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Background: Surgical site infections (SSIs) incur up to $10 billion annually due to their excessive morbidity. SSI prevention bundles have had variable success in colorectal surgery. For example, at the University of Wisconsin Hospital, a 505-bed regional referral center, SSI rates have remained high despite the introduction of a 14-element SSI prevention bundle in 2016. To aid in the implementation of this complex bundle, the hospital started Strike Teams in 2019. We have described the impact of Strike Teams on colorectal SSI rates in our tertiary-care hospital. Methods: A Strike Team with key stakeholders from colorectal surgery (ie, surgeon, OR director, nurses, surgical technicians), anesthesia, pharmacy, infection prevention, and infectious disease was formed, supported by the hospital’s executive leadership. The Strike Team met monthly throughout 2019 to review each SSI case, discussed barriers to adherence for the SSI prevention bundle elements with implementation difficulties (Table 1), and proposed actionable feedback to increase adherence. The latter was disseminated to frontline clinicians by the teams’ surgical leaders during everyday clinical practice. The Strike Team was paused in 2020 due to resource reallocation in response to the COVID-19 pandemic. Monthly and quarterly SSI surveillance was conducted according to CDC guidance. Results: Colorectal SSI rates before, after, and during Strike Team activity are shown in Fig. 1. Adherence rates to the bundle elements targeted by the Strike Team are shown in Fig. 2. Conclusions: Adherence to the preferred antibiotic prophylaxis increased, although adherence to other bundle elements of focus did not change significantly. SSI rates decreased below our expectation while the Strike Team was active in our hospital, although SSI reduction was not sustained. Further research should study the effectiveness of Strike Teams as a long-term implementation strategy for SSI prevention in colorectal surgery.

Abstract Objectives To determine the diagnostic accuracy of 3T multiparametric magnetic resonance imaging (mpMRI) for detecting and locating prostate cancer (PCa) on Dickinson's 27‐sector map, using histopathology specimens from radical prostatectomy (RP) as the reference standard. Patients and methods The authors studied a continuous series of 140 patients who underwent RP over three consecutive years. Prior to RP, all patients had mpMRI for detection and localization of PCa and further assessment by biopsy. To minimize the potential of disease progression, 25 patients were excluded because the interval between mpMRI and RP exceeded 6 months, which left 115 patients eligible for analysis. The mpMRI findings were reported using the Prostate Imaging‐Reporting and Data System (PI‐RADS) v2, considering PI‐RADS ≥ 3 to indicate PCa. The histopathology findings from RP specimens were graded using the Gleason scoring system, considering Gleason ≥ 6 to indicate PCa. The location of the tumors was mapped on Dickinson's 27‐sector map for both mpMRI and histopathology and compared by rigid sector‐by‐sector matching. Results The cohort of 115 patients eligible for analysis was aged 66.5 ± 6.0 years at RP. Of the 3105 sectors analyzed, there were 412 true positives (13%), 28 false positives (1%), 68 false negatives (2%), and 2597 true negatives (84%). Across the 27 sectors of the prostate, mpMRI sensitivity ranged from 50% to 100% and specificity from 96% to 100%, while PPV ranged from 50% to 100%, and NPV from 91% to 100%. For the anterior prostate, mpMRI had a sensitivity of 80% (CI, 71%‐86%), specificity of 99% (CI, 99%‐100%), PPV of 91% (CI, 83%‐95%), and NPV of 99% (CI, 98%‐99%). For the posterior prostate, mpMRI had a sensitivity of 88% (CI, 84%‐91%), specificity of 98% (CI, 97%‐99%), PPV of 94% (CI, 92%‐96%), and NPV of 96% (CI, 94%‐97%). Overall, mpMRI had a sensitivity of 86%, specificity of 99%, PPV of 94%, and NPV of 97%. Conclusions The accuracy of mpMRI in detecting and locating prostate tumors depends on the affected region, but its high NPV across all sectors suggests that negative findings may not need corroboration by other techniques.

