Qualitative Measures Research Articles

DANTE-CAIPI Accelerated Contrast-Enhanced 3D T1: Deep learning-based image quality improvement for Vessel Wall MR.

Accelerated and blood-suppressed post-contrast 3D intracranial vessel wall MRI (IVW) enables high-resolution rapid scanning but is associated with low SNR. We hypothesized that a deep-learning (DL) denoising algorithm applied to accelerated, blood-suppressed post-contrast IVW can yield high-quality images with reduced artifacts and higher SNR in shorter scan times. Sixty-four consecutive patients underwent IVW, including conventional post-contrast 3D T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) and delay-alternating with nutation for tailored excitation (DANTE) blood-suppressed and CAIPIRINHIA-accelerated (CAIPI) 3D T1-weighted TSE post-contrast sequences (DANTE-CAIPI-SPACE). DANTE-CAIPI-SPACE acquisitions were then denoised using an unrolled deep convolutional network (DANTECAIPI-SPACE+DL). SPACE, DANTE-CAIPI-SPACE, and DANTE-CAIPI-SPACE+DL images were compared for overall image quality, SNR, severity of artifacts, arterial and venous suppression, and lesion assessment using 4-point or 5-point Likert scales. Quantitative evaluation of SNR and contrast-to-noise ratio (CNR) was performed. DANTE-CAIPI-SPACE+DL showed significantly reduced arterial (1 [1-1.75] vs. 3 [3-4], p<0.001) and venous flow artifacts (1 [1-2] vs. 3 [3-4], p<0.001) compared to SPACE. There was no significant difference between DANTE-CAIPI-SPACE+DL and SPACE in terms of image quality, SNR, artifact ratings and lesion assessment. For SNR ratings, DANTE-CAIPI-SPACE+DL was significantly better compared to DANTE-CAIPI-SPACE (2 [1-2], vs. 3 [2-3], p<0.001). No statistically significant differences were found between DANTECAIPI-SPACE and DANTE-CAIPI-SPACE+DL for image quality, artifact, arterial blood and venous blood flow artifacts, and lesion assessment. Quantitative vessel wall SNR and CNR median values were significantly higher for DANTE-CAIPI-SPACE+DL (SNR: 9.71, CNR: 4.24) compared to DANTE-CAIPI-SPACE (SNR: 5.50, CNR: 2.64), (p<0.001 for each), but there was no significant difference between SPACE (SNR: 10.82, CNR: 5.21) and DANTE-CAIPI-SPACE+DL. Deep-learning denoised post-contrast T1-weighted DANTE-CAIPI-SPACE accelerated and blood-suppressed IVW showed improved flow suppression with a shorter scan time and equivalent qualitative and quantitative SNR measures relative to conventional post-contrast IVW. It also improved SNR metrics relative to post-contrast DANTE-CAIPI-SPACE IVW. Implementing deep-learning denoised DANTE-CAIPI-SPACE IVW has the potential to shorten protocol time while maintaining or improving the image quality of IVW. DL=deep learning; IVW=Intracranial vessel wall MRI; SPACE=sampling perfection with application-optimized contrasts by using different flip angle evolution; DANTE=delay-alternating with nutation for tailored excitation; CAIPI=controlled aliasing in parallel imaging; CNR=contrast-to-noise ratio.

Durability and Functionality of Conventional Polymeric Packaging Materials in Reusable Packaging Systems

