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Background: Rates of self-harm and suicide are rising for young people globally and many implicate social media in this problem. To address this concern and to increase the confidence of adults to communicate safely about suicide and social media with young people, the #chatsafe Guide for Parents and Carers was developed in Australia. With significant uptake of the resource among Australian adults, the aim of the current study was to update and contextualise the #chatsafe Guide for Parents and Carers for audiences in 15 countries globally. To improve the relevance of this resource for parents and carers in these countries, the present study sought to understand the concerns held by parents, carers and suicide prevention professionals around the world about these topics and to explore the extent to which a resource such as #chatsafe would be helpful within their communities. Methods: Seven focus groups were conducted via Zoom with parents, carers and suicide prevention professionals (n = 40) from 15 countries. Transcribed data were coded and thematically analysed using both inductive and deductive processes. Results: Six themes are reported: (1) Two scary 'S' words; (2) Country and culture impact who talks (or is silent) about self-harm and suicide; (3) The need for a protective social ecosystem; (4) #chatsafe is a tool that can help parents, carers and young people worldwide; (5) #chatsafe should consider local context and end users to improve its relevance for parents and carers worldwide; and (6) A range of marketing and dissemination strategies are needed to reach adults with #chatsafe information. Findings of this study informed the update and contextualisation of the #chatsafe Guide for Parents and Carers for adult audiences in 15 countries. Conclusions: The findings from this study underscore a universal need for psychoeducation initiatives that provide adults with the skills and knowledge to support the mental health of young people, both online and offline, and that resources like #chastafe can play an important role in providing reliable information about these topics to adults across a range of cultures and contexts. [ABSTRACT FROM AUTHOR]

Barrier islands are landscape features that protect coastlines by reducing wave energy and erosion. Quantifying vegetation-topographic interactions between adjacent habitats are essential for predicting long-term island response and resilience to sea-level rise and disturbance. To understand the effects of dune dynamics on adjacent interior island ecosystem processes, we quantified how sediment availability and previous disturbance regime interact with vegetation to influence dune building and ease of seawater and sediment movement into the island interior on two US mid-Atlantic coast barrier islands. We conducted field surveys of sediment accretion, vegetative cover, and soil characteristics in dune and swale habitats. Digital elevation models provided assessment of water flow resistance from the mean high water mark into the island interior. We found that geographic location impacted sediment accretion rates and Panicum amarum (a species increasing in abundance over time in the Virginia barrier islands) accreted sediment at a significantly lower rate compared to other dune grasses. Dune elevation impacted the ease of seawater flow into the island interior, altering soil chlorides, annual net primary productivity, and soil carbon and nitrogen. Our work demonstrates the importance of incorporating biological processes and cross-island connectivity into future scenario modeling and predictions of rising sea-levels and increased disturbance. [ABSTRACT FROM AUTHOR]

Rotor angle stability, which involves electromechanical oscillation damping and control, is very important in maintaining the stability of modern power grid systems. Renewable energy sources like wind energy are undergoing massive integration into modern power grid systems to meet energy demands and decarbonize power grid systems of carbon emissions from fossil fuel generators. To enable increased integration of wind renewable energy sources, precise models are needed for research and analytical purposes. Wind renewable energy is generated through a wind energy conversion system (WECS); one such conversion system is the doubly fed induction generator (DFIG) system. In this study, a precise model of a DFIG-WECS was modeled and integrated into the IEEE's two-area Kundur power test system, which represents the available power grid system, and is also a multimachine power system using the Matlab/Simulink 2023 software. A damping controller known as the power system stabilizer (PSS), whose optimal parameters were obtained using artificial eco-system optimization (AEO), was also incorporated into the integrated power grid system to control and damp electromechanical oscillations. The results showed that the PSS damping controller effectively damped electromechanical oscillations in the integrated power grid system. [ABSTRACT FROM AUTHOR]

Researchers have found that many post-secondary music students suffer from physical and mental health issues. However, researchers have mainly studied these problems at the individual level, with little investigation of how music students' work is shaped by the coordinating effects of policies, texts, and discourses at and beyond their local site. This paper describes a protocol for an international project that will explore the health of music students in the context of their daily work. Using an institutional ethnography approach, we will examine the social organization of music students' work at three universities: two in Canada and one in Australia. This will be the first set of studies that use institutional ethnography specifically for the purpose of understanding how the social organization of music students' work shapes their health. Data will be collected using several methods common to institutional ethnography: interviews, focus groups, observations, and collecting texts. Data analysis will begin during the data collection process and proceed in two fluid stages. The first stage will involve a detailed investigation of the pertinent work activities at each music school. The second will involve linking that work to specific social relations within and beyond the institution. After data analysis has been completed at all three sites, findings will be compared to one another to identify commonalities and differences in how students' work is organized. Findings of the entire project may inform policy-making and lead to positive change at the institutions studied, as well as others where similar social organization may occur. The novel approach described here will provide opportunities to expand current knowledge about music students' work and health beyond what has been learned through approaches that focus on students' individual behaviours and attributes. [ABSTRACT FROM AUTHOR]

Vibrations in electromechanical machines pose a risk of performance deterioration and mechanical failures, stressing the need for precise all-weather vibration detection and identification of modal parameters for predictive and proactive maintenance. Using an experimental approach, a dataset of interferograms is generated from an optical sensor with labeled vibration amplitudes corresponding to frequencies ranging from 50 Hz to 250 Hz through voltages of 10 V and 15 V, respectively. The experimental setup integrates a Mach-Zehnder interferometer (MZI) with a vibrating motor to capture minute displacements induced by vibration frequencies and record them as fringe images via a CCD camera. The k-nearest neighbor (k-NN) machine learning and FFT algorithms are employed for analysis. The vibration modes and resonant frequency of the motor are determined from the fringe images using the FFT technique. The dataset is split into a 70% training set and a 30% validation set. Computer vision techniques are applied to extract the features of a local binary pattern (LBP) from the training fringe images. The machine learning model is trained to accurately detect the vibration amplitudes based on the LBP in each fringe image. The proposed approach achieves 98.5% accuracy in detecting the motor vibration frequency. Consequently, MZI has a potential for monitoring the real-time vibrations in electromechanical equipment. [ABSTRACT FROM AUTHOR]

Phase shift plays a vital role in the analysis of interference and manipulation of polarization behavior in interferometric techniques. The Sagnac interferometer (SI) is initially studied due to its ability to withstand external environmental factors, including noise, temperature, and other interferences. However, the real impact of these factors is not demonstrated. To address this, comparative studies are conducted involving both mathematical theories, simulations, and physical experiments of Sagnac and Mach-Zehnder interferometers (MZI), both utilizing a phase shift. The purpose is to explore the SI advantages over the MZI in a series of experiments with both interferometers to validate the superior configuration. Numerical simulations of the total electric field are performed at the output of these interferometers. By adjusting the orientation of a half-wave plate from 45 and 135 degrees at a step of 90 degrees, the interference fringe pattern and respective signal are generated. These simulation parameters are then implemented experimentally, and the results from both approaches are carefully analyzed and compared. It is shown that the light reflection through the SI setup makes it more tolerant to noise compared to the MZI. Consequently, these results confirm that the image intensity and pixel level of the SI are higher than that of the MZI, potentially leading to greater brightness for the simplified image analysis. [ABSTRACT FROM AUTHOR]

