Homogeneous Group Research Articles

Metacognitive Abilities and Socio-Psychological Adaptation of People of Mature Age: Features of Relationships

The analysis is aimed at determining characteristics of relationships between metacognitive abilities and socio-psychological adaptation in homogeneous cluster groups represented by people of mature age. The main research methods were: cluster analysis, which allows us to identify relatively homogeneous groups; “bootstrap” method to check the normality of the distribution. The study also used factor analysis to determine the relationship between the characteristics of metacognitive abilities and socio-psychological adaptation. The total following variance in the factor models (86.24%, 99.77%, and 100%) as well as the levels of predictive consistency (p≤0.01 to p≤0.05) reflect the reliability and significance of the results obtained. Data processing and interpretation were carried out using qualitative and quantitative statistical methods: Fisher’s angular transformation criterion (φ*) for comparing two samples according to the occurrence frequency of the effect which is interesting to the researcher; Kruskal-Wallis rank sum test (IBM SPSS Statistics).The results of the study allow us to talk about ambivalence in the manifestation of metacognitive abilities formation in people of mature age: on the one hand, a general tendency towards a decrease in the development of metacognitive abilities was discovered, on the other hand, an increase in the degree of structural organization of the entire metacognitive system was revealed in the process of growing up, which generally compensates for the natural decline of potential resource capabilities of adults. This ambiguity in the manifestation of metacognitive abilities is reflected in their relationship with indicators of socio-psychological adaptation of adults. The identified features of the relationship in terms of harmony/inconsistency, integrity, and the content of crystallizing factors generally indicate a multidimensional structure of the relationship between metacognitive abilities and socio-psychological adaptation, when only in some cases can we talk about a direct correlation of these variables: a high level of development of metacognitive abilities determines high social-psychological adaptation.

Risk it for a biscuit: Food safety behaviours and food insecurity of older adults

Foodborne disease presents a significant public health issue, costing the UK economy £9 billion annually, with many incidences being due to food-related behaviours in the home. Adults aged 60 and over account for around a quarter of the population in England and Wales and are at a greater risk of foodborne disease and may suffer a much higher burden. Research into risky food behaviours has previously focused on larger cohorts and typically treats the over 60's as one homogenous group. The current paper aims to identify the characteristics associated with risky food-related practices related to cooking, cleaning, chilling, cross-contamination, and use-by date adherence. The current research analysed data from the Official Statistics survey, Food and You 2: Wave 6 (2022–23). A series of binary logistic regression models examined the characteristics associated with risky food-related practices. We demonstrate that the characteristics associated with risky behaviours are not uniform, with different factors being associated with specific behaviours. We suggest that risky behaviours cannot be targeted efficiently with a one size fits all approach. This research provides an evidence base for policy makers to target risky food behaviours in this understudied vulnerable group.

Phenotypic Variability of LGMD 2C/R5 in a Genetically Homogenous Group of Bulgarian Muslim Roma.

Sarcoglycanopathies are among the most frequent and severe forms of autosomal recessive forms of limb-girdle muscular dystrophies (LGMDs) with childhood onset. Four subtypes are known: LGMDR3, LGMDR4, LGMDR5 and LGMDR6, which are caused, respectively, by mutations in the SGCA, SGCB, SGCG and SGCD genes. We present the clinical variability of LGMD 2C/R5 among a genetically homogeneous group of 57 patients, belonging to 35 pedigrees. Molecular genetic analysis showed that all 57 patients were homozygous for the C283Y variant. The muscles of the pelvic girdle and the trunk were affected early and were more severely affected, followed by the shoulder girdle. Macroglossia, hypertrophy of the calves, scapular winging and lumbar hyperlordosis were common in the ambulatory phase. A great intra and interfamilial variability in the clinical presentation of LGMD 2C/R5 was observed, despite having the same underlying molecular defect. Females demonstrated a relatively milder clinical course compared to males. Mean creatine phosphokinase (CK) CK levels were 20 times above normal values. Muscle computer tomography (CT) CT or MRIs showed earlier and more severe involvement of the flexor proximal limb muscles in comparison to extensor muscles.

