Background Characteristics Research Articles

Geriatric assessment and management with question prompt list using a web-based application for elderly patients with cancer to communicate aging-related concerns: A randomized clinical trial (J-SUPPORT 2101 study).

1511 Background: Older adults with cancer have aging-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these aging-related problems and guide management. Communication support might also facilitate implementation of GA-guided management (GAM). We conducted this single-blind, parallel-group, multicenter, randomized controlled trial to evaluate the efficacy of a program providing GAM recommendation and communication support between older Japanese patients with cancer and their oncologists. Methods: Eligibility criteria were age≥70 years, advanced or recurrent cancers of gastrointestinal origin, referral to one of the two institutions for first- or second-line systemic therapy, and impairment in at least one GA domain as assessed using a web-based application at baseline. In the intervention group, GAM recommendations and question prompt list (QPL) were provided to patients by trained intervention providers to be shared with their oncologists at the first outpatient visit after randomization. Over 5 months after the initial intervention, implementation of GAM recommendations was reviewed monthly by the intervention providers with the patients and their oncologists. Patients in the control group received usual care. The primary endpoint was the number of conversations about aging-related concerns at the first visit. The quality of conversations was assessed in terms of the number of conversations in which stated concerns were acknowledged and considered further by the oncologist and the number of conversations in which acknowledged concerns motivated implementation of GAM recommendations. Results: A total of 215 patients (99 women, 116 men; median age 75 [range 70-88] years) were randomized (n=108/107 in the intervention/control group) between September 2021 and September 2023. There were no differences between two groups in patient background characteristics including the prevalence of GA impairments. The number of conversations about aging-related concerns was significantly higher in the intervention group than in the control group (mean [SD] 2.95 [1.53] vs. 1.90 [1.49], p<0.0001). The number of high-quality conversations and number of conversations about GAM recommendations were also significantly higher in the intervention group than in the control group (1.73 [1.40] vs. 1.12 [1.16], p=0.001; 0.57 [0.74] vs. 0.28 [0.47], p=0.001, respectively). Conclusions: Our program providing GAM recommendations and communication support successfully facilitated aging-related communications between patients and their oncologists. We will further examine whether facilitated communication leads to actual implementation of GAM and improved patient health outcomes in a follow-up study. Clinical trial information: UMIN000045428 .

Comparison of Transient and Persistent Adverse Events After COVID-19 Vaccination: A Retrospective Analysis.

Most reported adverse events following COVID-19 vaccination have been transient. However, persistent adverse events may occur with some frequency. This study aimed to analyze patient background characteristics and trends, with a focus on whether adverse events following COVID-19 vaccination were transient or persistent. A retrospective study was performed at a single institution in Japan. The study cohort included 47 patients who presented with symptoms after COVID-19 vaccination between May 2021 and September 2023. The patients were classified into two groups based on the duration of symptoms: transient group, less than fourweeks; persistent group, greater than or equal to four weeks. Data on age, sex, body mass index, smoking history, underlying conditions, type of COVID-19 vaccination, number of doses, onset, symptoms, and treatments were collected retrospectively. The median age was 51.0 years and 74.5% were females, with a particularly high proportion of women in their 40s. The use of the bivalent omicron-containing booster vaccine (BA.1) was significantly more common in the persistent group than in the transient group (p = 0.0267). Onset in the transient group was more common after the first vaccination, whereas onset in the persistent group was more common after the second and subsequent vaccinations (p = 0.003). Regarding symptoms, pain was more frequent in the persistent group than in the transient group (60% vs. 13.6%; p = 0.001). This study investigated the presence of persistent symptoms, especially pain, after COVID-19 vaccination. Persistent symptoms were frequently reported after the second vaccination. It should be noted that the study does not negate the usefulness of COVID-19 vaccines.

