Previous Experience Research Articles

Capacity and crisis: examining the state-level policy response to COVID-19 in Tamil Nadu, India.

The capacity of government agencies to develop effective policy responses to external shocks is an important area of focus for health policy processes, as illustrated by the COVID-19 pandemic. However, few empirical studies exploring sub-national capacity of governments and the influence of institutional, organizational and political factors in shaping the policy response to complex emergencies have been conducted. The purpose of this study is to examine the governance capacity to develop and implement a policy response to a major health emergency-COVID-19-in Tamil Nadu, India, and to understand the factors shaping governance capacity during the first and second waves (2020-2021). Tamil Nadu offers a useful case for exploring governance capacity due to its longstanding public health institutions and previous experiences with disaster and outbreak response. We utilized three sources of data: (1) a review of key policy documents (n = 164); (2) a review of English-language media articles in the Indian press (n = 336); and (3) in-depth interviews with senior decision-makers, technical experts and other stakeholders (n = 10). We present four key findings from this analysis. First, Tamil Nadu's institutional framework enabled state-level governance capacity during an emergency of massive complexity, allowing for flexibility and nimbleness to adapt to evolving dynamics of centralization and decentralization over the course of the pandemic. Second, the ability to integrate public health expertise was circumscribed at important phases. Third, while coordination with external experts was utilized extensively, engagement with civil society groups was perceived as limited. Fourth, the electoral cycle was perceived by some to have constrained governance capacity at a critical point in the pandemic. By analysing the dynamics of state-level capacity in Tamil Nadu during a complex emergency, this study provides important learnings for other contexts globally regarding the drivers shaping capacity to develop and implement policy responses to crises.

An innovative two-level yielding knee-braced frame with deformation-controlled ring damper

Previous earthquake experiences have shown that conventional yielding dampers designed for an earthquake intensity cannot perform adequately at higher intensity levels. This paper addresses this issue by proposing a two-level yielding configuration for knee-braced steel frames having an innovative deformation-controlled ring damper (CRD). The proposed configuration includes a knee element damper (KED) and a CRD with a deformation-control device. In weak or moderate earthquakes, the CRD serves as the primary energy absorber. In contrast, in higher-intensity earthquakes, the deformation of the CRD is controlled and the KED acts as a secondary fuse for energy dissipation. In this study, four traditional ring dampers with different geometric properties and two CRD were experimentally tested and their numerical models in Abaqus were successfully verified. The results demonstrated stable and asymmetric hysteretic curves with satisfactory ductility and energy absorption of the ring dampers. Additionally, the CRD revealed a proper control of deformation. Subsequently, a previously tested knee-braced frame specimen with the common ring damper was numerically modeled. After verifying the validity of the model, the behavior of a typical knee-braced frame equipped with a deformation-controlled multi-ring damper (CRD-KBF) was investigated and compared with a common KBF and ring-braced frame (RBF). The obtained results confirmed the expected two-level yielding behavior of the proposed configuration. The numerical analyses demonstrated higher ductility and energy dissipation capacity of the CRD-KBF compared to the other frames.

COVID-19 Vaccine Preferences in General Populations in Canada, Germany, the United Kingdom, and the United States: Discrete Choice Experiment.