Does it run in the family? - Improving radiological risk assessment in the coastal environment using taxonomic and phylogenetic perspectives in macroalgae species

Marine macroalgae are widely used indicator species for monitoring environmental radioactivity. Empirical studies have demonstrated a range in radionuclide transfer coefficients, or concentration ratios (CRs), between taxonomic groups, however the CR values used for dose estimation assume that macroalgae are a homogenous group, represented by a single CR. This study demonstrates the presence of a taxonomic signal in macroalgae CRs for multiple anthropogenic and naturally occurring radionuclides (137Cs, 241Am, 239+240Pu, 210Po) based on a collation of available data. A Residual Maximum Likelihood (REML) mixed model was applied, producing relative estimate CRs specific to each species within the datasets. The collated data was also analysed for a phylogenetic signal, but only a weak signal was found for one radionuclide in one group (239+240Pu in Phaeophyceae). A theoretical case study using the estimated CRs and the ERICA tool was carried out to demonstrate the implications of these findings in a real-world scenario.

Madheshi Women’s Struggles against Discrimination in Nepal

Madheshi women experience various ways of discrimination in Nepali society. They suffer from race, caste, class and gender-based discrimination in society. In this context, this study explores the experiences and perceptions of Madheshi women about discrimination based on race, gender, class, caste/ethnicity, age and education through qualitative research. Eighteen participants were selected through purposive sampling. An in-depth interview was conducted with fourteen Madheshi women from various backgrounds and four Madheshi males were the key information participants. The Madheshi women from various backgrounds experienced discrimination and marginalization based on caste/ethnicity, class, race, gender, age and education. Madheshi women are not a homogeneous group, as they experience different kinds of exclusion in diverse settings. This study suggests enhancing the respect and recognition of Madheshi women in society. Furthermore, it suggests implementing and formulating relevant policies and legislation for Madheshi women, considering the prevalence of discrimination faced by Madheshi women in Nepal.

Association of sex with in-hospital management and outcomes of patients with heart failure: Data from the REAL-HF registry

BackgroundThere are sex differences in HF patients. It is not clear whether such differences mainly reflect cultural behaviours and clinical inertia, and the role of sex on clinical outcomes is still controversial. We aimed to investigate the association of sex with in-hospital management and outcomes in patients with HF. MethodsWe analyzed data of 4016 adult patients hospitalized for HF in 2020-2021 and enrolled in a multicentre national registry. ResultsWomen (n=1818[45%]) were older than men (83vs77 years, p<0.0001), with a higher prevalence of arterial hypertension (73%vs69%, p=0.011) and atrial fibrillation. Women presented more frequently with HF and preserved ejection fraction -HFpEF (55%vs32%, p<0.001). They were more often hospitalized in internal medicine departments (71%vs51%), and men in highly specialized cardiology units (49%vs29%). When considering HF pharmacological treatments at discharge in the subgroup with reduced ejection fraction -HFrEF (n=1525), there were no significant differences (49% of women treated with GDMT [guideline-directed medical therapy] vs 52% of men, p=0.197). Sex was not associated either with hospital readmissions (30-days OR[95%CI]=0.89[0.71-1.11], p=0.304; 1-year OR[95%CI]=1.02[0.88-1.19], p=0.777) or with mortality (in-hospital OR[95%CI]=1.14[0.73-1.78], p=0.558; 1-year OR[95%CI]=1.08[0.87-1.33], p=0.478). Similar results were obtained when considering different HF categories based on left ventricular ejection fraction. ConclusionsWomen and men exhibited distinct clinical profiles. Although this may have had an impact on hospital pathways (non-cardiology/cardiology units) and pharmacological prescriptions, sex per se did not appear as an independent determinant of clinical choices. Moreover, when considering homogeneous groups, women were not undertreated. Finally, female sex was not associated with worse clinical outcomes.

Effects of Bacillus subtilis on Growth Performance, Metabolic Profile, and Health Status in Dairy Calves.

