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Daniel A Ostrovsky,1 Mitchell T Heflin,2 Margaret T Bowers,3 Nicholas M Hudak,4 Erin R Leiman,5 Tracy Truong,6 Kathleen Waite7 1Departments of Internal Medicine and Pediatrics, Duke University, Durham, NC, USA; 2Department of Medicine, Duke University, Durham, NC, USA; 3Department of Cardiology, Duke University, Durham, NC, USA; 4Department of Family and Community Medicine, Duke University, Durham, NC, USA; 5Department of Emergency Medicine, Duke University, Durham, NC, USA; 6Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA; 7Department of Internal Medicine, Duke University, Durham, NC, USACorrespondence: Daniel A Ostrovsky, Email daniel.ostrovsky@duke.eduPurpose: Several national health profession organizations endorse or have developed competencies for telehealth, yet there is no standardized curriculum for teaching telehealth to health professions students. Additionally, implementing telehealth curricula is challenging due to limited curricular space and differing needs of various health profession programs. We describe the development, implementation, and pilot assessment of an online, modular telehealth curriculum for health professions students.Methods: An online, modular telehealth curriculum for health professions students was developed in 2021– 2022. Nine modules were created, focusing on the logistics of performing a telehealth visit and system-based virtual assessments. In academic year 2022– 2023, course directors from the Duke doctor of medicine (MD), physician assistant (PA), and nurse practitioner (NP) programs utilized modules in their courses. For modules taken, students were surveyed and self-assessed their confidence, knowledge gained, and likelihood of utilizing the telehealth skills taught in the module(s).Results: During the 2022– 2023 academic year, MD, NP, and PA students at Duke participated in one or more of the telehealth modules in an existing course. The median responses to self-assessed confidence questions for all health profession students to be in the “moderately” or “very confident” range. Similarly, students reported a median response of “moderate knowledge gained” for each module taken. NP students reported slightly lower levels of confidence and likelihood of utilizing telehealth skills than other professions. No other significant differences in the remainder of responses were observed between health professions.Conclusion: Exposure of health professions students to telehealth through utilization of online, interactive modules may result in increased telehealth skill confidence and knowledge, and furthermore, a belief that they will utilize these skills in future practice. Larger scale implementation of the telehealth curriculum and development of outcome measures which assess clinical application of skills conveyed will provide more information about the efficacy of the curriculum.Keywords: interprofessional education, web-based education, asynchronous education, curricula innovation

Abstract In our search for novel small molecules activating procaspase-3, we have designed and synthesized two series of novel (E)-N'-arylidene-2-(2-oxoindolin-1-yl)acetohydrazides (4) and (Z)-2-(5-substituted-2-oxoindolin-1-yl)-N'-(2-oxoindolin-3-ylidene)acetohydrazides (5). Cytotoxic evaluation revealed that the compounds showed notable cytotoxicity toward three human cancer cell lines: colon cancer SW620, prostate cancer PC-3, and lung cancer NCI-H23. Especially, six compounds, including 4f–h and 4n–p, exhibited cytotoxicity equal or superior to positive control PAC-1, the first procaspase-3 activating compound. The most potent compound 4o was three- to five-fold more cytotoxic than PAC-1 in three cancer cell lines tested. Analysis of compounds effects on cell cycle and apoptosis demonstrated that the representative compounds 4f, 4h, 4n, 4o and 4p (especially 4o) accumulated U937 cells in S phase and substantially induced late cellular apoptosis. The results show that compound 4o would serve as a template for further design and development of novel anticancer agents.

