Group Size Research Articles

Adaptive patterns of anti-predator escape behavior in a globally introduced bird species

Introduced species can represent quasi-experimental, anthropogenic case studies of both ecological and evolutionary principles. When these species are firmly established, competitive interactions between native and introduced species interactions, including foraging, spacing, and breeding competition, may be among the ecological costs incurred from such species invasions. In turn, genetic and/or plasticity-driven changes in behavior and morphology could also take place in the invading species with increasing introduction lag (time since the onset of introduction). Critically, however, introduction lag is difficult to study in any single non-native population without long-term observations, and, instead, it requires geographically repeated measures of the focal response variables across invasive populations that were introduced at different times. Here we tested a priori predictors of predator-avoidance behaviors through the flight initiation distance (FID) assay of a widely distributed invasive bird species, the common myna Acridotheres tristis. The species was extensively and consistently sampled throughout most of its independently introduced ranges across all hemispheres. Critically, FID increased with greater introduction lag. We also detected additional functional patterns in that FID increased towards the rural range within a continuous metric of urban-rural gradient and also at shorter distances from the Equator. Any robust study of FID must also include proximate predictors as well and, accordingly, we found that FID increased with greater starting distance, with lower immediate human density, with flighted over walking escape responses, and at lower heights of a bird’s perch above ground but was unrelated to myna group size. Respectively, these factors are informative about the sensory cues triggering anti-predator behaviors in invasive mynas and imply an adaptive set of patterns of anti-predator responses in the introduced ranges of this species. Control measures of invasive common myna populations should take into account their extensive behavioral and cognitive flexibilities and adjust the planned management methods accordingly.

The influence of service performance in China's sci-tech commissioner system: Using social network analysis and interpretable machine learning

The Sci-Tech Commissioner System (SCS) is a result of exploratory efforts by the Chinese government to use science and technology to strengthen the agricultural sector. Social network analysis (SNA) and machine learning (ML) techniques make it feasible to assess the service performance in China's SCS by using indicators such as group types and structure features. In this study, SNA and a clustering algorithm were employed to categorize service group types of sci-tech commissioners. By comparing the accuracy of different classification algorithms in predicting the clustering results, LightGBM algorithm was finally select to determine the clustering features of sci-tech commissioners and establish an interpretable ML model. Then, the SHAP was used to algorithm to analyze influences affecting service performance. Results show that the service forms of sci-tech commissioners are group-oriented, and that group types include small groups of young commissioners with close cooperation, larger groups of young and middle-aged commissioners, small groups of middle-aged and old commissioners with close cooperation, and isolated points of highly-influential commissioners. Furthermore, while group size is not the determinant of a commissioner's average performance, group structure and coordination ability were found to be more critical. Moreover, while differences in distinct types of service performance are caused by various factors, but good group structures and extensive social contacts are essential for high service performance.

Aggressive interactions influence cognitive performance in Western Australian magpies.

Extensive research has investigated the relationship between the social environment and cognition, suggesting that social complexity may drive cognitive evolution and development. However, evidence for this relationship remains equivocal. Group size is often used as a measure of social complexity, but this may not capture intraspecific variation in social interactions. Social network analysis can provide insight into the cognitively demanding challenges associated with group living at the individual level. Here, we use social networks to investigate whether the cognitive performance of wild Western Australian magpies (Gymnorhina tibicen dorsalis) is related to group size and individual social connectedness. We quantified social connectedness using four interaction types: proximity, affiliative, agonistic and vocal. Consistent with previous research on this species, individuals in larger groups performed better on an associative learning task. However, social network position was also related to cognitive performance. Individuals receiving aggressive interactions performed better, while those involved in aggressive interactions with more group members performed worse. Overall, this suggests that cognitive performance is related to specific types of social interaction. The findings from this study highlight the value of considering fine-grained metrics of sociality that capture the challenges associated with social life when testing the relationship between the social environment and cognition.

Longitudinal patterns of patient-reported cognitive impairment in patients with non-Hodgkin lymphoma (NHL) treated with chemotherapy: A group-based trajectory analysis of a nationwide community-based cohort.