Effect of Emotional Intelligence on Economic Teachers’ Self-Efficacy: The Moderating Role of Background Characteristics

The study examined the moderating role of teacher background characteristics on the influence of emotional intelligence on the self-efficacy of Economics teachers in senior high schools. The model testing correlational research design was employed for the study. Eighty-eight (88) senior high school economics teachers participated in the study, from an initial accessible population of 300. The General Self-Efficacy scale developed by Schwarzer and Jerusalem (1995) and the Quick Emotional Intelligence Self-Assessment scale developed by Mohapel (2015) were adapted to measure economics teachers' self-efficacy and emotional intelligence, respectively. The reliability and validity of the instruments were established using Cronbach's alpha, composite reliability and convergent validity. Smart-PLS (Partial Least Square modelling) was used to estimate the model to establish the relationship among teachers' background characteristics, emotional intelligence and self-efficacy. The study revealed that senior high school economics teachers' marital status, gender and teaching experience affected their emotional intelligence and self-efficacy in teaching economics. Economics teachers' emotional intelligence affected their self-efficacy. However, teachers' marital status, gender and teaching experience did not moderate the effect of emotional intelligence on the self-efficacy of economics teachers. It is recommended that training interventions by the Ghana Education Service, Continuous Professional Development service providers and other educational stakeholders be channeled towards improving self-concepts, especially emotional intelligence and teachers' self-efficacy. Training for teachers on emotional intelligence and self-efficacy should be targeted based on their gender, marital status and teaching experience, as they differed significantly on these self-concepts in terms of these background characteristics.

Prognostic subgroups of chronic pain patients using latent variable mixture modeling within a supervised machine learning framework

The present study combined a supervised machine learning framework with an unsupervised method, finite mixture modeling, to identify prognostically meaningful subgroups of diverse chronic pain patients undergoing interdisciplinary treatment. Questionnaire data collected at pre-treatment and 1-year follow up from 11,995 patients from the Swedish Quality Registry for Pain Rehabilitation were used. Indicators measuring pain characteristics, psychological aspects, and social functioning and general health status were used to form subgroups, and pain interference at follow-up was used for the selection and the performance evaluation of models. A nested cross-validation procedure was used for determining the number of classes (inner cross-validation) and the prediction accuracy of the selected model among unseen cases (outer cross-validation). A four-class solution was identified as the optimal model. Identified subgroups were separable on indicators, predictive of long-term outcomes, and related to background characteristics. Results are discussed in relation to previous clustering attempts of patients with diverse chronic pain conditions. Our analytical approach, as the first to combine mixture modeling with supervised, targeted learning, provides a promising framework that can be further extended and optimized for improving accurate prognosis in pain treatment and identifying clinically meaningful subgroups among chronic pain patients.

Clinical Features and Therapeutic Process of Sacral Fatigue Fractures in Adolescents

Background: Sacral fatigue fractures are a rare injury but should be considered as a differential diagnosis for low back and buttock pain in young adults. Collective reports are limited, most of which have focused on long-distance runners. Purpose: To investigate the characteristics of sacral fatigue fractures in adolescents. Study Design: Case series; Level of evidence, 4. Methods: We analyzed patient background characteristics, physical examination and imaging findings, and treatment courses of those diagnosed with sacral fatigue fractures using magnetic resonance imaging. Results: Among 34 patients with sacral fatigue fractures, 15 and 19 were male and female patients, respectively, with an age range of 11 to 19 years (mean age, 15.0 years). Almost all patients were athletes, and 29 patients performed their sport ≥5 times a week. Long-distance runners were the most commonly affected, comprising 7 patients, and participants in other common sports such as baseball (6 patients), basketball (4 patients), and soccer (3 patients) were also affected. Physical examination revealed tension sign (Lasègue test) on the affected side in 6 patients and tight hamstrings in 24 patients. Imaging findings included 18 patients with right-side involvement, 12 with left-side involvement, and 4 with involvement on both sides. In 11 patients, spina bifida occulta was observed at S1 and 8 patients had a history of lumbar spondylolysis with 4 patients having concurrent sacral fatigue fractures. Physical therapy was performed concurrently with the cessation of exercise, and return to exercise was permitted if the pain had been relieved after 1 month. All patients returned to sports at a median of 48 days (range, 20-226 days) after symptom onset. However, 2 patients experienced recurrence (1 patient on the ipsilateral side and 1 patient on the contralateral side). Conclusion: Sacral stress fractures are not limited to long-distance runners in this population and can manifest as lower back pain or buttock pain in athletes participating in a variety of sports. Although the course of treatment was generally good, the possibility of recurrence must always be considered.

