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Objective: To analyze duties, tasks, and task elements of health workers in charge of vaccination at public health centers in South Korea. Design: Descriptive study using a survey. Sample: Health workers in charge of vaccination for more than 1 year at 254 public health centers in South Korea. Of 631 health workers, 401 responded to the questionnaire, and 379 responses were included in the analysis after excluding 22 incomplete responses. Measurements: The Developing A Curriculum (DACUM) workshop was conducted to identify the frequency, importance, and difficulty of duties, tasks, and task elements. Results: Four duties (vaccination promotion, vaccination administration and symptom management, execution of vaccination, and vaccination education), 18 tasks, and 81 task elements were identified. "Execution of vaccination" exhibited the highest determinant coefficient. "Implementing the budget" exhibited the highest determinant coefficient among tasks, and "dealing with an emergency in the case of adverse events" exhibited the highest determinant coefficient among task elements. Conclusions: Duty, task, and task elements with high determinant coefficients have high educational needs. Education demands was higher for administrative work than for direct vaccination. Developing an educational curriculum based on DACUM results could contribute to the professional education of vaccine workers. [ABSTRACT FROM AUTHOR]

Delpazolid (LCB01‐0371) is a novel oxazolidinone derivative with a good safety profile for treating gram‐positive pathogenic infections such as Mycobacterium abscessus, a highly pathogenic drug‐resistant Mycobacterium. In this study, we evaluated the pharmacokinetics (PK) and pharmacodynamics (PD) of delpazolid after 14 days of multiple oral administration, using data from adult patients with pulmonary tuberculosis. 800 mg once a day, 400 mg twice a day, 800 mg twice a day, and 1200 mg once a day delpazolid for 14 days were tested in 63 patients with pulmonary tuberculosis. For PK blood collection, inpatient and outpatient scheduling were separately implemented. Plasma concentrations of delpazolid were measured at visits 2, 4, 6, and 8 in outpatients, and four sparse blood samples were measured in inpatients. PD models were sequentially fitted using individual PK parameter estimates obtained from PK compartmental models. For PK modeling, 180 plasma concentrations of delpazolid from 56 patients were included. A two‐compartment mixed first‐ and zero‐order absorption model best described the time course of plasma concentration. For the PD model, 448 bacterial titer data from 60 patients were used. The time course of bacterial titers (log10 CFU/mL) was described by a model that consists of the growth and killing rate of bacteria with the sigmoid Emax model. The PK–PD simulation suggested that the bacterial titers are the lowest on the 800 mg bid regimen among the four, consistent with observed data, as all regimens substantially decrease. In the dose–response relationship, the effectiveness of delpazolid was suggested. [ABSTRACT FROM AUTHOR]

BACKGROUND: The US Department of Agriculture's (USDA) summer meal programs are designed to provide meals at no cost while school is out of session. In response to the COVID‐19 pandemic, several regulatory waivers were enacted to facilitate meal distribution. The aim of this study was to assess the rates of meal distribution before and after these waivers were in effect. METHODS: Meal distribution patterns for 2019, 2020, and 2021 were examined through (1) a descriptive comparison of the number of participating districts, sponsors, meal sites, and meals distributed statewide, and (2) repeated measures ANOVAs to examine changes among districts in operation all years. RESULTS: The waivers were associated with an increase in the total number of participating districts, sponsors, and meal sites; an increase in the total number of meals distributed to children during the summer months; and an increase in meal distribution among sponsors that had been in place since 2019. Conclusion: Expanding the area eligibility criteria and enabling flexibility in meal distribution methods increased the number of meals provided. This study provides important preliminary evidence to suggest that the USDA should consider permanent regulatory changes to this program to maximize its reach. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate the impact of intratumoral metabolic heterogeneity and quantitative 18F‐FDG PET/CT imaging parameters in predicting patient outcomes in thymic epithelial tumors (TETs). Methods: This retrospective study included 100 patients diagnosed with TETs who underwent pretreatment 18F‐FDG PET/CT. The maximum and mean standardized uptake values (SUVmax and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on PET/CT were measured. Heterogeneity index‐1 (HI‐1; standard deviation [SD] divided by SUVmean) and heterogeneity index‐2 (HI‐2; linear regression slopes of the MTV according with different SUV thresholds), were evaluated as heterogeneity indices. Associations between these parameters and patient survival outcomes were analyzed. Results: The univariate analysis showed that Masaoka stage, TNM stage, WHO classification, SUVmax, SUVmean, TLG, and HI‐1 were significant prognostic factors for progression‐free survival (PFS), while MTV, HI‐2, age, gender, presence of myasthenia gravis, and maximum tumor diameter were not. Subsequently, multivariate analyses showed that HI‐1 (p < 0.001) and TNM stage (p = 0.002) were independent prognostic factors for PFS. For the overall survival analysis, TNM stage, WHO classification, SUVmax, and HI‐1 were significant prognostic factors in the univariate analysis, while TNM stage remained an independent prognostic factor in multivariate analyses (p = 0.024). The Kaplan Meier survival analyses showed worse prognoses for patients with TNM stages III and IV and HI‐1 ≥ 0.16 compared to those with stages I and II and HI‐1 < 0.16 (log‐rank p < 0.001). Conclusion: HI‐1 and TNM stage were independent prognostic factors for progression‐free survival in TETs. HI‐1 generated from baseline 18F‐FDG PET/CT might be promising to identify patients with poor prognosis. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the systematic review is to verify the presence of PANoptosis in periodontitis based on the published literatures studying cell death in periodontitis. Materials and Methods: We conducted a comprehensive review of literature studying the types of cell death in vitro cellular experiments, in vivo rodent studies and clinical studies from three major databases: PubMed, Scopus, and Web of Science. The present systematic review was recorded in the PROSPERO database, under registration number CRD42022383456. Results: In total, 51 articles were included in this study. Our analysis of in vitro cell models revealed that pyroptosis, necroptosis, and apoptosis could be induced by periodontal pathogens in macrophages, fibroblasts, stem cells, and periodontal ligament cells. Furthermore, three types of cell death were detected in in vivo rodent periodontitis models. Clinical studies on human periodontitis tissue specimens and gingival crevicular fluid (GCF) showed that some key proteins related to pyroptosis, necroptosis, and apoptosis were elevated in periodontitis. Conclusions: Various studies have established similar in vivo and in vitro models with three modes of death detected under the same conditions, revealing complex interactions between different types of cell death pathways in periodontitis and the potential for PANoptosis to occur in periodontitis. [ABSTRACT FROM AUTHOR]

Objective: Idiopathic gingival fibromatosis (IGF) is a rare heterogeneous disease that results in the progressive and diffuse hyperplasia of gingival tissues. MicroRNAs are implicated in the development and progression of various tumors. The present study aimed to explore the potential roles and mechanisms of miR‐148a‐3p in IGF. Methods: Gingival fibroblasts (GFs) were transfected with miR‐148a‐3p mimics, miR‐148a‐3p inhibitors, or siNPTX1, and then, the proliferation and apoptosis of GFs and the expression of related genes were evaluated using Cell Counting Kit‐8 assays, 5‐ethynyl‐2′‐deoxyuridine assays, flow cytometry, reverse transcription‐quantitative polymerase chain reaction, and western blot analysis, respectively. Results: miR‐148a‐3p was highly expressed in GFs of IGF (IGF‐GFs) as compared with normal GFs (N‐GFs). Overexpression of miR‐148a‐3p promoted the proliferation and inhibited the apoptosis of N‐GFs, whereas downregulation of miR‐148a‐3p had the opposite effect in IGF‐GFs. Knockdown of NPTX1 reversed miR‐148a‐3p‐mediated effects in IGF‐GFs. Dual‐luciferase reporter assay confirmed that NPTX1 is a direct target of miR‐148a‐3p. Conclusion: These findings identify that miR‐148a‐3p could regulate cell proliferation and apoptosis by targeting NPTX1, providing new insights for the further study of the molecular mechanism and treatment of IGF. [ABSTRACT FROM AUTHOR]

Background: Students who are blind are integrated into public schools in many countries, yet are often excluded from full participation in science since most learning materials are visual. To create a compensatory route, an existing model‐based inquiry‐learning environment was adapted by means of sonification (addition of non‐speech sounds that represent dynamic information). The learning environment uses agent‐based models and a complex systems approach to teach the Kinetic Molecular Theory (KMT) and Gas Laws. The models are accompanied by a workbook consisting of text (printed or auditory) and images (printed or tactile). Objectives: The current research examined whether such perceptual compensation creates a comparable learning environment for learners who are blind compared with learners who are sighted using the original learning environment. The aim of the study is to expand knowledge about how the auditory channel may compensate the visual channel among individuals who are blind. Methods: Conceptual learning in science and reasoning about complex systems were assessed using pre‐ and post‐questionnaires. To explore learners' learning progression throughout the unit, four progression analysis 'windows' were selected. These were groups of adjacent or nearly adjacent items in the workbook that permitted a glimpse of learners' progression. Results: The sonified environment not only supported the learning of learners who are blind compared with the learning of learners who are sighted using visual material, but even furthered their learning with respect to diffusion, one of the more challenging concepts in KMT. It seems the types of sonified representations used in this study increased listeners' sensitivity to the micro‐level interactions in a way less accessible in visual representations. Takeaways: Sonified environments can be provide learners who are blind with equitable participation by compensating and complementing the visual channel. Sonification can have implications for students who are blind as well as students who are sighted. Lay Description: What is already known: Sonification is the use of non‐speech sounds to represent dynamic information. Sonification can potentialy be used to allow equitable participation for students who are blind. What this paper adds: To test this, the study compared the outcomes of learners who are blind who used a sonified learning environment (L2C) to that of learners who are sighted who used a visual environment. Implications for practice: Learners who are blind showed equal or better learning outcomes using the sonified models compared with the learners who are sighted using the visual models. There are major implications for integrating students who are blind in public school classrooms. [ABSTRACT FROM AUTHOR]

