bluuebunny/crossref_metadata_2025 huggingface dataset:
Feedback on clinical team performance: how does it work, in what contexts, for whom, and for what changes? A critical realist qualitative multiple case study
Authors: Rapin Joachim , Gendron Sylvie , Mabire Cédric , Dubois Carl-Ardy
Published: April 2023

Background

Feedback on clinical performance aims to provide teams in health care settings with structured results about their performance in order to improve these results. Two systematic reviews that included 147 randomized studies showed unresolved variability in professional compliance with desired clinical practices. Conventional recommendations for improving feedback on clinical team performance generally appear decontextualized and, in this regard, idealized. Feedback involves a complex and varied arrangement of human and non-human entities and interrelationships. To explore this complexity and improve feedback, we sought to explain how feedback on clinical team performance works, for whom, in what contexts, and for what changes. Our goal in this research was to present a realistic and contextualized explanation of feedback and its outcomes for clinical teams in health care settings.

Methods

This critical realist qualitative multiple case study included three heterogeneous cases and 98 professionals from a university-affiliated tertiary care hospital. Five data collection methods were used: participant observation, document retrieval, focus groups, semi-structured interviews, and questionnaires. Intra- and inter-case analysis performed during data collection involved thematic analysis, analytical questioning, and systemic modeling. These approaches were supported by critical reflexive dialogue among the research team, collaborators, and an expert panel.

Results

Despite the use of a single implementation model throughout the institution, results differed on contextual decision-making structures, responses to controversy, feedback loop practices, and use of varied technical or hybrid intermediaries. Structures and actions maintain or transform interrelationships and generate changes that are in line with expectations or the emergence of original solutions. Changes are related to the implementation of institutional and local projects or indicator results. However, they do not necessarily reflect a change in clinical practice or patient outcomes.

Conclusions

This critical realist qualitative multiple case study offers an in-depth explanation of feedback on clinical team performance as a complex and open-ended sociotechnical system in constant transformation. In doing so, it identifies reflexive questions that are levers for the improvement of team feedback.
“More” work for nurses: the ironies of eHealth
Authors: Frennert Susanne , Petersson Lena , Erlingsdottir Gudbjörg
Published: April 2023

Background

eHealth applications are considered a technological fix that can potentially address some of the grand challenges in healthcare, including burnout among healthcare professionals, the growing burden of patients with chronic conditions, and retaining and recruiting healthcare professionals. However, as the deployment of eHealth applications in healthcare is relatively novel, there is a lack of research on how they affect the work environment of healthcare professionals. This study explores how work evolves—particularly for nurses—during the utilisation of three eHealth applications.

Methods

The study is a qualitative case study with an interpretive approach. The utilisation of three different eHealth applications was studied. Seventy-five healthcare professionals were interviewed, most of whom were nurses (n = 47). Interviews were transcribed verbatim and qualitative content analysis was used to analyse the text.

Results

Three main themes were identified:work that is ignored and overlooked; actions needed to complete visible work; andmore sedentary work activities. The findings suggest that work surrounding the utilisation of eHealth applications in care practices is mostly performed by nurses. While the promise of more efficient workflows resulting from healthcare’s digital transformation may be realised to different degrees, the utilisation of eHealth applications creates additional invisible labour for nurses.

Conclusion

We identified through our analysis that the extra work created by eHealth applications is invisible at the organisational level. Most of the invisible labour was performed by nurses, who were engaged in utilising the eHealth applications. This needs to be recognised when implementing eHealth applications in care practices.
Single-cell sequencing reveals the immune microenvironment landscape related to anti-PD-1 resistance in metastatic colorectal cancer with high microsatellite instability
Authors: Wu Tao , Zhang Xuan , Liu Xinxing , Cai Xinyi , Shen Tao , Pan Dingguo , Liang Rui , Ding Rong , Hu Ruixi , Dong Jianhua , Li Furong , Li Jinsha , Xie Lin , Wang Chunlong , Geng Shilei , Yang Zhaoyu , Xing Lu , Li YunFeng
Published: April 2023

Background

The objective response rate of microsatellite instability-high (MSI-H) metastatic colorectal cancer (mCRC) patients with first-line anti-programmed cell death protein-1 (PD-1) monotherapy is only 40–45%. Single-cell RNA sequencing (scRNA-seq) enables unbiased analysis of the full variety of cells comprising the tumor microenvironment. Thus, we used scRNA-seq to assess differences among microenvironment components between therapy-resistant and therapy-sensitive groups in MSI-H/mismatch repair-deficient (dMMR) mCRC. Resistance-related cell types and genes identified by this analysis were subsequently verified in clinical samples and mouse models to further reveal the molecular mechanism of anti-PD-1 resistance in MSI-H or dMMR mCRC.