Despite strong evidence supporting COVID-19 vaccine efficacy and safety, a proportion of the population remains hesitant to receive immunization. Discrete choice experiments (DCEs) can help assess preferences and decision-making drivers. We aim to (1) elicit preferences for COVID-19 vaccines in Canada, Germany, the United Kingdom, and the United States; (2) understand which vaccine attributes people there value; and (3) gain insight into the choices that different population subgroups make regarding COVID-19 vaccines. Participants in the 2019nCoV-408 study were aged ≥18 years; self-reported antivaccinationists were excluded. A DCE with a series of 2 hypothetical vaccine options was embedded into a survey to determine participant treatment preferences (primary objective). Survey questions covered vaccine preference, previous COVID-19 experiences, and demographics, which were summarized using descriptive statistics to understand the study participants' backgrounds. In the DCE, participants were provided choice pairs: 1 set with and 1 without an "opt-out" option. Each participant viewed 11 unique vaccine profiles. Vaccine attributes consisted of type (messenger RNA or protein), level of protection against any or severe COVID-19, risk of side effects (common and serious), and potential coadministration of COVID-19 and influenza vaccines. Attribute level selections were included for protection and safety (degree of effectiveness and side effect risk, respectively). Participants were stratified by vaccination status (unvaccinated, or partially or fully vaccinated) and disease risk group (high-risk or non-high-risk). A conditional logit model was used to analyze DCE data to estimate preferences of vaccine attributes, with the percentage relative importance calculated to allow for its ranking. Each model was run twice to account for sets with and without the opt-out options. The mean age of participants (N=2000) was 48 (SD 18.8) years, and 51.25% (1025/2000) were male. The DCE revealed that the most important COVID-19 vaccine attributes were protection against severe COVID-19 or any severity of COVID-19 and common side effects. Protection against severe COVID-19 was the most important attribute for fully vaccinated participants, which significantly differed from the unvaccinated or partially vaccinated subgroup (relative importance 34.8% vs 30.6%; P=.049). Avoiding serious vaccine side effects was a significantly higher priority for the unvaccinated or partially versus fully vaccinated subgroup (relative importance 10.7% vs 8.2%; P=.044). Attributes with significant differences in the relative importance between the high-risk versus non-high-risk subgroups were protection against severe COVID-19 (38.2% vs 31.5%; P<.000), avoiding common vaccine side effects (12% vs 20.5%; P<.000), and avoiding serious vaccine side effects (9.7% vs 7.5%; P=.002). This DCE identified COVID-19 vaccine attributes, such as protection against severe COVID-19, that may influence preference and drive choice and can inform vaccine strategies. The high ranking of common and serious vaccine side effects suggests that, when the efficacy of 2 vaccines is comparable, safety is a key decision-making factor.

Factors affecting the growth of small and medium Enterprises in Luangnamtha Province

The purpose of this study is to study the operating conditions and factors affecting the growth of small and medium enterprises in LuangNamtha Province. which uses descriptive study methods, surveys, and questionnaires to collect data from small and medium-sized enterprise operators who have registered enterprises at the Department of Industry and Trade in LuangNamtha Province according to the law in the number of 233 business units using basic statistics such as average value and standard deviation and analyzed with an ordinary least squares regression model. The results of the study found that most of the business operators are males aged between 37-43 years old, have a high degree of specialization, and have previous experience in the service sector, which a business is owned by a single Lao person. The registered capital of the business is less 100,000,000 kip, it is a source of funds for the family, there are between 5-20 people, the duration of the business operation is less 5 years, the customer group is in the province, the business is mainly in the commercial sector, but the performance is not good compared to last year. Such as, revenue and net profit decreased. The importance of factors affecting the growth of small and medium-sized enterprises in LuangNamtha province is very important. The factors affecting the growth of enterprises include four factors that have a relationship in the same direction, such as leadership factors affecting the growth of enterprises with a statistical significance level of 0.1, strategic decision-making factors affecting the growth of enterprises with a statistical significance level of 0.05, financial factors affecting the growth and stability of enterprises with a statistical significance level of 0.01 and 0.1, respectively, and marketing factors affecting the stability of the enterprise with a statistical significance level of 0.1.

