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Background: Preserved Ratio Impaired Spirometry (PRISm) is considered to be a precursor of chronic obstructive pulmonary disease. Radiomics nomogram can effectively identify the PRISm subjects from non-COPD subjects, especially when during large-scale CT lung cancer screening. Methods: Totally 1481 participants (864, 370 and 247 in training, internal validation, and external validation cohorts, respectively) were included. Whole lung on thin-section computed tomography (CT) was segmented with a fully automated segmentation algorithm. PyRadiomics was adopted for extracting radiomics features. Clinical features were also obtained. Moreover, Spearman correlation analysis, minimum redundancy maximum relevance (mRMR) feature ranking and least absolute shrinkage and selection operator (LASSO) classifier were adopted to analyze whether radiomics features could be used to build radiomics signatures. A nomogram that incorporated clinical features and radiomics signature was constructed through multivariable logistic regression. Last, calibration, discrimination and clinical usefulness were analyzed using validation cohorts. Results: The radiomics signature, which included 14 stable features, was related to PRISm of training and validation cohorts (p < 0.001). The radiomics nomogram incorporating independent predicting factors (radiomics signature, age, BMI, and gender) well discriminated PRISm from non-COPD subjects compared with clinical model or radiomics signature alone for training cohort (AUC 0.787 vs. 0.675 vs. 0.778), internal (AUC 0.773 vs. 0.682 vs. 0.767) and external validation cohorts (AUC 0.702 vs. 0.610 vs. 0.699). Decision curve analysis suggested that our constructed radiomics nomogram outperformed clinical model. Conclusions: The CT-based whole lung radiomics nomogram could identify PRISm to help decision-making in clinic. Key message: What is already known on this topic: Identifying PRISm subjects among non-COPD subjects, especially in the context of large-scale CT lung cancer screening, is currently a challenge. What this study adds: In this retrospective, and multicentric study that included 1481 subjects, radiomics nomogram developed by integrating radiomics signature and clinical features achieved good performance for the identification of PRISm, with AUC of 0.787, 0.773 and 0.702 in training, internal and external validation cohort. How this study might affect research, practice or policy: Radiomics nomogram, as a promising tool for identifying the PRISm from non-COPD subjects, hold great potential for guiding timely treatment and showing the added value of chest CT to evaluate the lung function status besides the morphological evaluation, especially during large-scale CT lung cancer screening. [ABSTRACT FROM AUTHOR]

Rationale: Preserved ratio impaired spirometry (PRISm) is a recently recognized spirometric pattern defined by a ratio of forced expiratory volume in 1 second to forced vital capacity of at least 0.70 and a forced expiratory volume in 1 second  <80% of reference. For unclear reasons, PRISm is associated with increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is a major mechanism of CV disease, which can be measured by carotid-femoral pulse-wave velocity (cfPWV). Objectives: We explored the hypothesis that cfPWV would be increased in individuals with PRISm and airflow limitation (AL). Methods: We measured forced spirometry, lung volumes by body plethysmography, and cfPWV in 9,466 subjects recruited from the general population in the Austrian cross-sectional LEAD (Lung, Heart, Social, Body) study and tested the association of arterial stiffness with PRISm and AL by multivariable linear regression analysis. Individuals younger than 18 years were excluded from the study. Results: Individuals with PRISm (n = 431; 4.6%) were of similar age to those with normal spirometry (n = 8,136; 85.9%) and significantly younger than those with AL (n = 899; 9.5%). Arterial hypertension, diabetes mellitus, coronary artery disease, heart failure, and peripheral arterial occlusive disease were significantly more common in individuals with PRISm than in those with normal lung function and similar to those with AL. There was a significant association between PRISm and arterial stiffness on bivariate linear regression analysis (crude model, β = 0.038; 95% confidence interval [CI], 0.016–0.058), which persisted after robust adjustment for clinical confounders upon multivariable analysis (final model, β = 0.017; 95% CI, 0.001–0.032). cfPWV was significantly higher in individuals with PRISm irrespective of the presence of established CV disease or pulmonary restriction. AL also showed a significant association with arterial stiffness on multivariable linear regression analysis (final model, β = 0.025; 95% CI, 0.009–0.042). Conclusions: Arterial stiffness measured by cfPWV is increased in individuals with PRISm independent of CV disease and risk factors. The pathobiological mechanisms underlying this association deserve further research. [ABSTRACT FROM AUTHOR]

Although waste‐to‐energy (WtE) incineration projects have boosted the economic effectiveness of the waste management system, locals frequently view them with suspicion, opposition, or even outright rejection because of potential environmental and health risks. In this study, by incorporating two additional variables, namely, objective knowledge and benefit perceptions, the planned risk information seeking model (PRISM) was extended in the context of the WtE incineration project. A total of 1726 respondents were interviewed in person. Results from the structural equation modeling indicated that the extended PRISM achieved excellent fits, suggesting the generalizability of the model in these contexts. Objective knowledge and subjective knowledge have a positive and direct impact on perceived knowledge insufficiency. The impact of benefit and risk perceptions on worry is the opposite, with risk perceptions having a greater direct effect on worry. However, compared with risk perceptions, the direct effect that benefit perceptions have on perceived knowledge insufficiency is stronger. Additionally, perceived knowledge insufficiency partially or completely mediates the relationships between all antecedents, except perceived seeking control, and information‐seeking intention. This study suggests that risk managers carefully consider how to establish powerful communication tactics to shape these antecedents when introducing a "not in my backyard" project to the local community. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a serious public health problem affecting 37.3 million Americans. Diabetes shared medical appointments (SMAs) are an effective strategy for providing diabetes self-management support and education in primary care. However, practices delivering SMAs experience implementation challenges. This analysis examined conditions associated with successful practice implementation of diabetes SMAs in the context of participation in a pragmatic trial. Methods: Mixed methods study using qualitative and quantitative data collected from interviews, observations, surveys, and practice-reported data, guided by the practical, robust implementation and sustainability model (PRISM). Data were analyzed using qualitative comparative analysis (QCA). Successful implementation was defined as meeting patient recruitment targets (Reach) during the study period. Participants were clinicians and staff members from 22 primary care practices in Colorado and Missouri, USA. Results: The first necessary condition identified from the QCA was the presence of additional resources for patients with diabetes in the practice. Within practices that had these additional resources, we found that a sufficiency condition was the presence of an effective key person to make things happen with the SMAs. A second QCA was conducted to determine conditions underlying the presence of the effective key person (often performing functions of an implementation champion), which revealed factors including low or managed employee turnover, a strong baseline practice culture, and previous experience delivering SMAs. Conclusions: Identification of key factors necessary and sufficient for implementation of new care processes is important to enhance patient access to evidence-based interventions. This study suggests that practice features and resources have important implications for implementation of diabetes SMAs. There may be opportunities to support practices with SMA implementation by enabling the presence of skilled implementation champions. Trial registration: Registered at clinicaltrials.gov under trial ID NCT03590041, registered on July 18, 2018. [ABSTRACT FROM AUTHOR]

