Study Reports Research Articles

Discourse Effect on Children’s Interpretation of Pre-Subject Exclusive Zhiyou ‘Only’

ABSTRACT It has been reported for decades that preschool children (age 4-7) tend to assign non-adult-like interpretations for sentences with pre-subject exclusive only. This study reports findings from two experiments investigating (1) the effects of (in)congruent implicit questions in discourse contexts and (2) word order transformation on children’s interpretations of Mandarin pre-subject zhiyou ‘only’. Experiment 1 showed that children performed non-adult-like in the incongruent discourse condition, similar to the patterns found in previous studies, but adult-like in the congruent discourse condition. Experiment 2 showed that using sentences similar to English ‘Those who ate apples was only the boy’ where the VP precedes the subject NP with zhiyou ‘only’ was not sufficient to overcome the processing difficulty caused by the incongruent discourse for preschool children. The results demonstrate that a congruent context taking the VP as the background (i.e., given and salient information) in Experiment 1, but not the syntactic manipulation in Experiment 2, is sufficient for children to interpret sentences with pre-subject zhiyou ‘only’ at an adult-like level of accuracy. The findings demonstrate that children have the syntactic knowledge for sentences with exclusive zhiyou ‘only’, but the discourse incongruence hinders them from correctly interpreting sentences with exclusive zhiyou ‘only’ when it is in pre-subject position.It has been reported for decades that preschool children (age 4-7) tend to assign non-adult-like interpretations for sentences with pre-subject exclusive only. This study reports findings from two experiments investigating (1) the effects of (in)congruent implicit questions in discourse contexts and (2) word order transformation on children’s interpretations of Mandarin pre-subject zhiyou ‘only’. Experiment 1 showed that children performed non-adult-like in the incongruent discourse condition, similar to the patterns found in previous studies, but adult-like in the congruent discourse condition. Experiment 2 showed that using sentences similar to English ‘Those who ate apples was only the boy’ where the VP precedes the subject NP with zhiyou ‘only’ was not sufficient to overcome the processing difficulty caused by the incongruent discourse for preschool children. The results demonstrate that a congruent context taking the VP as the background (i.e., given and salient information) in Experiment 1, but not the syntactic manipulation in Experiment 2, is sufficient for children to interpret sentences with pre-subject zhiyou ‘only’ at an adult-like level of accuracy. The findings demonstrate that children have the syntactic knowledge for sentences with exclusive zhiyou ‘only’, but the discourse incongruence hinders them from correctly interpreting sentences with exclusive zhiyou ‘only’ when it is in pre-subject position.

Miniature Optical Fiber Fabry-Perot Interferometer Based on a Single-Crystal Metal-Organic Framework for the Detection and Quantification of Benzene and Ethanol at Low Concentrations in Nitrogen Gas.

This study reports for the first time, to the best of our knowledge, a real-time detection of ultralow-concentration chemical gases using fiber-optic technology, combining a miniaturized Fabry-Perot interferometer (FPI) with metal-organic frameworks (MOFs). The sensor consists of a short and thick-walled silica capillary segment spliced to a lead-in single-mode fiber (SMF), housing a tiny single crystal of HKUST-1 MOF, imparting chemoselectivity features. Ethanol and benzene gases were tested, resulting in a shift in the FPI interference signal. The sensor demonstrated high sensitivity, detecting ethanol gas concentrations (EGCs) with a sensitivity of 0.428 nm/ppm between 24.9 and 40.11 ppm and benzene gas concentrations (BGCs) with a sensitivity of 0.15 nm/ppm between 99 and 124 ppm. The selectivity study involved a combination of three ultralow concentrations of ethanol, benzene, and toluene gases, revealing an enhancement factor of 436% for benzene and 140% for toluene, attributed to the improved miscibility of these conjugated ring molecules with the alkane chains of the ethanol-modified HKUST-1. Experimental tests confirmed the sensor's viability, demonstrating significantly improved response time and spectral characteristics through crystal polishing, indicating its potential for quantifying and detecting chemical gases at ultralow concentrations. This technology may prevent energy resource losses, and the sensor's small size and robust construction make it applicable in confined and hazardous locations.