Methods

The response of primary and metastatic lesions to first-line anti-PD-1 monotherapy was evaluated by radiology. Cells from primary lesions of patients with MSI-H/dMMR mCRC were analyzed using scRNA-seq. To identify the marker genes in each cluster, distinct cell clusters were identified and subjected to subcluster analysis. Then, a protein‒protein interaction network was constructed to identify key genes. Immunohistochemistry and immunofluorescence were applied to verify key genes and cell marker molecules in clinical samples. Immunohistochemistry, quantitative real-time PCR, and western blotting were performed to examine the expression of IL-1β and MMP9. Moreover, quantitative analysis and sorting of myeloid-derived suppressor cells (MDSCs) and CD8+ T cells were performed using flow cytometry.

Results

Tumor responses in 23 patients with MSI-H/dMMR mCRC were evaluated by radiology. The objective response rate was 43.48%, and the disease control rate was 69.57%. ScRNA-seq analysis showed that, compared with the treatment-resistant group, the treatment-sensitive group accumulated more CD8+ T cells. Experiments with both clinical samples and mice indicated that infiltration of IL-1β-driven MDSCs and inactivation of CD8+ T cells contribute to anti-PD-1 resistance in MSI-H/dMMR CRC.

Conclusions

CD8+ T cells and IL-1β were identified as the cell type and gene, respectively, with the highest correlation with anti-PD-1 resistance. Infiltration of IL-1β-driven MDSCs was a significant factor in anti-PD-1 resistance in CRC. IL-1β antagonists are expected to be developed as a new treatment for anti-PD-1 inhibitor resistance.
Estimated sdLDL-C for predicting high-risk coronary plaque features in psoriasis: a prospective observational study
Authors: Sorokin Alexander V. , Patel Nidhi , Li Haiou , Hong Christin G. , Sampson Maureen , O’Hagan Ross , Florida Elizabeth M. , Teague Heather L. , Playford Martin P. , Chen Marcus Y. , Mehta Nehal N. , Remaley Alan T.
Published: April 2023

Background

Psoriasis (PSO) is a skin disorder with systemic inflammation and high coronary artery disease risk. A distinct lipid phenotype occurs in psoriasis, which is characterized by high plasma triglycerides (TGs) with typically normal or even low LDL-C. The extent to which cholesterol on LDL subfractions, such as small dense LDL-C (sdLDL-C), are associated with vulnerable coronary plaque characteristics in PSO remains elusive.

Methods

A recently developed equation for estimating sdLDL-C from the standard lipid panel was utilized in a PSO cohort (n = 200) with 4-year follow-up of 75 subjects. Coronary plaque burden was assessed by quantitative coronary computed tomography angiography (CCTA). Multivariate regression analyses were used for establishing associations and prognostic value of estimated sdLDL-C.

Results

Estimated sdLDL-C was positively associated with non-calcified burden (NCB) and fibro-fatty burden (FFB), which remained significant after multivariate adjustment for NCB (β = 0.37; P = 0.050) and LDL-C adjustment for FFB (β = 0.29; P < 0.0001). Of note, total LDL-C calculated by the Friedewald equation was not able to capture these associations in the study cohort. Moreover, in the regression modelling estimated sdLDL-C was significantly predicting necrotic burden progression over 4 years follow-up (P = 0.015), whereas LDL-C did not. Finally, small LDL particles (S-LDLP) and small HDL particles (S-HDLP), along with large and medium TG-rich lipoproteins (TRLPs) had the most significant positive correlation with estimated sdLDL-C.

Conclusions

Estimated sdLDL-C has a stronger association than LDL-C with high-risk features of coronary atherosclerotic plaques in psoriasis patients.

Clinical trial registration

URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01778569
Comparative serum lipid and immunohematological values among adult pulmonary tuberculosis and tuberculosis lymphadenitis cases and their association with sputum bacilli load and time to culture positivity in Northwestern Ethiopia
Authors: Mekonnen Daniel , Nibret Endalkachew , Munshea Abaineh , Derbie Awoke , Zenebe Yohannes , Tadese Aimro , Birku Tigist , Tesfa Endalamaw , Sinishaw Mulusew Alemneh , Getachew Hailu , Gashaw Yosef , Yismaw Gizachew , Kebede Mihiretu M. , Gelaw Baye
Published: April 2023

Background

The serum lipid and immunohematological values of tuberculosis lymphadenitis (TBLN) patients is poorly documented relative to pulmonary tuberculosis (PTB) cases. Therefore, the aim of this study was to investigate the serum lipid and immunohematological values of patients with TBLN in comparison with PTB (PTB) patients.