7071 Background: Cognitive problems are an important clinical concern for cancer patients. We previously published that patients with lymphoma experienced worsening in cognitive functions and perceived function from pre-to post-treatment. Limited data exists in NHL, importantly previously reported group means of cognitive function may not capture interindividual heterogeneity. Therefore, we identified distinct subgroups of NHL patients with similar trajectories of cognitive function over time and investigated potential predictors. Methods: We included 181 NHL patients receiving chemotherapy (mean age [SD]: 59.0 [11.8]; 63.5% male; 54% diffuse large B-cell, 22% follicular lymphoma) enrolled in the National Cancer Institute Community Oncology Research Program. Cognitive function was assessed by the patient-reported Functional Assessment of Cancer-Therapy-Cognitive Function (total score and perceived cognitive impairment [PCI]) prior to chemotherapy (T1), after chemotherapy (T2), and 6 months following T2 (T3). Patient and cancer characteristics were collected through questionnaires or medical records at T1. We utilized group-based trajectory modeling (GBTM) to identify latent clusters of individuals with similar cognitive function patterns over time. Model selection and assessment were based on the Bayes factor, group size, model diagnostics, and clinical interpretability. Multinomial logistic regression models were identified characteristics associated with group membership. Results: Four groups were identified by GBTM: Group A had high perceived impairment, which decreased at T2 and remained high at T3 (n=17, 9.4%); Group B had moderate perceived impairment, with a continuous decline at T2 and T3 (n=21, 11.6%); Group C had low perceived impairment and remained stable at T2 and T3 (n=95, 52.5%); Group D had moderate perceived impairment, without changes at T2 and T3 (n=48, 26.5%). Similar trajectory groups were identified for the PCI subscale. Compared to ≥ some college education, ≤ high school was associated with an increased odds of membership in Group D relative to Group C (OR 3.45, 95% CI 1.44, 8.30). Patients with a higher fatigue score (MFSI) were more likely to report worse cognitive impairment (Group A vs. C: OR 1.10, 95% CI 1.07, 1.14; Group B vs. C: OR 1.05, 95% CI 1.02, 1.08; Group D vs. C: 1.05, 95% CI 1.03, 1.07). Stage, lymphoma subtype, and treatment regimen were not associated with group membership. Conclusions: Our analysis revealed that patients with perceived impairment experienced stable impairment or further decline over time, which is associated with education and fatigue; a subgroup of patients did not experience cognitive worsening. These data help identify patients with different patterns of cognitive impairment to inform personalized interventions.

Do environmental regulations affect firms’ investment decisions? Evidence from renewable energy policy

This paper studies whether climate transition risks affect manufacturing firms’ real investment decisions by exploiting the state-level adoption of the Renewable Portfolio Standards (RPS), a set of prominent energy and environmental regulations in the U.S. from 1984–2022. Using a staggered difference-in-differences analysis, we show that while these programs impose substantial compliance costs on emission sources and result in a marked increase in electricity prices, they do not alter manufacturers’ capital expenditures, mergers and acquisitions, and alliance formation. This finding survives a battery of robustness checks. It broadly persists in cross-sectional tests of firms with varied exposure to RPS, in different size groups, and with varying degrees of financial constraints, operating leverage, market competition, and corporate governance quality. Only manufacturing firms from more competitive markets reduce their capital expenditures after RPS’ adoption. Furthermore, our results show that RPS do not influence other firm decisions and outcomes, such as employment growth, innovation, and firm performance. Our study documents novel evidence of manufacturers’ notable resilience to transition risks associated with energy and environmental policies. Our findings provide implications for the debate on the benefits and costs of regulations tackling climate change and call for further research on firms’ climate adaptation strategies.