Impact of perioperative prognostic nutritional index changes on the survival of patients with stage II/III colorectal cancer.

To assess the impact of perioperative prognostic nutritional index (PNI) changes on prognosis and recurrence after colorectal cancer surgery. A total of 475 patients who underwent curative resection for primary colorectal adenocarcinoma and were diagnosed with pathological stage (pStage) II/III were retrospectively reviewed. The patients were divided into two groups: the high group (preoperative PNI ≤ postoperative PNI, n = 290) and the low group (preoperative PNI > postoperative PNI, n = 185). The low group exhibited significantly higher recurrence and mortality rates (all p < 0.001). Kaplan-Meier analysis showed worse overall and recurrence-free survival in the low group (all p < 0.001). Perioperative PNI changes predicted prognosis and recurrence independent of preoperative nutritional conditions. Subgroup analyses showed better overall survival and recurrence-free survival in the high group across various parameters, such as patient background, surgical outcomes, adjuvant chemotherapy, and pathological characteristics. Multivariate analysis revealed that the low group based on perioperative PNI changes (hazard ratio [HR]: 5.809, 95% confidence interval [CI]: 3.451-9.779, p < 0.001), pathological T stage (HR: 1.962, 95% CI: 1.184-3.253, p = 0.009), and pathological N stage (HR: 3.434, 95% CI: 1.964-6.004, p < 0.001) were identified as independent predictors of worse overall survival. Patients with pStage II/III colorectal cancer who demonstrate a lower postoperative PNI levels compared to preoperative had poorer overall survival and recurrence-free survival. Perioperative PNI changes can serve as useful biomarkers for predicting survival and recurrence.

A porcine large animal model of radiofrequency ablation-induced left bundle branch block

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Medtronic Background and Objective ECG features of left bundle branch (LBB) block (LBBB) can be observed in up to 20–30 % of patients that suffer from heart failure with reduced ejection fraction. The resulting mechanical intraventricular asynchrony contributes to the worsening of left ventricular hemodynamics and has a relevant impact on the prognosis of the affected patients. The fact that we still cannot accurately predict which LBBB patients will benefit from cardiac resynchronization therapy (CRT) underscores that our understanding of the pathophysiology of LBBB remains incomplete. Here, a translational animal model of LBBB could be a major contributor to improving our knowledge of the molecular and translational pathomechanisms underlying LBBB. Methods A total of 15 male pigs underwent RF catheter ablation of the LBB, guided by fluoroscopy and intracardiac ECG signals. Before LBBB induction and after a follow-up period of one week or three weeks, a thorough clinical characterization was performed including 12-lead ECG, echocardiography, and electroanatomical mapping. To further test the feasibility of cardiac resynchronization in our model, 3 pigs were implanted with a CRT pacemaker on day seven after LBB ablation. Results Upon LBB ablation, 12-lead ECGs displayed typical characteristics of LBBB like a QRS broadening, a QRS slurring in left lateral leads, and a change of the QRS axis. The QRS width was prolonged from 64.2±4.2 ms to 93,4±7.4 ms and the R wave peak time in V6 was extended from 19.3±3.9 ms to 42.7±4.2 ms. Cardiac electromechanical asynchrony was further confirmed by echocardiography, where the appearance of a septal flash, the prolongation of the septal to posterior wall movement delay and extended left ventricular as well as interventricular electromechanical delays were documented. Electroanatomical mapping demonstrated a shift of the left ventricular breakthrough site. After LBBB-induction, left ventricular activation times, defined as the average of the maximum 10 % of activation times minus the average of the minimum 10 % of activation times were significantly prolonged from 36.3±7.1 ms to 60.8±10.2 ms while right ventricular activation times remained unchanged. Finally, RF-induced LBBB persisted over an observation period of three weeks. The pigs that underwent CRT showed a reduction in QRS duration from 99.1±8.2 ms on day seven after LBBB induction to 75.5±8.2 ms and echocardiography provided additional evidence of successful resynchronization. Conclusions In summary, our porcine large animal model accurately recapitulates the electrical and electromechanical phenotype, observed in LBBB patients. This closed-chest model of LBBB therefore provides an experimental platform to study both, molecular and translational characteristics of cardiac electromechanical asynchrony in a reproducible and clinically relevant setting.