Abstract Background Team-based instructional change is a promising model for improving undergraduate STEM instruction. Teams are more likely to produce sustainable, innovative, and high-quality outcomes than individuals working alone. However, teams also tend to involve higher risks of failure and can result in inefficient allocation of valuable resources. At this point, there is limited knowledge of how teams in the context of STEM higher education should work to achieve desirable outcomes. Results In this study, we collect semi-structured interview data from 23 team members from a total of 4 teams at 3 institutions across the USA. We analyze the results using a grounded theory approach and connect them to the existing literature. This study builds upon the first part of our work that developed a model of team inputs that lead to team outcomes. In this part, we identify the mechanisms by which input characteristics influence teamwork and outcomes. Team member data expand this initial model by identifying key aspects of team processes and emergent states. In this paper, we present five team processes: strategic leadership, egalitarian power dynamics, team member commitment, effective communication, and clear decision-making processes, that shape how teams work together, and three emergent states: shared vision, psychological safety, and team cohesion, that team members perceived as important aspects of how teams feel and think when working together. Conclusions This work furthers our understanding of how instructional change teams can be successful. However, due to the highly complex nature of teams, further investigation with more teams is required to test and enrich the emerging theory.

Background: Cardiac implantable electronic devices (CIED)—ie, pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices—have recently been designed to allow for patients to safely undergo magnetic resonance imaging (MRI) when specific programming is implemented. MRI AutoDetect is a feature that automatically switches CIED’s programming into and out of an MR safe mode when exposed to an MRI environment. Objective: The purpose was to analyze de-identified daily remote transmission data to characterize the utilization of the MRI AutoDetect feature. Methods: Home Monitoring transmission data collected from MRI AutoDetect–capable devices were retrospectively analyzed to determine the workflow and usage in patients experiencing an MRI using the MRI AutoDetect feature. Results: Among 48,756 capable systems, 2197 devices underwent an MRI using the MRI AutoDetect feature. In these 2197 devices, the MRI AutoDetect feature was used a total of 2806 times with an average MRI exposure of 40.83 minutes. The majority (88.9%) of MRI exposures occurred on the same day as the MRI AutoDetect programming. A same day post-MRI exposure follow-up device interrogation was performed 8.6% of the time. A device-related complaint occurred within 30 days of the MRI exposure in 0.25% of MRI exposures using MRI AutoDetect but with no adverse clinical outcome. Conclusion: As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure—reducing resource utilization and creating workflow flexibility.

In this paper, a set of best practice data sharing guidelines for wind turbine fault detection model evaluation is developed, which can help practitioners overcome the main challenges of digitalisation. Digitalisation is one of the key drivers for reducing costs and risks over the whole wind energy project life cycle. One of the largest challenges in successfully implementing digitalisation is the lack of data sharing and collaboration between organisations in the sector. In order to overcome this challenge, a new collaboration framework called WeDoWind was developed in recent work. The main innovation of this framework is the way it creates tangible incentives to motivate and empower different types of people from all over the world to share data and knowledge in practice. In this present paper, the challenges related to comparing and evaluating different SCADA-data-based wind turbine fault detection models are investigated by carrying out a new case study, the “WinJi Gearbox Fault Detection Challenge”, based on the WeDoWind framework. A total of six new solutions were submitted to the challenge, and a comparison and evaluation of the results show that, in general, some of the approaches (Particle Swarm Optimisation algorithm for constructing health indicators, performance monitoring using Deep Neural Networks, Combined Ward Hierarchical Clustering and Novelty Detection with Local Outlier Factor and Time-to-failure prediction using Random Forest Regression) appear to exhibit high potential to reach the goals of the Challenge. However, there are a number of concrete things that would have to have been done by the Challenge providers and the Challenge moderators in order to ensure success. This includes enabling access to more details of the different failure types, access to multiple data sets from more wind turbines experiencing gearbox failure, provision of a model or rule relating fault detection times or a remaining useful lifetime to the estimated costs for repairs, replacements and inspections, provision of a clear strategy for training and test periods in advance, as well as provision of a pre-defined template or requirements for the results. These learning outcomes are used directly to define a set of best practice data sharing guidelines for wind turbine fault detection model evaluation. The guidelines can be used by researchers in the sector in order to improve model evaluation and data sharing in the future.

