Consecutive Periods Research Articles

The Effect of Play-Based Movment Education Program in Supporting the Development of Sedentary 5-Year-Old Children

This study aims to investigate the impact of a play-based movement education program conducted outdoors and in the classroom on the motor development, physical activity, and social skills of sedentary five-year-old children. The experimental phase of the study spans a total of eight weeks, divided into two consecutive four-week periods. In line with this, children in the experimental group participated in the movement education program both outdoors and in the classroom. On the contrary, children in the control group solely engaged in daily classroom activities during the same designated times. Throughout these activities, the number of steps taken by children in both groups was meticulously recorded through pedometer measurements. The findings of this study demonstrate that the play-based movement education program significantly boosted the motor development and social skills of the children in the experimental group, while no noticeable improvement was observed in these aspects among the children in the control group. Notably, the number of steps taken by the children in the experimental group was markedly higher compared to those taken by the children in the control group. The results indicate that the skills acquired by the children in the experimental group displayed a lasting impact.

Measuring emotions in dairy cows: Relationships between infrared temperature of key body parts, lateralised behaviour and milk production

The emotions of cows could be reflected in their body temperature, productivity and behaviours. We tested whether there is a positive correlation between non-invasive infrared temperature (IRT) and right-side laterality (presumed to indicate anxiety), and negative correlation with milk production in a large group of randomly selected cows. Lactating cows (n = 171) were examined individually in 3 consecutive one-month periods. Each month maximum infrared temperatures of the head and coronary bands of forelimbs were recorded daily for 6 days and lateralisation was determined from ten daily forced lateralisation tests. In the first month right-lateralised cows had higher IRT in their eyes than left-lateralised cows. The absence of an association between IRT and laterality in periods 2 and 3 suggests habituation to the test conditions. Right lateralised cows waited for longer before milking than left lateralised cows, and limb IRTs were negatively related to the waiting time before milking. We conclude that the connection between lateralised behaviour and eye IRT in this study provides evidence of differences in cows’ emotional response to the forced lateralisation test.

Sodium acetate alleviates the liver injury induced by high carbohydrate diets in swamp eel Monopterus albus through inhibiting inflammation formation

Optimal carbohydrate level in diets could improve growth and feed efficiency，whereas HC (high carbohydrate) diets usually induce the liver injury in reared fish. While SA (sodium acetate) has demonstrated its potential to alleviate liver injury in mammals, the mechanism underlying its impact on liver health in fish remains elusive. This study aims to elucidate the effect of dietary SA on liver injury in the female Monopterus albus. In our study, groups of M. albus were fed with different diets: NC (normal, 20% carbohydrate), HC (high carbohydrate, 32% carbohydrate) and HC+A (HC supplemented with 0.2% SA) diets, in separate, for a consecutive period of 56 days. Our findings showed that HC+A diets improved growth (weight gain rate, from 263.27 ± 9.87–292.34 ± 6.18%) and FE (feed efficiency, from 67.28 ± 2.18–75.91 ± 1.90%) (P < 0.05). Simultaneously, HC+A diets alleviated the liver injury caused by HC diets, including the decrease of serum AST (aspartate aminotransferase) (P < 0.05). Meanwhile, HC-A diets decreased the relative areas of hepatic glycogen compared with the HC diets by histological analysis (P < 0.05). In addition, the transcriptomic analysis of DEG (differentially expressed genes) in liver showed that all the DEG involved in anti-inflammatory (PPARα, APOA-I) were up-regulated in HC+A group compared with NC and HC group (P < 0.05). In general, sodium acetate could improve the liver injury induced by HC diets of swamp eel through inhibiting the formation of inflammatory. Our results indicated that sodium acetate can be used as a functional additive in the application of aquatic HC diets.

