Potential Discrepancies Research Articles

The Effect of Wholesome Scattering Game students on Communication Skills

Wholesome scattering is a game which students predict the content of passage and duplicate sentences by using single word that have been given by the teacher. This study aims to find out the effect of wholesome scattering game to improving students' communication skills of the and to develop their achievement in English language. The researcher depend on the experimental method, a sample of (67) female students studying in University of Tikrit / collage for women are divided into two groups. The first group is called control group which consist of (34) students and the second group is called experimental group which consist of (33) students. The two groups are equivalent according to the age and their marks in English in previous year. The accomplishment exam served as a pre test to demonstrate the quality of the group, additionally it served as posttest to assess any potential discrepancies between two groups as well as the effect of wholesome scattering game as a way to discuss their progresses in the English languages so the study’s finding shows that there are statistically significant differences between the students’ performance in the Experimental group in the pre-test and their performance in the post-test in favor of the wholesome scatting game strategy. These results support the researcher’s recommendation that the wholesome scattering game is useful strategy and it’s important to apply in learning English in order to increase students’ achievement in English language.

Editorial Expression of Concern.

On 15 September 2022, Science published the Research Article “Structural basis for strych-nine activation of human bitter taste receptor TAS2R46” by Weixiu Xu et al. (1). The editors have been made aware that the examination of data provided after publication revealed potential discrepancies with fig. S10D. This figure was used to support a proposal of precoupling between TAS2R46 and the G protein gustducin. We are alerting readers to these concerns while the authors’ institution investigates further.

Penile Autophotography Underestimates the Degree of Penile Curvature in Peyronie’s Disease

BackgroundPenile curvature is the most debilitating symptom of Peyronie’s disease (PD); the evaluation of the degree of angulation is essential for planning treatment strategy. However, the most used method of penile at-home autophotography (AHP) is associated with some potential pitfalls and discrepancies compared with different assessment methods. ObjectiveTo compare the degree of penile curvature quantified by AHP and in-office intracavernosal alprostadil injection (ICI) prior to therapy. Design, setting, and participantsData from 55 PD patients of a single tertiary referral center were analyzed. All patients provided standardized AHP of the erect phallus. Clinic-based assessment included ICI with curvature measurement and completion of the International Index of Erectile Function (IIEF-15). Outcome measurements and statistical analysisThe Wilcoxon and/or chi-square test was used to compare the degree of curvature obtained using AHP and ICI, and to evaluate whether erectile dysfunction was a predictor of a relevant difference of >10° in curvature assessment between AHP and ICI. Results and limitationsOur study showed a significant (p < 0.001) difference in the degree of penile curvature between AHP (48° [38°; 55°]) and ICI (50° [40°; 65°]). Patients suffering from erectile dysfunction tend to have a higher difference in the degree of penile curvature between AHP and ICI than patients with good erectile function (p < 0.001). Our study is not devoid of limitations. First, we did not use Peyronie's Disease Questionnaire, as suggested by the European Association of Urology guidelines. Second, we did not evaluate inter- and intraobserver variations in the measurements. ConclusionsAHP tends to underestimate the extent of penile curvature compared to ICI. Erectile dysfunction is an independent predictor of measurement differences of >10° between AHP and ICI. Patient summaryIt is necessary to evaluate the degree of penile curvature in Peyronie’s disease prior to therapy decision. The at-home self-photography underestimates the real degree of penile curvature compared with an erection by in-office penile drug injection. Especially men suffering from erectile dysfunction carry the risk of a high difference in the measured degree of penile curvature, with a potential impact on the further treatment.

Kinetic study of multiphase reactions under microwave irradiation: A mini-review

Microwave (MW) heating is rapid, selective, and volumetric, and it is a compelling non-conventional heating approach for driving chemical reactions. The effect of MW irradiation on the kinetics of thermal/catalytic reactions is still under debate. A group of researchers reported that the effect of MW heating on reaction kinetics is highlighted through the non-thermal effects of MWs on kinetic parameters and reaction mechanisms in addition to the thermal effect. However, another group attributed the observations to the thermal effect only. In the present work, we summarized and critically synthesized available information in the literature on the subject. It can be concluded that MW heating has solely the thermal effect on gas-solid reactions, and the variations of kinetic parameters are related to the direct and indirect impacts of that. Temperature measurement limitations, physical structure variation, and non-uniform temperature distribution are the primary sources of the discrepancy in previous studies. In ionic liquid-solid reactions, the presence of electromagnetic fields can affect the movement of ions/polar molecules which can be considered a non-thermal effect of MWs. However, the effect of MW absorption by solid/catalyst, and the formation of hot spots must be taken into account to avoid potential discrepancy. Therefore, further theoretical/experimental studies are required to clarify the effect of MWs on liquid-solid reactions. In addition, developing reliable temperature measurement methods and isothermal reaction domain are required for an accurate kinetic study during MW irradiation.