Building Resilience during Compassion Fatigue: Autoethnographic Accounts of College Students and Faculty

Compassion fatigue (CF) is a well-researched topic in the fields of mental health and nursing. However, studies on CF in the fields of primary, secondary, and higher education are very recent and scant. Compassion fatigue (CF) can be defined as the empathic strain or general exhaustion experienced by helping professionals such as psychotherapists, nurses, social workers, healthcare workers, family caregivers, and elderly caregivers. In this paper, utilizing the Double ABC-X Stress Model, we explored the antecedents, experiences, and consequences of compassion fatigue among college students and professionals who have previous personal experiences with stress and trauma, work with children and families, and work in higher education to prepare professionals to work in such fields. This study uses an autoethnographic approach, where the five authors of the study were also the participants. Utilizing the lifespan and ecological perspectives, we examined the symptoms preceding compassion fatigue and preventative strategies, as well as risk factors and protective factors. This study covers a breadth of compassion fatigue, from predisposition to onset and recovery, and considers alternative strategies for coping, including creating meaning from difficult experiences.

Factors influencing nursing students' willingness to volunteer during wartime emergencies: A cross sectional study in Israel

BackgroundDuring wartime emergencies, the Ministry of Health in Israel faces workforce shortages, prompting consideration of nursing students as auxiliary support. Understanding the factors influencing nursing students' willingness to volunteer, is essential for effective crisis preparedness. AimThe research seeks to identify how self-efficacy, positive attitudes, institutional support, knowledge, age, gender, prior experience, and familial obligations impact nursing students' readiness to volunteer during mass casualty events in wartime. DesignThis study employed a descriptive, cross-sectional research approach. SettingsNursing schools in Israel. ParticipantsA convenience sample of 300 nursing students who had commenced their studies for at least one month. The study targeted nursing students across Israel, regardless of their specific school affiliation. Recruitment was conducted through various channels, including face-to-face recruitment, emails, and synchronous chat groups. MethodsData were collected using a structured self-report questionnaire based on Bandura's self-efficacy theory and adapted from existing literature. Statistical analyses, included t-tests, Pearson correlation, and linear rand logistic regressions. ResultsThe study found high levels of intent (M = 3.33, SD = 0.83), perceived self-efficacy (M = 3.25, SD = 0.54), and positive attitudes towards volunteering during wartime (M = 3.57, SD = 0.54) among nursing students towards volunteering during wartime. Significant correlations were observed between students' willingness to volunteer during wartime and factors such as positive attitudes to volunteer during wartime (r = 0.543, p < 0.01), perceived self-efficacy (r = 0.313, p < 0.01), institutional support (r = 0.313, p < 0.01), knowledge (r = 0.138, p < 0.05), age (r = 0.179, p < 0.01), and previous volunteering experience (r = 0.158, p < 0.01). Regression analyses indicated that positive attitudes towards wartime volunteering, perceived self-efficacy, institutional support, and prior volunteering were significant predictors of the intention to volunteer. ConclusionsNursing students in Israel demonstrate a high willingness to volunteer during wartime, influenced by factors such as perceived self-efficacy, positive attitudes towards volunteering, and institutional support. While these findings suggest potential areas for enhancing volunteerism, further research is needed to assess the effectiveness of targeted training and support interventions. Nonetheless, fostering these key factors could strengthen the healthcare system's capacity to respond to wartime emergencies.

Rotator cuff-related shoulder pain (RCRSP): semistructured patient interviews to explore the barriers and enablers to rehabilitation exercises

This study aimed to explore the barriers and enablers to physiotherapist-prescribed rehabilitation exercises for people with rotator cuff-related shoulder pain (RCRSP) and to guide the development of a theoretically informed...