Background: The clinical staging of non‐small cell lung cancer (NSCLC) is well known to be related to their prognosis. However, there is usually a discrepancy between clinical staging and pathological staging. There are few analyses of clinical staging accuracy in patients with NSCLC. We compared the concordance rate between clinical and pathological staging of NSCLC and evaluated factors affecting the accuracy in real‐world data. Methods: Altogether, 811 patients with primary NSCLC who had undergone curative lung resection surgery in Severance Hospital from January 2019 to December 2020 were retrospectively reviewed. We used the eighth edition of the American Joint Committee on Cancer TNM staging. Results: Among 811 patients, endobronchial ultrasound (EBUS) and positron emission tomography (PET‐CT) were performed in 31.6% and 96.7%, respectively. The concordance rates between clinical and pathological TNM staging, T factor, and N factor, were 68.7%, 77.7%, and 85.8%, respectively. With multivariable logistic regression analysis, current smokers (OR 0.49; 95% CI: 0.32–0.76, p = 0.001) and a higher clinical stage (p < 0.001) contributed to the clinical staging inaccuracy. Additionally, the presence of a bronchoscopy specialist was significantly associated with clinical staging accuracy (OR 1.53; 95% CI: 1.10–2.13, p = 0.011). Conclusion: Clinical staging accuracy in NSCLC improved compared to before the widespread use of PET‐CT and EBUS in clinical staging work‐up. Smoking history and absence of expert bronchoscopy specialists showed a meaningful correlation with the inaccuracy of clinical staging. Thus, training more bronchoscopy experts would improve the staging accuracy of NSCLC, which could positively affect the prognosis of NSCLC. [ABSTRACT FROM AUTHOR]

Eschar dermabrasion is an easy, cost‐effective and dependable technique for debriding deep partial‐thickness burn wounds, highly suitable for paediatric scalds. Postoperative dressing plays a crucial role in the subsequent healing process. While allogenic skin (AGS) has long been considered as the optimal coverage for abraded burn wounds by Chinese burn specialists, its clinical application on children has encountered challenges. In recent years, our department has observed promising results in the application of bacterial cellulose dressing on paediatric burn wounds after dermabrasion surgery. This study aimed to retrospectively review qualified cases from the past 5 years and categorize them into two groups: 201 cases in the AGS group and 116 cases in the bacterial cellulose dressing (BCD) group. Upon statistical analysis, no differences were oberved between the groups in terms of demographic information and wound characteristics. However, the BCD group had a significantly longer surgery time (44.3 ± 7.0 min vs. 31.5 ± 6.1 min, p < 0.01) and shorter healing time (19.6 ± 2.2 days vs. 24.4 ± 4.3 days, p < 0.01) compared to the AGS group. Moreover, the BCD group required fewer dressing changes (3.5 ± 0.8 vs. 6.7 ± 2.1, p < 0.01) and demonstrated lower rates of skin grafting (10/116 vs. 46/201, p = 0.036). In conclusion, our findings suggest that the bacterial cellulose material may serve as an optimal coverage option for paediatric abraded scald wounds. [ABSTRACT FROM AUTHOR]

Background: Radiomics is increasingly utilized to distinguish pulmonary nodules between lung adenocarcinoma (LUAD) and tuberculosis (TB). However, it remains unclear whether different segmentation criteria, such as the inclusion or exclusion of the cavity region within nodules, affect the results. Methods: A total of 525 patients from two medical centers were retrospectively enrolled. The radiomics features were extracted according to two regions of interest (ROI) segmentation criteria. Multiple logistic regression models were trained to predict the pathology: (1) The clinical model relied on clinical‐radiological semantic features; (2) The radiomics models (radiomics+ and radiomics−) utilized radiomics features from different ROIs (including or excluding cavities); (3) the composite models (composite+ and composite−) incorporated both above. Results: In the testing set, the radiomics+/− models and the composite+/− models still possessed efficient prediction performance (AUC ≥ 0.94), while the AUC of the clinical model was 0.881. In the validation set, the AUC of the clinical model was only 0.717, while that of the radiomics+/− models and the composite+/− models ranged from 0.801 to 0.825. The prediction performance of all the radiomics+/− and composite+/− models were significantly superior to that of the clinical model (p < 0.05). Whether the ROI segmentation included or excluded the cavity had no significant effect on these models (radiomics+ vs. radiomics−, composite+ model vs. composite−) (p > 0.05). Conclusions: The present study established a machine learning‐based radiomics strategy for differentiating LUAD from TB lesions. The ROI segmentation including or excluding the cavity region may exert no significant effect on the predictive ability. [ABSTRACT FROM AUTHOR]

This study systematically evaluates the efficacy of autologous platelet‐rich plasma (PRP) combined with negative pressure sealing drainage (NPSD) in the treatment of diabetic foot ulcers (DFU). A comprehensive computerized search was conducted in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for randomized controlled trials (RCTs), from database inception to November 2023, on the treatment of DFU using autologous PRP combined with NPSD. Two researchers independently screened the literature, extracted data, and conducted quality assessments based on inclusion and exclusion criteria. Data analysis was performed using RevMan 5.4 software. A total of 17 RCTs involving 1325 DFU patients were included. The analysis revealed that the application of autologous PRP combined with NPSD in DFU patients significantly increased the ulcer healing rate (OR = 3.54, 95% CI: 2.71–4.62, p < 0.001) and the overall treatment efficacy rate (OR = 4.99, 95% CI: 3.46–7.19, p < 0.001), and significantly reduced the wound healing time (SMD = −2.05, 95% CI: −2.61 to −1.49, p < 0.001). This study indicates that the treatment of DFU with autologous PRP combined with NPSD accelerates wound healing, improves the overall treatment efficacy rate, and offers a new option for the management of DFU. [ABSTRACT FROM AUTHOR]

It is difficult to avoid deep surgical site infection after spinal surgery. Debridement combined with closed suction irrigation (CSI) and other treatment methods lead to greater trauma and lower satisfaction. We developed a new method for the treatment of SSI, which has the advantages of less invasiveness and lower cost. The cohort of this retrospective study comprised 26 patients with SSI after undergoing spinal surgery in our hospital from August 2017 to March 2022. The patients were divided into CSI and microtube drainage group according to treatment methods. The durations of antibiotic use and hospital stay, hospitalization costs, and functional scores during follow‐up were compared between the two groups. The only baseline characteristic that differed between the two groups was sex. Infection was controlled in both groups and there were no recurrences during follow‐up. However, the length of hospital stay after the first operation and the total length of stay were significantly greater in the CSI group. Hospitalization costs and antibiotic costs were significantly higher in the CSI group. Additionally, the duration of intravenous antibiotic use was significantly longer in the CSI group. Both the CSI and microtube drainage groups had significantly improved of Short Form Health Survey (SF‐36) scores 6 months postoperatively. However, 3 months postoperatively, SF‐36 scores were significantly lower in the CSI group. Compared with debridement followed by CSI, percutaneous micro‐drainage tube irrigation combined with high negative pressure tube drainage is a more efficient and economical means of treating SSI after spinal surgery. [ABSTRACT FROM AUTHOR]

Objective: Emerging evidence suggests that meeting the 24‐h movement guidelines is associated with optimal mental health. However, there remains some uncertainty regarding this association in children. Therefore, this study aimed to examine the association between meeting the 24‐h movement guidelines and psychosocial health in children. Methods: A cross‐sectional study design was employed to investigate 2005 children aged 9–12 years from four districts of Shanghai, China. The 24‐h movement behaviours were assessed using selected items from the Health Behaviour in School‐aged Children (HBSC) survey questionnaire. Children's self‐rated psychosocial health was evaluated using the Strengths or Difficulties Questionnaire (SDQ). Generalised Linear Models with the ordinal logistic module were employed to analyse the association between meeting the 24‐h movement guidelines and psychosocial health. Results: The overall prevalence of meeting all three 24‐h movement recommendations was 10.2%. Among children, 7.9% of them exhibited abnormal total difficulties, with a notable difference between sex (boys: 11.2%, girls: 7.0%, p = 0.001). Meeting all three 24‐h movement behaviour recommendations was associated with reduced total difficulties, emotional symptoms, conduct problems, hyperactivity and peer problems. Furthermore, a dose–response association was observed, indicating that meeting a greater number of 24‐h movement behaviour recommendations was associated with enhanced psychosocial health, particularly in boys. Conclusion: The findings of this study highlight the positive association between meeting the 24‐h movement guidelines and psychosocial health in children. Notably, meeting more of these recommendations was associated with a lower likelihood of experiencing psychosocial problems, with greater benefits observed in boys compared with girls. [ABSTRACT FROM AUTHOR]

