Data Analysis Research Articles

Types of refractive errors in a sample of Iraqi children with Intermittent exotropia

Background One of the most common strabismus types in children is intermittent exotropia, which masks the deviation of one eye outward, mostly in children aged 2-4 years. It may affect visual development and often coexists with refractive mistakes. Unlike esotropia, which usually links to hyperopia, intermittent exotropia might have a different relationship with refractive errors and thus lead to myopia. Methods In this cross-sectional study from August 2021 to December 2023, 179 patients diagnosed with intermittent exotropia were recruited via an outpatient clinic of Najah Al-Quraishi, Baghdad, Iraq. The refractive errors were compared by autorefractometry and retinoscopy after cycloplegic dilation. Data analysis was constructed under the use of IBM SPSS V.26 for the determination of emmetropia, myopia, and hyperopia prevalence. Results The most expected refractive error among the 179 patients was emmetropia, which occurred in 68 patients (38%). Low hyperopia and low myopia were also common, with 64 and 40, respectively. A limited number of patients had moderate/high myopia and moderate/high hyperopia; in detail, the prevalence was following: 5% of patients had moderate myopia, while 0.5% of patients suffered from high myopia; symmetrically, 5% were moderate to high hyperopia. From the data collected, a trend emerged for a low refractive error and symmetric refractive error in both eyes. Conclusion Contrasted to prior conventional wisdom about refractive error in strabismus, it established the greater incidence of emmetropia in patients with intermittent exotropia. The findings call for specific management strategies to be applied in this population.

The Role of Lobying and Negotiation Process are Public Relation Consultant in Property Businesses

One form of communication to work together with other parties is lobbying and negotiation. This study aims to examine the negotiation and lobbying strategies carried out by negotiators. This study uses a qualitative approach using primary data in the form of interviews and secondary data such as journals, the internet and books. Data analysis uses Miles and Hubermen. The results of the study explain that the negotiation strategy carried out by approaching both parties by knowing the character of both parties conducting the negotiation. Lobbying and negotiation will provide benefits to both parties or a win-win solution. The technique used in negotiation is compromising by providing time and an agenda so that negotiation and lobbying are carried out mutually beneficially.

Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus with and without Pulmonary Tuberculosis

Background: Vitamin D has a role in the body's calcium balance and immunodeficiency effects, and stimulates dendric cells, monocytes, T cells, macrophages in pathogenic microbes’ elimination. The variation occurrence as polymorphism on VDR might cause problem in production, transportation, and activity of vitamin D. The gap between the occurrence findings in previous studies shows that there are indication factors of VDR levels that probably associate with the T2DM range in comorbid with pulmonary tuberculosis. To determine vitamin D levels and factors associated with vitamin D deficiency in Type 2 Diabetes Mellitus (T2DM) patients with and without pulmonary Tuberculosis (TB). Method: The design of this study was cross-sectional. T2DM subjects with pulmonary TB were 45 people, and 43 people without pulmonary TB were 43 people. Sampling was done by consecutive sampling from October to December 2017. We collected data through interviews and examination of plasma vitamin D (25-OH) levels by ELISA. Data analysis using the Mann-Whitney test, and chi-square test with a confidence level of 95%. Result: There were 88 T2DM patients who met the inclusion criteria, consisting of 43 T2DM patients without pulmonary TB and 45 T2DM patients with pulmonary TB as the study subjects. There were differences in the distribution of T2DM subjects based on sex and BMI measurements. The mean plasma vitamin D levels in T2DM with pulmonary TB and T2DM without pulmonary TB were 20.08 ng/ml (SD ± 0.83 ng/ml) and 20.29 ng/ml (SD ± 0.81 ng/ml), respectively, we found no significant result in statistic (p = 0.287). Vitamin D deficiency was not associated with the incidence of pulmonary TB in T2DM, whereas female sex, age> 50 years, BMI ? 25.0 kg /m2, and duration of T2DM> 5 years were associated with vitamin D deficiency (p <0.05). This research has contributed in novel findings of the correlation between sex and BMI associated in duration of T2DM impacted the Vitamin D insufficiently. Conclusion: Sex, age, BMI, and duration of T2DM had a significant correlation with vitamin D deficiency in T2DM patients with and without pulmonary TB.