Methods

An institution-based comparative cross-sectional study was conducted in Northwest Ethiopia from March to December 2021. The study participants were bacteriologically confirmed PTB (n = 82) and TBLN (n = 94) cases with no known comorbidity and whose ages was greater than 18 years and with no current pregnancy. Independent sample t-test, one-way ANOVA, box plot, and correlation matrix were used to analyze the data.

Results

The body mass index (BMI), CD4 + T cell count, and high-density lipoprotein-Cholesterol (HDL-C) values were significantly higher among TBLN cases compared with PTB cases. Additionally, the total white blood cell (WBC) count, hemoglobin (Hb), total Cholesterol (CHO) and creatinine (Cr) values were relatively higher among TBLN than PTB (P > 0.05). On the reverse, the platelet count and triacylglycerol (TAG) values were relatively higher among PTB than in TBLN cases. While the mean days of culture positivity were 11.6 days for TBLN, the mean days of culture positivity were 14.0 days for PTB. Anemia and serum lipid values showed no correlation with sputum bacilli load and time to culture positivity.

Conclusion

Tuberculous lymphadenitis patients were well-endowed with serum lipid, immunological and nutritional status compared with PTB cases. Hence, the high incidence rate of TBLN in Ethiopia could not be explained by low peripheral immunohematological values, malnutrition, Anemia, and dyslipidemia. Further study for identifying the predictors for TBLN in Ethiopia is highly desirable.
Influence of the initial recurrence site on prognosis after radical surgery for colorectal cancer: a retrospective cohort study
Authors: Pu Hongjiang , Chen Yaxue , Shen Ruoxia , Zhang Yin , Yang Duan , Liu Lizhu , Dong Xingxiang , Yang Guangjun
Published: April 2023

Background & Aims

In this retrospective study, we aimed to elucidate how the initial recurrence site influences the post-recurrence survival (PRS) after the curative resection of colorectal cancer.

Patients and methods

We collected samples from patients with stage I-III colorectal adenocarcinoma who were admitted to Yunnan Cancer Hospital from January 2008 to December 2019. Four hundred and six patients who developed recurrence after radical resection were included. The cases were classified according to the original site of recurrence as follows: liver metastases (n = 98), lung metastases (n = 127), peritoneum (n = 32), other individual organ (n = 69), two or more organs or sites (n = 49), and local recurrence (n = 31). Kaplan–Meier survival curves were used to compare the PRS of patients with different initial sites of recurrence. The influence of the initial recurrence site on PRS was analyzed using the Cox proportional hazards model.

Results

The 3-year PRS of simple liver metastasis was 54.04% (95% CI, 45.46%-64.24%), and the 3-year PRS of simple lung metastasis was 50.05% (95% CI, 42.50%-58.95%). No significant difference was observed between simple liver metastasis or simple lung metastasis and local recurrence with a 3-year PRS of 66.99% (95% CI, 53.23%-84.32%). The 3-year PRS for peritoneal metastases was 25.43% (95% CI, 14.76%-43.82%), and the 3-year PRS for two or more organ sites was 34.84% (95% CI, 24.16%-50.24%). The peritoneal (hazard ratio [HR], 1.75; 95% CI, 1.10–2.79; P = 0.0189) and metastasis to two or more organs or sites (HR, 1.59; 95% CI, 1.05–2.43; P = 0.0304) were PRS-independent adverse prognostic factors.

Conclusion

The prognosis of patients with peritoneum and multiple organs or sites recurred was poor. This study suggests early monitoring of peritoneal and multiple organ or site recurrence after surgery. This part of patients should receive comprehensive treatment as early as possible to improve their prognosis.
Heartworm adulticide treatment: a tropical perspective
Authors: Dantas-Torres Filipe , Ketzis Jennifer , Pérez Tort Gabriela , Mihalca Andrei Daniel , Baneth Gad , Otranto Domenico , Watanabe Malaika , Linh Bui Khanh , Inpankaew Tawin , Borrás Pablo , Arumugam Sangaran , Penzhorn Barend Louis , Ybañez Adrian Patalinghug , Irwin Peter , Traub Rebecca J.
Published: April 2023

Dirofilaria immitis (the canine heartworm) is widespread in the tropics, with prevalence surpassing 30% in high-risk areas. In addition to the suitable climatic conditions that favour mosquito abundance and filarial larva development, there is low compliance with the recommended year-round use of preventives in these transmission hotspots. This represents a major concern, considering that melarsomine (first-line heartworm adulticide) is unavailable in several tropical countries, resulting in the so-called slow-kill protocol being the only available adulticide treatment option. In this article, the members of TroCCAP (Tropical Council for Companion Animal Parasites) review the current distribution of heartworm in the tropics and the availability of melarsomine, and discuss alternatives for the management of heartworm infections in dogs.

Graphical Abstract
Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021
Authors: Attafuah Priscilla Yeye Adumoah , Everink Irma HJ , Lohrmann Christa , Abuosi Aaron , Schols Jos MGA
Published: April 2023

Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services.

Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.
The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015–16 & 2018–19)
Authors: Sharma Himani , Singh Shri Kant
Published: April 2023

Background

Unintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015–19.

Methods

The data for the present study is derived from the two-wave longitudinal survey “Understanding the lives of adolescents and young adults” (UDAYA) conducted in 2015–16 (Wave 1) and 2018–19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.

Results

The results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).

Conclusions

Despite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.
Predictors of in-hospital mortality among patients with symptoms of stroke, Mashhad, Iran: an application of auto-logistic regression model
Authors: Hadianfar Ali , Sasannezhad Payam , Nazar Eisa , Yousefi Razieh , Shakeri Mohammadtaghi , Jafari Zahra , Hashtarkhani Soheil
Published: April 2023

Background

Stroke is the second leading cause of death in adults worldwide. There are remarkable geographical variations in the accessibility to emergency medical services (EMS). Moreover, transport delays have been documented to affect stroke outcomes. This study aimed to examine the spatial variations in in-hospital mortality among patients with symptoms of stroke transferred by EMS, and determine its related factors using the auto-logistic regression model.

Methods

In this historical cohort study, we included patients with symptoms of stroke transferred to Ghaem Hospital of Mashhad, as the referral center for stroke patients, from April 2018 to March 2019. The auto-logistic regression model was applied to examine the possible geographical variations of in-hospital mortality and its related factors. All analysis was performed using the Statistical Package for the Social Sciences (SPSS, v. 16) and R 4.0.0 software at the significance level of 0.05.

Results

In this study, a total of 1,170 patients with stroke symptoms were included. The overall mortality rate in the hospital was 14.2% and there was an uneven geographical distribution. The results of auto-logistic regression model showed that in-hospital stroke mortality was associated with age (OR = 1.03, 95% CI: 1.01–1.04), accessibility rate of ambulance vehicle (OR = 0.97, 95% CI: 0.94–0.99), final stroke diagnosis (OR = 1.60, 95% CI: 1.07–2.39), triage level (OR = 2.11, 95% CI: 1.31–3.54), and length of stay (LOS) in hospital (OR = 1.02, 95% CI: 1.01–1.04).

Conclusion

Our results showed considerable geographical variations in the odds of in-hospital stroke mortality in Mashhad neighborhoods. Also, the age- and sex-adjusted results highlighted the direct association between such variables as accessibility rate of an ambulance, screening time, and LOS in hospital with in-hospital stroke mortality. Thus, the prognosis of in-hospital stroke mortality could be improved by reducing delay time and increasing the EMS access rate.
An empirical link between motivation gain and NBA statistics: applying hierarchical linear modelling
Authors: Shim Yunsik , Shin Myoungjin
Published: April 2023

Background

This study tested whether the motivation gain in groups is the result of social compensation or the Köhler effect by examining scaled individual salaries of National Basketball Association (NBA) players. Both factors explain the positive effects of a group, unlike social loafing. However, differing causes in motivation gain relate to whether players are low or high performers and the Köhler effect or social compensation.

Methods

To test motivation gain, this study used 11-year NBA statistical data of 3247 players by applying hierarchical linear modelling (HLM) and HLM 7.0 was used for analysis. The players’ individual statistics and annual salaries were collected from the NBA and ESPN websites, respectively. Whereas previous studies have looked at motivation gain through track-and-field and swimming relay records, this study verified motivation gain through salary variations among NBA players and their affiliated teams.

Results

The high performers, while selecting teams with larger performance gaps among team members, earned a higher salary than while selecting teams with lower performance gaps among team members. This study found that motivation gain existed in high performers, which can be interpreted as support for social compensation rather than the Köhler effect.

Conclusions

We used our result to elucidate the basis for play-by-play decisions made by individuals and team behaviour. Our results are applicable for the enhancement of coaching strategies, ultimately improving team morale and performance. It can be interpreted that the motivation gains of high performers in the NBA are driven by the Cost Component of the Team member Effort Expenditure Model (TEEM), rather than the Expectancy and Value Components.
Functional scales used by the Egyptian physiotherapist in the assessment of low back pain: a cross-sectional study
Authors: Elhafez Haytham Mohamed , Sweed Maha Mabrouk , Abd El-hay Mohamed Ibrahim
Published: April 2023

Background

The use of functional scales is crucial for the management of low back pain. Numerous pertinent outcome measures are available; however, it is unknown how much use Egyptian physiotherapists make of these scales and measurements when diagnosing and treating patients with low back pain.

Aim

The purpose of this study was to investigate how Egyptian physical therapists working in Egypt used functional outcome measures and scales when treating low back pain.

Design and methods

A cross-section study used an online web-based survey which was accessible to all Egyptian physiotherapists practicing in Egypt.

