Search

Evaluation of child-friendly school (CFS) policies is essential to determine the achievements of school efforts in reducing violence cases. This research aims to proving the reliability and validity of CFS policy evaluation instruments in elementary schools with different locations. This investigation uses the Context Input Process Product (CIPP) evaluation model to confirm the factor structure or dimensions of several observed variables (items) to evaluate the reliability and validity of the CFS policy evaluation tool in elementary schools. The validity and reliability of previously created instruments are evaluated quantitatively, but this study utilises different subjects and study sites. There were 320 respondents, with 145 school principals and 175 teachers taken randomly. Confirmatory factors analysis (CFA) results show goodness of fit (GOF), and the model is acceptable. The CFS evaluation instrument can be accepted after eliminating several question items and modifying them. All items of the teal instrument meet the goodness of fit criteria in terms of chi-square and root mean square error of approximation (RMSEA). The instrument for evaluating CFS policies in primary schools using the CIPP model has met a valid and reliable psychometric property test so that it can be applied.

The purpose of this study is to determine the level of digital literacy related to history among students at Universitas Pendidikan Indonesia (UPI) and the State University of Malang (UM). The recent decline in historical literacy among Indonesians has piqued historians' interest. In this context, the gap between technological potential and literacy problems may be advantageous for initiatives to enhance Indonesian young historical literacy. This research uses a quantitative-descriptive approach. The respondents were first-year and second-year history students at UPI and UM. The data collection technique used was a historical literacy test that has Higher Order Thinking Skills (HOTS) levels 1-4. This study used descriptive data analysis and an independent sample t-test. The results of this study show that students from both universities have a low level of historical literacy, both in first-year and second-year students. This condition is a signal for teachers to start improving. Gadget technology is suggested as a solution to the problem because these students belong to Generation Z (a generation that is very aware of current events and technological advancements). The methodology of Scholarship of Teaching and Learning (SOTL) was selected because its principles are appropriate for fostering digital historical literacy. It is student-focused, context-based, collaborative, methodical and well-developed in the community.

BackgroundAs differentiating between lipomas and atypical lipomatous tumors (ALTs) based on imaging is challenging and requires biopsies, radiomics has been proposed to aid the diagnosis. This study aimed to externally and prospectively validate a radiomics model differentiating between lipomas and ALTs on MRI in three large, multi-center cohorts, and extend it with automatic and minimally interactive segmentation methods to increase clinical feasibility.MethodsThree study cohorts were formed, two for external validation containing data from medical centers in the United States (US) collected from 2008 until 2018 and the United Kingdom (UK) collected from 2011 until 2017, and one for prospective validation consisting of data collected from 2020 until 2021 in the Netherlands. Patient characteristics, MDM2 amplification status, and MRI scans were collected. An automatic segmentation method was developed to segment all tumors on T1-weighted MRI scans of the validation cohorts. Segmentations were subsequently quality scored. In case of insufficient quality, an interactive segmentation method was used. Radiomics performance was evaluated for all cohorts and compared to two radiologists.FindingsThe validation cohorts included 150 (54% ALT), 208 (37% ALT), and 86 patients (28% ALT) from the US, UK and NL. Of the 444 cases, 78% were automatically segmented. For 22%, interactive segmentation was necessary due to insufficient quality, with only 3% of all patients requiring manual adjustment. External validation resulted in an AUC of 0.74 (95% CI: 0.66, 0.82) in US data and 0.86 (0.80, 0.92) in UK data. Prospective validation resulted in an AUC of 0.89 (0.83, 0.96). The radiomics model performed similar to the two radiologists (US: 0.79 and 0.76, UK: 0.86 and 0.86, NL: 0.82 and 0.85).InterpretationThe radiomics model extended with automatic and minimally interactive segmentation methods accurately differentiated between lipomas and ALTs in two large, multi-center external cohorts, and in prospective validation, performing similar to expert radiologists, possibly limiting the need for invasive diagnostics.FundingHanarth fonds.

