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Mathematical word problem-solving skills are crucial for students across their lives, yet solving such tasks poses challenges for many. Therefore, understanding the characteristics of mathematical word problems that are associated with students' performance is important. The objective of this systematic review and meta-analysis was to evaluate the effects of linguistic and numerical task characteristics associated with mathematical word problem-solving performance among elementary school-aged children (Grades 1 to 6). The systematic review was based on five electronic databases and citation searching. Reporting was conducted following The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The findings (K = 69) showed that five of the six investigated linguistic task characteristics (i.e., the position of the unknown, schematic structure, irrelevant information, realistic considerations, and lexical consistency) and one of the two numerical task characteristics (i.e., number of operations) were related (g = 0.39 to 4.26) with elementary school-aged children's mathematical word problem-solving. However, the findings did not provide support for a general association between a familiar situational narrative or the required operation with mathematical word problem-solving. The findings highlight that elementary school-aged children especially struggle with mathematical word problems requiring realistic considerations or multiple mathematical operations, containing lexical inconsistency, and problems in which the position of the unknown is the first value. This further understanding of elementary schoolers' word problem-solving performance may guide the design of appropriate and progressive instruction and assessment tools and steer research into the interactions within task characteristics and with individual characteristics.

Sorghum is an attractive feedstock for biobased fuel and chemical production because it is familiar to farmers, naturally drought tolerant, and versatile as a food, feed, and fuel crop. Although sorghum is a promising feedstock, particularly in regions that experience drought stress, little is known about how drought conditions impact the ease of conversion of sorghum to fuels and products. This study combines agronomic field trials with a high-throughput experimental pipeline to explore the field performance and liquid biofuel (bisabolene) yields resulting from three sorghum types (photosensitive forage sorghum, optimized grain sorghum, and drought-resistant grain sorghum) grown under pre- and postflowering water limitations in two different California locations. Multiple drought treatments are compared to the control, as the timing (preflowering versus postflowering) of drought stress elicits different survival strategies and corresponding impacts on yield and composition. Forage-type sorghum maintained the highest biomass yields across all irrigation conditions and locations. Glucose and xylose yields resulting from ionic liquid pretreatment and enzymatic saccharification were not significantly impacted by irrigation treatments but differed by location and genotype. However, Rhodosporidium toruloides grown on the resulting plant hydrolysates unexpectedly produced higher titers of bisabolene for drought-stressed sorghum samples regardless of genotype.

Viral infections remain a major risk in immunocompromised pediatric patients, and virus-specific T cell (VST) therapy has been successful for treatment of refractory viral infections in prior studies. We performed a phase II multicenter study (NCT03475212) for the treatment of pediatric patients with inborn errors of immunity and/or post allogeneic hematopoietic stem cell transplant with refractory viral infections using partially-HLA matched VSTs targeting cytomegalovirus, Epstein-Barr virus, or adenovirus. Primary endpoints were feasibility, safety, and clinical responses (>1 log reduction in viremia at 28 days). Secondary endpoints were reconstitution of antiviral immunity and persistence of the infused VSTs. Suitable VST products were identified for 75 of 77 clinical queries. Clinical responses were achieved in 29 of 47 (62%) of patients post-HSCT including 73% of patients evaluable at 1-month post-infusion, meeting the primary efficacy endpoint (>52%). Secondary graft rejection occurred in one child following VST infusion as described in a companion article. Corticosteroids, graft-versus-host disease, transplant-associated thrombotic microangiopathy, and eculizumab treatment correlated with poor response, while uptrending absolute lymphocyte and CD8 T cell counts correlated with good response. This study highlights key clinical factors that impact response to VSTs and demonstrates the feasibility and efficacy of this therapy in pediatric HSCT.

Adolescents with substance use problems (SUP) constitute a group expected to face increased mental health problems (MHP). SUP can exacerbate mental health issues while also serving as a coping mechanism. Understanding the interplay between psychological, substance-related, and social factors is crucial for shaping effective interventions for this demographic. This article presents a three-year follow-up study with adolescents who had outpatient treatment for SUP, focusing on MHP and psychiatric conditions.