Diet and trophic structure of fishes in the Barents Sea: Effects of size within (ontogenetic) and between species

A large data set on stomach content (over 27,000 individual fish) – collected in the Barents Sea in 2015 – was used to examine ontogenetic and interspecific changes in diet with size for 35 fish species. The analysis combined the use of hierarchical clustering and random forest. Two different diet metrics were used (% weight of prey types per weight of stomach content or per weight of fish, the latter reflecting also feeding intensity), and data were analysed based on average diet of predator groups (species and size groups) across the entire sample series (from the whole Barents Sea in different seasons), or for data broken down by geographical areas and seasons. Similar trophic groups (clusters) were identified for the various data sets suggesting that the results on trophic structure were robust. The trophic groups including size information were broadly similar to groups found earlier with data averaged at species level. Hierarchical clustering produces a hierarchy of trophic groups (or trophic guilds) at various levels of diet dissimilarity. With 12 clusters identified, one cluster had fish as dominant prey, and 5–6 others had either plankton or benthos as dominant prey. The clusters tended to be distinct and homogenous with one dominant prey category in average diet (often > 60 %). This was especially the case for the plankton clusters, with copepods, euphausiids, hyperiid amphipods, or gelatinous zooplankton as dominant prey in each of 4 trophic groups. The benthos clusters tended to be less dissimilar with more overlap in diet composition, with predominance of either hard-shelled forms (echinoderms and molluscs) or softer prey (polychaetes and crustaceans) for groups of clusters. There were clear patterns of ontogenetic shifts in fish diet. Fish that clustered as piscivores at larger size tended to grow from being planktivores when smaller. Smaller species of planktivores or benthivores shifted position among trophic groups but remained within the categories of planktivores or benthivores, respectively. Taxonomy (species) tended to be more important than size for explaining the diet composition of the different clusters of fish predators.

Economic Dynamics and Constraints of Chickpea Production in Rajasthan

The study examined the economics of chickpea production and identified constraints faced by farmers in Jaipur district. The study evaluated the cost of cultivation across different farm sizes using various cost concepts, including operational costs, fixed costs, and net income for 2020-21. The results revealed that the total cost of cultivation increased as the farm size increased. The share of operational costs towards total costs also increased with increases in farm size. The total fixed cost was maximum for medium-sized groups and minimum for marginal farm sizes. The cost of production was maximum for marginal farm sizes (Rs. 2900.97 per ha) and minimum for medium farm sizes (Rs. 2766.26 per ha). Gross return was maximum for medium farm size (Rs.65745 per ha) and minimum for marginal farm size group (Rs. 54491 per ha). The output-input ratio was 183.59 per cent in cases of medium farm size and 175.80 per cent in the case of marginal farm size. However, constraints such as labour shortages during peak cultivation periods and timely non-availability of irrigation and inputs posed challenges to chickpea production. Therefore, interventions such as improved labour management, ensuring irrigation availability, and adopting disease-resistant seeds may enhance chickpea production in the study area.

Periareolar Skin-Sparing Mastectomy and Immediate Implant-Based Reconstruction

Introduction Skin-sparing mastectomy (SSM) is often used when tumor location prohibits performing a nipple-sparing mastectomy (NSM). We examined a square excision of the nipple-areolar complex (NAC) and an X-shaped purse string closure after implant-based reconstruction. Methods A retrospective review was performed on patients undergoing periareolar SSM and immediate implant-based reconstruction from January 2015 through December 2022, specifically identifying those patients who had square NAC excision and skin closure. Results Twenty-nine patients met the inclusion criteria. They underwent 54 periareolar SSM and immediate implant-based reconstruction (bilateral 25, unilateral 4). Indications for surgery were cancer (30) and prophylactic (24; 2 patients had bilateral cancer). Reconstructive methods included tissue expander (TE) (36 [66.7%]) and direct-to-implant (DTI) (18 [33.3%]). The mean mastectomy weights and final implant sizes were similar between the 2 groups. Overall wound complications occurred in 13 (24.1%) of the breasts: mastectomy skin flap necrosis (MSFN; 10 [18.5%]) and infection (3 [5.6%]). Reconstructive failure occurred in 3 cases: TE, 1 (infection); DTI, 2 (MSFN/exposure). MSFN by reconstructive method: TE, 4 (11.1%); DTI, 6 (33.3%) (P = 0.05, comparing MSFN rates between TE and DTI methods). The mean initial TE fill volume was 247.1 cc; mean implant size in the DTI group was 417.8 cc (P < 0.0001). Conclusions The square NAC excision and closure can minimize the surgical incision in implant reconstruction. Two-stage TE reconstruction permits lower initial fill volumes, which reduces the risk of MSFN after box to X closure of SSM and implant-based reconstruction. It is useful in small- to moderate-sized breasts with mild ptosis in patients who are not candidates for NSM.

