Search

The aim of the research was to determine the self-assessment of digital competences and assessment of skills among students of professional and university studies at the University of Split (N=466), as well as to check whether there is a significant difference between them in terms of their year of study, gender, and scientific field of study. The results showed that senior students show a higher digital skills level, and that first-year students of humanities and social studies achieve better results than senior students on the digital skills test.

Caribbean health research has overwhelmingly employed measures developed elsewhere and rarely includes evaluation of psychometric properties. Established measures are important for research and practice. Particularly, measures of stress and coping are needed. Stressors experienced by Caribbean people are multifactorial, as emerging climate threats interact with existing complex and vulnerable socioeconomic environments. In the early COVID-19 pandemic, our team developed an online survey to assess the well-being of health professions students across university campuses in four Caribbean countries. This survey included the Perceived Stress Scale, 10-item version (PSS-10) and the Brief Resilient Coping Scale (BRCS). The participants were 1,519 health professions students (1,144 females, 372 males). We evaluated the psychometric qualities of the measures, including internal consistency, concurrent validity by correlating both measures, and configural invariance using confirmatory factor analysis (CFA). Both scales had good internal consistency, with omega values of 0.91 for the PSS-10 and 0.81 for the BRCS. CFA suggested a two-factor structure of the PSS-10 and unidimensional structure of the BRCS. These findings support further use of these measures in Caribbean populations. However, the sampling strategy limits generalizability. Further research evaluating these and other measures in the Caribbean is desirable.

This research explored students’ artistic preferences for musical and visual arts (paintings) from different world cultures, outside the dominant Western European and Anglo-Saxon art field. The main goal of the research was to examine the possibility of predicting these preferences based on multicultural personality traits, within the concept of multicultural effectiveness. A total of 427 participants took part in the study. The following instruments were used: General Data Questionnaire, Multicultural Personality Inventory, Musical Preferences Questionnaire, and Painting Preferences Questionnaire. The results indicated a significant correlation between age and musical preferences, as well as between artistic experience (attending theatre productions and art exhibitions) and musical/painting preferences. Among the multicultural personality traits, only open-mindedness and cultural empathy positively correlated with artistic preferences. Results of regression analysis in which preferences were used as criteria showed that, after demographics of participants and their artistic experience have been controlled for, open-mindedness positively predicted musical and painting preferences, while both open-mindedness and cultural empathy proved to be significant positive predictors of painting preferences. Other significant predictor for both preferences was attending art exhibitions. Musical preferences were related with older age, while vocational high school education predicted higher preferences for paintings. Although predictors explained relatively small amount of criterion variance, the obtained results confirmed that multicultural personality dispositions have little, but significant contribution to world artistic preferences.

Abstract Background Patients with cardiac disease with or without depression may also have major physical and mental problems. This study assesses and compares the quality of life (QOL) of patients with cardiac disease with and without depression and accompanying comorbidities. Methods A cross-sectional study was conducted with a convenience sample of 388 patients with cardiac disease. The 12-item Short-Form (SF-12)-patient was used to measure physical component scale (PCS) and mental component scale (MCS) QOL, and the Patient Health Questionnaire (PHQ-9) was used to measure depression. The Charlson Comorbidity Index was used to estimate 10-year survival probability. Descriptive statistics, analysis of covariance (ANCOVA), chi-square tests, and binary logistic regression were used for analysis. Results The prevalence of minimal to mild depression was 65.7% [(95% CI (60.8, 70.4)] and that of moderate to severe depression was 34.3% [95% CI (29.6, 39.2)]. There was no significant association between the level of PHQ-categorised depression and age (p = 0.171), sex (p = 0.079), or ethnicity (p = 0.407). The overall mean PCS and MCS QOL was 32.5 [95% CI (24.4, 40.64)] and 45.4 [95% CI (44.4, 46.4)], respectively, with no significant correlation between PCS and MCS [r (Pearson’s) = 0.011; p = 0.830)]. There were QOL differences among the five PHQ categories (PCS: p = 0.028; MCS: p ≤ 0.001) with both MCS and PCS decreasing with increasing depression. ANCOVA (with number of comorbidities as the covariate) showed a significant age × ethnicity interaction for PCS (p = 0.044) and MCS (p = 0.039), respectively. Young Indo-Trinidadians had significantly lower PCS than did Afro-Trinidadians, while the converse was true for MCS. Depression, age, and number of comorbidities were predictors of PCS, while depression, age, and sex were predictors of MCS. Conclusions Increasing severity of depression worsened both PCS and MCS QOL. Age and level of clinical depression predicted QOL, with number of comorbidities predicting only PCS and sex predicting only MCS. Efforts must be made to treat depression in all age groups of patients with cardiac disease.