The “weekend effect” does not impact on outcome of trauma laparotomy – Experience from a level 1 trauma centre in New Zealand

PurposeTrauma centres have been proven to provide better outcomes in developed countries for overall trauma, but there is limited literature on the systematic factors that describe any discrepancies in outcomes for trauma laparotomies in these centres. This study was conducted to examine and interrogate the effect of systematic factors on patients undergoing a trauma laparotomy in a developed country, intending to identify potential discrepancies in the outcome. MethodsThis was a retrospective study of all laparotomies performed for trauma at a level 1 trauma centre in New Zealand. All adult patients who had undergone an index laparotomy for trauma between February 2012 and November 2020 were identified and laparotomies for both blunt and penetrating trauma were included. Repeat laparotomies and trauma laparotomies in children were excluded. The primary clinical outcomes reviewed included morbidity, length of hospital stay, and mortality. All statistical analysis was performed using R v.4.0.3. ResultsDuring the 9-year study period, 204 trauma laparotomies were performed at Waikato hospital. The majority (83.3%) were performed during office hours (170/204), and the remaining 16.7% were performed after hours (34/204). And 61.3% were performed on a weekday (125/204), whilst 38.7% were performed on the weekend/public holiday (79/204). Most of the parameters in office hours and after hours groups had no statistically significant difference, except lactate (p = 0.026). Most of the variables in weekday and weekend groups had no statistically significant difference, except pH, lactate, length of stay, and gastrointestinal complications (p = 0.012, p < 0.001, p = 0.003, p = 0.020, respectively). ConclusionThe current trauma system at Waikato hospital is capable of delivering care for trauma laparotomy patients with the same outcome regardless of working hours or after hours, weekday or weekend. This confirms the importance of a robust trauma system capable of responding to the sudden demands placed on it.

Assessing the impact of a pharmacy-provided personalized vaccination recommendation on immunization rates of adolescents

BackgroundAdolescents should receive timely doses of recommended vaccinations. The coronavirus disease 2019 (COVID-19) vaccination approval for adolescents presented an opportunity for community pharmacists to address gaps in adolescent immunization schedules. ObjectivesThe objectives of this research were to (1) identify adolescent immunization gaps, (2) identify number of patients receiving recommended vaccination(s) at the community pharmacy, and (3) determine how many vaccinations were administered after the intervention. MethodsThree pharmacies conducted the prospective intervention. Adolescents aged 11-17 years initiating the Pfizer-BioNTech COVID-19 vaccination series were eligible to receive a personalized vaccination recommendation (PVR), which included up to 3 other vaccinations. State immunization information systems were assessed after dose 1 of the COVID-19 vaccine to create the recommendation(s) and reassessed 6 months after providing the PVR for accepted recommendations. Patient demographics and number of vaccinations administered were assessed using descriptive statistics. ResultsOf the 225 adolescents who received COVID-19 vaccine dose 1, 74.7%, 75.1%, and 83.1% were indicated to receive tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal conjugate (MenACWY), or human papillomavirus (HPV) vaccine, respectively. Thirty-three (14.7%) adolescents were up to date on all 3 vaccinations assessed. Of the 225 adolescents, 180 returned to the same location for COVID-19 vaccine dose 2 and received a PVR. Forty-two caregivers reported that their adolescent previously received 1 or more of the recommended vaccinations, indicating that state immunization information systems were inaccurate. Six months after the PVRs were given, 24 vaccinations had been administered. ConclusionsMost adolescents presenting for a COVID-19 vaccine were indicated, according to state immunization information systems, to receive at least 1 additional vaccination. After pharmacist-provided PVR and education, vaccine uptake occurred. Considering caregiver-reported inaccuracies, pharmacists should be cognizant of potential discrepancies when providing PVRs. In addition, this study highlights the value of a state immunization information system.

