Low Performance Research Articles

Is Warm-Up Preservation Modulated by Biological Maturation and Sex? Effects on Lower Limbs Performance.

Children and adults may react differently to warm-up preservation due to different physical characteristics. This study aimed to: (i) assess the impact of different rewarm-up routines in swimmers during a transition phase (20-25 min), including passive rest (SWU) or dynamic activities (RWU), on countermovement jump and swimming start performances, and (ii) explore potential RWU adaptations considering maturity offset (peak height velocity-PHV) and sex. Performance was analyzed using mixed effect ANCOVA, considering protocol, maturity offset (pre-PHV, mid-PHV, post-PHV, and adv. post-PHV), and sex. Results favored RWU over SWU with substantial magnitudes for jump height: pre-PHV (min-20, ES = 1.21; min-25, ES = 1.65), mid-PHV (min-20, ES = 1.23; min-25, ES = 1.14), post-PHV (min-20, ES = 1.37; min-25, ES = 0.73), and adv. post-PHV (min-20, ES = 1.03; min-25, ES = 0.65). Significant interactions at 25 min (p = 0.033, 0.047) showed that RWU outperformed SWU, especially in younger groups (pre-PHV, mid-PHV). RWU was superior to SWU for the reactive strength index at 20 min (p = 0.042) and 25 min (p = 0.047), with females having lower RSI than males at 20 min (p = 0.008, p = 0.015) and 25 min (p = 0.049) in later developmental stages. The flight distance (p = 0.009) and horizontal hip velocity (p = 0.014) revealed significant three-way interactions, with the male adv. post-PHV group responding better to RWU. Knee angular velocity was also higher after RWU, with male adv. post-PHV group showing more pronounced improvements (p = 0.016). These results suggest that though RWU had higher influence in male adults, it is a valuable approach for varying ages athletes.

Sociodemographic predictors and cross-cultural comparisons in tests performance from the Cambridge Neuropsychological Testing Automated Battery (CANTAB) among children aged 6-8 years from Montevideo, Uruguay.

Cross-culturally comparative data on measures of executive function (EF) are essential, but the 6-8-year group remains insufficiently described. This study examined the sociodemographic predictors of EF test performance employing the Cambridge Neuropsychological Testing Automated Battery (CANTAB). It also compared developmental trends in EF among children from Uruguay, the United States, and Mexico. EFs were assessed with the Intra-dimensional/Extra-dimensional shift, Spatial Span (SSP), and Stockings of Cambridge (SOC) tests from the CANTAB. The study sample consisted of 6-8-year-old children from the Salud Ambiental Montevideo (SAM) cohort in Uruguay. Differences between cohorts were examined, and we performed generalized linear regressions to assess the association between sociodemographic factors, and each EF domain. The final sample consisted of 525 participants (mean age in months 82.5 ± 6.0). Across all ages, SAM children had significantly lower performance in the SSP and SOC tasks compared to U.S. and Mexican children. On the Intra-dimensional/Extra-dimensional shift task, SAM children had similar scores to U.S. and Mexican children. Mother's intelligence quotient (IQ; β = 0.01; 95% CI [0.005, 0.02]), child's IQ (0.02 [0.02, 0.03]), the HOME total score (0.02 [0.01, 0.03]), as well as HOME subscales of accompaniment (0.13 [0.07, 0.20]), enrichment (0.11 [0.06,0.16]), and physical environment (0.07 [0.03, 0.10]) were positively associated with the span length (SSP task). Child's IQ (0.02 [0.01,0.03]) was positively associated with the number of problems solved on the SOC test. Uruguayan children perform lower in working memory and planning tests than U.S. children but similarly to Mexican children, while cognitive flexibility is consistent across all groups. Further, mother and child IQ, as well as the home environment, are important predictors of EF. These differences should be examined in the context of diverse cultural values and sociodemographic factors affecting CANTAB construct validity in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Performance analysis of a photovoltaic component integrated into a hybrid power plant in Southeast Mauritania

