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Remote or online proctoring (invigilating) is a technology primarily used to improve the integrity of online examinations. The use of remote proctoring increased significantly as the world switched to online assessment during the COVID-19 pandemic. Remote proctoring received negative media attention, including concerns about user privacy, discrimination and the accuracy of automated systems for detecting and reporting cheating. However, it is unclear whether these media concerns fully reflect the experiences of students. Online assessment offers a number of potential advantages to learners and education providers, and it seems likely that it is here to stay. It is essential to fully understand the learner experience of remote proctoring, with a view to ensuring it is as effective as possible while meeting the needs of all stakeholders, especially those being proctored. We undertook a scoping review of research into the student experience of online proctoring, with a pragmatic focus, aimed at developing guidance for higher education providers, based on the student experience. We reviewed primary research studies which evaluated the student experience of the use of remote proctoring for summative assessment in Higher Education. We used the Education Research Information Center database (ERIC) and Google Scholar. 21 papers were identified, from which the positives and negatives of the student experience were extracted, along with the main recommendations from the research. These were then synthesised into a series of summary recommendations by thematic analysis, by a team of researchers that included students and academic staff. We found that student experience was largely negative, influenced by concerns over privacy, technological challenges, fairness and stress. Recommendations were to include the student voice in decisions about how and why to use remote proctoring and limiting the use of remote proctoring. Working with students as partners and limiting the use of remote proctoring where possible, are key to ensuring a positive student experience.

IntroductionHeart failure (HF) is a frequent cause of readmissions. Despite caring for underresourced patients and dependence on government funding, safety net hospitals frequently incur penalties for failing to meet pay-for-performance readmission metrics. Limited research exists on the causes of HF readmissions in safety net hospitals. Therefore, we sought to investigate predictors of 30-day all-cause readmission in HF patients in the safety net setting.MethodsWe performed a retrospective chart review of patients admitted for HF from October 2018 to April 2019. We extracted data on demographics and medical comorbidities and performed patient-specific review of social determinants and mental health in 4 domains: race/ethnicity, housing status, substance use, and mental illness. Multivariable Poisson regression modeling was employed to evaluate associations with 30-day all-cause readmission.ResultsThe study population included 290 patients, among whom the mean age was 59 years and 71% (n = 207) were male; 42% (120) were Black/African American (AA), 22% (64) were Hispanic/Latino, and 96% (278) had public insurance; 28% (79) were not housed, 19% (56) had a diagnosis of mental illness, and active substance use was common. The 30-day readmission rate was 25.5% (n = 88). Factors that were associated with increased risk of readmission included self-identifying as Black/AA (relative risk 2.28, 95% confidence interval 1.00-5.20) or Hispanic/Latino (2.53, 1.07-6.00), experiencing homelessness (2.07, 1.21-3.56), living in a shelter (3.20, 1.27-8.02), or intravenous drug use (IVDU) (2.00, 1.08-3.70).ConclusionRace/ethnicity, housing status, and substance use were associated with increased risk of 30-day all-cause readmission in HF patients in a safety net hospital. In contrast to prior studies, medical comorbidities were not associated with increased risk of readmission.

Although children display strong individual differences in emotion expression, they also engage in emotional synchrony or reciprocity with interaction partners. To understand this paradox between trait-like and dyadic influences, the goal of the current study was to investigate children's emotion expression using a Social Relations Model (SRM) approach. Playgroups consisting typically of four same-sex unfamiliar nine-year-old children (N = 202) interacted in a round-robin format (6 dyads per group). Each dyad completed two 5-minute tasks, a challenging frustration task and a cooperative planning task. Observers coded children's emotions during the tasks (happy, sad, angry, anxious, neutral) on a second-by-second basis. SRM analyses provided substantial evidence of both the trait-like nature of children's emotion expression (through significant effects for actor variance, multivariate actor-actor correlations, and multivariate intrapersonal correlations) and the dyadic nature of their emotion expression (through significant effects for partner variance, relationship variance, dyadic reciprocity correlations, and multivariate interpersonal correlations).

