High Level Of Confidence Research Articles

Is confidence in knowledge related to childbirth fear and mode of birth among Polish women?

Abstract Background In Poland, cesarean section (CS) rate is 48% what means that it is one of the highest rate among OECD countries and the highest in the European Union. WHO has considered that CS rates higher than 15% at the population level are not associated with reductions in maternal and newborn mortality rates. Fear and attitudes towards childbirth are shaped years before the first pregnancy. Yet, little is understood about how young people’s knowledge, attitudes and fears concerning the birth process shape their healthcare preferences around birth. Thus, the aim of the study was to examine whether confidence in knowledge was associated with childbirth fear prior to pregnancy and preference for CS. Methods We recruited 782 women aged 18 - 35 (mean 24.7, sd = 3.19) who had never been pregnant but wished to have at least one child in the future. The women answered questions about: (i) socio-economic situation, (ii) confidence in knowledge and educational needs related to pregnancy and childbirth; (iii) fear of childbirth prior to pregnancy; (iv) preferred mode of birth in the hypothetical pregnancy in which there are no medical indications for cesarean section. Results Almost one in four women (22.1%) preferred CS in a hypothetical low-risk pregnancy. In addition, most often young women gained knowledge on pregnancy and birth from experiences and stories of family members (62.3%). Women with moderate and high level of confidence in knowledge had respectively lower odds of high level of childbirth fear prior to pregnancy comparing to women with low level of confidence in knowledge (OR = 0.57, 95% CI: 0.39-0.83 and OR = 0.54, 95% CI: 0.33-0.88, respectively). Conclusions Increasing knowledge about pregnancy and childbirth among young women might lower childbirth fear and thus, indirectly, lower rates of CS in the future. Key messages • The results of this study may solve very important public health problem i.e. the growing rates of cesarean section. • Confidence in knowledge may be an important factor associated with the level of childbirth fear.

Proteome-wide associations of pulse pressure in the UK Biobank

Abstract Introduction Large artery stiffness (LAS) significantly contributes to the burden of cardiovascular morbidity and mortality, and is marked by an increased pulse pressure (PP)(1). Therapeutically targeting LAS may help in mitigating cardiovascular disease and other comorbidities. Purpose We aimed to investigate the proteomic associations of PP, and their putative causal role using Mendelian randomization (MR). Methods We first investigated associations between baseline circulating protein levels for 2,941 protein analytes measured using Olink technology, and PP in the UK Biobank (N=54,219). Regression analyses were adjusted for age, sex, mean arterial pressure, body mass index and stroke volume. Next, we conducted two-sample MR analyses to evaluate associations between genetically-predicted plasma protein levels and PP, for 1,820 proteins with available genetic instruments. We conducted inverse-variance weighted MR as our main analysis, and genetic colocalization analyses as sensitivity. We used a 5% false discovery rate (FDR) threshold to account for multiple comparisons. Results After correction for multiple comparisons, measured levels of 61 out of 2,923 proteins were significantly associated with PP (Figure 1). Genetically-predicted levels for 58 proteins were significantly associated with PP after FDR correction (Figure 2). At nominal significance, 31 proteins were concordantly associated with PP in both analyses, and 19 had consistent directions of effect, including natriuretic peptide B (NPPB, βobservational=0.04, Standard Error (SE)=0.009, PFDR<0.001), thrombospondin-2 (THBS2, βobservational=0.05, SE=0.009, PFDR<0.001), paraoxonase-2 (PON2, βobservational=-0.03, SE=0.008, PFDR<0.001), and sclerostin (SOST, βobservational=-0.03, SE=0.009, PFDR<0.001). NPPB was concordant in direction of effect and met an FDR-corrected significance threshold. Conclusions Our study identifies multiple novel proteins with a putative causal effect on PP. Our findings identify NPPB with a high level of statistical confidence, which could have important implications given the current availability of FDA-approved medications to boost NPPB effects. Our findings will lead to further investigations regarding the biology and clinical role of the identified candidate therapeutic targets.