This meta‐analysis evaluates the impact of topical ketorolac on surgical site wound healing and scar formation after cataract surgery. A thorough literature search, adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, identified eight relevant studies from 2348 articles. The selected studies were analysed for wound healing efficacy, using the redness, edema, ecchymosis, discharge and approximation (REEDA) scale, and scar formation, assessed by the Manchester scar scale (MSS). Results indicated that ketorolac significantly improved wound healing, with lower REEDA scores 1 week post‐surgery (I2 = 97%; Random: standardised mean difference (SMD): −10.93, 95% CI: −13.85 to −8.00, p < 0.01), and reduced scar formation, evidenced by lower MSS scores 3 months post‐surgery (I2 = 74%; Random: SMD: −9.67, 95% CI: −11.03 to −8.30, p < 0.01). The findings suggest that topical ketorolac is beneficial in post‐cataract surgery care, enhancing wound healing and reducing scarring. [ABSTRACT FROM AUTHOR]

Objective: Fibroblast‐like synoviocytes (FLSs) contribute to inflammation and joint damage in rheumatoid arthritis (RA). However, the regulatory mechanisms of FLSs in relapse and remission of RA remain unknown. Identifying FLS heterogeneity and their underlying pathogenic roles may lead to discovering novel disease‐modifying antirheumatic drugs. Methods: Combining single‐cell RNA sequencing (scRNA‐seq) and spatial transcriptomics, we sequenced six matched synovial tissue samples from three patients with relapse RA and three patients in remission. We analyzed the differences in the transcriptomes of the FLS subsets between the relapse and remitted phases. We validated several key signaling pathways using quantitative real‐time PCR (qPCR) and multiplex immunohistochemistry (mIHC). We further targeted the critical signals in vitro and in vivo using the collagen‐induced arthritis (CIA) model in rats. Results: Lining and sublining FLS subsets were identified using scRNA‐seq. Differential analyses indicated that the fibroblast growth factor (FGF) pathway was highly activated in the lining FLSs from patients with relapse RA for which mIHC confirmed the increased expression of FGF10. Although the type I interferon pathway was also activated in the lining FLSs, in vitro stimulation experiment suggested that it was independent of the FGF10 pathway. FGF10 knockdown by small interfering RNA in FLSs significantly reduced the expression of receptor activator of NF‐κB ligand. Moreover, recombinant FGF10 protein enhanced bone erosion in the primary human‐derived pannus cell culture, whereas the FGF receptor (FGFR) 1 inhibitor attenuated this process. Finally, administering an FGFR1 inhibitor displayed a therapeutic effect in a CIA rat model. Conclusion: The FGF pathway is a critical signaling pathway in relapse RA. Targeted tissue‐specific inhibition of FGF10/FGFR1 may provide new opportunities to treat patients with relapse RA. [ABSTRACT FROM AUTHOR]

The study investigated the influence of the humanistic orientation on the perspectives of service providers working with individuals with intellectual and developmental disabilities (IDD) and the self‐evaluation of service users. The humanistic orientation, which emerged in the 1990s, emphasizes the rights of people with IDD to lead a meaningful life based on their personal needs and desires. However, challenges persist as some service providers prioritize the acquisition of normative life skills over fostering autonomy. The study was based on quantitative methodology and included 61 service providers and 95 of their service users. The study's findings indicate that the humanistic orientation was endorsed by nearly one half of the service providers compared with one third who endorsed a medical orientation. Those endorsing a humanistic orientation also reported that their service users had higher levels of efficacy than those with a medical perception of IDD. Positive correlations were found regarding the assessments made by service providers and their service users on self‐efficacy. Findings suggest that a humanistic orientation encourages optimism among service providers and a positive dyadic interaction between providers and users. It is suggested that the humanistic orientation be applied as a guiding principle underlying the daily support provided to adults with IDD. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy‐induced esophagitis (RE) diminishes the quality of life and interrupts treatment in patients with non‐small cell lung cancer (NSCLC) undergoing postoperative radiotherapy. Dosimetric models showed limited capability in predicting RE. We aimed to develop dosiomic models to predict RE. Methods: Models were trained with a real‐world cohort and validated with PORT‐C randomized controlled trial cohort. Patients with NSCLC undergoing resection followed by postoperative radiotherapy between 2004 and 2015 were enrolled. The endpoint was grade ≥2 RE. Esophageal three‐dimensional dose distribution features were extracted using handcrafted and convolutional neural network (CNN) methods, screened using an entropy‐based method, and selected using minimum redundancy and maximum relevance. Prediction models were built using logistic regression. The areas under the receiver operating characteristic curve (AUC) and precision‐recall curve were used to evaluate prediction model performance. A dosimetric model was built for comparison. Results: A total of 190 and 103 patients were enrolled in the training and validation sets, respectively. Using handcrafted and CNN methods, 107 and 4096 features were derived, respectively. Three handcrafted, four CNN‐extracted and three dosimetric features were selected. AUCs of training and validation sets were 0.737 and 0.655 for the dosimetric features, 0.730 and 0.724 for handcrafted features, and 0.812 and 0.785 for CNN‐extracted features, respectively. Precision‐recall curves revealed that CNN‐extracted features outperformed dosimetric and handcrafted features. Conclusions: Prediction models may identify patients at high risk of developing RE. Dosiomic models outperformed the dosimetric‐feature model in predicting RE. CNN‐extracted features were more predictive but less interpretable than handcrafted features. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic, and the response of governments to mitigate the pandemic's spread, resulted in exceptional circumstances that comprised a major global stressor, with broad implications for mental health. We aimed to delineate anxiety trajectories over three time‐points in the first 6 months of the pandemic and identify baseline risk and resilience factors that predicted anxiety trajectories. Within weeks of the pandemic onset, we established a website (covid19resilience.org), and enrolled 1362 participants (n = 1064 from US; n = 222 from Israel) who provided longitudinal data between April–September 2020. We used latent growth mixture modelling to identify anxiety trajectories and ran multivariate regression models to compare characteristics between trajectory classes. A four‐class model best fit the data, including a resilient trajectory (stable low anxiety) the most common (n = 961, 75.08%), and chronic anxiety (n = 149, 11.64%), recovery (n = 96, 7.50%) and delayed anxiety (n = 74, 5.78%) trajectories. Resilient participants were older, not living alone, with higher income, more education, and reported fewer COVID‐19 worries and better sleep quality. Higher resilience factors' scores, specifically greater emotion regulation and lower conflict relationships, also uniquely distinguished the resilient trajectory. Results are consistent with the pre‐pandemic resilience literature suggesting that most individuals show stable mental health in the face of stressful events. Findings can inform preventative interventions for improved mental health. [ABSTRACT FROM AUTHOR]

The ability of knowledge, attitude, and practice of intensive care unit (ICU) nurses to perform medical device‐related pressure injuries (MDRPIs) can affect the incidence of MDRPI in ICU patients. Therefore, in order to improve ICU nurses' understanding and nursing ability of MDRPIs, we investigated the non‐linear relationship (synergistic and superimposed relationships) between the factors influencing ICU nurses' ability of knowledge, attitude, and practice. A Clinical Nurses' Knowledge, Attitude, and Practice Questionnaire for the Prevention of MDRPI in Critically Ill Patients was administered to 322 ICU nurses from tertiary hospitals in China from January 1, 2022 to June 31, 2022. After the questionnaire was distributed, the data were collected and sorted out, and the corresponding statistical analysis and modelling software was used to analyse the data. IBM SPSS 25.0 software was used to conduct Single factor analysis and Logistic regression analysis on the data, so as to screen the statistically significant influencing factors. IBM SPSS Modeler18.0 software was used to construct a decision tree model of the factors influencing MDRPI knowledge, attitude, and practice of ICU nurses, and ROC curves were plotted to analyse the accuracy of the model. The results showed that the overall passing rate of ICU nurses' knowledge, attitude, and practice score was 72%. The statistically significant predictor variables ranked in importance were education background (0.35), training (0.31), years of working (0.24), and professional title (0.10). AUC = 0.718, model prediction performance is good. There is a synergistic and superimposed relationship between high education background, attended training, high years of working and high professional title. Nurses with the above factors have strong MDRPI knowledge, attitude, and practice ability. Therefore, nursing managers can develop a reasonable and effective scheduling system and MDRPI training program based on the study results. The ultimate goal is to improve the ability of ICU nurses to know and act on MDRPI and to reduce the incidence of MDRPI in ICU patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role of interleukin‐23 (IL‐23) in pathologic bone remodeling in inflammatory arthritis. Methods: In this study we investigated the role of IL‐23 in osteoclast differentiation and activation using in vivo gene transfer techniques in wild‐type and myeloid DNAX‐activation protein 12–associating lectin‐1 (MDL‐1)–deficient mice, and by performing in vitro and in vivo osteoclastogenesis assays using spectral flow cytometry, micro–computed tomography analysis, Western blotting, and immunoprecipitation. Results: Herein, we show that IL‐23 induces the expansion of a myeloid osteoclast precursor population and supports osteoclastogenesis and bone resorption in inflammatory arthritis. Genetic ablation of C‐type lectin domain family member 5A, also known as MDL‐1, prevents the induction of osteoclast precursors by IL‐23 that is associated with bone destruction, as commonly observed in inflammatory arthritis. Moreover, osteoclasts derived from the bone marrow of MDL‐1–deficient mice showed impaired osteoclastogenesis, and MDL‐1−/− mice had increased bone mineral density. Conclusion: Our data show that IL‐23 signaling regulates the availability of osteoclast precursors in inflammatory arthritis that could be effectively targeted for the treatment of inflammatory bone loss in inflammatory arthritis. [ABSTRACT FROM AUTHOR]