Understanding the prevalence of abnormal lung function and its associated factors among patients recovering from COVID-19 is crucial for enhancing post-COVID care strategies. This study primarily aimed to determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with a secondary objective of identifying its associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients at least three months post-discharge from hospitals following moderate-to-critical COVID-19. Of 408 patients studied, abnormal spirometry was found in 46.8%, with 28.4% exhibiting a restrictive pattern, 17.4% showing preserved ratio impaired spirometry (PRISm), and 1.0% displaying an obstructive pattern. Factors independently associated with abnormal spirometry included consolidation on chest X-ray (OR 8.1, 95% CI 1.75–37.42, p = 0.008), underlying cardiovascular disease (OR 3.5, 95% CI 1.19–10.47, p = 0.023), ground-glass opacity on chest X-ray (OR 2.6, 95% CI 1.52–4.30, p < 0.001), and oxygen desaturation during the 6-min walk test (OR 1.9, 95% CI 1.20–3.06, p = 0.007). This study highlights that patients recovering from moderate-to-critical COVID-19 often exhibit abnormal spirometry, notably a restrictive pattern and PRISm. Routine spirometry screening for high-risk patients is recommended. [ABSTRACT FROM AUTHOR]

Binocular diplopia limits quality of life by hampering visual function. There are several treatment options with individual advantages and drawbacks. Contact lenses have recently emerged as an attractive treatment delivery mechanism due to advances in lens manufacturing and imaging modalities. Contact lenses can offer better comfort, efficacy, and cosmetic appeal compared to alternative treatments such as spectacles. They also present unique challenges due to risks of inflammation, infection, and intolerability. This review will explore the management of binocular diplopia using several types of contact lenses including base down prism in contact lenses, scleral lenses, occlusive lenses, and monovision lenses. Increased awareness of differing contact lens will help providers and patients make better informed decisions about diplopia management. [ABSTRACT FROM AUTHOR]

Abstract Background Preserved Ratio Impaired Spirometry (PRISm) is considered to be a precursor of chronic obstructive pulmonary disease. Radiomics nomogram can effectively identify the PRISm subjects from non-COPD subjects, especially when during large-scale CT lung cancer screening. Methods Totally 1481 participants (864, 370 and 247 in training, internal validation, and external validation cohorts, respectively) were included. Whole lung on thin-section computed tomography (CT) was segmented with a fully automated segmentation algorithm. PyRadiomics was adopted for extracting radiomics features. Clinical features were also obtained. Moreover, Spearman correlation analysis, minimum redundancy maximum relevance (mRMR) feature ranking and least absolute shrinkage and selection operator (LASSO) classifier were adopted to analyze whether radiomics features could be used to build radiomics signatures. A nomogram that incorporated clinical features and radiomics signature was constructed through multivariable logistic regression. Last, calibration, discrimination and clinical usefulness were analyzed using validation cohorts. Results The radiomics signature, which included 14 stable features, was related to PRISm of training and validation cohorts (p

Abstract Background Diabetes is a serious public health problem affecting 37.3 million Americans. Diabetes shared medical appointments (SMAs) are an effective strategy for providing diabetes self-management support and education in primary care. However, practices delivering SMAs experience implementation challenges. This analysis examined conditions associated with successful practice implementation of diabetes SMAs in the context of participation in a pragmatic trial. Methods Mixed methods study using qualitative and quantitative data collected from interviews, observations, surveys, and practice-reported data, guided by the practical, robust implementation and sustainability model (PRISM). Data were analyzed using qualitative comparative analysis (QCA). Successful implementation was defined as meeting patient recruitment targets (Reach) during the study period. Participants were clinicians and staff members from 22 primary care practices in Colorado and Missouri, USA. Results The first necessary condition identified from the QCA was the presence of additional resources for patients with diabetes in the practice. Within practices that had these additional resources, we found that a sufficiency condition was the presence of an effective key person to make things happen with the SMAs. A second QCA was conducted to determine conditions underlying the presence of the effective key person (often performing functions of an implementation champion), which revealed factors including low or managed employee turnover, a strong baseline practice culture, and previous experience delivering SMAs. Conclusions Identification of key factors necessary and sufficient for implementation of new care processes is important to enhance patient access to evidence-based interventions. This study suggests that practice features and resources have important implications for implementation of diabetes SMAs. There may be opportunities to support practices with SMA implementation by enabling the presence of skilled implementation champions. Trial registration Registered at clinicaltrials.gov under trial ID NCT03590041, registered on July 18, 2018.

Abstract Understanding the prevalence of abnormal lung function and its associated factors among patients recovering from COVID-19 is crucial for enhancing post-COVID care strategies. This study primarily aimed to determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with a secondary objective of identifying its associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients at least three months post-discharge from hospitals following moderate-to-critical COVID-19. Of 408 patients studied, abnormal spirometry was found in 46.8%, with 28.4% exhibiting a restrictive pattern, 17.4% showing preserved ratio impaired spirometry (PRISm), and 1.0% displaying an obstructive pattern. Factors independently associated with abnormal spirometry included consolidation on chest X-ray (OR 8.1, 95% CI 1.75–37.42, p = 0.008), underlying cardiovascular disease (OR 3.5, 95% CI 1.19–10.47, p = 0.023), ground-glass opacity on chest X-ray (OR 2.6, 95% CI 1.52–4.30, p

One of the primary theories regarding the development of schizophrenia revolves around genetics, indicating the involvement of hereditary factors in various processes, including inflammation. Research has demonstrated that inflammatory reactions occurring in microglia can impact the progression of the disease. It has also been established that genetically determined changes in IL-1 can contribute to schizophrenia, thereby confirming the role of the IL-1 gene cluster in disease susceptibility. The aim of this study is a computer-based assessment of the structural interactions of IL-1 proteins with their receptors in schizophrenia. The study utilized the DisGeNET database, enabling the assessment of the reliability of identified IL-1 polymorphisms. Polymorphisms were also sought using NCBI PubMed. The NCBI Protein service was employed to search for and analyze the position of the identified polymorphisms on the chromosome. Structures for modeling were extracted from the Protein Data Bank database. Protein modeling was conducted using the SWISS-MODEL server, and protein interaction modeling was performed using PRISM. Notably, this study represents the first prediction of the interactions of IL-1α, IL-1β, and IL- 1RA proteins, taking into account the presence of single-nucleotide polymorphisms associated with schizophrenia in the sequence of the corresponding genes. The results indicate that the presence of SNP rs315952 in the IL-1RA protein gene, associated with schizophrenia, may lead to a weakening of the IL-1RA binding to receptors, potentially triggering the initiation of the IL-1 signaling pathway by disrupting or weakening the IL-1RA binding to receptors and facilitating the binding of IL-1 to them. Such alterations could potentially lead to a change in the immune response. The data obtained contribute theoretically to the development of ideas about the molecular mechanisms through which hereditary factors in schizophrenia influence the interactions of proteins of the IL-1 family, which play an important role in the processes of the immune system.

Abstract The applicability of the main theories of risk information seeking to novel risk scenarios is not well understood. According to Hovick, Kahlor, and Liang (Journal of Health Communication 19:511-527, 2014), this study retested the Planned Risk Information Seeking Model (PRISM) and examined the impact of additional variables on the model in order to investigate the critical factors (expanded PRISM) that affect people’s intention to seek information about COVID-19 risks and determine whether the PRISM model is more appropriate in this context than expanded PRISM based on survey data from 1031 Chinese adults. The results showed that PRISM fit the data better. Furthermore, future study should focus on two new variables: source beliefs and past information seeking. Theoretical and practical implications are considered.