Genomic characterization of Pantoea dispersa A003 isolated from a clinical patient

IntroductionPantoea dispersa is a Gram-negative bacterium generally considered as a plant pathogen and rarely causes human infections. To date, there have been 13 studies that have documented clinical infections linked to P. dispersa, with a primary emphasis on the initial identification of this pathogen. The genomic features and the mechanisms underlying the pathogenesis of P. dispersa remain largely uninvestigated. In the present study, we describe a clinical infection caused by P. dispersa and provide the first genomic analysis of this bacterium.MethodsThe bacterial strain designated A003 was isolated from blood samples. Preliminary identification of strain A003 was conducted using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) technology (VITEK® MS, bioMérieux, France). Biochemical and antimicrobial susceptibility assessments were carried out utilizing the VITEK-2 compact automated microbial analysis system (bioMérieux, France). Additionally, whole genome sequencing and subsequent analysis were performed to further elucidate the potential pathogenicity.ResultsThe bacterial isolate was cultured overnight at 35°C in a CO2-enriched environment on Columbia blood agar, resulting in the appearance of a white, smooth, Gram-negative rod-shaped bacterium with diameters ranging from 1 to 2 mm. Identification of strain A003 was achieved with a high confidence level of 99.9% as P. dispersa using MALDI-TOF mass spectrometry. The average nucleotide identity (ANI) value between strain A003 and the reference strain P. dispersa DSM 30073T was 98.08%, while the DNA–DNA hybridization (DDH) value was 84.10% (Formula 2) based on genome sequencing data, which further confirmed that A003 belonged to the P. dispersa species. Comprehensive analysis revealed the presence of 372 virulence factors, 15 antibiotic resistance genes, 222 carbohydrate-active enzymes, and 666 genes related to Type III secretion system (T3SS) effector proteins, as identified through the core databases of VFDB (Virulence Factors of Pathogenic Bacteria), CARD (Comprehensive Antibiotic Resistance Database), CAZY (Carbohydrate-Active enZYmes Database), and T3SS. The virulence factors included type IV pili (TFP), type VI secretion system, flagella, iron uptake system, and ompA, which are implicated in bacterial pathogenicity. The antibiotic resistance profile indicated resistance to fluoroquinolones, cephalosporins, penams, macrolides, and aminoglycosides, as annotated by the CARD database.ConclusionThe draft genome sequenced represents the inaugural genomic sequence of P. dispersa derived from clinical sources. This advancement may enhance clinical practitioners’ comprehension of the organism’s clinical attributes and serve as a foundational resource for future research into its virulence, antibiotic resistance, and host–pathogen interactions.

Dynamic Retrieval Augmented Generation of Ontologies using Artificial Intelligence (DRAGON-AI)

BackgroundOntologies are fundamental components of informatics infrastructure in domains such as biomedical, environmental, and food sciences, representing consensus knowledge in an accurate and computable form. However, their construction and maintenance demand substantial resources and necessitate substantial collaboration between domain experts, curators, and ontology experts.We present Dynamic Retrieval Augmented Generation of Ontologies using AI (DRAGON-AI), an ontology generation method employing Large Language Models (LLMs) and Retrieval Augmented Generation (RAG). DRAGON-AI can generate textual and logical ontology components, drawing from existing knowledge in multiple ontologies and unstructured text sources.ResultsWe assessed performance of DRAGON-AI on de novo term construction across ten diverse ontologies, making use of extensive manual evaluation of results. Our method has high precision for relationship generation, but has slightly lower precision than from logic-based reasoning. Our method is also able to generate definitions deemed acceptable by expert evaluators, but these scored worse than human-authored definitions. Notably, evaluators with the highest level of confidence in a domain were better able to discern flaws in AI-generated definitions. We also demonstrated the ability of DRAGON-AI to incorporate natural language instructions in the form of GitHub issues.ConclusionsThese findings suggest DRAGON-AI's potential to substantially aid the manual ontology construction process. However, our results also underscore the importance of having expert curators and ontology editors drive the ontology generation process.

Impact of a PD-L1 Learning Collaborative: outcomes from a mixed-methods evaluation