Purpose To describe how Qualitative Meaning Analysis (QMA), based on a lifeworld theoretical approach, can be made accessible to students and researchers not well-versed in the philosophy of science or qualitative research. Additionally, to demonstrate that it is a more rigorous approach than qualitative content analysis in guiding healthcare inquiries. Method In recent years, qualitative approaches in nurse education and research have increasingly relied on various content analytical procedures. Liberated from clear philosophical underpinnings, they offer a seemingly pragmatic stance to nursing inquiries. However, by prioritizing ‘sorting content’ over the exploration of meaning, there’s a risk of adopting a mechanistic approach to qualitative analysis. This is problematic because we contend that the search for meaning lies at the heart of qualitative inquiry in nursing and healthcare research, dealing with existential phenomena surrounding health, illness, and care. Result This paper explores the search for meaning in health care research, particularly in nursing, and introduces key epistemological aspects. It also discusses practical considerations to further familiarize and encourage the use of QMA in graduate nursing education and research. Conclusion Qualitative inquiry with a focus on meaning is a powerful means when the intention is to develop person-centered care, and the relationship between the professionals and patients is in focus. Such an approach has the potential to illuminate existential suffering as well as innate health capacities in patients.

Plant-associated microbial communities shift in composition as a result of environmental perturbations, such as drought. It has been shown that Actinobacteria are enriched in plant roots and rhizospheres during drought stress. However, the correlations between microbiome dynamics and plant response to drought are poorly understood. Here we apply a combination of bacterial community composition analysis and plant metabolite profiling in Sorghum bicolor roots, rhizospheres, and soil during drought and drought recovery to investigate potential contributions of host metabolism to shifts in bacterial composition. Our results provide a detailed view of metabolic shifts across the plant root during drought and show that the response to rewatering differs between root and soil; additionally, we identify drought-responsive metabolites that are highly correlated with the observed changes in Actinobacteria abundance. Furthermore, we find that pipecolic acid is a drought-enriched metabolite in sorghum roots, and that exogenous application of pipecolic acid inhibits root growth. Finally, we show that this activity functions independent of the systemic acquired resistance pathway and has the potential to impact Actinobacterial taxa within the root microbiome.

This article presents a series of recommendations for the publication of archaeological data, to improve their usability. These 12 recommendations were formulated by archaeological data experts who mined thousands of publications for different data types (including funerary practices, accelerator mass spectrometry dating, stable isotopes, zooarchaeology, archaeobotany and pathologies) during the initial construction of the Big Interdisciplinary Archaeological Database (BIAD). We also include data harmonisation vocabularies utilised for the integration of data from different recording systems. The case studies we cite to illustrate the recommendations are grounded in examples from the published literature and are presented in a problem/solution format. Though practically oriented towards the facilitation of efficient databasing, these recommendations – which we refer to as the BIAD Standards – are broadly applicable by those who want to extract scientific data from archaeological information, those who work with a specific region or theoretical focus and journal editors and manuscript authors. We anticipate that the use of the BIAD Standards will increase the usability, visibility, interoperability and longevity of published data and also increase the citations of those publications from which data were mined. The Standards will also help frame a unified foundation to support the continued integration of the natural sciences with archaeological research in the future.

In this paper, we critically discuss the impact of policy documents on the construction of national narratives on the provision of support for cultural-linguistic diversity in education systems in two European countries. The analysis focuses upon a selection of national policy documents that deal with the planning and provision of HLE since the 1990s. We take critical pedagogy and sociomateriality as theoretical lenses to investigate educational policies on HLE. Thus, this study critically traces the ways in which language ideologies are enmeshed with legislative, political and educational discourses by following an inductive and retroductive process, wherein key-concepts, themes and critical configurations of HLE are mapped, compared, re-assembled and discussed in terms of a complex system. The analysis shows that the (non-)provision of HLE shapes the educational space and the value references and world views that prevail and are (re)produced in it. Emerging deficit perspectives, linguistic assimilation and marginalisation processes limit the path towards more inclusive and equitable educational institutions and practices.

