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Shan Xiao,1,&ast; Jie Ou,2,&ast; Wangli Qiu,3,&ast; Chunxin Ye,1 Na Li,1 Sida Chen,1 Yuting Lai,1 Zhishan Deng,4 Fan Wu,4 Yan Shen1 1Department of Pulmonary and Critical Care Medicine, Shenzhen Longgang District Central Hospital, Shenzhen, People’s Republic of China; 2State Key Laboratory of Respiratory Disease, Guangzhou Chest Hospital, Guangzhou, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, People’s Republic of China; 4State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan Shen, Email drshenyan2022@163.com Fan Wu, Email wu.fan@vip.163.comBackground: Preserved ratio impaired spirometry (PRISm) is defined as forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)≥ 0.70 and FEV1< 80% predicted. Previous studies have shown that individuals with PRISm may develop airflow obstruction and have an increased mortality risk. However, studies with long-term follow-up are lacking, and this topic has not been evaluated in the general population. We explored the all-cause mortality risk of individuals with PRISm in a large sample of the general population.Methods: We used data from the National Health and Nutrition Examination Survey III and 2007– 2012. Participants aged 20– 79 years at baseline and who underwent spirometry were included. Normal spirometry was defined as a prebronchodilator FEV1/FVC≥ 0.70 and FEV1≥ 80% predicted. We used Cox proportional hazards regression models to compare all-cause mortality between the groups. We performed sensitivity analyses stratified by the lower limit of normal definition of spirometry criteria. Subgroup analyses by sex, age, smoking status, race, body mass index, level of education, poverty-to-income ratio, respiratory symptoms, and comorbidities were performed in participants with the different spirometry classifications.Results: Overall, 24,691 participants were included, with a median follow-up time of 25.7 years. Of these, 19,969 had normal spirometry and 1,452 had PRISm. PRISm was associated with a high all-cause mortality risk (unadjusted hazard ratio [HR]=2.47, 95% confidence interval [CI]: 2.25– 2.71, P< 0.001; adjusted HR=1.69, 95% CI: 1.54– 1.86, P< 0.001) compared with normal spirometry. Sensitivity analyses and subgroup analyses showed a similar increased all-cause mortality risk in PRISm.Conclusion: Our finding revealed that PRISm was significantly associated with increased risk of all-cause mortality in the general population compared with normal spirometry. Further research is needed to explore the intervention effect of PRISm.Keywords: PRISm, preserved ratio with impaired spirometry, normal spirometry, all-cause mortality, symptom, comorbidity

Masonry buildings remain popular worldwide due to their readily available materials, high compressive strength, ease of construction, and affordability. Therefore, understanding the impact of mortar on the compressive strength of masonry is essential. This study aimed to determine the compressive strength and failure patterns of masonry, focusing particularly on mortar. An experimental program was conducted, involving a total of 54 specimens: 27 cubes, 27 cylinders, and 9 masonry prisms. The cement-to-sand ratio (c/s) varied at ratios of 1:3, 1:4, and 1:5, while the water-to-cement ratio (w/c) remained fixed at 0.45. Each prism consisted of 5 bricks separated by a 10 mm mortar layer. Compressive strength data for cubes and cylinders were collected at 3, 7, and 28 days, while data for prisms were collected only at 28 days. The best results have been obtained at a c/s ratio of 1:3, with compressive strengths of 3555.5 psi for cubes, 3282.98 psi for cylinders, and a compressive force value of 129.33 kN for prisms at 28 days. The compressive strength of cubes and cylinders increases by approximately 68.19% and 64.61%, respectively, and the compressive force of masonry prisms increases by approximately 76.48% at 28 days when the cement-to-sand ratio is changed from 1:5 to 1:3. Stresses, graphs, and failure patterns have been analyzed and compared with the Bangladesh National Building Code (BNBC) 2020 and available literature, revealing a strong correlation.

Abstract Laterite is a naturally occurring rock formation that is used worldwide as a building material in tropical regions. Its unique features have enabled some of the most astounding architectural feats, which irrevocably altered the cultural and historical contexts of their surroundings. This study examines the laterite stone masonry performance, with a specific focus considering its mechanical properties, mineral composition, and microstructure. However, mineralogical composition and microstructural features vary, affecting mechanical qualities and endurance. The study also extensively examines four varieties of laterite samples used for construction in the Udupi region. Experiments were performed to determine the percentage of water absorption and its impact on the compressive strength of Laterite stone. L1 Laterite stone showed better performance due to its exceptional strength. It surpasses the other samples and is well-suited for the construction of load-bearing structures as it aligns with the IS 3620 standards. Stack bond masonry prism samples were built using four varieties of laterite stones with 1:6 cement mortar for the joints. These prism specimens were subsequently tested under compression, tension, and shear loading to determine the variation in their behaviour. The series of tests performed revealed that the prisms failed due to splitting and crushing under compression loads. In shear and tensile bond tests, all laterite masonry prism samples failed due to rupture of the joint. Microstructure study confirmed that the increased strength of lateritic samples L1 and L2 is due to less prominent clay particles coupled with a higher percentage of ferrous content.