ABSTRACT - BACKGROUND: Dysphagia can lead to aspiration pneumonia, impacting the nutritional status and quality of life of the patient. The videofluoroscopy is highlighted for allowing both a real-time evaluation and the recording of the images for later review and analysis. AIM: This study aimed to describe the characteristics of the population referred for videofluoroscopy and its value as an investigation method. METHODS: A descriptive and retrospective study was conducted. Exams were analyzed in lateral and anteroposterior views and reviewed using the frame-by-frame analysis software. The variables analyzed were an indication of the exam, previous diseases, dynamics of the oral and pharyngeal phases, and the degree of penetration/aspiration. RESULTS: A total of 141 exams were analyzed. The study population had a median age of 66.24±17.78 years. For the indication of the exam, the investigation of dysphagia was highlighted (n=87, 61.7%) and for previous conditions, diverticulum (n=13, 9.2%), pharyngeal bar (n=12, 8.51%), and stroke and Parkinson’s disease (n=9, 6.4%) were highlighted. In the oral phase, 45 (31.9%) patients had a premature loss, and 108 (76.6%) patients had normal transit time. However, 100 (70.9%) had inadequate ejection. In the pharyngeal phase, 119 (84.4%) had efficient laryngeal displacement and 107 (75.9%) had an adequate opening of the upper esophageal sphincter. The beginning of the pharyngeal phase was classified as inadequate in 131 (92.9%) patients, and 80 (56.74%) had pharyngeal residue. Notably, 100 (70.9%) patients had grade 1 on the penetration/aspiration scale. CONCLUSION: Despite the didactic division of phases, swallowing is complex and has transition stages. Videofluoroscopy is the only method for evaluating all phases of swallowing and its events.

The purpose of this study was to expand the mutation spectrum by searching the causative mutations in nine Lebanese families with Usher syndrome (USH) using whole-exome sequencing. The pathogenicity of candidate mutations was first evaluated according to their frequency, conservation, and in silico prediction tools. Then, it was confirmed via Sanger sequencing, followed by segregation analysis. Finally, a meta-analysis was conducted to calculate the prevalence of USH genes in the Lebanese population. Three missense mutations, two splice site mutations, and one insertion/deletion were detected in eight of the families. Four of these variants were novel: c.5535C > A; p.(Asn1845Lys) in exon 41 of CDH23, c.7130G > A; p.(Arg2377Gln) in exon 32 of ADGRV1, c.11390-1G > A in USH2A, and c.3999–6A > G in PCDH15. All the identified mutations were shown to be likely disease-causing through our bioinformatics analysis and co-segregated with the USH phenotype. The mutations were classified according to the ACMG standards. Finally, our meta-analysis showed that the mutations in ADGRV1, USH2A, and CLRN1 are the most prevalent and responsible for approximately 75% of USH cases in Lebanon. Of note, the frequency USH type 3 showed a relatively high incidence (23%) compared to the worldwide prevalence, which is around 2–4%. In conclusion, our study has broadened the mutational spectrum of USH and showed a high heterogeneity of this disease in the Lebanese population.

Abstract HHV‐6B is the subtype most often involved in the systemic manifestations of the DRESS, but also in myelosuppression in bone marrow transplant. We report a new observation of its myelosuppressive effect: a case of DRESS complicated by agranulocytosis with detectable HHV‐6 RNA in bone marrow.

The teaching of history in the French-speaking European area has grown and diversified, but still remains fragile and incomplete in its structure. Among those who brought it to the fore, Suzanne Citron stressed its national confinement before Henri Moniot gave it its legitimacy by highlighting the differences and interactions between history and its school version. Completing a 2008 summary note by Nicole Allieu-Mary and Nicole Lautier, the lively debates in public space on the past, its transmission and its memory have marked the evolution of this didactics, as well as the concept of knowledge flavour (Jean-Pierre Astolfi) derived from its elementary nature and mobilizing true historical thinking. The productions of the didactics of history are rich and diverse, but the doctoral theses that succeed hardly lead to stable positions in the academic world. There is therefore a gap between this reality and the magnitude of the challenges that this didactics has to face in today's world.