This article examines recent technological and cultural developments that have transformed the publishing industry in the past two decades—the rise of social media platforms for writing and reading genre fiction as well as the translingual practices they enable. My focus on the digital aims to update earlier studies of translingualism in a world literary space (Stephen G. Kellman, Pascale Casanova). In particular, I examine a French-language platform (Fyctia) and a multilingual one (Wattpad) to argue that digital platforms' affordances and constraints shape the translingual strategies of their writers and readers. [ABSTRACT FROM AUTHOR]

HaCohen et al. (2018) identified three types of narratives that emerge in the context of integrating a difficult event into one's life story. We use their identification while focusing on the quality of emotional involvement evidenced in texts, and combining it with an abstract-content text analysis. This allows us to quantify emotional engagement in Expressive Writing (EW) texts. We analyze personal-experience narratives produced in EW, and examine whether good EW outcome cases (in terms of well-being improvement) would be characterized with different types of narratives than poor outcome cases. Results show that texts produced by good outcome cases presented more emotional involvement than poor cases. Furthermore, good cases presented with a more complex and well-integrated narrative of their story than poor cases. It is suggested that good outcome participants' writings are more emotionally involved, integrated and personal. Our findings emphasize the importance of context-sensitive and function-oriented accounts of EW texts. [ABSTRACT FROM AUTHOR]

Introduction: Gait impairments in Parkinson's disease (PD) are treated with dopaminergic medication or deep-brain stimulation (DBS), although the magnitude of the response is variable between individuals. Computer vision-based approaches have previously been evaluated for measuring the severity of parkinsonian gait in videos, but have not been evaluated for their ability to identify changes within individuals in response to treatment. This pilot study examines whether a vision-based model, trained on videos of parkinsonism, is able to detect improvement in parkinsonian gait in people with PD in response to medication and DBS use. Methods: A spatial–temporal graph convolutional model was trained to predict MDS-UPDRS-gait scores in 362 videos from 14 older adults with drug-induced parkinsonism. This model was then used to predict MDS-UPDRS-gait scores on a different dataset of 42 paired videos from 13 individuals with PD, recorded while ON and OFF medication and DBS treatment during the same clinical visit. Statistical methods were used to assess whether the model was responsive to changes in gait in the ON and OFF states. Results: The MDS-UPDRS-gait scores predicted by the model were lower on average (representing improved gait; p = 0.017, Cohen's d = 0.495) during the ON medication and DBS treatment conditions. The magnitude of the differences between ON and OFF state was significantly correlated between model predictions and clinician annotations (p = 0.004). The predicted scores were significantly correlated with the clinician scores (Kendall's tau-b = 0.301, p = 0.010), but were distributed in a smaller range as compared to the clinician scores. Conclusion: A vision-based model trained on parkinsonian gait did not accurately predict MDS-UPDRS-gait scores in a different PD cohort, but detected weak, but statistically significant proportional changes in response to medication and DBS use. Large, clinically validated datasets of videos captured in many different settings and treatment conditions are required to develop accurate vision-based models of parkinsonian gait. [ABSTRACT FROM AUTHOR]

Policy PointsThe increasing political polarization of states reached new heights during the COVID‐19 pandemic, when response plans differed sharply across party lines.This study found that states with Republican governors and larger Republican majorities in legislatures experienced higher death rates during the COVID‐19 pandemic—and in preceding years—but these associations often lost statistical significance after adjusting for the average income and health status of state populations and for the policy orientations of the states.Future research may help clarify whether the higher death rates in these states result from policy choices or have other explanations, such as the tendency of voters with lower incomes or poorer health to elect Republican candidates. Context: Increasing polarization of states reached a high point during the COVID‐19 pandemic, when the party affiliation of elected officials often predicted their policy response. The health consequences of these divisions are unclear. Prior studies compared mortality rates based on presidential voting patterns, but few considered the partisan orientation of state officials. This study examined whether the partisan orientation of governors or legislatures was associated with mortality outcomes during the COVID‐19 pandemic. Methods: Data on deaths and the partisan orientation of governors and legislators were obtained from the Centers for Disease Control and Prevention and the National Conference of State Legislatures, respectively. Linear regression was used to measure the association between Republican representation (percentage of seats held) in legislatures and (1) age‐adjusted, all‐cause mortality rates (AAMRs) in 2015–2021 and (2) excess death rates during three phases of the COVID‐19 pandemic, controlling for median household income, the prevalence of four risk factors (obesity, chronic obstructive pulmonary disease, heart attack, stroke), and state policy orientation. Associations between excess death rates and the governor's party were also examined. Findings: States with Republican governors or greater Republican representation in legislatures experienced higher AAMRs during 2015–2021, lower excess death rates during Phase 1 of the COVID‐19 pandemic (weeks ending March 28, 2020, through June 13, 2020), and higher excess death rates in Phases 2 and 3 (weeks ending June 20, 2020, through April 30, 2022; p < 0.05). Most associations lost statistical significance after adjustment for control variables. Conclusions: Mortality was higher in states with Republican governors and greater Republican legislative representation before and during much of the pandemic. Observed associations could be explained by the adverse effects of policy choices, reverse causality (e.g., popularity of Republican candidates in states with lower socioeconomic and health status), or unmeasured factors that predominate in states with Republican leaders. [ABSTRACT FROM AUTHOR]

This article analyses the mass media reception of Annie Ernaux’s 2022 Nobel Prize, particularly the criticisms in the French press. After the award announcement, Ernaux was at once celebrated for her feminist writing and vilified for her socio-ethnographic approach and political engagements. French journalists and critics have deemed her Nobel illegitimate, calling into question the Swedish Academy’s choice. The article probes the concept of ‘il/legitimacy’ by drawing on Pierre Bourdieu’s sociology of culture and by reading Ernaux’s award within three contexts: the history of the Nobel Prize in Literature; mass media evaluations of her works’ aesthetic value; and literary debates about the impact of authors’ politics on their candidacy to the Nobel. I argue that the legitimacy of Ernaux’s Nobel Prize is the result of a process of cultural negotiation involving authors, texts, and individual as well as institutional agents. Becoming a Nobel laureate is a lengthy process that needs to be examined in the light of all these factors. [ABSTRACT FROM AUTHOR]