Reusable packaging is increasingly recognised as a sustainable solution to address issues related to increasing packaging waste generation and harmful environmental impacts. The packaging sector consumes a significant portion of Europe’s plastic production, which is mostly single-use packaging. There is a sense of urgency to develop sustainable reusable alternatives. Unlike single-use packaging, the longevity of reusable plastic packaging is paramount, necessitating material durability and functionality. This study examines the durability of conventional polymeric packaging materials (polyethylene terephthalate (PET), polypropylene, high-density polyethylene) and investigates the effectiveness of scratch resistance additives. A specialised test set-up was created to evaluate the performance of various polymers in reusable takeaway food packaging scenarios. The research included scratch testing, wear analysis and wash cycles to assess the reuse potential of these materials. Qualitative measures were employed to compare material characteristics. Results indicated that polymer type significantly affects hardness and scratch performance, while additives had minimal impact on hardness and modulus. Although current scratch resistance additives do not effectively mitigate wear in reusable packaging in the experimental scenarios, tailored additives could present potential in increasing the durability and longevity of reusable packaging. PET demonstrated notable recovery post-washing, suggesting that washing conditions could influence material resilience. This study emphasises the need for further research to optimise scratch resistance additives and understand the impact of washing conditions on different polymers, aiming to enhance the design and longevity of reusable packaging systems.

A multidisciplinary group-based survivorship intervention for those living with multiple myeloma: a feasibility study

BackgroundWhile multiple myeloma continues to be an incurable cancer, advances in its understanding and management have led to significantly improved survival rates. Survivorship interventions for those living with multiple myeloma remain scarce, despite mounting evidence for multiple unmet support needs among multiple myeloma survivors. The current study aimed to evaluate the feasibility and preliminary effectiveness of a novel multidisciplinary group-based multiple myeloma survivorship intervention.MethodsA mixed-method, repeated measures feasibility study was conducted within a routine cancer support service. Seven participants, aged over 18, who had a multiple myeloma diagnosis and were clinically assessed as suitable for the intervention by their haemato-oncologist, attended online for six weekly group sessions of physical exercise and self-management input, completing qualitative, physical and self-report measures at baseline, post-intervention and follow-up.ResultsThe intervention was deemed overall feasible, with relatively high uptake, participants describing it as largely acceptable and appropriate and providing recommendations for feasibility-enhancing intervention refinements. Findings regarding the preliminary effectiveness of the intervention were mixed. While qualitative analyses stressed the benefits of the intervention (e.g. peer support, connectedness, improved well-being) and large effect sizes were observed for most physical outcomes, no improvements in self-reported outcomes (i.e. quality of life, fatigue) were reported.ConclusionsThis study represents the first investigation of a promising novel survivorship intervention for those living with multiple myeloma, highlighting the importance of peer support in particular, on which future clinical trials, aiming to establish the intervention’s effectiveness for routine care, will be able to build.

From the Perspective of People with Dementia: Using Creative Qualitative Measures to Assess the Values and Opinions on Freedom and Safety among People Living with Dementia.

With the growing numbers of people living in old age, a system that sustains autonomy, dignity and freedom of movement for people living with dementia (PwD) needs to be installed. However, due to the cognitive constraints in the cohort of PwD, traditional qualitative methods of inquiry, such as interviews, are often not a good match. This study aimed to use creative qualitative assessment tools to assess the values and opinions of PwD in nursing homes on freedom and safety. Twenty-two nursing home residents with memory problems participated in this study. Important themes related to freedom and safety were identified using a diverse set of methodologies. Overall, residents had a similar view on 'safety', relating this to having a homely environment where people look out for you, with a good balance between busy and quiet areas and being able to retain cognitive and physical function. Values around freedom were more diverse. Residents who were still capable of logical speech generally voiced a wish for independence, making one's own decisions and wanting to go outside. For residents who no longer spoke, freedom seemed to be experienced more through the connection to other people. These results show that PwD still have distinct personal values concerning freedom and safety, which should be given due consideration in decision-making regarding nursing home policy, thereby potentially improving the quality of life of PwD.