Reproducible research is needed to ensure that scientific results in the literature are reliable, unbiased, and verifiable by others. The journal Image Processing On Line (IPOL) publishes reproducible articles since 2010. This means publishing an algorithm by a literary description, a pseudocode, its source code, a series of test examples, an online facility allowing to test the code on this data and other data submitted by the user, and finally an experimental archive. In this work, we discuss how to publish and review reproducible research in the specific discipline of remote sensing. We put a special emphasis on the construction and proper documentation of public datasets. We show case studies of remote sensing articles publicly available in IPOL, which demonstrate the feasibility of reproducible research in this area. The methods and their application are explained, along with details on how the datasets were built and made available for evaluation, comparison, and scoring to eventually help establish a reliable state-of-the-art of the discipline. Finally, we give specific recommendations for authors and editors willing to publish reproducible research in remote sensing.

ABSTRACT Golden mussel is an invasive species in Brazil which impacts local environments, dislocating native species and altering microecological conditions as well as affecting hydroelectric power plants and water treatment systems. The objective of this research is to establish a method that is both effective and efficient to quantify the population of the Golden mussel in hydroelectric power plant reservoirs, with a focus on population control measures. A two-dimensional mathematical model was developed combining hydrodynamics and populational dynamics to simulate the distribution of mussels in a reservoir. The results showed that dam’s region was progressively infested, and after 18 months of simulation it has reached around 80% of its carrying capacity. The method proved to be satisfactory and the generated map of cluster locations for the golden mussel corresponds to field observations. Furthermore, the result of the algae density simulation matched chlorophyll-a density map obtained from satellite images. The methodology can be further applied to new areas and could be expanded to predict population variations in order to guide environmental measures for preservation and recovery of impacted reservoirs, presenting another tool for hydroelectric operators who can use information together with field inspections to plan maintenance intervals before infestation damages equipment.

The pathways from trauma—via dissociation—to psychosis have been thoroughly tested and evidenced, but what has received less attention has been the social pathways—via dissociation—to psychosis. Often social factors are more commonly linked to other influences, e.g., to appraisals and the creation of negative schema in cognitive models, or to unsupportive caregiving experiences where there is high “expressed emotion.” However, evidence is now emerging that negative social rank experiences, such as being excluded or shamed, may themselves have dissociative properties, which poses intriguing questions as to how trauma pathways and social pathways might interact. This article reviews the state of knowledge in trauma and social pathways to psychosis and then considers the potential mechanisms and the relationships between them, specifically (i) dissociation, (ii) attachment, and (iii) social rank. Recommendations are suggested for future modeling and testing of three-way interactions (dissociation × attachment × social rank) in the pathway from trauma to psychosis.

Nicardipine hydrochloride is an anti-hypertensive drug that is used off-label to treat hypertension in children. A previous oral formulation of nicardipine hydrochloride was developed using a commercial vehicle as an excipient. However, ready-to-use vehicles are prone to supply shortages, and their composition may undergo substantial modifications. The aim of this study was to propose a new oral formulation of nicardipine hydrochloride 2 mg/mL using simple excipients. The formulation included hydroxypropylmethylcellulose, simple syrup, polysorbate 80, sodium saccharin, citrate buffer, strawberry flavor and 0.2% potassium sorbate. The uniformity of content was maintained before and after agitation. Nicardipine hydrochloride concentration assessed by HPLC-MS/MS remained above 90% for 365 days before opening and for 28 days after opening. pH and osmolality were maintained throughout the study, and no microbial contamination was observed. The uniformity of mass of the delivered doses was evaluated using four different devices. A new oral formulation of nicardipine hydrochloride 2 mg/mL was developed using simple and safe excipients. Pharmacological and clinical parameters remain to be assessed and compared with those of the previous formulation.

RESUMO Objetivo Elaborar e validar um protocolo multiprofissional para identificação do risco de disfagia em pessoas com HIV no momento da internação hospitalar. Método Após revisão bibliográfica, o protocolo de rastreio de disfagia criado foi submetido a análise de juízes especialistas em HIV/Aids e público-alvo na aplicação deste instrumento para realização da validação de face/conteúdo. Esses avaliadores poderiam sugerir mudanças no protocolo, julgando os quesitos como clareza, pertinência e abrangência. Para avaliar o grau de concordância do instrumento, foi utilizado o Índice de Validade de Conteúdo (IVC) mínimo de 0,78. Resultados O protocolo foi elaborado com 16 itens, incluindo aspectos relacionados à fase oral e faríngea da deglutição, e a pontuação final foi calculada baseada nos diferentes riscos para complicações clínicas. O instrumento apresentou IVC acima de 0,78 para todos os itens nas duas fases da validação, bem como IVC total de 0,92. Conclusão A partir dos dados obtidos, foi possível a construção e validação do protocolo de rastreio do ponto de vista de aparência e conteúdo, uma vez que apresentou IVC total acima do valor mínimo estipulado na validação dos juízes especialistas e do público-alvo, constatando-se assim IVC adequado para o protocolo como um todo.