In this paper, we propose an adaptation of the well-known k -means algorithm for solving the multiple spheres detection problem when data points are homogeneously scattered around several spheres. We call this adaptation the k - closest spheres algorithm. In order to choose good initial spheres, we use a few iterations of the global optimizing algorithm DIRECT , resulting in the high efficiency of the proposed k -closest spheres algorithm. We present illustrative examples for the case of non-intersecting and for the case of intersecting spheres. We also show a real-world application in analyzing earthquake depths. • Efficient novel algorithm for solving the multiple spheres detection problem. • k -Closest spheres algorithm based on the k -means algorithm. • Initial spheres are determined using a few iterations of the DIRECT algorithm. [ABSTRACT FROM AUTHOR]

Background: Psychological factors such as catastrophizing, anxiety, and depression influence clinical outcomes in many conditions. Our purpose was to examine trends and associations between these and outcomes of rotator cuff surgery. Methods: 148 patients (76 W:72 M, 55.1 ± 8.2 years) with unilateral symptomatic rotator cuff syndrome were followed for 1 year after surgery. The Western Ontario Rotator Cuff Score (WORC), the Pain Catastrophizing Score (PCS), and the Hospital Anxiety and Depression Score (HADS) were administered. Evolution and associations of WORC, HADS and PCS scores were examined using uni- and multivariate analyzes. Results: At 1 year, PCS, HADS-A, and HADS-D scores negatively correlated with WORC score (R = −0.6, −0.61, −0.69). The strength of correlation was lower between baseline PCS, HADS-A, and HADS-D scores and 1-year WORC score (R = −0.38, −0.43, −0.42). Prior anxiety diagnosis was associated with higher HADS-A scores at 2- and 6- weeks post-op (p = 0.013, 0.011). 106 participants experienced an improving HADS-D over the year of follow-up. Worse pre-op pain, WORC, PCS, HADS-A, HADS-D, cardiovascular disease and current smoking were associated with non-improving HADS-D. Discussion: Patient-reported outcomes of rotator cuff surgery are associated with patient-reported anxiety, depression, and pain catastrophizing. In many, all outcome scores improved over time suggesting a two-way association between shoulder condition and psychological parameters. Level of evidence: II. [ABSTRACT FROM AUTHOR]

Background: Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors' knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies have been limited to specific geographic area. Therefore, this analysis was aimed to estimate the pooled prevalence of suboptimal birth spacing and its predictors among childbearing women in SSA. Methods: Pooled DHS data from 35 SSA countries were used and a weighted sample of 221,098 reproductive-age women was considered in the analysis. The survey across all countries employed a cross-sectional study design and collected data on basic sociodemographic characteristics and different health indicators. Forest plot was used to present the overall and country-level prevalence of suboptimal birth spacing. Multilevel mixed-effects models with robust Poisson regression were fitted to identify the predictors of suboptimal birth spacing. Akaike's and Bayesian information criteria and deviance were used to compare the models. In a multivariable regression model, a p-value less than 0.05 and an adjusted prevalence ratio with the corresponding 95% CI were used to assess the statistical significance of the explanatory variables. Results: The pooled prevalence of suboptimal birth spacing among women in SSA was 43.91% (43.71%-44.11%), with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%). It was also found that 14 of the 35 countries had a prevalence above the average for SSA. Rural residence [APR (95% CI) = 1.10 (1.12–1.15)], non-exposure to media [APR (95% CI) = 1.08 (1.07–1.11)], younger maternal age [APR (95% CI) = 2.05 (2.01–2.09)], non-use of contraception [APR (95% CI) = 1.18 (1.16–1.20)], unmet need for family planning [APR (95% CI) = 1.04 (1.03–1.06)], higher birth order [APR (95% CI) = 1.31 (1.28–1.34)], and desire to have at least six children [APR (95% CI) = 1.14 (1.13–1.16)] were the predictors of suboptimal birth spacing practice. Conclusion: More than four out of ten reproductive-age women in SSA countries gave birth to a subsequent child earlier than the recommended birth spacing, with considerable variations across the countries. Thus, interventions designed at enhancing optimal birth spacing should pay particular attention to young and socioeconomically disadvantaged women and those residing in rural regions. Strengthening community health programs and improving accessibility and availabilities of fertility control methods that ultimately impacts optimal reproductive behaviors is crucial to address contraceptive utilization and unmet need. [ABSTRACT FROM AUTHOR]

Background & Aims: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Studies evaluated the effect of several diets on inflammatory markers in IBD patients. Nevertheless, the results have been inconsistent. Therefore, we conducted this review to evaluate the effectiveness of dietary interventions on inflammatory markers in IBD. Methods: A comprehensive electronic literature search strategy using the PubMed, Embase, and Scopus was conducted in March 2023 and evaluated inflammatory markers included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin (FC), as well as disease severity scores. We included full-text articles that met our inclusion and exclusion criteria. To evaluate the included studies, we used the NHLBI quality evaluation tools. Results: A total of 16 studies were included in our qualitative synthesis. Elemental and polymeric diets showed similar efficacy in reducing Crohn's disease activity index (CDAI) and CRP levels. On the other hand, most studies evaluating the effects of omega 3 fatty acids reported no significant improvement. Moreover, protein supplementation was not seen to improve ESR or CRP levels. Except for improvements in FC levels with IgG4-guided exclusion diet in CD patients with elevated CDAI levels, restrictive diets were successful in controlling functional abdominal symptoms but did not appear to have an impact on inflammation in most studies. Furthermore, disease severity scores, CRP, ESR, and FC levels did not significantly change when eating a high-fiber, low-refined-carb, low-fat diet. Conclusions: Diet plays a vital role in managing IBD by impacting the inflammatory response. Among the interventions studied, enteral nutrition showed the most promising results, improving patients' inflammatory status. Restrictive diets effectively managed symptoms and clinical remission but had limited impact on inflammatory markers. Supplementing the diet with fatty acids, omega 3, or proteins did not definitively improve patients' condition or inflammation. [ABSTRACT FROM AUTHOR]

Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital. Methodology: A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale. Results: The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1). Conclusion: This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility. [ABSTRACT FROM AUTHOR]

The Mercury Theatre on the Air adaptation of Dracula updated the novel's protomodernist fears of technology, subsuming and enthralling its subjects through the new medium of radio. Retaining the novel's moments of travel, Orson Welles would bleed diegetic layers of the epistolary form together and rework the narrative's relationships to reflect the asymmetric dynamics of broadcaster and listener. I argue that Welles evokes debates around radio to highlight the medium's potential to both empower and subjugate. [ABSTRACT FROM AUTHOR]