Rice cultivation is crucial in providing global food needs, particularly in highland areas with distinct environmental conditions. Adapting promising rice lines suitable for highland ecosystems is essential to ensure sustainable rice production in such regions. This study assesses the agronomic performance, heritability, and correlation of traits in new promising rice lines adapted to highland ecosystems. The latest promising rice lines are designed with the unique environmental conditions of highland regions in mind. This research was conducted in Buntu Barana’ Village, Tikala Sub-district, with an elevation of 858.4 m above sea level. The study was carried out in rain-fed semi-irrigated paddy fields. The research was conducted from May 2023 to January 2024. The research methodology involves testing various agronomic traits for yield production components of the new type of promising rice lines at different highland locations. The research procedures included the selection of viable seed strains, seeding, fertilization, balanced irrigation, control of plant pest organisms, harvesting, and post-harvesting. Evaluated agronomic traits encompass plant height, days to maturity, number of productive tillers, length of panicles, number of filled grains per panicle, and grain yield. Additionally, heritability analysis is performed to assess the extent to which observed trait variations are attributed to genetic factors. Research findings reveal significant variations in agronomic traits among the new type of promising rice lines. The highest grain yield is achieved in genotype UKIT102-2-056, which is 8.3 tons per hectare of paddy rice. These lines exhibit objective adaptation to the highland ecosystem, with some lines demonstrating superior performance in specific parameters, especially early maturity, namely 97 days after planting. Heritability analysis indicates that certain traits have high heritability levels, suggesting a significant role of genetic factors in controlling these traits. Furthermore, this study unveils correlation patterns among the observed agronomic traits. Significant positive and negative correlations among several traits indicate complex interrelationships among these agronomic characteristics. These findings offer further insights into the relationships between these traits and can be utilized to develop more adaptive rice lines in highland environments.

The integration of multidisciplinary tumor boards (MTBs) is fundamental in delivering state-of-the-art cancer treatment, facilitating collaborative diagnosis and management by a diverse team of specialists. Despite the clear benefits in personalized patient care and improved outcomes, the increasing burden on MTBs due to rising cancer incidence and financial constraints necessitates innovative solutions. The advent of artificial intelligence (AI) in the medical field offers a promising avenue to support clinical decision-making. This review explores the perspectives of clinicians dedicated to the care of cancer patients—surgeons, medical oncologists, and radiation oncologists—on the application of AI within MTBs. Additionally, it examines the role of AI across various clinical specialties involved in cancer diagnosis and treatment. By analyzing both the potential and the challenges, this study underscores how AI can enhance multidisciplinary discussions and optimize treatment plans. The findings highlight the transformative role that AI may play in refining oncology care and sustaining the efficacy of MTBs amidst growing clinical demands.

Sex-related differences in psychopharmacology present unique challenges in both clinical and research settings. Recognition of sex differences in psychopharmacological treatment has increased in recent years, but a significant research gap regarding variations between men and women still exists. Biological factors, including hormonal fluctuations, genetic factors, and brain structure differences, contribute significantly to differential drug responses. Moreover, social determinants can influence the differential burden of psychiatric disorders between the sexes and may impact treatment plans. Incorporating sex as a key variable in personalized treatment programs and plans holds the potential to optimize efficacy and minimize adverse effects in psychopharmacology. Sex-related challenges in psychopharmacology necessitate a nuanced approach to treatment. Further research is needed to fully understand these differences and to develop guidelines for personalized medication management. By addressing these challenges, clinicians can improve treatment outcomes and enhance the quality of life of patients with psychiatric disorders.

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.