Genetic Profiling and Survival Outcomes in Romanian Colorectal Cancer Patients.

The increasing incidence of colorectal cancer is one of the most frequently addressed medical topics worldwide. It represents the third most commonly diagnosed cancer in both men and women globally, with significant implications for public health. Mortality for this type of malignancy remains high, second only to lung cancer. Given their clinical relevance, the identification and understanding of KRAS and BRAF mutations have become crucial components of personalized medicine approaches in colorectal cancer. Hence, our desire is to carry out a research that analyzes the impact of these mutations in terms of survival and mortality on patients diagnosed with colorectal cancer. We conducted a retrospective study spanning from 2018 to 2022, which involved 118 patients diagnosed with colorectal cancer. The patients were selected from the databases of the Oradea County Emergency Clinical Hospital and Pelican Oradea Hospital. Genetic testing was performed at the "Resident Laboratory" clinic. Subsequently, patients were divided into two groups of equal size based on the presence or absence of mutations. The survival rate one year after the diagnosis of colorectal cancer is 84.74% (N=50/59) for the mutant group versus 67.96% (N=40/59) for the wild-type group. The survival rate at five years from the diagnosis of colorectal cancer is 25.93% (N=15/59) for patients with wild-type tumors compared to 33.54% (N=20/59) for patients with tumors with mutant status (p=0.483, HR=1.153, CI 95% 0.7661-1.735). The five-year survival rate, depending on the mutation present, highlights the fact that the average overall survival for those with the KRAS mutation is 38.6 months (CI 95% 35.22-41.97) and for those with the BRAF mutation is 8.3 months (CI 95% 5.42-11.17) (p=0.039). The mortality rate for mutant KRAS is 44.89% (N=22/50), while for those with mutant BRAF, it is 100% (N=6/6). We observed no statistically significant difference in overall survival rate and disease-free interval between the two studied groups, but the overall survival was better for those with mutations present (38.64 months versus 31.07 months for wild-type tumors). The mortality rate is higher among tumors with wild-type status (p=0.005), in the first year after the diagnosis of colorectal cancer. The BRAF mutation confers a much worse prognosis than the KRAS mutation, from both the survival analysis and the mortality rate.

Influence of health education based on the transtheoretical model on kinesiophobia levels and rehabilitation outcomes in elderly patients undergoing total knee arthroplasty

ObjectiveIn this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. MethodsElderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. ResultsBetween January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. ConclusionHealth education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Long‐term tracking reveals the influence of body size and habitat type on the home range of Antillean manatees (Trichechus manatus manatus)

AbstractAntillean manatees (Trichechus manatus manatus) are endangered coastal, marine, and riverine megaherbivores with high environmental plasticity, constrained by tidal and seasonal water level cycles that affect access to food and fresh water. Accurate quantification of the species' habitat requirements, typically achieved through home range (HR) estimation, is required to implement area‐based conservation initiatives. In this study, we used GPS tracking data from 38 wild and captive‐rehabilitated released manatees to estimate HR using autocorrelated kernel density estimators (AKDE) and average time speed. We investigated whether body size, habitat type, sex and behavioural group influence home range size due to energy requirements, resources availability, a scramble‐competitive polygyny mating system, and adaptation to the wild. Eighteen manatees exhibited range‐resident behaviour, with a mean 95% home range of 72.96 km2 (± 218.52) and a median of 10.69 km2. The mean daily speed was estimated to be 13.47 km/day (± 4.16). Home range and body size were positively correlated, consistent with HR allometry theory. Long‐term tracked individuals showed a trend of increasing HR over time. Only four released animals (17.4%) were range‐resident, suggesting that they may need additional time to establish a home range. Individuals using only the marine environment had larger home ranges compared to mixed (marine and estuarine) and estuarine environments, probably due to freshwater availability. Our study contributes to the understanding of the factors driving manatee movement and provides more accurate estimates of area requirements, which can inform the establishment and zoning of marine protected areas.

