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Objective: The aims of this pilot study were: first, to assess the impact of a brief classroom-based mindfulness program on students' reported levels of mindfulness, well-being, and stress; and, second, to understand students' experiences of participating in the program. Participants: Students at a private midwestern research-intensive university, 133 (16%) students completed either the study's pretest or post-test survey. Methods: The study had an observational design using pre- and post-test survey responses from students taking courses from faculty who were trained to facilitate brief classroom-based mindfulness activities. Results: Students who participated in the semester-long program reported reduced levels of stress and increased mindfulness. Qualitative data indicate that students found the program to be beneficial. Conclusions: Brief classroom-based mindfulness activities led by faculty may have benefits for students in higher education settings. More research is recommended to better understand the impact of mindfulness in the classroom on students and faculty.

In recent decades, the prevalence of myopia has increased worldwide as well as in European countries, and it has become an important medical and socioeconomic problem. Our prospective single-center study analysed the changes in ocular axial length (AXL) in a population of Central European schoolchildren from 2016 to 2019. The study included 528 eyes of 264 children with a mean age of 12.2 years at the beginning of the study. Visual acuity, ocular AXL, anterior chamber depth, and the questionnaire were examined at 6-month intervals (in spring and autumn, following the winter and summer periods, respectively). The average ocular AXL was 23.329 mm (median: 23.315 mm) at the beginning of the study and 23.525 mm (median: 23.505 mm) at the end of the study. The change in ocular AXL per month was significantly higher ( p < 0.0001) during the winter period (average: 0.013 mm, median: 0.011 mm) than during the summer period (average: -0.001 mm, median: 0.000 mm). We observed a significantly higher increase in ocular AXL in a Caucasian population during the winter period (with lower daylight exposure) than the summer period., Competing Interests: All authors declare that they have no conflicts of interest., (Copyright © 2023 Lenka Hecova et al.)

Nurse educators and students are partners in co-creation of a classroom culture of assessment for learning rather than assessment of learning. Three essential sources of feedback-instructor feedback, peer feedback, and self-reflection-contribute to development of metacognitive skills necessary for nursing practice. Triangulation of feedback from multiple sources develops skills in peer evaluation, professional accountability, emotional regulation, and lifelong learning. Feedback processes are supported by creative use of learning technologies such as learning management systems, survey tools, videography using institutional equipment or students' personal devices, social annotation strategies and applications, and audience response systems., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included., Methods and Results: A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up., Conclusion: OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.

Background: Recognizing insufficient support for healthy eating and physical activity in early childhood education centers in Greenville, South Carolina, a group of stakeholders formed a workgroup as an organizing structure. Members developed and implemented a 2-year community-based participatory research initiative aimed at nutrition and physical activity policy, systems and environment change in 10 early childhood education centers., Objectives: This article 1) describes engagement efforts and partnerships leading to formation of the workgroup and initiative, 2) presents data on Workgroup members' knowledge and engagement, and 3) shares lessons learned., Methods: Workgroup member knowledge and engagement related to obesity prevention was measured at two time points during the ECE initiative using the "Stakeholder-driven Community Diffusion Survey.", Lessons Learned: Knowledge and engagement scores increased over the measurement period. Scores for engagement were higher than scores for knowledge at both time points. There was a substantial increase in perceived leadership and stewardship, knowledge of intervention factors and how to intervene sustainably, and understanding of local resources and roles. An important strength was stakeholder buy-in and ownership of planning and implementation processes.