Khalil Issa,1,* Ralph Abi Hachem,1,* Alexander Gordee,2 Tracy Truong,2 Richard Pfohl,3 Barry Doublestein,4 Walter Lee1 1Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, NC, USA; 2Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA; 3School of Business, LeTourneau University, Longview, TX, USA; 4School of Business & Leadership, Regent University, Virginia Beach, VA, USA*These authors contributed equally to this workCorrespondence: Walter LeeDepartment of Head and Neck Surgery & Communication Sciences, Duke University Health System, Room 3532 - Blue Zone, Durham, NC, 27710, USATel +1 919-681-8449Fax +1 919-613-6524Email Walter.lee@duke.eduPurpose: To analyze self and 360-evaluation scores of the professionalism intelligence model domains within an academic Otolaryngology-Head and Neck Surgery Department.Methods: A leadership course was introduced within the Department of Head and Neck Surgery & Communication Sciences at Duke University Medical Center. A 360 evaluation assessing domains of the professional intelligence model was recorded for all participants. Participant demographics included gender (male vs female), generation group (generation Y vs older generations) and physician status of participants (physician vs non-physician). Differences in mean self-scores were modeled using linear regression. When analyzing the evaluator scores, gaps were defined as self-score minus evaluator-score for each member of a participant’s evaluator groupings (supervisor, peer, and direct report). Two types of linear mixed models were fit with a random intercept to account for the correlated gaps in the same participant.Results: Scores of 50 participants and 394 evaluators were analyzed. The average age was 40.6 (standard deviation 9.3) years, and 50% (N=25) of participants were females. Physicians accounted for 36% (N=18) of the cohort, and 61% (N=11) of physicians were residents. Physicians scored themselves lower than non-physicians when assessing leadership intelligence, interpersonal relations, empathy, and focused thinking. On average, participants under-rated themselves compared to their evaluators with direct reports giving higher scores than managers and peers. When compared with generation Y, older generations tended to rate themselves lower than their peers and managers in cognitive intelligence. No significant association was observed between gender and any scores.Conclusion: Participants rate themselves lower on average than their evaluators. This work is important in understanding how perceived leadership qualities are assessed and developed within an academic surgical department. Finally, the results presented could serve as a model to address the gap between self- and other-perceptions of defined leadership virtues in future leadership development activities.Keywords: leadership intelligence, healthcare workers, emotional intelligence, cognitive intelligence, physicians

ObjectiveTo estimate the incubation period of Vietnamese confirmed COVID-19 cases.MethodsOnly confirmed COVID-19 cases who are Vietnamese and locally infected with available data on date of symptom onset and clearly defined window of possible SARS-CoV-2 exposure were included. We used three parametric forms with Hamiltonian Monte Carlo method for Bayesian Inference to estimate incubation period for Vietnamese COVID-19 cases. Leave-one-out Information Criterion was used to assess the performance of three models.ResultsA total of 19 cases identified from 23 Jan 2020 to 13 April 2020 was included in our analysis. Average incubation periods estimated using different distribution model ranged from 6.0 days to 6.4 days with the Weibull distribution demonstrated the best fit to the data. The estimated mean of incubation period using Weibull distribution model was 6.4 days (95% credible interval (CrI): 4.89-8.5), standard deviation (SD) was 3.05 (95%CrI 3.05-5.30), median was 5.6, ranges from 1.35 to 13.04 days (2.5th to 97.5th percentiles). Extreme estimation of incubation periods is within 14 days from possible infection.ConclusionThis analysis provides evidence for an average incubation period for COVID-19 of approximately 6.4 days. Our findings support existing guidelines for 14 days of quarantine of persons potentially exposed to SARS-CoV-2. Although for extreme cases, the quarantine period should be extended up to three weeks.

This paper analyzed the implementational aspects of the contourlet filter bank (or the pyramidal directional filter bank (PDFB)), and considered its application in image coding. First, details of the binary tree-structured directional filter bank (DFB) are presented, including a modification to minimize the phase delay factor and necessary steps for handling rectangular images. The PDFB is viewed as an overcomplete filter bank, and the directional filters are expressed in terms of polyphase components of the pyramidal filter bank and the conventional DFB. The aliasing effect of the conventional DFB and the Laplacian pyramid to the directional filters is then considered, and the conditions for reducing this effect are presented. The new filters obtained by redesigning the PDFBs satisfying these requirements have much better frequency responses. A hybrid multiscale filter bank consisting of the PDFB at higher scales and the traditional maximally decimated wavelet filter bank at lower scales is constructed to provide a sparse image representation. A novel embedded image coding system based on the image decomposition and a morphological dilation algorithm is then presented. The coding algorithm efficiently clusters the significant coefficients using progressive morphological operations. Context models for arithmetic coding are designed to exploit the intraband dependency and the correlation existing among the neighboring directional subbands. Experimental results show that the proposed coding algorithm outperforms the current state-of-the-art wavelet-based coders, such as JPEG2000, for images with directional features.