The aim of this research was to determine the relationship between mindfulness, absorption in music, and emotion regulation through music in people who have different tastes in music. The research started from the assumption that absorption in music means the possibility of deep “absorption” in musical experience and thus a greater possibility of emotion regulation through music. In contrast to absorption, mindfulness as full awareness of the current moment or a state of consciousness in which attention is intentionally focused on one’s own experiences (bodily sensations, senses, thoughts, or emotions) could make it difficult to indulge in a musical experience. In order to test these assumptions, a study was conducted on 252 participants in late adolescence and young adulthood age who, in addition to using instruments designed to examine absorption in music, mindfulness, and emotion regulation through music, assessed their musical taste. The results showed a positive correlation between the preferences for different music styles and absorption in music, as well as between absorption in music and different strategies for regulating emotions through music. Mindfulness, on the other hand, proved to be negatively correlated with both absorption in music and most strategies for regulating mood through music. Conducted regression analyses showed that in addition to controlling musical taste, absorption in music is a positive predictor of all emotion regulation strategies, while mindfulness is a negative predictor of discharging negative emotions and forgetting unwanted thoughts and feelings through music.

Abstract Background Cardiovascular disease remains the most common cause of death. However, effective and timely secondary care contributes to improved quality of life, decreased morbidity and mortality. This study analyzed the medical care of patients in a resource limiting country with a first presentation of acute myocardial infarction (AMI). Methods A cross-sectional retrospective study was conducted on first time AMI patients admitted between March 1st 2011 and March 31st 2015 to the only tertiary public hospital in a resource limiting country, Trinidad. Relevant data were obtained from all confirmed AMI patients. Results Data were obtained from 1106 AMI patients who were predominantly male and of Indo Trinidadian descent. Emergency treatment included aspirin (97.2%), clopidogrel (97.2%), heparin (81.3%) and thrombolysis (70.5% of 505 patients with ST elevation MI), but none of the patients had primary angioplasty. Thrombolysis was higher among younger patients and in men. There were no differences in age, sex, and ethnicity in all other treatments. Of the 360 patients with recorded times, 41.1% arrived at the hospital within 4 h. The proportion of patients receiving thrombolysis (door to needle time) within 30 min was 57.5%. In-patient treatment medication included: aspirin (87.1%), clopidogrel (87.2%), beta blockers (76.5%), ACEI (72.9%), heparin (80.6%), and simvastatin (82.5%). Documentation of risk stratification, use of angiogram and surgical intervention, initiation of cardiac rehabilitation (CR), and information on behavioral changes were rare. Electrocardiogram (ECG) and cardiac enzyme tests were universally performed, while echocardiogram was performed in 57.1% of patients and exercise stress test was performed occasionally. Discharge treatment was limited to medication and referrals for investigations. Few patients were given lifestyle and activity advice and referred for CR. The in-hospital death rate was 6.5%. There was a significantly higher relative risk of in-hospital death for non-use of aspirin, clopidogrel, simvastatin, beta blockers, and heparin, but not ACE inhibitors and nitrates. Conclusions Medication usage was high among AMI patients. However, there was very minimal use of non-pharmacological measures. No differences were found in prescribed medication by age, sex, or ethnicity, with the exception of thrombolysis.

Abstract Background Outcomes following acute myocardial infarction (AMI) may result in death, increased morbidity, and change in quality of life (QOL). This study explores health-related QOL of first-time patients following AMI. Methods This cross-sectional study used a sample of patients with first-time AMI experienced between April 2011 and March 2015 at a tertiary health institution. Recruited patients belonged to different post-AMI periods: 2–10 weeks, 5–22 months, and > 22 months to 4 years post AMI. Inclusion criteria were not confused and communicating freely. Exclusion criteria were non-contactable, refusing to participate, and deceased. One-on-one interviews were conducted using the validated and pre-tested Quality of Life after Myocardial Infarction (QLMI) questionnaire. QOL of patients after AMI was evaluated at each period. Descriptive, Mann–Whitney U, Kruskal–Wallis, and regression analyses were conducted using SPSS version 24. Results A total of 534 participant interviews (overall response rate 65.4%) were conducted. Interviewees were predominantly male (67%), aged 51–65 years (45%), Indo-Trinidadian (81.2%), NSTEMI (64.4%), and hypertensive (72.4%). Overall QOL improved over time and in all domains: Emotional, Physical, and Social. Lower QOL was found among women, patients with NSTEMI, and diabetics in all domains; in patients with hypertension and renal disease in the Physical and Social domains only; and in patients with ischaemic heart disease (IHD) in the Physical domain only. Self-reported stress and lack of exercise were associated with lower QOL while drinking alcohol and eating out were related to better QOL. Hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Declining QOL in the Physical domain with age was also found. The leading components of QOL were self-confidence and social exclusion (early post AMI), lack of self-confidence (intermediate post AMI), and tearfulness (late post AMI). Conclusions QOL in AMI survivors improves over time. Female gender, NSTEMI, diabetes, hypertension, renal disease, stress, and lack of exercise were associated with lower QOL while hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Cardiac rehabilitation and psychological support may enhance earlier increased QOL among survivors, particularly among vulnerable groups.