This research evaluates the viability of the artificial eco-system optimization (AEO), a novel metaheuristic algorithm, for optimal power system stabilizers (PSSs) tuning in single-machine infinite bus (SMIB) and western system coordinating council (WSCC) multi-machine power systems. The PSS design problem was converted to an optimization problem to achieve optimal tuning, and an eigenvalue-based objective function was employed. The eigenvalue objective function was defined to optimally obtain the PSSs parameters and enhance the power system dynamic performance by improving the damping of electromechanical modes (EMs). The proposed AEO-based PSS performance was validated by comparing the results obtained with genetic algorithm (GA)-based PSS, particle swarm optimization (PSO)- based PSS design, and similar published work. AEO-based PSS method of tuning has been shown to damp electromechanical modes (EMs), control low-frequency oscillations (LFO), and provide better transient performance and convergence rate. [ABSTRACT FROM AUTHOR]

Twenty percent of older adults report having a concern about their mental health. Mental health concerns lead to impairments in physical, mental, and social functioning and complicate the management of chronic illness. These concerns are widely underrecognized and often untreated or under-treated in community-dwelling older adults. A 6-week student-led mental health promotion initiative for older adults living in publicly supported housing was developed. The initiative included student-led weekly "mood" screenings which aimed to destigmatize mental illness and educational sessions teaching the older adults how to use iPads and access the internet and Wi-Fi. The goal of the project was to have residents engage in telehealth visits that promote mental health and improve quality of life. Ungirded by the RE-AIM framework, the initiative focused on achieving Reach by ensuring participants had sufficient knowledge and skill in using the telehealth technology and were not encumbered by mental illness stigma. The project sample of older adults living in publicly supported housing self-reported minimal depressive symptoms and demonstrated stigma toward seeking help for mental illness. Cultural implications contribute to these findings. To have a program with good Reach as delineated in the RE-AIM model, it must recognize facilitators and barriers. Integrating affordability, cultural congruency, and a social connection to community in its design together with the utilization of students during implementation may promote mental health and mitigate some of the negative health consequences. [ABSTRACT FROM AUTHOR]

Background Women's increased risk of HIV acquisition during pregnancy and postpartum may be mediated by changes in vaginal microbiota and/or cytokines. Methods A cohort of 80 Kenyan women who were HIV-1 seronegative contributed 409 vaginal samples at 6 pregnancy time points: periconception, positive pregnancy test result, first trimester, second trimester, third trimester, and postpartum. Concentrations of vaginal bacteria linked with HIV risk and Lactobacillus spp were measured using quantitative polymerase chain reaction. Cytokines were measured by immunoassay. Results Based on Tobit regression, later pregnancy time points were associated with lower concentrations of Sneathia spp (P =.01), Eggerthella sp type 1 (P =.002), and Parvimonas sp type 2 (P =.02) and higher concentrations of Lactobacillus iners (P <.001), Lactobacillus crispatus (P <.001), Lactobacillus vaginalis (P <.001), interleukin 6 (P <.001), TNF (P =.004), C-X-C motif chemokine ligand 10 (CXCL10; P <.001), C-C motif ligand 3 (P =.009), C-C motif ligand 4 (P <.001), C-C motif ligand 5 (P =.002), interleukin 1β (P =.02), and interleukin 8 (P =.002). Most cervicovaginal cytokines and vaginal bacteria clustered separately in principal component analysis, except for CXCL10, which did not group with either cytokines or bacteria. The shift toward a Lactobacillus -dominated microbiota during pregnancy mediated the relationship between pregnancy time point and CXCL10. Conclusions Increases in proinflammatory cytokines, but not vaginal bacterial taxa linked with higher HIV risk, could provide an explanation for increased HIV susceptibility during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to assess if single nucleotide polymorphisms (SNPs) in lung mucins MUC5B and MUC5AC are associated with Mycobacterium tuberculosis outcomes. Methods Independent SNPs in MUC5B and MUC5AC (genotyped by Illumina HumanOmniExpress array) were assessed for associations with tumor necrosis factor (TNF) concentrations (measured by immunoassay) in cerebral spinal fluid (CSF) from tuberculous meningitis (TBM) patients. SNPs associated with CSF TNF concentrations were carried forward for analyses of pulmonary and meningeal tuberculosis susceptibility and TBM mortality. Results MUC5AC SNP rs28737416 T allele was associated with lower CSF concentrations of TNF (P = 1.8 × 10−8) and IFN-γ (P = 2.3 × 10−6). In an additive genetic model, rs28737416 T/T genotype was associated with higher susceptibility to TBM (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.03–1.49; P =.02), but not pulmonary tuberculosis (OR, 1.11, 95% CI,.98–1.25; P =.10). TBM mortality was higher among participants with the rs28737416 T/T and T/C genotypes (35/119, 30.4%) versus the C/C genotype (11/89, 12.4%; log-rank P =.005) in a Vietnam discovery cohort (n = 210), an independent Vietnam validation cohort (n = 87; 9/87, 19.1% vs 1/20, 2.5%; log-rank P =.02), and an Indonesia validation cohort (n = 468, 127/287, 44.3% vs 65/181, 35.9%; log-rank P =.06). Conclusions MUC5AC variants may contribute to immune changes that influence TBM outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Immune recovery following haematopoietic cell transplantation (HCT) functions as a dynamical system. Reducing the duration of intense immune suppression and augmenting antigen presentation has the potential to optimise T‐cell reconstitution, potentially influencing long‐term outcomes. Methods: Based on donor‐derived T‐cell recovery, 26 patients were adaptively randomised between mycophenolate mofetil (MMF) administered for 30‐day post‐transplant with filgrastim for cytokine support (MMF30 arm, N = 11), or MMF given for 15 days with sargramostim (MMF15 arm, N = 15). All patients underwent in vivo T‐cell depletion with 5.1 mg kg−1 antithymocyte globulin (administered over 3 days, Day −9 through to Day −7) and received reduced intensity 450 cGy total body irradiation (3 fractions on Day −1 and Day 0). Patients underwent HLA‐matched related and unrelated donor haematopoietic cell transplantation (HCT). Results: Clinical outcomes were equivalent between the two groups. The MMF15 arm demonstrated superior T‐cell, as well as T‐cell subset recovery and a trend towards superior T‐cell receptor (TCR) diversity in the first month with this difference persisting through the first year. T‐cell repertoire recovery was more rapid and sustained, as well as more diverse in the MMF15 arm. Conclusion: The long‐term superior immune recovery in the MMF15 arm, administered GMCSF, is consistent with a disproportionate impact of early interventions in HCT. Modifying the 'immune‐milieu' following allogeneic HCT is feasible and may influence long‐term T‐cell recovery. [ABSTRACT FROM AUTHOR]