PROPOSAL TO DEVELOP AND VALIDATE A MOODLE-BASED FLIPPED LEARNING PLATFORM FOR ENHANCING ARABIC COMMUNICATION SKILLS

This research proposes the development and validation of a Moodle-based flipped learning strategy for enhancing basic communication in Arabic among undergraduates in Nigeria, using Al-Hikmah University as a case study. Flipped learning is a model that redefines traditional classroom activities, enhances engagement, and deepens understanding. Integration with Moodle, a widely used Learning Management System (MLS), creates a structured environment for content delivery. The study involves creating Arabic language modules on Moodle, including instructional videos, multimedia, and interactive exercises. These modules support self-paced learning, enabling students to review materials before class, with in-class time dedicated to collaborative activities. Effectiveness will be assessed through quantitative and qualitative measures, including pre- and post-assessment tests, surveys, and focus group discussions. Anticipated outcomes include improved language proficiency, increased participation, and enhanced communication skills. Validating the flipped learning platform using Moodle at Al-Hikmah University will provide valuable insights into language education, particularly for enhancing Arabic communication skills. The study's novelty lies in its innovative use of flipped learning, customized application of Moodle, focus on a unique demographic, and practical approach to language acquisition. This research offers a blueprint for future implementations in diverse educational settings, promoting the broader adoption of technology-enhanced learning methods.

Super-Mentors to Train Multiple Neonatal Advanced Practice Providers: Pros and Cons.

Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor. To create and measure outcomes of a 12-month program to educate Neo APP "Super-Mentors" able to train 2 Neo APP learners simultaneously. Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach. Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1±0.37) than postprogram (4.7±0.47) ( P <.001). The most important preprogram subscale item was "vacation" versus "quality of assistive personnel" postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics. Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3-6 Months After Injury.

Fractional ablative CO2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries,which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended;however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients. Patients who received three or more laser treatment sessions and completed both pre- and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4-8-week intervals. Patients starting treatment before 6 months after injury were classified as the early-stage intervention group and those beginning treatment at 6-12 months after injury were classified as the late-stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser-assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two-way ANOVA, Student's t-test, and Mann-Whitney U-test were used to compare scores from the pre- to posttreatment evaluations. There were no significant differences between the groups for any of the demographic or scar-specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early- and middle-stage initiation showed scar symptom improvement in five out of six scales. In the late-stage intervention, the Patient and Observer Scar Assessment Scale-Patientaverage score did not show improvement. In the early-stage intervention, the Vancouver Scar Scaletotal did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in either group. The Scar Comparison Scaledemonstrated the greatest improvement across groups. Laser treatment led to scar improvement in at least one scale at each stage of initiation. Both intervention timelines resulted in equivalent outcomes, and early intervention should be considered when initiating FLSR treatment in burn scars to alleviate symptoms earlier.

Getting a Grip on Triangular Fibrocartilage Complex Tears: A Retrospective Comparative Study on Triangular Fibrocartilage Complex Debridement Outcomes

Abstract Background A retrospective analysis was performed to compare the clinical outcomes and complications of patients who underwent triangular fibrocartilage complex (TFCC) debridement based on gripping posteroanterior (PA) view ulnar variance measures. Methods Patients in Group A (N = 17) demonstrated ulnar variance measures &lt;1.0 mm on the standard PA view and ≥1.0 mm on the gripping PA view. Patients in Group B (N = 13) maintained ulnar variance measures &lt;1.0 mm on standard and gripping PA views. Clinical outcome measures included return to work, visual analog scale (VAS) scores, and range of motion. Complications included persistent pain, postoperative injections, and indication for revision surgery. Qualitative and quantitative measures were analyzed using Fisher exact tests and Student's t-tests, respectively. Results Significantly more patients in Group A (7/17) did not return to work compared with Group B (1/13) (p &lt; 0.05). Mean VAS scores decreased from 7.0 to 5.3 in Group A and from 6.8 to 2.0 in Group B. Group A reported lower flexion–extension and pronation–supination arcs compared with Group B (110 vs. 130 degrees and 161 vs. 174 degrees) (p &lt; 0.05). Significantly more patients in Group A (10/17) reported persistent pain at ≥3 months postoperatively compared with Group B (2/13) (p &lt; 0.05). Seven cases were indicated for revision surgery in Group A, while no cases were indicated in Group B (p &lt; 0.05). Conclusion Patients in Group A reported inferior clinical outcomes compared with Group B based on pain, range of motion, and indication for revision surgery. Dynamic ulnar variance may play a role in the clinical outcomes of patients treated with TFCC debridement. Level of Evidence Level IV. Type of Study/Level of Evidence Retrospective Comparative Study/Level IV.