Results

334 Egyptian physical therapists participated in this study. The use of the pain disability index and back pain functional scale represents the highest frequency of (always/often) of 56.3% and 53.6% respectively, whereas the use of the Quebec Back Pain Disability Scale or the Roland-Morris Disability Questionnaire represents the highest frequency of (rarely/never) 45.8% and 53%, respectively. There was no significant association between gender, years of experience, educational level, and work setting with the use of functional outcome measures (p > 0.05).

Conclusion

Egyptian physiotherapists more usually utilize the pain disability index and back pain functional scale (PDI and BPFS), when evaluating their patients with low back pain, although they did not commonly use the Roland-Morris Disability Questionnaire or the Quebec Back Pain Disability Scale
Higher Peripheral Thyroid Sensitivity Is Linked to a Lower Risk of Heart Failure After Acute Myocardial Infarction
Authors: Lang Xueyan , Zhao Bing , Fang Shaohong , Li Lulu , Li Zhaoying , Wu Nilian , Zhang Yuheng , Xing Lei , Li Yilan , Zhang Yao
Published: April 2023

Context

It is still not clear how the free triiodothyronine (FT3) to free thyroxine (FT4) ratio affects the prognosis of acute myocardial infarction (AMI), especially the risk of heart failure (HF) subsequent to AMI.

Objective

The purpose of this study was to see how peripheral sensitivity to thyroid hormones, as measured by the FT3/FT4 ratio, affected HF and mortality after AMI.

Methods

Our study was a retrospective cohort study. The primary endpoint was HF after AMI during and after hospitalization. The secondary endpoints were all-cause death and cardiovascular death after hospitalization.

Results

The main sample included 3648 inpatients with AMI with a median age of 61.0 years; 68.9% were male. In the fully adjusted model, compared with patients in the lowest Q1 of the FT3/FT4 ratio, the risk of in-hospital HF in the highest Q4 patients was reduced by 44% (OR 0.56, 95% CI 0.44-0.72, P trend < .001), the risk of out-of-hospital HF was reduced by 37% (HR 0.63, 95% CI 0.48-0.84, P trend < .001), and the risks of all-cause and cardiovascular death were also significantly reduced. The analysis of different subgroups is consistent with the overall results. Furthermore, the sensitivity analysis of the euthyroid sample of 2484 patients was consistent with the main sample. Mediation analysis showed that altered levels of amino-terminal pro-B-type natriuretic peptide were mediators between the FT3/FT4 ratio and all endpoints in our study.

Conclusion

The thyroid hormone peripheral sensitivity of the FT3/FT4 ratio is an independent predictor of HF and mortality after AMI.
Pregnancies in the United States by Desire for Pregnancy: Estimates for 2009, 2011, 2013, and 2015
Authors: Kost Kathryn , Zolna Mia , Murro Rachel
Published: April 2023

We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by retrospectively reported pregnancy desires: pregnancies reported as having occurred at about the right time, later than wanted, too soon, or not wanted at all, and those for which individuals expressed other feelings, including uncertainty, ambivalence, or indifference. We calculate the proportionate distributions of these pregnancies and rates among U.S. women aged 15–44, as well as change over time, overall and among age groups. Characterization of desires for a past pregnancy shifted in a number of ways between 2009 and 2015, and changes across age groups were not uniform. Rates of pregnancies reported as occurring later than wanted increased among older women, while rates of pregnancies reported as occurring too soon decreased among all women. These findings shed light on previous research documenting an increasing age at first birth, increasing rates of pregnancy and childbearing among the oldest age groups, and changes in patterns of contraceptive use, particularly among young women. Our analysis explores limitations and challenges of two major sources of data on pregnancies in the United States and their measures of retrospectively reported pregnancy desires.
Shared retinoic acid responsive enhancers coordinately regulate nascent transcription of Hoxb coding and non-coding RNAs in the developing mouse neural tube
Authors: Afzal Zainab , Lange Jeffrey J. , Nolte Christof , McKinney Sean , Wood Christopher , Paulson Ariel , De Kumar Bony , Unruh Jay , Slaughter Brian D. , Krumlauf Robb
Published: April 2023