Alexander Evans,1 Yasir Tarabichi,2 Wilson D Pace,3,4 Barry Make,5 Nicholas Bushell,6 Victoria Carter,7 Ku-Lang Chang,8 Chester Fox,9 MeiLan K Han,10 Alan Kaplan,11,12 Janwillem WH Kocks,13– 15 Chantal Le Lievre,6 Alexander Roussos,6 Neil Skolnik,10,16 Joan B Soriano,17 Barbara P Yawn,10 David Price1,6,7,18 1Observational and Pragmatic Research Institute, Singapore, Singapore; 2Center for Clinical Informatics Research and Education, MetroHealth, Cleveland, OH, USA; 3DARTNet Institute, Aurora, CO, USA; 4Department of Family Medicine, Anschutz Medical Campus University of Colorado, Aurora, CO, USA; 5Department of Medicine, National Jewish Hospital, Denver, CO, USA; 6Optimum Patient Care, Brisbane, Queensland, Australia; 7Optimum Patient Care, Oakington, Cambridge, UK; 8Lucas Research, a Centricity Research Company, Morehead City, NC, USA; 9University at Buffalo, Buffalo, NY, USA; 10University of Minnesota, Minneapolis, MN, USA; 11Family Physician Airways Group of Canada, Stouffville, Ontario, Canada; 12University of Toronto, Toronto, Canada; 13General Practitioners Research Institute, Groningen, the Netherlands; 14Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 15Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 16Abington Jefferson Health, Jenkintown, PA, USA; 17School of Medicine, Universitat de les Illes Balears, Palma, Spain; 18Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UKCorrespondence: David Price, Observational and Pragmatic Research Institute, 22 Sin Ming Lane, &num;06-76, Midview City, Singapore, 573969, Singapore, Tel +65 3105 1489, Email dprice@opri.sgBackground: Preserved ratio impaired spirometry (PRISm) represents a population with spirometry results that do not meet standardized COPD obstruction criteria, yet present with high respiratory symptom burden and might benefit from respiratory management and treatment. We aimed to determine prevalence of PRISm in US primary care patients diagnosed with COPD, describe their demographic, clinical, and CT scan characteristics.Methods: An observational registry study utilizing the US APEX COPD registry, composed of patients diagnosed with COPD aged 35+ years. Demographic and clinical data were collected from EHRs and complemented by questionnaires. Multivariable logistic regression was performed to assess whether PRISm predicts lung function decline.Results: Prevalence of PRISm within a primary care population clinically diagnosed with COPD was 23.6% (678/2866, 95% CI 22.0– 25.1). Those with PRISm were more likely female (55.9% vs 46.9%), younger (66.3± 11.1 vs 69.2± 10.3 years), with a greater mean BMI (33.5± 9.2 vs 27.8± 7.2 kg/m2), more often African American or Hispanic (37.2% vs 26.3%), and with fewer current smokers (33.1% vs 36.8%) when compared to those meeting COPD spirometry criteria (all p< 0.05). Compared to COPD GOLD 0 patients, individuals with PRISm had greater BMI (33.5± 9.2 vs 30.6± 7.8), and were more likely current smokers (33.1% vs 23.4%), both p< 0.05. Patients with PRISm had similar respiratory symptoms (chronic bronchitis, CAT, and mMRC) to overall COPD patients, but more frequently than GOLD 0 COPD patients (p< 0.01). Emphysema was more commonly reported in CT scans from patients with PRISm 70.3% (260/369, 95% CI 65.8– 75.3) than those with GOLD 0 COPD 64.1% (218/340, 95% CI 58.8– 69.2) (p< 0.05). PRISm status was not predictive of lung function decline.Interpretation: One in four primary care patients with clinically diagnosed COPD in a large US registry fulfil the spirometric definition of PRISm rather than COPD, but suffers from emphysema in CT and significant respiratory symptoms.Keywords: APEX, COPD, PRISm, US primary care, COPD exacerbations, electronic health records, patient reported outcomes

AIM: To investigate the effect of using base-out prisms on nystagmus, visual acuity and contrast sensitivity in patients with albinism. METHODS: In this interventional study, patients with albinism who had nystagmus were enrolled. A comprehensive eye exam was conducted, which included refraction, assessment of far and near vision acuity, and contrast sensitivity measurements. To check for the nystagmus, a videonystagmography was used. The tests were carried out in three modes: without any correction, with optical correction, and with correction using base-out prisms in three different powers, including 4, 6, and 8 prism diopters. RESULTS: Totally 23 patients with average age of 28.65±12.13 were examined. It was found that the use of optical correction and optical correction with prisms resulted in a statistically significant improvement in both far (at least: P

BackgroundPreserved Ratio Impaired Spirometry (PRISm) is increasingly recognized as a precursor to Chronic Obstructive Pulmonary Disease (COPD). The impact of Ultra-Processed Foods (UPFs) intake on PRISm and lung function remains underexplored, and we aimed to explore their associations.MethodsThis study included 8,336 U.S. adults. Weighted logistic and linear regression models were employed for main analysis. Dose–response relationship was examined through restricted cubic spline (RCS) analysis, and subgroup analyses explored interactions with selected covariates.ResultsParticipants in the PRISm group were older and exhibited various adverse health characteristics. The percentage of total daily energy intake from UPFs (%Kcal) intake was associated with a non-significant increase in PRISm risk (OR 1.67, 95% CI: 0.96–2.92, p = 0.07). However, the highest quartile of UPFs (%Kcal) intake was significantly linked to increased PRISm risk (OR 1.36, 95% CI: 0.99–1.86, P for trend = 0.043). Furthermore, higher UPFs (%Kcal) intake negatively affected lung function, with participants in the highest quartile showing a significant reduction in forced expiratory volume in 1 s (FEV1) of −45.5 mL (95% CI: −87.6 to −3.4, P for trend = 0.045) and a decrease in forced vital capacity (FVC) of −139.4 mL (95% CI: −223.5 to −55.4, p