This study investigated the performance of photovoltaic components of the 1.3MW KIFFA hybrid power plant in Mauritania. Data from the plant's monitoring system (January-December 2021) was used to assess various performance metrics. The analysis revealed a high daily reference yield (5.60 h/d), indicating good solar resource availability. However, final and array yields (4.78 h/d and 4.86 h/d, respectively) suggested potential for improvement. System component efficiencies were within acceptable ranges, with particularly high inverter efficiency (98.31%). Array capture losses were moderate (0.74 h/d), and system losses were minimal (0.08 h/d). The annual performance ratio (86.33%) and capacity factor (19.91%) indicated good overall plant performance. These findings were then compared with data from similar installations in various climate zones to understand the impact of climatic variations on photovoltaic performance. Compared to installations in temperate zones with lower irradiation levels, the KIFFA plant's reference yield was significantly higher. However, the final and array yields were closer due to potentially higher operating temperatures in Mauritania affecting module efficiency. Interestingly, comparisons with installations in other desert regions with similarly high irradiation levels revealed lower performance, particularly in terms of final yield, (4.71 h/d) in Algéria (Adrar) and (4.10 h/d) in Oman (Muscat). This suggests that climatic factors beyond just sunlight availability, such as dust accumulation, may have played a significant role in their performance compared to the KIFFA plant.

보편적 학습설계와 증거기반교수를 적용한 수학 수업이 초등학생의 곱셈·나눗셈 성취도와 수학적 학습 태도에 미치는 효과

Objectives The purposes of this study was to examine the effects of mathematics instruction, incorporate Universal Design for Learning(UDL) and evidence-based instruction, on the multiplication and division achievement and mathematical learning attitudes of 4th grade elementary school students with typical or low achievement in mathematics. Methods The study involved 46 subjects, comprising students from two 4th-grade classes in a public elementary school in Seoul. The subjects were divided into experimental and control groups, with each group further subdivided based on their level of mathematics achievement. The experimental design employed a pretest-posttest control group design along with a repeated measures design. Improvements in students’ multiplication and division achievements were analyzed using a hierarchical linear growth model, while differences in attitudes towards mathematical learning were assessed using paired samples t-tests and analysis of covariance(ANCOVA). Results First, the rate of change in multiplication and division achievement among students with typical math performance in the experimental group was statistically significantly higher than that in the control group. Second, the rate of change in multiplication and division achievement among students with low math performance in the experimental group was significantly higher than that in the control group. Third, within the experimental group, students with low math performance demonstrated a significantly greater rate of improvement in achievement compared to students with typical math performance. Fourth, students in the experimental group showed statistically significant improvement in most areas of mathematical learning attitudes. Finally, there was no statistically significant difference in mathematical learning attitudes between the two subgroups of the experimental group, except for their level of confidence in multiplication and division. Conclusions First, mathematics instruction incorporating Universal Design for Learning (UDL) and evidencebased instruction was effective in improving multiplication and division achievement as well as mathematical learning attitudes among 4th grade elementary students. Finally, it can be inferred that this approach could be an effective method for ensuring foundational academic skills and bridging achievement gaps in general education settings with diverse student characteristics.

주식시장 수익률과 개인 투자자의 매매 성향

This study examines the relationship between individual investors and the KOSPI stock market using long-term data spanning 25 years from 1999 to 2023. However, this study analyzes the relationship between individual investors' net buys and KOSPI returns by dividing the entire period into five sun-periods of five years and applying two-sided regression and structural vector autoregressive (SVAR) models. The main findings are as follows: First, compared to foreign investors, both institutional and individual investors exhibit relatively higher turnover ratios. Second, cross-sectional analysis shows that KOSPI returns decrease monotonically with the individuals' net buys. Third, the results of the two-sided regressions indicate a Granger causality, where past returns negatively influence individual investors' net buys. In addition, today's individual net buys negatively Granger cause future returns. Fourth, the SVAR analysis also shows that KOSPI returns have a strong negative effect on individual net buys. Finally, according to the results of SVAR impulse response function, net buys response negatively to KOSPI shocks, and this response dissipates almost entirely by the third day. In summary, individual investors tend to engage in net selling in response to positive news in the KOSPI market, and this tendency may be a key reason for their lower performance.

Performance of breast MRI for high-risk screening during lactation.