A longitudinal test of the impact of CLIL on language emotions and learning motivation

This study relies on a longitudinal design to test the added value of a Content and Language Integrated Learning approach (CLIL) for socio-affective outcomes. 756 French-speaking pupils at primary or secondary school, learning either English or Dutch (as a ‘language other than English’), in a CLIL track or in non-CLIL mainstream foreign language classes, participated in the study. The participants twice completed a questionnaire and several tests over an 18-month interval. The questionnaire included items measuring their emotions in the classroom (anxiety and enjoyment) and motivation for language learning (perceived task value, expectancy for success, and perceived cost). A range of individual background characteristics, including initial vocabulary knowledge in the target language, were included in the analyses. The findings of the group comparison between CLIL and non-CLIL (between-subject) showed that the CLIL group reported more favorable emotions and motivation for language learning, in line with previous cross-sectional research on socio-affective outcomes. However, the longitudinal results (within-subject) indicated that the effects of CLIL were limited, particularly when initial vocabulary knowledge was factored in. Our findings thus contradict or moderate the (largely theoretical) claim that CLIL de facto would generate advantages in terms of socio-affective factors such as language emotions and learning motivation.

Long-Term Outcomes of Orthotopic Neobladder Versus Ileal Conduit Urinary Diversion in Robot-Assisted Radical Cystectomy (RARC): Multicenter Results from the Asian RARC Consortium

PurposeRobot-assisted radical cystectomy (RARC) has gained traction in the management of muscle invasive bladder cancer. Urinary diversion for RARC was achieved with orthotopic neobladder and ileal conduit. Evidence on the optimal method of urinary diversion was limited. Long-term outcomes were not reported before. This study was designed to compare the perioperative and oncological outcomes of ileal conduit versus orthotopic neobladder cases of nonmetastatic bladder cancer treated with RARC.Patients and MethodsThe Asian RARC consortium was a multicenter registry involving nine Asian centers. Consecutive patients receiving RARC were included. Cases were divided into the ileal conduit and neobladder groups. Background characteristics, operative details, perioperative outcomes, recurrence information, and survival outcomes were reviewed and compared. Primary outcomes include disease-free and overall survival. Secondary outcomes were perioperative results. Multivariate regression analyses were performed.ResultsFrom 2007 to 2020, 521 patients who underwent radical cystectomy were analyzed. Overall, 314 (60.3%) had ileal conduit and 207 (39.7%) had neobladder. The use of neobladder was found to be protective in terms of disease-free survival [Hazard ratio (HR) = 0.870, p = 0.037] and overall survival (HR = 0.670, p = 0.044) compared with ileal conduit. The difference became statistically nonsignificant after being adjusted in multivariate cox-regression analysis. Moreover, neobladder reconstruction was not associated with increased blood loss, nor additional risk of major complications.ConclusionsOrthotopic neobladder urinary diversion is not inferior to ileal conduit in terms of perioperative safety profile and long-term oncological outcomes. Further prospective studies are warranted for further investigation.

BOOSTING SKULL-STRIPPING PERFORMANCE FOR PEDIATRIC BRAIN IMAGES.