Knowledge and perception of a clinical trial among the participants: An experience from oral cholera vaccine study in Koshi Province, Nepal

ABSTRACT Clinical trials (CT) have been the cornerstones in developing medicines, vaccines, and new interventions. Despite tremendous efforts, a CT cannot succeed without participants’ involvement. Various factors can affect people’s attitude and participation in a CT. Hence, this study was conducted to assess the knowledge and perception of a clinical trial among the participants of a CT at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. This was a population-based descriptive cross-sectional study conducted during 2021–2022. Participants involved in a phase III clinical trial were enrolled, and an in-depth interview was conducted using a semi-structured questionnaire. Demographic information, knowledge and perception about CT were assessed, and a descriptive analysis was done. Among 622 participants, the majority were males (321; 51.6%), literate (587; 94.37%), of indigenous ethnic groups (Janajatis 61.4%), and without previous experience of CT (504; 81.1%). The majority had adequate knowledge (566/622; 91%) and positive perception (595/622; 95.7%) of CT. Most participants (467; 75.1%) had participated in CT to get protection from the particular disease from the provided vaccine and (603; 96.9%) believed CT to benefit mankind. Further studies comparing pre- and post-participation knowledge and perception might be helpful for planning and better management of CTs in such settings.

Gender differences in preferences for mental health apps in the general population – a choice-based conjoint analysis from Germany

BackgroundMen and women differ in the mental health issues they typically face. This study aims to describe gender differences in preferences for mental health treatment options and specifically tries to identify participants who prefer AI-based therapy over traditional face-to-face therapy.MethodA nationally representative sample of 2,108 participants (53% female) aged 18 to 74 years completed a choice-based conjoint analysis (CBCA). Within the CBCA, participants evaluated twenty choice sets, each describing three treatment variants in terms of provider, content, costs, and waiting time.ResultsCosts (relative importance [RI] = 55%) emerged as the most critical factor when choosing between treatment options, followed by provider (RI = 31%), content (RI = 10%), and waiting time (RI = 4%). Small yet statistically significant differences were observed between women and men. Women placed greater importance on the provider, while men placed greater importance on cost and waiting time. Age and previous experience with psychotherapy and with mental health apps were systematically related to individual preferences but did not alter gender effects. Only a minority (approximately 8%) of participants preferred AI-based treatment to traditional therapy.ConclusionsOverall, affordable mental health treatments performed by human therapists are consistently favored by both men and women. AI-driven mental health apps should align with user preferences to address psychologist shortages. However, it is uncertain whether they alone can meet the rising demand, highlighting the need for alternative solutions.

Antecedents of Customer Participation on Sharing Platforms: A Meta‐analysis

AbstractGiven the substantive influence of the digital revolution on the sharing economy, it is timely and relevant to ask why some sharing platforms (e.g. Airbnb and Uber) achieve significant success while others fail. To determine which factors encourage customers to participate in sharing goods and services on sharing platforms, and when they do so, this study conducts a meta‐analysis of empirical findings from 192 independent samples, extracted from 167 studies involving 171,344 customers. As the results clarify, customer‐related factors (customer motives, customer competence, customer satisfaction and subjective norms) are key antecedents. However, platform‐related factors (service quality of the platform, trust in the platform, performance expectancy and effort expectancy) and service‐provider‐related factors (service quality of the provider, trust in the provider and provider gender) also exert meaningful effects. To assess the generalizability of these antecedents, the meta‐analysis includes contextual moderators, namely customer type (previous provider experience), provider type (private/professional supply), platform characteristics (rivalry on the platform, prestige of ownership and services/goods) and exchange type (for‐profit/non‐profit and ownership transfer). The findings advance the literature on the sharing economy and provide specific guidance for platform managers about when to focus on certain antecedents.

Exploring a learning model for knowledge integration and the development of critical thinking among nursing students with previous learning: a qualitative study protocol

Students often struggle to apply their knowledge of bioscience to their care practice. Such knowledge is generally learned through remembering and understanding, but retention quickly fades. They also experience difficulty progressing to higher-order cognitive skills such as applying, analyzing, evaluating, and even creating, which are necessary to develop soft skills, such as critical thinking, in the care profession. In order to improve existing programs, there is a need to better understand students' prior learning experiences and processes. The proposed study will explore the previous learning experiences of nurses enrolled in a two-year nursing program at a Taiwan university and identify the challenges they face in integrating multidisciplinary knowledge and developing critical thinking competency. The study will adopt a constructivist grounded theory methodology to collect interview data. The findings are expected to improve higher cognitive learning performance and inform the revision of the two-year nursing curriculum.