Black Garlic Supplementation and Glomerular Protection in Hyperuricemic Rats: A Study on Kidney Health Prevention

Introduction: Hyperuricemia is a significant risk factor for the development of chronic kidney disease. Excessive uric acid can deposit in the kidneys, triggering inflammatory reactions and oxidative stress, leading to structural damage in the glomeruli. Black garlic, with its antioxidant and bioactive compounds, has the potential to protect the kidneys from hyperuricemia-induced damage. Our objective is to evaluate the effect of black garlic supplementation on the histopathological features of glomeruli in a hyperuricemic rat model. Methods: This study was an analytical observational study using Biological Remnant Materials (BRM) from a previous study. The sample consisted of 30 male Sprague-Dawley rats divided into 5 groups: disease control, drug control (allopurinol), and 3 black garlic dose groups (240 mg/day, 480 mg/day, and 960 mg/day). Data were collected through histopathological examination of kidney tissue using the glomerular damage scoring method (0-3). Data analysis was performed using one-way ANOVA and post hoc LSD tests. Results: Black garlic demonstrated protective effects on the histopathological features of glomeruli in hyperuricemic rats. The 240 mg/day dose showed the most significant improvement in kidney health, reducing glomerular damage scores compared to the disease control group (p < 0.05). These findings suggest that black garlic can serve as a preventive agent against kidney complications caused by hyperuricemia. Conclusion: Black garlic provides protective effects on glomerular histopathology in hyperuricemic rats, with the 240 mg/day dose being the most effective. These results suggest potential use for black garlic in preventing kidney complications in hyperuricemia.

Barriers to Family History Collection and Family Medical Screening Recommendation in the Sudden Death in the Young Case Registry.

Sudden death in the young (SDY) poses a public health problem affecting thousands of individuals annually in the United States. The SDY Case Registry utilizes existing infrastructure of death investigation programs, including medical examiner/coroner (ME/C) systems, to enhance understanding of SDY causes and risk factors to inform prevention strategies. This includes identifying and promoting screening recommendations for at-risk family members. To explore barriers to family history collection and familial screening recommendation procedures across Registry sites, nine individuals from seven SDY sites were interviewed. Interviews focused on logistics, methods to address barriers, and recommendations for improvements. Despite variability in practices, data analysis revealed three common themes related to barriers of these processes: (1) timing and grief, (2) lack of family history in medical records, and (3) families lost to follow-up. This study offers insights into these processes within the Registry and sheds light on broader practices within the death investigation domain. Data analysis led to recommendations for the improvement of these practices including the prioritization of three key family history questions during the initial death investigation by a designated individual in each office/system.

Technologies in Urban Planning: Systematic Review on Unauthorized Building Modifications Monitoring

This systematic literature review (SLR) explores the application of geospatial technologies, particularly Geographic Information Systems (GIS), in unauthorized building modifications in urban areas. Unauthorized building modifications pose significant challenges to urban planning, including unregulated growth, safety hazards, and non-compliance with zoning laws. This review aims to synthesize current research, identify effective GIS strategies, and highlight challenges and opportunities in integrating geospatial technologies for regulatory compliance and urban management. Findings suggest that while GIS offers advanced tools for precise monitoring and data analysis, there are notable hurdles concerning technological readiness, organizational adoption, and legislative frameworks

Correlation Between Axial Length and Amplitude of Accommodation in Myopia Patients

Background: Myopia is the most common refractive disorder and is a global concern because it can cause more serious eye problems. Excessive prolonged axial growth of the eyeball can lead to myopia. The amplitude of accommodation is the strength of the eye accommodation during the minimum and maximum accommodation conditions. Based on the above data, the researchers wanted to assess the relationship between eyeball length and accommodation amplitude in myopia patients. Method: The research was conducted at the Hospital of Prof CPL University of North Sumatra from November 2023 to March 2024. Data analysis was done analytically and presented in the form of data tabulation. Result: This study included 54 myopia patients, 27 males and 27 females, who visited the eye clinic. The mean age of the subjects was (52%). The mean age of the subjects was 23 years old with the youngest being 22 years old and the oldest being 24 years old. The mean of axial length for mild myopia, moderate myopia and severe myopia were 24.51 cm, 25.75 cm and 28.38 cm respectively. The lowest NPA value was found in severe myopia (27.33 cm) and the highest in mild myopia (43 cm). The lowest NPC value was found in mild myopia (36.61 cm) and the highest in severe myopia (38.56 cm). There was a significant relationship between eyeball length and accommodation amplitude with a Spearman correlation value of -0.685 as well as after cycloplegic administration with a Spearman correlation value of 0.438. NPA values showed an increase when receiving spherical correction, whether accompanied by cycloplegics or not, and a decrease when not receiving spherical correction. NPC values showed a decrease in all treatments. Conclusion: There is a correlation between axial length and amplitude of accomodation values (NPA and NPC) in patients with myopia.