Skull-stripping is the removal of background and non-brain anatomical features from brain images. While many skull-stripping tools exist, few target pediatric populations. With the emergence of multi-institutional pediatric data acquisition efforts to broaden the understanding of perinatal brain development, it is essential to develop robust and well-tested tools ready for the relevant data processing. However, the broad range of neuroanatomical variation in the developing brain, combined with additional challenges such as high motion levels, as well as shoulder and chest signal in the images, leaves many adult-specific tools ill-suited for pediatric skull-stripping. Building on an existing framework for robust and accurate skull-stripping, we propose developmental SynthStrip (d-SynthStrip), a skull-stripping model tailored to pediatric images. This framework exposes networks to highly variable images synthesized from label maps. Our model substantially outperforms pediatric baselines across scan types and age cohorts. In addition, the <1-minute runtime of our tool compares favorably to the fastest baselines. We distribute our model at https://w3id.org/synthstrip.

Pixel-Level Crack Identification for Bridge Concrete Structures Using Unmanned Aerial Vehicle Photography and Deep Learning

Traditional manual inspection technology has the problems of high risk, low efficiency, and being time-consuming in bridge safety management. The unmanned aerial vehicle (UAV)-based detection technology is widely used in bridge structure safety monitoring. However, the existing deep learning-based concrete crack identification method has great limitations in dealing with complex background and tiny cracks in bridge structures. To address these problems, this study designs a crack pixel-level high-performance segmentation model for bridge concrete cracks that is suitable for UAV detection scenarios using machine vision (MV) and deep learning (DL) algorithms. First, considering the high requirements for the computing performance of the MV-based model for UAV-based detection, the ResNet-18-based lightweight convolutional neural network is used to represent the traditional large-scale backbone network of the pyramid scene parsing network (PSPNet) to develop a high-performance crack automatic identification model. Then, considering that bridge concrete cracks have the characteristics of subtle shapes and complex backgrounds, the spatial position self-attention module is inserted into the PSPNet to improve its detection accuracy. A concrete bridge is used for the case study, and a dataset of cracks in bridge concrete structures collected by UAVs is constructed and used for model training. The experimental results show that the loss function of the developed method in the training process results in a smooth decline, and the developed algorithm achieves the evaluation indicators of 0.9008 precision, 0.8750 recall, 0.8820 accuracy, and 0.9012 IOU on the bridge concrete crack dataset, which are significantly higher than other state-of-the-art baseline methods. In addition, four common UAV bridge detection scenarios, including low light, complex crack forms, high background roughness, and complex background scenes, are used to further test the crack detection ability of the developed crack identification model. The experimental results show that the proposed crack identification method can effectively overcome interference and real-size pixel-level segmentation of crack morphology. In addition, it also achieved a detection efficiency of 35.04 FPS, which shows that the real-time detection ability of the method has good applicability in the UAV detection scene.

Students With Growth Mindset Learn More in School: Evidence From California’s CORE School Districts

Previous research provides evidence that developing a growth mindset—believing that one’s capabilities can improve—promotes academic achievement. Although this phenomenon has undergone prior study in a representative sample of ninth graders in the United States, it has not been studied in representative samples of other grade levels or with standardized assessment measures of achievement rather than more subjective grades. Using a rich longitudinal data set of more than 200,000 students in Grades 4 through 7 in California who we followed for a year until they were in Grades 5 through 8, this article describes growth mindset gaps across student groups and confirms, at a large scale, the predictive power of growth mindset for achievement gains. We estimate that a student with growth mindset who is in the same school and grade level and has the same background and achievement characteristics as a student with a fixed mindset learns 0.066 SD more annually in English language arts, approximately 18% of the average annual growth or 33 days of learning if we assume learning growth as uniform across the 180 days of the academic year. For mathematics, the corresponding estimates are 0.039 SD, approximately 17% of average annual growth or 31 days of learning.

Exploring the determinants of risk behavior for transfusion transmissible infections among first-time blood donors in Mandalay General Hospital, Myanmar.