Testing an insurance-based monetary incentive program for exercise: RCT design and rationale

Participation in regular physical activity (PA) has numerous health benefits; however, as few as 10% of U.S. adults meet guidelines when device-based assessments of PA are used. The present paper presents the design and rationale for an RCT examining the efficacy of an exercise incentive program currently offered by at least three major US insurance companies, in which participants must attend a YMCA fitness facility at least 50 times within 6 months to receive an incentive. In a factorial design, incentive amount ($200, $100, $0) is crossed with a comparison of the standard gain-framed incentive program and a loss-framed incentive condition in which participants are told their membership fee is being held and will be returned or forfeited depending on their fitness facility attendance. Participants (N = 330) are randomized to gain-framed $100 incentive (n = 55), gain-framed $200 incentive (n = 55), loss-framed $100 incentive (n = 55), loss-framed $200 incentive (n = 55), or control (n = 110). Each participant is enrolled in the same condition for two consecutive 6-month periods for a total of 12 months per participant. The primary outcome is number of visits to the fitness facility over each 6-month period, verified by objective swipe-card data. Secondary outcomes include total moderate-to-vigorous PA (MVPA) over 7-day periods assessed at 3-month intervals through accelerometers (Actigraph wGT3x-BT) and self-report. Habit formation and anticipated regret are putative mediators and household income is a putative moderator of the incentive-based programs. A payer-perspective, within-trial cost-utility analysis will quantify the incremental costs per (a) quality-adjusted life year gained, (b) YMCA attendance, and (c) change in MVPA.

Impact of Patient Selection and Management over Different Time Periods on the Outcome of Patients with Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy

Introduction. Autologous chimeric antigen receptor (CAR) T-cell therapy targeting CD19 is an effective treatment for relapsed or refractory large B-cell lymphoma (LBCL). Real-world studies have reported improved outcomes in terms of safety and efficacy in comparison with pivotal trials. These differences have been associated to a learning curve in patient selection and adverse event control, but this hypothesis has not been proven. The aim of this study was to analyze patient selection and CAR T-cell management across different time periods and assess its impact on treatment outcomes Methods. This retrospective analysis included all consecutive LBCL patients receiving CAR-T cell therapy (axicabtagene-ciloleucel [axi-cel] and tisagenlecleucel) in the third line setting from approval in 2019 to 2023 and reported in the Spanish Registry. Patients were categorized in 3 consecutive time periods of 18 months each according to infusion date. Baseline characteristics, manufacturing times and production failures as well as efficacy and safety outcomes were compared across periods. An additional safety and efficacy analysis was conducted in patients receiving axi-cel. Results. The study included 458 patients: 117 (26%), 194 (42%) and 147 (32%) in the early (EP) (January 2019-June 2020), intermediate (IP) (July 2020-December 2021) and recent period (RP) (January 2022-June 2023), respectively. In terms of patient profile, baseline characteristics evolved overtime as patients in the RP had received less number of prior therapies, had less primary refractory disease, less bulky disease and had lower LDH at lymphodepletion. On the contrary, the RP had more patients with ECOG performance status ³2 and higher comorbidity burden. Regarding the product, the use of axi-cel increased overtime, from 45% in the EP to 83% in the RP (Table). The time from apheresis to infusion improved overtime, moving from 48 days in the EP to 38 days in the RP. Manufacturing failures (5%) and use of bridging therapy (81%) remained stable overtime. Regarding efficacy, overall (complete) response rates improved overtime (from 66% [25%] in the EP to 78% [52%] in the RP [p&amp;lt;0.001], respectively). Median PFS and OS for the whole cohort were 3.9 months (95% CI 3.23-5.83) and 18.5 months (95% CI 13.53 - 27.67) without differences across periods. In terms of toxicity, patients in the RP had more grade &amp;gt; or = 3 CRS and ICANS, received more tocilizumab and corticosteroids and required more ICU admission compared with the EP. These results were driven by the higher use of axi-cel in the RP. When focusing exclusively on axi-cel patients (n=301), the CR rate also improved overtime (32% in the EP; 37% in the IP and 55% in the RP, p=0.016) (Figure) while median PFS (6.63 months, 95%CI 3.90 - 11.43) and OS (25.73 months, 95%CI 18.57 - NA) remained stable. In the multivariable analysis, ECOG PS &amp;gt; 1 (HR 2.68, 95% CI 1.35-5.09, p=0.005) and LDH ³ 500 UI/L (HR 1.54, 95% CI 1.02-2.31, p=0.04) but not treatment period were associated with a shorter PFS. In terms of toxicity, the time to CRS onset (median of 3 vs. 1 days, p=0.001) and ICANS (median of 8 vs. 6 days, p=0.06) was later in the EP compared with the RP. The incidence of grade &amp;gt; or = 3 CRS and ICANS (ranging from 10% to 7% and 36% to 41%, respectively), the use of tocilizumab, corticosteroids, and anakinra as well as ICU admission rate and 12-month non-relapse mortality (2% vs 5%) remained stable across periods. Conclusion. The criteria for selecting patients for CAR T-cell therapy have evolved overtime towards a less aggressive disease profile and allowing less fit patients for therapy in recent times. Patients treated in the RP were more likely to respond to these therapies but this did not translate into prolonged survival or an improved safety profile.