Aim: To quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system and compare them with healthcare costs in the general population. Design: Retrospective cohort study. Setting: Inpatient and outpatient care settings of Israel's largest public healthcare provider (that covers 4.7 million members). Participants: Participants included 1173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. Measurements: The main outcome was monthly healthcare costs. Findings The mean monthly healthcare cost of members with opioid use disorder was $1102 compared with $211 among controls (5.2‐fold difference; 95% CI, 4.6–6.0). After excluding members with heroin related diagnoses before the index date (to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6‐fold; 95% CI, 3.9–5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1‐fold (95% CI, 5.2–7.1), whereas those 65 years and older experienced cost difference of 3.4‐fold (95% CI, 2.6–4.5), compared with controls. The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7‐fold (95%CI, 7.2–10.4) greater than among controls. Conclusions: Healthcare costs among individuals with opioid use disorder in Israel's public health system are substantially higher than among controls, at least partially attributable to prescription opioid use disorder. Differences are greater among individuals under 65 years. [ABSTRACT FROM AUTHOR]

Aim: To estimate the incidence and identify risk factors of postpartum hemorrhage (PPH) after vaginal delivery. Methods: A systematic review and meta‐analysis was conducted. PubMed, Cochrane Library, CINAHL, Web of Science, EMBASE, and ClinicalTrials.gov databases were systematically searched from inception to April 30th, 2022. Cross‐sectional, cohort, case–control, and secondary analysis of randomized controlled studies that reported the incidence of PPH and the related risk factors in vaginal delivery were eligible through screening of 2343 articles. The incidence, associated standard error, adjusted odds ratios, relative risks and associated 95% confidence intervals were combined in the meta‐analysis. Results: Thirty‐six articles were included in the descriptive review. The incidence of PPH (blood loss ≥500 mL and blood loss ≥1000 mL) was 17% and 6%, respectively. Forty‐one identified risk factors were divided into five categories under two criteria: history and demographics; maternal comorbidity; pregnancy‐related factors; labor‐related factors; delivery‐related factors. Conclusions: With the increasing incidence of PPH globally, obstetric health care providers need to improve their awareness of these multi‐factorial risks to optimize obstetric care and reduce maternal morbidity. This systematic review and meta‐analysis have raised important questions about the nature of vaginal delivery, such as the duration of prolonged labor, details on the use of oxytocin, and the presence of genital tract trauma. There should be highlighted by obstetric personnel on these factors during a patients' labor process. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the response prediction and prognostic values of different peripheral blood cell biomarkers for advanced lung adenocarcinoma (LUAD) patients receiving first‐line therapy. Methods: Patients diagnosed with advanced LUAD as well as healthy controls and patients with benign pulmonary diseases were collected in this retrospective study. Propensity score matching (PSM) was performed in a 1:1 ratio. Survival state was estimated by the Kaplan–Meier method and the Cox proportional hazard model was used to assess the prognostic factors. Results: Compared with the control groups, the level of peripheral blood leucocyte, neutrophil, monocyte, platelet, and neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, platelet to lymphocyte ratio, and systemic inflammation response index (SIRI) were higher in LUAD patients (all p < 0.001). Some inflammatory markers decreased at the time of optimal response and then increased again as the disease progressed. Multivariate analysis revealed that SIRI and lactate dehydrogenase (LDH) were independent prognostic factors no matter before or after PSM analysis. Area under the curve (AUC) of SIRI and LDH were 0.625 (p < 0.001) and 0.596 (p = 0.008), respectively. When SIRI and LDH were combined, the AUC reached 0.649 (p < 0.001). Conclusions: Pretreatment SIRI was an independent prognostic factor of progression free survival (PFS) in advanced LUAD patients. Dynamic monitoring of inflammatory index changes could help to predict therapeutic efficacy. The combination of SIRI and LDH is expected to be a promising clinically accessible biomarker in the future. [ABSTRACT FROM AUTHOR]

This study aimed to develop and evaluate a population pharmacokinetic (PPK) combined machine learning approach to predict tacrolimus trough concentrations for Chinese adult liver transplant recipients in the early posttransplant period. Tacrolimus trough concentrations were retrospectively collected from routine monitoring records of liver transplant recipients and divided into the training data set (1287 concentrations in 145 recipients) and the test data set (296 concentrations in 36 recipients). A PPK model was first established using NONMEM. Then a machine learning model of Xgboost was adapted to fit the estimated individual pharmacokinetic parameters obtained from the PPK model with Bayesian forecasting. The performance of the final PPK model and Xgboost model was compared in the test data set. In the final PPK model, tacrolimus daily dose, postoperative days, hematocrit, aspartate aminotransferase, and concomitant voriconazole, were identified to significantly influence the clearance. The postoperative days along with hematocrit significantly influence the volume of distribution. In the Xgboost model, the first 5 predictors for predicting the clearance were concomitant with voriconazole, sex, single nucleotide polymorphisms of CYP3A4*1G and CYP3A5*3 in recipients, and tacrolimus daily dose, for the volume of distribution were postoperative days, age, weight, total bilirubin and graft : recipient weight ratio. In the test data set, the Xgboost model showed the minimum median prediction error of tacrolimus concentrations, less than the PPK model with or without Bayesian forecasting. In conclusion, a PPK combined machine learning approach could improve the prediction of tacrolimus concentrations for Chinese adult liver transplant recipients in the early posttransplant period. [ABSTRACT FROM AUTHOR]

Background: With the widespread use of alectinib in patients with anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC), its cardiotoxicity has gradually emerged, including new-onset sinus bradycardia (SB). However, the incidence, timing, severity, and risk factors of alectinib-induced bradycardia remain unknown. Methods: From January 2020 to June 2022, 93 patients with ALK-positive NSCLC treated with alectinib were enrolled in this retrospective analysis. These patients had heart rate (HR) recorded before and after alectinib administration. By reviewing electronic medical records and follow-up, the HR changes of patients during medication were recorded. The potential risk factors associated with alectinib-induced SB were explored. Results: According to an HR cut-off of 60 beats per minute (bpm), 47 patients (50.54%) experienced at least one recorded bradycardia. The mean HR of total participants before alectinib administration was 78.32 (standard deviation [SD], 9.48) and after was 64.88 (SD, 12.21). The median maximum change in HR (range) for all patients was 11 (-55, +4) bpm. For the bradycardia subgroup, the HR of most patients (76.60%) hovered around 50-60 bpm, and 61.70% of SB occurred within 3 months after alectinib administration. Multivariate analysis indicated that baseline HR (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.79-0.93, p < 0.001) and history of hypertension (OR 13.71, 95% CI 2.49-76.38, p = 0.003) were independent risk factors for alectinib-related bradycardia. Conclusions: Alectinib-induced bradycardia had a high incidence, appeared relatively early, and was reversible by dose reduction or withdrawal. [ABSTRACT FROM AUTHOR]

Background: A physical performance evaluation can inform fall risk in older people, however, the predictiveness of a one‐time assessment is limited. The trajectory of physical performance over time has not been well characterized and might improve fall prediction. We aimed to characterize trajectories in physical performance and determine if fall prediction improves using trajectories of performance. Methods: This was a cohort design using data from the National Health and Aging Trends Study. Physical performance was measured by the short physical performance battery (SPPB) with scores ranging from 0 (worst) to 12 (best). The trajectory of SPPB was categorized using latent class modeling and slope‐based multilevel linear regression. We used Cox proportional hazards models with an outcome of time to ≥2 falls from annual self‐report to assess predictiveness after adding SPPB trajectories to models of baseline SPPB and established non‐physical‐performance‐based variables. Results: The sample was 5969 community‐dwelling Medicare beneficiaries aged ≥65 years. The median number of annual SPPB evaluations was 4 (IQR, 3–7). Mean baseline SPPB was 9.2 (SD, 3.0). The latent class model defined SPPB trajectories over a range of two to nineteen categories. The mean slope from the slope‐based model was −0.01 SPPB points/year (SD, 0.14). Discrimination of the baseline SPPB model to predict time to ≥2 falls was fair (Harrell's C, 0.65) and increased after adding the non‐performance‐based predictors (Harrell's C, 0.70). Discrimination slightly improved with the SPPB trajectory category variable that had the best fit (Harrell's C, 0.71) but did not improve with the SPPB linear slope. Calibration with and without the trajectory categories was similar. Conclusions: We found that the trajectory of physical performance did not meaningfully improve upon fall prediction from a baseline physical performance assessment and established non‐performance‐based information. These results do not support longitudinal SPPB assessments for fall prediction. [ABSTRACT FROM AUTHOR]