Blood donation is vital to healthcare, but it must be kept safe by mitigating the risk of transfusion transmissible infections (TTIs). The objective of this study was to investigate the factors that influence risk behavior for transfusion transmissible infections among first-time blood donors at Mandalay General Hospital, Myanmar. This study utilized a cross-sectional study design using secondary data. Mandalay city and Mandalay Blood Bank in Mandalay General Hospital were purposely selected and a total of 406 first-time blood donors participated. A structured questionnaire administered by an interviewer was used. The questionnaire contained background characteristics, knowledge on TTIs, attitude toward TTIs, and TTIs risk behaviors. To examine the determinants (background characteristics, knowledge, and attitude) that affect risk behavior, inferential statistics techniques that included the chi-squared test, bivariable logistic regression, and multivariable logistic regression were applied. A p-value of less than 0.05 signified statistical significance. Among 406 first-time blood donors, 52.9% were under 20 years old, and 53.7% were male. Most had undergraduate education (77.6%), were married (84.2%), and were students (55.7%). Additionally, 76.8% hadn't received the hepatitis B vaccine. Blood groups were distributed as follows: B (40.0%), O (33.8%), A (23.4%), AB (8.9%). About 15.8% showed high knowledge level, and 63.6% had high attitude. Notably, 29.3% exhibited high-risk behavior for TTIs. Age was associated with lower risk behavior (OR = 1.54, 95% CI: 0.99, 2.38, p = 0.049), but lost significance in multivariable regression (p = 0.214). Knowledge on TTIs didn't show significance. However, high attitudes were significantly associated with lower risk behavior (OR = 11.4, 95% CI: 1.25, 103.83, p = 0.017, retained in multivariable regression, p = 0.012). Findings of this study contribute in the development of programs that ensure a safe and reliable blood supply chain. To improve blood safety standards among first-time blood donors, this study highlights the value of targeted education and screening processes, placing particular emphasis on acquiring knowledge and positive attitude toward blood donation and risk behavior.

Gut Inflammation Markers, Diet, and Risk of Islet Autoimmunity in Finnish Children – A Nested Case-Control Study

BackgroundGut dysbiosis and increased intestinal permeability have been reported to precede type 1 diabetes-related autoimmunity. The role of gut inflammation in autoimmunity is not understood. ObjectivesThis study aimed to assess whether gut inflammation markers are associated with risk of islet autoimmunity and whether diet is associated with gut inflammation markers. MethodsA nested case-control sample of 75 case children with islet autoimmunity and 88 control children was acquired from the Finnish Type 1 Diabetes Prediction and Prevention cohort. Diet was assessed with 3-d food records, and calprotectin and human β-defensin-2 (HBD-2) were analyzed from stool samples at 6 and 12 mo of age. Conditional logistic regression analysis was used in a matched case-control setting to assess risk of autoimmunity. Analysis of variance, independent samples t test, and a general linear model were used in secondary analyses to test associations of background characteristics and dietary factors with inflammation markers. ResultsIn unadjusted analyses, calprotectin was not associated with risk of islet autoimmunity, whereas HBD-2 in the middle (odds ratio [OR]: 3.23; 95% confidence interval [CI]: 1.03, 10.08) or highest tertile (OR: 3.02; 95% CI: 1.05, 8.69) in comparison to the lowest at 12 mo of age showed borderline association (P-trend = 0.063) with higher risk of islet autoimmunity. Excluding children with cow milk allergy in sensitivity analyses strengthened the association of HBD-2 with islet autoimmunity, whereas adjusting for dietary factors and maternal education weakened it. At age 12 mo, higher fat intake was associated with higher HBD-2 (β: 0.219; 95% CI: 0.110, 0.328) and higher intake of dietary fiber (β: −0.294; 95% CI: −0.510, −0.078), magnesium (β: −0.036; 95% CI: −0.059, −0.014), and potassium (β: −0.003; 95% CI: −0.005, −0.001) with lower HBD-2. ConclusionsHigher HBD-2 in infancy may be associated with higher risk of islet autoimmunity. Dietary factors play a role in gut inflammatory status.