Diverticular disease (DD) is the most frequent condition in the Western world that affects the colon. Although chronic mild inflammatory processes have recently been proposed as a central factor in DD, limited information is currently available regarding the role of inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α). Therefore, we conducted a systematic review and meta-analysis aiming to assess the mucosal TNF-α levels in DD. We conducted a systematic literature search using PubMed, Embase, and Scopus to identify observational studies assessing the TNF-α levels in DD. Full-text articles that satisfied our inclusion and exclusion criteria were included, and a quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The principal summary outcome was the mean difference (MD). The results were reported as MD (95% confidence interval (CI)). A total of 12 articles involving 883 subjects were included in the qualitative synthesis, out of which 6 studies were included in our quantitative synthesis. We did not observe statistical significance related to the mucosal TNF-α levels in symptomatic uncomplicated diverticular disease (SUDD) vs. the controls (0.517 (95% CI −1.148–2.182)), and symptomatic vs. asymptomatic DD patients (0.657 (95% CI −0.883–2.196)). However, the TNF-α levels were found to be significantly increased in DD compared to irritable bowel disease (IBS) patients (27.368 (95% CI 23.744–30.992)), and segmental colitis associated with diverticulosis (SCAD) vs. IBS patients (25.303 (95% CI 19.823–30.784)). Between SUDD and the controls, as well as symptomatic and asymptomatic DD, there were no significant differences in the mucosal TNF-α levels. However, the TNF-α levels were considerably higher in DD and SCAD patients than IBS patients. Our findings suggest that TNF-α may play a key role in the pathogenesis of DD in specific subgroups and could potentially be a target for future therapies. [ABSTRACT FROM AUTHOR]

Background: The majority of global COVID deaths have occurred in developed countries. Not much is known about the clinical outcomes for the patients admitted with COVID in Nigeria. We thus described the clinical characteristics, outcomes, and predictors of outcomes of hospitalized Nigerian COVID-19 patients. Methodology: We performed multilevel and mixed effects regression, Kaplan-Meir survival, and Cox proportionate hazards analyses to evaluate factors associated with death in patients admitted for COVID-19 in 13 high-burden states of Nigeria between 25th February 2020 and 30th August 2021. Results: Of the 3462 patients (median age, 40 years (interquartile range 28 years 54 years), 2,990(60.6%) were male and, 213(6.15%) of them died while on admission. Male sex (adjusted odds ratio [aOR], 1.78 [95% confidence interval {CI}, 1.23-2.56]), age group 45-65 years (OR, 3.93 [95% CI, 1.29-12.02]), age group 66-75 years (aOR, 5.37 [95% CI, 1.68-17.14]), age group > 75 years (aOR, 6.81 [95% CI, 2.0422.82]), chronic cardiac disease (aOR, 3.07 [95% CI, 1.20-7.86]), being diabetic (aOR, 2.16 [95% CI, 1.413.31]), and having chronic kidney disease (OR, 11.01 [95% CI, 2.74-44.24]), were strongly associated with increased odds of death. Having concurrent malaria (aOR, 0.45 [95% CI, 0.16-1.28]), use of Azithromycin for treatment (aOR, 0.33 [95% CI, 0.19-0.54]), and use of Chloroquine/Hydroxychloroquine for treatment (aOR, 0.07 [95% CI, 0.03-0.14]) were significantly associated with decreased odds of death. Conclusions: The cumulative probability of death of male patients, diabetics, hypertensives, and patients with CKD was higher than that of female patients and those without those comorbidities while concurrent malaria and use of chloroquine/hydroxychloroquine in the treatment regimen were associated with a decreased risk of dying in patients treated in our isolation centers. [ABSTRACT FROM AUTHOR]

The article provides information on a study which examined overuse of reflux medications in infants with gastroesophageal reflux (GER). Topics discussed include methodology of the study, and contributing factors to GER disease (GERD) which includes poor weight gain, pain or mucosal injury on endoscopy.

Albert Camus the French Algerian lived a short but action filled life; from losing his father when he was just one year old to the poverty he experienced in his grandmother's house where he grew up after his father's passage. From suffering from tuberculosis at a time its cure was still uncertain to his brilliance in school, his love for football, the country-side and philosophy, his becoming a renowned philosopher who rose beyond his mentors Messieurs Louis Germain and Jean Grenier in his writings, Camus became peers with French philosophers of his time notably, Jean-Paul Sartre, Simone de Beauvoir Nathalie Sarraute and a number of others. Added to this is his love for women as research reveals that he married twice and equally had a plethora of female lovers. The objective of our research is to look at his poor family background which made him experience extreme poverty as a child including a silent and sickly mother and an authoritative grandmother; we shall consider these in order to establish that on becoming a person of renown the joy of living well which he now experienced pushed him beyond the brink making him to spare no opportunity at enjoying life whatsoever such opportunities were. [ABSTRACT FROM AUTHOR]

Understanding adaptive reservoir management strategies that balance ecological outcomes with other objectives necessitates properly articulated environmental objectives. Aside from flood pulse extent related metrics, residual‐based descriptors provide robust descriptions of fish assemblage structure and harvest.We proposed a model framework based on spectral analysis of hydrologic variation and the Multivariate AutoRegressive State Space (MARSS) model to statistically quantify the effect sizes of hydrologic variation impacts on total fish catch and functional group (migration types) fish harvest and applied it to 17 years of fish harvest data from the Lower Mekong River Basin (LMB).Our findings suggest that duration and timing of hydrologic anomalies matter as much as their magnitude. Anomaly droughts coupled with strong pulse can benefit species if timed correctly. Longitudinal migrators were more sensitive to anomalous floods and droughts than other migratory species. Fish catch projections using effect sizes derived from historical data revealed that a well‐timed and protracted drought followed by a powerful flood pulse would be advantageous to the fishery, but a flood delay could negate such benefits.Synthesis and applications: We designed a spectral analysis framework to quantify hydrological variation and linked it with fishery harvest records. Quantified effect sizes of hydrologic anomalous events demonstrated one designed hydrograph for fishery benefits: properly timed prolong drought followed by a strong flood pulse. Our results add to a growing body of research that suggests ecological flows can be engineered. For most dams, the rule curve describing reservoir releases and resulting downstream hydrograph are designed in an ecological vacuum in which the objectives are to maximize human services—power production, flood control or navigation. Our work demonstrates that hydrograph can be designed to manage aspects of functional biodiversity directly. Though the exact shape of our hydrograph may not apply to other engineered river systems, we suggest that the approach can be applied generally, and globally both to developed and developing river basins. Specifically, a functional biodiversity rule curve could be optimized as an additional objective function in a multi‐objective optimization framework. Our methodology provides a quantitative method for deriving an ecological flow for this larger tradeoff analysis. [ABSTRACT FROM AUTHOR]

Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index. Randomized controlled trial. Eight elementary schools in 2 Northern Colorado districts. Fourth-grade students; 7-month interventions: school (S.FFF)—theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities. Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight. Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05. The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable. Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions. [ABSTRACT FROM AUTHOR]