Objective: The predominant mechanism driving hyperuricemia in gout is renal uric acid underexcretion; however, the standard urate‐lowering therapy (ULT) recommendation is first‐line xanthine oxidase inhibitor (XOI), irrespective of the cause of hyperuricemia. This comparative effectiveness clinical trial was undertaken to compare first‐line nontitrated low‐dose benzbromarone (LDBen) uricosuric therapy to XOI ULT with low‐dose febuxostat (LDFeb) in gout patients with renal uric acid underexcretion. Methods: We conducted a prospective, randomized, single‐center, open‐label trial in men with gout and renal uric acid underexcretion (defined as fractional excretion of urate <5.5% and uric acid excretion ≤600 mg/day/1.73 m2). A total of 196 participants were randomly assigned to receive LDBen 25 mg daily or LDFeb 20 mg daily for 12 weeks. All participants received daily urine alkalization with oral sodium bicarbonate. The primary end point was the rate of achieving the serum urate target of <6 mg/dl. Results: More participants in the LDBen group achieved the serum urate target than those in the LDFeb group (61% compared to 32%, P < 0.001). Rates of adverse events, including gout flares and urolithiasis, did not differ between groups, with the exception of greater transaminase elevation in the LDFeb group (4% for LDBen compared to 15% for LDFeb, P = 0.008). Conclusion: Compared to LDFeb, LDBen has superior urate‐lowering efficacy and similar safety in treating relatively young and healthy patients with renal uric acid underexcretion–type gout. [ABSTRACT FROM AUTHOR]

Background: Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce. Aim: This study aimed to quantify the changes in occlusion using T‐Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time. Design: In this study, we enrolled children with severe early childhood caries (S‐ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T0), 1 week after treatment (T1), and 1 month (T2) and 3 months (T3) after treatment during follow‐up visits. Repeated‐measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test. Results: Forty patients (mean age = 4.25 ± 0.63 years, age range = 3–5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p =.03). The total of force at the 3‐month follow‐up visit increased significantly (p =.009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1‐month follow‐up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p =.069). The VDO was recovered at the 1‐month follow‐up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p >.05). Conclusion: After undergoing eight PMC restorations under general anesthesia, occlusal re‐equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment. [ABSTRACT FROM AUTHOR]

Objective: Amyopathic dermatomyositis (ADM) is a heterogeneous and life‐threatening autoimmune disease with a high mortality rate. In particular, anti–melanoma differentiation–associated protein 5 antibody–positive patients are at a high risk of developing rapidly progressive interstitial lung disease (RPILD). This study was undertaken to identify immunologic signatures among patients who have ADM with ILD (ADM‐ILD) and to discover the biomarkers predicting prognosis. Methods: The landscape of 42 immune cell phenotypes in the peripheral blood of 82 ADM‐ILD patients and 82 age‐ and sex‐matched healthy donors was assessed by multicolor flow cytometry. Patients were stratified using an unsupervised machine learning method (hierarchical clustering analysis) by immune cell subsets. Multiple Wilcoxon's signed rank tests and supervised machine learning methods were performed to identify important immune cell subsets. Kaplan‐Meier survival analysis with log rank tests was used to create survival curves. Results: We identified 2 distinct clusters correlating with different disease activities and clinical outcomes in ADM‐ILD. Cluster 1 was enriched in the activated CD45RA+HLA–DR+CD8+ T cells with decreased CD56dim natural killer cell proportions and showed a higher prevalence of RPILD and higher mortality. In contrast, the other subgroup, cluster 2 (the nonactivated T cell–dominant cluster), displayed favorable clinical outcomes with high survival rates. Our data also revealed that immunophenotype was an independent risk factor associated with 1‐year survival. Conclusion: Peripheral immunologic features may have the potential to stratify patients with ADM‐ILD according to different disease severity and clinical outcomes, which may have implications for outcome prediction, pathogenesis study, and therapy selection. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. Methods: This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance. Results: There were no significant differences between the two groups (p >.05) regarding demographic questions, professional identity, or resilience at baseline (p >.05). Significant differences were found in professional identity between groups (p <.001), measurement times (p =.026), and in the interaction between groups and measurement times (p =.018) from T0 to T2. Significant differences were found in resilience between groups (p <.001), measurement times (p =.007), and in the interaction between groups and measurement times (p =.035) from T0 to T2. Conclusions: The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology. [ABSTRACT FROM AUTHOR]

Background: Data from trials of medications for alcohol use disorder (AUD) can be used to identify predictors of drinking outcomes regardless of treatment, which can inform the design of future trials with heterogeneous populations. Here, we identified predictors of abstinence, no heavy drinking days, and a 2‐level reduction in World Health Organization (WHO) drinking levels during treatment for AUD in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study. Methods: We utilized data from the COMBINE Study, a randomized placebo‐controlled trial evaluating the efficacy of naltrexone and acamprosate, both alone and in combination, for AUD (n = 1168). A tree‐based machine learning algorithm was used to construct classification trees predicting abstinence, no heavy drinking days, and a 2‐level reduction in WHO drinking levels in the last 4 weeks of treatment, based on 89 baseline variables. Results: The final tree for predicting abstinence had one split based on consecutive days abstinent prior to randomization, with a higher proportion of subjects achieving abstinence among those classified as abstinent for >2 versus ≤2 consecutive weeks prior to randomization (66% vs. 29%). The final tree for predicting no heavy drinking days in the last 4 weeks of treatment had three splits based on consecutive days abstinent, age, and total Alcohol Dependence Scale score at baseline. Seventy‐three percent of the subjects classified as abstinent for >2 consecutive weeks prior to randomization had no heavy drinking days in the last 4 weeks of treatment. Among those classified as abstinent ≤2 consecutive weeks prior, three additional splits showed that younger subjects (age ≤44 years; 37%), and older subjects (age >44) with a total Alcohol Dependence Scale score >13 and complete abstinence (56%) or other drinking goals (35%), were less likely to have no heavy drinking days than older subjects with a total Alcohol Dependence Scale score ≤13 (67%). The final tree for predicting a 2‐level reduction in WHO levels had no splits. Conclusions: Consecutive days abstinent prior to randomization may predict abstinence and no heavy drinking days and total Alcohol Dependence Scale score and age may predict no heavy drinking days. The 2‐level reduction in WHO levels outcome may be less likely to discriminate based on multiple patient characteristics. [ABSTRACT FROM AUTHOR]

Objective: Echocardiography is a time and cost‐effective imaging modality, providing evidence of myocardial ischemia by detecting the regional wall motion abnormalities (RWMA). However, quite a few coronary heart disease (CHD) patients do not present RWMA. The left atrium (LA) plays an irreplaceable role in determining the prognosis and risk stratification of cardiovascular disease including CHD. In this present study, we intend to explore the myocardial mechanics changes of LA mainly using four‐dimensional (4D) LA quantitative volume‐strain in CHD patients without RWMA at rest but were confirmed by coronary angiography (CAG) and to figure out several variables of the LA that could contribute to the identification of those patients. Methods: We prospectively enrolled 76 patients who underwent two‐dimensional echocardiography (2DE), four‐dimensional echocardiography (4DE), and CAG for suspected CHD but without echocardiographic visible RWMA at rest. Patients diagnosed with CHD by CAG were furtherly divided into three groups according to the extent of coronary stenosis accessed by Gensini score (GS) as the mild, moderate, and severe CHD group. Twenty‐four subjects with negative CAG results served as the control group. LA end‐systolic anteroposterior diameter (LAAPD) and biplane LV ejection fraction (Biplane LVEF) were measured by 2DE; LA maximum volume (LAVmax), LA minimum volume (LAVmin), LA volume at the onset of atrial contraction (LAVpreA), LAVmax index (LAVmaxI), LA ejection volume (LAEV), LA ejection fraction (LAEF) accompanied by LA longitudinal strain during reservoir phase (LASr), conduit phase (LAScd), contraction phase (LASct) and LA circumferential strain during reservoir phase (LASr_c), conduit phase (LAScd_c), contraction phase (LASct_c) were measured by 4DE automatically. We compared these parameters between groups, explored how they change and whether they are related to the CHD severity. Results: LAEF, LASr_c, and LASct_c was lower in CHD group compared with the control group (p =.031,.002,.004, respectively). Pearson correlation analysis showed that LASr, LASct, LASr_c, and LASct_c negatively correlated with the GS. Additionally, LASr of patients in the severe CHD group decreased significantly compared with those in the mild CHD group, moderate CHD group, and control group, demonstrating the highest area under the receiver operating characteristic (ROC) curve (AUC) (AUC =.736 [p =.003, 95% CI.589–.884], sensitivity 67.8%, specificity 70.6%) with the cut‐off value of 17.5% for predicting severe CHD patients. Conclusion: Four‐dimensional LA strain may provide new insight into identification and management for CHD patients and correlate with CHD severity. LASr showed good sensitivity (67.8%) and specificity (70.6%) for diagnosing severe CHD individuals. [ABSTRACT FROM AUTHOR]