Background Preserved Ratio Impired Spirometry (PRISm) refers to the non-obstructive pulmonary function abnormalities with a decrease forced expiratory volume in one second (FEV1) while the FEV1/forced vital capacity (FVC) remains constant. The PRISm population may be one of the pre-chronic obstructive pulmonary disease (COPD) populations. However, the incidence, characteristics and risk factors of PRISm in the physical examination population in China are still unknown. Objective To analyze the characteristics and influencing factors of PRISm in physical examination population. Methods From January 2017 to December 2019, a total of 970 patients received physical examination in the Third Medical Center of Chinese PLA General Hospital were selected. The baseline data and physical examination results were collected, pulmonary function was measured for vital capacity (VC), FVC, FEV1, forced expiratory volume in six second (FEV6), FEV1/FVC, peak expiratory flow (PEF), FEF25, FEF50 and FEF75, the relevant indexes were expressed as "%pre" as a percentage of the expected value. The included subjects were divided into the airflow obstruction group with FEV1/FVC60 years (OR=0.951, 95%CI=0.602-1.504, P=0.002), smoking history (OR=2.201, 95%CI=1.519-3.187, P60 years old, with the history of smoking and hypertension. Early intervention may alleviate the progression of COPD.

This paper presents a new approach sensor, and its effectiveness as a chemical sensor using surface plasmon resonance (SPR) is evaluated. The suggested design consists of a ZnO-Silicon (Si) and silver (Ag) layer, above BaF2 prism and a sensing layer that contains analytes on top. Si has a high refractive index (RI), a semiconducting nature, is compatible with microfabrication techniques and biocompatibility, and is suitable for a wide range of biological and chemical sensing applications. The angular interrogation method is used to analyze the Kretschmann configuration. Sellmeier equations are used to calculate reflectivity and other multilayer design parameters. In this sample, the sensitivity for the sensing medium 1.3264 (D2O), 1.35, and 1.36 (Acetone) is obtained to be 201.8°/RIU, 257.85°/RIU and 311°/RIU, respectively. The corresponding evaluated values for the figure of merit (FOM) are 60.54/RIU, 54.66/RIU, and 70.18/RIU, respectively. Moreover, the ZnO layer's effect is utilized to compare the proposed sensor with other prisms like CsF, NFK51A, and BK7. In various applications, the proposed sensor performance is improved for RI of sensing medium detection between 1.3264 and 1.36. [ABSTRACT FROM AUTHOR]

Objective. To identify the frequency and relative importance of symptoms experienced by adults with fibromyalgia (FM) and determine factors associated with a higher disease burden. Methods. We conducted semistructured interviews with 15 participants with FM, collecting 1479 quotes regarding the symptomatic burden of FM. We then performed an international cross-sectional study involving 1085 participants with FM to determine the prevalence and relative importance (scale 0-4) of 149 symptoms representing 14 symptomatic themes. We performed subgroup analysis to determine how age, sex, disease duration, medication use, employment status, change in employment status, missing work due to FM, and ability level are related to symptomatic theme prevalence. Results. The symptomatic themes with the highest prevalence in FM were pain (99.8%), muscle tenderness (99.8%), and fatigue (99.3%). The symptomatic themes that had the greatest effect on patients' lives were related to fatigue (2.88), pain (2.85), muscle tenderness (2.79), and impaired sleep and daytime sleepiness (2.70). Symptomatic theme prevalence was most strongly associated with the modified Rankin Scale level of disability, disability status, and change in employment status (on disability vs not on disability). Conclusion. Participants with FM identify a variety of symptoms that significantly affect their daily lives. Many of these symptoms, such as fatigue, sleep disturbance, and activity limitation, are life-altering and not related to traditional diagnostic criteria. Symptom prevalence in this population varies across subgroups based on demographic categories and disability status. [ABSTRACT FROM AUTHOR]

The applicability of the main theories of risk information seeking to novel risk scenarios is not well understood. According to Hovick, Kahlor, and Liang (Journal of Health Communication 19:511-527, 2014), this study retested the Planned Risk Information Seeking Model (PRISM) and examined the impact of additional variables on the model in order to investigate the critical factors (expanded PRISM) that affect people's intention to seek information about COVID-19 risks and determine whether the PRISM model is more appropriate in this context than expanded PRISM based on survey data from 1031 Chinese adults. The results showed that PRISM fit the data better. Furthermore, future study should focus on two new variables: source beliefs and past information seeking. Theoretical and practical implications are considered. [ABSTRACT FROM AUTHOR]

Background: To track improvement in diplopia symptoms with strabismus-specific health-related quality of life (HRQOL) questionnaire across a treatment consisting of prism correction followed by vision therapy/orthoptics when prism treatment alone has not succeeded. Methods: Forty-eight participants with diplopia and a mean age of 62.45 were asked to complete an Adult Strabismus-20 (AS-20) questionnaire and a Diplopia Questionnaire (DQ) before and after prism correction. Inclusion criteria were diplopia reported on the DQ as "sometimes", "often" or "always" at reading or straight-ahead distance. The prism correction was classified as successful if the participant reported "never" or "rarely" on the DQ for reading and straight-ahead distance; and unsuccessful if the perceived diplopia worsened or remained the same. For all participants, mean initial AS-20 scores were compared with mean post-prism correction scores, taking into account AS-20 subscales (reading and general functions, and self-perception and interaction). Participants in the failed prism treatment subgroup subsequently underwent a programme of vision therapy wearing their prism correction, the results of which were again determined by participants' responses on the AS-20 questionnaire, completed before and after the vision therapy. Results: Five of the 48 participants dropped out of the study. Prism correction was classified as successful in 22 of 43 participants (51%), and unsuccessful in 21 (49%). Those participants for whom the prism correction was classified as a success showed a statistically significant improvement (p = 0.01) in both reading and general functions. In the failed treatment subgroup, no significant change in AS-20 score was recorded for any of the domains (p = 0.1). After treatment with vision therapy/orthoptics, however, 13 of the 20 participants in the unsuccessful prism correction subgroup (one of them dropped out the study) achieved binocular vision and statistically significant improvement in reading and general functions (p = 0.01). Conclusions: Although effective prism correction of diplopia is correlated with enhanced HRQOL, prism correction alone is frequently not sufficient to achieve this objective. In these cases, vision therapy/orthoptics treatment as a coadjutant to prism correction is shown to improve HRQOL. [ABSTRACT FROM AUTHOR]

Efficient water management strategies are of utmost importance in drought-prone regions, given the fundamental role irrigation plays in avoiding yield losses and food shortages. Traditional methodologies for estimating irrigation amounts face limitations in terms of overall precision and operational scalability. This study proposes to estimate irrigation amounts from soil moisture (SM) data by adapting the PrISM (Precipitation Inferred from Soil Moisture) methodology. The PrISM assimilates SM into a simple Antecedent Precipitation Index (API) model using a particle filter approach, which allows the creation and estimation of irrigation events. The methodology is applied in a semi-arid region in the Ebro basin, located in the north-east of Spain (Catalonia), from 2016 to 2023. Multi-year drought, which started in 2020, particularly affected the region starting from the spring of 2023, which led to significant reductions in irrigation district water allocations in some of the areas of the region. This study demonstrates that the PrISM approach can correctly identify areas where water restrictions were adopted in 2023, and monitor the water usage with good performances and reliable results. When compared with in situ data for 8 consecutive years, PrISM showed a significant person's correlation between 0.58 and 0.76 and a cumulative weekly root mean squared error (rmse) between 7 and 11 mm. Additionally, PrISM was applied to three irrigation districts with different levels of modernization, due to the different predominant irrigation systems: flood, sprinkler, and drip. This analysis underlined the strengths and limitations of PrISM depending on the irrigation techniques monitored. PrISM has good performances in areas irrigated by sprinkler and flood systems, while difficulties are present over drip irrigated areas, where the very localized and limited irrigation amounts could not be detected from S M observations. [ABSTRACT FROM AUTHOR]