Dosadašnje su studije o ulozi kognitivnih procesa u objašnjenju nastanka i razvoja depresije upućivale na važnost stjecanja jasnijeg uvida u njihove međusobne odnose, stoga se ovim istraživanjem pokušalo provjeriti kakav je doprinos metakognitivnih vjerovanja, ruminacije, potiskivanja misli i usredotočenosti objašnjenju razine depresivnosti te ispitati kakva je njihova međusobna povezanost kod kliničke i ne-kliničke skupine. Kliničku skupinu (N=70) su sačinjavale osobe oboljele od depresivnog poremećaja, a ne-kliničku (N=70) osobe bez poteškoća mentalnog zdravlja. Dobiveni su rezultati pokazali da depresivne osobe više ruminiraju, imaju pozitivnija vjerovanja o ruminaciji, nižu usredotočenu svjesnost, češće potiskuju misli te imaju negativnija vjerovanja o opasnosti i posljedicama ruminacije nego mentalno zdrave osobe. Doprinos je ruminacije kod depresivnih osoba posredovan negativnim vjerovanjima o posljedicama ruminacije dok je kod mentalno zdravih osoba ruminacija direktno povezana sa stupnjem depresivnosti. Rezultati daju dodatne smjernice u psihoterapijskom pristupu koji bi u tretmanu depresivnog poremećaja trebao uključivati i tretman ruminacije i trening usredotočene svjesnosti.

Tourism is extremely interacted with the environment. Taking into account that tourism uses the space and related resources, it seems right to pay for the damages caused to the environment. This is the basis of the tourist spatial eco rent. The paper evaluates the space and resources used by tourism as the basis for the introduction of the tourism eco-rent in the area of Makarska Riviera, a traditional tourism destination. It is divided into three main spatial units: urban areas, bathing zone (beaches), Biokovo Park of Nature. According to natural and geographical reasoning, a number of zones with different spatial values within each spatial unit has been identified. Each unit, i.e. zone was evaluated according to various criteria relevant to the evaluation of space for tourism and tourism development purposes. Having ranked zones within each unit, using the multiriteria ranking method PROMETHEE II, comparative analysis of the obtained results was carried out as well.

Background: Progressive harm reduction policies have been implemented in British Columbia, Canada. However, youth who use drugs face barriers to receiving harm reduction care, resulting in increasing opioid-related hospitalizations and drug toxicity deaths. This scoping review collates peer-reviewed evidence to understand the barriers and facilitators faced by youth who use drugs when accessing harm reduction programming in British Columbia, Canada., Methods: This scoping review entailed conducting a systematic search of relevant databases to identify relevant articles. Articles were included if they: (i) contained youth falling between the ages of 12 and 26 years old; (ii) explored accessibility, barriers, and/or facilitators to harm reduction care or related topics; (iii) were empirical research articles using primary data (i.e., reviews, grey literature, theoretical or conceptual papers, books, etc. were excluded); and (iv) were available in the English language, given the geographic focus on British Columbia., Results: A total of 398 sources were identified and ultimately, data from 13 sources were charted and extracted. When investigating barriers to harm reduction care among youth, four themes emerged: self-stigma, service navigation, service delivery, and negative provider interactions. Furthermore, in exploring factors that facilitate harm reduction care for youth, four themes surfaced: ability to meet basic needs, positive provider interactions, social networks, and risk mitigation guidance., Conclusions: The expansion of harm reduction services in 2016 did not fully address accessibility challenges faced by youth who use drugs. Barriers continue to hinder harm reduction engagement, while supportive networks, positive provider interactions, and the ability to meet basic needs facilitated sustained access. Tailored policy interventions rooted in equity are crucial to improving access to harm reduction services for youth who use drugs., (© 2024. The Author(s).)