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

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

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

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

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

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

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

Pipe jacking is one of the most important construction methods in trenchless technology. Pipe jacking guidance technology acquires the jacking route by collecting the attitude and position information of the pipe jacking machine. It ensures that the deviation between the jacking route and the route designed in the engineering drawings during the construction is kept within the error range and prevents the damage to other facilities caused by the deviation of the construction route. It improves the construction efficiency and ensures the precision and safety of pipeline laying. In this paper, the basic principle and working mode of the pipe jacking guidance system are sorted out, and the current technical means are classified and organized. A systematic overview of the research on pipe jacking guidance methods is given, the development trend of pipe jacking guidance systems towards automation, intelligence and multi-source data fusion are discussed, and the challenges faced by pipe jacking guidance systems in complex scenarios are elaborated. This is to provide guidance and reference for the research and practice in related fields and to promote the further innovation and application of pipe jacking guidance technology.

Sustainability has become crucial in today’s business landscape. Customers, suppliers, partners, and investors are increasingly demanding that companies be aware of their impacts on the environment and society. Achieving sustainability in business operations, including social, economic, and environmental aspects, is one of the major challenges for companies today. Integrating sustainability into project management fosters the development of more sustainable and responsible projects, considering environmental, social, and economic aspects. This integration allows for benefits such as risk and operational cost reduction, strengthening of the company’s reputation, and gaining stakeholders’ trust. This study takes an exploratory approach, focusing on a pilot test to investigate how the PRiSM™ (Projects Integrating Sustainable Methods) methodology can be applied in a business context to assess the level of maturity of sustainable project management practices and thus raise awareness of the importance of these issues. PRiSM™ was developed by GPM® Global (Global Project Management, Lees Summit, MO, USA) in 2013 to help organizations integrate project processes with sustainable initiatives and it is based on the P5 Standard, which incorporates tangible tools and methods to manage the balance between finite resources, social responsibility, and delivery of sustainable project outcomes. Based on the PRiSM™ methodology and the P5 Standard (2nd Edition), a comprehensive questionnaire was developed under the Portuguese Project Management Observatory® to assist companies in assessing their performance in terms of sustainable practices, resulting in a sustainable maturity level. The questionnaire aimed to evaluate companies in four impact categories: product/process impacts, social impacts, economic impacts, and environmental impacts. The results, obtained from 30 respondents, indicated that the majority of organizations achieved medium-level ratings, with an overall average of 65%. However, some still showed unsatisfactory performance, with a minimum score of 14%, indicating there is still a long way to go for the full integration of sustainability. Based on participants’ feedback, the study found that many recognized the importance of sustainability but were unaware of how to integrate sustainability practices into their project management activities, highlighting the importance of promoting education and raising awareness about sustainable project management practices. The findings, while based on a limited sample, provide valuable initial insights into the potential of PRiSM™ to foster sustainability in project management. This research underscores the need for further studies to expand and validate these preliminary conclusions.

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

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

Terrestrial Radar Interferometry (TRI) is widely adopted in geomonitoring applications due to its capability to precisely observe surface displacements along the line of sight, among other key characteristics. As its deployment grows, TRI is also increasingly used to monitor smaller and more dispersed geological phenomena, where the challenge is their precise localization in 3d space if the pose of the radar interferometer is not known beforehand. To tackle this challenge, we introduce a semi-automatic target-based georeferencing method for precisely aligning TRI data with 3d point clouds obtained using long-range Terrestrial Laser Scanning (TLS). To facilitate this, we developed a multi-modal corner reflector (mmCR) that serves as a common reference point recognizable by both technologies, and we accompanied it with a semi-automatic data-processing pipeline, including the algorithms for precise center estimation. Experimental validation demonstrated that the corner reflector can be localized within the TLS data with a precision of 3–5 cm and within the TRI data with 1–2 dm. The targets were deployed in a realistic geomonitoring scenario to evaluate the implemented workflow and the achievable quality of georeferencing. The post-georeferencing mapping uncertainty was found to be on a decimeter level, matching the state-of-the-art results using dedicated targets and achieving more than an order of magnitude lower uncertainty than the existing data-driven approaches. In contrast to the existing target-based approaches, our results were achieved without laborious visual data inspection and manual target detection and on significantly larger distances, surpassing 2 km. The use of the developed mmCR and its associated data-processing pipeline extends beyond precise georeferencing of TRI imagery to TLS point clouds, allowing for alternatively georeferencing using total stations, mapping quality evaluation as well as on-site testing and calibrating TRI systems within the application environment.