Background: Visual adjustability is the ability of the visual system to be flexible enough to rapidly adjust and guide the body’s motor responses quickly and accurately, while the surroundings change. The time it takes the visual system to adjust to the changes in the sporting environment will determine the efficiency of the motor response. Aim: The aim of this study was to assess visual adjustability in a group of university football players in different positions of play. Visual adjustability was then trained using a cluster ball, and the skill was measured again to check for any improvement. The results were then compared with the control group and the norms by Buys and Ferreira. Setting: The study was conducted at the University of Limpopo Optometry Department and the offices of the University of Limpopo Soccer League. Methods: Ninety-seven footballers took part in the current study. The participants were divided into control and experimental groups. Visual adjustability was assessed in both groups before and after the training and compared with the norms by Buys and Ferreira. Results: Visual adjustability improved in the different positions of play after training. Comparing the results with the norms, footballers started training with visual adjustability at ‘ineffective’ and ‘average’, and improved to ‘above average’ when compared with the norms by Buys and Ferreira. Conclusion: Visual adjustability improved after training when compared to the control group and the suggested norms. Control group improvements were statistically not significant. Contribution: The current study aims to contribute more information on the subject of visual adjustability and recommend more research on the topic and draw attention to the significance of visual adjustability to sports performance. The study recommends that visual adjustability be made sport-specific.

Background: The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) developed and offered a course on evidence-based public health (EBPH) in five sub-Saharan African (SSA) countries to enhance individual and institutional capacity. Aim: This study aims to assess, compare and learn from implementing the CEBHA+ EBPH course using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Practical, Robust, Implementation and Sustainability Model (PRISM). Setting: This study involved CEHBA+ partner universities in five countries in SSA. Methods: We developed a framework that draws on signalling questions for RE-AIM and PRISM dimensions. Country teams reflected on, discussed and mapped unique experiences. Using this framework, we then elicited common themes across countries and distilled country-specific experiences through virtual discussions. Results: Across countries, 130 public health practitioners, researchers and students completed the course (Reach). The course increased EBPH knowledge and skills and the capacity to teach EBPH and resulted in immediate opportunities for applying skills (Effectiveness). Hybrid offering in two countries presented challenges regarding Internet connectivity and hybrid discussions. Facilitators had previous training in teaching EBPH. While learning material was the same across countries, the content was adapted to represent local public health priorities (Implementation, Adoption). Course materials have informed other related training leading to spin-offs (Maintenance). Institutionalisation is dependent on external funding. Conclusion: Strengthening EBPH capacity across contexts is feasible. Curricula containing both core and contextualised elements create an authentic learning environment. Formal evaluations should be embedded within capacity-strengthening initiatives. Contribution: This is the first study evaluating EBPH training in SSA using an implementation science lens, offering learning about context-relevant adaptations that assist with plans for sustainability and scale.

Abstract Background Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM). Methods Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman’s Rho was used to reveal correlations between knowledge, skills, and interests in the cohort. Results Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p

Jia Huang,1 Wenjun Li,2 Yecheng Sun,1,&ast; Zhutang Huang,1,&ast; Rong Cong,1,&ast; Chen Yu,1,&ast; Hongyan Tao2 1The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China; 2Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongyan Tao, Department of Respiratory, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China, Email 1165463182@qq.comAbstract: Preserved Ratio Impaired Spirometry (PRISm) manifests notable epidemiological disparities across the globe, with its prevalence and influential factors showcasing pronounced diversities among various geographical territories and demographics. The prevalence of PRISm fluctuates considerably among regions such as Latin America, the United States, and Asian nations, potentially correlating with a myriad of determinants, including socioeconomic status, environmental factors, and lifestyle modalities. Concurrently, the link between PRISm and health risks and other disorders, especially its distinction and interrelation with chronic obstructive pulmonary disease (COPD), has become a pivotal subject of scientific enquiry. Radiographic anomalies, such as perturbations in the pulmonary parenchyma and structural alterations, are posited as salient characteristics of PRISm. Furthermore, PRISm unveils intricate associations with multiple comorbidities, inclusive of hypertension and type 2 diabetes, thereby amplifying the intricacy in comprehending and managing this condition. In this review, we aim to holistically elucidate the epidemiological peculiarities of PRISm, its potential aetiological contributors, its nexus with COPD, and its association with radiographic aberrations and other comorbidities. An integrative understanding of these dimensions will provide pivotal insights for the formulation of more precise and personalised preventative and therapeutic strategies.Keywords: PRISm, pulmonary function, epidemiology, comorbid associations

Abstract Background Early diagnosing Chronic Obstructive Pulmonary Disease (COPD) is relatively difficult. Therefore, the concepts of preserved ratio impaired spirometry (PRISm) and small airway disease (SAD) were proposed to achieve early diagnosis for COPD. Besides, the occurrence of COPD is positively related to age. However, the relationship among COPD, PRISm, and SAD still requires clarification. Thus, we estimated the proportions and risk factors of COPD and PRISm in the positive screening participants, and searched the methods of early diagnosing COPD via the SAD indicators. Methods A total of 53,641 residents aged more than 60 years old from Shaoxing City, Zhejiang Province, China, completed a series of screening projects. And 2327 of positive screening participants ultimately finished bronchodilator tests. The data were statistically analyzed to figure out the proportions and risk factors of COPD and PRISm, and the efficacy of early diagnosing COPD by the SAD indicators. Results Totally 2229 positive screening participants were included, the proportion of PRISm was 6.3% (141/2229), and of COPD was 78.2% (1743/2229). Statistical analyses showed that COPD patients were more likely to be smokers, males, and older. And COPD patients had higher questionnaire scores, meaning that they were more prone to have family history of respiratory diseases and more severe respiratory symptoms. Additionally, COPD patients had lower maximal mid-expiratory flow (MMEF) pred, forced expiratory flow (FEF) 75pred, and FEF50pred. And we found that male sex and presence of respiratory symptoms might lead to COPD and PRISm. Also, the methods of early diagnosing COPD through the SAD indicators might be acceptable. Conclusion There is a close association between COPD and decreased small airway function (SAF) among the participants included. Age, smoking, male sex, worse SAF, and respiratory symptoms might cause the progressing from normal people to PRISm, then to COPD patients. Besides, the SAD indicators such as MMEFpred, FEF75pred, and FEF50pred were included in lung function tests and bronchodilator tests. Intriguingly, it was found that early diagnosing COPD via the SAD indicators might be feasible. In the future, early diagnosis for COPD requires further research.