Effectiveness of Bacopa Monnieri (Brahmi) in the management of schizophrenia: a systematic review.

Schizophrenia is a psychotic disorder affecting approximately 0.32% of the global population. Despite advancements in pharmacological treatments, many patients with schizophrenia continue to experience significant impairments, and approximately one-third of these patients do not respond to antipsychotic drugs. However, various studies have demonstrated the potential benefits of herbs in managing schizophrenia due to the diverse biological activities of phytochemicals, including neuroprotective activity, anti-oxidant potential, modulation of neurotransmission, and anti-inflammatory activity. Bacopa monnieri (Brahmi) is a widely studied herb used in the treatment of the central nervous system. This study conducted a systematic review to determine the effectiveness of Brahmi in managing schizophrenia. PubMed, Scopus, Web of Science, and Cochrane databases were searched between February and March, 2024. A total of 103 articles were found, with only 9 studies meeting the eligibility criteria. Data analysis was done by using themes. The review found that Brahmi could reverse positive, negative, and cognitive symptoms of schizophrenia. It does this by changing the glutamatergic pathway and GABAergic transmission, lowering MDA levels, raising GSH levels, slowing down the activity of acetylcholinesterase (AchE), and maintaining the density of neurones. It is recommended that additional research elucidating the effects of Brahmi in other models of schizophrenia and the possible mechanisms of action be conducted.

Efforts to Develop Tourism Village Programs in an Effort to Improve Original Village Income in Gronjong Wariti Tourism Village, Mejono Village Plemahan District, Kediri Regency

Gronjong Wariti is a village tourism that has the characteristic of providing a tourist village as an entertainment object for tourists. The development of Gronjog Wariti Tourism Village has been attempted to develop to face a number of obstacles, including the many informal tourism managers. This research method is descriptive qualitative. The subjects are the Head of Mejono Village, the Head of the Gronjong Wariti Tourism Village Management Board, community leaders and residents of Gronjong Wariti Tourism Village. Interviews and observations are used in data collection. In this study, data analysis was carried out by collecting data, reducing data and presenting data to draw conclusions. The findings of this study explain that efforts to develop Gronjong Wariti Tourism Village can be seen from the aspects of tourist objects and attractions, tourism infrastructure, tourism facilities, and management/infrastructure management, the community. In terms of tourist objects and destinations, the village government has coordinated with the people to clean and rearrange tourist objects so that they can be visited by tourists. In terms of tourism infrastructure, the management of Gronjong Wariti Tourism Village works together with the community to provide places of worship, parking lots, toilets, food stalls, souvenir shops, and others. In terms of tourism facilities, the management of Gronjong Wariti Tourism Village has collaborated with the community to provide home accommodation and transportation services for tourists. In terms of management/infrastructure, the village government has developed a regulatory system to manage and develop tourism villages. In terms of the village community, the village government has made socialization to the community and tourism managers.

Awareness Ayah atas Perkembangan Agama Anak 5-6 Tahun di Kalangan Nelayan Pulau Jinato Selayar

This study aims to understand the form of father's attention, inhibiting and supporting factors, and the impact of father's awareness on children's religious development. The research method used is qualitative descriptive. Primary data was obtained from interviews with fishermen's fathers, while secondary data came from village profiles, journals, and related documents. Data analysis is carried out through data reduction, coding, presentation, and drawing conclusions. The results showed variations in the form of fatherly attention. There are fathers who pay great attention to the development of children's religion, but there are also those who leave it completely to the mother or teacher. Factors that inhibit father's consciousness include a lack of time and religious knowledge, while the supporting factors are the role of teachers and the existence of Islamic boarding schools. The impact of the father's lack of awareness is the lack of religious stimulation in the child. This study concludes the importance of education for fisherman fathers about the importance of providing religious education to early childhood. The implication of this research is the need for educational programs for educators and further research on the introduction of monotheism in early childhood. This research also provides a comprehensive overview of the situation on the ground and provides recommendations to improve the quality of religious education for children on Jinato Island

Self protective health care in childhood cancer survivors from the perspective of survivors, parents, and professionals: a qualitative study.