Cultivating active engagement in pair work through peer modelling

AbstractThe present study reports on how peer modelling with collaborative ground rules may contribute to the pair dynamics of one intermediate‐level English L2 learner when interacting with peers of the same as well as higher proficiency levels. The study was one‐semester long (i.e., nine sessions) and our pair talk data were collected from an intact class where pair members were involved in performing narrative tasks. In this study, we focused on how one intermediate (i.e., core) learner as listener interacted in core‐intermediate and core‐advanced pairs in the opening talk of narrative tasks across sessions. Each session, adult Teaching English as a Foreign Language (TEFL) students narrated their short stories to three different interlocutors and also listened to three short stories of their classmates while recording their voices. On the fifth session, students viewed a staged peer modelling demonstration with built‐in collaborative ground rules. The peer modelling was intended to demonstrate to the learners how best to perform the task to their mutual benefit. We transcribed pair talk data from the focused pairs and analysed them for instances of changes in pair dynamics and quantity of collaborative features based on Storch's framework. The results indicated that both core‐intermediate and core‐advanced pairs demonstrated more collaborative pair dynamics after the peer modelling session; the core‐advanced pairs made greater improvement in terms of instances and number of collaborative features. Trends in our data support peer modelling as one effective pedagogical technique to raise learners’ awareness and to assist them in creating quality learning opportunities in their pair interaction. Our findings are discussed in terms of its implications for the integration of peer modelling in pair work tasks in language learning settings.

Colletotrichum siamense is associated with post‐harvest anthracnose of red onion in the Philippines

AbstractOnion (Allium cepa L.) is an important crop widely cultivated in the Philippines. In the Philippines, Colletotrichum gloeosporioides sensu lato and C. circinans have been reported to cause anthracnose twister disease and onion smudge, respectively. This study reports C. siamense from anthracnose‐infected onion bulbs. The fungus was identified using morpho‐cultural characterization and multi‐locus analyses of the nuclear ribosomal internal transcribed spacer with 5.8S region (ITS) glyceraldehyde‐3‐phosphate dehydrogenase gene (GAPDH) and beta‐tubulin (TUB2). Koch's postulates were established in pathogenicity assays where the fungus caused diseases in wounded and non‐wounded onion bulbs. This study is the first scientific report of C. siamense as a post‐harvest anthracnose pathogen of onion bulbs in the Philippines.

Crystal chemistry and molar volume of potassic-chloro-hastingsite

Abstract. Several geological processes such as crustal and mantle metasomatism, high-grade metamorphism, and the formation of ore deposits involve the exchange of halogens, especially chlorine, between silicate minerals and fluids. It is well established that the presence of octahedral iron is vital to the process of Cl incorporation into amphiboles. However, other compositional controls on Cl incorporation, such as the effect of TAl, ANa, AK, and A-site occupancy are not as well constrained. This study reports on the compositional and structural relationships amongst a suite of 25 synthetic calcium amphiboles with a diverse range of Cl contents (0–1.68 atoms per formula unit (apfu)). Most amphiboles were synthesized along the potassic-hastingsite–potassic-chloro-hastingsite join (KCa2(Fe4Fe3+)(Al2Si6)O22(OH,Cl)2). Additional work involved substitution of Na for K, variable Al content, and substitution of Mg for Fe2+ in the bulk composition to explore these compositional effects on Cl incorporation. The relationship between pressure and the Cl content of amphiboles was also explored over the pressure range 0.3–2.0 GPa. Otherwise, synthesis conditions were 700 °C and 0.3 GPa with fO2 near Ni–NiO. Iron (II) chloride was used as the source of Cl. Some experiments used variably concentrated FeCl2 brines (0–100 molal), while others were nominally anhydrous, containing only the water absorbed by the hygroscopic FeCl2. All amphiboles were characterized by Rietveld refinements of powder X-ray diffraction patterns, electron microprobe analysis, and Mössbauer spectroscopy, the latter to determine Fe3+ fraction. This study finds a positive relationship between pressure and the Cl content of the amphibole. Both Fe2+ and Fe3+ are positively correlated with Cl among amphiboles with variable Fe#, but the correlation is poor to nonexistent for Mg-free amphiboles. Results indicate that the substitution of CFe2+,3+ for CMg and CFe2+,3+ for CAl facilitate Cl incorporation, with the former having a larger effect. The A-site occupancy is positively correlated with Cl in all amphiboles except those synthesized in dilute FeCl2 brines (≤ 6 m), which are negatively correlated. No correlation is observed between the Cl content of the amphibole and either the species of A cation (K vs. Na) or TAl. The composition vs. unit cell parameter data were analyzed using multivariate linear regression to better understand the process of Cl incorporation and to predict the molar volume of endmember chloro-amphiboles. The regression indicates an expansion of 0.181 Å (0.99 %) and 0.048 Å (0.90 %) along the b and c edges respectively, a reduction in β by 0.76° (0.72 %), and a contraction of 0.060 Å (0.59 %) along a when fully substituting Cl for OH in potassic-hastingsite. The multivariate linear regression equations allow the prediction of molar volumes for select endmember chloro-amphiboles, such as potassic-chloro-hastingsite = 964.63 ± 1.29 Å3 or 290.5 ± 0.4 cm3 mol−1.

