Search

Mindful practices have been found to decrease levels of stress, anxiety, and burnout, while enhancing resilience and coping in those who engage in them. The beneficial effects of mindfulness on improving physiological and psychological well-being are well supported within the literature. However, little has been done to learn how faculty in higher education, specifically in nursing, may experience the effect of mindful practices. The purpose of this study was to explore nursing faculty perceptions of how mindfulness may influence their teaching-learning practices as well as their daily lives. Fourteen full-time and part-time nursing faculty participated in a three-part mindfulness training workshop series delivered over 6 weeks. Upon completing the workshop series, seven of the 14 nursing faculty participated in a focus-group interview about their experiences engaging in the mindful activities during and in-between the workshops. Clandinin and Connelly's (2000) narrative inquiry method was used to analyze participant accounts. This process entailed crafting a composite story that was sent to the participants for member checking. The composite story was analyzed using the three levels of justification: personal, practical, and social. Two significant patterns emerged: (1) Integrating mindful practices into personal life, and (2) Integrating mindful practices into the teaching and learning situations. The findings from this study contribute to the growing body of knowledge on how engaging in mindful practices may enhance the personal and the professional well-being of faculty in higher education, and thus support their teaching-learning encounters.

Abstract Clinical trial matching is the task of identifying trials for which patients may be eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process also results in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic, datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present an end-to-end large-scale empirical evaluation of a clinical trial matching system and validate it using real-world EHRs. We perform comprehensive experiments with proprietary LLMs and our custom fine-tuned model called OncoLLM and show that OncoLLM outperforms GPT-3.5 and matches the performance of qualified medical doctors for clinical trial matching.

To retrieve columnar intensive aerosol properties from sun–sky photometers, both irradiance and radiance calibration factors are needed. For the irradiance the solar calibration constant, V0, which denotes the instrument counts for a direct normal solar flux extrapolated to the top of the atmosphere, must be determined. The solid view angle, SVA, is a measure of the field of view of the instrument, and it is important for obtaining the radiance from sky diffuse irradiance measurements. Each of the three sun-photometer networks considered in the present study (SKYNET, AERONET, WMO GAW) adopts different protocols of calibration, and we evaluate the performance of the on-site calibration procedures, applicable to every kind of sun–sky photometer but tested in this analysis only on SKYNET Prede POM01 instruments, during intercomparison campaigns and laboratory calibrations held in the framework of the Metrology for Aerosol Optical Properties (MAPP) European Metrology Programme for Innovation and Research (EMPIR) project. The on-site calibration, performed as frequently as possible (ideally monthly) to monitor changes in the device conditions, allows operators to track and evaluate the calibration status on a continuous basis, considerably reducing the data gaps incurred by the periodic shipments for performing centralized calibrations. The performance of the on-site calibration procedures for V0 was very good at sites with low turbidity, showing agreement with a reference calibration between 0.5 % and 1.5 % depending on wavelengths. In the urban area, the agreement decreases between 1.7 % and 2.5 %. For the SVA the difference varied from a minimum of 0.03 % to a maximum of 3.46 %.

A mixed methodologies study was completed to evaluate an elementary school-based Community-Based Instruction (CBI) program for students with autism and secondary findings were identified in the focus group analysis related to barriers to program success, facilitators of program success and implications for practice including occupational therapy. Developed and coordinated by an occupational therapist, the program's mission was to develop work behaviors, job skills, social skills, career interests, and self-determination skills by generalizing knowledge from the classroom through the performance of jobs within the elementary school. Jobs in the school community included running a coffee cart, performing library jobs, organizing a Lost and Found, maintaining a garden, and running a farmer's market to name a few. The program evaluation results showed positive program knowledge and positive attitudes among three stakeholder groups (staff, parents, and administrators) through quantitative and qualitative findings. Through the thematic analysis of the focus groups, barriers to program implementation, facilitators of program success and implications for practice were identified including implications for school-based occupational therapy practitioners which this article further explains.