Abstract Pervasive SARS-CoV-2 infections in humans have led to multiple transmission events to animals. While SARS-CoV-2 has a potential broad wildlife host range, most documented infections have been in captive animals and a single wildlife species, the white-tailed deer. The full extent of SARS-CoV-2 exposure among wildlife communities and the factors that influence wildlife transmission risk remain unknown. We sampled 23 species of wildlife for SARS-CoV-2 and examined the effects of urbanization and human use on seropositivity. Here, we document positive detections of SARS-CoV-2 RNA in six species, including the deer mouse, Virginia opossum, raccoon, groundhog, Eastern cottontail, and Eastern red bat between May 2022–September 2023 across Virginia and Washington, D.C., USA. In addition, we found that sites with high human activity had three times higher seroprevalence than low human-use areas. We obtained SARS-CoV-2 genomic sequences from nine individuals of six species which were assigned to seven Pango lineages of the Omicron variant. The close match to variants circulating in humans at the time suggests at least seven recent human-to-animal transmission events. Our data support that exposure to SARS-CoV-2 has been widespread in wildlife communities and suggests that areas with high human activity may serve as points of contact for cross-species transmission.

Abstract Background Mobile upright PET devices have the potential to enable previously impossible neuroimaging studies. Currently available options are imagers with deep brain coverage that severely limit head/body movements or imagers with upright/motion enabling properties that are limited to only covering the brain surface. Methods In this study, we test the feasibility of an upright, motion-compatible brain imager, our Ambulatory Motion-enabling Positron Emission Tomography (AMPET) helmet prototype, for use as a neuroscience tool by replicating a variant of a published PET/fMRI study of the neurocorrelates of human walking. We validate our AMPET prototype by conducting a walking movement paradigm to determine motion tolerance and assess for appropriate task related activity in motor-related brain regions. Human participants (n = 11 patients) performed a walking-in-place task with simultaneous AMPET imaging, receiving a bolus delivery of F18-Fluorodeoxyglucose. Results Here we validate three pre-determined measure criteria, including brain alignment motion artifact of less than

This paper presents advances in the data management strategy applied to 4D multimodal mechanics of material sample microstructures. Guidelines to build a data platform allowing for complex workflows, involving several high-throughput experimental and numerical techniques, and complying with FAIR data management principles, are discussed. Next, their implementation within the open-source Python package Pymicro is presented, offering a high-level interface to build complex datasets through multimodal methodologies. Its capability to enable and automate complex workflows by building a digital twin of a commercially pure titanium sample under tension are then demonstrated. The digital twin contains microstructural and mechanical data for thousands of grains gathered on the same sample through synchrotron DCT and in-situ SEM experiments, as well as full-field numerical simulation. Finally, a local and statistical comparison between simulation and measurements of plastic slip and crystal rotation in hundreds of grains is shown, as an example of the contribution of this platform to multimodal data convergence and its importance for the development of a new generation of material models.

The design of heliostats throughout a concentrated solar power (CSP) plant are currently of uniform design, however, research into the variation in heliostat wind loading within a radially staggered field array can provide insight into potential material cost savings in heliostat field design. Experimental investigation was carried out on a field array model in the University of Adelaide large wind tunnel. A total of 64 heliostat models of size 0.1 × 0.1 m were radially arranged over four surround rows. Four 3-axis load cells were utilized to analyze field array cases of morning (0700 hours), noon (1200 hours), and evening (1700 hours) configurations. Angle calculations for beam reflection were made for the 21st March (equinox). Results show mean and peak drag force coefficients reduce with distance into the field for a 1700 hour case due to high upstream blockage. Comparing the downstream drag and lift force coefficients against each test configuration, when heliostats are at steep elevation angles, high flow blockage leads to a reduction of coefficients downstream (0700 hour and 1700 hour cases). When elevation angles are reduced (1200 hours), drag and lift coefficients increase with distance from the central tower in the downstream direction. Results also show the central tower increases load coefficients on downstream heliostats, and therefore should be considered in heliostat wind loading and field design.