Forming impressions of others is a fundamental aspect of social life. These impressions necessitate the integration of many and varied sources of information about other people, including social group memberships, apparent personality traits, inferences from observed behaviors, and so forth. However, methodological limitations have hampered progress in understanding this integration process. In particular, extant approaches have been unable to measure the independent contributions of multiple features to a given impression. In this article, after describing these limitations and their constraints on theory testing and development, we present a multinomial processing tree model as a computational solution to the problem. Specifically, the model distinguishes the contributions of multiple cues to social judgment. We describe an empirical demonstration of how applying the model can resolve long-standing debates among person perception researchers. Finally, we survey a variety of questions to which this approach can be profitably applied. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Nanoparticle-mediated mRNA delivery has emerged as a promising therapeutic modality, but its growth is still limited by the discovery and optimization of effective and well-tolerated delivery strategies. Lipid nanoparticles containing charged or ionizable lipids are an emerging standard for in vivo mRNA delivery, so creating facile, tunable strategies to synthesize these key lipid-like molecules is essential to advance the field. Here, we generate a library of N-substituted glycine oligomers, peptoids, and undertake a multistage down-selection process to identify lead candidate peptoids as the ionizable component in our Nutshell nanoparticle platform. First, we identify a promising peptoid structural motif by clustering a library of >200 molecules based on predicted physical properties and evaluate members of each cluster for reporter gene expression in vivo. Then, the lead peptoid motif is optimized using design of experiments methodology to explore variations on the charged and lipophilic portions of the peptoid, facilitating the discovery of trends between structural elements and nanoparticle properties. We further demonstrate that peptoid-based Nutshells leads to expression of therapeutically relevant levels of an anti-respiratory syncytial virus antibody in mice with minimal tolerability concerns or induced immune responses compared to benchmark ionizable lipid, DLin-MC3-DMA. Through this work, we present peptoid-based nanoparticles as a tunable delivery platform that can be optimized toward a range of therapeutic programs.

Racial stereotypes are commonly activated by informational cues that are detectable in people's faces. Here, we used a sequential priming task to examine whether and how the salience of emotion (angry/scowling vs. happy/smiling expressions) or apparent race (Black vs. White) information in male face primes shapes racially biased weapon identification (gun vs. tool) decisions. In two experiments (Ntotal = 546) using two different manipulations of facial information salience, racial bias in weapon identification was weaker when the salience of emotion expression versus race was heightened. Using diffusion decision modeling, we tested competing accounts of the cognitive mechanism by which the salience of facial information moderates this behavioral effect. Consistent support emerged for an initial bias account, whereby the decision process began closer to the "gun" response upon seeing faces of Black versus White men, and this racially biased shift in the starting position was weaker when emotion versus race information was salient. We discuss these results vis-à-vis prior empirical and theoretical work on how facial information salience moderates racial bias in decision-making.

Arwel W Jones,1 Vanessa M McDonald,2– 5 Rebecca F McLoughlin,2– 4 Teresa M Vella,6 Anthony W Flynn,7 John D Blakey,8,9 Luke Wolfenden,10,11 Mark Hew,12 John W Upham,13,14 Dennis Thomas,2,4 Philip Bardin,15 Anne E Holland1,2,16 1Respiratory Research@Alfred, Monash University, Melbourne, VIC, Australia; 2Centre of Excellence in Treatable Traits, University of Newcastle, Newcastle, NSW, Australia; 3School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia; 4Hunter Medical Research Institute Asthma and Breathing Program, Newcastle, NSW, Australia; 5Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia; 6Brand and Engagement, Asthma Australia, Brisbane, QLD, Australia; 7Research, Information and Evaluation, Asthma Australia, Melbourne, VIC, Australia; 8Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia; 9Medical School, Curtin University, Perth, WA, Australia; 10Hunter New England Population Health, Wallsend, NSW, Australia; 11School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; 12Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, VIC, Australia; 13Frazer Institute, University of Queensland, Brisbane, QLD, Australia; 14Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia; 15Monash Lung Sleep Allergy & Immunology, Monash University and Medical Centre, Clayton, VIC, Australia; 16Physiotherapy Department, Alfred Health, Melbourne, VIC, AustraliaCorrespondence: Arwel W Jones, Respiratory Research@Alfred, School of Translational Medicine, Monash University, Alfred Centre, Melbourne, VIC, 3004, Australia, Email arwel.jones@monash.eduPurpose: Oral corticosteroids (OCS) are an effective treatment for severe uncontrolled asthma or asthma exacerbations, but frequent bursts or long-term use carry serious and sometimes irreversible adverse effects, or complications such as adrenal insufficiency upon discontinuation. Our aim was to survey people with asthma on their experiences of, and attitudes towards, using OCS.Patients and Methods: This study was a national descriptive cross-sectional survey of people with asthma in Australia. An anonymous survey was hosted online with invitations to participate distributed by national consumer peak bodies. Survey free-text responses were coded to the Theoretical Domains Framework (TDF) to elicit determinants of OCS use.Results: 1808 people with asthma participated between 3 and 16 May 2022. Most common reasons for using OCS were severe asthma symptoms (40%), doctor prescription (38%) or asthma action plan recommendations (20%). Approximately 55% of people had experienced adverse effects from OCS use. Commonly reported adverse effects were trouble sleeping (69%), weight gain (56%) and mood problems (41%). Of people who had OCS at home or an OCS script, 44% did not have an action plan that described when and how they should take them. People (33%) did not feel well informed about OCS adverse effects from their healthcare team. People had varied awareness (3– 65%) of current available strategies to reduce OCS use. ‘Knowledge’, ‘Environmental context and resources’ and ‘Social influences’ were the most coded TDF domains influencing OCS use.Conclusion: Adverse effects of OCS use are common. People with asthma are not adequately informed about optimal OCS use or strategies to reduce overuse. These findings can help guide the implementation of OCS stewardship initiatives.Keywords: asthma, corticosteroids, consumer behaviour, attitude, patient participation