Efficacy and Safety of Roxadustat for Treatment of Anemia in Patients with Lower-Risk Myelodysplastic Syndrome (LR-MDS) with Low Red Blood Cell (RBC) Transfusion Burden: Results of Phase III Matterhorn Study

Presented on behalf of all MATTERHORN (FGCL-4592-082) study investigators Introduction: For patients (pts) with LR-MDS, anemia poses a major clinical challenge, with limited response to first-line erythropoietin (EPO)-stimulating agents (ESAs) and a median duration of response ≤2 years. Further, pts with RBC transfusion dependence (≥2 packed RBC [pRBC] units every 8 weeks [Q8W]) are less likely to respond to ESAs. Anemia treatments with novel mechanisms of action enabling transfusion independence (TI) are needed to reduce frequent RBC transfusion burden. Roxadustat is a first-in-class, hypoxia-inducible factor prolyl hydroxylase inhibitor for treatment of anemia with chronic kidney disease. In the MATTERHORN (NCT03263091) dose-selection stage, roxadustat was well-tolerated, and 37.5% of pts (9/24) with LR-MDS and low RBC transfusion burden ([LTB] 1 pRBC unit Q8W for two consecutive 8-week periods or 2-4 pRBC units Q8W) achieved TI. In the MATTERHORN double-blind stage, TI response rate and safety of roxadustat were further assessed. Methods: MATTERHORN is an ongoing, double-blind, Phase III, randomized, placebo (PBO)-controlled trial. Eligible adult pts (≥18 years of age) had very low-, low-, or intermediate-risk primary MDS per Revised International Prognostic Scoring System (IPSS-R) classification (&amp;lt;5% bone marrow blasts); hemoglobin (Hb) ≤10.0 g/dL at baseline (BL); and LTB. Prior ESA use (&amp;gt;8 weeks before randomization) was permitted. Pts were randomized 3:2 to roxadustat or PBO, then stratified by serum EPO concentration (≤200 or 200-400 mIU/mL), IPSS-R risk, and transfusion burden. Pts received oral roxadustat (starting dosage: 2.5 mg/kg three times weekly based on the dose-selection stage) or PBO with best supportive care (BSC; per institutional criteria, including RBC transfusion) for a 52-week treatment period, followed by a 4-week follow-up period. Primary efficacy endpoint was percentage of pts with TI (the absence of RBC transfusion) for ≥56 consecutive days during the first 28 treatment weeks (TI responder). The percentage of pts with TI and mean Hb increase of ≥1.0 and ≥1.5 g/dL (averaged over 8 weeks) compared with BL pretransfusion Hb was also assessed (to be reported separately). Safety (including treatment-emergent adverse events [TEAEs] and serious TEAEs) was evaluated throughout the study. Results: As of the final 28-week interim analysis of the double-blind stage (data cutoff: April 24, 2023), 140 pts (82 roxadustat, 58 PBO) were randomized and treated. Across arms, median age was 71.5 years (range, 26-96), 59.3% (83/140) were male, and 80.0% (112/140) were white. Most pts (72.1% [101/140]) had IPSS-R low-risk disease and a transfusion burden of 2-4 pRBC units Q8W (92.1% [129/140]). Median (range) BL transfusion burden was 2.5 (1-10) pRBC units. Seventy pts (50.0%) received prior ESAs (98.6% [69/70] were ESA-refractory). Eighty-four pts (41/82 [50.0%] roxadustat, 43/58 [74.1%] PBO) completed 28 weeks of treatment, and 15 pts (6/82 [7.3%] roxadustat, 9/58 [15.5%] PBO) were continuing treatment. Median (range) treatment duration was 24.1 (1.1-28.0) weeks for the roxadustat arm and 28.0 (0.1-28.0) weeks for the PBO arm. A greater percentage of pts in the roxadustat arm compared with the PBO arm were TI responders (47.5% vs. 33.3%). However, this difference did not reach statistical significance ( p=0.22; figure). Percentages of pts with TEAEs of any grade, serious TEAEs, and TEAEs leading to treatment discontinuation were similar across arms (table). Six deaths occurred on study (roxadustat: pneumonia [n=2], acute myocardial infarction and ischemic stroke [n=1], multiorgan failure [n=1]; PBO: urosepsis [n=1], disease progression [n=1]). Three pts (all in roxadustat arm) progressed to acute myeloid leukemia. The study was terminated by the sponsor and is currently being completed. Conclusions: Despite not meeting the primary endpoint, roxadustat plus BSC was well-tolerated, and a high percentage of pts with LR-MDS and LTB were TI responders. The high TI response rate in the PBO arm, historically poor outcomes in pts with ESA-refractory disease, and the inclusion of pts who were not transfusion-dependent (1 pRBC unit Q8W) may have contributed to the lack of a statistically significant difference in TI response rates between arms. MATTERHORN outcomes highlight the continued unmet need for effective and safe therapies that reduce RBC transfusion burden in LR-MDS.