Objectives: Although the passage of blood in stools in children represents a medical emergency, children seeking emergency department (ED) care remain poorly characterized. Our primary objective was to compare clinical characteristics and etiologic pathogens in children with acute diarrhea with and without caregiver‐reported hematochezia. Secondary objectives were to characterize interventions and resource utilization. Methods: We conducted a secondary analysis of the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) database. Children <18 years presenting to two pediatric EDs within a 24‐hour period and <7 days of symptoms were consecutively recruited. Results: Of 1,061 participants, 115 (10.8%) reported hematochezia at the enrollment visit at which time those with hematochezia, compared to those without, had more diarrheal episodes/24‐hour period (9 vs. 6; difference: 2; 95% confidence interval [CI]: 2.0, 4.0; p < 0.001), and were less likely to have experienced vomiting (54.8% vs. 80.2%; difference: −25.4; 95% CI: −34.9, −16.0; p < 0.001). They were more likely to receive intravenous fluids (33.0% vs. 17.9%; difference: 15.2; 95% CI: 6.2, 24.1; p < 0.001) and require repeat health care visits (45.5% vs. 34.7%; difference: 10.7; 95% CI: 0.9, 20.6; p = 0.03). A bacterial pathogen was identified in 33.0% of children with hematochezia versus 7.9% without (difference: 25.1; 95% CI: 16.3, 33.9; p < 0.001); viruses were detected in 31.3% of children with hematochezia compared to 72.3% in those without (difference: −41.0%, 95% CI: −49.9, −32.1; p < 0.001). Conclusion: In children with acute diarrhea, caregiver report of hematochezia, compared to the absence of hematochezia, was associated with more diarrheal but fewer vomiting episodes, and greater resource consumption. The former group of children was also more likely to have bacteria detected in their stool. [ABSTRACT FROM AUTHOR]

Background: Multiple myeloma (MM) is a hematological malignancy. Coronavirus disease 2019 (COVID‐19) infection correlates with MM features. This study aimed to identify MM prognostic biomarkers with potential association with COVID‐19. Methods: Differentially expressed genes (DEGs) in five MM data sets (GSE47552, GSE16558, GSE13591, GSE6477, and GSE39754) with the same expression trends were screened out. Functional enrichment analysis and the protein‐protein interaction network were performed for all DEGs. Prognosis‐associated DEGs were screened using the stepwise Cox regression analysis in the cancer genome atlas (TCGA) MMRF‐CoMMpass cohort and the GSE24080 data set. Prognosis‐associated DEGs associated with COVID‐19 infection in the GSE164805 data set were also identified. Results: A total of 98 DEGs with the same expression trends in five data sets were identified, and 83 DEGs were included in the protein‐protein interaction network. Cox regression analysis identified 16 DEGs were associated with MM prognosis in the TCGA cohort, and only the cytochrome c oxidase subunit 6C (COX6C) gene (HR = 1.717, 95% CI 1.231–2.428, p =.002) and the nucleotide‐binding oligomerization domain containing 2 (NOD2) gene (HR = 0.882, 95% CI 0.798–0.975, p =.014) were independent factors related to MM prognosis in the GSE24080 data set. Both of them were downregulated in patients with mild COVID‐19 infection compared with controls but were upregulated in patients with severe COVID‐19 compared with patients with mild illness. Conclusions: The NOD2 and COX6C genes might be used as prognostic biomarkers in MM. The two genes might be associated with the development of COVID‐19 infection. [ABSTRACT FROM AUTHOR]

Purpose: To compare the survival outcome between radical hysterectomy and simple hysterectomy with radiation therapy in patients with stage II endometrial cancer. Materials and Methods: This is a retrospective cohort study based on the SEER database from January 1, 1988 to December 31, 2015. Results: Of 577 patients were enrolled in the study, 117 patients received radical hysterectomy and 460 patients received simple hysterectomy combined with vaginal brachytherapy. All patients received external beam radiation therapy after the surgery. The median follow‐up duration was 82.77 ± 1.44 months. No differences were found on the baseline information between two groups. Both the 5‐year overall survival (62.31% vs. 78.48%, p < 0.001) and 5‐year cause‐specific survival (74.60 vs. 85.38%, p = 0.01) were shorter in radical hysterectomy than in simple hysterectomy combined with vaginal brachytherapy group. However, the positive outcomes were further validated in patients with high‐risk endometrial cancer, not in patients with grade 1–2 low‐risk endometrial cancer both on cause‐specific survival and overall survival. In patients with grade 3 low‐risk endometrial cancer, the tendency was only found with lower overall survival not cause‐specific survival. Conclusions: This study revealed that in patients' high‐risk stage II endometrial cancer, radical hysterectomy was associated with shorter survival outcome than simple hysterectomy combined with vaginal brachytherapy. [ABSTRACT FROM AUTHOR]

Background/Objective: Poor air quality is implicated as a risk factor for cognitive impairment and dementia. Few studies have examined these associations longitudinally in well‐characterized population‐based cohorts with standardized annual assessment of both mild cognitive impairment (MCI) and dementia. We investigated the association between estimated ambient fine particulate matter (PM2.5) and risk of incident MCI and dementia in a post‐industrial region known for historically poor air quality. Setting/Participants: Adults aged 65+ years in a population‐based cohort (n = 1572). Measurements: Census tract level PM2.5 from Environmental Protection Agency (EPA) air quality monitors; Clinical Dementia Rating (CDR)®. Design: We estimated ambient PM2.5 exposure (μg/m3, single‐year and 5‐year averages) by geocoding participants' residential addresses to census tracts with daily EPA PM2.5 measurements from 2002 to 2014. Using Bayesian spatial regression modeling adjusted for age, sex, education, smoking history, and household income, we examined the association between estimated PM2.5 exposure and risk of incident MCI (CDR = 0.5) and incident dementia (CDR ≥ 1.0). Results: Modeling estimated single‐year exposure, each 1 μg/m3 higher ambient PM2.5 was associated with 67% higher adjusted risk of incident dementia (hazard ratio [HR] = 1.669, 95% credible interval [CI]: 1.298, 2.136) and 75% higher adjusted risk of incident MCI (HR = 1.746, 95% CI: 1.518, 2.032). Estimates were higher when modeling 5‐year ambient PM2.5 exposure for incident dementia (HR = 2.082, 95% CI: 1.528, 3.015) and incident MCI (HR = 3.419, 95% CI: 2.806, 4.164). Conclusions: Higher estimated ambient PM2.5 was associated with higher risk of incident MCI and dementia, particularly when considering longer‐term exposure, and independent of demographic characteristics and smoking history. Targeting poor air quality may be a reasonable population‐wide intervention to reduce the risk of cognitive impairment in older adults, particularly in regions exceeding current recommendations for safe exposure to PM2.5. [ABSTRACT FROM AUTHOR]

Objectives: To compare the prevalence of chronic periodontitis between men who had semen abnormalities and those who had normozoospermia through a case–control study. Materials and Methods: Male patients who visited the assisted reproduction clinic of a large general hospital and were diagnosed with semen abnormalities were included in the case group. The control group was composed of patients of the same clinic with normozoospermia. The semen analysis included sperm concentration, count and progressive and total motility, which were measured in the laboratory. A questionnaire and clinical periodontal examination were conducted for all participants. Logistic regression was performed to explore the relationship between chronic periodontitis and male infertility. Results: A total of 192 participants were included: 63 participants (32.8%) had some type of semen abnormality (case group), while 129 participants (67.2%) had normozoospermia (control group). The case group had a significantly higher prevalence of moderate/severe periodontitis than the control group (33.3% vs. 17.8%, p =.012). The logistic regression showed that participants who had moderate/severe periodontitis had a greater chance of having semen abnormalities after adjusting for other confounding factors (OR = 3.377, p =.005). Conclusions: Periodontitis is associated with semen abnormalities and sperm motility in men. [ABSTRACT FROM AUTHOR]