Angela T Burge,1,2 Narelle S Cox,1,3 Simone Dal Corso,1 Arwel W Jones,1 Fahrayhansyah Muhammad Faqih,1 Anne E Holland1– 4 1School of Translational Medicine, Monash University, Melbourne, VIC, Australia; 2Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia; 3Institute for Breathing and Sleep, Melbourne, VIC, Australia; 4Department of Respiratory Medicine, Alfred Health, Melbourne, VIC, AustraliaCorrespondence: Angela T Burge, Respiratory Research@Alfred, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia, Email angela.burge@monash.eduPurpose: Oral corticosteroids (OCS) are recommended for the treatment of exacerbations in people with COPD; however, high cumulative lifetime doses (≥ 1000mg prednisolone-equivalent) are associated with adverse health effects. This issue is well defined in asthma but is less well understood in COPD. The aim of this study was to examine cumulative OCS dispensed to people with COPD over 12 months.Patients and Methods: This was a secondary analysis of data from two randomised controlled trials involving people with COPD followed up for 12 months following pulmonary rehabilitation. Clinical and administrative (respiratory-related hospital admissions and emergency presentations, dispensed OCS and COPD maintenance medications) data were examined to determine cumulative OCS dose relative to the 1000mg threshold and the relationship with clinical features.Results: Of 232 participants (126 females, age mean 68 ± SD 9 years, FEV1 53 ± 22% predicted), 48% (n = 112) were dispensed OCS at least once over 12 months. Sixty-two participants (26%) were dispensed ≥ 1000mg. Participants with a high cumulative dose were more likely to have had a respiratory admission (OR 4.1, 95% CI 2.3 to 8.7) and greater breathlessness (modified Medical Research Council scale ≥ 2, OR 2.5, 95% CI 1.3 to 5.0); no relationship with disease severity or maintenance medications was demonstrated.Conclusion: One in four people with COPD were dispensed unsafe lifetime cumulative OCS doses over a period of only 12 months. Further work is needed to determine the magnitude of this issue in COPD and strategies to address exposure to high doses of OCS.Keywords: exacerbations, systemic corticosteroids, prescriptions, side effects

Andrew W Lindsley,1 Njira Lugogo,2 Kaitlin AG Reeh,3 Joseph Spahn,3 Jane R Parnes1 1Amgen Inc., Thousand Oaks, CA, USA; 2Michigan Medicine Asthma Program, University of Michigan, Ann Arbor, MI, USA; 3AstraZeneca, Gaithersburg, MD, USACorrespondence: Andrew W Lindsley, US Medical Affairs, Amgen Inc., One Amgen Center Dr, Thousand Oaks, CA, 91320, USA, Email alindsle@amgen.comAbstract: Airway inflammation, a hallmark feature of asthma, drives many canonical features of the disease, including airflow limitation, mucus plugging, airway remodeling, and hyperresponsiveness. The T2 inflammatory paradigm is firmly established as the dominant mechanism of asthma pathogenesis, largely due to the success of inhaled corticosteroids and biologic therapies targeting components of the T2 pathway, including IL-4, IL-5, IL-13, and thymic stromal lymphopoietin (TSLP). However, up to 30% of patients may lack signatures of meaningful T2 inflammation (ie, T2 low). In T2-low asthma patients, T2 inflammation may be masked due to anti-inflammatory treatments or may be highly variable depending on exposure to common asthma triggers such as allergens, respiratory infections, and smoke or pollution. The epithelium and epithelial cytokines (TSLP, IL-33) are increasingly recognized as upstream drivers of canonical T2 pathways and as modulators of various effector cells, including mast cells, eosinophils, and neutrophils, which impact the pathological manifestations of airway smooth muscle hypertrophy, hypercontractility, and airway hyperresponsiveness. Approved biologics for severe asthma target several distinct mechanisms of action, leading to differential effects on the spectrum of T2 inflammation, inflammatory biomarkers, and treatment efficacy (reducing asthma exacerbations, improving lung function, and diminishing symptoms). The approved anti-asthma biologics primarily target T2 immune pathways, with little evidence suggesting a benefit of targeting non-T2 asthma-associated mediators. Indeed, many negative results challenge current assumptions about the etiology of non-T2 asthma and raise doubts about the viability of targeting popular alternative inflammatory pathways, such as T17. Novel data have emerged from the use of biologics to treat various inflammatory mediators and have furthered our understanding of pathogenic mechanisms that drive asthma. This review discusses inflammatory pathways that contribute to asthma, quantitatively outlines effects of available biologics on biomarkers, and summarizes data and challenges from clinical trials that address non-T2 mechanisms of asthma.Keywords: thymic stromal lymphopoietin, TSLP, T2 inflammation, asthma, biologics, biomarker, anti-TSLP