High-risk pregnancy and risk of breastfeeding failure

BackgroundThere is growing evidence that supports the role of breastfeeding in reducing the burden of non-communicable diseases (NCDs). There are considerable gaps in breastfeeding outcomes in mothers with chronic diseases due to a lack of knowledge and support in the postpartum period. Mothers who have NCDs and pregnancy complications are at risk of breastfeeding failure.AimTo compare breastfeeding outcomes in mothers with NCDs with healthy mothers and determine the underlying challenges that lead to poor outcomes.MethodsA prospective cohort study was conducted among 150 women (50 with high-risk pregnancies (HRP) and 100 with normal pregnancies (NP)). They were recruited from those attending the immunization and outpatient clinics at Sohag General Hospital. Mothers were recruited at 34 weeks gestation and were followed up at 2 weeks, 6 weeks, and 6 months after delivery. A pretested and validated questionnaire was used to collect detailed epidemiological, personal, health-related status, medications, hospitalizations, reproductive history, current delivery, and previous breastfeeding experiences. On follow-up they were assessed for breastfeeding practices, their health and health and growth of their children, and social support.ResultsDelivery by cesarean section and postpartum bleeding were commoner among HRP patients. Initiation of breastfeeding in the 1st hour of delivery was significantly lower among women with HRP than those with normal pregnancies (48.0% versus 71.0%, p = 0.006). The most common reason for not initiating breastfeeding among the NP group was insufficient milk (34.5%), while in the HRP group, it was the mother’s illness (80.8%). Skin-to-skin contact with the baby after birth was significantly less practiced in the HRP than in the NP group (38.0% vs 64.0% at p = 0.003). Herbs (such as cumin, caraway, cinnamon, aniseed, and chamomile) were the most common pre-lacteal feeds offered (63.0% in NP vs 42.0% in HRP). Artificial milk was more used in HRP than NP (24.0% vs 4.0%). Breast engorgement was 3 times more common in the HRP compared to the NP group (61.5% vs19.6%). Stopping breastfeeding due to breast problems was 2.5 times higher in the HRP than in the NP group (38.5% vs. 15.2%, p = 0.003). Nipple fissures were twice as common among the NP than among the HRP group ((73.0%) vs. (38.5%), p = 0.026). Exclusive breastfeeding during the period of follow-up was lower in the HRP than in the NP group (40.0% vs 61.0%, p < 0.05) and formula feeding was twice as common in the HRP as in the NP group (34.0% vs. 18.0%, p = 0.015). Child illness was significantly higher among women with HRP than those with NP (66.0% vs 48.0%, p = 0.037).ConclusionsWomen with HRP are at a high risk of poor breastfeeding outcomes with increased lactation problems and formula feeding rates. Encouraging women especially those with HRP to achieve optimal breastfeeding practices is a simple intervention that can be included in daily practice and may have a positive impact on mothers’ health.

The effect of environmental stressors perceived by surgical intensive care unit patients on hopelessness level

The aim of the research was to determine the effects of environmental stressors perceived by patients hospitalized in the surgical intensive care unit on hopelessness level. This descriptive research was performed between September 2023 and February 2024. The population of the study included all adult patients hospitalized in the Surgical Intensive Care Clinic of a City Hospital in Eastern Türkiye. The sample of the study includes 230 patients selected by random sampling method from this population. We used Personal Information Form, Intensive Care Unit Environmental Stressors Scale (ICUESS) and Beck Hopelessness Scale (BHS) to collect the data. Descriptive statistics, t-test, ANOVA, and correlation analysis tests were used to evaluate the data. The ICUESS mean score of the patients participated in the study was found to be at a high level with 102.13±15.95. Beck hopelessness scale score mean was found to be at a mild level with 6.36±5.78. It was found that the patients' gender, age, educational status, chronic disease status and previous intensive care experience affected the level of hopelessness. The relationship between ICUESS and BHS scores of the patients included in the study was examined and it was found that there was a low level of positive significant relationship between them (r: 0.162, p: 0.014). The hopelessness level of patients in surgical intensive care units was found to increase as the level of exposure to environmental stressors increased. It may be recommended to identify environmental stressors affecting the hopelessness level of patients and to implement interventions to reduce them.