Background: Team debriefing is an important teamwork development intervention for improving team outputs in healthcare. Debriefing is a key component of experiential team training teamwork development interventions such as simulation-based training. Improving the quality of debriefing of healthcare teams, therefore, has multiple benefits. We investigated whether the quality of student-led debriefing improved using a shortened guide., Methods: Senior medical students, nurse anesthesia students, and senior undergraduate nursing students participated in student operating room team training at a health sciences center in the southeastern United States. Student teams participated in a dual-scenario simulation-based training session with immediate after-action debriefings after each scenario. In 2018, student teams conducted the second debriefing using as a guide the teamwork assessment scale, an 11-item, 3-subscale, 6-point Likert-type instrument. In 2019, they used a shortened, revised, 5-item version of the teamwork assessment scale, the quick teamwork assessment scale. Trained observers rated the quality of the student-led debriefings using the Objective Structured Assessment of Debriefing, an 8-item, 5-point instrument. The Wilcoxon-Mann-Whitney test was used to compare the teamwork assessment scale-guided and the quick teamwork assessment scale-guided mean item debriefing scores., Results: Two observers rated 3 student-led team debriefings using the teamwork assessment scales as a guide in 2018, and 6 such debriefings happened using the quick teamwork assessment scale as a guide in 2019. For each debriefing, observer scores were averaged for each Objective Structured Assessment of Debriefing item; these mean scores were then averaged with other mean scores for each year. The use of the quick teamwork assessment scale resulted in a statistically significant higher mean score for the Analysis Objective Structured Assessment of Debriefing item compared with the use of the teamwork assessment scale (4.92 [standard deviation 0.20] versus 3.83 [standard deviation 0.76], P = .023)., Conclusion: The use of a shortened teamwork assessment instrument as a debriefing guide for student teams in student operating room team training was more effective in analysis of actions than the original, longer tool. Next steps include determining the efficacy of the quick teamwork assessment scale in an actual clinical setting., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The peak sports performance of elite athletes is the result of talent and long-term, systematic training. Only minor differences among athletes determine the results in sport today. In selected sports events, stereoscopic vision has a fundamental influence on the executed sports performance., Methods: The quality of stereopsis was determined in 2 groups of top-level athletes at the age of 16-18 years (21 pole vaulters and high jumpers and 25 swimmers) and in a control group of 25 nonathletes in the same age category. Two measured parameters (results and time in the stereopsis test) were compared among the studied groups. To determine the quality of stereopsis, the "Fly-S Stereo Acuity Test with LEA Symbols" field stereoacuity test was used., Results: The average level of stereopsis in the pole vaulters and high jumpers reached the value of 9.9 (max. 10), and the average time needed for performing the stereopsis test was 11.6 seconds. The group of swimmers and control group showed worse results in both measured parameters (the average level of stereopsis: 9.4, resp. 9.1, the average test time: 30.0 seconds, resp. 36.1 seconds). A significant difference between the group of pole vaulters and high jumpers and swimmers was confirmed in both monitored parameters. No significant differences were found between the group of swimmers and nonathletes., Conclusions: On the basis of the stereopsis test results, we can say that top-level pole vaulters and high jumpers have a high quality of stereopsis and very fast identification and decision-making abilities in spatial orientation.

The capsular tension ring (CTR) is a useful aid in cataract surgery involving zonular impairment. In standard implantation with tweezers or injectors, there is limited control of the leading eyelet, and this can cause excessive stress on the zonular fibers and lead to damage of the capsular bag. Several techniques have been investigated with the aim of reducing these risks. In this study, a simple new modification of the suture-guided CTR technique is described. Adding a loop to the suture can facilitate manipulation during implantation and removal of cortex residues at the end of cataract extraction.

Methods: The cohort included 65 clear corneal incisions of 49 patients who underwent cataract surgery. Corneal incisions were recorded using a Leica Proveo 8 microscope with an intraoperative OCT EnFocus™ device continuously during the surgery. Corneal incision morphology before and after lateral stromal hydration was analysed., Results: Good adaptation of the corneal incision before hydration was present in 39 cases (60%), in 16 cases (24.6%), the prominence of posterior lip was present, and, in 10 cases (15.4%), the posterior lip tongue was inverted/retracted into the incision. In 38 cases (58.5%), hydration had no effect on the incision architecture; most often, it was primarily a well-adapted corneal incision (46.2%), less often an incision with posterior lip prominence (10.8%), or tongue inversion into the incision (1.6%) prior to hydration. Hydration worsened the incision architecture in 14 cases (21.5%); most often, it induced/worsened posterior lip prominence (15.4%), less often posterior lip retraction (1.6%), tongue inversion into the incision (1.6%), gap development in the peripheral part of the corneal incision (1.6%), or incomplete opening of the corneal incision (1.6%). In 13 cases (20%), hydration improved the incision architecture, especially in cases with inverted or retracted posterior lip tongue (12.3%), less often in cases with posterior lip prominence (7.7%)., Conclusion: Lateral stromal hydration seldom affects the condition of the corneal incision. Still, it can cause both deterioration and improvement of the corneal incision architecture. Intraoperative OCT provides real-time monitoring of corneal incision morphology during hydration procedure., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Jiri Cendelin et al.)