Signaling pathways regulate the patterns of Hox gene expression that underlie their functions in the specification of axial identity. Little is known about the properties of cis-regulatory elements and underlying transcriptional mechanisms that integrate graded signaling inputs to coordinately control Hox expression. Here, we optimized a single molecule fluorescent in situ hybridization (smFISH) technique with probes spanning introns to evaluate how three shared retinoic acid response element (RARE)-dependent enhancers in the Hoxb cluster regulate patterns of nascent transcription in vivo at the level of single cells in wild-type and mutant embryos. We predominately detect nascent transcription of only a single Hoxb gene in each cell, with no evidence for simultaneous co-transcriptional coupling of all or specific subsets of genes. Single and/or compound RARE mutations indicate that each enhancer differentially impacts global and local patterns of nascent transcription, suggesting that selectivity and competitive interactions between these enhancers is important to robustly maintain the proper levels and patterns of nascent Hoxb transcription. This implies that rapid and dynamic regulatory interactions potentiate transcription of genes through combined inputs from these enhancers in coordinating the retinoic acid response.
Biological Advantage of the Arrangements of C-Phycocyanin Chromophores in Phycobilisome from the Electronic Energy Transfer Viewpoint
Authors: Mishima Kenji , Shoji Mitsuo , Umena Yasufumi , Shigeta Yasuteru
Published: April 2023

In the present study, we report the electronic energy transfer (EET) rate and the EET dynamics in the hexamer of C-phycocyanin (C-PC). The EET rate for the Förster theory was calculated by a quantum chemical method and a master equation was used to describe the dynamics. Our calculation results suggest that the natural arrangements of phycocyanobilin (PCB) chromophores α84, β84, and β155 in C-PC are cooperatively well-adjusted to achieve the shortest EET time-length. It is the appropriate regular periodicity of the intermolecular distances and intermolecular angles of the ground and the first excited transition dipole moments of PCBs α84, β84, and β155, i.e., the three-fold symmetry and stacking order of their layers found in terrestrial plants and algae, that are some of the most important requisites in achieving such a highly efficient EET in PBS.
The genome sequence of the Dot Moth, Melanchra persicariae (Linnaeus, 1761)
Authors: Boyes Douglas , Holland Peter W.H. ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: April 2023

We present a genome assembly from an individual male Melanchra persicariae (the Dot Moth; Arthropoda; Insecta; Lepidoptera; Noctuidae). The genome sequence is 647.9 megabases in span. Most of the assembly is scaffolded into 31 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.4 kilobases in length.
A Decomposition Algorithm with Fast Identification of Critical Contingencies for Large-Scale Security-Constrained AC-OPF
Authors: Curtis Frank E. , Molzahn Daniel K. , Tu Shenyinying , Wächter Andreas , Wei Ermin , Wong Elizabeth
Published: April 2023

The article “A Decomposition Algorithm with Fast Identification of Critical Contingencies for Large-Scale Security-Constrained AC-OPF” presents the decomposition algorithm used by Team GO-SNIP for the ARPA-E Grid Optimization (GO) Competition Challenge 1, held from November 2018 through October 2019. The algorithm involves unique contingency ranking and evaluation strategies for determining the important contingencies to include in a master problem that approximates the original large-scale security-constrained problem. It also involves efficient strategies for handling the complementarity constraints that appear in the model and for handling the arising degeneracies. Software implementation details are described, and the results of an extensive set of numerical experiments are provided to illustrate the effectiveness of each of the used techniques. Team GO-SNIP received a second-place finish in Challenge 1 of the Go Competition.
Eating Habits and Diet Diversity of Saudi Arabia Residents during the COVID-19 locked-down
Authors: Alzaben Abeer S. , Al-Masud Alaa A. , M. Gaid Reham , Almahmoud Elham F. , F. Alghannam Abdullah , Altalhi Arwa S. , A. Alothman Shaima
Published: April 2023

Background: The COVID-19 pandemic has had a negative impact on overall health and well-being. Therefore, certain preventive measures may affect many lifestyle habits. This study aimed to explore the eating habits, food variety score (FVS), and diet diversity score (DDS) of adults residing in Saudi Arabia during the mandatory stay-at-home advisory for COVID-19. Methods: A cross sectional study was targeted adults living in Saudi Arabia during the COVID-19 lockdown (May – June 2020). An electronic self-reported survey was conducted through Research Electronic Data Capture (Redcap) distributed on social media platforms. The Arabic version of the questionnaire was previously evaluated for its reliability and validity. A total of 359 individuals who completed the food frequency questionnaire were included in the study. Diet diversity score (DDS) and food variety score (FVS) was calculated. Results: The study found that the distribution of FVS ranged between 4-27 food items. The distribution of DDS ranged between 3-14 food items. Income, working status, and living status were factors associated with the FVS and/or DDS. The majority of the cohort (>67%) had at least one snack/day and < 3 meals/day. Conclusion: Diet diversity was acceptable among Saudi adults during the COVID-19 lockdown period. Age, sex, having children, marital status, education level, and income were factors associated with diet diversity and eating habits (having breakfast, skipping meals, and number of snacks).
Osteochondritis dissecans
Authors: Hashim Sophia SR , Morgan Catrin , Sarraf Khaled M
Published: April 2023