Caribbean health research has overwhelmingly employed measures developed elsewhere and rarely includes evaluation of psychometric properties. Established measures are important for research and practice. Particularly, measures of stress and coping are needed. Stressors experienced by Caribbean people are multifactorial, as emerging climate threats interact with existing complex and vulnerable socioeconomic environments. In the early COVID-19 pandemic, our team developed an online survey to assess the well-being of health professions students across university campuses in four Caribbean countries. This survey included the Perceived Stress Scale, 10-item version (PSS-10) and the Brief Resilient Coping Scale (BRCS). The participants were 1,519 health professions students (1,144 females, 372 males). We evaluated the psychometric qualities of the measures, including internal consistency, concurrent validity by correlating both measures, and configural invariance using confirmatory factor analysis (CFA). Both scales had good internal consistency, with omega values of 0.91 for the PSS-10 and 0.81 for the BRCS. CFA suggested a two-factor structure of the PSS-10 and unidimensional structure of the BRCS. These findings support further use of these measures in Caribbean populations. However, the sampling strategy limits generalizability. Further research evaluating these and other measures in the Caribbean is desirable., Competing Interests: None., (© The Author(s) 2024.)

We present 4k video and whole transcriptome data for seven deep-sea invertebrate animals collected in the Eastern Pacific Ocean during a research expedition onboard the Schmidt Ocean Institute's R/V Falkor in August of 2021. The animals include one jellyfish (Atolla sp.), three siphonophores (Apolemia sp., Praya sp., and Halistemma sp.), one larvacean (Bathochordaeus mcnutti), one tunicate (Pyrosomatidae sp.), and one ctenophore (Lampocteis sp.). Four of the animals were sequenced with long-read RNA sequencing technology, such that the reads themselves define a reference assembly for those animals. The larvacean tissues were successfully preserved in situ and has paired long-read reference data and short read quantitative transcriptomic data for within-specimen analyses of gene expression. Additionally, for three animals we provide quantitative image data, and a 3D model for one siphonophore. The paired image and transcriptomic data can be used for species identification, species description, and reference genetic data for these deep-sea animals., (© 2024. The Author(s).)

Models for digital triage of sick children at emergency departments of hospitals in resource poor settings have been developed. However, prior to their adoption, external validation should be performed to ensure their generalizability. We externally validated a previously published nine-predictor paediatric triage model (Smart Triage) developed in Uganda using data from two hospitals in Kenya. Both discrimination and calibration were assessed, and recalibration was performed by optimizing the intercept for classifying patients into emergency, priority, or non-urgent categories based on low-risk and high-risk thresholds. A total of 2539 patients were eligible at Hospital 1 and 2464 at Hospital 2, and 5003 for both hospitals combined; admission rates were 8.9%, 4.5%, and 6.8%, respectively. The model showed good discrimination, with area under the receiver-operator curve (AUC) of 0.826, 0.784 and 0.821, respectively. The pre-calibrated model at a low-risk threshold of 8% achieved a sensitivity of 93% (95% confidence interval, (CI):89%-96%), 81% (CI:74%-88%), and 89% (CI:85%-92%), respectively, and at a high-risk threshold of 40%, the model achieved a specificity of 86% (CI:84%-87%), 96% (CI:95%-97%), and 91% (CI:90%-92%), respectively. Recalibration improved the graphical fit, but new risk thresholds were required to optimize sensitivity and specificity.The Smart Triage model showed good discrimination on external validation but required recalibration to improve the graphical fit of the calibration plot. There was no change in the order of prioritization of patients following recalibration in the respective triage categories. Recalibration required new site-specific risk thresholds that may not be needed if prioritization based on rank is all that is required. The Smart Triage model shows promise for wider application for use in triage for sick children in different settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kigo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Revolutionary advancements in underwater imaging, robotics, and genomic sequencing have reshaped marine exploration. We present and demonstrate an interdisciplinary approach that uses emerging quantitative imaging technologies, an innovative robotic encapsulation system with in situ RNA preservation and next-generation genomic sequencing to gain comprehensive biological, biophysical, and genomic data from deep-sea organisms. The synthesis of these data provides rich morphological and genetic information for species description, surpassing traditional passive observation methods and preserved specimens, particularly for gelatinous zooplankton. Our approach enhances our ability to study delicate mid-water animals, improving research in the world's oceans.