Digital media availability has surged over the past decade. Because of a lack of comprehensive measurement tools, this rapid growth in access to digital media is accompanied by a scarcity of research examining the family media context and sociocognitive outcomes. There is also little cross-cultural research in families with young children. Modern media are mobile, interactive, and often short in duration, making them difficult to remember when caregivers respond to surveys about media use. The Comprehensive Assessment of Family Media Exposure (CAFE) Consortium has developed a novel tool to measure household media use through a web-based questionnaire, time-use diary, and passive-sensing app installed on family mobile devices. The goal of developing a comprehensive assessment of family media exposure was to take into account the contextual factors of media use and improve upon the limitations of existing self-report measures, while creating a consistent, scalable, and cost-effective tool. The CAFE tool captures the content and context of early media exposure and addresses the limitations of prior media measurement approaches. Preliminary data collected using this measure have been integrated into a shared visualization platform. In this perspective article, we take a tools-of-the-trade approach (Oakes, 2010) to describe four challenges associated with measuring household media exposure in families with young children: measuring attitudes and practices; capturing content and context; measuring short bursts of mobile device usage; and integrating data to capture the complexity of household media usage. We illustrate how each of these challenges can be addressed with preliminary data collected with the CAFE tool and visualized on our dashboard. We conclude with future directions including plans to test reliability, validity, and generalizability of these measures., (Copyright © 2020 Barr, Kirkorian, Radesky, Coyne, Nichols, Blanchfield, Rusnak, Stockdale, Ribner, Durnez, Epstein, Heimann, Koch, Sundqvist, Birberg-Thornberg, Konrad, Slussareff, Bus, Bellagamba and Fitzpatrick.)

Background: Medication - related osteonecrosis of the jaw (MRONJ) is a rare but serious complication of antiresorptive and/or antiangiogenic therapy. It mainly affects oncological patients, however, it can occur in patients with metabolic bone diseases, although this is less frequent. These lesions not only significantly impair the quality of life but can also have impact on the treatment of any underlying disease. In some rare cases MRONJ can be life-threatening. There is still no ideal consensus for treatment, though surgical therapy has been mostly preferred in recent years., Materials and Methods: A monocentric retrospective evaluation of surgical therapy of MRONJ in osteoporotic patients, treated in the time period 3/2014-3/2018 using the uniform department-specific protocol., Results: 26 osteoporotic patients with 32 MRONJ lesions of stage 1 (9%), stage 2 (75%) and stage 3 (16%) were treated surgically. The maxilla: mandibula ratio was 1:2.2, in 19% of patients there was multiple jaw involvement. 69.2% of patients had received bisphosphonates, 15.4% denosumab and 15.4% had a history of both types of antiresorptive treatment. Complete healing was observed in all patients, in 9% of cases by secondary intention in the mean period of 6 weeks. The mean follow-up was 20.5 months., Conclusion: The presented protocol for surgical therapy was effective in the management of all MRONJ stages in the osteoporotic patients described here. The surgery is indicated as an early treatment to prevent complications and the progression of the lesions. It leads to improvement in quality of life and option to resume antiresorptive therapy if interrupted.

It is the position of the Academy of Nutrition and Dietetics that nutrition informatics is a rapidly evolving area of practice for registered dietitian nutritionists and nutrition and dietetic technicians, registered; and that the knowledge and skills inherent to nutrition informatics permeate all areas of the dietetics profession. Further, nutrition and dietetics practitioners must continually learn and update their informatics knowledge and skills to remain at the forefront of nutrition practice. Nutrition informatics is the intersection of information, nutrition, and technology. However, informatics is not just using technology to do work. The essence of nutrition informatics is to manage nutrition data in combination with standards, processes, and technology to improve knowledge and practice that ultimately lead to improved quality of health care and work efficiency. Registered dietitian nutritionists and nutrition and dietetic technicians, registered, are already experts in using evidence to practice in all areas of nutrition and dietetics. To remain at the forefront of technological innovation, the profession must actively participate in the development of standards, processes, and technologies for providing nutrition care., (Copyright © 2019 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Extracellular vesicles (EVs) comprise a heterogeneous group of small membrane vesicles, including exosomes, which play a critical role in intracellular communication and regulation of numerous physiological processes in health and disease. Naturally released from virtually all cells, these vesicles contain an array of nucleic acids, lipids and proteins which they transfer to target cells within their local milieu and systemically. They have been proposed as a means of "cell-free, cell therapy" for cancer, immune disorders, and more recently cardiovascular disease. In addition, their unique properties of stability, biocompatibility, and low immunogenicity have prompted research into their potential as therapeutic delivery agents for drugs and small molecules. In this review, we aim to provide a comprehensive overview of the current understanding of extracellular vesicle biology as well as engineering strategies in play to improve their therapeutic potential.