Osteochondritis dissecans is a condition characterised by acquired pathological subchondral bone lesions and its incidence is unknown. It has a multifactorial aetiology, with a combination of genetic and acquired risk factors. It commonly presents in adolescents and young adults. Patients have variable presentations, including trauma, insidious onset and pain exacerbated by exercise. The joints primarily affected are the knee, ankle and elbow joint. Early identification is key to treatment and to prevent future osteoarthritis of the joint. This article gives an overview of the presentation, assessment and management of the juvenile form of osteochondritis dissecans.
The Advanced Clinical Practice Integrated Degree Apprenticeship end point assessment: history, challenges and implementation
Authors: MacArthur Vicky
Published: April 2023

The advanced clinical practitioner (ACP) apprenticeship is one of several new apprenticeships that have been developed since the introduction of higher apprenticeships in England in 2010. The end point assessment (EPA) is a compulsory part of an apprenticeship and forms an independent assessment of the occupational competence of the apprentice. The EPA is set out in an assessment plan that end point assessment organisations (in this case, the higher education institution delivering the master's degree) must adhere to. Its initial introduction presented challenges for educators, because of its unfamiliar nature. These challenges have been addressed through an end point assessment organisation (EPAO) network, hosted by the Association of Advanced Practice Educators UK (AAPEUK), who have provided support, consistency and a wealth of resources for educators and students preparing to take the EPA. Since the first EPAs were delivered in 2020, more is known about how learners might best prepare and how educators and supervisors in practice can support them. The ACP EPA is becoming recognised as a valuable synoptic module that marks the successful achievement of the apprenticeship programme. The achievement allows both learners and employers to appreciate and have confidence in their abilities during the sometimes-challenging transition to advanced practice roles.
Project-Based Learning as a Strategy in Physical Education Teacher Training: Creating A Cultural Route Promoting Active Commuting
Authors: Zavala-Crichton Juan Pablo , Hinojosa-Torres Claudio , Yáñez-Sepúlveda Rodrigo
Published: April 2023

This study analyzes the narrated reflection of the students in relation to their learning, based on the perceptions that emerge from their experience in the development of the project. Participants were 53 fourth year Pedagogy in Physical Education students, with an average age of 24.3, who were divided into 13 groups. A qualitative study that used the narrated reflection of the students in relation to learning, based on a driving question. In order to help guide the students’ work, and to collect the perceptions they experienced during their participation, the following four components were integrated into the development of the project and included in the final product: a) historical and heritage sites, b) technology used to measure energy expenditure, c) type of active commuting, d) reflection on what was learned. The students designed 13 routes of active commuting through the city, which included different cultural, heritage and historical landmarks. The students analyzed the learning experience, highlighting the importance of knowing and caring for the heritage of the different cities around which they traveled. PBL can be a didactic alternative in initial Physical Education teacher training to achieve learning by linking subject content with the motivations and interests of the students.
Science Awareness: Analysis of Moroccan Curriculum Framework for Preschool Education
Authors: Ouabich Raja , Tifroute Lahcen , Bounabe Abdelaaziz
Published: April 2023

Morocco has undergone significant reforms in the education and training field, including the implementation of preschool education as a compulsory stage in the education system. Several studies have shown that attitudes toward science tend to decline between the ages of 11 and 14. Therefore, it is crucial to promote the acquisition of different modes of reasoning and forms of thought from early childhood. The primary objective of preschool education in Morocco should be to promote positive attitudes toward science. This study aims to analyze the preschool program prescribed in the Moroccan curriculum framework with regard to scientific awareness as well as its methodological and practical implications. The analysis was conducted using a designed grid and including the following criteria: construction of school science; axiological and psychological foundations of science learning; objectives and competencies; contents; approaches; activities; teaching strategies; didactic resources; pedagogical design and evaluation. The study's findings revealed that the Moroccan Curriculum Framework for Preschool Education featured a number of dimensions related directly to scientific awareness. However, no explicit statements about scientific awareness or science literacy were made. Moreover, some elements suggested in the program document were out of phase with the current trends of scientific awareness. Therefore, the study offered some suggestions for improving the proposal provided by this pedagogical document. In conclusion, Morocco's focus on preschool education is a positive step towards building a more scientifically literate society. However, to fully benefit from it, the guidance document must be revised to reflect current scientific awareness trends.
SIMULATOR SICKNESS AND ITS RELATIONSHIP TO OCULOMOTOR ACTIVITY – COMPARISONS OF A FIXEDBASE VS. FULL-MOTION SIMULATOR
Authors:   Military Institute of Aviation Medicine, Warsaw, Poland, Biernacki Marcin
Published: April 2023