LIMBIC-CENC: Successfully conducting longitudinal mTBI research during the COVID-19 pandemic.

Conducting mild traumatic brain injury (mTBI) longitudinal studies across multiple sites is a challenging endeavor which has been made more challenging because of COVID-19. This article briefly describes several concerns that need to be addressed during the conduct of research to account for COVID-19's impact. The recent actions and steps taken by the Long-term Impact of Military-relevant Brain Injury Consortium (LIMBIC)-Chronic Effects of Neurotrauma Consortium (CENC) researchers are reviewed. COVID-19's effects on the conduct of LIMBIC-CENC for the short-term and long-term were considered to ensure the study continued safely for participants and researchers. COVID-19 may have long-lasting health and especially neurological effects which may confound the quantitative and qualitative measures of this any comparable longitudinal studies. The recognition, understanding, and preparation of COVID-19's impact on a longitudinal military and veteran mTBI population is crucial to successfully conducting LIMBIC-CENC and similar neurological research studies. Developing a plan based on the best available information while remaining agile as new information about COVID-19 emerge, is essential. Research presented in this special issue underscores the complexity of studying long-term effects of mTBI, in a population exposed to and symptomatic from COVID-19.

Imaging the optic nerve with optical coherence tomography.

Optical coherence tomography (OCT) is a non-invasive imaging technology, which may be used to generate in vivo quantitative and qualitative measures of retinal structure. In terms of quantitative metrics, peripapillary retinal nerve fiber layer (pRNFL) thickness provides an indirect evaluation of axonal integrity within the optic nerve. Ganglion layer measures derived from macular scans indirectly reflect retinal ganglion cell status. Notably, ganglion layer indices are platform dependent and may include macular ganglion cell inner plexiform layer (mGCIPL), ganglion cell layer (GCL), and ganglion cell complex (GCC) analyses of thickness or volume. Interpreted together, pRNFL thickness and ganglion layer values can be used to diagnose optic neuropathies, monitor disease progression, and gauge response to therapeutic interventions for neuro-ophthalmic conditions. Qualitative assessments of the optic nerve head, using cross-sectional transverse axial, en face, and circular OCT imaging, may help distinguish papilledema from pseudopapilloedema, and identify outer retinal pathology. Innovations in OCT protocols and approaches including enhanced depth imaging (EDI), swept source (SS) techniques, and angiography (OCTA) may offer future insights regarding the potential pathogenesis of different optic neuropathies. Finally, recent developments in artificial intelligence (AI) utilizing OCT images may overcome longstanding challenges, which have plagued non-vision specialists who often struggle to perform reliable ophthalmoscopy. In this review, we aim to discuss the benefits and pitfalls of OCT, consider the practical applications of this technology in the assessment of optic neuropathies, and highlight scientific discoveries in the realm of optic nerve imaging that will ultimately change how neuro-ophthalmologists care for patients.

A System Dynamics Model of Organizational Resilience

AbstractResilience is the ability to avoid, withstand, and recover from adversity. In this paper, we examine organizational resilience using a case study of an organization that suffers from a series of scandals that lead to problems with its reputation as an inclusive organization, which results in difficulties in recruiting and retaining employees. We suggest some policies involving leadership efforts to change the culture in the organization and thereby restore its reputation. Based on the results of a System Dynamics Model that mixes quantitative and qualitative measures, we find that changing organizational culture is difficult. There can be inertia and long delays before the leadership sees results in improved recruiting and retention statistics.