Biochar from crop residues plays an important role in reclamation of degraded rice soil due to imbalance fertilizer application and soil carbon sequestration. The objective of this study aimed to evaluate the best type and rate of biochar application for rice dry matter and soil organic carbon improvement. Therefore, pot experiments were carried out in two seasons of spring and summer 2023 at the University of Agriculture and Forestry, Hue University. Twelve treatments including 2 types of biochar (rice husk and peanut shell) and 6 application rates (0, 1, 2, 3, 4, 5%) were used and arranged in a randomized block design with three replications. Research results showed that the shoot dry matter was higher 9.5-27.0% (spring season) and 19.1-26.9% (summer season) at a rate of 5% application in both types of biochar than control. Rice husk biochar application had higher shoot dry matter than peanut shell biochar application in the same application rate from 0.30-0.46 g/plant in both seasons. Similarly, organic carbon was found the highest content (2.15-2.21%) when the application of biochar from crop residues at a rate of 5%. Biochar from crop residues is considered as a good amendment for increasing crop dry matter and soil organic carbon. [ABSTRACT FROM AUTHOR]

In recent years, there has been a notable increase in interest regarding monolithic porous polymers known as poly(High Internal Phase Emulsion) – poly(HIPE) – which are synthesized from high internal phase emulsions. This is due to their exceptional capability to produce three‐dimensional structures with substantial porosity. Nevertheless, the exploitation of this family of materials in energy‐driven applications is still limited, mainly because of their lack of conductivity. The exploration of conducting materials with 3D polymeric frameworks remains a promising avenue for research. In this context, pyrolysed poly(HIPE) seems to be the simplest and most cost‐effective strategy to directly transform a 3D polymer into a 3D conductive carbon foam, that is, carboHIPE. Currently, CarboHIPE and its derivatives are becoming alternatives to commercially available activated carbon/graphite or expensive graphene and carbon nanotube‐based materials. Accordingly, gaining insight into the formation of these materials is crucial to accelerate their use in commercial energy devices. This review aims to provide a comprehensive summary of various synthesis pathways utilized to modify the characteristics of CarboHIPEs, as well as the recent developments in their application as active components in energy‐based systems. [ABSTRACT FROM AUTHOR]

Immunosuppression plays a pivotal role in assisting tumors to evade immune destruction and promoting tumor development. We hypothesized that genetic variation in the immunosuppression pathway genes may be implicated in breast cancer tumorigenesis. We included 42,510 female breast cancer cases and 40,577 controls of European ancestry from 37 studies in the Breast Cancer Association Consortium (2015) with available genotype data for 3595 single nucleotide polymorphisms (SNPs) in 133 candidate genes. Associations between genotyped SNPs and overall breast cancer risk, and secondarily according to estrogen receptor (ER) status, were assessed using multiple logistic regression models. Gene-level associations were assessed based on principal component analysis. Gene expression analyses were conducted using RNA sequencing level 3 data from The Cancer Genome Atlas for 989 breast tumor samples and 113 matched normal tissue samples. SNP rs1905339 (A>G) in the STAT3 region was associated with an increased breast cancer risk (per allele odds ratio 1.05, 95 % confidence interval 1.03–1.08; p value = 1.4 × 10−6). The association did not differ significantly by ER status. On the gene level, in addition to TGFBR2 and CCND1, IL5 and GM-CSF showed the strongest associations with overall breast cancer risk (p value = 1.0 × 10−3 and 7.0 × 10−3, respectively). Furthermore, STAT3 and IL5 but not GM-CSF were differentially expressed between breast tumor tissue and normal tissue (p value = 2.5 × 10−3, 4.5 × 10−4 and 0.63, respectively). Our data provide evidence that the immunosuppression pathway genes STAT3,IL5, and GM-CSF may be novel susceptibility loci for breast cancer in women of European ancestry.

Modelling phenomena with interval differential equations (IDEs) is an effective way to consider the uncertainties that are unavoidable when collecting data. Similarly to the theory of ordinary differential equations, IDEs have been parallelly investigated with the interval difference equations from the beginning. These two branches can be regarded as one when unifying continuous and discrete solution domains. A conspicuous advantage when merging these areas is that the proof of several analogous properties in both theories need not be repeated. The paper provides a common and efficient tool for studying IDEs not only with continuous or discrete solution domains but also with more general ones. We propose the diamond-α derivative for interval-valued functions (IVFs) on time scales with respect to the generalized Hukuhara difference. Differently from most of the studies on the derivatives of functions on time scales, using the language of epsilon-delta, the novel concept is naturally studied according to the limit of IVFs on time scales as in classical mathematics. A particular class of IDEs on time scales is then considered with respect to the diamond-α derivative. Numerical problems are elaborated to illustrate the necessity and efficiency of the latter. [ABSTRACT FROM AUTHOR]