Perceived Monkeypox Concern and Risk among Men Who Have Sex with Men: Evidence and Perspectives from The Netherlands.

The current monkeypox epidemic is most prevalent among men who have sex with men (MSM). PrEP users and MSM with HIV (MSMHIV) are considered at highest risk of monkeypox infection in The Netherlands, and are being targeted for monkeypox vaccination. Together with the epidemiological evidence, perceived concern and risk are also relevant for decision making about health behaviour, e.g., vaccination uptake. It is thus timely to examine which subpopulations among MSM consider themselves to be most at risk and are most concerned about monkeypox. This study aimed to help determine if the current measures to curb the epidemic are successfully targeted or not in The Netherlands. We conducted an online survey among 394 MSM living in The Netherlands. We first calculated the prevalence and standardised prevalence ratio (SPR) of high perceived monkeypox concern/risk by PrEP-use and HIV status. We then conducted two multivariable logistic regression analyses to investigate perceived monkeypox concern/risk and their potential socio-demographic/behavioural/health/psycho-social determinants. Among the included MSM, 52% showed high perceived concern about and 30% showed high perceived risk of monkeypox infection. PrEP users (SPR = 0.83) showed a significantly lower chance of perceived concern; in addition, MSMHIV (SPR = 2.09) were found to have a significantly higher chance of perceiving high risk of monkeypox infection. In the multivariable logistic analyses, non-PrEP users (aOR = 2.55) were more likely to perceive higher concern, while MSM who were retired (aOR = 0.23) and who had had chemsex recently (aOR = 0.63) were less likely to perceive higher concern. MSMHIV (aOR = 4.29) and MSM who had an unknown/undisclosed HIV status (aOR = 6.07), who had attended private sex parties (aOR = 2.10), and who knew people who have/had monkeypox (aOR = 2.10) were more likely to perceive a higher risk for monkeypox infection. We found that high perceived risk (aOR = 2.97) and high perceived concern (aOR = 3.13) were correlated with each other. In sum, only one-third of MSM living in The Netherlands considered themselves at high risk of monkeypox infection, and only half of them reported high concern. We identified a potential discrepancy between “actual risk” and perceived risk of and concern about monkeypox among MSM in this early stage of the monkeypox epidemic in The Netherlands, especially among PrEP users and MSMHIV. More refined public health communication strategies may be needed to improve the understanding and knowledge of the “actual risk” of monkeypox infections among MSM sub-populations, to facilitate health behaviour uptake.

Patients' Opinions on Critical Portions of Surgical Procedures in Foot and Ankle Surgery

Category: Other; Ankle Introduction/Purpose: Over the last decade, simultaneous or overlapping procedures in orthopedic surgery have come under increased media attention and public scrutiny. While little is known about what surgeons consider to be 'critical portions' of the myriad of foot and ankle procedures performed, even less is known about the expectations and opinions of patients themselves. In this study we aimed to elucidate patients' expectations of foot and ankle surgeons regarding their presence at different portions of a given surgery and what portions of a surgery they considered to be 'critical'. Methods: In this survey, data was collected using a questionnaire that was filled out by 49 patients presenting to an orthopedic foot and ankle tertiary referral clinic. The questions were designed around three common foot and ankle procedures: open reduction, internal fixation of fractures (ORIF), Achilles tendon repair, and ankle arthroscopy. For each procedure, the key steps were identified, and the responding patient was asked to characterize each step as 'Always Critical' 'Often Critical' 'Sometimes Critical' 'Rarely Critical' or 'Never Critical.' Additionally, demographics, education level, number of prior surgeries, and profession were also collected from the patients. Data were described using means, ranges, and percentages. Results: Of the 49 patients surveyed, the average age was 52.9 years old; 59% were female and 41% were male; 76% of respondents were college graduates, 8% completed some college, and 12% were high school graduates. Overall, 12% of respondents work in a healthcare related field. The average number of previous surgeries was 2.0, with a minimum of 0 and a maximum of 14. In all three procedures, the steps for which more than 50% of the patients identified as 'Always Critical' were discussion of risks, benefits, and alternatives, marking the surgical site, pre-operative time-out, skin incision for ORIF, soft tissue dissection, reduction of fracture, fracture fixation with hardware, repair of the tendon, and scoping the ankle. Across all three procedures, transferring the patient between operating table and bed, applying a sterile bandage, and applying a splint were categorized as the least critical portions of the procedure (Figure 1). Conclusion: The result of this study offers insight on what the most critical portion of three common foot and ankle procedures from the patient's perspective. Generally speaking, patients perceived initial dissection and even closure to be critical, in addition to procedural elements such as fracture reduction. Ongoing research aims to correlate these findings with the perceptions of foot and ankle surgeons themselves. Nonetheless, it highlights the potential discrepancy in perceptions between clinicians and patients as it pertains to 'critical portions' of a given procedure.