Abstract Introduction A dynamic molecular biomarker that can identify early efficacy of immune checkpoint inhibitor (ICI) therapy remains an unmet clinical need. Here we evaluate if a novel circulating tumor DNA (ctDNA) assay, xM, used for treatment response monitoring (TRM), that quantifies changes in ctDNA tumor fraction (TF), can predict outcome benefits in patients treated with ICI alone or in combination with chemotherapy in a real-world (RW) cohort. Methods This retrospective study consisted of patients with advanced cancer from the Tempus de-identified clinical genomic database who received longitudinal liquid-based next-generation sequencing. Eligible patients had a blood sample ≤ 40 days prior to the start of ICI initiation and an on-treatment blood sample 15–180 days post ICI initiation. TF was calculated via an ensemble algorithm that utilizes TF estimates derived from variants and copy number information. Patients with molecular response (MR) were defined as patients with a ≥ 50% decrease in TF between tests. In the subset of patients with rw-imaging data between 2 and 18 weeks of ICI initiation, the predictive value of MR in addition to rw-imaging was compared to a model of rw-imaging alone. Results The evaluable cohort (N = 86) was composed of 14 solid cancer types. Patients received either ICI monotherapy (38.4%, N = 33) or ICI in combination with chemotherapy (61.6%, N = 53). Patients with MR had significantly longer rw-overall survival (rwOS) (hazard ratio (HR) 0.4, P = 0.004) and rw-progression free survival (rwPFS) (HR 0.4, P = 0.005) than patients with molecular non-response (nMR). Similar results were seen in the ICI monotherapy subcohort; HR 0.2, P = 0.02 for rwOS and HR 0.2, P = 0.01 for rwPFS. In the subset of patients with matched rw-imaging data (N = 51), a model incorporating both MR and rw-imaging was superior in predicting rwOS than rw-imaging alone (P = 0.02). Conclusions xM used for TRM is a novel serial quantitative TF algorithm that can be used clinically to evaluate ICI therapy efficacy.

Background Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder with a wide clinical, cognitive, and behavioral expressivity.

ObjectivesTo discuss the opportunities and challenges of the qualitative solicited diary approach using digital technologies as an innovative way to access insights into people’s lives and their unique stories in times of COVID-19-related social distancing in Switzerland.MethodsThis case study provides reflective arguments from a social science perspective for the selection of different (digital) diary designs to optimize data collection in the SNSF-funded project “PubliCo - an experimental online platform for COVID-19-related public perception.”ResultsThe findings highlight some opportunities of using (digital) diaries, such as empowering participants, gathering real-time data, and ethical and methodological challenges when it comes to gaining access to alternative narratives.ConclusionTo gain in-depth insights during a crisis and to reach the lesser-heard voices that are central to democratic debates, it is necessary to adapt data gathering methods and build trust with diverse communities. While digital technologies open up new possibilities for public engagement, there is a need to think critically how data gathering is approached, how trustworthy the results are, and whose voices are captured, amplified, or left out.

Understanding disease burden and transmission dynamics in resource-limited, low-income countries like Nepal are often challenging due to inadequate surveillance systems. These issues are exacerbated by limited access to diagnostic and research facilities throughout the country. Nepal has one of the highest COVID-19 case rates (915 cases per 100,000 people) in South Asia, with densely-populated Kathmandu experiencing the highest number of cases. Swiftly identifying case clusters (hotspots) and introducing effective intervention programs is crucial to mounting an effective containment strategy. The rapid identification of circulating SARS-CoV-2 variants can also provide important information on viral evolution and epidemiology. Genomic-based environmental surveillance can help in the early detection of outbreaks before clinical cases are recognized and identify viral micro-diversity that can be used for designing real-time risk-based interventions. This research aimed to develop a genomic-based environmental surveillance system by detecting and characterizing SARS-CoV-2 in sewage samples of Kathmandu using portable next-generation DNA sequencing devices. Out of 22 sites in the Kathmandu Valley from June to August 2020, sewage samples from 16 (80%) sites had detectable SARS-CoV-2. A heatmap was created to visualize the presence of SARS-CoV-2 infection in the community based on viral load intensity and corresponding geospatial data. Further, 47 mutations were observed in the SARS-CoV-2 genome. Some detected mutations (n = 9, 22%) were novel at the time of data analysis and yet to be reported in the global database, with one indicating a frameshift deletion in the spike gene. SNP analysis revealed possibility of assessing circulating major/minor variant diversity on environmental samples based on key mutations. Our study demonstrated the feasibility of rapidly obtaining vital information on community transmission and disease dynamics of SARS-CoV-2 using genomic-based environmental surveillance.

Given the selection of elderly patients with AML in first complete remission (CR1) the advantage of consolidation with allogeneic hematopoietic cell transplantation (HCT) over chemotherapy is still unclear. Newly diagnosed AML patients in CR1 aged 60-75 years were registered and a donor search initiated. After one consolidation cycle, patients with a matched donor were randomized to HCT with fludarabine/lowdose total body irradiation and cyclosporine/mycophenolate mofetil immunosuppression or conventional non-HCT. Primary outcome was restricted mean leukemia-free survival (RM-LFS) up to five years. Between 2010 and 2017, 245 patients (median age 67 years) were registered at CR1. After one consolidation, 26.9% of patients failed inclusion criteria. Of the 179 (73%) patients still on study, 75.4% had an HLA identical donor. Ten ineligible patients were excluded, and 125 randomized to HCT (n=83) or non-HCT (n=42). The primary outcome RM-LFS up to 5 years was 24.5 months (95%CI:18.9-30.1) in the HCT and 15.6 months (95%CI:10.4-20.8) in the non-HCT arm (p=0.022) due to a decrease in cumulative relapse incidence from 91.1 (95%CI:80.7-100.0) after non-HCT to 37.8 (95%CI:27.2-48.4)% after HCT (p