Ethnic minority underachievement in UK higher education: an analysis of nationally representative data provides little support for the intersectionality thesis

ABSTRACT This study evaluated the intersectionality thesis, which suggests that the interaction of ethnicity, sex, and socioeconomic status significantly affects achievement in UK higher education. The study used a sample of 135,699 students from the Graduate Outcomes survey for the 2018/19 cohort, the last to leave higher education before the COVID-19 pandemic. Conditioning on a rich set of background characteristics, results from a series of regressions indicated that some interactions are statistically significant predictors of obtaining a good degree. However, the estimated size of these interaction effects, as estimated using marginal effects, appeared to be negligible. Robustness checks included consideration of selection on observables using Inverse Probability Weighted Regression Adjustment (IPWRA), which confirmed the main results’ robustness. Overall, the findings suggest that the data do not support the intersectionality thesis and that markers of disadvantage, when combined, do not have an effect on educational outcomes that is over and above that of the single factors in isolation. These results could have implications for recent policies introduced in England to close ethnic achievement gaps in higher education by 2038. However, the findings should be treated with some caution due to the ethnic categories used in the analysis and the potential bias from omitted and unobserved variables that may lead to an underestimation of ethnic penalties.

Development of the Psychotherapist Character Virtues (PCV) Interview.

To develop an interview-based rating method for assessing therapists' beneficial character traits and evaluate its reliability and validity. The semi-structured Psychotherapist Character Virtues (PCV) interview and evaluation method, based on Erik Erikson's and Heinz Kohut's writings on 16 virtues or abilities and achievements of an adult self, was administered to 68 psychodynamic and solution-focused therapists. Inter-rater reliability was assessed based on 20 videorecorded interviews, rated by two evaluators. In a mixed-methods design, validity was investigated against (i) therapist's questionnaire-based self-reported professional and personal background characteristics and (ii) a qualitative content analysis of emotional atmosphere in the interview. Interrater reliability for individual 16 virtues was acceptable (median correlation .72). From individual virtues, three principal components (Creative Will, Empathy, and Love/Care) emerged with good/excellent internal consistency (component determinacies .95, .85, and .90, respectively) and criterion validity with self-reported professional and personal characteristics. Cluster analysis of therapists' component scores yielded six different therapist character profiles. In qualitative analysis, character profiles meaningfully differed in their impact on the interview's emotional atmosphere. PCV appears promising for evaluating therapists' character virtues, posited to undergird therapists' sensitive attunement and responsiveness. Further research is needed on PCV's predictive validity for therapeutic relationships and outcomes.

Trust in primary health care and COVID-19 vaccine uptake among Iranian pediatric: a web-based cross-sectional survey

BackgroundChildren are the most vulnerable group to diseases. Thus, it’s critical to evaluate parents’ or guardians’ willingness to vaccinate their children. This study aims to investigate the prevalence and predictors of pediatric COVID-19 vaccination in Iran and its relationship with trust in the Primary Health Care (PHC) system.MethodA cross-sectional online survey of 549 Iranian parents was conducted between January and March 2023. This study collected data from all provinces of Iran using a questionnaire shared on Google Forms and various social media platforms. After considering various background factors, we used a multivariable logistic regression model. This model explored how trust in the PHC system and parent-related and child-related factors were related to parents’ vaccine uptake for their children.ResultsOf 549 parents aged between 19 and 67 years (median = 38 years), 65.2% (358) were female. The prevalence of vaccine uptake among parents was 46.8%. After adjusting for background features, child’s age (adjusted odds ratio [AOR] 0.81, 95% CI 0.71–0.91), vaccine doses (1-dose: AOR 14.72, 95% CI 6.44–33.65, 2-dose: AOR 32.54, 95% CI 15.22–69.57), child’s disease (AOR 5.31, 95% CI 2.19–12.85), and trust in PHC (AOR 1.01, 95% CI 1.00–1.02) were associated with parental uptake of the COVID-19 vaccine.ConclusionsThe findings of this study suggest that the child’s age, vaccine doses received, diseases, and trust in PHC are significant predictors of parental uptake of the COVID-19 vaccine for children in Iran. The results can be used in service planning regarding children’s COVID-19 vaccination.