Secure and efficient vehicle data downloading scheme with privacy-preserving in VANETs

Data downloading is a basic data transfer requirement in VANETs. Cooperation data downloading can use all V2C, V2I and V2V communications to improve the data downloading efficiency. Security and identity privacy preserving of data downloading should be paid more attention to protect the required vehicle. Otherwise, the data and identity information leakages would lead to immeasurable loss. To address these challenges, we propose a lattice-based secure vehicle data downloading scheme with privacy-preserving for VANETs. The vehicle request message authentication and identity privacy of the vehicle are achieved by a designed lattice-based ring signature. We prove that the proposed scheme is strong unforgeable and unconditional privacy preserving in the random oracle model. The request data also is encrypted by a symmetric encryption algorithm to achieve the data confidentiality. Moreover, thanks to the post-quantum security of the lattice-based cryptographic tools, the proposed data downloading also can defend against the quantum attacks. At the same time, cooperation data downloading also can be used in this paper to improve the effects of data downloading. Performance comparison and analysis shows that the proposed scheme shares some advantages with respect to the space and computation efficiency. The main character of the proposed scheme is that the impact of the vehicle ring group number on both the computation and space efficiency is effective controlled, such as the fixed signature length for any ring group size. As a result, the bandwidth and computation resources of VANETs can be saved by using the proposed scheme. We also simulate the proposed scheme by NS-3 which shows the average download success ratio is always within the interval [95%−100%] and cooperative downloading can improve the downloading efficiency by 86%.

Association between clinical and disease characteristics and detectable or undetectable baseline ctDNA in patients with metastatic uveal melanoma.

9537 Background: Tebentafusp, a bispecific soluble TCR specific for a gp100 peptide, is licensed for the treatment of metastatic uveal melanoma (mUM) in HLA-A*02:01+ individuals. 82% of patients (pts) with mUM in the IMCgp100-102 (previously treated; 2L+) and 61% in IMCgp100-202 (frontline; 1L) studies, respectively, had detectable baseline ctDNA. There is a strong relationship between decrease in ctDNA by 9 weeks and overall survival (OS) [Carvajal 2022; Hassel & Piperno-Neumann 2023]. Patients with undetectable baseline ctDNA had improved survival despite having macroscopic disease. In this study, we report the characteristics of baseline ctDNA undetectable vs detectable disease. Methods: Disease characteristics of 202 1L (Study 202) and 117 2L+ (Study 102) pts who had baseline undetectable or detectable ctDNA (unDNA vs detDNA) were compared in a post-hoc unplanned analysis. ctDNA detection was analysed at baseline and up to week 9 on tebentafusp using targeted mPCR-NGS assay for mutations in 15 genes including GNAQ, GNA11, SF3B1, CYSLTR2, PLCB4 and EIF1AX. Largest lesion size groups (≤ 3 cm, 3-8 cm, > 8 cm) were defined by American Joint Committee on Cancer 7th Ed. Presence of oncogenic mutations in GNAQ, GNA11, SF3B1 and BAP1 were assessed by WES on metastatic tissue biopsies. Results: Baseline ctDNA levels increased in association with size of largest lesion regardless of number of prior therapies. However, there was an association between disease burden (defined by largest lesion size) and unDNA vs detDNA in both studies, with all pts with largest liver lesion > 8 cm having detDNA. In Study 202, % of the population with unDNA vs detDNA was 50% vs 50% for ≤ 3cm and 27% vs 73% for 3.1-8 cm. While OS was similar for unDNA & detDNA in pts with ≤ 3cm lesions, OS was longer for pts with unDNA vs detDNA who had baseline tumor size 3.1-8 cm in both studies (Table). Within this 3.1-8 cm group, pts with unDNA tended to have lower LDH, AST, and ALP. Initial analysis showed no difference in the frequency of GNAQ, GNA11, SF3B1 or BAP1 mutations between unDNA and detDNA groups. Further data on somatic mutation defined groups and RNAseq gene expression in unDNA and detDNA groups will be presented. Conclusions: Patients with unDNA were more likely to have smaller disease burden than those with detDNA; however, many pts with unDNA had a significant burden of metastatic disease. Baseline unDNA was associated with improved OS outcome vs detDNA in pts with 3.1-8 cm baseline metastatic deposits, but not in pts with ≤ 3cm disease. No association was seen between oncogenic background of GNAQ/GNA11/SF3B1/BAP1 and unDNA vs detDNA. Clinical trial information: NCT02570308 ; NCT03070392 . [Table: see text]