This simulation study aims to optimize the dimensions of an invasive Electrical Capacitance Tomography (ECT) sensor for conducting pipe applications. Conventional non-invasive ECT techniques are ineffective for conducting pipes, as they cannot penetrate the pipe wall. This study explores the use of an invasive ECT system to identify homogeneous and non-homogeneous dielectric media within conducting pipes. A simulation model is developed using the finite element method (FEM) and the Linear Back Projection (LBP) algorithm for image reconstruction, further enhanced by a global threshold method. Various sensor dimensions are tested in a 150 mm length steel pipe, with a sinusoidal waveform source of 25 Vpp and a frequency of 400 kHz applied to the model in both homogeneous and non-homogeneous dielectric media conditions. The simulation results reveal that the sensitivity and resolution of the invasive ECT system are significantly influenced by the sensor dimensions. Optimal sensor dimensions indicate that longer and wider sensors, covering approximately 80% of the sensor coverage area and 60% of the pipe length, provide higher electrical voltage and better resolution. Overall, this study provides valuable insights into optimizing invasive ECT sensor dimensions for observing dielectric media inside conducting pipes, significantly improving the accuracy and reliability of industrial process monitoring in both homogeneous and non-homogeneous media.

Purpose In patients with acute left-sided colonic obstruction, stenting can convert an emergency operation into a semi-elective procedure. However, its use continues to be debated. We performed a cost-effective analysis using our institution’s experiences. Methods Endoscopic, surgical, and financial details were prospectively collected for patients who presented with acute colonic obstruction and underwent stenting between 2019 and 2022. Outcomes were defined as technical/clinical success and successful surgical resection. The financial cost of stenting was compared with the expected cost without stenting. Results Forty patients were included, with 29 undergoing definitive resection. The most common pathology was primary colon cancer (27 patients, 93%). Endoscopic stenting had high technical (90%) and clinical (83%) success rates, with low rates of complications such as perforation (2 patients, 7%) and migration (0 patients, 0%). As a bridge to surgery, the median procedure time was 226 minutes and the surgical outcomes also showed a low rate of complications (3 patients, 11%), such as anastomotic leakage (0 patients, 0%), intraabdominal abscesses (2 patients, 7%), and 30-day postoperative mortality (0 patients, 0%). The cumulative costs with colonic stenting were $32,900, while the expected costs with emergency surgery, including stoma reversal, were $40,700 (healthcare cost-savings of $7,800 per person). The difference was mainly due to the avoidance of upfront emergency surgery. The incremental cost-effectiveness ratio was 0.81, favoring colonic stenting over upfront emergency surgery. Conclusion Colonic stenting as a bridge to surgery is safe and cost-effective for treating left-sided colonic obstruction with high success rates and low complication rates.