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

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

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

A theoretical approach is presented to significantly enhance the spectral sensitivity of prism-based SPR sensors. The spectral sensitivity of prism-based SPR sensors is derived based on the coupling conditions of SPR and might exceed 105 nm/RIU for analytes with large RI values when other sensor parameters are carefully considered, including the RI of the prism, the angle of incidence, and the SPR active material. The spectral sensitivity could be markedly enhanced, reaching up to 10,000 nm/RIU by fine-tuning the effective RI of the incident light to be slightly larger, specifically 0.01~0.02 RIU, than the RI of the analyte, which is attributed to the large dielectric permittivity of the SPR active material, the key factor for achieving high sensitivity. The dynamic range is 0.040 RIU in the case of high sensitivity, which is sufficient in most applications. Moreover, the spectral sensitivity could be pushed even higher, into the range of 106~108 nm/RIU, by positioning the effective RI of the incident light closer to that of the analyte. However, it requires a careful balance between optimizing the sensitivity and maintaining an acceptable dynamic range.

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

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

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

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

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

Purpose – This research aims to understand how organizational workplace meetings surrounding the COVID-19 pandemic impacted logistics Airmen across the United States Air Force and how these meetings impacted their risk seeking behavior on social media. Design/methodology/approach – This survey research tested an extended Planned Risk Information Risk Seeking Model (PRISM) with organizational meetings as an antecedent to determine if current meetings influenced an Airman's perceived behavioral control, attitude toward seeking, subjective norms, knowledge sufficiency and intention to seek information regarding COVID-19. Findings – Results of the CFA showed that the expanded PRISM model had good model fit. Additionally, using a custom dialog PROCESS macro in SPSS, it was found that perceptions of existing meetings were directly, positively related to attitude toward seeking, subjective norms and perceived behavioral control, and indirectly related to knowledge sufficiency threshold and information seeking. Theoretical and managerial implications are discussed. Originality/value – This research adds to the limited body of knowledge of crisis communication and effectively expands the PRISM model to include an antecedent that helps explain information seeking during times of uncertainty.

There is an ever-increasing number of publications using meta-analyses, but Thai academics and Thai researchers still have very little use of the R program for meta-analysis in the health sciences research context, including teaching the use of R in statistical analysis for research. Therefore, in this research article, the objectives are 1. to synthesize documents for meta-analysis using the basic R program and 2) to suggest guidelines for researchers to conduct additional studies beyond meta-analysis basic. The research results found that. 1. Basic meta-analysis had shown that R could perform basic meta-analysis no worse than any other program. This research article would divide the presentation of basic meta-analysis into 2 Parts. Part 1 introduced the concept of systematic literature review (Systematic Review), which consisted of 2 sub-parts as follows: Sub-part 1) discussed the application of PICO to clearly define research questions as a basis for selection. into the literature for meta-analysis next, and in the second sub-part was the application of PRISMA to explain the inclusion and exclusion of studies that would be used for meta-analysis next in the section Second, a meta-analysis using R program on relevant topics according to international principles was introduced. Starting from importing the dataset for further meta-analysis, the meta-analysis would display the analysis results in the form of text (Text Output), and analysis of various sub-statistics. Important factors required in reporting research results included the pooled effect size in the form of Common (Fixed) effect and Random effect, as well as Test of heterogeneity analysis. There was also a visual analysis of the Forest plot and Funnel plot related to Publication bias analysis. 2. The guidelines for researchers to conduct additional studies that were higher than basic meta-analysis was to be able to use the R program to conduct a meta-analysis that was comprehensive had a high standard and had many capabilities that may be higher than the program. For this reason, Thai academics and Thai researchers could use the R program to conduct meta-analyses and publish in world-leading journals, no different from international researchers who had used the R program. It was used in meta-analyses in the context of health sciences and published in world-class journals.

Abstract Background To increase uptake of implementation science (IS) methods by researchers and implementers, many have called for ways to make it more accessible and intuitive. The purpose of this paper is to describe the iPRISM webtool (Iterative, Practical, Robust Implementation and Sustainability Model) and how this interactive tool operationalizes PRISM to assess and guide a program’s (a) alignment with context, (b) progress on pragmatic outcomes, (c) potential adaptations, and (d) future sustainability across the stages of the implementation lifecycle. Methods We used an iterative human-centered design process to develop the iPRISM webtool. Results We conducted user-testing with 28 potential individual and team-based users who were English and Spanish speaking from diverse settings in various stages of implementing different types of programs. Users provided input on all aspects of the webtool including its purpose, content, assessment items, visual feedback displays, navigation, and potential application. Participants generally expressed interest in using the webtool and high likelihood of recommending it to others. The iPRISM webtool guides English and Spanish-speaking users through the process of iteratively applying PRISM across the lifecycle of a program to facilitate systematic assessment and alignment with context. The webtool summarizes assessment responses in graphical and tabular displays and then guides users to develop feasible and impactful adaptations and corresponding action plans. Equity considerations are integrated throughout. Conclusions The iPRISM webtool can intuitively guide individuals and teams from diverse settings through the process of using IS methods to iteratively assess and adapt different types of programs to align with the context across the implementation lifecycle. Future research and application will continue to develop and evaluate this IS resource.