Experiences of clinical nurses with medication interruption: A systematic review and qualitative meta-synthesis.

Managing medication interruptions is considered one of the biggest dilemmas for nurses in clinical settings. To improve medication safety, it was imperative to conduct a systematic review to get a deeper understanding of nurses' experiences with medication interruptions. A systematic review and qualitative meta-synthesis aimed to explore clinical nurses' experiences of interruption during medication in hospitals. Systematic searches were conducted in PubMed, CINAHL, Ovid Medline, Embase, Web of Science, and The Cochrane Library from inception to January 2024. The search strategy included four groups of keywords: (1) qualitative research, (2) nurses, (3) medication interruption, and (4) experience. Critical Appraisal Skills Programme was used to assess the quality of the studies. Meta-ethnography was utilized to synthesize the findings of the included studies. Nine articles published between 2012 and 2023 were included; the number of participants varied from 5 to 40, aged 20-68 years, and the majority were female. Four synthesized findings were identified as follows: (1) an inevitable part of the routine, (2) a decision-making process, (3) working in a minefield, and (4) coping with interruption. Nurses embraced interruptions as an inherent component of clinical care. Previous experience and nursing culture, encompassing personal and professional aspects, significantly influence nurses' attitudes toward medication interruptions. It is crucial to incorporate the distinctive work experiences of nurses into techniques aimed at efficiently handling interruptions in future research. The registration number in PROSPERO is CRD42023470276.

The Low-Income and Middle-Income Countries' Perspective on Global Neurosurgery Collaborations.

Access to neurosurgical care is limited in low-income and middle-income countries (LMICs) and in marginalized communities in high-income countries (HICs). International partnerships represent one possible means of addressing this issue. Insights from surgeons in HICs have been explored, but data from LMICs' counterparts are scarce. We aimed to study the perspectives of neurosurgeons and trainees from LMICs regarding global neurosurgery (GN) collaborations and interests, motivators, and challenges in participating. An online survey was conducted targeting neurosurgeons and trainees from LMICs. The survey explored demographics, previous experiences, ongoing activities, interests, and barriers related to GN activities. Data were collected between July 2022 and December 2022 and analyzed. Responses involved 436 individuals. The most represented region (25%) was sub-Saharan Africa, and most respondents were male (87.8%) aged 35-49 years. Interest in GN was high, with 91% after its developments. Most respondents (96.1%) expressed interest in training, professional, or research experience in HICs, but only 18.1% could cover the expenses. A majority (73.2%) strongly agreed to return to their home country for work after HIC training. Ongoing HIC-LMIC partnerships were reported by 27.8% of respondents. Clinical exposure emerged as the most relevant motivating factor (87%), while financial concerns, lack of opportunities, and lack of program support were identified as important barriers. Funding and dedicated time were highlighted as the most crucial facilitators. Understanding the perspectives of neurosurgeons and trainees from LMICs is essential to expanding HICs-LMICs collaborations and improving access to neurosurgical care worldwide. Financial support and targeted interventions are needed to address barriers and promote equitable partnerships in GN.

Changes in Trait Mindfulness after a Brief Mindfulness Training Program of Self-Breathing.

