is essential to addressing public concern while maintaining and expanding much-needed research in virology.

IntroductionWith the increasing utilization of text-based suicide crisis counseling, new means of identifying at risk clients must be explored. Natural language processing (NLP) holds promise for evaluating the content of crisis counseling; here we use a data-driven approach to evaluate NLP methods in identifying client suicide risk.MethodsDe-identified crisis counseling data from a regional text-based crisis encounter and mobile tipline application were used to evaluate two modeling approaches in classifying client suicide risk levels. A manual evaluation of model errors and system behavior was conducted.ResultsThe neural model outperformed a term frequency-inverse document frequency (tf-idf) model in the false-negative rate. While 75% of the neural model’s false negative encounters had some discussion of suicidality, 62.5% saw a resolution of the client’s initial concerns. Similarly, the neural model detected signals of suicidality in 60.6% of false-positive encounters.DiscussionThe neural model demonstrated greater sensitivity in the detection of client suicide risk. A manual assessment of errors and model performance reflected these same findings, detecting higher levels of risk in many of the false-positive encounters and lower levels of risk in many of the false negatives. NLP-based models can detect the suicide risk of text-based crisis encounters from the encounter’s content.

BackgroundAccurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded.Methods and findingsRetrospective cohort study using 2 linked datasets of routinely collected clinical data in England. We identified adults with diagnosed intellectual disability in a large secondary mental healthcare database and used general hospital records to investigate recording of intellectual disability when people were admitted to general hospitals between 2006 and 2019. Trends over time and factors associated with intellectual disability being unrecorded were investigated. We obtained data on 2,477 adults with intellectual disability who were admitted to a general hospital in England at least once during the study period (total number of admissions = 27,314; median number of admissions = 5). People with intellectual disability were accurately recorded as having the condition during 2.9% (95% CI 2.7% to 3.1%) of their admissions. Broadening the criteria to include a nonspecific code of learning difficulty increased recording to 27.7% (95% CI 27.2% to 28.3%) of all admissions. In analyses adjusted for age, sex, ethnicity, and socioeconomic deprivation, having a mild intellectual disability and being married were associated with increased odds of the intellectual disability being unrecorded in hospital records. We had no measure of quality of hospital care received and could not relate this to the presence or absence of a record of intellectual disability in the patient record.ConclusionsRecognition and recording of intellectual disability in adults admitted to English general hospitals needs to be improved. Staff awareness training, screening at the point of admission, and data sharing between health and social care services could improve care for people with intellectual disability.

Although many insect-based foods are nutritious and often an inexpensive option for human and domesticated animal consumption, there remains a negligible market for such foods in many countries. Several environmental and economic considerations underscore the potential value of insect-based foods, and emerging science suggests that diets incorporating such foods might also convey some genuine health benefits. However, if expanded markets for insect-based foods in cultures naïve to entomophagy are to be pursued, it will be important to develop multifaceted and coordinated strategies to 1) delineate authentic health benefits, 2) explore means of optimizing insect husbandry and food processing, 3) examine cultural barriers to acceptance, 4) formulate workable approaches to marketing, and 5) address relevant food regulations. We sought to construct a multidisciplinary coalition whose goals are to investigate the above-mentioned 5 issues. Eighteen individuals from government, industry, and academia, with collective expertise in the fields of entomology, insect husbandry, human nutrition, sustainable agriculture, entomophagy, consumer product development and marketing, food-processing technologies, food regulatory affairs, and the anthropology of food selection, convened a 1-d summit and formed a tripartite organization to integrate their varied perspectives. Collaborative efforts are underway among members of this coalition to accomplish these multiple goals. Coordinating efforts between accomplished experts in relevant fields of academia, government, and industry will greatly expand our knowledge of and appreciation for the potential benefits of insect-based foodstuffs to individuals, to society, and to the sustainability of the global food supply, and thereby inform us as to how to proceed in a judicious and intelligent manner.