To assess the diagnostic performance of breast MRI during lactation in the setting of high-risk breast cancer screening. Screening breast MRIs performed between April 2008 and March 2024 were retrospectively reviewed. Background parenchymal enhancement (BPE) grade was compared between lactating patients and patients who recently stopped lactating using the Mann-Whitney test. Breast Imaging Reporting and Data System (BI-RADS) scores prevalence rates were compared between lactating patients and controls encompassing young non-lactating patients using the Chi-square test. Diagnostic performance was calculated for patients with a biopsy reference or a 1-year radiologic follow-up. One-hundred forty-two screening breast MRIs were performed in lactating patients (n = 104, median age, 36.0 ± 6.0 years). Marked BPE appeared in 82% of cases (116/142), with a higher BPE grade in exams performed during lactation as compared with those performed in patients who had recently ceased lactating (p < 0.001). Screening MRIs performed during lactation had a higher rate of BI-RADS 3 scores (40/142, 28% vs. 683/8922, 7%, p < 0.001) and a lower rate of BI-RADS 1/2 scores (88/142, 62% vs. 7549/8922, 84.6%, p = 0.002) compared with those performed in controls (n = 8922). One pregnancy-associated breast cancer was detected, and one interval-cancer occurred. All MRI-guided biopsies were negative (n = 13). Screening breast MRI during lactation had 50% sensitivity (1/2), 60% specificity (72/120), 2.0% positive predictive value (1/49), and 98.6% negative predictive value (71/82). The efficacy of breast MRI for high-risk screening during lactation is limited by prominent BPE, leading to an increased rate of BI-RADS 3 categorization and diminished overall specificity. Question Studies on breast MRI during lactation were solely focused on studies conducted in patients with known cancer but not in the screening setting. Findings Screening breast MRI during lactation usually results in marked background parenchymal enhancement, negatively impacting its diagnostic performance. Clinical relevance Despite the lower performance, and amidst the significant risk of pregnancy-associated breast cancer, this screening approach remains relevant for lactating patients with high-risk profiles, such as BReast Cancer (BRCA) carriers. Radiologists should be familiar with the normal appearance of breast MRI duringlactation.

초등학교 5학년 일반 학생과 발달성 난독 학생의 영어 수행력 프로파일링

Objectives Most Korean students learn English as a second language from 3rd grade in public school curriculum. Despite receiving the same instruction in schools, there are concerns about the individual differences in English abilities among Korean students. Students with developmental dyslexia, who have difficulties in reading and writ-ing in their native language, also struggle with reading and writing in English. This study aimed to confirm the strengths and weaknesses of students through individual profiling of English abilties. Methods This study focused on two typical development students(TD who are A and B) and two developmental dyslexic students(DD who are C and D) in 5th grade. We developed the tests to profile English abilities, focusing on word reading, word writing, vocabulary, and meta-linguistic awareness abilities. Results In word reading and word writing, the TD showed higher performance than DD. In vocabulary, A, B, and C showed similar high performance, while D showed lower performance. In meta-linguistic awareness abilities, including phonological awareness(PA), syntactic awareness(SA), and orthographical awareness(OA), TD showed high performance in all abilities. Among the DD, C had weaknesses in SA compared to PA and OA, while D showed weaknesses in all abilities. Conclusions This study highlights the profiling of diverse English abilities among four 5th grade students. While DD showed different profiles in this study, they commonly demonstrated lower performance in reading and writing compared to TD, as well as lower metalinguistic awareness. It suggests that DD may require individualized educa-tion plan(IEP) based on their strengths and weaknesses.

SOCIO-ECONOMIC SUSTAINABILITY OF THE TOURISM SECTOR ENTERPRISES IN THE CONTEXT OF THE COVID-19 PANDEMIC: GLOBAL AND UKRAINIAN DIMENSIONS

In 2020, one of the main negative factors affecting the development of the tourism sector was the COVID-19 pandemic. Complicating the economic situation due to the coronavirus crisis for developing countries and local communities that are disproportionately dependent on tourism threatens the growth of poverty in these countries, not to mention the possibility of developing the tourism industry on a sustainable basis. The article examines the situation in the tourism industry of Ukraine, which has arisen as a result of the spread of the COVID-19 pandemic, and analyzes the possibilities of recovery and development of the tourism industry based on sustainable tourism. Based on the analysis of statistical data and the study of the level and trends in the development of the tourism business at the global and national levels, the authors proposed practical directions for the recovery of the tourism industry in the context of COVID-19, which will be beneficial not only for Ukraine but for developing countries as well. It is shown that the crisis in the tourism industry, which arose as a result of quarantine restrictions to reduce the spread of the pandemic, has complicated the process of implementing the Sustainable Tourism Concept for countries with low economic performance. It has been proven that the further development of tourism in developing countries based on cooperation and consistency of measures is needed to regulate travel at the bilateral, regional and international levels, to ensure safety for travellers and workers. Bringing together the government, the public, and the business community to work on a practical and implementable plan to revive the tourism sector. Increasing investment in technology, green infrastructure and jobs.