Childhood cancer survivors experience many health problems that they must protect themselves from their destructive physical and psychological effects. Understanding experiences of children about self-protective care will help health care providers manage long-term care plans. Therefore, this study was conducted with the aim of exploring self-protection care in childhood cancer survivors. This is a phenomenological study that was conducted in the clinics and cancer care centers of Urmia and Khoy in Iran. 27 participants were selected by purposive sampling until data saturation. The data was collected using a semi-structured and in-depth face to face interview. Content analysis approach used for data analysis and MAXQUDA 10 software used for data management. Data analysis led to the emergence of "self-protection health care" as a main category, two categories "maintaining physical health" and "keeping a strong mindset" and 9 sub-categories including "abstain activities that may cause harm", "refusing contact with others for possible infection", "monitoring symptoms and side-effects of cancer coming back", "avoiding unhealthy diet", "knowing about cancer from similar others", "keep away negative thoughts and emotions", "drawing on spiritual resources", "creating a bridge to life again" and "being healthy for the sake of one's family". According to the results of this study, self-protection is one of the most important cares for childhood cancer survivors. Over time, the influence of the clinical team and parents on children's health care diminishes. Therefore, they should promote their health and well-being behaviors and use a variety of protective approaches to self-care.

Influences on Consumer Behaviour Regarding the Purchase Intention of Poultry Products

Objective: The objective of this study is to identify factors influencing effective purchasing behaviours in the context of poultry products. Theoretical Framework: The investigation into agricultural product purchases remains a relatively under-researched area within academic literature, particularly concerning detailed analyses of consumer behaviour. This study responds to the theoretical need raised by Pang et al. (2021) to apply their research methodology to different contexts. Method: The methodology adopted for this research was an online survey with a sample of 358 individuals in Colombia. The data analysis was carried out using Structural Equations Modelling with structures in variance. Results and Discussion: The results obtained revealed that aspects such as Trust, Corporate ability, Brand positioning, Consumer cognition and Health consciousness are crucial for consumers of these products. Research Implications: The practical and theoretical implications of this research are discussed indicate that aspects such as Trust, Corporate ability, Brand positioning, Consumer cognition and Health consciousness are crucial for consumers of these products. These factors are considered critical for consumers engaged in purchasing these types of products and provide substantive insights for the broader market of primary consumer goods. Originality/Value: The findings contribute to the scarce literature on consumer behaviour in agricultural product purchasing, offering a nuanced understanding of the determinants that drive consumer choices in this sector.

Perceived lack of behavioral control is a barrier to a healthy lifestyle in post-menopause: a qualitative study.

Menopause is a natural phase in a woman's life, but the quality of life and health of postmenopausal women are often compromised by unhealthy lifestyles. Therefore, it is crucial to identify the factors that influence their well-being. The main objective of this study is to explore the barriers to a healthy lifestyle among Iranian postmenopausal women. Qualitative exploratory research was conducted among postmenopausal women aged 45-65 years in three different health centers located in urban areas with varying economic level in a central city of Iran. These areas represented upscale, downtown, and downscale areas with different economic statuses (wealthy, relatively wealthy, and less wealthy). Nine focus group discussions were held, focusing on managing menopausal symptoms, physical activity, and healthy nutrition. Each topic was discussed separately in a different health center, with 10 women participating in each session. Data analysis was conducted using Graneheim and Lundman's method. The study revealed a prominent theme, "perceived lack of behavioral control as a barrier to a healthy lifestyle in post-menopause." Two categories, "False attitudes" and "Perceived inability to engage in behavior," were derived from 26 codes related to managing menopausal symptoms. Furthermore, a category, "Perceived inability to engage in behavior," was formed from 11 to 13 codes related to physical activity and healthy nutrition, respectively. The theme highlighted that the perceived lack of behavioral control prevented the women from adopting a healthy lifestyle. Improving perceived behavioral control through the modification of attitudes and abilities is essential for maintaining a healthy postmenopausal lifestyle.