This study performed a comparative analysis of five new meta-heuristic algorithms specifically adopted based on two general classifications; namely, nature-inspired, which includes artificial eco-system optimization (AEO), African vulture optimization algorithm (AVOA), gorilla troop optimization (GTO), and non-nature-inspired or based on mathematical and physics concepts, which includes gradient-based optimization (GBO) and Runge Kutta optimization (RUN) for optimal tuning of multi-machine power system stabilizers (PSSs). To achieve this aim, the algorithms were applied in the PSS design for a multi-machine smart power system. The PSS design was formulated as an optimization problem, and the eigenvalue-based objective function was adopted to improve the damping of electromechanical modes. The expressed objective function helped to determine the stabilizer parameters and enhanced the dynamic performance of the multi-machine power system. The performance of the algorithms in the PSS's design was evaluated using the Western System Coordinating Council (WSCC) multi-machine power test system. The results obtained were compared with each other. When compared to nature-inspired algorithms (AEO, AVOA, and GTO), non-nature-inspired algorithms (GBO and RUN) reduced low-frequency oscillations faster by improving the damping of electromechanical modes and providing a better convergence ratio and statistical performance. [ABSTRACT FROM AUTHOR]

Pianists experience high rates of Playing-Related Musculoskeletal Disorders (PRMDs). Biomechanical factors have been investigated by both researchers and music teachers as potentially significant in PRMD development. Knowledge exchange between the fields of music and science about PRMDs may be beneficial, but differences in language use can make interdisciplinary communication challenging. One potential solution is to translate pedagogical ideas into language that is consistent with biomechanical science. Doing so could improve interdisciplinary communication and allow for scientific examination of pedagogical ideas. However, no methods for doing so have been published. To fill this gap, we developed a methodological framework with two stages for translating ideas about piano technique into scientific language: Stage 1 uses Qualitative Content Analysis to summarize pedagogical content; then, Stage 2 includes an "Analysis of Biomechanical Language," in which researchers translate the ideas described in Stage 1. Both stages are collaborative and rely on expert consultation to produce an appropriate translation. This article outlines the framework and explains how it was used in an initial study on the Taubman Approach. Further methodological guidance to assist researchers in future studies is given based on some of the challenges encountered in the initial study. The framework and guidance here will allow researchers to carry out more studies of this kind. Because the framework is newly developed, it will likely need to be adapted further as more studies are done. [ABSTRACT FROM AUTHOR]

A recombinant version of the AGAAN antimicrobial peptide (rAGAAN) was cloned, expressed, and purified in this study. Its antibacterial potency and stability in harsh environments were thoroughly investigated. A 15 kDa soluble rAGAAN was effectively expressed in E. coli. The purified rAGAAN exhibited a broad antibacterial spectrum and was efficacious against seven Gram-positive and Gram-negative bacteria. The minimal inhibitory concentration (MIC) of rAGAAN against the growth of M. luteus (TISTR 745) was as low as 60 µg/ml. Membrane permeation assay reveals that the integrity of the bacterial envelope is compromised. In addition, rAGAAN was resistant to temperature shock and maintained a high degree of stability throughout a reasonably extensive pH range. The bactericidal activity of rAGAAN ranged from 36.26 to 79.22% in the presence of pepsin and Bacillus proteases. Lower bile salt concentrations had no significant effect on the function of the peptide, whereas higher concentrations induced E. coli resistance. Additionally, rAGAAN exhibited minimal hemolytic activity against red blood cells. This study indicated that rAGAAN may be produced on a large scale in E. coli and that it had an excellent antibacterial activity and sufficient stability. This first work to express biologically active rAGAAN in E. coli yielded 8.01 mg/ml at 16 °C/150 rpm for 18 h in Luria Bertani (LB) medium supplemented with 1% glucose and induced with 0.5 mM IPTG. It also assesses the interfering factors that influence the activity of the peptide, demonstrating its potential for research and therapy of multidrug-resistant bacterial infections. [ABSTRACT FROM AUTHOR]

Pianists experience high rates of Playing-Related Musculoskeletal Disorders (PRMDs). Biomechanical factors have been investigated by both researchers and music teachers as potentially significant in PRMD development. Knowledge exchange between the fields of music and science about PRMDs may be beneficial, but differences in language use can make interdisciplinary communication challenging. One potential solution is to translate pedagogical ideas into language that is consistent with biomechanical science. Doing so could improve interdisciplinary communication and allow for scientific examination of pedagogical ideas. However, no methods for doing so have been published. To fill this gap, we developed a methodological framework with two stages for translating ideas about piano technique into scientific language: Stage 1 uses Qualitative Content Analysis to summarize pedagogical content; then, Stage 2 includes an "Analysis of Biomechanical Language," in which researchers translate the ideas described in Stage 1. Both stages are collaborative and rely on expert consultation to produce an appropriate translation. This article outlines the framework and explains how it was used in an initial study on the Taubman Approach. Further methodological guidance to assist researchers in future studies is given based on some of the challenges encountered in the initial study. The framework and guidance here will allow researchers to carry out more studies of this kind. Because the framework is newly developed, it will likely need to be adapted further as more studies are done. [ABSTRACT FROM AUTHOR]

This report describes the development and revision of core competencies for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education program leaders, supervisors, and paraprofessional educators across the land-grant university system. The developing curriculum methodologies were used to engage panels of exemplary employees and an advisory panel of program leaders. A crosswalk examined key documents, and a gap analysis explored the competencies of similar professions. The resulting job duties and tasks reflect cultural, environmental, and educational trends. The core competencies are critical for writing job descriptions, guiding hiring, evaluating performance, and providing initial and ongoing training for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education. [ABSTRACT FROM AUTHOR]

To describe the implementation and process characteristics of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF). Mixed methods. Elementary schools in 2 Northern Colorado school districts. Fourth graders (aged 9–11 years), parents, school staff, and implementation researchers; measured over 2 consecutive years in 8 schools (851 students, 45 classrooms). Social Cognitive and active learning theory-based classroom cooking with tasting lessons, active recess games, cooking with tasting food promotion during school lunch, family nights, and take-home intervention reinforcements. A 7-month program delivered by a trained intervention team. Implementation measures (observations and debriefings) assessed context, reach, dose delivered, fidelity, and dose received; process measures (surveys) assessed student and parent perceptions and intervention participation. Descriptive statistics for quantitative and themes for qualitative data. Minor adjustments in program delivery plans were required to accommodate changes in school schedules and policies. Process measures demonstrated > 90% achievement of goals for nearly all child-centered activities. One-quarter of eligible families participated in evening events, with strong parent and student approval. Fifty out of 116 parents (43%) completing an online survey reported preparing ≥ 1 of 5 recipes with their child. Fifty-nine percent of eligible students completed >1 of 10 take-home activity sheets with their parents. Engagement and commitment of the intervention team and school staff supported strong implementation. Participant responses were positive, but improvement in parent engagement requires investigation. [ABSTRACT FROM AUTHOR]