Abstract Introduction/Objective PD-L1 Immunohistochemistry testing is often required to determine eligibility for immune checkpoint inhibitor therapy. An ASCP PD-L1 Learning Collaborative (LC) was formed aiming to: 1) identify ways to streamline PD-L1 testing; 2) encourage members to locally implement changes; and 3) develop a resource guide for the community. Methods/Case Report The PD-L1 LC (n=38 pathologists and laboratory professionals) participated in 3 activities: 1) 4 meetings in which LC members discussed current literature and practice; 2) 3 30-minute on-demand, credit-bearing panel videos, in which selected LC members summarized the LC outputs and shared their experiences; and 3) a guide summarizing resources relevant to streamlining PD-L1 testing. The mixed-methods evaluation included: 1) five- minute surveys before (n=24), immediately after (n=11) and 7-months post-LC (n=17); 2) polling questions (2-4 per meeting); 3) semi-structured interviews (n=5). Quantitative data was analysed using descriptive and inferential analysis, qualitative data using a thematic analysis / inductive reasoning approach. Results (if a Case Study enter NA) Baseline data confirmed delays in testing caused by unstandardized PD-L1 testing processes and suboptimal confidence in PD-L1 validation and methodologies. Post-LC, members self-reported perceived increased knowledge and higher confidence levels regarding discussion of PD-L1 scientific evidence and best practices. At the 7-month follow-up, 59% of respondents reported at least one PD-L1-related practice change, with 29% of participants selecting:1) Improving protocols for specimen acquisition, handling, or processing; 2) Improving communication with multidisciplinary care team; 3) Optimizing biomarker testing workflows. Remaining suboptimal knowledge post-LC suggests need for further educational efforts. Participants identified “Tumor-specific considerations” as the main resource missing for PD-L1 testing. Conclusion A learning collaborative has shown impact in improving PD-L1 testing processes and related practices among a group of pathology professionals. The group successfully made available three panel videos and a resource guide, and PD-L1-related practice changes were reported. Future initiatives should address remaining gaps and develop tumor-specific PD-L1 testing considerations.

An International Survey of the Diagnosis and Management of Ménière's Disease Amongst Otolaryngology Consultants.

Ménière's Disease (MD) is a disease that may be difficult to diagnose and manage. Our UK survey showed variability in the practice of UK Otolaryngology consultants. We hence surveyed Otolaryngology consultants internationally, to assess their confidence levels in diagnosing MD, their use of the AAO-HNS guidelines and current diagnostic and treatment modalities. An online questionnaire was distributed internationally over four weeks. The questionnaire asked respondents to anonymously rank their confidence in diagnosing MD, identify the minimum investigations required to make a diagnosis, describe their use of the AAO-HNS criteria, share their preferred treatment modalities for acute attacks, and state their 1st and 2nd-line preventative treatment options. A total of 173 responses were collected with 77% of respondents reporting high levels of confidence in diagnosing MD. Most respondents stated the minimum tests required were "History, Otoscopy, Clinical Vestibular testing, and Pure Tone Audiometry" although some chose as few as 1 test. Regarding the use of the AAO-HNS criteria, responses ranged from "always" (20.2%) to "never" (22.5%). Cinnarizine was the first-line treatment for acute attacks followed by betahistine. Betahistine (30.1%) and dietary restrictions (28.3%) were recommended almost equally as first-line preventative measures. The most popular second-line measure was intratympanic steroids injection (30.1%). Our survey revealed disparities in the diagnosis of MD and its management, like the results of our previously conducted UK survey. This suggests the need for an international consensus regarding the diagnosis and subsequent management strategies for this disease.

Best Practice for Publishing Environmental DNA (eDNA) Data According to FAIR Principles

Reversing global biodiversity loss will require transformational human actions and robust measurements of their effectiveness. Diversity assessment using environmental DNA (eDNA) has emerged as a cutting-edge technique with the potential to address the challenges of measuring biodiversity. Vast amounts of eDNA sequences and eDNA-based species detections are generated in scientific studies. These datasets are typically stored in a variety of different repositories in multiple formats, hindering their reuse (Berry et al. 2020). Ensuring the publication of eDNA data following the FAIR (Findable, Accessible, Interoperable, Reusable) principles (Wilkinson et al. 2016) would revolutionise environmental assessment, including monitoring of biodiversity, individual species, and interactions across extensive spatial and temporal scales, and generate critical knowledge for evidence-based management. Archiving FAIR eDNA data requires standardising data formats and vocabularies, cyberinfrastructures, guidelines, data sharing policy, and collaboration among scientists and institutions. Some of these requirements are addressed by existing data standards and infrastructures, including Darwin Core (DwC) (Wieczorek et al. 2012), Minimum Information about any (x) Sequence (MIxS) (Yilmaz et al. 2011), the Global Biodiversity Information Facility (GBIF) network, and International Nucleotide Sequence Database Collaboration (INSDC) partners (Arita et al. 2020). However, multiple challenges remain and FAIR data practices have yet to be established among the eDNA community. This is partly because critical attributes unique to eDNA data are not adequately accommodated by existing standards. For example, monitoring contamination and excluding non-target taxa, and the parameters used for quality filtering and species detection vary greatly between studies, depending on the study scopes and the associated financial and ecological costs of incorrectly inferring presence or absence. Making such information FAIR is needed for future studies reusing data and requiring high confidence levels in species detection and taxonomic assignment. Furthermore, the procedures of targeted-taxon detection approach (e.g., interpretations of quantitative polymerase chain reaction (qPCR) results in detecting the presence of DNA from individual taxa) have not yet been fully captured by existing standards. Increasing efforts have been made to establish minimum reporting requirements to validate eDNA study methods and data (Klymus et al. 2020, Thalinger et al. 2021). These requirements need further development to be translated into data standards and formats to enhance machine readability and reusability, and to support and guide the eDNA community, so that they are effectively utilised. In this talk, we share our best practice guide for formatting and publishing eDNA data, developed by an international multidisciplinary working-group comprising eDNA researchers, journal editors, and biodiversity and omics data scientists. We identified required data types, formats and metadata checklists through reviewing and integrating existing data standards, devising subject-specific vocabularies, and introducing additional terms to accommodate the distinctive properties of eDNA data. Implementing the FAIR eDNA data best practice guide, offers a pivotal step towards standardising and enhancing the publication and re-use of eDNA data.