Investigation of hip flexibility training on dancesport optimization using machine learning video analysis

Dancesport, particularly the Paso Doble, requires high agility, coordination, and flexibility, especially in the hips. This study investigates the impact of an eight-week targeted Hip Flexibility Training (HFT) program on the performance of professional Paso Doble dancers. The need for this research stems from the lack of objective, data-driven evaluations in the field, where traditional methods rely heavily on subjective assessments. Previous studies have examined general flexibility in dance, but few have focused on the direct Biomechanical Effects (BF) and Physiological Effects (PE) of specific HFT on dancers. Further, such studies could not accurately measure hip joint movements and their coordination in order to achieve dance performance efficiency. The proposed study used motion-capturing devices to collect key movement data that impacts performance efficiency. The collected data is analyzed using the hybrid receptive field block (RFB) and residual network (ResNET) ML models to study the pre- and post-HFT results. Twelve highly trained dancers were assigned to have biomechanical and physiological metrics measured after and before the training. The data analysis has shown that there has been a significant increase in hip flexion from 65.4 ± 4.5° to 75.2 ± 3.7° (P < 0.05), hip extension from 25.3 ± 2.4° to 30.1 ± 2.1° (P < 0.05), and joint velocity from 1.18 ± 0.15 m/s to 1.32 ± 0.12 m/s (P < 0.05). Physiological metrics also showed improvements, such as a reduction in Oxygen Consumption (OC) from 2.02 ± 0.21 L/min to 1.85 ± 0.18 L/min (P < 0.05) and Energy Cost (EC) from 50.1 ± 7.2 kJ/min to 45.6 ± 6.4 kJ/min (P < 0.05).

Registration and characteristics of clinical trials on traditional Chinese medicine and natural medicines for endometriosis: a comprehensive analysis

ObjectiveTo investigate the characteristics of clinical trials on traditional Chinese medicine (TCM) or natural medicines for treating endometriosis, aiming to inform future clinical practice and the development of new effective drugs.MethodThe global clinical trial registration platform was searched to identify clinical trials investigating the efficacy of TCM/natural medicine in treating endometriosis. Relevant trials were selected based on stringent inclusion and exclusion criteria. Data entry was performed using Microsoft Excel, while data analysis was conducted using SPSS version 23.ResultsThe study encompassed 57 trials, of which ClinicalTrials.gov accounted for 18, ChiCTR for 3, ICRP for 15, and ChiDTR for 21 trials. The number of registrations showed a significant positive correlation with the years. Of the 57 clinical trials, 87.7% were randomized, 63.2% were blinded, 78.9% followed a parallel intervention model, and 56.1% had a sample size below 100. Regarding trial phases, 45.6% of clinical trials did not specify a phase, while Phase 3 and Phase 4 clinical trials accounted for 17.5%. Nine clinical trials involved drugs that are already on the market, including six Chinese patent medicines: Sanjie Zhentong Capsules, Honghua Ruyi Pills, Huayu Sanjie Enema Liquid, Kuntai Capsules, Wenjing Tang, and Xuefu Zhuyu Capsules. Outside China, Iran has the highest number of registrations for natural medicine treatments for endometriosis, with curcumin being the most registered natural medicine.ConclusionThe analysis reveals that clinical trials on TCM and natural remedies for endometriosis often utilize randomization; however, substantial deficiencies remain in blinding and sample size adequacy. These findings suggest that, despite growing interest in TCM and natural remedies, further methodological improvements are necessary to enhance the credibility of future studies. This research highlights the importance of rigorously designed clinical trials in verifying the safety and efficacy of these alternative therapies, which may influence future therapeutic approaches for managing endometriosis.

Serum triglyceride to high density lipoprotein cholesterol ratio in late pregnancy as a potential predictor of adverse birth outcomes: an analysis of real-world data