Background: New technologies and therapies allow the possibility of a single-visit test and treat model for hepatitis C virus (HCV), addressing some of the barriers to care faced by people who inject drugs. Methods: The TEMPO Pilot Study was an interventional cohort study evaluating a single-visit test and treat intervention among people with recent injecting drug use at a one peer-led needle and syringe program (NSP) in Sydney, Australia between September 2019 and February 2021. This analysis evaluated awareness of HCV status and agreement of self-report with HCV RNA test results. The analysis also assessed acceptability of: modality of result delivery, modality of blood sampling, site of treatment, and duration of treatment. Results: Among 101 participants (median age 43; 31% female), 100 had a valid HCV RNA test result and 27% (27/100) were HCV RNA detectable. Overall, 65% (65/100) were aware of their status. Among people with a positive HCV RNA result, 48% (13/27) were aware of their status. People preferred same-day HCV test results (95%, 96/101), and preferred to receive results in person (69%, 70/101). Receiving treatment at an NSP was acceptable (100%, 101/101) and 78% (79/101) were willing to discuss their health with a peer NSP worker. Conclusion: Half of people with current HCV infection were aware of their status. The high acceptability of simplified testing and treatment pathways delivered at NSPs indicates that this is an appropriate strategy to improve HCV awareness and treatment uptake in this population.

Abstract Background Women with ovarian cancer can present with a variety of symptoms and signs, and an increasing range of tests are available for their investigation. A number of international guidelines provide advice for the initial assessment of possible ovarian cancer in symptomatic women. We systematically identified and reviewed the consistency and quality of these documents. Methods MEDLINE, Embase, guideline-specific databases and professional organisation websites were searched in March 2018 for relevant clinical guidelines, consensus statements and clinical pathways, produced by professional or governmental bodies. Two reviewers independently extracted data and appraised documents using the Appraisal for Guidelines and Research Evaluation 2 (AGREEII) tool. Results Eighteen documents from 11 countries in six languages met selection criteria. Methodological quality varied with two guidance documents achieving an AGREEII score ≥ 50% in all six domains and 10 documents scoring ≥50% for “Rigour of development” (range: 7–96%). All guidance documents provided advice on possible symptoms of ovarian cancer, although the number of symptoms included in documents ranged from four to 14 with only one symptom (bloating/abdominal distension/increased abdominal size) appearing in all documents. Fourteen documents provided advice on physical examinations but varied in both the examinations they recommended and the physical signs they included. Fifteen documents provided recommendations on initial investigations. Transabdominal/transvaginal ultrasound and the serum biomarker CA125 were the most widely advocated initial tests. Five distinct testing strategies were identified based on the number of tests and the order of testing advocated: ‘single test’, ‘dual testing’, ‘sequential testing’, ‘multiple testing options’ and ‘no testing’. Conclusions Recommendations on the initial assessment and investigation for ovarian cancer in symptomatic women vary considerably between international guidance documents. This variation could contribute to differences in the way symptomatic women are assessed and investigated between countries. Greater research is needed to evaluate the assessment and testing approaches advocated by different guidelines and their impact on ovarian cancer detection.

It stands to reason that a criterion is needed that can serve as a common denominator for weighing or assessing different values or ideals. Dignity is offered as a possible candidate, to be presented from religio-legal and cross-cultural vantages. A definition will be offered for dignity and its parts defended throughout the paper. The approach is not only not rigorously analytic – there are no case studies – but is instead a presentation of topic areas where we should expect to find the concept of dignity to be relevant. Utilizing a rights-moral and duties-ethical framework, it is in essence an argument for further elevating the prestige of dignity so that it might provide a widely-accepted groundwork for ethics and morality. .