Expediting Discharges on the Inpatient Medicine Teaching Services

Introduction: Delayed discharges can adversely affect patient flow throughout the hospital. Late afternoon discharges may lead to high hospital occupancy, admission bottlenecks, ER overcrowding, and disrupted ICU transfers. Discharge by noon (DBN) is key to enhancing hospital capacity, bed utilization, and patient satisfaction and outcomes. Last year, DBN for patients returning home with or without home care services (HHC) was chosen as one of three annual priorities for our hospital medicine division. This was implemented in October 2023 but did not gain momentum among the medical resident teaching services (MTS), paving the way for our QI project. Model for Improvement: Baseline data on the percentage of MTS DBN to home and HHC were available from November 2023 to January 2024. We surveyed our residents/faculty and conducted a root-cause analysis. The main barriers to DBN included a lack of planning and motivation, delayed communication with case management, and prolonged rounding. Aims Statement: Our goal was to increase the median percentage of MTS discharge orders placed by noon to home and HHC from 22% to 35% within 3 months. Measures: Our primary outcome measure was the percentage of MTS DBN to home and HHC. Weekly EMR-generated reports were collected. The outcome measure was then calculated and uploaded weekly on a run chart for analysis. Qualitative process measures included assessing if residents were planning discharges and documenting the number of discharges completed before noon. Changes: Our interventions targeted the lack of planning and motivation. These included introducing the expedited initiative and its importance to residents/faculty through conferences. In addition, a process was created where potential next-day discharges were discussed at afternoon sign-out and a tracking chart of DBN orders was designed for each team room. Tests of Change: Our pre-intervention median percentage of MTS DMB to home and HHC was 22% and improved to 40% post-intervention. While we observed a variation in discharge practice based on the rounding attending, we had notably sustained an upward shift in practice from our baseline when data was plotted on a run chart. We are currently continuing data collection to track sustainability and variability among rounding physicians. Conclusion: We attained an upward shift in the percentage of MTS DBN to home and HHC post-intervention. Although an upward shift has been achieved, we are looking to sustain and further improve it. In future PDSA cycles, we will look at individualizing feedback and optimizing interdisciplinary rounds. We plan on further investigating balancing measures such as bed availability, discharge timing for rehabilitation destinations, and patient and staff satisfaction.

Longitudinal tracking of hemocyte populations in vivo indicates lineage relationships and supports neural progenitor identity in adult neurogenesis

Adult neurogenesis, which takes place in both vertebrate and invertebrate species, is the process by which new neurons are born and integrated into existing functional neural circuits, long after embryonic development. Most studies in mammals suggest that self-renewing stem cells are the source of the new neurons, although the extent of self-renewal is a matter of debate. In contrast, research in the crayfish Procambarus clarkii has demonstrated that the neural progenitors producing adult-born neurons are capable of both self-renewing and consuming (non-self-renewing) divisions. However, self-renewing divisions are relatively rare, and therefore the production of adult-born neurons depends heavily on progenitors that are not replenishing themselves. Because the small pool of neural progenitors in the neurogenic niche is never exhausted throughout the long lives of these animals, we hypothesized that there must also be an extrinsic source of these cells. It was subsequently demonstrated that the neural progenitors originate in hemocytes (blood cells) produced by the immune system that travel in the circulation before ultimately integrating into niches where the neural lineage begins. The current study examines the developmental lineage of the three hemocyte types — hyaline (HC), semigranular (SGC) and granular (GC) cells — with the goal of understanding the origins of the progenitor cells that produce adult-born neurons. Longstanding qualitative metrics for hemocyte classification were validated quantitatively. Then, in a longitudinal study, proliferation markers were used to label the hemocytes in vivo, followed by sampling the circulating hemocyte population over the course of two months. Hemolymph samples were taken at intervals to track the frequencies of the different hemocyte types. These data reveal sequential peaks in the relative frequencies of HCs, SGCs and GCs, which were identified using qualitative and quantitative measures. These findings suggest that the three hemocyte types comprise a single cellular lineage that occurs in the circulation, with each type as a sequential progressive stage in hemocyte maturation beginning with HCs and ending with GCs. When combined with previously published data, this timeline provides additional evidence that HCs serve as the primary neural progenitor during adult neurogenesis in P. clarkii.