МНОГОЛЕТНИЕ ИЗМЕНЕНИЯ ВЕТРОВОГО РЕЖИМА В СЕВЕРО-ЗАПАДНОЙ ЧАСТИ КАСПИЯ

In recent years, much attention has been paid to climate change issues. Regional climate change can be manifested in the changes in the main climate-forming factors, including wind. Studying the climatic characteristics of wind in the Caspian Sea is considered as the most important task, since wind affects the variability of currents, the formation of hydrological and hydrochemical processes, and the information about the wind regime is necessary for the operation of marine organizations, the specifics of which is the dependence of all stationary and mobile objects in the sea on hydrometeorological conditions. The paper provides an analysis of the frequency of wind directions and wind speeds for individual months, seasons, years, different gradations of wind speed. For the climatic characteristics of wind speed for consecutive 30-year periods, a comparative analysis of changes in climatological normals is carried out, and deviations of wind characteristics relative to the standard reference period are revealed.

Bamboo Preservation Experiments as Encapsulation for Liquid-State PCM

Bamboo has been known for its sustainability and versatility, which presents a promising green alternative material from tropical countries. This paper explores bamboo’s potential as an encapsulation material for liquid phase change material (PCM), addressing leakage and fungal growth. The experimental procedures involve treating two different types of bamboo (black and tropical green) to see their capability as an encapsulation for phase change material. In addition, three experiments were applied: waterproofing, varnish, and pre-treatment. Qualitative analysis is conducted over a consecutive fourteen-day period, evaluating all the twenty different samples with different treatments as they hold the liquid PCM. Several pre-treated bamboos show leakage. Consequently, varnishing and waterproofing treatments emerged as crucial in effectively addressing bamboo encapsulation. The findings demonstrate that tropical green bamboo, treated with waterproofing on both sides, exhibited impeccable leakage prevention and successfully removed fungal growth, even when exposed to extended periods of moisture.

Biochemical composition changes can be linked to the tolerance of four grassland species under more persistent precipitation regimes

AbstractClimate models suggest that the persistence of summer precipitation regimes (PRs) is on the rise, characterized by both longer dry and longer wet durations. These PR changes may alter plant biochemical composition and thereby their economic and ecological characteristics. However, impacts of PR persistence have primarily been studied at the community level, largely ignoring the biochemistry of individual species. Here, we analyzed biochemical components of four grassland species with varying sensitivity to PR persistence (Holcus lanatus, Phleum pratense, Lychnis flos‐cuculi, Plantago lanceolata) along a range of increasingly persistent PRs (longer consecutive dry and wet periods) in a mesocosm experiment. The more persistent PRs decreased nonstructural sugars, whereas they increased lignin in all species, possibly reducing plant quality. The most sensitive species Lychnis seemed less capable of altering its biochemical composition in response to altered PRs, which may partly explain its higher sensitivity. The more tolerant species may have a more robust and dynamic biochemical network, which buffers the effects of changes in individual biochemical components on biomass. We conclude that the biochemical composition changes are important determinants for plant performance under increasingly persistent precipitation regimes.