CEO Locality and Employment Stickiness

AbstractWe explore whether CEOs’ hometown identity involves labour adjustment decisions. We document that local CEOs, with their hometown ties, reduce employment to a lesser degree following sales downturns than nonlocal CEOs. This finding suggests that local CEOs’ strong local attachments motivate them to prioritise employee interests and build good reputations, which create private benefits or reserve future career paths in their hometowns. Our findings are more pronounced in areas where local connections are highly valued, thus supporting our argument. We further find that the retention efforts of local CEOs are related to low future performance. We extend the cost stickiness literature by documenting that CEOs’ place attachment influences resource adjustment decisions, particularly regarding labour, which eventually influences subsequent performance.

Midwives’ readiness for midwife-led care: a mixed-methods study

Background/ProblemTo integrate midwife-led care in Belgian maternity services, understanding whether midwives are primed of executing the change is needed. AimTo explore Belgian midwives’ readiness for midwife-led care and understand the underlying processes. MethodsA mixed-methods sequential study: 1) A survey including 414 practising midwives and 2) individual interviews with 12 (student) midwives. General linear model analysis was used to examine the trend between knowledge, self-efficacy and performance mean scores - indicators of midwife-led care readiness - proposed in a 27-item questionnaire. The Readiness Assessment Framework served as a template for qualitative thematic analysis. FindingsTemplate analysis illustrated the underlying mechanisms of midwifery-led care readiness: Governmental and institutional steering and rule-making functions, regulation and reimbursement, awareness of midwife-led care among stakeholders, capacity to extend primary care postpartum services to antenatal and intrapartum care and healthcare professionals’ lack of awareness of available data of women’s experiences and midwife-led care efficacy in Belgium. These qualitative findings contribute to the understanding of the significant trend with decreasing function for knowledge, self-efficacy and performance mean scores of 25 midwife-led care readiness indicators, and the two non-significant indicators referring to a physiological postpartum period. Discussion/ConclusionIn determining midwife readiness for midwife-led care, we observed adequate knowledge mean scores, associated with low self-efficacy and even lower midwife-led care performance mean scores. Our findings suggest limited readiness for MLC in antenatal and intrapartum care. Belgian midwives are the domain experts of postpartum services but face challenges in extending midwife-led care to antenatal and intrapartum services.

Korean nurses' knowledge, opinions and current practice of trauma-informed pediatric nursing care in South Korea: a descriptive study.

This study aimed to investigate the knowledge, opinions, competence, and barriers of nurses providing trauma-informed care (TIC) to children in hospitals. Data were collected from 198 nurses nationwide using the TIC Provider Survey developed by the Center for Pediatric Traumatic Stress in July, 2024. Descriptive statistics, t tests, and one-way ANOVA were conducted using the IBM SPSS Statistics software (ver. 23.0, IBM Corp.). Of the 13 items assessing knowledge of TIC, seven had a correct response rate of over 90%. However, the correct response rate for these three items were less than 30%. Regarding opinions on the TIC, more than 90% of participants agreed with five of the seven items. In self-rated competence in providing TIC, they were not competent in responding to a child's (or parent's) questions about whether the child is going to die or understanding how traumatic stress may present differently according to developmental stages. The major barriers to providing TIC were time constraints, lack of training, and organizational support. Items with relatively low performance rates were 'teach parents what to say to their child after a difficult/sick/scary experience, and teach child or parents the specific ways to cope with unpleasant experiences'. This study suggests that it can contribute to the development of specific guidelines for nurses to effectively apply TIC in pediatric and family nursing practice, emphasizing the need for educational programs to support this implementation.