Academic survival: student retention in sport and exercise sciences

ABSTRACT Retention of higher education students is of major concern within the United Kingdom due to the financial and reputational impact on institutions, financial and personal impact on students and loss of potential skills and knowledge within society. Student background characteristics are acknowledged as the initial factors influencing retention within various models, however subject specific understanding is limited. This study aimed to identify pre-enrolment factors associated with student retention in Sport, Health and Exercise Science programmes. Student retention at department and programme level were calculated by ‘time to event’ analysis using Kaplan–Meier survival trend curves and log rank (Mantel–Cox) analysis for; gender, age, locality to the university, highest qualification on entry and participation of local areas in higher education (POLAR4) classifications. Results identified that male students, students from low Higher Education participation neighbourhoods and students who enter Higher Education without A-Level or foundation qualifications were at an increased risk of degree non-completion. Importantly, these characteristics were also disproportionally high in the student populations considered here. It is imperative that initiatives to improve retention, particularly in these populations, are sought and implemented at department level to improve student and institutional outcomes.

Sign language recognition based on dual-path background erasure convolutional neural network

Sign language is an important way to provide expression information to people with hearing and speaking disabilities. Therefore, sign language recognition has always been a very important research topic. However, many sign language recognition systems currently require complex deep models and rely on expensive sensors, which limits the application scenarios of sign language recognition. To address this issue, based on computer vision, this study proposed a lightweight, dual-path background erasing deep convolutional neural network (DPCNN) model for sign language recognition. The DPCNN consists of two paths. One path is used to learn the overall features, while the other path learns the background features. The background features are gradually subtracted from the overall features to obtain an effective representation of hand features. Then, these features are flatten into a one-dimensional layer, and pass through a fully connected layer with an output unit of 128. Finally, use a fully connected layer with an output unit of 24 as the output layer. Based on the ASL Finger Spelling dataset, the total accuracy and Macro-F1 scores of the proposed method is 99.52% and 0.997, respectively. More importantly, the proposed method can be applied to small terminals, thereby improving the application scenarios of sign language recognition. Through experimental comparison, the dual path background erasure network model proposed in this paper has better generalization ability.

The relationship between health literacy and the adoption of COVID-19 preventive behaviors: A cross-sectional study in Iran.

Health literacy (HL) is one of the effective factors in controlling the COVID-19 epidemic. Considering the high prevalence of COVID-19 disease, the present study aimed to determine the relationship between HL and the adoption of COVID-19 preventive behaviors. This was a descriptive-cross sectional study conducted on 214 students selected by simple random sampling method in Esfarayen Faculty of Medical Sciences, Iran, in 2022. The data included demographic and background characteristics, health literacy for Iranian Adults (HELIA), and a valid and reliable questionnaire to measure COVID-19 preventive behaviors. The data were analyzed using SPSS 23, descriptive statistics, and ordinal logistic regression tests. The mean and standard deviation of the scores of adoption of COVID-19 preventive behaviors and HL among students were 18.18) 4.02(out of 25 and 72.14) and 12.75 (out of 100, respectively. The results of the logistic regression test showed that the HL (P = 0.003), gender (P<0.001), mother's education (P = 0.039), educational level (P = 0.031), smoking (P = 0.032), and physical activity (P = 0.007) were effective factors in adopting preventive behaviors. Adopting preventive behaviors against COVID-19 was lower among students with lower levels of health literacy, male students, students with less physical activity, students with illiterate mothers, undergraduate students, and finally smokers. Therefore, it is necessary to pay more attention to these students in designing educational programs. It is suggested to carry out more extensive studies to clarify the effect of HL on the adoption of COVID-19 preventive behaviors.