This study focused on assessing whether the inclusion of probiotics (B. subtilis) as feed additives during the preweaning stage can enhance the body weight and metabolic condition of neonatal calves. A total of 50 Holstein calves, all born on the same farm, were randomly divided into two homogeneous treatment groups after birth. The calves in the control group (CG) were fed a milk replacer (n = 25) (13 females and 12 males) and those in the B. subtilis-supplement-treated group (TG), (n = 25) (13 females and 12 males) were fed a milk replacer with 7.5 mL/calf/day of B. subtilis probiotic (complied with the manufacturer's guidelines). The probiotic was administered 24 h post-birth, signifying the start of the experimental period. It took one month to collect the animals. Body weight was measured at birth for all animals. A local veterinarian, working on the farm, conducted daily health checks of the calves, recording health parameters and any antibiotic treatments. Blood samples were collected from each calf at birth and 30, 60, and 90 days by puncturing the jugular vein using 10 mL evacuated serum tubes before morning feeding. Significant differences in body weight were observed between the CG and the TG at 30, 60, and 90 days of age. At 30 days, the TG had a 4.11% higher average body weight than the CG (54.38 kg vs. 52.71 kg). At 60 days, the TG's average weight was 3.75% higher (79.21 kg vs. 76.34 kg), and at 90 days, the TG had a 2.91% higher average weight (112.87 kg vs. 109.67 kg). At 30 days of age, the TG showed significantly lower AST activity, with a 41.12% decrease compared to the CG (51.02 IU/L vs. 72.00 IU/L). Conversely, GGT activity was significantly higher in the TG by 64.68% (40.64 IU/L vs. 14.35 IU/L). Phosphorus concentration at 30 days was also significantly higher in the TG by 9.36% (3.27 mmol/L vs. 2.99 mmol/L). Additionally, the TG had a significantly lower total protein concentration, with a 21.63% decrease at 30 days (46.32 g/L vs. 56.34 g/L) and a 20.28% decrease at 60 days (48.32 g/L vs. 58.12 g/L) compared to the CG. These findings indicate that dairy calves given conventional milk replacer along with a daily dose of 7.5 mL of B. subtilis probiotic experienced enhanced growth performance and a more favourable metabolic profile during the first 90 days of their lives.

A homogeneous multi-vehicle cooperative group decision-making method in complicated mixed traffic scenarios

Connected and Automated Vehicles (CAVs) are expected to reshape the transportation system, and cooperative group intelligence of CAVs has great potential for improving transportation efficiency and safety. One challenge for CAV group driving is the decision-making under scenarios mixed with CAV and human-driven vehicles (HDV). Current studies mainly use methods based on single physical rules such as platoon driving or formation switch control, failing to reach a balanced and homogeneous state of optimal efficiency and risk in mixed traffic environments. In addition, most studies focus only on one specific type of scene, lacking the scene adaptability to various surrounding conditions. This paper proposes a homogeneous multi-vehicle cooperative group decision-making method targeting mixed traffic scenarios. A bi-level framework composed of behavior-level and trajectory-level decision-making is established to achieve balanced optimal cooperation. A region-driven behavioral decision mechanism is designed to decompose vehicle actions into a unified form of sequential target regions. Solutions are derived based on Cooperative Driving Safety Field, a risk assessment module inspired by field energy theory. The trajectory-level decision module takes the target regions as input and generates the control quantities of the CAVs through target point selection, conflict reconciliation, and dynamic constraint consideration. Experimental results on 19 various scenarios and continuous traffic flow scenes indicate that the proposed method significantly increases passing efficiency, reduces driving risk, and improves scene adaptability. In addition, experiments on multiple kinds of scenarios including intersections, ramps, bottlenecks, etc. prove that our method can adapt to various road topology structures. Feasibility is also verified through scaled physical platform validations and real-vehicle road tests.

Solid health care waste management practice in Ethiopia, a convergent mixed method study

IntroductionHealthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods.This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town.MethodA mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town.ResultSeventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ‘‘the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market’’. The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus.ConclusionHand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level.