A comparison of ultrasound-based testis volume with Prader orchidometry and stability of testis size relative to peers from birth to 28weeks.

Testis volume, an indicator of the reproductive development during minipuberty, is commonly measured by Prader orchidometer, despite ultrasound being the gold standard. Data are lacking on the longitudinal relationship between these two measures and on the stability of boys' relative testis size across infancy. To examine the relationship between ultrasound-based and orchidometer-based testis volume measurements and to assess the stability of relative testis size among individual boys in the study. The Infant Feeding and Early Development study is a longitudinal cohort of healthy infants recruited from hospitals in the Philadelphia area during 2010-2013. We measured testis size from birth to 28weeks in 147 infants using Prader orchidometry (nine study visits) and ultrasound (five study visits). We modeled testis growth, extracted predicted volumes for each boy on each day of the study, and ranked these volumes from smallest to largest. The average testis volume trajectory exhibited linear growth over the first 16weeks followed by slower growth and then a plateau. Prader orchidometry overestimated testis size by almost 3-fold, compared to ultrasound. A range of ultrasound volumes corresponded to each bead size (e.g., bead size of 1 cm3 corresponded to an ultrasound-based volume between 0.11 and 0.87 cm3). Infants changed rankings of median of 22 positions (of 147) across the entire 6-month follow-up. Infants' ranks near birth were highly correlated with their ranks at the end of the study. Consistent with other studies, we found wide variability in testis size during infancy and that Prader orchidometry overestimates testis size. When compared to ultrasound, orchidometry only crudely estimates testis size in this age group. Ultrasound-based volumes generally showed stability in relative testis size across infancy. Accurate measurement of testis size is difficult using orchidometry in infants. This highlights the need for ultrasound for accurate measurement, with a one-time measurement likely sufficient to determine relative testis size across the first 6 months of infancy.

Encapsulation of Lactobacillus plantarum in W1/O/W2 double emulsions stabilized with the high-intensity ultrasound-treated pea protein and pectin

This study focuses on developing a water-in-oil-in-water (W1/O/W2) double emulsion system using high-intensity ultrasound (HIU)-treated pea protein isolate (HIU-PPI) and pectin to encapsulate Lactobacillus plantarum (L. plantarum). The effects of ultrasound treatment on pea protein isolate (PPI) characteristics such as solubility, particle size, emulsification, surface hydrophobicity, and surface free sulfhydryl group were examined, determining optimal HIU processing conditions was 400 W for 10 min. The developed W1/O/W2 double emulsion system based on HIU-PPI demonstrated effective encapsulation and protection of L. plantarum, especially at the HIU-PPI concentration of 4 %, achieving an encapsulation efficiency of 52.65 %. Incorporating both HIU-PPI and pectin as emulsifiers increased the particle size and significantly enhanced the emulsion’s viscosity. The highest bacterial encapsulation efficiency of the emulsion, 59.94 %, was attained at a HIU to pectin concentration ratio of 3:1. These emulsions effectively encapsulate and protect L. plantarum, with the concentration of HIU-PPI being a critical factor in enhancing probiotic survival under simulated gastrointestinal digestion. However, the concurrent utilization of pectin and HIU-PPI as emulsifiers did not provide a notable advantage compared to the exclusive use of HIU-PPI in enhancing probiotic viability during in vitro simulated digestion. This research offers valuable perspectives for the food industry on harnessing environmentally friendly, plant-based proteins as emulsifiers in probiotic delivery systems. It underscores the potential of HIU-modified pea protein and pectin in developing functional food products that promote the health benefits of probiotics.