Beyond Benchmarking: A Diagnostic Inquiry into the Underlying Determinants of Low Performance in Philippine PISA Science

The Philippines’ consistently low performance in the Program for International Student Assessment (PISA) Science Assessment has sparked concerns about the country’s educational quality and competitiveness. The science scores are due to socioeconomic status, teacher quality, resource deficiencies, and systemic issues. A multi-pronged approach with evidence-based interventions is recommended to improve scientific literacy. This paper conducts a diagnostic inquiry into the underlying determinants contributing to Filipino students’ underachievement in PISA science. Drawing from an extensive literature review, the analysis identifies several interrelated factors spanning multiple levels of the educational system. Socioeconomic status, motivation, self-efficacy beliefs, and language proficiency emerged as significant predictors at the student level. School-level determinants include resource deficiencies, lack of qualified science teachers, and inadequate instructional practices. Furthermore, systemic issues like fragmented policy implementation, curriculum misalignment, and insufficient investment in education undermine performance. The paper argues for a holistic, multi-pronged approach targeting these diverse determinants through evidence-based interventions and policy reforms to enhance scientific literacy and elevate educational outcomes in the Philippines.

Explaining the Anomaly Detection in Additive Manufacturing via Boosting Models and Frequency Analysis

Anomaly detection is an important feature in modern additive manufacturing (AM) systems to ensure quality of the produced components. Although this topic is well discussed in the literature, current methods rely on black-box approaches, limiting our understanding of why anomalies occur, making complex the root cause identification and the consequent decision support about the action to take to mitigate them. This work addresses these limitations by proposing a structured workflow designed to enhance the explainability of anomaly detection models. Using the wire arc additive manufacturing (WAAM) process as a case study, we examined 14 wall structures printed with INVAR36 alloy under varying process parameters, producing both defect-free and defective parts. These parts were classified based on surface appearance and welding camera images. We collected welding current and voltage data at a 5 kHz sampling rate and extracted features from both time and frequency domains using a knowledge-based approach. Isolation Forest, k-Nearest Neighbor, Artificial Neural Network, XGBoost, and LGBM models were trained on these features, and the results shown best performance of boosting models, achieving F1 scores of 0.927 and 0.945, respectively. These models presented higher performance compared to other models like k-Nearest Neighbor, whereas Isolation Forest and Artificial Neural Network posses lower performance due to overfitting, with an F1 score of 0.507 and 0.56, respectively. Then, by leveraging the feature importance capabilities of these models, we identified key signal characteristics that distinguish between normal and anomalous behavior, improving the explainability of the detection process and in general about the process physics.

Efficacy of jute-glass hybrid laminate composite wrapping under flexural loading

The demand for sustainable engineering materials has catalyzed interest in hybrid composites that combine natural fibers like jute with synthetic fibers such as E-glass. This study investigates the flexural strength of jute/E-glass/epoxy hybrid composite laminates under different stacking sequences, employing the ANOVA method to analyze their mechanical performance. The materials, including jute fabric, E-glass fabric, and epoxy resin, were arranged in various configurations and tested for flexural strength following ASTM D790 standards. The results indicated significant variability, with the GJGJ configuration exhibiting the highest average flexural strength of 71.20 MPa, while the GJG configuration had the lowest at 26.33 MPa. The ANOVA analysis confirmed a statistically significant effect of laminate configuration on flexural strength (F = 6.41, p = 0.004). These findings underscore the critical role of laminate arrangement in enhancing the mechanical properties of hybrid composites. The superior performance of the GJGJ configuration suggests that alternating layers of jute and E-glass fibers can effectively distribute stress and enhance load-bearing capacity. Conversely, suboptimal configurations like GJG demonstrated lower performance, highlighting the importance of strategic fiber arrangement. This research contributes to the development of optimized hybrid composites for various engineering applications, providing valuable insights into the interplay between natural and synthetic fibers within a composite matrix. The study's conclusions support the broader use of hybrid composites in industries such as automotive, construction, and aerospace, where material sustainability and performance are paramount. Future research should explore further optimization of stacking sequences and volume fractions of fibers, as well as investigate other mechanical properties such as tensile and impact strength, to fully realize the potential of hybrid composites in advanced engineering applications

Tl2XY (X, Y = S, Se) monolayers with low lattice thermal conductivity and high thermoelectric performance by full-band approach with four scattering mechanisms