An exploration of the Return to Practice experience of nursing students: An evaluative mixed methods research study

AimThis study was conducted to explore the experiences of nursing students on a Return to Practice course; including their confidence levels and intention to remain on the nursing register. BackgroundNurses and midwives whose registration with the NMC (Nursing & Midwifery Council) has lapsed may choose to undertake a Return to Practice course. This course enables those who have left the profession to update their skills and knowledge and to re-join the register. Currently, little information exists concerning the experience of returners as they prepare to re-enter the nursing workforce. DesignExploring the confidence levels and preparedness of Return to Practice nursing students and measuring the effectiveness of a Return to Practice course using an online questionnaire. MethodsMixed methods research design was used to address the evaluative research questions. An anonymous questionnaire was administered online to collect quantitative and qualitative data reflecting the experiences of the Return to Practice nursing students. ResultsReturn to Practice nursing students feel well prepared by their Return to Practice course and report a high level of confidence in returning to the clinical workforce. ConclusionsDespite their concerns around aspects of nursing, such as the highly pressured working environment, most Return to Practice students intend to continue as a nurse for the remainder of their careers and should therefore be supported with this route into the nursing profession.

The Influence of Thoracic Ultrasound on the Clinical Practice of Pulmonologists in Portugal.

Thoracic ultrasound (TUS) has garnered increased recognition, both in aiding pleural procedures and as a complement to physical examination. Operator ability is essential to obtain reliable findings. This study aimed to inquire pulmonology specialists and residents about their confidence with the technique and to determine future needs. A self-administered online survey, including a total of 24 questions, was sent to pulmonology specialists and residents registered as members of the Portuguese Pulmonology Society. Participation was pseudoanonymized and voluntary. One hundred fourteen valid answers were obtained. Most responders had prior TUS training. The primary method for knowledge consolidation was unsupervised practice. The majority had an ultrasound machine available in their daily practice; only 17% performed TUS more than 3 times per week. Overall confidence in TUS usage for diagnostic purposes (median: 7/10), disease monitoring (median: 7/10), and invasive procedures (median: 8/10) were high. There was a significant relation between higher levels of confidence and regularly attending TUS courses and performing TUS more than 3 times per week. The main reasons cited as preventing regular use of TUS were the availability/cost of courses and the availability/cost of equipment. Regular TUS training and utilization are essential to boost user's confidence degree. Its use is already a regular feature in the daily practice of pulmonologists in Portugal, but further and better structured training is required to meet the needs of clinicians. The inclusion of mandatory TUS training in residency programs should be considered in the future.

Looking for Actives in the Haystack: Merging HRMS2-Based Molecular Networking, Chemometrics, and 13C NMR-Based Dereplication Approaches.