Applying the American Association of Endodontists and American Academy of Oral and Maxillofacial Radiology guidelines for cone-beam computed tomography prescription: Impact on endodontic clinical decisions

BackgroundThe American Association of Endodontists (AAE) and the American Academy of Oral and Maxillofacial Radiology (AAOMR) developed guidelines for the prescription of cone-beam computed tomographic (CBCT) imaging. The impact of appropriately prescribed CBCT imaging on endodontic diagnosis and treatment (Tx) decisions was examined. MethodsThe clinical databases at the School of Dentistry at the University of California, Los Angeles, Los Angeles, California, were queried to identify patients referred for CBCT imaging from the postgraduate endodontic clinic over a consecutive 36-month period. Primary and secondary indications for CBCT imaging were recorded. Pre-CBCT uncertainty in diagnosis, Tx of the teeth in question, and post-CBCT changes to the diagnosis and Tx plan were recorded. ResultsCBCT imaging was prescribed for 12% of patients. A total of 442 scans were prescribed to evaluate 526 teeth. Molars accounted for 51% of teeth examined. Overall, CBCT effected a change in periapical diagnosis (21%) and in the Tx plan (69%). The 5 most frequent primary indications for CBCT imaging were, in order, AAE-AAOMR recommendations 7, 9, 2, 12, and 6. The impact of these recommendations on Tx decisions varied from 48% through 93%. ConclusionsThis study validates the use of the AAE-AAOMR guidelines for prescribing CBCT imaging for endodontic evaluations. CBCT imaging contributed predominantly to Tx decisions rather than diagnostic determinations. Practical ImplicationsThis study validates AAE-AAOMR case selection guidelines for CBCT imaging and shows a positive impact of prescription imaging on endodontic decision making.

An experimental study on lung deposition of inhaled 2 μm particles in relation to lung characteristics and deposition models

BackgroundThe understanding of inhaled particle respiratory tract deposition is a key link to understand the health effects of particles or the efficiency for medical drug delivery via the lung. However, there are few experimental data on particle respiratory tract deposition, and the existing data deviates considerably when comparing results for particles > 1 μm.MethodsWe designed an experimental set-up to measure deposition in the respiratory tract for particles > 1 μm, more specifically 2.3 μm, with careful consideration to minimise foreseen errors. We measured the deposition in seventeen healthy adults (21–68 years). The measurements were performed at tidal breathing, during three consecutive 5-minute periods while logging breathing patterns. Pulmonary function tests were performed, including the new airspace dimension assessment (AiDA) method measuring distal lung airspace radius (rAiDA). The lung characteristics and breathing variables were used in statistical models to investigate to what extent they can explain individual variations in measured deposited particle fraction. The measured particle deposition was compared to values predicted with whole lung models. Model calculations were made for each subject using measured variables as input (e.g., breathing pattern and functional residual capacity).ResultsThe measured fractional deposition for 2.3 μm particles was 0.60 ± 0.14, which is significantly higher than predicted by any of the models tested, ranging from 0.37 ± 0.08 to 0.53 ± 0.09. The multiple-path particle dosimetry (MPPD) model most closely predicted the measured deposition when using the new PNNL lung model. The individual variability in measured particle deposition was best explained by breathing pattern and distal airspace radius (rAiDA) at half inflation from AiDA. All models underestimated inter-subject variability even though the individual breathing pattern and functional residual capacity for each participant was used in the model.ConclusionsWhole lung models need to be tuned and improved to predict the respiratory tract particle deposition of micron-sized particles, and to capture individual variations – a variation that is known to be higher for aged and diseased lungs. Further, the results support the hypothesis that the AiDA method measures dimensions in the peripheral lung and that rAiDA, as measured by the AiDA, can be used to better understand the individual variation in the dose to healthy and diseased lungs.