Developing and cultivating mindfulness exerts a positive effect on psychological and cognitive performance. Sharpening the skill requires continuous mindfulness-based training (MT), which can be challenging for people leading busy lives. Therefore, the current study examined whether trait mindfulness can be improved by a flexible and brief MT program of self-breathing using a pre-post intervention design. Trait mindfulness was assessed using the Japanese version of the Five Facet Mindfulness Questionnaire (FFMQ) before the intervention (pre), after 2 weeks (during), and 4 weeks after the intervention started (post). Data were analyzed using the Friedman test followed by the Dunn-Bonferroni correction. The study sample consisted of 22 healthy participants aged from 20 to 60 years with no previous experience with yoga or meditation equivalent to MT. The mean number of days of MT practice was 26.4, and 11 participants had interruptions. The median values of pre-, during-, and post-total FFMQ scores were 115.5, 123, and 129, respectively. Significant differences were observed in the total pre and post (p < 0.001) and during and post (p = 0.002) FFMQ scores, though a medium effect was found (r = 0.30) only between the pre and post scores. Of the five sub-scales of FFMQ, significant differences were observed only between pre and post Observing (p = 0.01), Nonreactivity (p < 0.001), and Describing (p = 0.01), and during and post Nonjudging (p = 0.016), and Nonreactivity (p = 0.025). Our findings suggest that the simple, brief, and flexible self-breathing method employed in this study has a substantial effect on fostering trait mindfulness and, therefore, can be adopted by people with hectic daily schedules.

Admissions pathways and international undergraduates’ academic achievement

ABSTRACT Background There are a number of pathways available for international students to gain admission into universities in English-speaking countries. While many international students for whom English is not their first language succeed academically, there is concern that some do not cope with the demands of university which can affect their retention and academic success. This study considers the effects of different admissions pathways on international undergraduate students’ academic success in one New Zealand university. Purpose Findings from the first phase of this research revealed that international students who entered university with the National Certificate of Educational Achievement (NCEA) gained at high school in New Zealand performed significantly worse academically than their peers who entered through three other admissions pathways. This study aimed to ascertain whether there were salient features of students’ prior education and undergraduate experiences which contributed to this outcome. Method In-depth interviews were conducted with nine students who entered a university in New Zealand via two admissions pathways: NCEA or the International English Language Testing System (IELTS). The data generated through these interviews was analysed to enable qualitative comparisons between the two groups. Findings Results suggest that the IELTS group outperformed their NCEA peers due to maturity and prior education in their home countries. While the NCEA students had spent some years at high school in the host country, they did not, in general, demonstrate the same level of academic literacy as their IELTS peers. Conclusion International students’ outcomes appear to differ due to previous educational experiences. Students who enter via NCEA are potentially more likely to need support, as they may still be dealing with language proficiency issues, whereas those who enter via IELTS with prior higher-level education in their home country may be more academically prepared. It is important that institutions promote learning support opportunities for all international students, to ensure they experience a positive social and learning experience, which can ultimately contribute to their retention in learning, and their academic success.

Implementation and analysis of clinically-relevant anatomy imaging for first-year dental students.

Radiographic imaging interpretation is a central competency of the dental profession. Previous research has determined that radiographic interpretations vary across dentists. In addition, the efficacy of empirical learning within the realm of medical imaging analysis remains understudied. This project aimed to improve an existing anatomy curriculum as well as students' radiographic interpretation skills via implementation of medical radiographic case studies with scaffolded exercises. Three medical imaging activities were developed by the authors and presented in the anatomy laboratory for 60 first-year dental students. Each module included identical pre-activity and post-activity questionnaires, radiographic images with corresponding lesson plans, and open-response questions on the activity's valuable and challenging components. Pre-activity and post-activity questionnaire scores were compared via a Wilcoxon signed rank test. Kruskal-Wallis tests were conducted to determine the impact of previous anatomy experience and previous medical imaging experience on student performance. Thematic analysis was applied to open response comments. A statistically significant improvement in questionnaire scores was observed in the first medical imaging activity. No significant change in scores was observed for the other two activities. Students valued the activities' interactive structure, review of course material, and application to the dental profession. Students reported challenges in radiographic image interpretation and lack of previous knowledge on course concepts. While medical imaging activities failed to consistently improve student-learning outcomes, they introduced skill development in radiographic analysis and increased student confidence. These findings suggest a need for additional research on experiential methodologies within medical imaging education.