Electrospun PCL Filtration Membranes Enhanced with an Electrosprayed Lignin Coating to Control Wettability and Anti-Bacterial Properties.

This study reports on the two-step manufacturing process of a filtration media obtained by first electrospinning a layer of polycaprolactone (PCL) non-woven fibers onto a paper filter backing and subsequently coating it by electrospraying with a second layer made of pure acidolysis lignin. The manufacturing of pure lignin coatings by solution electrospraying represents a novel development that requires fine control of the underlying electrodynamic processing. The effect of increasing deposition time on the lignin coating was investigated for electrospray time from 2.5 min to 120 min. Microstructural and physical characterization included SEM, surface roughness analysis, porosity tests, permeability tests by a Gurley densometer, ATR-FTIR analysis, and contact angle measurements vs. both water and oil. The results indicate that, from a functional viewpoint, such a natural coating endowed the membrane with an amphiphilic behavior that enabled modulating the nature of the bare PCL non-woven substrate. Accordingly, the intrinsic hydrophobic behavior of bare PCL electrospun fibers could be reduced, with a marked decrease already for a thin coating of less than 50 nm. Instead, the wettability of PCL vs. apolar liquids was altered in a less predictable manner, i.e., producing an initial increase of the oil contact angles (OCA) for thin lignin coating, followed by a steady decrease in OCA for higher densities of deposited lignin. To highlight the effect of the lignin type on the results, two grades of oak (AL-OA) of the Quercus cerris L. species and eucalyptus (AL-EU) of the Eucalyptus camaldulensis Dehnh species were compared throughout the investigation. All grades of lignin yielded coatings with measurable antibacterial properties, which were investigated against Staphylococcus aureus and Escherichia coli, yielding superior results for AL-EU. Remarkably, the lignin coatings did not change overall porosity but smoothed the surface roughness and allowed modulating air permeability, which is relevant for filtration applications. The findings are relevant for applications of this abundant biopolymer not only for filtration but also in biotechnology, health, packaging, and circular economy applications in general, where the reuse of such natural byproducts also brings a fundamental demanufacturing advantage.

Isochronous rhythms: Facilitating song coordination across taxa?

The biological expression of isochronous rhythms- rhythms like those produced by a metronome- was once thought to be unique to humans. A new study reports that faster and more isochronous rhythms lead to more successful duets in singing gibbons: isochronous rhythms might be an important component of song coordination across taxa.

Sense of coherence moderates job demand-resources and impact on burnout among nurses and midwives in the context of the COVID-19 pandemic: A cross-sectional survey.

This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. Cross-sectional quantitative survey. The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. There was no patient or public contribution in this study, as the focus was on nurses and midwives.