Climate change is globally affecting rainfall patterns, necessitating the improvement of drought tolerance in crops. Sorghum bicolor is a relatively drought-tolerant cereal. Functional stay-green sorghum genotypes can maintain green leaf area and efficient grain filling during terminal post-flowering water deprivation, a period of ~10 weeks. To obtain molecular insights into these characteristics, two drought-tolerant genotypes, BTx642 and RTx430, were grown in replicated control and terminal post-flowering drought field plots in Californias Central Valley. Photosynthetic, photoprotective, and water dynamics traits were quantified and correlated with metabolomic data collected from leaves, stems, and roots at multiple timepoints during control and drought conditions. Physiological and metabolomic data were then compared to longitudinal RNA sequencing data collected from these two genotypes. The unique metabolic and transcriptomic response to post-flowering drought in sorghum supports a role for the metabolite galactinol in controlling photosynthetic activity through regulating stomatal closure in post-flowering drought. Additionally, in the functional stay-green genotype BTx642, photoprotective responses were specifically induced in post-flowering drought, supporting a role for photoprotection in the molecular response associated with the functional stay-green trait. From these insights, new pathways are identified that can be targeted to maximize yields under growth conditions with limited water.

Background: Neoehrlichia mikurensis infections can cause symptomatic disease, particular among immunosuppressed persons. Long-lasting asymptomatic carriage of N. mikurensis may be common in endemic areas. This study explores possible associations between carriage of N. mikurensis DNA and persistent health complaints in persons who attribute their symptoms to a tick-borne disease. Methods: Eleven persons tested positive for N. mikurensis DNA by PCR in a study cohort of 285 persons reporting persistent health complaints. The 11 persons were tested again in a follow-up sample. Oral doxycycline treatment was given if the confirmatory PCR-test was positive. Treatment response was assessed by telephone interview. Demographics, clinical manifestations, tick exposure, physical health, somatic symptom burden and fatigue were compared to persons with negative N. mikurensis PCR (controls, N = 274). Results: Six persons had detectable N. mikurensis DNA in a follow-up sample up to 9.5 months after the index sample. Seven persons (one without a positive confirmative test) received doxycycline treatment. Three reported symptom restitution after completed antibiotic treatment. However, their symptoms were not clearly attributed to infection by N. mikurensis. We did not find any significant differences between infected persons and non-infected controls regarding their clinical manifestations and health burdens. Conclusions: We corroborate previous evidence of long-term carriage of N. mikurensis, but cannot infer that to be causative of persistent health complaints.

Purpose: Isolated spinal aneurysms (iSAs) are rare, with an uncertain natural history and no established treatment guidelines. Multiple iSAs are even more uncommon, complicating treatment decisions. Methods: This study reports a case of a ruptured radiculo-pial artery aneurysm in a patient with multiple iSAs, treated with surgical excision, assisted by intraoperative neurophysiological monitoring (IONM). Further, we review and analyze all previously reported cases of multiple iSAs. Results: A 67-year-old woman with spinal subarachnoid hemorrhage and spinal cord compression due to a ruptured radiculo-pial artery aneurysm was treated surgically. Digital subtraction angiography (DSA) showed three spinal aneurysms. Intraoperative indocyanine green video-angiography (ICG-VA) revealed an aneurysm contributing to the left posterior spinal artery. The aneurysm was excised after proximal inflow occlusion under IONM. The other aneurysms spontaneously regressed, and the patient had a good functional outcome. Through a systematic literature review, we analyzed 13 multiple iSAs including our case, involving 34 aneurysms in total. Conclusions: There is no standardized treatment approach for multiple iSAs. These aneurysms are often fusiform and clustered in contiguous metameric regions. They can be classified into flow-related and wall-weakening aneurysms. Surgery offers definitive treatment for ruptured iSAs and relieves spinal cord compression. Due to the common fusiform shape, parent vessel sacrifice may be necessary, and should include IONM and ICG-VA to minimize complications. Conservative treatment is viable as spontaneous regression often occurs.