Introduction: Studies on simulator sickness take into account an increasing number of factors regarding individual characteristics (e.g., gender, age, experience), testing time as well as simulator testing conditions, to name a few. In addition to the symptoms of simulator sickness expressed at the level of subjective indicators, it is also important to consider physiological indicators. The present study was designed to test whether the use of a fixed-base vs. fullmotion simulator influences the severity of simulator sickness symptoms and changes in the level of oculomotor variables. Methods: Twelve male subjects with age M=29.8, SD=4.26 participated in this study. Each subject performed two 30-minute simulator tasks following the same route. Each of these tasks was performed in different configuration of a truck simulator manufactured by ETCPZL Aerospace Industries: Condition 1 – fixed-base simulator, Condition 2 – full-motion simulator. Eye movements were recorded during the simulator task. Additionally, the SSQ questionnaire was filled out immediately after the simulator task and 1 h after leaving the simulator. Results: The results show a higher level of most symptoms of simulator sickness under 2nd condition (full-motion simulator). In the case of measurement immediately after completing the task on the simulator, there was an increase in oculomotor problems. On the other hand, the measurement after 1 h also revealed a significant increase in nausea, oculomotor and disorientation. Moreover, after 1 hour, a relationship between nausea symptoms and oculomotor indices was found. Discussion and Conclusions: Results indicate the influence of simulator testing conditions on the occurrence of simulator sickness symptoms. In addition, the relationship between variables measured by the oculograph and subjective symptoms of simulator sickness was demonstrated. The results obtained indicate changes in the sensitivity of physiological indicators and are discussed in the context of the possibility of using simulators in the diagnosis and training of selected functions.
Linearly polarized fiber amplifier with narrow linewidth of 5 kW exhibiting a record output power and near-diffraction-limited beam quality
Authors: Wang Yanshan , Peng Wanjing , Liu Hang , Yang Xiaobo , Yu Hongming , Wang Yao , Wang Jue , Feng Yujun , Sun Yinhong , Ma Yi , Gao Qingsong , Tang Chun
Published: April 2023

In this work, a narrow-linewidth polarization-maintaining (PM) all-fiber amplifier with near-diffraction-limited beam quality and record output power is presented. First, a 4.45-kW PM fiber amplifier with a 3-dB linewidth of 0.08 nm and root mean square (rms) linewidth of 0.22 nm is achieved based on optimized phase modulation. However, the sideband of the spectrum broadens significantly during the amplification process, which is mainly caused by the additional intensity variation of the injected signal. Meanwhile, an up to 5.04-kW linearly polarized fiber laser with a relatively stable spectral bandwidth is achieved by effectively suppressing spectral broadening. At the maximum output power, the rms linewidth is 0.2 nm, the beam quality factor M2 is less than 1.3, the polarization extinction ratio (PER) is 16.5 dB, and the signal-to-noise ratio (SNR) is approximately 53 dB. The further power scaling of the amplifier is mainly limited by the pump power. To the best of our knowledge, this is the maximum output power of a narrow linewidth linearly polarized fiber amplifier to date.
An Analytical Model to Determine the Optimal System for a Fluorescence Based Multilayered 3D Optical Data Storage System
Authors: Saini Anuj
Published: April 2023

To understand the limitations and capabilities of a fluorescence based three-dimensional optical data storage system, it is essential to perform calculations based on its photothermal mechanism. With this paper, an analytical approach of figuring out the amount of fluorescence attenuation in various layers of a multilayered polymer film by looking at the temperature rise upon illumination with a focused laser pulses shorter than thermal diffusion time of the polymer. The effect of changing the concentration of dye absorbing the laser radiation and the thickness of active layer is explored to provide a pathway for determining the optimum system configuration for a fluorescence based multilayered optical data storage system.
Point cloud registration algorithm based on NPFC neighborhood feature descriptor
Authors: Xingyu Chen , Le Xie , Mingde Zhang
Published: April 2023

Point cloud registration technology is widely used in machine vision, reverse engineering, and other neighborhood applications, and its efficiency and accuracy have an important impact on product data models. Aiming at the problems of the traditional ICP registration algorithm, such as slow convergence speed and high requirements on the initial point cloud position, this paper proposes a point cloud registration algorithm based on the neighborhood point feature covariance matrix descriptors. First, the key points of the point cloud data are extracted by combining the average angle of the neighborhood normal vector and ISS algorithms; then, the NPFC descriptors of the key points are calculated, and the two-way nearest neighbor feature matching is performed according to the similarity of the NPFC to obtain the initial correspondence; for the initial correspondence, the RANSAC algorithm is used to reject the mismatches to obtain the final correspondence pairs, and the initial registration parameters are calculated by using the final correspondence; finally, the iterative nearest point algorithm is used to perform the fine registration. Experiments on public datasets show that NPFC descriptor has high descriptiveness and robustness in the face of noise. The registration results also confirm the superiority of our registration method in terms of accuracy and efficiency.