The identification of bioactive natural products (NPs) in complex mixtures has become an important subject of contemporary NP research. In an attempt to address this challenge, the present work proposes an integrated strategy that combines tandem mass spectrometry (MS2)-based molecular networking (MN), a partial least-squares (PLS) chemometric model, as well as 13C NMR-based dereplication using MixONat software. In addition, an advanced glycation end product (AGEs) assay was used for activity evaluation. The approach was implemented on a Garcinia parvifolia bark extract that comprised a high content of prenylated xanthones and had previously shown a notable inhibitory effect on AGE formation. As a main result, the proposed strategy permitted the identification of potentially active metabolites within complex mixtures and their annotation with a higher level of confidence by NMR data. Overall, this comprehensive approach provides a powerful and efficient solution for the targeting and annotating of active compounds in complex NP mixtures.

Untargeted Metabolomic Biomarker Discovery for the Detection of Ectopic Pregnancy.

Ectopic pregnancy (EP) is the leading cause of maternal morbidity and mortality in the first trimester. Using an untargeted metabolomic approach, we sought to identify putative plasma biomarkers using tandem liquid chromatography-mass spectrometry for the detection of tubal EP. This case-control study included the prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. To avoid over-fitting, logistic regression models were developed in a randomly selected discovery group (30 cases vs. 30 controls) and validated in the test group (20 cases vs. 20 controls). In total, 585 mass spectral features were detected, of which 221 molecular features were significantly altered in EP plasma (p < 0.05). Molecular networking and metabolite identification was employed using the Global Natural Products Social Molecular Networking (GNPS) database, which identified 97 metabolites at a high confidence level. Top significant metabolites include subclasses of sphingolipids, carnitines, glycerophosphocholines, and tryptophan metabolism. The top regression model, consisting of D-erythro-sphingosine and oleoyl-carnitine, was validated in a test group and achieved an area under receiving operating curve (AUC) (95% CI) = 0.962 (0.910-1) with a sensitivity of 100% and specificity of 95.9%. Metabolite alterations indicate alterations related to inflammation and abnormal placentation in EP. The validation of these metabolite biomarkers in the future could potentially result in improved early diagnosis.

Developing and implementing an Einsteinian science curriculum from years 3–10: B. Teacher upskilling: response to training and teacher’s classroom experience

Abstract Recent years have seen a growing interest in modernizing school science curricula to reflect the discoveries in physics since 1900, especially with the recent broad recognition of the importance of quantum physics in the modern world. Much effort has been expended in the development of appropriate teaching instruments for teaching Einsteinian physics in schools, but less effort on the crucial topic of teacher professional development. Successful curriculum innovation requires teacher professional development. This paper reports an analysis of teacher professional development for practising primary and secondary teachers who were upskilled as part of a process for implementing an 8-year Einsteinian curriculum across 38 primary and secondary schools in Australia. Most participants had little prior knowledge of Einsteinian physics. Using self-assessment through questionnaires and interviews, combined with classroom validation, we show that three different professional development programs led to high levels of content knowledge and confidence to teach Einsteinian physics in classes from Year 3 to Year 10. The analysis presented supports our conclusion that it is feasible to upskill teachers from diverse backgrounds in Einsteinian physics and break the cycle that has inhibited the modernisation of school curricula.

Приоритетный рост заработной платы как фактор повышения производительности труда

Based on Rosstat data, the trends and factors determining labor productivity in modern Russia are assessed. It is shown that the main trend in the development of the Russian economy is a decrease in the growth rate of labor productivity. It is shown that the influence of wages and accumulated fixed capital on labor productivity is equivalent. At the same time, with a high level of confidence, labor productivity is determined by the amount of wages, and the advance of wage growth in relation to productivity growth largely determines the growth of labor productivity.

Interrater agreement and variability in visual reading of [18F] flutemetamol PET images.

The purpose of this study was to validate the concordance of visual ratings of [18F] flutemetamol amyloid positron emission tomography (PET) images and to investigate the correlation between the agreement of each rater and the Centiloid (CL) scale. A total of 192 participants, clinically classified as cognitively normal (CN) (n = 59), mild cognitive impairment (MCI) (n = 65), Alzheimer's disease (AD) (n = 55), or non-AD dementia (n = 13), participated in this study. Three experts conducted visual ratings of the amyloid PET images for all 192 patients, assigning a confidence level to each rating on a three-point scale (certain, probable, or neither). The positive or negative determination of amyloid PET results was made by majority vote. The CL value was calculated using the CapAIBL pipeline. Overall, 101 images were determined to be positive, and 91 images were negative. Of the 101 positive images, the three raters were in complete agreement for 92 images and in disagreement for 9 images. Of the 91 negative images, the three raters were in complete agreement for 75 images and in disagreement for 16 images. Interrater reliability among the three experts was particularly high, with both Fleiss' kappa and Conger's kappa measuring 0.83 (0.76-0.89). The CL values of the unanimous positive group were significantly greater than those of the other groups, whereas the CL values of the unanimous negative group were significantly lower than those of the other groups. Images with rater disagreement had intermediate CLs. In cases with a high confidence level, the positive or negative visual ratings were in almost complete agreement. However, as confidence levels decreased, experts' visual ratings became more variable. The lower the confidence level was, the greater the number of cases with disagreement in the visual ratings. Three experts independently rated 192 amyloid PET images, achieving a high level of interrater agreement. However, in patients with intermediate amyloid accumulation, visual ratings varied. Therefore, determining positive and negative decisions in these patients should be performed with caution.