Exposure to environmental pollutants increases the risk for metabolic dysfunction. Dietary and lifestyle interventions may reduce the risks associated with this toxicity. We conducted this 4-week, observational, clinical study to explore the safety and efficacy of a proprietary dietary program formulated to enhance cardiometabolic functioning, metabolic transformation, and gut health. Thirty-eight generally healthy overweight subjects were assigned a low-glycemic load, Mediterranean-style food plan with targeted nutraceutical supplementation and a physical activity regimen. Subjects expressed positive subjective health and symptom changes coincident with improvements in anthropomorphic variables, lipid profiles, glycemic measures, vascular biomarkers, cardiovascular risk, systemic inflammation, hepatic function, urinary heavy metal excretion, and gut health. Thus combining targeted nutraceutical supplementation with a low-glycemic load food plan and exercise may represent a novel nutritional approach to improving the body's ability to modulate the toxicity of pollutants and reducing cardiometabolic risk factors in generally healthy overweight persons.

Monitoring trace levels of endocrine-disrupting steroid hormones in water is essential in environmental assessment, necessitating development of appropriate sampling techniques. Grab/passive sampling methods are commonly used, but use of time-integrated microflow in-situ extraction (TIMFIE) for sampling steroid hormones remains unexplored. This study aimed to evaluate the feasibility of TIMFIE samplers equipped with a hydrophilic-lipophilic balanced sorbent for monitoring seven different steroid hormones in different water matrices. Method validation demonstrated good reproducibility and accuracy of the TIMFIE samplers for extracting almost all target hormones in surface water and effluent wastewater, but not influent wastewater. Method quantification limit (0.4 ng L−1) of TIMFIE samplers for estrone (E1) in surface water and effluent wastewater met EU Water Framework Directive requirements. Comparison of TIMFIE samples and the parallel flow-based composite samples confirmed the consistency of E1, estradiol (E2), 17α-ethinylestradiol, and dienogest measurements in effluent wastewater. With TIMFIE samplers deployed in surface water, the time-weighted average concentrations of E1 (0.5–1.5 ng L−1) and E2 (0.3–0.4 ng L−1) were found below the predicted no-effect concentrations, indicating low risk to aquatic organisms. Given the challenges in assessing trace levels of steroid hormones in waters, TIMFIE as active, time-integrated samplers is a promising, green sampling tool for efficient, resource-conscious in situ extraction of steroid hormones, allowing a sustainable monitoring of these chemicals in the environment, including conditions under frozen-surfaced water bodies.

Spin glasses are inherently dynamical. Taken properly, measurements of these materials can capture their dynamics and provide a wealth of insight into the physics of the spin glass state. In this methods review, two magnetometry methods are directly compared–ac and dc. Because these measurements are taken differently, the resulting data of each method will contain different information about spin glass behavior. This review will specifically focus on how the out-of-equilibrium effects of aging, rejuvenation, and memory manifest in each of these techniques, and how to construct protocols to measure these effects. We then describe the physical significance of each type of measurement and how to interpret their results. Finally, we explicitly detail which applications are most appropriate for which method. This will help the reader select the most helpful technique to carry out their own future experiments.

Purpose To describe and analyse experiences of living with lipedema. Methods: Individual, semi-structured interviews with a purposive sample of 12 women diagnosed with lipedema and analysed by qualitative content analysis utilizing an inductive approach. Results The overarching theme, “An uncertain uphill battle against a divergent body and societal ignorance”, covers the experiences of living with lipedema and is based on five categories; “Captivated by a disintegrating body”, “Face the impairments of a chronic condition”, “Experience social exclusion”, “Need emotional support to go on” and “Mull over an insecure future”. The women felt entrapped within their bodies and experienced social exclusion due to the chronic symptoms and the progressive body shape alteration caused by their illness. Having experienced deficient information on the illness, varying support from other people, and a deteriorating economic situation, the women face an uncertain future. Conclusions Symptoms and restrictions caused by lipedema affect women’s livelihood and future, as there are no indications for disease improvement. Preventive work aimed at reducing health deterioration should be a priority. More research is needed to raise healthcare awareness regarding difficulties experienced by patients with lipedema.