The growth in the prevalence of myopia leads to the growth of socioeconomic stress in society. It is important to detect any potential risk factors leading to myopia onset and progression. Among the potential risk factors, the lack of natural daylight exposure and the lack of the physical activity together with excess of near-work activities in children are the most prevalent. In the study, the axial length growth depending on the season and the type of behaviour was measured. The assessment was performed in 12-year-old children, 398 eyes of whom were included and measured during the winter and summer period. The children were categorized by the amount of time spent on near-work, physical, and outdoor activity. Results . Statistically significantly higher ( p < 0.0001) axial length growth was observed during the winter period. Statistically significantly ( p < 0.0001) more frequently, the eyeball growth has been proved during the winter season. According to the way of spending leisure time, no statistically significant difference was reported within the individual subgroups in the development of the eyeball length during the observed period. However, statistically significant differences were ascertained in the eyeball initial length within various groups. Conclusion . The lack of daylight exposure may lead to myopia progression.

Early childhood is characterized by memory capacity limitations and rapid perceptual and motor development [Rovee-Collier (1996). Infant Behavior & Development, 19, 385-400]. The present study examined 2-year olds' reproduction of a sliding action to complete an abstract fish puzzle under different levels of memory load and perceptual feature support. Experimental groups were compared to baseline controls to assess spontaneous rates of production of the target actions; baseline production was low across all experiments. Memory load was manipulated in Exp. 1 by adding pieces to the puzzle, increasing sequence length from 2 to 3 items, and to 3 items plus a distractor. Although memory load did not influence how toddlers learned to manipulate the puzzle pieces, it did influence toddlers' achievement of the goal-constructing the fish. Overall, girls were better at constructing the puzzle than boys. In Exp. 2, the perceptual features of the puzzle were altered by changing shape boundaries to create a two-piece horizontally cut puzzle (displaying bilateral symmetry), and by adding a semantically supportive context to the vertically cut puzzle (iconic). Toddlers were able to achieve the goal of building the fish equally well across the 2-item puzzle types (bilateral symmetry, vertical, iconic), but how they learned to manipulate the puzzle pieces varied as a function of the perceptual features. Here, as in Exp. 1, girls showed a different pattern of performance from the boys. This study demonstrates that changes in memory capacity and perceptual processing influence both goal-directed imitation learning and motoric performance., (© 2016 Wiley Periodicals, Inc.)

The purpose of this cross-sectional descriptive pilot study was to describe daily intake of select nutrients important for efficient wound healing and general health in a sample of older adults (64.25 ± 9.49 years of age) with chronic venous leg ulcers (CVLUs; N = 12), compared to recommended dietary allowances (RDA). Anthropometric data were also collected. Compared to RDA, participants on average consumed lower vitamin C (60.03 ± 49.73 mg/d) and higher sodium (3197.07 ± 1455.04 mg/d), sugar (181.21 ± 115.45 g/d), and saturated fat (33.75 ± 1.06 g/d). They also demonstrated a relatively high plasma n-6/n-3 polyunsaturated fatty acid ratio, a biomarker of inflammation (11.25 ± 1.99). The mean body mass index indicated extreme obesity (41.48 ± 11.47). A multidisciplinary treatment approach that includes routine dietary assessments followed by tailored dietary interventions may improve wound healing and long-term health outcomes in this population., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose. To determine the intraocular levels of growth factors and cytokines in patients with various degrees of severity of proliferative diabetic retinopathy (PDR) using multiplex xMAP technology. Methods. A prospective cohort study of 61 eyes from 56 patients who were divided into 3 groups based on the severity of PDR. Patients in group number 1 are those who presented PDR with no need of repeated surgical intervention; patients in group number 2 had repeated vitreous bleeding; and patients in group number 3 had refractory neovascular glaucoma. The concentrations of proangiogenic, antiangiogenic, inflammatory, and neurotrophic factors were measured in intraocular fluid. The results were also compared with levels of factors measured in 50 eyes from 50 patients prior to senile cataract surgery (control group). Results. Patients with refractory neovascular glaucoma (the highest clinical severity group) had higher levels of interleukin 6 (IL-6) (median1 37.19; median3 384.74; P = .00096), transforming growth factor beta 1 (TGFβ-1) (median1 49.00; median3 414.40; P = .0017), and vascular endothelial growth factor (VEGF) (median1 211.62; median3 352.82; P = .0454) compared with other PDR patients. Conclusions. Results of our study imply that levels of IL-6, TGFβ-1, and VEGF correlate with the severity of PDR.