Hybrid renewable energy system for sustainable residential buildings based on Solar Dish Stirling and wind Turbine with hydrogen production

In this work, an Hybrid Renewable Energy System (HRES) based on microgrid power is proposed and optimized to meet the electric demand of a sustainable multi-family buildings with possible generation of clean hydrogen. Hourly building simulation is carried out based on meteorological data to predict the year-round electrical consumption of the designed buildings. The proposed hybrid system includes a Solar Dish Stirling (SDS) technology combined with a Wind Turbine (WT) for power generation, an electrolyzer, a hydrogen storage tank, as well as a battery bank. The novelty of the study resides in the replacement of conventional hybrid systems, such as a photovoltaic PV/WT assembly, with an SDS/WT system that has the potential to reach higher efficiencies and economic competitiveness. An optimization process is investigated to evidence the optimum HRES design based on the lowest Net Present Cost (NPC). Sensitivity studies are performed to illustrate the effect of main functioning parameters and how they impact the overall project viability. Moreover, the performance of the model is evaluated in two selected sites in Morocco, namely Ouarzazate and Dakhla, and a comprehensive techno-economic study of the integrated system is investigated. The findings indicate that the HRES design and configuration are site-dependent due to discrepancies in wind and solar energy potential of the examined sites. The optimum architecture of the assessed HRES in Dakhla greatly promote the implementation of WT technology with a NPC/ LCOE of about 3.053 M€/0.0697 €/kWh, respectively. In Ouarzazate, it was found that the optimum design configuration relies exclusively on the SDS technology and correspond to NPC/ LCOE of 3.391 M€/ 0.126 €/kWh, respectively. LCOH values obtained by the optimum HRES configuration were determined 21.4 €/kg and 23.6 €/kg for Dakhla and Ouarzazate, respectively. This study demonstrates the viability of SDS implementation in future HRESs and open the perspectives for its role in carbon–neutral buildings.

Predictive analysis of COVID 19 disease based on mathematical modelling and machine learning techniques

ABSTRACT During the emergence of a novel pandemic, predictive modelling process is more important in the phase of public health planning and response. Relating models to data provides a view into unseen variables, such as the occurrence of cryptic transmission and the prevalence of infection. These models allow exploration of counterfactuals and hypothetical interventions. Predictive modelling is a valuable model based on the clear definition and estimation of the variables. Researchers or policy makers who use the model outputs have a clear understanding of what can and cannot be achieved by this method. The results of this study are suggested that substantially more cases were present in many countries than were reported in the official statistics. In this paper we have identified the potential discrepancy between reported cases and true disease burden provided a crucial early warning to the international community. In this research paper we proposed statistical modelling and data-driven computer simulations provided accurate projections of global epidemic dispersal, quantifying the role of physical distancing in places and reductions in international travel on the spatiotemporal pattern of spread of COVID-19 based on Linear regression analysis.

Predator responses to prey camouflage strategies: a meta-analysis.

Although numerous studies about camouflage have been conducted in the last few decades, there is still a significant gap in our knowledge about the magnitude of protective value of different camouflage strategies in prey detection and survival. Furthermore, the functional significance of several camouflage strategies remains controversial. Here we carried out a comprehensive meta-analysis including comparisons of different camouflage strategies as well as predator and prey types, considering two response variables: mean predator search time (ST) (63 studies) and predator attack rate (AR) of camouflaged prey (28 studies). Overall, camouflage increased the predator ST by 62.56% and decreased the AR of prey by 27.34%. Masquerade was the camouflage strategy that most increased predator ST (295.43%). Background matching and disruptive coloration did not differ from each other. Motion camouflage did not increase ST but decreases AR on prey. We found no evidence that eyespot increases ST and decreases AR by predators. The different types of predators did not differ from each other, but caterpillars were the type of prey that most influenced the magnitude of camouflage's effect. We highlight the potential evolutionary mechanisms that led camouflage to be a highly effective anti-predatory adaptation, as well as potential discrepancies or redundancies among strategies, predator and prey types.