The conventional farming model is increasingly criticized for its negative environmental impacts and inability to feed our planet’s ever-growing population with limited resources. Unlike the intensive model, the permaculture and bio-intensive micro-agriculture model developed at Bec Hellouin places nature at the heart of farming. The idea is to produce large amounts from small areas, at the same time replenishing the biosphere and gradually moving away from use of chemical inputs and fossil fuels. Although the Bec Hellouin model was created in a rural setting in northern France, its innovative approach is rooted in the circular economy and is equally suited to application in urban settings, where micro-farms provide myriad services to the local community, such as local produce, environmental benefits, microclimate, social ties, and more.

Abstract Background Streptococcus pneumoniae infection causes morbidity and mortality in multiple myeloma patients. Pneumococcal vaccination is commonly given to immunocompromised myeloma patients; however response data are sparse. Here, we present longitudinal response data to pneumococcal vaccination in multiple myeloma patients. Method Twenty‐eight multiple myeloma patients were included, 25 of whom were newly diagnosed. All the patients received two vaccines Prevnar13® and Pneumo23®. Serotype‐specific IgG was measured by ELISA for all 23 vaccine serotypes at baseline, and then sequentially at different time points postvaccination until treatment ended. Response to vaccination is available for 20 patients. The primary endpoint was the incidence rate of patients who obtained an isotype response serum concentration after vaccination. Secondary endpoints included detailed isotype increase, time to first increase, further assessment of a decreased anti‐pneumococcal serum concentrations following treatment including autologous stem cell transplantation (ASCT), rate of infection with a special attention to pneumococcal infection. Results The median age was 66 years and the male to female ratio was 0.6. Anti‐pneumococcal capsular polysaccharide (anti‐PCP23) IgG, IgG2, IgA, and IgM responses were detected within 1 week postvaccination. Response to at least one subtype of antibody was obtained in 85% (n = 17) of patients, for at least two subtypes in 65% (n = 13), for at least three subtypes in 55% (n = 11), and 2 patients responded to all four subtypes. The median increase in the concentration of anti‐PCP23 isotypes was threefold following vaccination, with the highest increase observed when Pneumo23® was given more than 30 days after Prevnar13®. The anti‐pneumococcal geometric mean concentration decreased significantly for all subtypes over time independently of treatment approaches. Conclusion Myeloma has the ability to demonstrate a response to pneumococcal vaccine, independently of preexisting hypogammaglobulinemia and possibly of treatment‐induced immunodepression. We also observed a drop in the serum response overtime and following autologous transplantation. Further studies in larger sample are needed to understand the benefit of vaccination strategies in these patients.

Abstract Background Instructional change efforts involving teams of change agents are becoming increasingly prevalent at higher education institutions across the US. Teams may be able to make more lasting and high-quality changes to STEM courses than instructors working alone. But team-based change efforts are also risky. They tend to require more resources than individually focused efforts, and there are many ways in which teams can fail to achieve their goals. So far, research on how change leaders can best support instructional change teams has been extremely limited. We lack a context-specific model that can help us to understand how, when, and why instructional change teams are likely to generate positive outcomes. This study begins to address this limitation by exploring the decisions that project leaders make when establishing supports for instructional change teams. Results We use a grounded theory approach to analyze interviews with 28 leaders of team-based instructional change projects and connect our findings to existing literature about teams in other contexts. We identify five categories of key team inputs: the nature of the task, who participates, process constraints, external engagement, and access to resources. We situate these team inputs in a preliminary model of instructional change teams. In our model, we posit that these team inputs are consequential for how teams work together and for how teams think and feel about their work. This in turn leads to various kinds of team outcomes. Conclusions Our current model lays out key decisions that project leaders make when setting up instructional change teams. It also highlights the mechanisms by which instructional change team inputs can lead to various outcomes. We argue that this can guide change leaders to have productive conversations when initiating new teams or troubleshooting collaboration challenges of existing teams. Our research also provides a foundation for deeper exploration into how teams work together and the consequences for team outcomes. In particular, future research focused on the perspectives of team members could test and build on this initial model.