Abstract For the fields of implementation science and health equity, understanding and being responsive to local contexts is of utmost importance to better inform the development, implementation, and evaluation of healthcare and public health interventions to increase their uptake and sustainment. Contexts are multi-level and include political, historical, economic, and social factors that influence health, as well as organizational characteristics, reflecting the richness of members’ views, resources, values, and needs. Poor alignment between solutions and those contextual characteristics could have an impact on inequities. The PRISM (Practical Robust Implementation and Sustainability Model) is a context-based implementation science framework that incorporates RE-AIM outcomes (Reach, Effectiveness, Adoption, Implementation, Maintenance) and offers guidance to researchers, practitioners, and their patient and community partners on how to conceptualize, assess, and address contextual domains with a focus on health equity. Drawing from systems thinking, participatory engagement, and health equity principles, this commentary expands on previous work to 1) offer a novel perspective on how to align an intervention’s core functions and forms with the PRISM’s contextual domains, and 2) foster an ongoing and iterative engagement process with diverse partners throughout the research and practice process using a co-creation approach. We recommend intervention-to-context alignment through iterative cycles. To that end, we present the RE-AIM Framework’s ‘outcomes cascade’ to illustrate touch points of opportunity and gaps within and across each of the five RE-AIM outcomes to illustrate ‘where things go wrong’. We present a case study to illustrate and offer recommendations for research and practice efforts to increase contextual responsiveness, and enhance alignment with context before, during, and after implementation efforts and to ensure equity is being addressed. We strive to make a conceptual contribution to advance the field of pragmatic research and implementation of evidence-based practices through the application of the contextually-based PRISM framework with a focus on health equity.

Purpose: It is vital to develop noninvasive approaches with high accuracy to discriminate the preserved ratio impaired spirometry (PRISm) group from the chronic obstructive pulmonary disease (COPD) groups. Radiomics has emerged as an image analysis technique. This study aims to develop and confirm the new radiomics-based noninvasive approach to discriminate these two groups. Methods: Totally 1066 subjects from 4 centers were included in this retrospective research, and classified into training, internal validation or external validation sets. The chest computed tomography (CT) images were segmented by the fully automated deep learning segmentation algorithm (Unet231) for radiomics feature extraction. We established the radiomics signature (Rad-score) using the least absolute shrinkage and selection operator algorithm, then conducted ten-fold cross-validation using the training set. Last, we constructed a radiomics signature by incorporating independent risk factors using the multivariate logistic regression model. Model performance was evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analyses (DCA). Results: The Rad-score, including 15 radiomic features in whole-lung region, which was suitable for diffuse lung diseases, was demonstrated to be effective for discriminating between PRISm and COPD. Its diagnostic accuracy was improved through integrating Rad-score with a clinical model, and the area under the ROC (AUC) were 0.82(95 %CI 0.79–0.86), 0.77(95 %CI 0.72–0.83) and 0.841(95 %CI 0.78–0.91) for training, internal validation and external validation sets, respectively. As revealed by analysis, radiomics nomogram showed good fit and superior clinical utility. Conclusions: The present work constructed the new radiomics-based nomogram and verified its reliability for discriminating between PRISm and COPD.

Background: Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM). Methods: Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman's Rho was used to reveal correlations between knowledge, skills, and interests in the cohort. Results: Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students' interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05). Conclusion: PRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education. [ABSTRACT FROM AUTHOR]

Background: Early diagnosing Chronic Obstructive Pulmonary Disease (COPD) is relatively difficult. Therefore, the concepts of preserved ratio impaired spirometry (PRISm) and small airway disease (SAD) were proposed to achieve early diagnosis for COPD. Besides, the occurrence of COPD is positively related to age. However, the relationship among COPD, PRISm, and SAD still requires clarification. Thus, we estimated the proportions and risk factors of COPD and PRISm in the positive screening participants, and searched the methods of early diagnosing COPD via the SAD indicators. Methods: A total of 53,641 residents aged more than 60 years old from Shaoxing City, Zhejiang Province, China, completed a series of screening projects. And 2327 of positive screening participants ultimately finished bronchodilator tests. The data were statistically analyzed to figure out the proportions and risk factors of COPD and PRISm, and the efficacy of early diagnosing COPD by the SAD indicators. Results: Totally 2229 positive screening participants were included, the proportion of PRISm was 6.3% (141/2229), and of COPD was 78.2% (1743/2229). Statistical analyses showed that COPD patients were more likely to be smokers, males, and older. And COPD patients had higher questionnaire scores, meaning that they were more prone to have family history of respiratory diseases and more severe respiratory symptoms. Additionally, COPD patients had lower maximal mid-expiratory flow (MMEF) pred, forced expiratory flow (FEF) 75pred, and FEF50pred. And we found that male sex and presence of respiratory symptoms might lead to COPD and PRISm. Also, the methods of early diagnosing COPD through the SAD indicators might be acceptable. Conclusion: There is a close association between COPD and decreased small airway function (SAF) among the participants included. Age, smoking, male sex, worse SAF, and respiratory symptoms might cause the progressing from normal people to PRISm, then to COPD patients. Besides, the SAD indicators such as MMEFpred, FEF75pred, and FEF50pred were included in lung function tests and bronchodilator tests. Intriguingly, it was found that early diagnosing COPD via the SAD indicators might be feasible. In the future, early diagnosis for COPD requires further research. [ABSTRACT FROM AUTHOR]

COPD has been found to be associated with frailty. However, longitudinal evidence for associations of COPD with frailty progression is inadequate. Furthermore, recent studies revealed a new phenotype of lung function impairment: preserved ratio impaired spirometry (PRISm) findings. Associations of PRISm findings and their transitions with frailty progression are unclear. What are the associations of PRISm findings, transitions of PRISm findings, and COPD with frailty progression? To analyze the associations of PRISm findings and COPD with frailty progression, 5,901 patients were included from the English Longitudinal Study of Ageing. Patients were classified into three lung function patterns of normal spirometry (NS) findings, PRISm findings, and COPD. Frailty progression was assessed by repeated measurements of the frailty index (FI) during follow-up. Among these 5,901 patients, 3,765 patients were included to analyze the associations of PRISm findings transitions with frailty progression. PRISm findings transitions were assessed based on the changes of lung function patterns after a 4-year interval. Linear mixed-effect models were used for statistical analyses. The median follow-up periods were 9.5 years for the analyses of PRISm findings and COPD with frailty progression and 5.8 years for PRISm findings transitions with frailty progression. When compared with participants with NS findings, patients with PRISm findings and COPD demonstrated accelerated FI progression with additional annual increases of 0.301 (95% CI, 0.211-0.392; P <.001) and 0.172 (95% CI, 0.102-0.242; P <.001), respectively. Patients who transitioned from NS findings to PRISm findings also demonstrated accelerated FI progression when compared with those with stable NS findings (β = 0.242; 95% CI, 0.008-0.476; P =.042). However, no accelerated FI progression was found in patients with PRISm findings who transitioned to NS findings (β = 0.119; 95% CI, –0.181 to 0.418; P =.438). Our findings indicate that PRISm findings and COPD are associated with accelerated frailty progression. Further studies are needed to elucidate the causality of the association of PRISm findings and COPD with frailty. [ABSTRACT FROM AUTHOR]