Discovery and Characterization of Brigimadlin, a Novel and Highly Potent MDM2-p53 Antagonist Suitable for Intermittent Dose Schedules.

p53 is known as the guardian of the genome and is one of the most important tumor-suppressors. It is inactivated in most tumors, either via tumor protein p53 (TP53) gene mutation or copy number amplification of key negative regulators, e.g., mouse double minute 2 (MDM2). Compounds that bind to the MDM2 protein and disrupt its interaction with p53 restore p53 tumor suppressor activity, thereby promoting cell cycle arrest and apoptosis. Previous clinical experience with MDM2-p53 protein-protein interaction antagonists (MDM2-p53 antagonists) have demonstrated that thrombocytopenia and neutropenia represent on-target dose-limiting toxicities that might restrict their therapeutic utility. Dosing less frequently, while maintaining efficacious exposure, represents an approach to mitigate toxicity and improve the therapeutic window of MDM2-p53 antagonists. However, to achieve this, a molecule possessing excellent potency and ideal pharmacokinetic properties is required. Here, we present the discovery and characterization of brigimadlin (BI 907828), a novel, investigational spiro-oxindole MDM2-p53 antagonist. Brigimadlin exhibited high bioavailability and exposure, as well as dose-linear pharmacokinetics in preclinical models. Brigimadlin treatment restored p53 activity and led to apoptosis induction in preclinical models of TP53 wild-type, MDM2-amplified cancer. Oral administration of brigimadlin in an intermittent dosing schedule induced potent tumor growth inhibition in several TP53 wild-type, MDM2-amplified xenograft models. Exploratory clinical pharmacokinetic studies (NCT03449381) showed high systemic exposure and a long plasma elimination half-life in cancer patients who received oral brigimadlin. These findings support the continued clinical evaluation of brigimadlin in patients with MDM2-amplified cancers, such as dedifferentiated liposarcoma.

Sperm depletion and mate choice of the crab spider, Ebrechtella tricuspidata (Fahricius)

Abstract Mounting evidence suggests that male sperm may be gradually depleted after consecutive matings, resulting in the decline of female reproductive output in insect species. It is predicted that females may employ adaptive strategies to avoid the sperm-depleted males, such as mating multiply with different males and/or discriminating against previously mated males (MMs). Similarly, males may exhibit adaptive behaviors toward females varying in mating status. However, in spiders with males lacking primary copulatory organs and their pedipalps modified to transfer sperm, there are few studies on male mating potential and previous mating experience on their subsequent mate choice. In this study, we used a polyandrous crab spider, Ebrechtella tricuspidata, a sit-and-wait predator with female-biased sex ratio as a model system to ascertain whether 1) male mating experiences influence female reproductive fitness; 2) females respond differently to males varying in mating status; and 3) males respond differently to females varying in mating status. Our results showed that female fecundity was independent of male mating experiences, but female fertility markedly declined with the increase of male previous mating experiences in the first eggsac. Counter to our predictions, females preferred to choose and mate with the larger males, regardless of their mating status. In contrast, male mating status influenced their mating preference toward females. Virgin males did not show any preference between virgin and mated females; however, MMs were more likely to prefer the virgin females over the mated ones. Overall, our results indicated that female choice depended primarily on male relative size rather than male mating status, whereas male choice depended on female mating status. Depending on the investigation of reproductive dynamics and mate choice in E. tricuspidata, the study will provide valuable insights into the adaptive behaviors of both males and females exhibiting toward mates varying in mating status.