Improving corrosion resistance of Zn–5Al (wt%) alloy by microalloying with samarium

The role of the rare earth element Sm in as-cast Zn–5Al alloy was studied in this work. A three times higher improvement than the control group on corrosion resistance was found with rare earth Sm adding (0.15 wt%). By using an electron prove micro analyzer (EPMA), focused ion beam (FIB) and scanning Kelvin probe force microscopy (SKPFM) techniques, two main mechanisms of the premium performance of the Sm adding were revealed. One was that the non-uniform nucleation and component undercooling induced by Sm adding, reduced the α-Al layer spacing thus improved the covering efficiency of the Al2O3 film. The other was that the dissolved Sm in the Zn/Al eutectic structure modulated the electron work function thus induced the attenuation of Volta potential discrepancy. The experimental results show that when the addition of Sm is 0.15 wt%, the minimum Volta potential difference between α-Al and η-Zn phases is achieved, and excessive or deficient Sm addition will increase the Volta potential difference.

European survey on valvular heart disease clinical experience from the European Society of Cardiology council on valvular heart disease.

AimsThe aim of this survey is to analyze how current recommendations on valvular heart disease (VHD) management have been adopted. Identifying potential discrepancies between recommendations and everyday clinical practice would enable us to better understand and address the remaining challenges in this controversial and complex field.Methods and resultsA total of 33 questions, distributed via email to all European Society of Cardiology (ESC) affiliated countries through the newsletter of the ESC council on VHD, were answered by 689 respondents, mainly from tertiary care settings. The results of this survey showed that VHD patients are mostly managed by tertiary care centres, where multi-disciplinary heart teams are frequently a reality. Cardiac computed tomography (CT) is often used in the preprocedural planning of transcatheter interventions, particularly for sizing and deliverability assessment. Echocardiography represents the most widely used imaging modality in the diagnostic, intra-operative and follow-up phase of VHD patients. Cardiac magnetic resonance (CMR) is still largely underused, also for conditions such as mitral annular disjunction, or for the assessment of left ventricle volumes where it is considered as the gold standard, despite 3D volumes by echocardiography having proved good comparability with CMR. As for endocarditis, despite still underused, transesophageal echocardiography (TEE) represents the approach of choice for the diagnosis of native and prosthesis valve endocarditis (up to 46% of the respondents use it). In this context, positron emission tomography-CT is largely underused.ConclusionThere is widespread adoption of current recommendation on the evaluation of VHD and these are frequently used to guide patient management. Nonetheless, there are still many discrepancies across centres and countries which need to be addressed with the aim of improving patients’ management and outcomes and ultimately positively impacting on healthcare resources.

Mentoring is in the ‘I’ of the beholder: supporting mentors in reflecting on their actual and preferred way of mentoring

BackgroundAn important strategy to support the professional development of mentors in health professions education is to encourage critical reflection on what they do, why they do it, and how they do it. Not only the ‘how’ of mentoring should be covered, but also the implicit knowledge and beliefs fundamental to the mentoring practice (a mentor’s personal interpretative framework). This study analyzed the extent to which mentors perceive a difference between how they actually mentor and how they prefer to mentor.MethodsThe MERIT (MEntor Reflection InstrumenT) survey (distributed in 2020, N = 228), was used to ask mentors about the how, what, and why of their mentoring in two response modes: (1) regarding their actual mentoring practice and (2) regarding their preferred mentoring practice. With an analysis of covariance, it was explored whether potential discrepancies between these responses were influenced by experience, profession of the mentor, and curriculum-bound assessment requirements.ResultsThe averaged total MERIT score and averaged scores for the subscales ‘Supporting Personal Development’ and ‘Monitoring Performance’ were significantly higher for preferred than for actual mentoring. In addition, mentors’ experience interacted significantly with these scores, such that the difference between actual and preferred scores became smaller with more years of experience.ConclusionsMentors can reflect on their actual and preferred approach to mentoring. This analysis and the potential discrepancy between actual and preferred mentoring can serve as input for individual professional development trajectories.