Massive growth in global electrical energy demand has necessitated a genuine exploration and integration of solar and wind energy into the electrical power mix. This incorporation goes a long way in improving the cumulative generated power capacity of the power system. However, wind and solar photovoltaic (PV) are intermittent in nature, making the provisioning of a good maximum power tracking (MPPT) scheme necessary. Furthermore, the integration is characterized by synchronization challenges and introduces various modes of power system oscillations as it is converter-driven. This greatly affects the overall stability of the integrated power mix. Consequently, various technological models have been designed to address these challenges ranging from MPPT schemes, phase-lock loop (PLL), virtual synchronous generator (VSG), power system stabilizers (PSS), flexible AC transmission system (FACTS), coordinated control and artificial intelligence (AI). In this work, a multi-machine power system model is reviewed for integration stability studies. Various technical solutions associated with the integration are also reviewed. MPPT, PLL, VSG, PSS, FACTS, coordinated control, and various optimization technique schemes used for damping controller design are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Social and structural barriers drive disparities in prenatal care utilization among minoritized women in the United States. This study examined the impact of Arizona's Health Start Program, a community health worker (CHW) home visiting intervention, on prenatal care utilization among an ethno-racially and geographically diverse cohort of women. Methods: We used Health Start administrative and state birth certificate data to identify women enrolled in the program during 2006–2016 (n = 7,117). Propensity score matching was used to generate a statistically-similar comparison group (n = 53,213) of women who did not participate in the program. Odds ratios were used to compare rates of prenatal care utilization. The process was repeated for select subgroups, with post-match regression adjustments applied where necessary. Results: Health Start participants were more likely to report any (OR 1.24, 95%CI 1.02–1.50) and adequate (OR 1.08, 95%CI 1.01–1.16) prenatal care, compared to controls. Additional specific subgroups were significantly more likely to receive any prenatal care: American Indian women (OR 2.22, 95%CI 1.07–4.60), primipara women (OR 1.64, 95%CI 1.13–2.38), teens (OR 1.58, 95%CI 1.02–2.45), women in rural border counties (OR 1.45, 95%CI 1.05–1.98); and adequate prenatal care: teens (OR 1.31, 95%CI 1.11–1.55), women in rural border counties (OR 1.18, 95%CI 1.05–1.33), primipara women (OR 1.18, 95%CI 1.05–1.32), women with less than high school education (OR 1.13, 95%CI 1.00-1.27). Conclusions for Practice: A CHW-led perinatal home visiting intervention operated through a state health department can improve prenatal care utilization among demographically and socioeconomically disadvantaged women and reduce maternal and child health inequity. Significance: What is already known on this subject? Prenatal care is associated with improved maternal and child health outcomes, but significant social and structural determinants affect utilization of services among minority women in the US. Home visiting programs have contributed to early initiation of and recommended frequency of prenatal care among health disparate populations. What does this study add? Most empirical studies of prenatal home visitation programs include teams with licensed health professionals. Arizona's Health Start Program is one of few home visiting interventions associated with increased prenatal care utilization in which CHWs are the primary interventionists. Impact of a community health worker (CHW) home visiting intervention on any and adequate prenatal care among ethno-racially diverse pregnant women of the US Southwest. [ABSTRACT FROM AUTHOR]

In recent years, French authors have called for the mobilization of literature in favor of migrants' rights and recognition. Writers, publishers, and booksellers have donated all revenue to humanitarian agencies such as La Cimade, Amnesty International, and UNHCR. At the same time, humanitarian NGOs have mobilized literary works to rally audiences around migrant issues. This essay examines how contemporary French literature and humanitarian organizations work in tandem to respond to the international migrant "crisis." Drawing on George Yúdice's notion of "culture as resource," I analyze two literary works—Matéi Visniec's play Migraaaants and Émilie de Turckheim's autofictional text Le Prince à la petite tasse —to argue that literary works' ability to raise awareness about current migrations is enhanced when they sit alongside the actions of humanitarian NGOs. [ABSTRACT FROM AUTHOR]

Bees in search of diet sources intensively fly within a radius of up to 3 km, encountering nectar, pollen, and water sources which are potentially contaminated. Consequently, their products can provide valuable information about potential pollution. In the current study, 27 macro and trace elements, including the most hazardous ones, were measured in bees, honey, wax, pollen, and larvae, obtained from seven explicitly industrial areas in eastern regions of Slovakia, using a validated ICP-MS method. All the analysed elements were detected at least in one matrix. The detected concentrations of toxic elements, such as Hg, Pb, and Cd were in some cases higher in wax and bee samples, compared with honey, larvae, and pollen. In particular, Pb and Hg maximum concentrations were detected in the wax samples from Poša (3193 µg/kg) and Strážske_A (90 μg/kg). In addition, adult bees accumulated more elements than larvae, while wax and adult bees seemed more suitable for monitoring macro and trace elements in the surrounding environment. Statistical analysis emphasizing bees and wax correlated Cd with the Strážske area, possibly attributed to the intensified industrial activity in this region. [ABSTRACT FROM AUTHOR]

The DSH examination (German Language Examination for University Admission) plays a special role within the examinations listed in the Framework Regulations for German Language Examinations for German University Admission (RO-DT for short). Apart from the German examination part of the assessment test of a preparatory college, it is the only examination that is not standardized in principle and is or can therefore be created decentrally. For these reasons, a constant site-related evaluation of the examination is necessary. Using the example of the DSH site Friedrich-Schiller-University Jena it will be shown how the socalled upper and lower group analysis or the simplified item analysis can support the evaluation with regard to the quality criteria difficulty and discriminatory power. With the help of the upper and lower group analysis, it is also possible to determine the level of difficulty for each task. On the basis of four DSH examination sets, this will be shown for the examination parts of the receptive skills reading comprehension and listening comprehension. The evaluation of these skills does not differ significantly in the selection of tasks types and is therefore suitable for an overarching consideration of the receptive examination parts. The upper and lower group analysis for the reading and listening comprehension parts of the exam results in a proposal for test evaluation, which can also be used at other DSH sites, as well as hints for the test preparation procedure. [ABSTRACT FROM AUTHOR]

Purpose To examine the nature of the interruptions during medication work. Design An exploratory descriptive design was used with 28 nurses during 15 medication rounds in the medical, surgical, and gynecology wards at a 1000‐bed tertiary teaching hospital in Saudi Arabia. Methods: Non‐participant prospective observational and follow‐up interview methods were used to collect data. A standard paper‐based tool and digital stopwatch to count the interruptions were used. Nurses' sources, the secondary tasks undertaken, and the impacts of the interruptions were considered. The data were analyzed via descriptive analysis. Results: A total of 87 medication‐related events occurred. In these, 182 interruptions accounted for 90.0% of the total. Interruptions were more frequent during medication administration and often occurred in the corridors and patients' rooms. Nurses, medical officers, and impediments were frequent sources of interruptions. The secondary tasks attended by the nurses were mostly related with impediment resolutions and patients' needs. System failures appeared to be associated with clinical and procedural errors. Conclusion: The results of this study provide information regarding the course of interruptions during medication work in a Saudi Arabian hospital. Nurses were the main source of interruptions related with the provision of patient care and resolution of impediments. Interruptions tended to be associated with clinical errors and procedural failures due to system failure. Promoting a culture of respect and workplace etiquette in global healthcare settings demands minimizing non‐life‐threatening interruptions during nursing works. Clinical relevance: Strategies used in hospital management systems that affect nursing, pharmacies, human resources, and ancillary service department collaborations should be monitored for effectiveness and to ensure patient safety. Various approaches toward medication management systems, such as the utilization of an Omnicell automatic dispensing machine and cabinets within each patient's room, as well as others, such as wearing a "no‐interruption zone" sign, could be tailored and matched to the context of the practice to reduce interruptions. [ABSTRACT FROM AUTHOR]