Relapse Predictors in Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of rare diseases with a chronic and relapsing course. Recent treatment guidelines offer many therapeutic options depending mainly on the type of diagnosis and disease manifestations. Areas that remain under discussion include whether all patients diagnosed with AAV belong to a homogeneous group with a similar prognosis at baseline or if the type and duration of remission-inducing treatment should depend on factors other than just diagnosis and disease severity. The aim of this review is to present the recent literature on the tools available to use while evaluating the risk of relapse in patients upon presentation as well as potential biomarkers of proceeding flare in patients upon remission.

Feeding almond hulls to light lambs: Effects on growth performance, digestive utilization and blood metabolites

The effects of including almond hulls (AH) in the concentrate fed to light lambs on animal performance, diet utilization, and blood metabolites. Three isonitrogenous and isoenergetic concentrates were formulated with either 0 (control), 6 (AH6) or 12 (AH12) g of AH per 100 g (fresh matter basis). Thirty Manchega breed lambs (15 males and 15 females; 12.3 ± 0.18 kg body weight (BW)) were distributed into six homogeneous groups according to BW (3 groups of each sex), which were randomly assigned within sex to each experimental concentrate. Lambs were fed concentrate and barley straw ad libitum until reaching about 23.0 kg BW. There were no differences (P ≥ 0.182) between groups in final BW, intake of concentrate and straw, and feed conversion rate. Average daily gain and digestibility of dry matter and crude protein tended (P < 0.10) to decrease by the AH inclusion in the concentrate. Lambs fed AH12 showed greater (P < 0.05) urinary losses than those fed the control concentrate (15.4 and 11.5 g per 100 g of N intake, respectively), despite the similar N intake in all groups. Feeding AH did not affect (P ≥ 0.213) blood concentrations of albumin, globulins, urea, creatinine, glucose, total bilirubin and cholesterol or blood activities of hepatic enzymes. The post-mortem analysis revealed no differences among groups in pH and total volatile fatty acids (VFA) concentrations in the rumen of lambs, but NH3-N concentrations were lower (P < 0.05) in the lambs fed the concentrates with AH. In addition, lambs fed AH12 diet had lower (P < 0.05) molar proportions of propionate and greater (P < 0.05) proportions of butyrate compared with lambs fed control and AH6 concentrate. In general, no concentrate x sex interactions were observed, and sex had no effect on the measured parameters except for some differences in ruminal VFA profile. In conclusion, AH can be included at in light lambs’ concentrate up to 12 g per 100 g of concentrate without impairing animal growth.

Machine Learning Model for Anesthetic Risk Stratification for Gynecologic and Obstetric Patients: Cross-Sectional Study Outlining a Novel Approach for Early Detection.

Preoperative evaluation is important, and this study explored the application of machine learning methods for anesthetic risk classification and the evaluation of the contributions of various factors. To minimize the effects of confounding variables during model training, we used a homogenous group with similar physiological states and ages undergoing similar pelvic organ-related procedures not involving malignancies. Data on women of reproductive age (age 20-50 years) who underwent gestational or gynecological surgery between January 1, 2017, and December 31, 2021, were obtained from the National Taiwan University Hospital Integrated Medical Database. We first performed an exploratory analysis and selected key features. We then performed data preprocessing to acquire relevant features related to preoperative examination. To further enhance predictive performance, we used the log-likelihood ratio algorithm to generate comorbidity patterns. Finally, we input the processed features into the light gradient boosting machine (LightGBM) model for training and subsequent prediction. A total of 10,892 patients were included. Within this data set, 9893 patients were classified as having low anesthetic risk (American Society of Anesthesiologists physical status score of 1-2), and 999 patients were classified as having high anesthetic risk (American Society of Anesthesiologists physical status score of >2). The area under the receiver operating characteristic curve of the proposed model was 0.6831. By combining comorbidity information and clinical laboratory data, our methodology based on the LightGBM model provides more accurate predictions for anesthetic risk classification. Research Ethics Committee of the National Taiwan University Hospital 202204010RINB; https://www.ntuh.gov.tw/RECO/Index.action.