Characterization and Distribution of SARS-CoV-2 Omicron Variant and its Sub-lineages in Uttarakhand using Next Generation Sequencing: A Retrospective Study

The etiological agent of coronavirus disease (COVID-19) that emerged at the end of year 2019 was first reported in Wuhan, China and was found to be SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2). The massive COVID-19 waves were due to various variants. As per the reports of other study it was also found that Omicron variant spread faster than various other variant such as delta variant. Omicron has been reported from various countries and now from many states of India too. Therefore, keeping this in mind, this study was undertaken to study all the lineages of SARS-CoV-2 Omicron variant of disease COVID-19 that are circulating in the population of Uttarakhand with objective to study next generation sequencing of all the RT-PCR positive of SARS-CoV-2 and to find out all the lineages of the Omicron variant of SARS-CoV-2. This was a retrospective study conducted from 1st January 2022 to 30th September 2022. Next generation sequencing was performed on all the samples that were tested for COVID-19 by using Ion AmpliSeq kit on Ion Chef instrument. A total of 2149 samples were tested in which majority of samples belong to age group of 21-40 years. Males were affected more than females. BA.2 was found to be the predominant lineage of total of 46 lineages that were identified. Their mutations were also studied. We conclude that different variants of clade 21L, 22B, 22D and Omicron subvariant BA.2, BA.2.38 and BA.2.75 were the ones that were circulating amongst the population of Uttarakhand. The characteristic mutation that was found were T19I and V213G in NTD, S373P, S375F, T376A, and D405N in RBD.

Materials and Climate Change: A Set of Indices as the Benchmark for Climate Vulnerability and Risk Assessment for Tangible Cultural Heritage in Europe

Among the issues most related to climate change, the built environment is also subjected to short- and long-term risks. Referring to tangible cultural heritage, materials and buildings are subjected to different types of damage that require adaptive risk prevention and containment strategies, currently missing from conventional risk assessments. Thus, there is an increasingly urgent need for scientific and technical knowledge, tools, and solutions aimed at solving critical issues in cultural heritage due to climate change. In this context, the aim of this study is to study the mechanisms of impacts brought about by climate change and the formulation of a possible set of indices as benchmarks to measure climate change’s effect on cultural heritage buildings. The study is structured on a methodology that identifies three sections: the first and second parts systematize and critically interpret data on impact mechanisms and indices for climate vulnerability and risk assessment; the third part, data processing, reports the perspective findings. The main intermediate indices, contributing to a comprehensive damage index, were identified, and a procedural protocol was developed. Finally, through the correlation of indices, a potential case study could be analyzed, and benchmarks made effective. The study reports partial results of one of the “Ecosystems of Innovation” pilot projects funded by the National Recovery and Resilience Plan. The study is still a work in progress and needs advancement and deepening to verify case study indices.

Exploring evidence selection with the inclusion network

Abstract Although systematic reviews are intended to provide trusted scientific knowledge to meet the needs of decision-makers, their reliability can be threatened by bias and irreproducibility. To help decision-makers assess the risks in systematic reviews that they intend to use as the foundation of their action, we designed and tested a new approach to analyzing the evidence selection of a review: its coverage of the primary literature and its comparison to other reviews. Our approach could also help anyone using or producing reviews understand diversity or convergence in evidence selection. The basis of our approach is a new network construct called the inclusion network, which has two types of nodes: primary study reports (PSRs, the evidence) and systematic review reports (SRRs). The approach assesses risks in a given systematic review (the target SRR) by first constructing an inclusion network of the target SRR and other systematic reviews studying similar research questions (the companion SRRs) and then applying a three-step assessment process that utilizes visualizations, quantitative network metrics, and time series analysis. This paper introduces our approach and demonstrates it in two case studies. We identified the following risks: missing potentially relevant evidence, epistemic division in the scientific community, and recent instability in evidence selection standards. We also compare our inclusion network approach to knowledge assessment approaches based on another influential network construct, the claim-specific citation network, discuss current limitations of the inclusion network approach, and present directions for future work.