BackgroundThe association between serum triglyceride to high density lipoprotein cholesterol ratio (THR) in late pregnancy and adverse birth outcomes (ABO) remains controversial because of inconsistent results. The present study assessed the association between maternal serum THR and incidence of ABO [preterm birth (PTB), small and large for gestational age (SGA/LGA), low birth weight (LBW) and macrosomia] in a Chinese population.MethodsA total of 11,553 consecutive participants from a real-world database with data on lipid profiles and birth outcomes were included. Logistic regression models were applied to assess the association between THR and incident ABO. Mediation analysis was performed to investigate the contribution of pregnancy complications [gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP) and pre-eclampsia (PE)] to this association.ResultsApproximately 6.6% (762/11,553), 8.9% (1023/11,553), 15.5% (1792/11,553), 4.3% (494/11,553), and 7.4% (851/11,553) of individuals developed PTB, SGA, LGA, LBW and macrosomia, respectively. Significant trends across the quintiles of THR toward decreasing incidence of SGA and LBW and increasing incidence of LGA and macrosomia were observed. The multivariate-adjusted odds ratios (OR) in the top quintile of serum THR (> 3.16) versus the bottom quintile (< 1.44) were 0.52 for PTB, 0.48 for SGA, 0.64 for LBW, 2.80 for LGA and 3.80 for macrosomia, respectively. A 1-standard deviation (SD) increase in serum THR was associated with decreased risk of PTB [OR = 0.84, 95% confidence interval (CI): 0.76–0.93), SGA (OR = 0.71, 95% CI:0.65–0.78) and LBW (OR = 0.76, 95% CI:0.65–0.90) and increased risk of LGA (OR = 1.40, 95% CI:1.32–1.49) and macrosomia (OR = 1.49, 95% CI:1.38–1.62). In mediation analyses, PE mediated − 19.8%, -10.6% and − 24.6% of THR-associated PTB, SGA and LBW, respectively, GDM accounted for − 3.7%, 6.8% and 4.3% of THR-associated PTB, LGA and macrosomia, respectively, and ICP explained − 1.9% and − 2.1% of THR-associated PTB and LBW, respectively. In addition, incorporating THR to ABO predictive models significantly improved the area under the curve for SGA (0.743 vs. 0.753, P < 0.001), LGA (0.734 vs. 0.745, P < 0.001) and macrosomia (0.786 vs. 0.800, P < 0.001).ConclusionReal-world data showed an association between serum THR in late pregnancy and ABO risk, and this association may be partially mediated by prevalent pregnancy complications (PE/GDM/ICP), suggesting a potential role of THR in predicting ABO (SGA/LGA/macrosomia).

Bouncing back from emotional ups and downs: insights in emotional recovery using survival analyses of burst ESM data.

Many experience sampling (ESM) studies suggested that high resilience is reflected by quickly recovering one's emotional baseline. However, former studies relied on coarse data and did not look into differential recovery from emotional ups and downs. This preregistered proof-of-concept study therefore used high-resolution data collected in 2022 to compute emotional recovery after high levels of positive versus negative emotions. Adults (N = 68) participated in a three-week ESM study with eight assessments per day, complemented by short-spaced burst assessments. Resilience was assessed at baseline (trait-level; TR) and daily (day-level; DR). Multilevel survival analyses showed that high DR predicted faster returns from negative emotions, but also delayed returns following positive emotions (exp(β) = 1.32, p = 0.006). Instead, TR did not relate to emotional recovery (exp(β) = 0.85, p = 0.067). These findings were generally robust across different sensitivity analyses. This illustrates how innovative ESM designs combined with time-to-event analyses may further our insight in emotional recovery and the timescale at which it unfolds.

A note on potential gains in precision of radiation risk estimates from joint analysis.

In estimating radiation-related risk of cancer and other diseases based on the RERF Life Span Study (LSS), joint analyses can be performed where multiple health outcome endpoints are combined in the same model, allowing some parameters to be estimated in common among all endpoints with possible increase in precision of radiation risk and other model parameter estimates. Using as a basis excess relative risk (ERR) and excess absolute risk (EAR) models of the type commonly used in analysis of LSS data at RERF, we use maximum likelihood theory to compute the asymptotic relative standard error of endpoint-specific radiation effect and other parameter estimates using joint analyses as compared to traditional independent analysis. We show that some gains in precision of endpoint-specific radiation risk parameter estimates can be achieved by sharing effect modifier and other model parameters, but only small or negligible gains in precision are achieved for endpoint-specific background modifying or effect modifying parameters when other model parameters are shared. The magnitude of the precision gain for radiation risk estimates depends on the number of endpoints, the baseline incidence rate of the endpoint, and the type of model being used.

The American Headache Society First Contact-Headache in Primary Care program: Current metrics, knowledge assessments, and direction for future initiatives.