Background and Purpose: The cerebral circulation is highly regulated to maintain brain perfusion, keeping an equilibrium between the brain tissue, cerebrospinal fluid (CSF) and blood of the arterial and venous systems. Cerebral venous drainage abnormalities have been implicated in multiple cerebrovascular diseases. The purpose of this study is to evaluate the relationship between the arterial inflow (AI) and the cerebral venous outflow (CVO) and their correlation with the cardiac outflow in healthy adults and children to understand the role of the emissary veins in normal venous drainage. Materials and Methods: A total of 31 healthy volunteers (24 adults (39.5 ± 16.0) and seven children (3.4 ± 2.2)) underwent intracranial 4D flow with full circle of Willis coverage and 2D PC-MRI at the level of the transverse sinus for measurement of the AI and CVO, respectively. The AI was calculated as the sum of the flow values in the bilateral internal carotid and basilar arteries. The CVO was calculated as the sum of the flow values in the bilateral transverse sinuses. The cardiac outflow was measured via 2D PC-MRI with retrospective ECG gating with images acquired at the proximal ascending aorta (AAo) and descending (DAo) aorta. The ratios of the AI/AAo flow and CVO/AI were calculated to characterize the fraction of cerebral arterial inflow in relation to cardiac outflow and venous blood draining through the transverse sinuses, respectively. Results: The AI and CVO were significantly correlated (r = 0.81, p < 0.001). The CVO constituted approximately 60–70% of the AI. The CVO/AI ratio was significantly lower in children versus adults (p = 0.025). In adults, the negative correlation of the AI with age remained strong (r = −0.81, p < 0.001). However, the CVO was not significantly associated with age. Conclusion: The CVO/AI ratio suggests an important role of the emissary veins, accounting for approximately 30–40% of venous drainage. The lower CVO/AI ratio in children, although partially related to decreased AI with age, suggests a greater role of the emissary veins in childhood, which strongly decreases with age.

Introduction: Since 2016, several therapies have been approved for treating atopic dermatitis (AD) in Singapore, including biologics, oral Janus kinase (JAK) inhibitors and topical crisaborole. This study supplements the 2016 Singapore treatment guidelines for AD, focusing on newer therapies for moderate-to-severe disease, while revisiting older treatment regimens to accommodate changes in knowledge and practice. Method: A modified Delphi panel was held, led by 2 co-chairs. The voting expert panel consisted of 12 dermatologists experienced in managing AD in Singapore. Delphi survey rounds were conducted between 24 July and 27 October 2023. Panellists indicated their agreement with drafted statements using a 5-point Likert scale. Consensus was defined as ≥80% agreement. An expert meeting was held to facilitate the consensus process between rounds 1 and 2 of voting. Results: All expert panellists participated in both survey rounds, with a 100% response rate. Thirty-nine statements, classified into general principles, conventional treatments, biologics and JAK inhibitors, were proposed. Of these, 27 statements reached consensus at the end of round 1. After the expert meeting, 17 statements were included in round 2, of which 16 statements reached consensus. One statement did not reach consensus. Key updates are the inclusion of dupilumab and JAK inhibitors as potential first-line treatments for moderate-to-severe AD, in certain populations. Conclusion: This modified Delphi study generated consensus among Singapore dermatology experts, to update treatment guidelines in moderate-to-severe atopic dermatitis. The consensus statements developed are intended to supplement the 2016 Singapore treatment guidelines for AD. Further revisions may be required when new evidence and/or treatments become available.

This community service aims to increase the knowledge and capacity of livestock officers in assessing the potential and carrying capacity of rice straw as feed for beef cattle. This community service activity uses a training method with planning, implementation, and evaluation stages. The assessment instruments for this service are pre-test and post-test and are analyzed using the Paired-Samples T-Test. The results of this community service show that the knowledge and capacity of livestock officers in assessing the potential and carrying capacity of rice straw as feed for beef cattle has increased. This is evidenced by the data before the training; the participant's knowledge score was 35.5, while after the training, it increased to 86.0.

This study evaluated the tolerability and efficacy of the topical rho-kinase inhibitor netarsudil for canine primary corneal endothelial degeneration (PCED). Twenty-six eyes of 21 client-owned dogs with PCED were enrolled in a prospective, randomized, vehicle control clinical trial and received topical netarsudil 0.02% (Rhopressa®) or vehicle control twice daily (BID) for the first 4 months. Then, all patients received netarsudil for the next 4 or 8 months. Complete ophthalmic examination, ultrasonic pachymetry, Fourier-domain optical coherence tomography, and in vivo confocal microscopy were performed at baseline and 1, 2, 4, 6, 8 and 12 months. Effect of netarsudil on central corneal thickness (CCT), percentage of cornea with edema, and endothelial cell density (ECD) were evaluated by repeated measures ANOVA. Kaplan-Meier curves and log-rank test were used to compare corneal edema and clinical progression of eyes in netarsudil versus vehicle control groups. All dogs developed conjunctival hyperemia in at least one eye while receiving netarsudil. Unilateral transient reticulated intraepithelial bullae and stromal hemorrhage were observed respectively in 2 dogs in the netarsudil group. Two dogs showed persistently decreased tear production while receiving netarsudil, requiring topical immunomodulatory treatment. No significant differences in CCT, ECD, corneal edema or clinical progression were observed between netarsudil or vehicle treated eyes. When comparing efficacy of topical netarsudil BID and topical ripasudil 0.4% administered four times daily from our previous study, dogs receiving ripasudil had significantly less progression than those receiving netarsudil.