Effects of different aquaculture patterns on growth, survival and yield of diploid and triploid Portuguese oysters (Crassostrea angulata)

Bivalve molluscs are increasingly being promoted as an alternative to land-based meat production due to their high levels of high-quality protein and lipids. The Crassostrea angulata, also known as the Portuguese oyster, has been a globally productive and renowned oyster species. In this study, we evaluated the aquaculture performance of C. angulata over two consecutive culture periods (pre-harvest phase, post-harvest phase) at different stocking densities and water depths, and compared the survival, growth and yield of diploid and triploid oysters. The experiment spanned 13 months, beginning in June 2022 and ending in June 2023. The results indicated that both stocking density and water depth significantly affected the aquaculture performance of C. angulata and exhibited distinct patterns in the two culture phases. Overall, compared to diploid C. angulata, triploid oysters showed significant culture advantages in the pre-harvest period, the growth rates and total yield of which were much higher than those of diploids. In the pre-harvest phase, the depth of 1 m and low-density culture (5 substrates/rope) favored the survival and growth of triploid oysters, while diploid C. angulata presented higher growth rates at high-density cultivation (15 substrates/rope), and the total oyster yield under 5 m culture reached a minimum for both diploids and triploids. In the post-harvest phase, the survival rate was stabilized, water depths of 1–3 m were optimal, and diploid oysters grew better at low (50 ind/cage) and medium (100 ind/cage) densities, whereas triploids had a higher growth rate of shell height at medium and high (150 ind/cage) densities. The findings of this research provide theoretical guidelines for exploring efficient C. angulata cultivation methods in the future, which will be beneficial to its commercial production.

Spatiotemporal patterns of healthy life expectancy and the effects of health financing in West African countries, 1995-2019: A Spatial Panel Modelling Study.

Health financing produce a broad range of healthy life expectancy (HLE) disparities. In West Africa, limited research exists on the association between health financing and HLE at ecological level during a consecutive period of time from the spatial perspectives. This study aimed to determine the existence, quantify the magnitude, and interpret the association between health financing and HLE. A Dynamic Spatial Durbin model was used to explain the association between HLE and health financing level and structure during 1995-2019 in West Africa. Spatial spillover effects were introduced to interpret the direct and indirect effects caused by health financing level and structure on HLE during the long and short terms. Spatial dependence and clustering on HLE were observed in West Africa. Although the overall level of total health spending, government health spending, out-of-pocket health spending, and development assistance for health (DAH) increased from 1995 to 2019, government health spending per person experienced a declining trend. Out-of-pocket health spending per total health spending was the highest among other sources of health financing, decreasing from 57% during 1995-1999 to 42% during 2015-2019. Total health spending and out-of-pocket health spending affected HLE positively and negatively in the long term, respectively. Government health spending and prepaid private health spending per person had positive effects on local and adjacent country HLE in the short-term, while DAH had negative effects on the same. The short-term spatial spillover effects of government health spending, DAH, and prepaid private health spending per person were more pronounced than the long-term effects. Spatial variations of HLE existed at country-level in West Africa. Health financing regarding government, non-government, as well as external assistance not only affected HLE disparities at local scale but also among nearby countries. Policymakers should optimise supportive health financing transition policies and narrow the national gap to reduce health disparities and increase HLE. Externalities of policy of those health financing proxies should be took into consideration to promote health equity to improve global health governance.

Pyromellitic acid grafted to cross-linked LDH by dendritic units: An efficient and recyclable heterogeneous catalyst for green synthesis of 2,3-dihydro quinazoline and dihydropyrimidinones derivatives

In this work, using layered double hydroxide (LDH) inorganic substrate, melamine as binding agent and dendrimer G1 and also pyromellitic acid (PMA) organic catalytic agent a heterogeneous acid catalyst was designed and prepared. After that, the prepared organic-inorganic catalyst was evaluated by various identification techniques such as FTIR, EDX, XRD, TGA, FESEM, and BET, and the results showed that the desired structure was successfully prepared. Also, in order to investigate the efficiency of the LDH@Me-PMA nanocatalyst as an efficient and heterogeneous catalyst, it was used for green and one-pot synthesis of 2,3-dihydro quinazoline and 3,4-dihydropyrimidinone-2-(1H)-ones derivatives. The use of LDH@Me-PMA catalyst led to the synthesis of the desired derivatives with higher efficiency and shorter reaction time than previously reported works. In addition, the prepared LDH@Me-PMA acid catalyst has the ability to be recycled and reused for 5 consecutive periods and has high stability, which is well consistent with the principles of green chemistry.