Likert-style surveys are a widely used research instrument to assess respondents’ preferences, beliefs, or experiences. In this paper, we propose and demonstrate how network analysis (NA) can be employed to model and evaluate the interconnectedness of items in Likert-style surveys. We explore the advantages of this approach by applying the methodology to the aspects of student experience scale datasets and compare the results to the principal component analysis. We successfully create a meaningful network based on survey item response similarity and use modular analysis of the network to identify larger themes built from the connections of particular aspects. The modular NA of the network of survey items identifies important themes that highlight differences in students’ overall experiences. Our network analysis for Likert-style surveys methodology is widely applicable and provides a new way to investigate phenomena assessed by Likert-style surveys.

This study evaluated HCV treatment initiation among people who inject drugs (PWID) following an intervention of campaign days involving peer connection, point-of-care HCV RNA testing, and linkage to nursing support. ETHOS Engage is an observational cohort study of PWID attending 25 drug treatment clinics and needle and syringe programs in Australia (May 2018–September 2019). Point-of-care results were provided to the nurse, facilitating confirmatory testing and treatment. The study aimed to evaluate treatment uptake and factors associated with treatment at 24 months post-enrolment. There were 317 people with current HCV infection and eligible for treatment (median age 43, 65% male, 15% homeless, 69% receiving opioid agonist treatment, 70% injected in last month). Overall, 15% (47/317), 27% (85/317), 38% (120/317), and 49% (155/317) of people with current HCV infection had initiated treatment at 3-, 6-, 12-, and 24-months following testing, respectively. Homelessness (adjusted hazard ratio (aHR): 0.40; 95% confidence interval: 0.23, 0.71) and incarceration in the past 12 months (vs. never, aHR:0.46; 0.28, 0.76) were associated with decreased treatment initiation in the 24 months post-enrolment. This testing campaign intervention facilitated HCV treatment uptake among PWID. Further interventions are needed to achieve HCV elimination among people experiencing homelessness or incarceration.

Objective To estimate the annual incidence rate of SLE in the USA.Methods A meta-analysis used sex/race/ethnicity-specific data spanning 2002–2009 from the Centers for Disease Control and Prevention network of four population-based state registries to estimate the incidence rates. SLE was defined as fulfilling the 1997 revised American College of Rheumatology classification criteria. Given heterogeneity across sites, a random effects model was employed. Applying sex/race/ethnicity-stratified rates, including data from the Indian Health Service registry, to the 2018 US Census population generated estimates of newly diagnosed SLE cases.Results The pooled incidence rate per 100 000 person-years was 5.1 (95% CI 4.6 to 5.6), higher in females than in males (8.7 vs 1.2), and highest among black females (15.9), followed by Asian/Pacific Islander (7.6), Hispanic (6.8) and white (5.7) females. Male incidence was highest in black males (2.4), followed by Hispanic (0.9), white (0.8) and Asian/Pacific Islander (0.4) males. The American Indian/Alaska Native population had the second highest race-specific SLE estimates for females (10.4 per 100 000) and highest for males (3.8 per 100 000). In 2018, an estimated 14 263 persons (95% CI 11 563 to 17 735) were newly diagnosed with SLE in the USA.Conclusions A network of population-based SLE registries provided estimates of SLE incidence rates and numbers diagnosed in the USA.

Six common beliefs about the usage of active learning in introductory STEM courses are investigated using survey data from 3769 instructors. Three beliefs focus on contextual factors: class size, classroom setup, and teaching evaluations; three focus on individual factors: security of employment, research activity, and prior exposure. The analysis indicates that instructors in all situations can and do employ active learning in their courses. However, with the exception of security of employment, trends in the data are consistent with beliefs about the impact of these factors on usage of active learning. We discuss implications of these results for institutional and departmental policies to facilitate the use of active learning.

The recent detection of natural hydrogen seeps in sedimentary basin settings has triggered significant interest in the exploration of this promising resource. If large economical resources exist and can be extracted from the sub-surface, this would provide an opportunity for natural hydrogen to contribute to the non-carbon-based energy mix. The detection and exploration of hydrogen gas in the sub-surface is a significant challenge that requires costly drilling, sophisticated instrumentation, and reliable analytical/sampling methods. Here, we propose the application of a commercial-based sensor that can be used to detect and monitor low levels of hydrogen gas emissions from geological environments. The sensitivity, selectivity (K > 1000), and stability (