Aim: Proliferative vitreoretinopathy is the major cause of retinal detachment surgery failure. Our prospective cohort study of 27 eyes aimed to determine intraocular levels of growth factors and cytokines in patients with retinal detachment with various degrees of severity of proliferative vitreoretinopathy using multiplex xMAP(®) Technology., Patients & Methods: The concentrations of 12 proangiogenic, antiangiogenic, inflammatory and neurotrophic factors were measured from 0.05-ml samples of intraocular fluid using multiplex xMAP Technology. The results were compared with levels of various factors, which were measured in samples from the control group of 31 eyes prior to senile cataract surgery., Results: The concentration of the MCP-1 cytokine was found to be higher in eyes with retinal detachment compared with the control group. The concentration of VEGF was found to be higher in eyes with retinal detachment complicated with proliferative vitreoretinopathy compared with the uncomplicated retinal detachment group and the control group., Conclusion: MCP-1 and VEGF may participate in pathogenesis of retinal detachment and proliferative vitreoretinopathy. Biomarkers in disease detection and management have become important tools in modern clinical medicine, and their application to retinal disease should be no exception.

Cyclic AMP was measured in leukocytes of normal and asthmatic subjects before and after one week of treatment with equal amounts of ephedrine. During the control and placebo periods, the measurements of cyclic AMP in leukocytes of asthmatic subjects were similar to those of normal individuals. After one week of treatment with ephedrine, both groups exhibited suppression of the leukocyte cyclic AMP response to adrenergic stimulation in vitro: however, the suppression of response was significantly greater in asthmatic subjects (p less than .u1). Subcutaneous administration of epinephrine was followed by further suppression of the leukocyte cyclic AMP response to in vitro stimulation which was similar in both groups during all treatment periods. The results indicate that in vivo exposure to adrenergic medications is followed by desensitization of the leukocyte responses to subsequent adrenergic stimulation in vitro. After administration of small doses of medication, the severity and/or duration of desensitization is significantly greater in asthmatic leukocytes.

Acute lymphoblastic leukaemic in two boys relapsed after engraftment of marrow from siblings identical at HLA A, B, and D loci but went into remission during subsequent graft-versus-host reactions without specific anti-leukaemia therapy. Later leukaemic relapse was primarily in extramedullary sites, with little or no involvement of bone-marrow, liver, or spleen. Cytogenetic studies in both cases showed that the relapsed leukaemic blasts were those of the recipients while marrow cells and blood lymphocytes detected during marrow remission originated from the female donors. Blood lymphocytes from one of the recepients kiled. 51Cr-labelled autologous lymphoblast. The prolonged bone-marrow remission in the face of active and even massive extramedullary leukaemia suggests a graft-versus-leukaemia reaction in these two patients.

Twenty patients with asthma controlled by oral inhalations of beclomethasone dipropionate (400 micrograms/day) were treated for concurrent rhinitis by the addition of flunisolide nasal solution (300 micrograms/day) and its placebo for three weeks each in a randomized, double-blind, crossover trial. Flunisolide produced a statistically significant benefit for each symptom parameter: sneezing (p = 0.013), runny nose (p = 0.027), stuffy nose (p = 0.005 and over-all severity (p = 0.005). More concomitant rhinitis medication was used during placebo treatment (p = 0.069). Seventy percent of the patients had "total" or "substantial" control of nasal symptoms with flunisolide vs. 45% with placebo (p less than 0.01). Eighty percent felt that flunisolide was either the only active drug or the more active (p less than 0.01). Three morning plasma cortisol determinations during the last week of each treatment period showed no drug-related effect. No nasal cultures were positive for Candida; the incidence of positive pharyngeal; cultures did not vary significantly. Adverse reactions consisted primarily of nasal burning and stinging; none was serious. In this group of twenty patients using inhalations of beclomethasone dipropionate for asthma, accompanying perennial rhinitis was substantially controlled by 300 micrograms of flunisolide nasal solution per day without significant additive effect on plasma cortisol levels or the incidence of overgrowth of Candida.

Blood specimens for measurement of leukocyte cyclic adenosine monophosphate (AMP) were obtained at weekly intervals from asthmatic children who were participating in a double-blind, crossover study to compare the effects of two adrenergic agents and a placebo. When patients were treated with the placebo, the basal measurements and the cyclic AMP responses of leukocytes to in vitro stimulation with epinephrine (10(-4) M) were similar to those of normal subjects but within one week after initiation of treatment with an adrenergic bronchodilator, leukocyte cyclic AMP responses to adrenergic stimulation in vitro decreased and remained low during the remainder of the treatment period. Within one week after discontinuation of adrenergic therapy, leukocyte cyclic AMP responses returned to the control level. Our results indicate that the alterations in leukocyte cyclic AMP metabolism which have been observed previously in asthmatic patients may result from medications used for treatment of asthma.