The effects of yoga on mental health and general wellbeing are not a new research endeavor, as there are many studies that explore this topic. However, there is little literature on the integration of yoga within a therapeutic context. We seek to fill that gap and demonstrate the connections we see between the philosophies and practices of yoga and experiential family therapy specifically. First, we give a background of the origins of yoga and its use in psychotherapy thus far in addition to the essentials of Satir's experiential family therapy. We then connect these fields by discussing how they overlap both in beliefs and practices and by providing a case example that utilized techniques from both disciplines. We end with sharing our reflections surrounding implications to consider and our hopes for where this discourse could lead us in the future. [ABSTRACT FROM AUTHOR]

Terrorism has become a daily and contemporary topical phenomenon that threatens humanity and transforms thousands of people into refugees. As a negative act of threat and tragedy, terrorism is condemned everywhere in the world. In literature, the theme of terrorism occupies an important place for several authors. In his Just Assasins, for example, Albert Camus sees the act of terrorism not as a reprehensible act but rather as an effective weapon in the fight against the injustice of despotic leaders. By use of a sociological theory, this article aims to study terrorism from a positive perspective via the Camusian literary worldview whose objective is to expose terrorism as a subtle means of revolt against injustice, subjugation and the domination of a bad political system. [ABSTRACT FROM AUTHOR]

Purpose: Primary care is the foundation of the health care workforce and the only part that extends life and improves health equity. Previous research on the geographic and specialty distribution of physicians has relied on the American Medical Association's Masterfile, but these data have limitations that overestimate the workforce.Methods: We present a pragmatic, systematic, and more accurate method for identifying primary care physicians using the National Plan and Provider Enumeration System (NPPES) and the Virginia All-Payer Claims Database (VA-APCD). Between 2015 and 2019, we identified all Virginia physicians and their specialty through the NPPES. Active physicians were defined by at least 1 claim in the VA-APCD. Specialty was determined hierarchically by the NPPES. Wellness visits were used to identify non-family medicine physicians who were providing primary care.Results: In 2019, there were 20,976 active physicians in Virginia, of whom 5,899 (28.1%) were classified as providing primary care. Of this primary care physician workforce, 52.4% were family medicine physicians; the remaining were internal medicine physicians (18.5%), pediatricians (16.8%), obstetricians and gynecologists (11.8%), and other specialists (0.5%). Over 5 years, the counts and relative percentages of the workforce made up by primary care physicians remained relatively stable.Conclusions: Our novel method of identifying active physicians with a primary care scope provides a realistic size of the primary care workforce in Virginia, smaller than some previous estimates. Although the method should be expanded to include advanced practice clinicians and to further delineate the scope of practice, this simple approach can be used by policy makers, payers, and planners to ensure adequate primary care capacity. [ABSTRACT FROM AUTHOR]

While web-based surveys are a convenient research tool, the ease of dropping out in the online setting has become a growing issue in ensuring data quality. One theory is that dropout, or attrition, occurs in phases that can be generalized to phases of high dropout and phases of stable use. In order to detect these phases, survey dropout is considered as a time-to-event outcome and tests within change-point hazard models are introduced. Here, we apply the multiple change-point exponential model and extend the single change-point Weibull model to account for multiple change-points. We also introduce a likelihood ratio test to aid in determining the number of distinct phases, using Monte Carlo simulations of the null hypothesis of no attrition phases or change-points against the alternative hypothesis that distinct attrition phases exist (at least one change-point). The performances of these change-point hazard models are compared using both a simulation study and also with application to survey data on patient cancer screening preferences, as well as compared to previous work with discrete models. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused significant disruption to a wide range of human activities, with academic commitment at universities being one of the most important. By the end of COVID-19, everyone will recognise that universities cannot be held responsible for the adoption of online studies. However, in the context of the COVID-19 pandemic, it is critical to investigate the relationship between "University Service Quality" and "Student Loyalty" in order to better comprehend the impact of online learning adoption. Studying the Influence of university service quality on student loyalty to online learning adoption in the context of the COVID-19 pandemic, on the other hand, will lead to greater understanding of how students' commitment to online learning is linked to how satisfied they are with their university's services in the wake of the COVID-19 outbreak. As a result, a focus group experiment was conducted with university students to determine their level of loyalty towards their universities based on their online studies instead of face-to-face. According to the findings, students believe they should be compensated in some way because they paid for face-to-face instruction while receiving online instruction. The universities should not charge the same amount for online learning as it does for face-to-face study. Consequently, they lost a lot of faith in the university, and their loyalty to the university dropped drastically. [ABSTRACT FROM AUTHOR]

Introduction. Seminomas are the most common testicular tumors. Initial therapy includes orchiectomy with resection of local lymph nodes, followed by adjuvant radiotherapy. Testicular tumors usually metastasize to retroperitoneal and mediastinal lymph nodes, lungs, liver, spleen, gastrointestinal tract, and adrenal glands. Bone metastases from testicular tumors are very rare, while seminoma metastasis to the bone marrow is a curiosity, without any references in the scientific literature. Case Report. A 66-year-old patient, previously treated for follicular non-Hodgkin lymphoma, was admitted due to complaints of malaise, abdominal and back pain, and hepatosplenomegaly. After examination and radiologically verified enlarged retroperitoneal lymph nodes, the patient was referred to a hematologist. Based on the patient’s medical history, a relapse of lymphoma was suspected, and bone marrow biopsy was performed. The hematoxylin-eosin staining of the biopsy sample showed diffuse large cell infiltrates with bright cytoplasm, polygonal nuclei and prominent nucleoli. By immunohistochemical staining, the cells showed positivity for cluster of differentiation 10, cluster of differentiation 117, octamer binding transcription factor 3/4, placental alkaline phosphatase, and cytokeratin 8/18, after which the diagnosis of seminoma metastasis to the bone marrow was made. Shortly after the histopathological diagnosis was made, the patient died. Conclusion. A seminoma is a testicular tumor with a favorable prognosis. Due to suppression of hematopoiesis, bone marrow metastases generally lead to the worst prognosis. The outcome of our patient highlights the importance of timely diagnosis and therapy, which would increase the chances of survival. [ABSTRACT FROM AUTHOR]