The role of emerging elites in the formation and development of communities after the fall of the Roman Empire

Elites played a pivotal role in the formation of post-Roman Europe on both macro- and microlevels during the Early Medieval period. History and archaeology have long focused on their description and identification based on written sources or through their archaeological record. We provide a different perspective on this topic by integrating paleogenomic, archaeological, and isotopic data to gain insights into the role of one such elite group in a Langobard period community near Collegno, Italy dated to the 6-8th centuries CE. Our analysis of 28 newly sequenced genomes together with 24 previously published ones combined with isotope (Sr, C, N) measurements revealed that this community was established by and organized around a network of biologically and socially related individuals likely composed of multiple elite families that over time developed into a single extended pedigree. The community also included individuals with diverse genetic ancestries, maintaining its diversity by integrating newcomers and groups in later stages of its existence. This study highlights how shifts in political power and migration impacted the formation and development of a small rural community within a key region of the former Western Roman Empire after its dissolution and the emergence of a new kingdom. Furthermore, it suggests that Early Medieval elites had the capacity to incorporate individuals from varied backgrounds and that these elites were the result of (political) agency rather than belonging to biologically homogeneous groups.

Circulating miRNA Signaling for Fatty Acid Metabolism in Response to a Maximum Endurance Test in Elite Long-Distance Runners.

Maximal oxygen uptake (VO2max) is a determining indicator for cardiorespiratory capacity in endurance athletes, and epigenetics is crucial in its levels and variability. This initial study examined a broad plasma miRNA profile of twenty-three trained elite endurance athletes with similar training volumes but different VO2max in response to an acute maximal graded endurance test. Six were clustered as higher/lower levels based on their VO2max (75.4 ± 0.9 and 60.1 ± 5.0 mL.kg-1.min-1). Plasma was obtained from athletes before and after the test and 15 ng of total RNA was extracted and detected using an SYBR-based 1113 miRNA RT-qPCR panel. A total of 51 miRNAs were differentially expressed among group comparisons. Relative amounts of miRNA showed a clustering behavior among groups regarding distinct performance/time points. Significantly expressed miRNAs were used to perform functional bioinformatic analysis (DIANA tools). Fatty acid metabolism pathways were strongly targeted for the significantly different miRNAs in all performance groups and time points (p < 0.001). Although this pathway does not solely determine endurance performance, their significant contribution is certainly achieved through the involvement of miRNAs. A highly genetically dependent gold standard variable for performance evaluation in a homogeneous group of elite athletes allowed genetic/epigenetic aspects related to fatty acid pathways to emerge.

Multimodal Approach Combining Thulium Laser Vaporization, Bipolar Transurethral Resection of the Prostate, and Bipolar Plasma Vaporization versus Bipolar Transurethral Resection of the Prostate: A Matched-Pair Analysis.

Background/Objectives: The aim of our study is to compare the perioperative and functional outcomes of a multimodal approach combining thulium laser vaporization, bipolar TURP, and bipolar plasma vaporization (TLP) with bipolar TURP in a matched-pair analysis. Methods: A nonrandomized, observational, retrospective, and matched-pair analysis was performed on two homogeneous groups of 60 patients who underwent TLP versus bipolar TURP at our center between March 2018 and December 2021. The American Society of Anesthesiologists (ASA) score and prostate volume (PV) were the main parameters used to match patients between the two groups. Follow-up was evaluated at 3, 6, 12, and 24 months after surgery. Results: There was a shorter operative time in favor of TLP (42 versus 45 min, p = 0.402). Median hemoglobin drop (-0.3 versus -0.6, p < 0.001) and median sodium drop (-0.3 versus -0.7, p < 0.001) after surgery were statistically significantly lower in TLP compared to bipolar TURP. The International Prostate Symptom Score (IPSS) and Quality of Life (QoL) scores were significantly lower, and the maximum urinary flow rate was higher in the TLP group. The median PSA decrease 2 years after surgery was 73.92% in the TLP group versus 76.17% in the bipolar TURP group (p = 0.578). The complication rate was lower in the TLP group (20% versus 21.67%, p = 1). Conclusions: The results show that both procedures are equally effective and safe in the treatment of symptomatic BPH with some advantages regarding the TLP technique.