Proposing the Model to Accelerate SMEs to Apply Green Economy Practices Through the Utilization of Social Crowdfunding

Following Indonesia's commitment to promoting the achievement sustainable consumption and production practices (RCP- SDGs Number 12), a plan must be put in place to motivate important players (SMEs) to support the green economy. The limitations of SMEs in terms of funding to be able to implement green economic practices are accommodated through access to financial technology, namely social crowdfunding. To gain insight into how SMEs implement green economic practices by utilizing social crowdfunding, a survey was conducted on 75 SMEs use descriptive research design. The results of the descriptive analysis found that some SMEs have not been able to take advantage of social crowdfunding due to several reasons: not being able to access the right website, having requirements that are difficult to fulfill and their technology skills are not yet good. An interesting insight that was extracted from the results of this survey is the high level of confidence among SMEs that implementing green economic practices using social crowdfunding can improve business performance and are confident that they can overcome all difficulties. The proposed conceptual model can apparently be supported by research results which produce the proposition namely:" willingness to participate in implementing green economic practices using social crowdfunding needs to be driven by creating strong awareness and interest by triggering 3 important determinants, namely stakeholder management, community engagement and entrepreneurship strategy”. In the future, this conceptual modeling can be used to conduct quantitative research so that it can explore the facts in the field in a comprehensive manner.

The implementation and evaluation of a mock trial using a flipped classroom pedagogy in practical nursing education.

Background: This quality improvement study explores the implementation and evaluation of a mock trial within a flipped classroom pedagogy to help first-year practical nursing learners meet the class objectives. Methods: Sixty-two (N=62) practical nursing learners participated in a mock trial as part of their first year Nursing Arts course at Bow Valley College in July 2022. The mock trial was evaluated using qualitative and quantitative data collection. Results: The thematic analysis suggested that a mock trial using a flipped classroom pedagogy may be an effective way of teaching course objectives. The learners reported a moderate to high level of confidence in managing challenging situations after participating in the mock trial. Conclusions: The study highlights the potential benefits of incorporating a mock trial using a flipped classroom pedagogy in practical nursing education.

Cognitive assessment of nursing home residents: Survey data on tools used and perceptions of use among social service professionals in one U.S. state.

Background: Social service professionals routinely use screening tools to assess for cognitive decline or identify suspected dementia in nursing home residents. Published literature lacks details about the specific tools used and how professionals use and perceive them in practice. The aim of this study is to better understand cognitive screening roles performed by nursing home social service professionals and how they view their use and efficacy.Methods: An online survey was administered to all 230 nursing homes in the US state of Alabama between October 2021 and March 2022. Fifty-three social service professionals who conduct resident cognitive screenings responded to the survey.Results: In addition to completing the US-mandated Brief Interview of Mental Status (BIMS) quarterly, 75% of participants reported using additional tools, most notably the Mini Mental Status Examination (MMSE). Participants reported using different tools for varied purposes. Those who used both the BIMS and MMSE rated the BIMS significantly higher on ease and time to administer while rating the MMSE higher on reliability and validity. Although most participants reported high levels of confidence using the tools, over half of participants indicated interest in further training in cognitive assessment tools.Discussion: Findings provide evidence regarding who administers nursing home cognitive screenings, which tools are used, and their experiences using those tools. Participant responses reveal the value of using multiple screening tools for improved detection of cognitive status and decline for residents as well as a need for additional training in cognitive assessment. Findings also suggest that the primary tool used for cognitive screening may be quick and easy to use at the expense of perceived reliability and validity. Further evaluation of nursing home cognitive assessment is needed.