Abstract The low lattice thermal conductivity and high thermoelectric performance of the Janus Tl2SSe monolayer in the temperature region of 300~700 K are identified based on the thermoelectric properties of the Tl2S2, Tl2SSe, and Tl2Se2 monolayers. The transport coefficients for carrier concentrations and temperatures are obtained by solving the linearized Boltzmann transport equation in a full-band electronic structure. Four scattering mechanisms of acoustic deformation potential, optical deformation potential, polar optical phonon, and ionized impurity scatterings are considered. The ionized impurity scattering is recognized as the most important. The lattice thermal conductivity of the Janus Tl2SSe monolayer is substantially smaller than those of the Tl2SSe, Tl2Se2 monolayers with higher symmetry. Moreover, we find that the Janus structures of the Tl2SSe monolayer increase the dielectronic constants and enhance the polar optical phonon scattering, then reduce the power factor to some extent. Therefore, the lattice thermal conductivity actually couples with the transport coefficient and cannot be individually regulated as is usually assumed. However, the ZT value of the Tl2SSe monolayer can still reach 1.77 at 700 K even if the intrinsic concentration and the bipolar effect are included. Therefore, the Tl2SSe monolayer is expected to be a promising candidate for thermoelectric materials.&amp;#xD;

Design an on-grid PV system to supply electricity to a school in Babil city using PVsyst software

The world attention is increasingly directed towards solar energy, particularly in countries of high solar radiation rates such as Iraq, due to the limitation of fossil fuel resources and the high pollution rates associated with using them. Engineers and researchers utilize different techniques in order to design the photovoltaic systems with low cost and high performance. This research aims at designing an optimal on-grid PV system to feed a school, located at Babel, Iraq using PVsyst program. The PVsyst methodology includes defining the geographical location of the project, determining the demand electrical load, selecting the type of the PV system components, and finally running the simulation. Detailed results, including the produced energy, loses diagram, economic and environmental evaluations can be obtained. The results show that a PV system comprising of 90 (450 Wp) panels and 3 (12 kWac) inverters on an area of 198 m2 can produce a net output energy at 70.23 MWh. The economic evaluation show that the project cost can be recovered within less than 10 years, and a net positive gain up to 20,000 USD can be attained during the 25 years project lifetime. A huge carbon emission equal to 1279.6 tCo2 can be saved as a result of this PV system installation. There is an obvious need to invest in solar energy for economic and environmental considerations. The main drawback of PV systems installations is the high capital cost. Using commercial packages, particularly PVsyst program, can significantly contributes toward optimizing the system design and hence reducing the project cost.

A Virtual Breakthrough Series Collaborative for Missed Test Results

Missed test results, defined as test results not followed up within an appropriate time frame, are common and lead to delays in diagnosis and treatment. To evaluate the effect of a quality improvement collaborative, the Virtual Breakthrough Series (VBTS), on the follow-up rate of 2 types of test results prone to being missed: chest imaging suspicious for lung cancer and laboratory findings suggestive of colorectal cancer. This stepped-wedge cluster-randomized clinical trial was conducted between February 2020 and March 2022 at 12 Department of Veterans Affairs (VA) medical centers, with a predefined 3-cohort roll-out. Each cohort was exposed to 3 phases: preintervention, action, and continuous improvement. Follow-up ranged from 0 to 12 months, depending on cohort. Teams at each site were led by a project leader and included diverse interdisciplinary representation, with a mix of clinical and technical experts, senior leaders, nursing champions, and other interdisciplinary team members. Analysis was conducted per protocol, and data were analyzed from April 2022 to March 2024. All teams participated in a VBTS, which included instruction on reducing rates of missed test results at their site. The primary outcome was changes in the percentage of abnormal test result follow-up, comparing the preintervention phase with the action phase. Secondary outcomes were effects across cohorts and the intervention's effect on sites with the highest and lowest preintervention follow-up rates. Previously validated electronic algorithms measured abnormal imaging and laboratory test result follow-up rates. A total of 11 teams completed the VBTS and implemented 47 (mean, 4 per team; range, 3-8 per team; mode, 3 per team) unique interventions to improve missed test results. A total of 40 027 colorectal cancer-related tests were performed, with 5130 abnormal results, of which 1286 results were flagged by the electronic trigger (e-trigger) algorithm as being missed. For lung cancer-related studies, 376 765 tests were performed, with 7314 abnormal results and 2436 flagged by the e-trigger as being missed. There was no significant difference in the percentage of abnormal test results followed up by study phase, consistent across all 3 cohorts. The estimated mean difference between the preintervention and action phases was -0.78 (95% CI, -6.88 to 5.31) percentage points for the colorectal e-trigger and 0.36 (95% CI, -5.19 to 5.9) percentage points for the lung e-trigger. However, there was a significant effect of the intervention by site, with the site with the lowest follow-up rate at baseline increasing its follow-up rate from 27.8% in the preintervention phase to 55.6% in the action phase. In this cluster-randomized clinical trial of the VBTS intervention, there was no improvement in the percentage of test results receiving follow-up. However, the VBTS may offer benefits for sites with low baseline performance. ClinicalTrials.gov Identifier: NCT04166240.