Background: Suicidal behavior is highly familial. Neurocognitive deficits have been proposed as an endophenotype for suicide risk that may contribute to the familial transmission of suicide. Yet, there is a lack of research on the neurocognitive functioning of first‐degree biological relatives of suicide attempters. The aim of the present study is to conduct the largest investigation to date of neurocognitive functioning in community youth with a family history of a fatal or nonfatal suicide attempt (FH). Methods: Participants aged 8–21 years from the Philadelphia Neurodevelopmental Cohort completed detailed clinical and neurocognitive evaluations. A subsample of 501 participants with a FH was matched to a comparison group of 3,006 participants without a family history of suicide attempt (no‐FH) on age, sex, race, and lifetime depression. Results: After adjusting for multiple comparisons and including relevant clinical and demographic covariates, youth with a FH had significantly lower executive function factor scores (F[1,3432] = 6.63, p =.010) and performed worse on individual tests of attention (F[1,3382] = 7.08, p =.008) and language reasoning (F[1,3387] = 5.12, p =.024) than no‐FH youth. Conclusions: Youth with a FH show small differences in executive function, attention, and language reasoning compared to youth without a FH. Further research is warranted to investigate neurocognitive functioning as an endophenotype for suicide risk. Implications for the prevention and treatment of suicidal behaviors are discussed. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to explore whether the ratio between negative and positive lymph nodes (RNP) could predict the overall survival (OS) of esophageal cancer (EC) patients with lymph node metastasis following esophagectomy. Methods: We utilized the Surveillance, Epidemiology and End Results (SEER) database to include the records of 2374 patients with lymph node metastases post‐surgery. All patients were randomly assigned into the training cohort (n = 1424) and validation cohort (n = 950). Multivariate Cox regression analyses were performed to identify independent prognostic factors. A novel RNP ‐based TRNPM staging system was proposed. The prognostic value of N, RNP, TNM and TRNPM staging system was evaluated using the linear trend χ2 test, likelihood ratio χ2 test, and Akaike information criterion (AIC) to determine the potential superiorities. We constructed nomograms to predict survival in both cohorts, and the calibration curves confirmed the predictive ability. Results: Univariate analyses showed that N and RNP stage significantly influenced the OS of patients. Multivariate analyses revealed that RNP was an independent prognostic predictor in both the training and validation cohorts. For the stratification analysis in the two cohorts, we found significant differences in the prognosis of patients in different RNP groups on the basis of the different N stages and the number of dissected lymph nodes. In addition, the lower AIC value of RNP stage and TRNPM staging system represented superior predictive accuracy for OS than the N stage and TNM staging system, respectively. Furthermore, the calibration curves for the probability of three‐ and five‐year survival showed good consistency between nomogram predictive abilities and actual observation. Conclusions: We demonstrated that compared to the classical pathological lymph nodal staging system, the RNP stage showed superior predictive accuracy for OS and can serve as a more effective prognostic guidance for lymph node positive EC patients. [ABSTRACT FROM AUTHOR]

Objective: Coagulopathy is one of the characteristics observed in critically ill patients with coronavirus disease 2019 (COVID‐19). Antiphospholipid antibodies (aPLs) contribute to coagulopathy, though their role in COVID‐19 remains unclear. This study was undertaken to determine the prevalence and characteristics of aPLs in patients with COVID‐19. Methods: Sera collected from 66 COVID‐19 patients who were critically ill and 13 COVID‐19 patients who were not critically ill were tested by chemiluminescence immunoassay for anticardiolipin antibodies (aCLs), anti–β2‐glycoprotein I (anti‐β2GPI) (IgG, IgM, and IgA), and IgG anti‐β2GPI–domain 1 (anti‐β2GPI–D1) and IgM and IgG anti–phosphatidylserine/prothrombin (anti‐PS/PT) antibodies were detected in the serum by enzyme‐linked immunosorbent assay. Results: Of the 66 COVID‐19 patients in critical condition, aPLs were detected in 31 (47%). Antiphospholipid antibodies were not present among COVID‐19 patients who were not in critical condition. The IgA anti‐β2GPI antibody was the most commonly observed aPL in patients with COVID‐19 and was present in 28.8% (19 of 66) of the critically ill patients, followed by IgA aCLs (17 of 66, or 25.8%) and IgG anti‐β2GPI (12 of 66, or 18.2%). For multiple aPLs, IgA anti‐β2GPI + IgA aCLs was the most common antibody profile observed (15 of 66, or 22.7%), followed by IgA anti‐β2GPI + IgA aCL + IgG anti‐β2GPI (10 of 66, or 15.2%). Antiphospholipid antibodies emerge ~35–39 days after disease onset. A dynamic analysis of aPLs revealed 4 patterns based on the persistence or transient appearance of the aPLs. Patients with multiple aPLs had a significantly higher incidence of cerebral infarction compared to patients who were negative for aPLs (P = 0.023). Conclusion: Antiphospholipid antibodies were common in critically ill patients with COVID‐19. Repeated testing demonstrating medium to high titers of aPLs and the number of aPL types a patient is positive for may help in identifying patients who are at risk of developing cerebral infarction. Antiphospholipid antibodies may be transient and disappear within a few weeks, but in genetically predisposed patients, COVID‐19 may trigger the development of an autoimmune condition similar to the antiphospholipid syndrome (APS), referred to as "COVID‐19–induced APS‐like syndrome." Long‐term follow‐up of COVID‐19 patients who are positive for aPLs would be of great importance in understanding the pathogenesis of this novel coronavirus. [ABSTRACT FROM AUTHOR]

Background: Circulating genetically abnormal cells (CACs) with specific chromosome variations have been confirmed to be present in non‐small cell lung cancer (NSCLC). However, the diagnostic performance of CAC detection remains unclear. This study aimed to evaluate the potential clinical application of the CAC test for the early diagnosis of NSCLC. Methods: In this prospective study, a total of 339 participants (261 lung cancer patients and 78 healthy volunteers) were enrolled. An antigen‐independent fluorescence in situ hybridization was used to enumerate the number of CACs in peripheral blood. Results: Patients with early‐stage NSCLC were found to have a significantly higher number of CACs than those of healthy participants (1.34 vs. 0.19; P < 0.001). The CAC test displayed an area under the receiver operating characteristic (ROC) curve of 0.76139 for discriminating stage I NSCLC from healthy participants with 67.2% sensitivity and 80.8% specificity, respectively. Compared with serum tumor markers, the sensitivity of CAC assays for distinguishing early‐stage NSCLC was higher (67.2% vs. 48.7%, P < 0.001), especially in NSCLC patients with small nodules (65.4% vs. 36.5%, P = 0.003) and ground‐glass nodules (pure GGNs: 66.7% vs. 40.9%, P = 0.003; mixed GGNs: 73.0% vs. 43.2%, P < 0.001). Conclusions: CAC detection in early stage NSCLC was feasible. Our study showed that CACs could be used as a promising noninvasive biomarker for the early diagnosis of NSCLC. Key points: What this study adds: This study aimed to evaluate the potential clinical application of the CAC test for the early diagnosis of NSCLC. Significant findings of the study: CAC detection in early stage NSCLC was feasible. Our study showed that CACs could be used as a promising noninvasive biomarker for the early diagnosis of NSCLC. [ABSTRACT FROM AUTHOR]

Background: The status of targeted genes and the association between targeted genes and clinicopathological features in Chinese lung cancer patients remains to be elucidated. Methods: The status of 10 targeted genes was evaluated by next‐generation sequencing (NGS) in 884 non‐small cell lung cancer (NSCLC) patients. The relationship between gene alterations and clinicopathological characters was analyzed. Results: Overall, 684 (77.4%) patients harbored gene alterations, and EGFR (510, 57.7%) was found to be the most common type of mutation followed by KRAS (91, 10.3%), HER2 (38, 4.3%), PIK3CA (32, 3.6%), ALK (21, 2.4%), BRAF (10, 1.1%), ROS1 (5, 0.6%), RET (5, 0.6%), MET (4, 0.5%) and NRAS (1, 0.1%). Gene alterations were more frequent in females, non‐smokers and adenocarcinoma (P < 0.001). EGFR mutations were associated with women, non‐smokers, normal level of serum tumor markers, and adenocarcinoma (P < 0.001). Patients without lymph node metastasis (P = 0.012), or early stage disease (P < 0.001) exhibited a higher EGFR mutation rate. KRAS mutations tended to arise in men (P < 0.001), smokers (P < 0.001) and patients with higher levels of serum tumor markers (P = 0.048). A mucus‐producing component was associated with KRAS (P < 0.001), ROS1 (P = 0.033) and ALK (P < 0.001) alterations. ALK and ROS1 rearrangements were more frequent in micropapillary structures (P = 0.004, P = 0.012). BRAF mutation was associated with advanced disease patients and micropapillary structure (P < 0.001). PIK3CA mutation was more likely to be found in elderly patients (P = 0.014). Some patients had synchronous gene alterations, including EGFR/PIK3CA, EGFR/HER2, HER2/KRAS, EGFR/KRAS, EGFR/ROS1, EGFR/NRAS, KRAS/PIK3CA, KRAS/PIK3CA/HER2. Conclusions: Most patients had at least one genetic alteration, and individual patients harbored synchronous mutation. Each gene alteration had unique clinicopathological characteristics. Key points: Significant findings of the study: This study revealed the frequency and distribution of 10 targeted gene abnormalities and their association with clinicopathological parameters of Chinese non‐small cell lung cancer (NSCLC) patients in eastern China. What this study adds: Some rare synchronous mutations were detected in our study by next‐generation sequencing (NGS). [ABSTRACT FROM AUTHOR]