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

Introduction: The most commonly used scoring systems for the assessment of predicted mortality (PDR) in the pediatric intensive care unit are the “pediatric risk of mortality” (PRISM) and the “pediatric index of mortality” (PIM) scores. The aim of this study is to evaluate the calibration and discrimination of PRISM III and PIM II scores in predicting mortality in a tertiary university hospital pediatric intensive care unit in Turkey.Methods:Demographic data of patients hospitalized in the pediatric intensive care unit between January 1, 2015 and December 31, 2018 were scanned form the electronic records. PRISM III and PIM II score, PDR, and standardized mortality rate (SMR) were calculated. In order to show the discrimination of the scores, the area under the ROC curve (AUC) was calculated and the significance limit was accepted as 0.80. Hosmer-Lemeshow Goodness-of-fit test was used to evaluate the calibrations and p>0.05 was considered significant.Results:After exclusions 825 patients included in the study. The mean value of the PRISM III was 9.5±6.8 and the mean value of the PIM II score was 1.9±8.2. The calculated SMR was 1.03 according to the PRISM III score and 0.76 according to the PIM II score. In the ROC analysis performed to evaluate the discrimination, the AUC values for PRISM III PDR and PIM II PDR were; 0.908±0.017 (p0.05).Conclusion:In this study, it has been shown that the discrimination and calibration of the PRISM III and PIM II score is good in predicting mortality in a tertiary pediatric intensive care unit where medical and surgical patients are accepted.

The dominating set of the graph G is a subset D of vertex set V, such that every vertex not in V-D is adjacent to at least one vertex in the vertex subset D. A dominating set D is a minimal dominating set if no proper subset of D is a dominating set. The number of elements in such set is called as domination number of graph and is denoted by $\gamma(G)$. In this work the domination numbers are obtained for family of prism graphs such as prism CL_n, antiprism Q_n and crossed prism R_n by identifying one of their minimum dominating set.

Wind loads for the design of wind-resistant high-rise buildings are generally evaluated based on spectral modal analysis or time-history response analysis using wind pressure data obtained from wind tunnel experiments with rigid models. The characteristics of the fluctuating wind pressures around vibrating buildings must be evaluated for relevant wind-resistant designs because the wind pressures around buildings are affected by their vibrations. One of the methods to investigate fluctuating fields is complex proper orthogonal decomposition (CPOD), which can express complicated pressure fields, including advection phenomena, as coherent structures. This paper presents the phase characteristics of fluctuating wind pressures around rigid and elastic models of a square-sectioned prism evaluated via CPOD analysis using the results of wind tunnel experiments. The evaluation procedure for the symmetricity of the fluctuating wind pressure modes obtained via CPOD is presented. The similarity of fluctuating wind pressure fields is evaluated as the congruency of the planes formed by the 1st- and 2nd-eigenmodes. With symmetricity and similarity, the fluctuating wind pressure fields are classified into three types: resonant and non-resonant states in smooth flow, and in gradient flow. The characteristics of the three types of wind pressure fields are shown, respectively, in the symmetric and anti-symmetric modes.

Background: The aim of the observational, prospective study was to validate a novel, nonverbal assessment tool for perceived disease burden—Pictorial Representation of Illness and Self-Measure (PRISM)—in ulcerative colitis (UC) against established patient health questionnaires. The cumulative burden of patients recently diagnosed (

Irrigated agriculture is the primary driver of freshwater use and is continuously expanding. Precise knowledge of irrigation amounts is critical for optimizing water management, especially in semi-arid regions where water is a limited resource. This study proposed to adapt the PrISM (Precipitation inferred from Soil Moisture) methodology to detect and estimate irrigation events from soil moisture remotely sensed data. PrISM was originally conceived to correct precipitation products, assimilating Soil Moisture (SM) observations into an antecedent precipitation index (API) formula, using a particle filter scheme. This novel application of PrISM uses initial precipitation and SM observations to detect instances of water excess in the soil (not caused by precipitation) and estimates the amount of irrigation, along with its uncertainty. This newly proposed approach does not require extensive calibration and is adaptable to different spatial and temporal scales. The objective of this study was to analyze the performance of PrISM for irrigation amount estimation and compare it with current state-of-the-art approaches. To develop and test this methodology, a synthetic study was conducted using SM observations with various noise levels to simulate uncertainties and different spatial and temporal resolutions. The results indicated that a high temporal resolution (less than 3 days) is crucial to avoid underestimating irrigation amounts due to missing events. However, including a constraint on the frequency of irrigation events, deduced from the system of irrigation used at the field level, could overcome the limitation of low temporal resolution and significantly reduce underestimation of irrigation amounts. Subsequently, the developed methodology was applied to actual satellite SM products at different spatial scales (1 km and 100 m) over the same area. Validation was performed using in situ data at the district level of Algerri-Balaguer in Catalunya, Spain, where in situ irrigation amounts were available for various years. The validation resulted in a total Pearson’s correlation coefficient (r) of 0.80 and a total root mean square error (rmse) of 7.19 mm∕week for the years from 2017 to 2021. Additional validation was conducted at the field level in the Segarra-Garrigues irrigation district using in situ data from a field where SM profiles and irrigation amounts were continuously monitored. This validation yielded a total bi-weekly r of 0.81 and a total rmse of −9.34 mm∕14-days for the years from 2017 to 2021. Overall, the results suggested that PrISM can effectively estimate irrigation from SM remote sensing data, and the methodology has the potential to be applied on a large scale without requiring extensive calibration or site-specific knowledge.