The Effects of Hemp Hay (Canapa sativa L.) in the Diets of Grazing Goats on Milk Production and Fatty Acid Profile.

Hemp (Cannabis sativa L.) is a cosmopolitan annual herbaceous plant used in the past as a source of textile fiber. Currently, hemp is receiving great interest as animal feed due to its chemical and nutritional properties. The aim of this study was to explore the effects of supplementing goats' diets with hemp hay on the milk yield, chemical composition, and fatty acid profile. Twenty multiparous goats, immediately after kidding, were divided into two homogenous groups (C: control vs. H: hemp); the goats had free access to the pasture, and both groups received a supplement of 500 g/head/day of a barley and corn meal mixture (50/50). In addition, group H was given 250 g/head/day of hemp hay while group C received the same amount of alfalfa hay. The milk yield was measured daily, and milk samples were collected monthly 4 times to evaluate the milk composition and fatty acid profile. The milk yield was significantly (p < 0.05) higher in the experimental group, while no differences were found in the milk chemical composition. Concerning the fatty acid profile, the milk from group H was characterized by significantly lower concentrations of C11:0, C12:0, C13:0, C14:0, C15:0, and C17:0 and higher C16:0 and C18:0. Among the polyunsaturated FA, C18:2 n6 and C20:4 were significantly (p < 0.001) lower, and C20:5 n3 was significantly (p < 0.05) higher in the milk from group H than that from group C. The n6/n3, LA/ALA and AA/EPA ratios were significantly (p < 0.001) lower in the milk from group H, while the CLAs were unaffected by the treatment.

Factors associated with non-response and nutrional status of non-responders at 6-month post-discharge: a cohort study nested in a MUAC-based nutrition programme for acutely malnourished children in Mirriah, Niger.

In the treatment of acute malnutrition (AM), non-response is considered a treatment failure for not meeting recovery criteria within a therapeutic window of 12-16 weeks, but this category of children is misunderstood. As current research emphasizes ways to simplify and optimize treatment protocols, non-response emerges as a new issue to enhance program efficiency. A prospective cohort study was conducted from 2019 to 2020 at two health centres in Mirriah, Niger among children aged 6-59 months with uncomplicated AM treated under the Optimising treatment for Acute MAlnutrition (OptiMA) protocol. Children who did not meet recovery criteria by 12 weeks (mid-upper arm circumference (MUAC) ≥125 mm without oedema for two consecutive weeks) were classified as non-responders. Non-responders received a home visit six-months post-discharge. Logistic regression was used to analyze factors associated with non-responders compared with children who recovered. Of the 1,112 children enrolled, 909 recovered and 139 were non-responders, of which 127 (80.6%) had significant MUAC gain (mean: +9.6 mm, sd = 5.1) at discharge. Girls (adjusted hazard ratio (aHR) = 2.07, 95% CI 1.33-3.25), children <12 months of age (aHr = 4.23, 95% CI 2.02-9.67), those with a MUAC <115 mm (aHR = 11.1, 95% CI 7.23-17.4) or severe stunting (aHR = 2.5, 1.38-4.83) at admission and a negative or flat MUAC trajectory between admission and week 4 (aHR = 4.66, 95% CI 2.54-9.13) were more likely to be non-responders. The nutritional status of non-responders had generally improved 6 months after discharge, but only 40% had achieved MUAC ≥125 mm. Non-responders are not a homogeneous group; while most children ultimately show significant nutritional improvement, rapid hospital referral is crucial for those not gaining MUAC early in treatment. As efforts to expand MUAC-based programming progress, adapting exit criterion and/or providing additional food supplementation with smaller daily ration for children with risk factors discussed here may help improve programme efficiency without adding to the cost of treatment.