Objective: To compare the prevalence of postpartum depression (PPD) symptoms between high-income countries (HIC) and low- and middle-income countries (LMIC) during the COVID-19 pandemic. Methods: The PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO, and CINAHL databases were searched until October 2022 for studies that collected data during the pandemic. The metaprop command was used in the Stata statistical software version 12.0 to run a random-effects meta-analysis. Results: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of PPD symptoms was 31% (95%CI 21.85-40.99). The pooled prevalence of PPD symptoms among women from HIC (30.5% [95%CI 16.95-46.02]) did not differ significantly from that of women from LMIC (31.5% [95%CI 19.26-45.15]). However, studies that analyzed women up to 1 month after childbirth reported a lower prevalence of PPD symptoms (17.5% [95%CI 9.85-26.62]) compared to those that observed them up to 1 year after childbirth (38.3% [95%CI 33.96-42.83]). Conclusions: The prevalence of PPD symptoms was high across countries, regardless of human development index. This condition must be regularly tracked worldwide to assess, discuss, and recommend more assertive steps that may be implemented to address it based on the particular characteristics of each country. Registration number: PROSPERO CRD42022346861.

Background: After an initial Takotsubo syndrome (TTS) event, there is growing recognition of adverse long-term outcomes, including recurrent TTS events. Recurrent events have been incompletely evaluated. Objectives: The objective of this study was to characterize recurrent TTS events and evaluate variables associated with recurrence. Methods: We studied 88 consecutive participants in the Cedars-Sinai Smidt Heart Institute Takotsubo Registry, an observational registry collecting retrospective and prospective data in TTS survivors. Detailed medical records are adjudicated. Standardized psychosocial questionnaires are administered remotely. Results: Of 88 participants with adjudicated TTS, 15 (17%) experienced at least 1 recurrent TTS event (median 3.30 years to first recurrent event, range 0.13-18.56 years). In 9 of these 15 participants, there were different patterns of wall motion abnormalities observed between events. The recurrence-free survival significantly differed based on the pattern of wall motion abnormalities at the index TTS event. Clinical, electrocardiographic, echocardiographic, and invasive data obtained at the index TTS event were similar between participants who went on to have at least 1 recurrent event and those who did not. Conclusions: Recurrent TTS episodes occurred in a significant proportion of cases, a median of 3.30 years after the index event. The recurrent episodes often had distinct triggers and different wall motion abnormalities compared to the index event. The wall motion pattern at the index event impacted the recurrence-free survival, though confirmatory studies are needed. TTS participants had a high rate of adverse psychosocial stress characteristics based on detailed questionnaires. (The Cedars-Sinai Smidt Heart Institute Takotsubo Registry & Proteomic Study; NCT03910569)

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

ObjectivesABRUPT was a prospective, noninterventional, observational study of resuscitation practices at 21 burn centers. The primary goal was to examine burn resuscitation with albumin or crystalloids alone, to design a future prospective randomized trial.Summary background dataNo modern prospective study has determined whether to use colloids or crystalloids for acute burn resuscitation.MethodsPatients ≥18 years with burns ≥ 20% total body surface area (TBSA) had hourly documentation of resuscitation parameters for 48 hours. Patients received either crystalloids alone or had albumin supplemented to crystalloid based on center protocols.ResultsOf 379 enrollees, two-thirds (253) were resuscitated with albumin and one-third (126) were resuscitated with crystalloid alone. Albumin patients received more total fluid than Crystalloid patients (5.2 ± 2.3 vs 3.7 ± 1.7 mL/kg/% TBSA burn/24 hours), but patients in the Albumin Group were older, had larger burns, higher admission Sequential Organ Failure Assessment (SOFA) scores, and more inhalation injury. Albumin lowered the in-to-out (I/O) ratio and was started ≤12 hours in patients with the highest initial fluid requirements, given >12 hours with intermediate requirements, and avoided in patients who responded to crystalloid alone.ConclusionsAlbumin use is associated with older age, larger and deeper burns, and more severe organ dysfunction at presentation. Albumin supplementation is started when initial crystalloid rates are above expected targets and improves the I/O ratio. The fluid received in the first 24 hours was at or above the Parkland Formula estimate.