This study examines the American Headache Society First Contact-Headache in Primary Care program metrics to date in order to assess the program's reach and provide direction for future initiatives. Approximately 4 million primary care office visits annually are headache-specific encounters. Therefore, it is important that primary care providers are knowledgeable about headache management. Recognizing the need, the American Headache Society First Contact designed the comprehensive First Contact-Headache in Primary Care program with input from an advisory board comprised of a diverse group of physicians and advanced practice providers with backgrounds in family and internal medicine, pediatrics, obstetrics and gynecology, and neurology. This is the first study to assess the reach of the program and critically examine how to best meet the needs of clinicians and patients going forward. We report descriptive statistics for the First Contact website metrics from October 2020 to June 2023 and grand rounds program data from May 2020 to December 2023. We also conducted a cross-sectional analysis of survey data from presentations conducted at two large national family medicine symposia, as well as a thematic analysis of the question: "Please indicate what areas of your practice could be enhanced or improved with additional education?" The First Contact program homepage was the second most visited page on the American Headache Society website (>100,000 views). A total of 20 podcast episodes were created for the program (>3500 plays). The First Contact program held 99 events (72 institutional grand rounds, 22 State-level meetings, and five national meetings), reaching >7000 clinicians. The institutional grand rounds and state-level meetings were held across 27 States and Washington D.C. Only 31.9% (30/94) of First Contact program events (excluding national meetings) occurred in the West census region, which has the fewest headache subspecialists and lowest headache subspecialist density in the United States. When examining survey data of participants who attended the two virtual national family medicine symposia (39.3% response rate, N = 636/1620), 85.7% (544/635) reported being "completely confident" or "veryconfident" in their ability to recognize and accurately diagnose patients presenting with a primary complaint of headache and 81.5% (517/634) reported being "completely confident" or "very confident" in their ability to develop evidence-based treatment plans that are tailored to the needs of individual patients. The use of diagnostic tools to recognize patients with migraine (60.4%, 384/636) and translating standards of care to the practice setting (42.5%, 270/636) were the most reported intended changes by participants. Most participants reported that program content was of clinical relevance and would improve their patients' outcomes (90.5% [571/631] and 90.6% [572/631], respectively). Over three-quarters (77.8%, 495/636) of participants reported areas of their practice that can be improved by additional education specifically regarding workflow, diagnosis, and management. This study evaluates one of the first national initiatives for primary care education. Data from the two First Contact Family Medicine national symposia indicate the program is generally well received with most participants reporting improved confidence and intention to implement key changes in practice to improve care for patients with headache; however, there remain areas of exploration for education that could further enhance participant experience and expand the reach of the initiatives. Areas for future programming include continued education on multifactorial approaches to headache treatment and suggestions for addressing cost, insurance, and time constraints. Also, future work may examine where the First Contact program might focus initiatives based on specific areas of need in headache care, such as geographic "desert" areas, racial and ethnic disparities, and uninsured/underinsured populations.

Covalent Stabilization of the Iridium-Containing Oxyhydrides Sr2Mn0.5Ir0.5O3.25H0.75 and Sr2Mn0.5Ir0.5O2.66H1.33.

Reaction between Sr2Mn0.5Ir0.5O4 and CaH2 or LiH yields the iridium-containing oxyhydride phases Sr2Mn0.5Ir0.5O3.25H0.75 or Sr2Mn0.5Ir0.5O2.66H1.33, respectively. Analysis of Mn K-edge XANES data indicate the presence of Ir3+ centers in these oxyhydride phases, whose low-spin d6 configuration is consistent with the "covalent stabilization" of the metastable oxyhydride phases, as seen previously in analogous ruthenium and rhodium containing materials. Neutron powder diffraction data indicate the hydride ions are located exclusively within the "equatorial" anion sites of Sr2Mn0.5Ir0.5O3.25H0.75. In contrast, hydride ions are observed on both the equatorial and axial anion sites of Sr2Mn0.5Ir0.5O2.66H1.33. This highly unusual anion distribution is attributed to a combination of the strong trans-influence of Ir-H σ-bonds and the stabilization of fac-IrO3H3 centers by spin-orbit coupling effects. Magnetization data indicate that Sr2Mn0.5Ir0.5O4 and Sr2Mn0.5Ir0.5O3.25H0.75 adopt spin glass states at low temperature, behavior which is attributable to the cation disorder in Sr2Mn0.5Ir0.5O4 and the cation and anion disorder in Sr2Mn0.5Ir0.5O3.25H0.75. In contrast, magnetization data collected from Sr2Mn0.5Ir0.5O2.66H1.33 show no evidence of any magnetic phase transition down to 5 K, consistent with the dilution of the magnetic network by the introduction of diamagnetic Ir3+ on the formation of the oxyhydride phase.