Siphonophores are ubiquitous and often highly abundant members of pelagic ecosystems throughout the open ocean. They are unique among animal taxa in that many species use multiple jets for propulsion. Little is known about the kinematics of the individual jets produced by nectophores (the swimming bells of siphonophores) or whether the jets are coordinated during normal swimming behavior. Using remotely operated vehicles and SCUBA, we video recorded the swimming behavior of several physonect species in their natural environment. The pulsed kinematics of the individual nectophores that comprise the siphonophore nectosome were quantified and, based on these kinematics, we examined the coordination of adjacent nectophores. We found that, for the five species considered, nectophores located along the same side of the nectosomal axis (i.e. axially aligned) were coordinated and their timing was offset such that they pulsed metachronally. However, this level of coordination did not extend across the nectosome and no coordination was evident between nectophores on opposite sides of the nectosomal axis. For most species, the metachronal contraction waves of nectophores were initiated by the apical nectophores and traveled dorsally. However, the metachronal wave of Apolemia rubriversa traveled in the opposite direction. Although nectophore groups on opposite sides of the nectosome were not coordinated, they pulsed with similar frequencies. This enabled siphonophores to maintain relatively linear trajectories during swimming. The timing and characteristics of the metachronal coordination of pulsed jets affects how the jet wakes interact and may provide important insight into how interacting jets may be optimized for efficient propulsion., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2023. Published by The Company of Biologists Ltd.)

Morphological features are the primary identifying properties of most animals and key to many comparative physiological studies, yet current techniques for preservation and documentation of soft-bodied marine animals are limited in terms of quality and accessibility. Digital records can complement physical specimens, with a wide array of applications ranging from species description to kinematics modeling, but options are lacking for creating models of soft-bodied semi-transparent underwater animals. We developed a lab-based technique that can live-scan semi-transparent, submerged animals, and objects within seconds. To demonstrate the method, we generated full three-dimensional reconstructions (3DRs) of an object of known dimensions for verification, as well as two live marine animals-a siphonophore and an amphipod-allowing detailed measurements on each. Techniques like these pave the way for faster data capture, integrative and comparative quantitative approaches, and more accessible collections of fragile and rare biological samples., Competing Interests: No competing interest is declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology.)

Using artificial intelligence to facilitate autonomy in robotics will provide new insights into marine life.

Appendicularia comprises 70 marine, invertebrate, chordate species. Appendicularians play important ecological and evolutionary roles, yet their morphological disparity remains understudied. Most appendicularians are small, develop rapidly, and with a stereotyped cell lineage, leading to the hypothesis that Appendicularia derived progenetically from an ascidian-like ancestor. Here, we describe the detailed anatomy of the central nervous system of Bathochordaeus stygius, a giant appendicularian from the mesopelagic. We show that the brain consists of a forebrain with on average smaller and more uniform cells and a hindbrain, in which cell shapes and sizes vary to a greater extent. Cell count for the brain was 102. We demonstrate the presence of three paired brain nerves. Brain nerve 1 traces into the epidermis of the upper lip region and consists of several fibers with some supportive bulb cells in its course. Brain nerve 2 innervates oral sensory organs and brain nerve 3 innervates the ciliary ring of the gill slits and lateral epidermis. Brain nerve 3 is asymmetric, with the right nerve consisting of two neurites originating posterior to the left one that contains three neurites. Similarities and differences to the anatomy of the brain of the model species Oikopleura dioica are discussed. We interpret the small number of cells in the brain of B. stygius as an evolutionary trace of miniaturization and conclude that giant appendicularians evolved from a small, progenetic ancestor that secondarily increased in size within Appendicularia., (© 2023 The Authors. Journal of Morphology published by Wiley Periodicals LLC.)

The analysis of plants featured in Baroque artworks on the eastern Adriatic coast has not previously been the subject of an in-depth study. The study of plant iconography in Baroque sacred artworks, which are mostly paintings, was carried out in eight churches and monasteries on the Pelješac peninsula in southern Croatia. Taxonomic interpretation of the painted flora on 15 artworks led to the identification of 23 different plant taxa (species or genera) belonging to 17 families. One additional plant was identified only by family taxonomic rank. The number of plants was relatively high, and most species were considered non-native (71%, "exotic" flora) phanerophytes. In terms of geographic origin, the Palaearctic region (Eurasia) and the American continent were identified as the main areas of plant origin. Lilium candidum , Acanthus mollis , and Chrysanthemum cf. morifolium , were the most common species. We think that the plants were selected for decorative and aesthetic reasons, as well as for their symbolic significance.