Healthcare-associated infections (HAIs) are common and expensive complications that can occur during inpatient hospital stays. Hand hygiene (HH)—which includes hand washing with soap and water and hand rubbing with alcohol-based hand sanitizer—is the primary tool used by healthcare personnel (HCP) to prevent HAIs. Consequently, the World Health Organization (WHO) proposed guidelines for effective HH in healthcare settings. However, consistent performance of HH by HCP is still lacking. HH in healthcare requires both compliance with indications for HH and quality of HH. Integrative approaches in human factors engineering (HFE) and infection prevention can be used to promote sustainable techniques that can be implemented by HCP to improve the quality of HH techniques. This research proposes a three-phase integrative approach that uses HFE-based methods to identify why HH is often insufficiently executed by HCP in hospital settings and ultimately to help guide HCP to improve HH quality. We performed i) a tabular task analysis (TTA), constructed by HFE personnel and infection prevention specialists, ii) card sorting with infection prevention subject matter experts to prioritize HH steps and analyzed with criticality analysis and subsequent modifications to the TTA, and iii) TTA validation and verification with subject matter experts. Finally, we conducted qualitative interviews with members of hospital leadership and determined that it is feasible to implement the use of TTAs in hospital settings. This research provides enhanced HH guidance using an integrative HFE-based approach and is directed to increase the quality of HH performed by HCP, thereby reducing HAI rates and improving patient safety. Furthermore, these results can be used to support the effective implementation of the WHO's HH guidance. Our findings elucidate some of the challenges to patient safety regarding HH and clarify best practices for HH in hospital settings.

With the prevalence of sexual violence in most countries and its increase in Sweden, it is important to understand the development of secondary traumatic reactions among professionals who work with sexually violated clients. The aim of this study was to describe the meaning of therapists’ personal experiences when treating survivors of sexual violence. We conducted a qualitative interview study of therapists in Sweden (N = 11) using thematic analysis and adding a phenomenological openess towards the phenomenon. The participants were all women, with different professional backgrounds and with further education in areas such as psychotherapy, sexology, trauma treatment, and forensic nursing. The essential meaning of their work could be described as a continuum where therapists were seeking balance between contradictory experiences, further described in four themes. They experienced their work as highly meaningful, and the use of self-care strategies helped to maintain protective boundaries. However, the incomprehensible violence they were indirectly exposed to, challenged their protective boundaries, thus causing negative reactions for the therapists. Increased understanding of the impact of work on therapists’ professional and private lives is crucial, and the need for therapists to have a model or framework of meaning and explanation for sexual violence that ties contradictory experiences together.

National parks are often places where people have previously lived and worked-they have been formed by a combination of natural and human processes that embody an identifiable history of cultural and political values. Conservation of protected areas is primarily about how we perceive such landscapes, how we place differential values on different landscape components, and who gets to decide on these values. Thus, conservation has been and still is very much about issues of power and environmental justice. This paper analyses the social, political and environmental histories of three national park regimes (South Africa, Sweden and Scotland) through the lens of public access rights. We examine the evolving status of access rights-in a broad sense that includes access to land, resources and institutions of governance-as a critical indicator of the extent to which conservation policies and legislation realise the aims of environmental justice in practice. Our case studies illustrate how access rights are contingent on the historical settings and ideological contexts in which the institutions controlling national park management have evolved. Dominant cultural, political and scientific ideologies have given rise to historical precedents and institutional structures that affect the promotion of environmental justice in and around national parks today. In countries where national parks were initially created to preserve perceived ′wilderness′, with decisions taken by powerful elites and central authorities, this historical legacy has prevented profound change in line with new policy directives. The comparative analysis of national park regimes, where historical trajectories both converge and diverge, was useful in improving our understanding of contemporary issues involving conservation, people and politics.

Umbrella reviews (reviews of systematic reviews) are increasingly used to synthesize findings from systematic reviews. One important challenge when pooling data from several systematic reviews is publication overlap, that is, the same primary publications being included in multiple reviews. Pieper et al. have proposed using the corrected covered area (CCA) index to quantify the degree of overlap between systematic reviews to be pooled in an umbrella review. Recently, this methodology has been integrated in Excel- or R-based tools for easier use. In this short letter, we highlight an important consideration for using the CCA methodology for pairwise overlap assessment, especially when reviews include varying numbers of primary publications, and we urge researchers to fine-tune this method and exercise caution when review exclusion decisions are based on its output.