While scientific knowledge acquisition is a vital premise for citizens' self-protection against COVID-19, the impact of anti-intellectualism on scientific information seeking has yet to be fully examined. Based on a cross-sectional survey, this study investigated the association of distrust and stigmatization forms of antiintellectualism (i.e. AID vs. AIS) with the Planned Risk Information Seeking Model (PRISM) in predicting Chinese netizens' information seeking about SARS-CoV-2 variants. The statistical results show that AIS is positively associated with seeking-related subjective norms and perceived control, indicating that it may boost a sense of self-empowerment. However, AIS is negatively related to affective risk response and the knowledge-sufficiency threshold, suggesting its possible link to overconfidence and trust in government. AID was found to be negatively associated with seeking-related attitudes and perceived control. Because AIS is far more popular than AID among respondents, its contradictory health implications should be brought into the vision of health communicators. [ABSTRACT FROM AUTHOR]

Objective: A pilot study to preliminarily examine the effects of Prism EFP NeuroFeedback (NF) in adult ADHD. Method: Prism EFP NF is a form of NF specifically designed to target emotional dysregulation (ED) through down regulation of amygdala activity. Prism EFP NF has been shown to improve other disorders with significant ED. Nine participants with adult ADHD received an open trial of Prism EFP NF consisting of fifteen sessions over 8 weeks; all completed at least 5 weeks of treatment with seven completing all 8 weeks. Outcomes were assessed by change in ADHD symptoms from baseline to End of Treatment. Results: About two-third reduction was seen in total DSM ADHD symptom scores (primary outcome measure) with improvement observed in all other clinical measures. No significant adverse events were seen. Conclusion: This preliminary trial found substantial effects of Prism EFP NF on ADHD/ED symptoms and global impairment. [ABSTRACT FROM AUTHOR]

Despite growing acceptability of health-related social needs (HRSN) screening and increasing policy incentives for adoption, clinical implementation of HRSN screening remains low. HRSN screening has been particularly difficult for Community Health Centers (CHCs), which have limited resources to implement and sustain new workflows. While CHCs provide care to patients with disproportionately high levels of unmet social needs, identifying HRSN screening implementation strategies that take CHC-specific contexts into account remains elusive. This study uses the Practical Robust Implementation and Sustainability Model (PRISM) to design an implementation strategy accounting for the unique context of CHCs. We used Rapid Ethnographic Assessment observations and stakeholder focus groups to identify current workflow barriers and facilitators to HRSN screening, and to develop implementation strategies that include multi-level contexts and perspectives. We identified eight themes contributing to low screening implementation: perceived stigma around screening; need for community-based solutions; re-confirming organizational priorities and values; Electronic Medical Record (EMR) limitations; multi-tasking pressures limiting implementation; staff turnover; limited knowledge of regulatory requirements; and community resource availability for referral. Based on the themes, we identified implementation strategies including non-EMR data collection; integration into the workflow for multiple staff members; creation of new training and educational modules; and identification of peer champions for retraining in real time. Administrative requirements are necessary but not sufficient for implementation of HRSN screening in CHCs. Resource-constrained settings benefit from context-specific stakeholder engagement to improve implementation success. The use of PRISM ensured contextual factors were central to the implementation strategy design. [ABSTRACT FROM AUTHOR]

For the fields of implementation science and health equity, understanding and being responsive to local contexts is of utmost importance to better inform the development, implementation, and evaluation of healthcare and public health interventions to increase their uptake and sustainment. Contexts are multi-level and include political, historical, economic, and social factors that influence health, as well as organizational characteristics, reflecting the richness of members' views, resources, values, and needs. Poor alignment between solutions and those contextual characteristics could have an impact on inequities. The PRISM (Practical Robust Implementation and Sustainability Model) is a context-based implementation science framework that incorporates RE-AIM outcomes (Reach, Effectiveness, Adoption, Implementation, Maintenance) and offers guidance to researchers, practitioners, and their patient and community partners on how to conceptualize, assess, and address contextual domains with a focus on health equity. Drawing from systems thinking, participatory engagement, and health equity principles, this commentary expands on previous work to 1) offer a novel perspective on how to align an intervention's core functions and forms with the PRISM's contextual domains, and 2) foster an ongoing and iterative engagement process with diverse partners throughout the research and practice process using a co-creation approach. We recommend intervention-to-context alignment through iterative cycles. To that end, we present the RE-AIM Framework's 'outcomes cascade' to illustrate touch points of opportunity and gaps within and across each of the five RE-AIM outcomes to illustrate 'where things go wrong'. We present a case study to illustrate and offer recommendations for research and practice efforts to increase contextual responsiveness, and enhance alignment with context before, during, and after implementation efforts and to ensure equity is being addressed. We strive to make a conceptual contribution to advance the field of pragmatic research and implementation of evidence-based practices through the application of the contextually-based PRISM framework with a focus on health equity. [ABSTRACT FROM AUTHOR]

Climate change is escalating the threat of heat stress to global public health, with the majority of humans today facing increasingly severe and prolonged heat waves. Accurate weather data reflecting the complexity of measuring heat stress is crucial for reducing the impact of extreme heat on health worldwide. Previous studies have employed Heat Index (HI) and Wet Bulb Globe Temperature (WBGT) metrics to understand extreme heat exposure, forming the basis for heat stress guidelines. However, systematic comparisons of meteorological and climate data sets used for these metrics and the related parameters, like air temperature, humidity, wind speed, and solar radiation crucial for human thermoregulation, are lacking. We compared three heat measures (HImax, WBGTBernard, and WBGTLiljegren) approximated from gridded weather data sets (ERA5‐Land, PRISM, Daymet) with ground‐based data, revealing strong agreement from HI and WBGTBernard (R2 0.76–0.95, RMSE 1.69–6.64°C). Discrepancies varied by Köppen‐Geiger climates (e.g., Adjusted R2 HImax 0.88–0.95, WBGTBernard 0.79–0.97, and WBGTLiljegren 0.80–0.96), and metrological input variables (Adjusted R2Tmax 0.86–0.94, Tmin 0.91–0.94, Wind 0.33, Solarmax 0.38, Solaravg 0.38, relative humidity 0.51–0.74). Gridded data sets can offer reliable heat exposure assessment, but further research and local networks are vital to reduce measurement errors to fully enhance our understanding of how heat stress measures link to health outcomes. Plain Language Summary: Extreme heat threatens human health. Rising intensity and duration of heat days expose more to hot environments. To understand how extreme heat affects human health, it is important to use accurate weather information and measures that reflect people's actual experience of the heat. Heat Index (HI) and Wet Bulb Globe Temperature (WBGT) are commonly used heat stress metrics that are widely used to set exposure guidelines and policies. However, there have been limited comparisons between daily heat measures and weather variables. In this study, we compared three heat measures (HI, WBGTBernard, and WBGTLiljegren) derived from three widely used gridded weather data sets (ERA5‐Land, PRISM, and Daymet) with ground‐based weather observations. The heat measures calculated from both the gridded weather data and the station data showed a reasonably strong agreement. However, the differences varied depending on the climate types. Gridded weather data sets can provide a reliable approach to assessing heat exposure and impacts based on meteorological variables to produce heat measures. However, further research and the establishment of local ground station networks are necessary to reduce measurement errors in exposure and improve accuracy. This will help us better understand the relationship between heat measures and their impact on health outcomes. Key Points: Compared heat stress measures using gridded data sets and in situ data from 17 institutions across 42 states in the contiguous USObserved variations in heat measures and weather variables align with Köppen‐Geiger climate classificationsInstalling more Wet Bulb Globe Temperature‐measuring stations in diverse microclimates is key to better heat exposure prevention strategies [ABSTRACT FROM AUTHOR]