Persuasive Strategies in Email Marketing: An Analysis of Appeal and Influence in Business Communication

This study examines the employment of persuasive strategies in informational emails that market products and/or services, illustrating how these strategies influence target customers and persuade them to make purchases. A corpus of 850 emails, encompassing over a million words, was compiled and analyzed using a mixed-method approach that integrated both quantitative and qualitative measures. The emails were collected between 2020 and 2021. The categorization of persuasive strategies was directed by predefined operational definitions and criteria, informed by Aristotle's model of persuasion. The analysis identified 11 persuasive strategies utilized within the email corpus. Notably, the findings revealed that the offering appeal and the appeal to authority are the most commonly used strategies, whereas the contrasting appeal and romantic expressions are the least employed. These results underscore the importance of persuasive strategies in business communication, especially within informational emails. The insights derived from this study carry significant implications for businesses in crafting compelling marketing messages. Furthermore, the findings contribute to English for Business Purposes courses, particularly in English as a Foreign Language (EFL) contexts, by offering guidance on constructing persuasive business emails.

Visual perception and user satisfaction in video see-through head-mounted displays: a mixed-methods evaluation

ObjectiveOur study addresses the challenges limiting the adoption of Extended Reality (XR) Head-Mounted Displays (HMDs), mainly focusing on device quality and cybersickness. We aim to investigate the impact of hardware and software on user experience and task performance while wearing Video See-Through (VST) HMDs. We employ a novel methodology designed to bridge the gaps identified in previous research.MethodsThis study uses a convergent mixed-methods approach, combining qualitative and quantitative data in a within-subjects evaluation involving 20 participants. This comprehensive evaluation examines visual perception, visual quality, and user experience through a range of tasks. Usability, comfort, and cybersickness are assessed, with insights derived from both user performance metrics and subjective measures collected through in-depth interviews and comments. The study includes three distinct HMDs—two prototypes (PD1 and PD2) and one commercial device (CD1)—to provide a broad analysis of the technology.FindingsOur findings reveal that while participants were generally satisfied with VST mode, their preferences varied across devices. CD1 was preferred for its realistic color representation and superior reading task performance due to its high-resolution display and camera. However, visual disturbances and temporal issues differed across devices, with CD1 exhibiting fewer artifacts when stationary but showing more disturbances when participants were moving. Participants found PD1 and PD2 more comfortable for extended use and fewer cybersickness symptoms, but they highlighted color and display resolution issues. These variations underscore the importance of considering both qualitative and quantitative measures in HMD evaluations.ConclusionThis mixed-methods evaluation emphasizes the limitations of relying solely on visual perception performance measures for VST HMDs. By integrating both quantitative and qualitative insights, we offer a more detailed evaluation framework to identify design flaws and user experience issues that quantitative metrics alone might miss. This methodology contributes to the field by illustrating how a mixed-methods approach provides a broader perspective on XR technology, guiding future improvements and enhancing VST adoption in future applications.

“It’s Time to see What I Can Do”: A Mixed-Methods Investigation into Trajectories of Resilience in Adolescents during the COVID-19 Pandemic

AbstractThere is a concern that adolescent mental well-being and resilience has been adversely affected by the COVID-19 pandemic. Consequently, the aim of the current investigation was to track adolescents’ resilience from the initial months of the pandemic (T1) to approximately two years later (T2) using both qualitative and quantitative methods. Through interviews, thirty-one adolescents narrated their COVID-19 experiences and reflected on their mental well-being across this timespan. Using these accounts, we identified four groups of adolescents exhibiting one of the following trajectories of resilience: (1) Enduring resilience, (2) Reaching resilience, (3) Declining resilience and (4) Enduring non-resilience. Our findings revealed that most adolescents were able to maintain or develop good resilience on prolonged exposure to COVID-19 adversity (trajectories 1 and 2). This finding is contrary to the prevailing notion that the majority of adolescents’ mental well-being and hence resilience was adversely impacted by COVID-19 in the short and long term. Further qualitative analysis identified key factors that contributed to maintaining and developing greater levels of resilience during the pandemic: quality of friendships, quality of family relationships and regaining a sense of control. Lastly, we found a lack of congruence between quantitative and qualitative measures of mental well-being and resilience, suggesting that they might tap into different constructs/experiences. Significantly, our findings highlight that the majority of teens showed adaptive resilience during the pandemic and highlight the need for further longitudinal qualitative and quantitative research to assess both adaptive and maladaptive impacts of adversity on the adolescents’ mental well-being and resilience.