Multidisciplinary perspective on a Finnish general upper-secondary school’s educational change: strengthening and hindering factors

ABSTRACT Sustaining change beyond individual teachers is challenging and understanding factors making educational change effective is needed. We aimed to identify the factors that educators and construction specialists considered influential to educational change of a general upper-secondary school that was under construction and was to meet the pedagogical goals of the concurrently renewed national core curriculum and legislation. The analysis of multidisciplinary interviews (n = 22) conducted during the early phase of the construction process assisted in identifying the factors that the participants perceived as strengthening and hindering educational change. The strengthening factors related to leadership support, collaboration opportunities, and teachers’ professional training, engagement, and transformative agency. The hindrances were constraints that related, for instance, to issues in funding, large group sizes and those that lacked applicable cross-curricular examples. We postulate the need to assist schools and individual teachers in creating conditions for educational change at all levels of municipal education.

Does Paraspinal Muscle Mass Predict Lumbar Lordosis before and after Decompression for Degenerative Spinal Stenosis?

Retrospective Cohort Study. The purpose of this study was to determine if muscle mass and quality of the lumbar paraspinal muscles was associated with improvements in lumbar lordosis and other sagittal parameters after isolated posterior lumbar decompression surgery for lumbar spinal stenosis. Over time, either due to degenerative changes or other spinal conditions, individuals may develop sagittal imbalance. In patients with lumbar spinal stenosis, sagittal imbalance can further exacerbate symptoms of pain and radiculopathy. Sarcopenia of paraspinal muscles has been implicated in previous spine research as a variable with influence on surgical outcomes. Sagittal parameters were measured on preoperative and postoperative lateral lumbar radiographs and included lumbar lordosis (LL), sacral slope (SS), and pelvic tilt (PT). Preoperative MRI images were evaluated at the base of the L4 vertebral body to assess muscles mass of the psoas muscle and paravertebral muscles (PVM) and Goutallier grade of the PVM. Patients were divided into 3 muscle size groups based on PVM normalized for body size (PVM/BMI): Group A (smallest), Group B, and Group C (largest). Patients in Group C had greater LL preoperatively (51.5° vs. 47.9° vs. 43.2, P=0.005) and postoperatively (52.2° vs. 48.9° vs. 45.7°, P=0.043). There was no significant difference in the ∆LL values between groups (P>0.05). Patients in Group C had larger SS preoperatively (35.2° vs. 32.1° vs. 30.0°, P=0.010) and postoperatively (36.1° vs. 33.0° vs. 31.7°, P=0.030). Regression analysis showed that PVM/BMI was a significant predictor of LL preoperatively (P=0.039) and postoperatively (P=0.031), as well as SS preoperatively (P=0.001) and postoperatively (P<0.001). Muscle mass of the paravertebral muscles significantly impacts lumbar lordosis and sacral slope in patients with lumbar spinal stenosis before and after posterior lumbar decompression. These findings highlight a need to address risk factors for poor muscle quality in patients with sagittal imbalance.

Catalysing cooperation: the power of collective beliefs in structured populations

Collective beliefs can catalyse cooperation in a population of selfish individuals. We study this transformative power of collective beliefs, an effect that intriguingly persists even when beliefs lack moralising components. Besides the process itself, we consider the structure of human populations explicitly. We incorporate the intricate structure of human populations into our model, acknowledging the bias brought by social and cultural identities in interaction networks. Hence, we develop our model by assuming a heterogeneous group size and structured population. We recognise that beliefs, typically complex story systems, might not spontaneously emerge in society, resulting in different spreading rates for actions and beliefs within populations. As the degree of connectedness can vary among individuals perpetuating a belief, we examine the speed of trust build-up in networks with different connection densities. We then scrutinise the timing, speed and dynamics of trust and belief spread across specific network structures, including random Erdös-Rényi networks, scale-free Barabási-Albert networks, and small-world Newman-Watts-Strogatz networks. By comparing these characteristics across various network topologies, we disentangle the effects of structure, group size diversity, and evolutionary dynamics on the evolution of trust and belief.