Effects of acupuncture on shoulder impingement syndrome: A systematic review and meta-analysis.

Shoulder impingement syndrome (SIS) is a common condition that causes chronic shoulder pain. The effectiveness of acupuncture in treating chronic shoulder pain has been documented in previous studies; however, existing systematic reviews and meta-analyses have often excluded Chinese databases and combined different types of acupuncture interventions, such as electroacupuncture, warm acupuncture, pharmacopuncture, and acupotomy. Thus, this study specifically examines the exclusive impact of manual acupuncture on SIS. Several databases, including PubMed, Cochrane Central, Embase, 1 Chinese database (China National Knowledge Infrastructure), and 5 Korean databases (ScienceON, Oriental Medicine Advanced Searching Integrated System, KoreaMed, Korean Studies Information Service System, and KMBASE), were systematically searched for relevant studies. The quality of the included studies was evaluated using the Cochrane Assessment Tool for Risk of Bias Version 2. Data collected from the selected studies were synthesized for meta-analysis. The primary outcome was a pain scale score, and the secondary outcomes were shoulder function and disability. This study included 5 randomized controlled trials. The primary outcome assessment revealed significantly reduced pain (standardized mean difference [SMD] = -0.50, 95% confidence interval [CI] = -0.74 to -0.27) and improvements in shoulder function and disability (SMD = -0.57, 95% CI = -0.96 to -0.19). A subgroup analysis based on treatment duration indicated that short-term acupuncture treatment (≤4 weeks) exhibited a high level of confidence with low heterogeneity (SMD = -0.37, 95% CI = -0.73 to -0.02). Manual acupuncture is effective for relieving pain and improving shoulder function and disability in patients with SIS. However, further research is necessary to validate these findings owing to the limited number of patients and heterogeneity among the studies reviewed.

Online Supercritical Fluid Chromatography Hyphenated to Fourier Transform Ion Cyclotron Resonance Mass Spectrometry with Quadrupole Detection for Microalgae Bio-Oil Characterization.

Microalgae are an attractive feedstock for biofuel production thanks to their renewable nature, high growth rate, and ability to use anthropogenic CO2. The conversion of microalgae by hydrothermal liquefaction (HTL) leads to a solid residue, a gaseous phase, and a biocrude. However, the bio-oil is rich in heteroatoms and requires upgrading processes to be used as biofuels. For these treatments to be effective, detailed knowledge of the sample is crucial. The bio-oil was characterized by direct introduction into a Fourier transform ion cyclotron resonance mass spectrometer (DI-FTICR MS) with an electrospray ionization source (ESI). Thousands of molecular formulas were assigned with a high level of confidence, mainly compounds with nitrogen and oxygen atoms. Additionally, the bio-oil was analyzed by coupling supercritical fluid chromatography (SFC) and FTICR to combine the separation power of SFC to the high performances of a 12 T FTICR. Quadrupole detection (2ω) was used in FTICR to have a high resolving power with a lower transient time. The coupling allowed the separation of many isomers along the chromatogram, showing the isomeric complexity of microalgae bio-oils. Moreover, classes of compounds were separated according to their heteroatom class thanks to the SFC separation. In this work, the advantages of DI-FTICR MS and SFC-FTICR MS proved complementary, and DI was useful to study the bio-oil at the molecular scale thanks to the high performances, while SFC proved useful for the characterization at the isomeric scale. This demonstrated the significant potential of this new online hyphenated technique for the characterization of complex matrices.

Accuracy of stochastic finite element analyses for the safety assessment of unreinforced masonry shear walls

ABSTRACT To examine structural safety and reliability, an accurate prediction of the variability of structural resistance must first be determined. This may be achieved through extensive physical testing or, more commonly in modern research, synthetic data generation, such as stochastic finite element analyses (SFEAs). Due to the prevalence and versatility of such techniques, and the need for a high level of confidence when performing a safety assessment, an understanding of the accuracy of data derived from SFEAs is essential. In this paper, SFEA models have been developed to predict the responses of 16 unreinforced masonry walls tested in a laboratory under cyclic in-plane lateral loading. Each SFEA has been developed to reflect the as-built conditions of these experimental specimens and focus on predicting the shear capacity of the failure mechanisms that unreinforced masonry shear walls are susceptible to. From the results of these SFEAs, the accuracy (quantified as model error) of this modelling strategy has been estimated by comparing the peak in-plane shear resistances of the laboratory and numerical models.