Phenylketonuria (PKU) is a genetic disorder caused by deficiency of the enzyme phenylalanine hydroxylase (PAH), which results in phenylalanine (Phe) accumulation in the blood and brain, and requires lifelong treatment to keep blood Phe in a safe range. Pegvaliase is an enzyme-substitution therapy approved for individuals with PKU and uncontrolled blood Phe concentrations (>600 μmol/L) despite prior management. Aggregated results from the PRISM clinical trials demonstrated substantial and sustained reductions in blood Phe with a manageable safety profile, but also noted individual variation in time to and dose needed for a first response. This analysis reports longer-term aggregate findings and characterizes individual participant responses to pegvaliase using final data from the randomized trials PRISM-1 (NCT01819727) and PRISM-2 (NCT01889862), and the open-label extension study 165–304 (NCT03694353). In 261 adult participants with a mean of 36.6 months of pegvaliase treatment, 71.3%, 65.1%, and 59.4% achieved clinically significant blood Phe levels of ≤600, ≤360, and ≤ 120 μmol/L, respectively. Some participants achieved blood Phe reductions with

Background To track improvement in diplopia symptoms with strabismus-specific health-related quality of life (HRQOL) questionnaire across a treatment consisting of prism correction followed by vision therapy/orthoptics when prism treatment alone has not succeeded. Methods Forty-eight participants with diplopia and a mean age of 62.45 were asked to complete an Adult Strabismus-20 (AS-20) questionnaire and a Diplopia Questionnaire (DQ) before and after prism correction. Inclusion criteria were diplopia reported on the DQ as “sometimes”, “often” or “always” at reading or straight-ahead distance. The prism correction was classified as successful if the participant reported “never” or “rarely” on the DQ for reading and straight-ahead distance; and unsuccessful if the perceived diplopia worsened or remained the same. For all participants, mean initial AS-20 scores were compared with mean post-prism correction scores, taking into account AS-20 subscales (reading and general functions, and self-perception and interaction). Participants in the failed prism treatment subgroup subsequently underwent a programme of vision therapy wearing their prism correction, the results of which were again determined by participants’ responses on the AS-20 questionnaire, completed before and after the vision therapy. Results Five of the 48 participants dropped out of the study. Prism correction was classified as successful in 22 of 43 participants (51%), and unsuccessful in 21 (49%). Those participants for whom the prism correction was classified as a success showed a statistically significant improvement (p = 0.01) in both reading and general functions. In the failed treatment subgroup, no significant change in AS-20 score was recorded for any of the domains (p = 0.1). After treatment with vision therapy/orthoptics, however, 13 of the 20 participants in the unsuccessful prism correction subgroup (one of them dropped out the study) achieved binocular vision and statistically significant improvement in reading and general functions (p = 0.01). Conclusions Although effective prism correction of diplopia is correlated with enhanced HRQOL, prism correction alone is frequently not sufficient to achieve this objective. In these cases, vision therapy/orthoptics treatment as a coadjutant to prism correction is shown to improve HRQOL.

Summary: Background: The prevalence, epidemiological and clinical heterogeneities, and impact profiles of individuals with preserved ratio impaired spirometry (PRISm), pre-COPD, young COPD, and mild COPD in general Chinese population were not known yet. Methods: Data were obtained from the China Pulmonary Health study (2012–2015), a nationally representative cross-sectional survey that recruited 50,991 adults aged 20 years or older. Definitions of the four early disease status were consistent with the latest publications and the Global Initiative for Chronic Obstructive Lung Disease criteria. Findings: The age-standardised prevalences of PRISm, pre-COPD, young COPD, and mild COPD were 5.5% (95% confidence interval, 4.3–6.9), 7.2% (5.9–8.8), 1.1% (0.7–1.8), and 3.1% (2.5–3.8), respectively. In summary, mild COPD was under more direct or established impact factor exposures, such as older age, male gender, lower education level, lower family income, biomass use, air pollution, and more accumulative cigarette exposures; young COPD and pre-COPD experienced more personal and parents’ events in earlier lives, such as history of bronchitis or pneumonia in childhood, frequent chronic cough in childhood, parental history of respiratory diseases, passive smoke exposure in childhood, and mother exposed to passive smoke while pregnant; pre-COPD coexisted with heavier symptoms and comorbidities burdens; young COPD exhibited worse airway obstruction; and most of the four early disease status harbored small airway dysfunction. Overall, older age, male gender, lower education level, living in the urban area, occupational exposure, frequent chronic cough in childhood, more accumulated cigarette exposure, comorbid with cardiovascular disease and gastroesophageal reflux disease were all associated with increased presence of the four early COPD status; different impact profiles were additionally observed with distinct entities. Over the four categories, less than 10% had ever taken pulmonary function test; less than 1% reported a previously diagnosed COPD; and no more than 13% had received pharmaceutical treatment. Interpretation: Significant heterogeneities in prevalence, epidemiological and clinical features, and impact profiles were noted under varied defining criteria of early COPD; a unified and validated definition for an early disease stage is warranted. Closer attention, better management, and further research need to be administrated to these population. Funding: Chinese Academy of Medical Sciences Institute of Respiratory Medicine Grant for Young Scholars (No. 2023-ZF-9); China International Medical Foundation (No. Z-2017-24-2301); Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (No. 2021-I2M-1-049); National High Level Hospital Clinical Research Funding (No. 2022-NHLHCRF-LX-01); Major Program of National Natural Science Foundation of China (No. 82090011).

This article discusses the management of diplopia (double vision) in a patient with endometrial cancer who experienced chemotherapy toxicity. Endometrial cancer is a common gynecologic cancer that primarily affects postmenopausal women. Chemotherapy drugs used to treat endometrial cancer can have side effects on the visual system, including diplopia. The case report describes a patient who developed diplopia during chemotherapy treatment but was successfully managed with prismatic correction and in-home visual exercises. The article emphasizes the importance of recognizing and addressing potential side effects of chemotherapy to maintain a good quality of life for cancer patients. [Extracted from the article]

Problem. The studied dynamic process of digging, taking into account the variable total moving mass of wheeled ZTM equipped with a dump, is not sufficient for the development of recommendations for selecting rational parameters for the performance of such a technological operation. The issue of determining and analyzing the parameters of the variable mass and volume of the material prism moved by the dumper has not been sufficiently investigated. There in no engineering technique that allows you to determine the parameters of the material prism that is gradually forming before dumping. Methodology. The measures are aimed at determining the parameters of the soil prism before the dump in the digging process using analytical dependencies. Results. For the processes of development and analysis of dynamic models of machines with a shovel working body for the stages of digging and transportation of material, it is necessary to take into account its mass in the form of mass attached to the mass of the machine itself. Originality. The obtained dependencies allow to take into account the variable mass of the attached material when performing the analysis of them bulldozer movement in the process of digging the environment being developed. Practical value. The obtained results can be recommended when studying the disciplines of industrial mechanical engineering.