Contributions of Caregiver Management Styles to the Discrepancy Between Reported and Observed Task Performance in People with Dementia.

The identification and understanding of the discrepancy between caregivers' reports of people with dementia's (PwD) performance of activities of daily living (ADLs) and observed performance, could clarify what kind of support a PwD effectively needs when completing tasks. Strategies used by caregivers have not been included in the investigation of this discrepancy. To (1) investigate if caregivers' report of PwD's ADL performance are consistent with PwD's observed performance; (2) explore if caregiver management styles, depression, and anxiety, contribute to this discrepancy. PwD (n = 64) were assessed with standardized performance-based (Assessment of Motor and Process Skills, AMPS) and informant-based (Disability Assessment for Dementia, DAD) ADL assessments. Caregivers completed depression (PHQ-9), anxiety (GAD-7), and dementia management style (DMSS: criticism, active-management, and encouragement) questionnaires. Cohen's kappa determined agreement/disagreement in ADL performance. To investigate the potential discrepancy between the DAD and AMPS, a continuous variable was generated: comparative ADL score. Multiple linear regression analysis explored whether caregivers' management styles, depression or anxiety could explain the ADL discrepancy. Poor level of agreement between observed and reported ADL performance [k = -0.025 (95% CI -0.123 -0.073)] was identified, with most caregivers underestimating ADL performance. The combined model explained 18% (R2 = 0.18, F(5,55) = 2.52, p≤0.05) of the variance of the comparative ADL score. Active-management (β= -0.037, t(60) = -3.363, p = 0.001) and encouragement (β= 0.025, t(60) = 2.018, p = 0.05) styles made the largest and statistically significant contribution to the model. Encouragement style could be advised for caregivers who underestimate ADL performance, while active management style for those who overestimate it. Findings have scope to increase caregivers' abilities to support PwD activity engagement in daily life.

Improvement in the Capacity for Activity Versus Improvement in Performance of Activity in Daily Life During Outpatient Rehabilitation.

Background and Purpose: We addressed questions about the potential discrepancy between improvements in activity capacity and improvements in activity performance in daily life. We asked whether this discrepancy is: Common in routine, outpatient care, or an artifact of intervention studies?Unique to upper limb (UL) rehabilitation, or is it seen in walking rehabilitation too?Only seen in persons with stroke, or a broader neurorehabilitation problem? Methods: A longitudinal, observational cohort of 156 participants with stroke or Parkinson disease (PD) receiving outpatient rehabilitation at 5 clinics was assessed around admission and monthly during their episode of care. Individual, longitudinal capacity (Action Research Arm Test or walking speed) and performance (wearable sensor measurements of use ratio or steps/day) data were modeled to extract predicted change scores. Simulation methods were used to determine whether an individual's change was greater than 1 standard error. Participants were classified into categories based on whether or not they improved in capacity (C+ or C−) and/or performance (P+ or P−). Results: A majority (59%) were classified as C+P−. Smaller portions of the sample were classified as C+P+ (20%) and C−P− (21%), with 1 participant (&lt;1%) classified as C−P+. The proportions in the C+P− category were significantly larger in the stroke (χ2 = 48.7, P &lt; 0.0001) and PD (χ2 = 24.3, P &lt; 0.0001) walking subgroups than in the stroke UL subgroup. Discussion and Conclusions: The discrepancy between improvements in capacity and performance is a problem in routine, outpatient neurorehabilitation. If performance information were available, patients and clinicians could act to address it. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A396).

Fault-Tolerant Control of Variable Speed Limits for Freeway Work Zone With Recurrent Sensor Faults

Congestion associated with freeway work zones can adversely affect mobility, safety, and sustainability. Variable speed limits (VSL) control has been widely studied to mitigate the congestion caused by lane closures at work zones. However, most VSL controllers are designed without consideration of traffic sensor faults, especially recurrent sensor faults (RSFs) that commonly exist in freeway transportation systems. Therefore, this study proposes an interacting multiple model approach with a pseudo-model set (IMMP) to achieve VSL control with fault tolerance to different types of RSFs. With the design of a traffic flow model, an adaptive model set is developed using likelihood estimation to reduce the associated computational complexity. To ensure reliable RSF diagnosis, state covariance adaption is proposed to compensate for potential discrepancies caused by improper model parameters. A pseudo-mode set is designed to provide accurate traffic state estimations for VSL control without the prerequisite of a good match between the model parameters and the extent of corresponding sensor failures. The proposed system is evaluated under a realistic work zone environment using the traffic simulator SUMO. The results demonstrate that the system can achieve reliable RSF diagnosis and consistent improvements in mobility, safety, and sustainability near a freeway work zone area despite RSFs.