The increased incidence of chronic cutaneous wounds is likely to lead to increased mortality, and therefore, deserves greater attention. More insight is needed into the magnitude of the problem of chronic cutaneous wounds and methods for their prevention and treatment in China. A retrospective analysis of data retrieved from an electronic health‐records database on 3300 patients with chronic skin wounds was conducted from 1 January 2018 to 31 December 2018. The patients had been admitted to the medical and surgical wards of 17 third‐grade class‐A hospitals in China. The study's aim was to compare the characteristics (eg, demographic and clinical) associated with different causes and distributions of patients' chronic wounds. Among the 3300 patients, 66.03% were males and 33.97% were females. The mean age was 57 years and the increasing prevalence of chronic skin wounds with aging was quite high. The primary causes of chronic wounds were diabetes or infection, followed by pressure ulcers, trauma, and iatrogenic wounds. The distribution of skin wounds was mainly in the lower extremities (56.1%), followed by the trunk (18.6%). The mean duration of hospital stay was 29 days and the mean recurrence was 3 months. Chronic skin wounds were related to occupation, educational level, lifestyle habits, and income. The main cause of chronic skin wounds has shifted from trauma to chronic disease. Normalization checks, bacterial cultures, and antibiotic use in China need to be standardized and the training of wound specialists should be further strengthened. The association of aging and wound infection was significant. Preventive management and efficient treatment should correspond to the needs of the different regions of China. These results may serve as a reference for other developing countries in their transitional development. [ABSTRACT FROM AUTHOR]

Objective: Interstitial lung disease (ILD) accompanied by anti–melanoma differentiation–associated gene 5 (anti–MDA‐5)–positive dermatomyositis (DM) is often rapidly progressive and associated with poor prognosis. Because there is no established treatment, we undertook this study to prospectively evaluate the efficacy and safety of a combined immunosuppressive regimen for anti–MDA‐5–positive DM patients with ILD. Methods: Adult Japanese patients with new‐onset anti–MDA‐5–positive DM with ILD (n = 29) were enrolled at multiple study centers from 2014 to 2017. They were treated with a regimen of high‐dose glucocorticoids (GCs), tacrolimus, and intravenous cyclophosphamide (IV CYC). Plasmapheresis was used if a patient's condition worsened after the regimen started. The primary end point was 6‐month survival, which was compared between this group of patients and a historical control group (n = 15) consisting of anti–MDA‐5–positive DM patients with ILD who received step‐up treatment (high‐dose GC and stepwise addition of immunosuppressant). Secondary end points were 12‐month survival rate, adverse events, and changes in laboratory data. Results: The combined immunosuppressive regimen group showed significantly higher 6‐month survival rates than the step‐up treatment group (89% versus 33%; P < 0.0001). Over a period of 52 weeks, improvements in anti–MDA‐5 titers, serum ferritin levels, vital capacity, and chest high‐resolution computed tomography scores were observed. The combined immunosuppressive regimen group received IV CYC nearly 20 days earlier with shorter intervals and tended to receive plasmapheresis more often than patients undergoing step‐up treatment. Cytomegalovirus reactivation was frequently observed over 52 weeks. Conclusion: A combined immunosuppressive regimen is effective for anti–MDA‐5–positive DM patients with ILD. Plasmapheresis can be used for additional effect in intractable disease. Patients should be carefully monitored for opportunistic infections during treatment. [ABSTRACT FROM AUTHOR]

Background: Emergency providers (EPs) are uniquely placed to advocate for firearm safety and have been shown to be at risk of exposure to firearms in the emergency department (ED). We sought to characterize EPs' knowledge of firearms, frequency of encountering firearms in the ED and level of confidence with safely removing firearms from patient care settings. Methods: This was a survey study of EPs representing medical centers in 22 states. A 15‐item questionnaire was e‐mailed to all EPs at all included institutions. Questions pertained to EPs' knowledge of firearms, experience with handling firearms, and exposure to firearms while at work. We calculated response proportions with p‐values and conducted association analyses among survey items. Results: Of 2,192 survey recipients, 1,074 (49.0%) completed the survey. A total of 635 (59.1%) reported encountering firearms in the ED or its immediate environment at least once per year, and 582 (54.2%) were not confident in their ability to safely handle a firearm found in a patient's possession. Frequency of handling firearms was significantly higher in states in the top quartile for firearm ownership, with 21.5% of respondents reporting handling firearms daily or weekly, compared to 10.9% in bottom‐quartile states. Level of firearms training also differed significantly: 42.1% of respondents in top‐quartile states reported formal training compared to 33.0% in bottom‐quartile states. Increased regional firearm ownership rates were associated with decreased rates of feeling unsafe at work. Conclusions: The majority of surveyed EPs reported little experience with handling firearms. Firearm experience was associated with comfort with managing firearms found in patients' possession. Regional differences were found regarding personal firearm experience and perceptions of workplace safety, both of which were associated with regional variations in firearm ownership. Despite this, no regional differences were found in encountering firearms in or around the ED. EPs may benefit from training on safely handling firearms. [ABSTRACT FROM AUTHOR]

Acetaminophen and Ojeok‐san are both frequently used analgesics. In this study, we evaluated acetaminophen pharmacokinetics (PK) and changes in microRNA‐122 (miR‐122) levels after multiple dosing of acetaminophen with or without Ojeok‐san. An open‐label, 1‐sequence, 2‐period, 2‐treatment crossover study was conducted in 18 subjects. In period 1, 500 mg of acetaminophen was administered 3 times on day 1 and once on day 2. In period 2, after the administration of 14.47 g of Ojeok‐san twice on day 2 and 3 times daily on days 3 to 7, Ojeok‐san and acetaminophen were coadministered 3 times each on day 8 and once each on day 9. The geometric mean ratios (90% confidence intervals) of acetaminophen with Ojeok‐san to acetaminophen alone were 0.98 (0.87 to 1.10) and 1.02 (0.98 to 1.05) for the maximum plasma concentration (Cmax) and the area under the plasma concentration‐time curve during the dosing interval (AUC0‐τ), respectively, of acetaminophen at steady state. The alanine aminotransferase (ALT) levels were within the reference range in all the participants throughout the study period, although the mean fold changes in both serum miR‐122 and ALT levels from baseline tended to increase on days 2 to 5. In conclusion, the PK properties of acetaminophen were not significantly affected by Ojeok‐san coadministration. For osteoarthritis patients taking acetaminophen with or without Ojeok‐san, monitoring potential liver toxicity using miR‐122 as a biomarker may be useful. [ABSTRACT FROM AUTHOR]

There are three distinct patterns of migration among Chinese migrant children: whole‐family, single‐parent‐first, and both‐parents‐first migration. This study investigated the life satisfaction of children who migrated under the different migration patterns and examined the mediating role of family functioning in the relationship between the children's migration patterns and their life satisfaction. Participants consisted of migrant children (N = 703) from primary and junior middle schools in Chengdu, China. The results showed that (a) migrant children from the whole‐family and single‐parent‐first patterns of migration reported greater life satisfaction than did those from the both‐parents‐first pattern, and (b) family functioning partially mediated the association between migration patterns and life satisfaction. The present study highlights the importance of avoiding separation of children from both parents during migration and the need to develop interventions for migrant children's psychological adaptation by improving their families' functioning. [ABSTRACT FROM AUTHOR]

Increasingly, student work is being conducted on computers and online, producing vast amounts of learning‐related data. The educational analytics fields have produced many insights about learning based solely on tutoring systems' automatically logged data, or "log data." But log data leave out important contextual information about the learning experience. For example, a student working at a computer might be working independently with few outside influences. Alternatively, he or she might be in a lively classroom, with other students around, talking and offering suggestions. Tools that capture these other experiences have potential to augment and complement log data. However, the collection of rich, multimodal data streams and the increased complexity and heterogeneity in the resulting data pose many challenges to researchers. Here, we present two empirical studies that take advantage of multimodal data sources to enrich our understanding of student learning. We leverage and extend quantitative models of student learning to incorporate insights derived jointly from data collected in multiple modalities (log data, video, and high‐fidelity audio) and contexts (individual vs. collaborative classroom learning). We discuss the unique benefits of multimodal data and present methods that take advantage of such benefits while easing the burden on researchers' time and effort. Lay Description: What is already known about this topic: When students use education software in the classroom, the software automatically logs their entries, clicks, and other submitted activity.Researchers can use this detailed software‐logged data to infer information about students' learning processes.However, software cannot log some important events that happen during students' learning experience.One example is students' interactions with others while they use the software.What this paper adds: We collected video and audio while students used educational software in the classroom, either individually or working with a partner.The audio and video provided information on students' learning processes and contexts that the software‐logged data could not provide.We were able to gain an improved understanding of students' learning processes through the audio and video data.Implications for practice and/or policy: Students who engage in productive struggle on difficult problems rather than taking an easier or more direct path to the answer show improved learning trajectories following those problems.Features of the language students use with each other when collaborating on math learning predict their math performance. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To examine the effects of a simulated emergency airway management education program on the self‐efficacy and clinical performance among nurses in intensive care units. Methods: A one‐group, pre‐ and post‐test design was used. Thirty‐five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team‐based practice, and debriefing. Self‐efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t‐test to compare the mean differences between the pre‐test and post‐test. The scores before and after education were compared. Results: After education, there was a significant improvement in the nurses’ self‐efficacy and clinical performance in emergency airway management situations. Conclusion: Simulation education effectively improved the self‐efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. Design and Sample This is a cross-sectional descriptive study that analyzed data from 466 adults. Measures Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. Results Men and women had significantly different beliefs about intimate partner violence ( t = −7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV ( F = 10.50, p = .000). Conclusions In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence. [ABSTRACT FROM AUTHOR]