Purpose: Determining the correct power and orientation of prism to be prescribed for patients with symptomatic, oblique-angle strabismus can be challenging and confusing, prone more to clinician gestalt than science or methodology. The author shares a simplified, approach not previously described in the scientific literature that utilizes commercially available equipment and freely available on-line prism calculators for choosing the correct Press-On™ prism power, positioning the prism correctly on the spectacle lens, and ultimately determining the correct prism prescription to be incorporated into the patient’s spectacles.

Abstract Objectives To compare Pictorial Representation of Illness and Self-Measure (PRISM) and a numeric scale for self-reflection in dental students. Methods Fourth year dental students were randomly assigned to each receive one interview based on PRISM or a numeric scale to self-assess their competencies at the beginning (t1), the middle (t2) and the end (t3) of integrated clinical course. Questionnaires were used to assess self-perceived benefit of the interviews at each time points. Results Students in PRISM group perceived a higher benefit regarding the self-assessment of their practical skills at all time points (P

Abstract Background: Preserved ratio impaired spirometry (PRISm) refers to decreased forced expiratory volume in 1 s (FEV1) in the setting of preserved ratio. Little is known about the role of PRISm and its complex relation with small airway dysfunction (SAD) and lung volume. Therefore, we aimed to investigate the associations between PRISm and SAD and lung volume. Methods: We conducted a cross-sectional community-dwelling study in China. Demographic data, standard respiratory epidemiology questionnaire, spirometry, impulse oscillometry (IOS) and computed tomography (CT) data were collected. PRISm was defined as post-bronchodilator FEV1/FVC ≥ 0.70 and FEV1 0.07 kPa/L/s and LAA− 856>20%, respectively. Analysis of covariance and logistic regression were used to determine associations between PRISm and SAD and lung volume. We then repeated the analysis with a lower limit of normal definition of spirometry criteria and FVC definition of PRISm. Moreover, we also performed subgroup analyses in ever smoker, never smoker, subjects without airway reversibility or self-reported diagnosed asthma, and subjects with CT-measured total lung capacity ≥70% of predicted. Results: The final analysis included 1439 subjects. PRISm had higher odds and more severity in spirometry-defined SAD (pre-bronchodilator: odds ratio [OR]: 5.99, 95% confidence interval [95%CI]: 3.87–9.27, P

Several countries show interest in the Generation-IV power reactor innovative small module (PRISM), including: Canada, Japan, Korea, Saudi Arabia and the United Kingdom. Generation IV International Forum (GIF) has recommended the utilizing of probabilistic safety assessment (PSA) in evaluating the safety of Generation-IV reactors. This paper reviews the PSA performed for PRISM using SAPHIRE 7.27 code. This work shows that the core damage frequency (CDF) of PRISM for a single module is estimated by 8.5E-8/year which is lower than the Generation-IV target that is 1E-6 core damage per year. The social risk of PRISM (likelihood of latent cancer fatality) with evacuation is estimated by 9.0E-12/year which is much lower than the basic safety objective (BSO) that is 1E-7/year. The social risk without evacuation is estimated by 1.2E- 11/year which is also much lower than the BSO. For the individual risk (likelihood of prompt fatality), it is concluded that it can be considered negligible with evacuation (1.0E-13/year). Assuming no evacuation, the individual risk is 2.7E-10/year which is again much lower than the BSO. In comparison with other PSAs performed for similar sodium fast reactors (SFRs), it shows that PRISM concept has the lowest CDF.

Abstract Background The Practical, Robust Implementation and Sustainability Model (PRISM) was developed in 2008 as a contextually expanded version of the broadly used Reach, Adoption, Effectiveness, Implementation, and Maintenance (RE-AIM) framework. PRISM provides researchers a pragmatic and intuitive model to improve translation of research interventions into clinical and community practice. Since 2008, the use of PRISM increased across diverse topics, populations, and settings. This citation analysis and scoping systematic review aimed to assess the use of the PRISM framework and to make recommendations for future research. Methods A literature search was conducted using three databases (PubMed, Web of Science, Scopus) for the period of 2008 and September 2020. After exclusion, reverse citation searches and invitations to experts in the field were used to identify and obtain recommendations for additional articles not identified in the original search. Studies that integrated PRISM into their study design were selected for full abstraction. Unique research studies were abstracted for information on study characteristics (e.g., setting/population, design), PRISM contextual domains, and RE-AIM outcomes. Results A total of 180 articles were identified to include PRISM to some degree. Thirty-two articles representing 23 unique studies integrated PRISM within their study design. Study characteristics varied widely and included studies conducted in diverse contexts, but predominately in high-income countries and in clinical out-patient settings. With regards to use, 19 used PRISM for evaluation, 10 for planning/development, 10 for implementation, four for sustainment, and one for dissemination. There was substantial variation across studies in how and to what degree PRISM contextual domains and RE-AIM outcomes were operationalized and connected. Only two studies directly connected individual PRISM context domains with RE-AIM outcomes, and another four included RE-AIM outcomes without direct connection to PRISM domains. Conclusions This is the first systematic review of the use of PRISM in various contexts. While there were low levels of ‘integrated’ use of PRISM and few reports on linkage to RE-AIM outcomes, most studies included important context domains of implementation and sustainability infrastructure and external environment. Recommendations are provided for more consistent and comprehensive use of and reporting on PRISM to inform both research and practice on contextual factors in implementation.