Corticosteroid Suppression in Patients Receiving Inhaled Glucocorticoids: Time to Reassess Risk?

It is estimated that 350 million people worldwide are affected by asthma (1) and, as such, any associated complications of treatment have the potential for a significant impact on global public health. The recent study by Kachroo et al in Nature Medicine is a valuable addition to the literature in relation to adrenal suppression in patients receiving inhaled glucocorticoid (GC) therapy. The authors applied corticosteroid metabolomic profiling to address the question of adrenal suppression using several different large datasets and methodologies. They identified significant suppression in serum corticosteroids (and their precursors/metabolites) associated with adrenocorticotropin (ACTH)-dependent steroidogenesis in participants with asthma compared with controls and assessed the association with inhaled corticosteroid (ICS) exposure (2). Tertiary adrenal insufficiency (TAI) occurs due to suppression of the hypothalamic–pituitary–adrenal (HPA) axis by exogenous GC exposure and is reported in association with all GC preparations (3). As both oral and inhaled GC therapy form an important component of asthma management (1), patients with asthma are undoubtedly at risk of TAI. However, the prevalence and potential consequences of TAI in this cohort remain uncertain due to the many challenges in determining the full impact of GC exposure on adrenal function in asthma, which include the wide spectrum of cumulative GC exposure between patients, differences in potency between various ICS preparations, and the potential discrepancy between the prescribed ICS dose and the dose received by the patient because of suboptimal adherence to ICS medication and incorrect inhaler technique (4).

Parental Self-Efficacy and Intra- and Extra-Familial Relationships

Relationships are at the heart of well-being. Parental self-efficacy emerges as a powerful construct for understanding parenting and parent–child relationships. However, person-centered approaches that allow identification of different family-specific configurations of mothers’ and fathers’ parental self-efficacy and potential within-family discrepancies remain scarce. Families are more than the sums of their parts, and holistic approaches are needed to deepen our understanding of potential family-level accumulation of relationship well-being and vulnerability. A latent profile analysis of 249 families of preadolescents identified four family profiles of parental self-efficacy: (1) low–low, (2) low–average, (3) high–average, and (4) high–high (a mother’s–a father’s parental self-efficacy within the family). We further applied the Mplus auxiliary function to explore what characterizes mothers’, fathers’, and their preadolescents’ intra- and extra-familial relationships within these profiles. Belonging to the balanced low parental self-efficacy family profile was associated with intra- and extra-familial relationship vulnerability: mothers, fathers, and preadolescents reported the highest social and emotional loneliness, parents perceived their family communication as less open, and preadolescents were evaluated as the least prosocial (in parent, teacher, and peer evaluations) and as the most antisocial (in parent evaluations). Mothers’, fathers’, and preadolescents’ intra- and extra-familial relationship well-being was the strongest in high parental self-efficacy family profiles. Promoting parental self-efficacy can be a promising way to enhance all family members’ relationship well-being. Moreover, as loneliness experiences accumulated in the balanced low parental self-efficacy family profile, efforts to tackle preadolescents’ loneliness should acknowledge the well-being of all family members.

Analyzing differences between parent- and self-report measures with a latent space approach

We explore potential cross-informant discrepancies between child- and parent-report measures with an example of the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR), parent- and self-report measures on children’s behavioral and emotional problems. We propose a new way of examining the parent- and child-report differences with an interaction map estimated using a Latent Space Item Response Model (LSIRM). The interaction map enables the investigation of the dependency between items, between respondents, and between items and respondents, which is not possible with the conventional approach. The LSIRM captures the differential positions of items and respondents in the latent spaces for CBCL and YSR and identifies the relationships between each respondent and item according to their dependent structures. The results suggest that the analysis of item response in the latent space using the LSIRM is beneficial in uncovering the differential structures embedded in the response data obtained from different perspectives in children and their parents. This study also argues that the differential hidden structures of children and parents’ responses should be taken together to evaluate children’s behavioral problems.