Growth and optical performance of short-period W/Al and polished W/Si/Al/Si multilayers

Short-period multilayer mirrors are used in wavelength-dispersive x-ray fluorescence to reflect and disperse elements in the O-Kα– Al-Kα range. In this work, we investigated sputter-deposited 2.5 nm W/Al with 20 periods. Our results show that W/Al is a poor reflector due to a combination of high interfacial roughness and strong W–Al intermixing. To address this, we introduced 0.5 nm Si seed layers at the W-on-Al and Al-on-W interfaces each consecutive period, while reducing the Al thickness from ∼2.0 to ∼1.0 nm. The Si seed layers significantly reduced interfacial roughness and W–Al intermixing, which led to an increase in the reflectance of the first Bragg peak at λ = 0.154 nm. To further reduce interfacial roughness, ion beam polishing of the top Si layer was applied at each period. The resulting structure of W/Si/Al/Si with ion beam polishing showed that the reflection coefficient of the first Bragg peak at λ = 0.154 nm was comparable to that of standard W/Si. These findings demonstrate the effectiveness of seed layers combined with polishing techniques in synthesizing smooth, high-reflectance multilayers containing two materials that are otherwise challenging to synthesize.

A Choice-Based Design Approach to Influence Beneficial Use of a Green Space by Family Caregivers at a Tertiary Care Hospital in India.

Principles of behavioral economics are now being used across fields in changing human behavior toward perceived benefit. We studied the effectiveness of simple, cost-effective design cues based on these principles, in encouraging use of a neglected outdoor space in a hospital. Benefits of access to nature and green spaces are established in healthcare; however, we found utilization of an outdoor space to be suboptimal. Presenting choices in different ways is known to influence user choice. We designed four design interventions based to nudge relative-caregivers waiting outside the operation theater toward utilizing an adjoining outdoor balcony. These included making the terrace prominent, reducing indoor sensory stimulation, adding stereotypical elements, and improving usability. We measured usage via video camera data and satisfaction using questionnaires. The number of users and average time per person spent on the balcony increased over the consecutive intervention periods as compared to baseline (trend p < .01 for both), mainly driven by the addition of stereotypical elements. There were no adverse events in the balcony. There was no difference in the satisfaction related outcomes on questionnaire; a larger percentage of positive comments tended to be related to the balcony in the final intervention. Cost-effective design cues nudged patient-caregivers toward spending more time with nature, thus changing behavior toward that with perceived benefits.

Evaluation of the Effect of Group Hope Therapy on Reducing Anxiety and Adherence to Treatment in Hemodialysis Patients

Background: Anxiety and non-compliance with treatment endanger the health of hemodialysis patients. Hope therapy focuses on human abilities and capabilities instead of weaknesses using a positive psychology approach. Objectives: This study aimed to evaluate the effect of group hope therapy (GHT) on reducing anxiety and adherence to treatment (ATT) in hemodialysis patients. Methods: This semi-experimental study was conducted with a pre-test and post-test on 40 patients undergoing hemodialysis as consecutive non-probability sampling from among the clients of two hemodialysis centers in Khorram Abad, Iran, in 2017. Primary data of the study was collected using the Spielberger State-Trait Anxiety Inventory (STAI) and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) in four stages, including before the intervention, immediately after the intervention, one and three months after the intervention. Hope therapy intervention was implemented in groups of five people for eight sessions (one session per week and each session for 60 minutes) by the researcher and with the supervision and approval of a psychiatrist and a clinical psychologist. The data were analyzed in the SPSS software version 21 at the significance level (α = 0.05). In addition, Cronbach’s alpha test was used to measure the reliability of the questionnaires. Results: There was a significant difference in the mean scores of anxiety and ATT between the two stages “before the intervention" and “immediately after the intervention" (P &lt; 0.05). In addition, there was no significant compliance with the treatment between the two stages “immediately after the intervention" and “three months after the intervention" (P &lt; 0.05), while the average scores of Overt and covert anxiety were significant (P &lt; 0.05). Conclusions: Based on the results, GHT effectively reduces overt and hidden anxiety and increases ATT in hemodialysis patients. Therefore, these results can help plan care for hemodialysis patients. Counseling sessions related to GHT should be offered for consecutive periods in educational and treatment centers by people with experience and training in working with hemodialysis patients.