The Minor Phytocannabinoid Delta-8-Tetrahydrocannabinol Attenuates Collagen-Induced Arthritic Inflammation and Pain-Depressed Behaviors.

Patients with arthritis report using cannabis for pain management, and the major cannabinoid delta-9-tetrahydrocannabinol (Δ9-THC) has anti-inflammatory properties, yet the effects of minor cannabinoids on arthritis are largely unknown. The goal of the present study was to determine the antiarthritic potential of the minor cannabinoid delta-8-tetrahydrocannabinol (Δ8-THC) using the collagen-induced arthritis (CIA) mouse model. Adult male DBA/1J mice were immunized and boosted 21 days later with an emulsion of collagen and complete Freund's adjuvant. Beginning on the day of the booster, mice were administered twice-daily injections of Δ8-THC (3 or 30 mg/kg), the steroid dexamethasone (2 mg/kg), or vehicle for two weeks. Dorsal-ventral paw thickness and qualitative measures of arthritis were recorded daily, and latency to fall from an inverted grid was measured on alternating days, to determine arthritis severity and functional impairment. On the final day of testing, spontaneous wire-climbing behavior and temperature preference in a thermal gradient ring were measured to assess CIA-depressed behavior. The Δ8-THC treatment (30 mg/kg) reduced paw swelling and qualitative signs of arthritis. Δ8-THC also blocked CIA-depressed climbing and CIA-induced preference for a heated floor without producing locomotor effects but did not affect latency to fall from a wire grid. In alignment with the morphologic and behavioral assessments in vivo, histology revealed that Δ8-THC reduced synovial inflammation, proteoglycan loss and cartilage and bone erosion in the foot joints in a dose-dependent manner. Together, these findings suggest that Δ8-THC not only blocked morphologic changes but also prevented functional loss caused by collagen-induced arthritis. SIGNIFICANCE STATEMENT: Despite increasing use of cannabis products, the potential effects of minor cannabinoids are largely unknown. Here, the minor cannabinoid delta-8-tetrahydrocannabinol blocked the development of experimentally induced arthritis by preventing both pathophysiological as well as functional effects of the disease model. These data support the development of novel cannabinoid treatments for inflammatory arthritis.

A sentiment and keyword analysis of college food pantry stigma among users and non-users

Food pantry stigma among college students has been documented as an issue that impacts the utili­zation of resources but has not been deeply investi­gated. The objective of this study was to explore sources of food pantry stigma to identify different strategies to encourage food pantry use, which has the potential to positively alter methods on cam­puses. This mixed-methods study was a branched (separate questions and responses from both food pantry users and nonusers), 51-item, online, Qualtrics survey that sampled randomly selected students from a rural university (n = 3,000) and recruited using flyers posted in food pantries on campus. Reported results include demographic characteristics, use of on-campus food pantries, a validated food insecurity questionnaire, food pantry self-stigma, and an adapted measure of self-stigma of seeking help, and affirming or nonaffirm­ing qualitative measures of food pantry stigma. Sentiment and keyword analyses were conducted by two researchers to analyze qualitative data to identify factors that influence food pantry stigma from food pantry users and nonusers. Quantitative data were analyzed with descriptive statistics. Qual­itative data determined areas of stigma and aligned with the descriptive statistics on self-stigma and help-seeking measures. Among survey participants (n = 594), 35.7% of food-insecure students did not use food pantries. Users (M = 23.12, SD = 9.06) reported higher perceptions of food pantry stigma than nonusers (M = 15.79, SD = 3.85). Of the food pantry nonusers (n = 461), 322 identified the presence of stigma (69.85%). Sixty-six food pantry users (n = 97) identified the presence of stigma (68.04%). The keyword analysis highlighted poten­tial influences of food pantry stigma among all par­ticipants including power hierarchy, financial bur­den, embarrassment, and feeling superfluous. This study highlights influences of stigma and places an emphasis on changing current approaches in cam­pus food pantry implementation and dissemina­tion. Future studies could investigate the barriers and solutions to current messaging and implemen­tation of campus food pantries utilizing implemen­tation science experts and frameworks.