Purpose: The COVID-19 pandemic precipitated a swift transition to online learning in medical and health sciences. This study investigated the associations of previous experience with online learning, current confidence with online learning, and resilient coping skills with perceived stress reported by pharmacy students during the emergency transition to online learning., Methods: Undergraduate pharmacy students (N=113, response rate = 41%) completed an online, self-report, cross-sectional survey during April-June 2020. Measures included Likert items measuring prior experience and current comfort levels with online learning, the Brief Resilient Coping Scale (BRCS), and the Perceived Stress Scale 10-Item Version (PSS-10). Experience, comfort with online learning, reported scores, and internal consistency for the BRCS and PSS-10 were summarized. A linear regression model examined the associations of prior experience with online education, gender, and resilient coping with perceived stress., Results: Of the 113 respondents (78% female, mean age 22.3 years), > 50% had only occasional prior experience with online learning, coursework, and examinations, but 63% expressed confidence with online learning. Mean PSS-10 and BRCS scores were 23.8 and 13.3, respectively, and both scales demonstrated good internal consistency (α > 0.80). BRCS score was the single predictor of the PSS-10 score (r 2 = 0.18, p < 0.001). Female gender was not a significant predictor ( p = 0.11). A multiple regression model explained moderate variation in perceived stress (adjusted R 2 = 0.19)., Conclusion: PSS-10 and BRCS scores indicated moderate levels of stress and coping skills among students during online teaching. Most students had some prior exposure to online learning, coursework, and examinations. Higher resiliency scores, but not prior online learning experience, predicted lower perceived stress., Competing Interests: Dr Md Anwarul Azim Majumder is the Editor-in-Chief of Advances in Medical Education and Practice (DovePress). The other authors report no conflicts of interest in this work., (© 2023 Campbell et al.)

Background: Measles elimination was accomplished in Croatia in 2016. Split-Dalmatia County, with population of ca. 425 000 inhabitants, is among the most important Croatian tourist areas with numerous seasonal workers coming during summer months. In both 2018 and 2019, more than 3 million tourists visited this county. In 2000-2018, there were no measles cases in this county, or their number was low (1-3 cases per year)., Methods: After measles was clinically suspected, all contacts were traced and contacted. Detection of specific IgM/IgG antibodies and real-time reverse transcription-polymerase chain reaction detection of viral RNA were used for laboratory confirmation. Sequencing and genotyping were performed for strains' molecular epidemiology analysis., Results: Six epidemiologically unlinked measles virus occurrences happened in Split-Dalmatia County in 15 May-19 July 2019. Causative viral strains belonged to genotypes B3 and D8. Four were single imported cases. Ten patients belonged to two separate clusters within domicile population. Multiple individual and public health measures were implemented. In total, 483 contacts were identified, 64.2% within healthcare system where two persons contracted the disease., Conclusions: Besides the importance of timely vaccination of children, the lessons learned from this outbreak point to the need of stricter implementation of other aspects of Croatian measles prevention programme, such as checking of vaccination status in early adulthood. Despite the fact that measles elimination within domicile population in this tourist region has been accomplished and maintained for years, continuous public health workers' efforts are still necessary for identification and diminishment of populational pockets of susceptibility., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: Effective triage at hospitals can improve outcomes for children globally by helping identify and prioritize care for those most at-risk of death. Paper-based pediatric triage guidelines have been developed to support frontline health workers in low-resource settings, but these guidelines can be challenging to implement. Smart Triage is a digital triaging platform for quality improvement (QI) that aims to address this challenge. Smart Triage represents a major cultural and behavioural shift in terms of managing patients at health facilities in low-and middle-income countries. The purpose of this study is to understand user perspectives on the usability, feasibility, and acceptability of Smart Triage to inform ongoing and future implementation., Methods: This was a descriptive qualitative study comprising of face-to-face interviews with health workers (n = 15) at a regional referral hospital in Eastern Uganda, conducted as a sub-study of a larger clinical trial to evaluate Smart Triage (NCT04304235). Thematic analysis was used to assess the usability, feasibility, and acceptability of the platform, focusing on its use in stratifying and prioritizing patients according to their risk and informing QI initiatives implemented by health workers., Results: With appropriate training and experience, health workers found most features of Smart Triage usable and feasible to implement, and reported the platform was acceptable due to its positive impact on reducing the time to treatment for emergency pediatric cases and its use in informing QI initiatives within the pediatric ward. Several factors that reduced the feasibility and acceptability were identified, including high staff turnover, a lack of medical supplies at the hospital, and challenges with staff attitudes., Conclusion: Health workers can use the Smart Triage digital triaging platform to identify and prioritize care for severely ill children and improve quality of care at health facilities in low-resource settings. Future innovation is needed to address identified feasibility and acceptability challenges; however, this platform could potentially address some of the challenges to implementing current paper-based systems., (© 2022. The Author(s).)