Revealing Academic Evolution and Frontier Pattern in the Field of Uveitis Using Bibliometric Analysis, Natural Language Processing, and Machine Learning

ABSTRACT Purpose Numerous uveitis articles were published in this century, underneath which hides valuable intelligence. We aimed to characterize the evolution and patterns in this field. Methods We divided the 15,994 uveitis papers into four consecutive time periods for bibliometric analysis, and applied latent Dirichlet allocation topic modeling and machine learning techniques to the latest period. Results The yearly publication pattern fitted the curve: 1.21335x2 − 4,848.95282x + 4,844,935.58876 (R2 = 0.98311). The USA, the most productive country/region, focused on topics like ankylosing spondylitis and biologic therapy, whereas China (mainland) focused on topics like OCT and Behcet disease. The logistic regression showed the highest accuracy (71.6%) in the test set. Conclusion In this century, a growing number of countries/regions/authors/journals are involved in the uveitis study, promoting the scientific output and thematic evolution. Our pioneering study uncovers the evolving academic trends and frontier patterns in this field using bibliometric analysis and AI algorithms.

Guselkumab-Treated Patients with Plaque Psoriasis Who Achieved Complete Skin Clearance for ≥156 Consecutive Weeks: A Post-Hoc Analysis From the VOYAGE 1 Clinical Trial.

Treatment of moderate-to-severe plaque psoriasis with biologics, such as guselkumab, has demonstrated greater efficacy over traditional non-biologic treatments. However, given patient diversity, greater understanding of the relationship between patient characteristics, positive clinical outcomes, and long-term response to biologics is crucial for optimizing treatment choices. This post-hoc analysis of the 5-year VOYAGE1 clinical trial compares baseline characteristics of patients maintaining a Psoriasis Area and Severity Index (PASI) score of 0 at all visits for ≥156 consecutive weeks (PASI=0 group) with those that never achieve PASI=0 (comparator group), using descriptive statistics and a multiple logistic regression model. Guselkumab plasma trough concentrations in both response groups were assessed from Weeks 4-156. Of patients who started guselkumab treatment at Week 0 or at Week 16 after switching from placebo, 22.7% (112/494) maintained PASI = 0 for ≥156consecutive weeks. Numerical differences in baseline characteristics, including age, obesity, diabetes, PASI score, disease duration, smoking status, and psoriatic arthritis comorbidity, were identified between the PASI = 0 group and comparator group. Plasma guselkumab levels were consistently higher in the PASI = 0 group. Multiple logistic regression analysis revealed absence of diabetes, lower Dermatology Life Quality Index score at baseline, and higher Week 4 guselkumab plasma concentration as significantly (p<0.05) associated with the PASI = 0 group. A substantial (22.7%) number of guselkumab-treated patients in the VOYAGE 1 clinical trial maintained complete skin clearance for a consecutive period of ≥156 weeks. Factors associated with this outcome may suggest clinical benefits of holistic treatment approaches. NCT02207231.

Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique’s central hospitals

IntroductionThere is a substantial body of knowledge on the effects of the COVID-19 pandemic on injuries showing frequent but inconsistent reductions in both volume and pattern. Yet, studies specifically addressing children are less common, not least from low- and middle-income countries. This study investigated whether changes in the pattern and outcome of paediatric injury admissions to Mozambique’s four regional referral hospitals during 2020.MethodsClinical charts of paediatric patients presenting to the targeted hospitals with acute injuries were reviewed using a set of child, injury, and outcome characteristics during each of two consecutive restriction periods in 2020 using as a comparator the same periods in 2019, the year before the pandemic. Differences between 2020 and 2019 proportions for any characteristic were examined using the t-test (significance level 0.05).ResultsDuring both restriction periods, compared with the previous year, reductions in the number of injuries were noticed in nearly all aspects investigated, albeit more remarkably during the first restriction period, in particular, greater proportions of injuries in the home setting and from burns (7.2% and 11.5% respectively) and a reduced one of discharged patients (by 2.5%).ConclusionDuring the restrictions implemented to contend the pandemic in Mozambique in 2020, although each restriction period saw a drop in the volume of injury admissions at central hospitals, the pattern of child, injury and outcome characteristics did not change much, except for an excess of home and burn injuries in the first, more restrictive period. Whether this reflects the nature of the restrictions only or, rather, other mechanisms that came into play, individual or health systems related, remains to be determined.