الحماية الجنائيّة للبيئة المائيّة في إطار التنمية المستدامة: قراءة في التشريع الأردني

The protection and conservation of ecosystems are of paramount importance for optimal utilization, particularly of the aquatic environment. This study aims to outline the approaches of the Jordanian criminal legislator in protecting the aquatic environment from pollution and to analyze the legal regulations for its preservation, ensuring the establishment of qualitative protective policies that prevent the depletion risks for future generations and meet Jordan's commitments to achieving sustainable development goals simultaneously. This is especially critical given the pressing water situation in Jordan. To achieve the study's objectives, the researchers employed descriptive and analytical methodologies to address the study's issues. The first section explored the nature of the aquatic environment as a value protected by criminal law, while the second section discussed the legal framework for the criminal protection of the aquatic environment in Jordanian legislation. The study concluded that an examination of the legislation reveals a significant concern from the Jordanian legislator in addressing violations that may occur against the aquatic environment. This is evidenced by the multiplicity of laws concerned with its protection, extending the scope of protection to include both quantitative and qualitative measures, criminalizing a wide range of actions, and adopting a broad approach in defining criminal activities. However, this multiplicity may lead to the pitfalls of overlapping applicable texts and the intermingling of their provisions. Consequently, the study recommends that related legislations on environmental protection should serve as a tool to guide the behavior of administrations, economic activities, and citizens to protect various environmental elements. Furthermore, the "Environmental Protection Law" should exclusively address criminal measures, stipulating the provisions of criminalization and punishment and organizing the rules of criminal responsibility within it, to prevent any conflict or ambiguity in the realm of criminal protection of the environment in general, and the aquatic environment in particular.

Expanding the Global Capacity for Childhood Cancer Registration: The ChildGICR Masterclass.

One determinant of the paucity of data on childhood cancer in low- and middle-income countries is the lack of capacity to register these cases. Combining expertise of the Global Initiative for Cancer Registry Development (GICR) and St Jude Global, we developed a ChildGICR educational program to promote data production. We first conducted a needs assessment to identify priority educational topics. Then, we designed the ChildGICR Masterclass, in which individuals with the potential to lead pediatric cancer registration were supported to prepare standard educational material. The outcomes were evaluated using qualitative and quantitative measures. On the basis of indications by 38 GICR collaborators, we identified seven topics relevant to childhood cancer: burden description, registration principles, tumor classification, tumor staging, data quality control, data analysis, and data use. The ChildGICR Masterclass was held online in 2021 over 12 weeks. The 22 nominated participants created presentations in working groups and during live sessions. They also designed future training courses tailored to the needs of their region. Nineteen participants viewed the course experience as excellent, and 20 would continue engagement in the ChildGICR training activities. The developed material was 89% useful according to the faculty of the three online end courses, taught to 88 participants in 16 countries in 2022 and 2023. Among the 75 responding participants, 72 agreed that the learning objectives were attained and 60 were keen to engage in childhood cancer registration activities. The ChildGICR Masterclass participants laid the foundation for a network of trainers. Knowledge dissemination in childhood cancer registration is the first necessary step toward evidence-based cancer control. The ChildGICR Masterclass can serve as a model to design, plan, and implement educational programs for health care professionals.