Modifiable risk factors of immediate and long-term outcomes in the operable and inoperable with left-sided infective endocarditis

ObjectivesTo evaluate the outcomes of left-sided infective endocarditis that can be operated on and cannot be operated on, and to focus on modifiable risk factors for immediate and long-term mortality. MethodsThis study retrospectively investigated patients with left-sided infective endocarditis who occurred in our medical center between January 2006 and November 2022. Results48 in-hospital deaths occurred (5.8 %, 48/832). We identified time from symptoms to admission and symptomatic neurological complications to be risk factors for multiple organ failure upon admission. Time from symptoms to admission and vegetation size in group of isolated medical treatment were significantly shorter than those in the group of heart operation. We also found that preoperative neurological complications, annulus destruction, levels of serum creatinine at 24 and 48 h post heart operation, and perivalvular leakage are risk factors for in-hospital mortality post heart operation. With 148 μmol/L as a cutoff level, the diagnostic sensitivity and specificity of serum creatinine level 48 h post surgery for in-hospital mortality post cardiac surgery are 100 % and 81.6 %, respectively. We found that vegetation size, ICU stay, postoperative serum creatinine at 48 h, left ventricular end diastolic size postoperative, and red blood cell transfusion were associated with all-time mortality. ConclusionsEarly diagnosis and treatment, improvement of surgical techniques, good protection for heart, kidney and blood and close follow-up are advocated to conduce to better immediate and long-term outcomes of the operable and inoperable with left-sided infective endocarditis.

Effectiveness of a chatbot in improving the mental wellbeing of health workers in Malawi during the COVID-19 pandemic: A randomized, controlled trial.

We conducted a randomized, controlled trial (RCT) to investigate our hypothesis that the interactive chatbot, Vitalk, is more effective in improving mental wellbeing and resilience outcomes of health workers in Malawi than the passive use of Internet resources. For our 2-arm, 8-week, parallel RCT (ISRCTN Registry: trial ID ISRCTN16378480), we recruited participants from 8 professional cadres from public and private healthcare facilities. The treatment arm used Vitalk; the control arm received links to Internet resources. The research team was blinded to the assignment. Of 1,584 participants randomly assigned to the treatment and control arms, 215 participants in the treatment and 296 in the control group completed baseline and endline anxiety assessments. Six assessments provided outcome measures for: anxiety (GAD-7); depression (PHQ-9); burnout (OLBI); loneliness (ULCA); resilience (RS-14); and resilience-building activities. We analyzed effectiveness using mixed-effects linear models, effect size estimates, and reliable change in risk levels. Results support our hypothesis. Difference-in-differences estimators showed that Vitalk reduced: depression (-0.68 [95% CI -1.15 to -0.21]); anxiety (-0.44 [95% CI -0.88 to 0.01]); and burnout (-0.58 [95% CI -1.32 to 0.15]). Changes in resilience (1.47 [95% CI 0.05 to 2.88]) and resilience-building activities (1.22 [95% CI 0.56 to 1.87]) were significantly greater in the treatment group. Our RCT produced a medium effect size for the treatment and a small effect size for the control group. This is the first RCT of a mental health app for healthcare workers during the COVID-19 pandemic in Southern Africa combining multiple mental wellbeing outcomes and measuring resilience and resilience-building activities. A substantial number of participants could have benefited from mental health support (1 in 8 reported anxiety and depression; 3 in 4 suffered burnout; and 1 in 4 had low resilience). Such help is not readily available in Malawi. Vitalk has the potential to fill this gap.