Background: Many patients come with respiratory symptoms of cough, expectoration and shortness of breath. They also exhibit history of risk factors like smoking etc. but on spirometry they do not meet spirometric criteria of chronic obstructive pulmonary disease (COPD). GOLD 2023 updates have considered such patients in the category of pre-COPD and preserved ratio impaired spirometry (PRISm) and advised to treat and follow these patients and try to prevent them from progressing to COPD. With this objective we tried to look for PRISm and its characteristics in our area. Material and methods: We analyzed the spirometric pattern of all the patients who underwent spirometry in our institution (GS Medical College & Hospital, Pilkhuwa) from January 2022 to December 2022. After applying inclusion and exclusion criteria, the patients were divided into three groups: (I) Normal Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 and normal FEV1 and FVC. (II) PRISm Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 but decreased FEV1 (< 80 %) and / or FVC (< 80 %). (III) Unrevealed COPD Group: Patients having post bronchodilator FEV1/FVC ratio < 0.7 irrespective of FEV1 and FVC. Data observed was compared among various groups and analyzed for various parameters. Results: A total of 986 patients underwent spirometry between 1st January 2022 and 31st December 2022. Of this, 302 patients were not considered for study because of exclusion criteria. 684 patients were considered for the study, of whom 261 (38.16%) had normal spirometry, 207 (30.26%) were in the PRISm group and 216 (31.58%) were found to have unrevealed COPD. Conclusion: Occurrence of PRISm is quite high (30.26%) in patients undergoing spirometry for various reasons in our area. Higher age and higher BMI may have contributed to the observations. Additionally, a considerable number of patients (31.58%) were found to have unrevealed COPD. Another finding is that smoking history is seen in more than 70% of male subjects in both PRISm and unrevealed COPD groups. However, the results need confirmation in more studies from different geographical areas.

Background: The aim of the observational, prospective study was to validate a novel, nonverbal assessment tool for perceived disease burden—Pictorial Representation of Illness and Self-Measure (PRISM)—in ulcerative colitis (UC) against established patient health questionnaires. The cumulative burden of patients recently diagnosed (<3 years) with UC was also evaluated. Methods: "ICONIC" - Understanding the impact of ulcerative colitis and its associated disease burden on patients - was a noninterventional, multicountry, multicenter study performed in a 2-year follow-up format in adult patients with recently diagnosed UC in 33 countries, regardless of disease severity or treatment. Data collection consisted of five visits, scheduled at approximately 6-month intervals. For the current analysis, patient data from Saudi Arabia and Kuwait were evaluated. The collected data comprised demographics, disease-related data, UC treatment, and healthcare resources, as well as physician- and patient-assessed quality-of-life and disease burden questionnaires. Correlations between selected questionnaire scores were performed using Spearman's rho. Results: Disease severity at baseline and throughout the study was slightly less favorable in this country analysis compared with the global study cohort. Disease burden was assessed by PRISM and improved within 24 months. Conclusions: The detected moderate correlation between PRISM and other assessment methods supports the validity of PRISM. Differences in perceptions of UC-related burden between physician and patient may reflect to some degree insufficient patient–physician communication. [ABSTRACT FROM AUTHOR]

Background: The syndemic of substance use and human immunodeficiency virus (HIV) is a well-recognized global phenomenon that threatens to undermine the priorities outlined by the National Institutes of Health "Ending the HIV Epidemic" initiative. There are few published studies on preexposure prophylaxis (PrEP) for adolescents and young adults (AYAs) with opioid use disorder (OUD) despite increasing availability of biomedical prevention options and Centers for Disease Control and Prevention recommendations to offer PrEP to this group. Methods: Healthcare providers who previously prescribed medications for OUD (MOUDs) and/or PrEP for AYA were purposively sampled. Audio-recorded in-depth individual interviews were conducted using chart-stimulated recall to explore barriers and facilitators to integrated MOUD and HIV prevention services. Interviews were double-coded, and qualitative analysis was performed using a modified grounded theory. Results: Of 19 providers sampled, most were physicians (63%). All recommended HIV screening at varying intervals; however, few counseled on (19%) or prescribed (11%) PrEP to patients on MOUD. Barriers to PrEP prescriptions included patient-level (ie, stigma surrounding PrEP use, adherence challenges, and competing social or mental healthcare needs), provider (perception of low risk, lack of training/experience), and system-level factors (including restricted visit types). Facilitators of PrEP prescriptions included patient-initiated requests, electronic health record system reminders, and the availability of consistent support staff (ie, navigators, certified recovery specialists). Conclusions: Our study confirms that discussions about HIV prevention and PrEP prescriptions may be rare for AYA patients receiving MOUD. Further research is needed to develop interventions that increase the integration of PrEP delivery within the context of OUD care among this key AYA population. [ABSTRACT FROM AUTHOR]

A set D of vertices in an isolate-free graph is a total dominating set if every vertex is adjacent to a vertex in D. If the set D has the additional property that the subgraph induced by D contains a perfect matching, then D is a paired dominating set of G. The total domination number γt(G) and the paired domination number γpr(G) of a graph G are the minimum cardinalities of a total dominating set and a paired dominating set of G, respectively. The total domination stability (respectively, paired domination stability) of G, denoted stγt(G) (respectively, stγpr(G)), is the minimum size of a non-isolating set of vertices in G whose removal changes the total domination number (respectively, paired domination number). In this paper, we study total and paired domination stability in prisms. [ABSTRACT FROM AUTHOR]

We model nematic liquid crystal configurations inside three-dimensional prisms, with a polygonal cross-section and Dirichlet boundary conditions on all prism surfaces. We work in a reduced Landau-de Gennes framework, and the Dirichlet conditions on the top and bottom surfaces are special in the sense that they are critical points of the reduced Landau-de Gennes energy on the polygonal cross-section. The choice of the boundary conditions allows us to make a direct correspondence between the three-dimensional Landau-de Gennes critical points and pathways on the two-dimensional Landau-de Gennes solution landscape on the polygonal cross-section. We explore this concept by means of asymptotic analysis and numerical examples, with emphasis on a cuboid and a hexagonal prism, focusing on three-dimensional multistability tailored by two-dimensional solution landscapes. [ABSTRACT FROM AUTHOR]

Abstract Climate change is escalating the threat of heat stress to global public health, with the majority of humans today facing increasingly severe and prolonged heat waves. Accurate weather data reflecting the complexity of measuring heat stress is crucial for reducing the impact of extreme heat on health worldwide. Previous studies have employed Heat Index (HI) and Wet Bulb Globe Temperature (WBGT) metrics to understand extreme heat exposure, forming the basis for heat stress guidelines. However, systematic comparisons of meteorological and climate data sets used for these metrics and the related parameters, like air temperature, humidity, wind speed, and solar radiation crucial for human thermoregulation, are lacking. We compared three heat measures (HImax, WBGTBernard, and WBGTLiljegren) approximated from gridded weather data sets (ERA5‐Land, PRISM, Daymet) with ground‐based data, revealing strong agreement from HI and WBGTBernard (R2 0.76–0.95, RMSE 1.69–6.64°C). Discrepancies varied by Köppen‐Geiger climates (e.g., Adjusted R2 HImax 0.88–0.95, WBGTBernard 0.79–0.97, and WBGTLiljegren 0.80–0.96), and metrological input variables (Adjusted R2 Tmax 0.86–0.94, Tmin 0.91–0.94, Wind 0.33, Solarmax 0.38, Solaravg 0.38, relative humidity 0.51–0.74). Gridded data sets can offer reliable heat exposure assessment, but further research and local networks are vital to reduce measurement errors to fully enhance our understanding of how heat stress measures link to health outcomes.