Abstract Background PRISM is a novel approach to support self-reflection and learning appraisal in dental students, based on a visual metaphor. The aim of this study was to evaluate whether PRISM measurments would be reproducible and sensitive to detect learning progress in undergraduate dental students in their clinical years. Methods Voluntarily participating dental students were included. To evaluate reproducibility, a mixed cohort of 10 students each in 3rd, 4th and 5th year (total n = 30) was recruited and received three identically structured PRISM interviews within one week without any other teaching events. To assess perceived learning progress, 29 volunteer 3rd year students participated in three interviews during their clinical simulation course (beginning, middle, end). Distances between Subject and Objects was measured in millimeter; objects were classified into close or branched clusters depending on their distance from each other on the PRISM board. Results Values for perceived competencies within PRISM interviews during one week were comparable between the three time points in the mixed cohort (n = 30; p > 0.05). Comparing the three subgroups (3rd, 4th and 5th year, each n = 10), PRISM indicated that 3rd year students perceived their competencies are significantly lower than the 4th and 5th year students (p

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

Abstract Purpose The study was aimed to assess the prognostic power The Pediatric Risk of Mortality-3 (PRISM-3) and the Pediatric Index of Mortality-3 (PIM-3) to predict in-hospital mortality in a sample of patients admitted to the PICUs. Design and methods The study was performed to include all children younger than 18 years of age admitted to receive critical care in two hospitals, Mashhad, northeast of Iran from December 2017 to November 2018. The predictive performance was quantified in terms of the overall performance by measuring the Brier Score (BS) and standardized mortality ratio (SMR), discrimination by assessing the AUC, and calibration by applying the Hosmer-Lemeshow test. Results A total of 2446 patients with the median age of 4.2 months (56% male) were included in the study. The PICU and in-hospital mortality were 12.4 and 16.14%, respectively. The BS of the PRISM-3 and PIM-3 was 0.088 and 0.093 for PICU mortality and 0.108 and 0.113 for in-hospital mortality. For the entire sample, the SMR of the PRISM-3 and PIM-3 were 1.34 and 1.37 for PICU mortality and 1.73 and 1.78 for in-hospital mortality, respectively. The PRISM-3 demonstrated significantly higher discrimination power in comparison with the PIM-3 (AUC = 0.829 vs 0.745) for in-hospital mortality. (AUC = 0.779 vs 0.739) for in-hospital mortality. The HL test revealed poor calibration for both models in both outcomes. Conclusions The performance measures of PRISM-3 were better than PIM-3 in both PICU and in-hospital mortality. However, further recalibration and modification studies are required to improve the predictive power to a clinically acceptable level before daily clinical use. Practice implications The calibration of the PRISM-3 model is more satisfactory than PIM-3, however both models have fair discrimination power.

Models that simulate ecosystems at local to regional scales require relatively fine resolution climate data. Many methods exist that downscale the native resolution output from global climate models (GCM) to finer resolutions. NASA NEX-DCP30 is a statistically downscaled 30 arcsecond resolution climate dataset widely used for climate change impact studies in the conterminous USA (CONUS), but it did not include vapor pressure data which is essential for many types of models. We downscaled vapor pressure data from 28 global climate models included in the Coupled Model Intercomparison Project Phase 5 (CMIP5) to 30 arcsecond resolution for CONUS to augment the NEX-DCP30 dataset. Monthly vapor pressure values were calculated from raw GCM output for the conterminous USA from 1950 to 2100, representing RCP4.5 and RCP8.5 climate change scenarios. Vapor pressure data were then downscaled from the GCM's native spatial resolutions to 30 arcsecond using the Bias Correction-Spatial Disaggregation (BCSD) statistical downscaling method, which had been used to create the original NEX-DCP30 dataset. PRISM LT71m gridded climate data for 1970-1999 served as the reference data. The newly created downscaled vapor pressure dataset may be used in conjunction with the existing NEX-DCP30 data as input for vegetation, fire, drought, or earth system models. The data is available at the Forest Service Research Data Archive.

The Palembang local wisdom-based mathematics learning video is a tangible manifestation of the nation's character building through education. The developed video discusses the prism materials for eighth-graders. The video was developed through development research by adopting the ADDIE design into ADD (analysis – design – development). The purpose of the study was to examine the feasibility of learning mathematics videos based on local wisdom from experts’ judgment on material, media, and language. The research instruments were a questionnaire and a suggestion sheet. Assessment of prototype 1 showed that the video is “Feasible Enough” but needs to be improved. After revisions are made, the video is called Prototype 2. The expert’s assessment of Prototype 2 showed that the video is "Feasible" and without revision. This video is an alternative learning media (on online or offline learning, even hybrid learning). However, the potential effect remains to be seen. So, this can be a space for other researchers to continue or develop into other materials.

Abstract Objectives Evidence-based practice for stroke prevention in high-income countries involves screening for abnormal transcranial Doppler (TCD) velocity and initiating regular blood transfusions for at least 1 year, followed by treatment with hydroxyurea. This practice has not been transferred to low-resource settings like Nigeria, the country with the highest global population density of SCD. Following a multi-center randomized controlled trial among children with SCA in northern Nigeria, screening for stroke and initiation of hydroxyurea was established as standard of care at the clinical trial sites and other locations. We aim to describe the critical steps we took in translating research into practice for stroke prevention in SCA in Nigeria. Guided by the PRISM framework, we describe how we translated results from a randomized controlled trial for primary prevention of stroke in children with sickle cell anemia into usual care for children with SCA in Kaduna, Nigeria. Results Findings from this study demonstrate the importance of organizational support and stakeholder involvement from the onset of a clinical trial. Having the dual objective of conducting an efficacy trial while simultaneously focusing on strategies for future implementation can significantly decrease the lag time between discovery and routine practice.