Commentary: Who gets the credit for "discovering" ADHD and what is the question, really?

Recognition of hyperactivity, impulsivity, distractibility, and emotional lability as a clinical syndrome is at the heart of identifying whether there is a discoverer of the condition of attention deficit hyperactivity disorder (ADHD). Just as clinics of children diagnosed with ADHD do not capture a homogeneous group of boys and girls, however, history does not either. What different observers/clinicians have chosen to highlight reflects what is important to them and to the times in which they lived. The child/children described by Heinrich Hoffman (of Fidgety Phil fame) and George Still (who highlighted impulsive aggression as a moral defect), for instance, did not come with a list of criteria (with which even now we cannot always agree) to prove unequivocally that they had ADHD. Who cares! It is sufficient that they recognized the importance of certain co-occurring behaviors and shared their observations with us such that we can conclude our clinic's children were recognized by good past observers. ADHD-like children, like the poor, have probably always been with us.

Impact of Native and Nonnative Study Partners on Medical Students’ Confidence and Collaborative Strategies in Second Language Medical Dutch Learning

Abstract Objective This study explored how native and nonnative study partners impact medical students’ confidence, learning strategies, and perceptions of learning experiences in second language (L2) medical Dutch learning using Kolb’s experiential learning framework. Methods Twelve third-year international bachelor medical students participated in a mixed-methods pre-post quasi-experimental design. Four students were paired with highly proficient native Dutch partners in a mixed group, and eight nonnative students formed pairs in a homogeneous group. The need satisfaction competence scale was used for pre- and post-tests, and individual interviews were analyzed for content and themes. Code co-occurrence and network analyses were carried out to identify the relationships between themes in the two groups. Results Common themes in both groups included a positive atmosphere, collaboration, and confidence. The mixed group prioritized language learning and motivation, while the homogeneous group emphasized interpersonal relationships and feedback-seeking behaviors. Nonnative students in homogeneous groups gained confidence, while confidence of those in mixed groups decreased, possibly due to comparing themselves with native partners. Homogeneous groups have communication focused collaborative strategies, while the mixed group emphasized personal growth with fewer drawbacks. Conclusions Our findings suggest that initiating the course with homogeneous nonnative student groups fosters collaboration and builds confidence among participants. However, to maintain motivation and further enhance language proficiency, it is advisable to introduce native Dutch partners at a later stage of the course. This approach allows students to benefit from both the positive collaborative atmosphere and interpersonal growth fostered in homogeneous groups, as well as the language learning and motivation gains associated with mixed-group experiences. Overall, our study highlights the importance of considering the stage of language learning and student needs in designing effective second language learning environments for medical students.

Unveiling Commonalities and Differences in Genetic Regulations via Two-Way Fusion.

Understanding the genetic regulation, for example, gene expressions (GEs) by copy number variations and methylations, is crucial to uncover the development and progression of complex diseases. Advancing from early studies that are mostly focused on homogeneous groups of patients, some recent studies have shifted their focus toward different patient groups, explored their commonalities and differences, and led to insightful findings. However, the analysis can be very challenging with one GE possibly regulated by multiple regulators and one regulator potentially regulating the expressions of multiple genes, leading to two distinct types of commonalities/differences in the patterns of genetic regulation. In addition, the high dimensionality of both sides of regulation poses challenges to computation. In this study, we develop a two-way fusion integrative analysis approach, which innovatively applies two fusion penalties to simultaneously identify commonalities/differences in the regulated pattern of GEs and regulating pattern of regulators, and adopt a Huber loss function to accommodate the possible data contamination. Moreover, a simple yet efficient iterative optimization algorithm is developed, which does not need to introduce any auxiliary variables and extra tuning parameters and is guaranteed to converge to a globally optimal solution. The advantages of the proposed approach are demonstrated in extensive simulations. The analysis of The Cancer Genome Atlas data on melanoma and lung cancer leads to interesting findings and satisfactory prediction performance.