Background and Aims: Data on the prevalence and characteristics of so-called rare HCV genotypes (GTs) in larger cohorts is limited. This study investigates the frequency of rare GT and resistance-associated substitutions and the efficacy of retreatment in a European cohort. Methods: A total of 129 patients with rare GT1-6 were included from the European resistance database. NS3, NS5A, and NS5B were sequenced and clinical parameters and retreatment efficacies were collected retrospectively. Results: Overall 1.5% (69/4,656) of direct-acting antiviral (DAA)-naive and 4.4% (60/1,376) of DAA-failure patients were infected with rare GT. Although rare GTs were almost equally distributed throughout GT1-6 in DAA-naive patients, we detected mainly rare GT4 (47%, 28/60 GT4; of these n = 17, subtype 4r) and GT3 (25%, 15/60 GT3, of these n = 8, subtype 3b) among DAA-failures. A total of 62% (37/60) of DAA failures had not responded to first-generation regimes and the majority was infected with rare GT4 (57%, 21/37). In contrast, among patients with failure to pangenotypic DAA regimens (38%, 23/60), infections with rare GT3 were overrepresented (57%, 13/23). Although NS5A RASs were uncommon in rare GT2, GT5a, and GT6, we observed combined RASs in rare GT1, GT3, and GT4 at positions 28, 30, 31, which can be considered as inherent. DAA failures with completed follow-up of retreatment, achieved a high SVR rate (94%, 45/48 modified intention-to-treat analysis; 92%, 45/49 intention-to-treat). Three patients with GT4f, 4r, or 3b, respectively, had virological treatment failure. Conclusions: In this European cohort, rare HCV GT were uncommon. Accumulation of specific rare GT in DAA-failure patients suggests reduced antiviral activities of DAA regimens. The limited global availability of pangenotypic regimens for first line therapy as well as multiple targeted regimens for retreatment could result in HCV elimination targets being delayed. Impact and implications: Data on the prevalence and characteristics of rare HCV genotypes (GT) in larger cohorts are still scarce. This study found low rates of rare HCV GTs among European HCV-infected patients. In direct-acting antiviral (DAA)-failure patients, rare GT3 subtypes accumulated after pangenotypic DAA treatment and rare GT4 after first generation DAA failure and viral resistance was detected at NS5A positions 28, 30, and 31. The limited global availability of pangenotypic DAA regimens for first line therapy as well as multiple targeted regimens for retreatment could result in HCV elimination targets being delayed.

High temperatures, especially non-uniform temperatures distributions, on glass structures can induce stress relaxation, viscous material behaviour and glass fracture. Temperature exposure of toughened glass to 290°C and above can result in a partial reduction in strength of the glass component and, in case of fracture, a change in the fracture pattern due to stress relaxation. To achieve a better understanding of the heat transfer in monolithic and laminated glass, test series in an electric furnace on different glass specimens were carried out. The specimens were made of monolithic and laminated soda-lime silicate glass in different components. The test set-up was chosen in a way to create an inhomogeneous temperature distribution from the heat source through the glass in order to create a more realistic load case than an assumption of homogeneity. The results of the experimental examinations were used to develop a first numerical model that was used to visualise details (e.g. temperature and stress distribution). In addition, the paper presents results of experimental and numerical examinations to the determination of the temperature distribution in different glass components, which leads to stress relaxation during high temperature exposure and affects fracture pattern in thermally toughened glass plates. This will pave the way towards understand of glass structures exposed to heat and fire and, as a vision, will form the fundamentals of a design concept.

This article offers the case of cystic fibrosis (CF), a multi-system disease, to illustrate how individuals with chronic illness cultivate and apply embodied knowledge to optimize their well-being. We identified three interrelated processes that occur when disease chronicity and menstrual cyclicity meet: 1) knowledge production with a period-tracking app; 2) application of embodied knowledge to manage life with menstrual-related CF symptoms; 3) cultivation of the body-self as a menstruating woman with CF. These dynamic processes capture how cis-gender women with CF attune to their bodies, navigate their illness, and situate themselves within their lifeworlds. Genetic conditions like CF are apt for studying these processes because adults have managed their disease for decades, with longitudinal experience that often exceeds that of their clinicians. Our evidence elucidates the co-constitutive nature of chronic disease, gendered subjectivity, and biological processes in flux. We explored the menstrual cyclicity of chronic disease symptoms by having 72 participants track their CF symptoms across 4 menstrual cycles on a customized period-tracking app. We performed semi-structured interviews with 20 participants to understand how they interpreted these cyclical CF symptoms. We learned that digital tracking attuned participants to monthly fluctuations in CF symptoms. They applied this knowledge to manage their lives and shape their sense of self. We argue that women with CF produce distinct embodied knowledge during their reproductive years, shaping their illness experience, disease management, overall health, quality of life, and selfhood. The dynamics we describe may reflect broader patterns by which women with other chronic illnesses experience their bodies and understand themselves in the world.