Abstract Background Despite the overwhelming prevalence and health implications of obesity, it is rarely adequately addressed in a health care setting. PATHWEIGH is a pragmatic approach to weight management that uses tools built into the electronic medical record to overcome barriers and guide care. Implementation strategies are employed to facilitate adoption and use of the PATHWEIGH tools and processes. The current study will compare the effectiveness of PATHWEIGH versus standard of care (SOC) on patient weight loss in primary care and explore factors for its successful implementation. Methods A stepped wedge cluster randomized trial design will be used within an effectiveness-implementation hybrid study. Adult patient weight loss and weight loss maintenance will be compared in PATHWEIGH versus SOC in 57 family and internal medicine clinics in a large health system in Colorado, USA. Effectiveness will be evaluated using generalized linear mixed models to determine statistical differences in weight loss and weight loss maintenance at 6, 12, and 18 months. Patient-, provider-, and clinic-level predictors will be identified using mediator and moderator analyses. Conceptually guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), a mixed methods approach including quantitative (practice surveys, use tracking) and qualitative (interviews, observations) data collection will be used to determine factors impeding and facilitating adoption, implementation, and maintenance of PATHWEIGH and evaluate specified implementation strategies. A cost analysis of the practice and system costs and resources required by PATHWEIGH relative to the reimbursement collected will be performed. Discussion The effectiveness and implementation of PATHWEIGH, and their interrelatedness, for patient weight loss are collectively the focus of the current trial. Findings from this study are expected to serve as a blueprint for available and effective weight management in primary care medical practice. Trial registration ClinicalTrials.gov NCT04678752 . Registered on December 21, 2020.

IntroductionSeveral scoring systems are available to assess the severity of sepsis in pediatric patients in diverse settings worldwide. This study investigates the quality and applicability of predictive models for determining pediatric sepsis mortality, especially in acute care and limited-resource settings.Data sourcesMortality prediction factors and models were searched in four databases using the following criteria: developed for pediatric health care, especially in acute settings, and with mortality as an outcome.Study selectionTwo or more reviewers performed the study selection to ensure no bias occurred. Any disagreements were solved by consensus or by the decision of a third reviewer.Data extractionThe authors extracted the results and mapped the selected studies qualitatively to describe the prognostic properties of the risk factors and models proposed in the study.Data synthesisThe final analysis included 28 mortality prediction models. Their characteristics, analysis, and performance measures were summarized. Performance was described in terms of calibration and discrimination, including assessing for risk of bias and applicability. A modified version of the PRISM-III score based on physiologic criteria (PRISM-III-APS) increased its predictive value to 0.85–0.95. The vasoactive-inotropic score at 12 h had a strong independent association with death. Albumin had an excellent predictive value when combined with other variables. Lactate, a biomarker widely measured in patients with sepsis, was highly associated with mortality. The bioimpedance phase angle was not considered applicable in our setting. Measurement using more straightforward methods, such as mid-upper arm circumference, was feasible in numerous health care facilities.ConclusionLeveraging prognostic models to predict mortality among pediatric patients with sepsis remains an important and well-recognized area of study. While much validation and development work remains to be done, available prognostic models could aid clinicians at the bedside of children with sepsis. Furthermore, mortality prediction models are essential and valuable tools for assessing the quality of care provided to critically ill pediatric patients.

Summary: Background: As novel therapeutic interventions are being developed and tested in the amyotrophic lateral sclerosis (ALS) population, there is a need to better understand the symptoms and issues that have the greatest impact on the lives of individuals with ALS. We aimed to determine the frequency and relative importance of symptoms experienced by adults in a national ALS sample and to identify factors that are associated with the greatest disease burden in this population. Methods: We conducted 15 qualitative interviews of individuals with varied ALS phenotypes and analyzed 732 quotes regarding the symptomatic disease burden of ALS between August 2018 and March 2019. We subsequently conducted a national, cross-sectional study of 497 participants with ALS and ALS variants through the Centers for Disease Control and Prevention's (CDC) National ALS Registry between July 2019 and December 2019. Participants reported on the prevalence and relative importance of 189 symptomatic questions representing 17 symptomatic themes that were previously identified through qualitative interviews. Analysis was performed to determine how age, sex, education, employment, time since onset of symptoms, location of symptom onset, feeding tube status, breathing status and speech status relate to symptom and symptomatic theme prevalence. Findings: Symptomatic themes with the highest prevalence in our sample were an inability to do activities (93.8%), fatigue (92.6%), problems with hands or fingers (87.7%), limitations with mobility or walking (86.7%), and a decreased performance in social situations (85.7%). Participants identified inability to do activities and limitations with mobility or walking as having the greatest overall effect on their lives. Interpretation: Individuals with ALS experience a variety of symptoms that affect their lives. The prevalence and importance of these symptoms differ among the ALS population. The most prevalent and important symptoms offer potential targets for improvements in future therapeutic interventions. Funding: Research funding was provided by ALS Association.