Cross-coupled prompt learning for few-shot image recognition

Prompt learning based on large models shows great potential to reduce training time and resource costs, which has been progressively applied to visual tasks such as image recognition. Nevertheless, the existing prompt learning schemes suffer from either inadequate prompt information from a single modality or insufficient prompt interaction between multiple modalities, resulting in low efficiency and performance. To address these limitations, we propose a Cross-Coupled Prompt Learning (CCPL) architecture, which is designed with two novel components (i.e., Cross-Coupled Prompt Generator (CCPG) module and Cross-Modal Fusion (CMF) module) to achieve efficient interaction between visual and textual prompts. Specifically, the CCPG module incorporates a cross-attention mechanism to automatically generate visual and textual prompts, each of which will be adaptively updated using the self-attention mechanism in their respective image and text encoders. Furthermore, the CMF module implements a deep fusion to reinforce the cross-modal feature interaction from the output layer with the Image–Text Matching (ITM) loss function. We conduct extensive experiments on 8 image datasets. The experimental results verify that our proposed CCPL outperforms the SOTA methods on few-shot image recognition tasks. The source code of this project is released at: https://github.com/elegantTechie/CCPL.

The effect of sleep effectiveness on examination scores of first year osteopathic medical students

Medical students frequently encounter high levels of stress and pressure, which can negatively affect their mental health and sleep quality, a key determinant of cognitive function and academic success. This study assesses the relationship between sleep effectiveness and academic performance among medical students. An observational, cross-sectional survey took place at A.T. Still University - School of Osteopathic Medicine in Arizona (ATSU-SOMA), involving participants from the 2027 cohort. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used and exam scores from the second exam of the fourth block were analyzed. For the purpose of our inquiry, the “Sleep Effectiveness” component score of the PSQI was used for our analysis. The results indicated a significant inverse relationship between sleep effectiveness and exam performance (R² = 0.087, p =0.000262), demonstrating that increased sleep effectiveness was associated with lower exam performance. The study highlights the sheer amounts of confounding variables in the preconceived notion that “,Sleep is the key for academic success.” This research suggests that academic performance is best explained by multiple variables rather than simply one. Future studies should investigate the long-term effects of sleep deprivation and explore interventions beyond sleep hygiene, including stress and time management strategies. Understanding the broader impact of sleep on medical education is essential for fostering better outcomes for students in both academic and clinical settings.

Sustainability of column‐supported slabs for buildings: A multi‐criteria assessment

AbstractThe global construction industry is experiencing significant growth, driving the demand for building floor area. However, this expansion comes with substantial environmental consequences, including high‐energy consumption and greenhouse gas (GHG) emissions, together with economic and social impacts. To address these challenges, this research aims at providing designers and decisions‐makers with an approach that will aid the quantification of those impacts relevant for the sustainability performance of flooring systems. A holistic sustainability assessment was performed considering economic, environmental, and social aspects using the Integrated Value Model for Sustainability Evaluations. This study focused on various flooring typologies, including reinforced concrete (RC) and fiber‐RC (FRC) slabs with solid and waffle (for RC solution) configurations. The most representative criteria and indicators of sustainability for concrete column‐supported slabs were identified, measured, and weighted—aggregated in a decision‐making tree—in order to obtain a representative a sustainability index (SI) for each alternative. The results of the analysis evidence that the RC solid slab has a higher overall SI than the other alternatives, the FRC alternatives performing with similar SI of that quantified for the RC solid slab solution and the RC waffle slab being that with the lower sustainability performance among those flooring systems considered in this study. The results of a sensitivity analysis showed that those alternatives using FRC have potential for improving the overall sustainability performance.