The ocean is experiencing unprecedented rapid change, and visually monitoring marine biota at the spatiotemporal scales needed for responsible stewardship is a formidable task. As baselines are sought by the research community, the volume and rate of this required data collection rapidly outpaces our abilities to process and analyze them. Recent advances in machine learning enables fast, sophisticated analysis of visual data, but have had limited success in the ocean due to lack of data standardization, insufficient formatting, and demand for large, labeled datasets. To address this need, we built FathomNet, an open-source image database that standardizes and aggregates expertly curated labeled data. FathomNet has been seeded with existing iconic and non-iconic imagery of marine animals, underwater equipment, debris, and other concepts, and allows for future contributions from distributed data sources. We demonstrate how FathomNet data can be used to train and deploy models on other institutional video to reduce annotation effort, and enable automated tracking of underwater concepts when integrated with robotic vehicles. As FathomNet continues to grow and incorporate more labeled data from the community, we can accelerate the processing of visual data to achieve a healthy and sustainable global ocean., (© 2022. The Author(s).)

Metachronal motion is used across a wide range of organisms for a diverse set of functions. However, despite its ubiquity, analysis of this behavior has been difficult to generalize across systems. Here we provide an overview of known commonalities and differences between systems that use metachrony to generate fluid flow. We also discuss strategies for standardizing terminology and defining future investigative directions that are analogous to other established subfields of biomechanics. Finally, we outline key challenges that are common to many metachronal systems, opportunities that have arisen due to the advent of new technology (both experimental and computational), and next steps for community development and collaboration across the nascent network of metachronal researchers., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.)

Aquatic animals have developed a wide array of adaptations specific to life underwater, many of which are related to moving in the water column. Different swimming methods have emerged, such as lift-based flapping, drag-based body undulations, and paddling. Patterns occur across scales and taxa, where animals with analogous body features use similar locomotory methods. Metachronal paddling is one such wide-spread propulsion mechanism, occurring in taxa as diverse as ctenophores, crustaceans, and polychaetes. Sequential movement of multiple, near identical appendages, allows for steady swimming through phase-offsets between adjacent propulsors. The soft-bodied, holopelagic polychaete Tomopteris has two rows of segmental appendages (parapodia) positioned on opposite sides along its flexible body that move in a metachronal pattern. The outer one-third of their elongate parapodia consist of two paddle-like pinnules that can be spread or, when contracted, fold together to change the effective width of the appendage. Along with metachronal paddling, tomopterid bodies undulate laterally, and by using high speed video and numerical modeling, we seek to understand how these two behaviors combine to generate effective swimming. We collected animals using deep-diving remotely operated vehicles, and recorded video data in shore- and ship-based imaging laboratories. Kinematics were analyzed using landmark tracking of features in the video data. We determined that parapodia are actively moved to generate thrust and pinnules are actively spread and contracted to create differences in drag between power and recovery strokes. At the same time, the body wave increases the parapodium stroke angle and extends the parapodia into undisturbed water adjacent to the body, enhancing thrust. Based on kinematics measurements used as input to a 1D numerical model of drag-based swimming, we found that spreading of the pinnules during the power stroke provides a significant contribution to propulsion, similar to the contribution provided by the body wave. We conclude that tomopterids combine two different propulsive modes, which are enabled by their flexible body plan. This makes their anatomy and kinematics of interest not only for biologists, but also for soft materials and robotics engineers., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.)

Annelids are predominantly found along with the seafloor, but over time have colonized a vast diversity of habitats, such as the water column, where different modes of locomotion are necessary. Yet, little is known about their potential muscular adaptation to the continuous swimming behaviour required in the water column. The musculature and motility were examined for five scale worm species of Polynoidae (Aphroditiformia, Annelida) found in shallow waters, deep sea or caves and which exhibit crawling, occasional swimming or continuous swimming, respectively. Their parapodial musculature was reconstructed using microCT and computational three-dimensional analyses, and the muscular functions were interpreted from video recordings of their locomotion. Since most benthic scale worms are able to swim for short distances using body and parapodial muscle movements, suitable musculature for swimming is already present. Our results indicate that rather than rearrangements or addition of muscles, a shift to a pelagic lifestyle is mainly accompanied by structural loss of muscle bundles and density, as well as elongation of extrinsic dorsal and ventral parapodial muscles. Our study documents clear differences in locomotion and musculature among closely related annelids with different lifestyles as well as points to myoanatomical adaptations for accessing the water column., (© 2021 The Authors.)

Mesobot , an autonomous underwater vehicle, addresses specific unmet needs for observing and sampling a variety of phenomena in the ocean's midwaters. The midwater hosts a vast biomass, has a role in regulating climate, and may soon be exploited commercially, yet our scientific understanding of it is incomplete. Mesobot has the ability to survey and track slow-moving animals and to correlate the animals' movements with critical environmental measurements. Mesobot will complement existing oceanographic assets such as towed, remotely operated, and autonomous vehicles; shipboard acoustic sensors; and net tows. Its potential to perform behavioral studies unobtrusively over long periods with substantial autonomy provides a capability that is not presently available to midwater researchers. The 250-kilogram marine robot can be teleoperated through a lightweight fiber optic tether and can also operate untethered with full autonomy while minimizing environmental disturbance. We present recent results illustrating the vehicle's ability to automatically track free-swimming hydromedusae ( Solmissus sp.) and larvaceans ( Bathochordaeus stygius ) at depths of 200 meters in Monterey Bay, USA. In addition to these tracking missions, the vehicle can execute preprogrammed missions collecting image and sensor data while also carrying substantial auxiliary payloads such as cameras, sonars, and samplers., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

The Adriatic islands in Croatia, usually divided into two archipelagos - the Kvarner and Dalmatian islands - is one of the largest groups of islands in Europe. Over 40 islands are still inhabited. Unfortunately the traditional use of medicinal plants was never properly documented there. Our data comes from 343 interviews carried out in 36 islands, including the 15 largest islands of the archipelago. The medicinal plants are mainly used to make herbal infusions or decoctions, occasionally medicinal liqueurs, syrups, compresses, or juices squeezed out of raw plants. We recorded the use of 146 taxa, among them 131 with at least one medicinal purpose and 15 only for tea. The frequency curve of use is relatively steep - several plants are used very frequently and most are reported only by one or two informants, which can be explained both by the large geographical spread of the area, and even more so by the devolution of local knowledge and disappearance of gathering practices due to specialization in tourism, modernization and depopulation. Most of the gathered plants already occur in ancient and medieval herbals and are a part of the pan-Mediterranean pharmacopoeia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Łuczaj, Jug-Dujaković, Dolina, Jeričević and Vitasović-Kosić.)

Competing Interests: Authors possess no conflict of interest.

Background: A common symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is post-exertional malaise (PEM). Various brain abnormalities have been observed in patients with ME/CFS, especially in insular and limbic areas, but their link with ME/CFS symptoms is still unclear. This pilot study aimed at investigating the association between PEM in ME/CFS and changes in functional connectivity (FC) of two main networks: the salience network (SN) and the default-mode network (DMN)., Methods: A total of 16 women, 6 with and 10 without ME/CFS, underwent clinical and MRI assessment before and after cognitive exertion. Resting-state FC maps of 7 seeds (3 for the SN and 4 for the DMN) and clinical measures of fatigue, pain and cognition were analysed with repeated-measure models. FC-symptom change associations were also investigated., Results: Exertion induced increases in fatigue and pain in patients with ME/CFS compared to the control group, while no changes were found in cognitive performance. At baseline, patients showed altered FC between some DMN seeds and frontal areas and stronger FC between all SN seeds and left temporal areas and the medulla. Significantly higher FC increases in patients than in controls were found only between the right insular seed and frontal and subcortical areas; these increases correlated with worsening of symptoms., Conclusions: Cognitive exertion can induce worsening of ME/CFS-related symptoms. These changes were here associated with strengthening of FC of the right insula with areas involved in reward processing and cognitive control., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Context: Opioid related deaths are at epidemic levels in many developed nations globally. Concerns about the contribution of prescribed opioids, and particularly high-dose opioids, continue to mount as do initiatives to reduce prescribing. Evidence around opioid tapering, which can be challenging and potentially hazardous, is not well developed. A recent national guideline has recognized this and recommended referral to multidisciplinary care for challenging cases of opioid tapering. However, multidisciplinary care for opioid tapering is not well understood or defined., Objective: Identify the existing literature on any multidisciplinary care programs that evaluate impact on opioid use, synthesize how these programs work and clarify whom they benefit., Study Design: Systematic rapid realist review., Dataset: Bibliographic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library), grey literature, reference hand search and formal expert consultation., Results: 95 studies were identified. 75% of the programs were from the United States and the majority (n = 62) were published after 2000. A minority (n = 23) of programs reported on >12 month opioid use outcomes. There were three necessary but insufficient mechanisms common to all programs: pain relief, behavior change and active medication management. Programs that did not include a combination of all three mechanisms did not result in opioid dose reductions. A concerning 20-40% of subjects resumed opioid use within one year of program completion., Conclusions: Providing alternative analgesia is insufficient for reducing opioid doses. Even high quality primary care multidisciplinary care programs do not reduce prescribed opioid use unless there is active medication management accomplished by changing the primary opioid prescriber. Rates of return to use of opioids from these programs are very concerning in the current context of a highly potent and lethal street drug supply. This contextual factor may be powerful enough to undermine the modest benefits of opioid dose reduction via multidisciplinary care., Competing Interests: The authors have declared that no competing interests exist.