Enhancing hydrodynamic efficiency of Savonius hydrokinetic turbine through circular deflector flow augmentation

ABSTRACT The present numerical study employs a passive flow control augmentation mechanism to enhance the hydrodynamic performance of the Savonius hydrokinetic turbine. Two cylindrical deflectors guide the flow over the Savonius rotor blades. The effectiveness of placing the deflectors is examined by positioning them upstream of the returning and advancing blades. The Savonius hydrokinetic rotor’s efficiency is improved by incorporating Deflector1 to decrease the counteracting torque from the returning blade and Deflector2 to magnify the positive torque produced by the advancing blade. The study focuses on finding a suitable position ( L 1 ) and size ( d 1 ) of Deflector1 while keeping the size ( d 2 ) and position ( L 2 and ⍺) of Deflector2 fixed. The diameter of Deflector1 ( d 1 ) changes as d 1 / d =0 .15, 0.20, 0.25, 0.30, and 0.35 for each position, L 1 / d of 1.35, 1.65, 1.95, and 2.25. The study reports that the augmented Savonius turbine operates most efficiently at d 1 / d =0 .15, L 1 / d = 1.65, corresponding to a tip speed ratio of 0.9. The deflector-assisted Savonius hydrokinetic turbine enhances the power coefficient (C P ) by 54.1% in comparison to the ordinary Savonius rotor lacking deflectors. Further, utilizing cylindrical deflectors upstream of the Savonius hydrokinetic rotor improves the operating TSR range of the Savonius hydrokinetic turbine.

Assessing consumer knowledge, attitudes, and adoption of circular economy practices in Colombia

Consumers play a pivotal role in the successful implementation of the circular economy (CE) model. In Colombia, despite measures designed to support CE, there is a paucity of empirical evidence regarding consumer engagement. This study aimed to assess consumer knowledge, attitudes, and adoption of CE in Colombia. A survey was conducted in three cities known for their strong interest in CE and their significant contributions to national development: Medellin, Pereira, and Barranquilla. The data gathered from 1184 responses were analyzed using descriptive and non-parametric statistical methods. The results revealed that only 26 % of consumer responses denote adequate knowledge of CE, highlighting a substantial lack of awareness regarding the CE concept and both government and private sector initiatives. Consumer attitudes towards CE were notably positive, with 77 % of responses expressing a favorable stance. Concerning the adoption of circular strategies in their daily lives, 53 % of consumer responses involved CE adoption, while 23 % exhibited resistance. Medellin and Pereira's consumers exhibited similar and encouraging circular behavior, while those in Barranquilla faced more barriers. Furthermore, this study reports that the city of residence, educational level, and socioeconomic stratum influence how consumers perceive, value, and adopt CE. These findings emphasize the urgent need to enhance consumer engagement and performance to support Colombia's CE plans. The implications outlined herein will benefit the identification and prioritization of synergistic actions to transform the role of the consumer and turn it into a catalyst for CE.

Outcomes and efficacy of magnetic resonance imaging-compatible sacral nerve stimulator for management of fecal incontinence: A multi-institutional study.

Fecal incontinence (FI) is an involuntary passage of fecal matter which can have a significant impact on a patient's quality of life. Many modalities of treatment exist for FI. Sacral nerve stimulation is a well-established treatment for FI. Given the increased need of magnetic resonance imaging (MRI) for diagnostics, the InterStim which was previously used in sacral nerve stimulation was limited by MRI incompatibility. Medtronic MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely used. To evaluate the efficacy, outcomes and complications of the MRI-compatible InterStim. Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport, University of Minnesota, Advocate Lutheran General Hospital, and University of Wisconsin-Madison was pooled and analyzed. Patient demographics, clinical features, surgical techniques, complications, and outcomes were analyzed. Strengthening the Reporting of Observational studies in Epidemiology(STROBE) cross-sectional reporting guidelines were used. Seventy-three patients had the InterStim implanted. The mean age was 63.29 ± 12.2 years. Fifty-seven (78.1%) patients were females and forty-two (57.5%) patients had diabetes. In addition to incontinence, overlapping symptoms included diarrhea (23.3%), fecal urgency (58.9%), and urinary incontinence (28.8%). Fifteen (20.5%) patients underwent Peripheral Nerve Evaluation before proceeding to definite implant placement. Thirty-two (43.8%) patients underwent rechargeable InterStim placement. Three (4.1%) patients needed removal of the implant. Migration of the external lead connection was observed in 7 (9.6%) patients after the stage I procedure. The explanation for one patient was due to infection. Seven (9.6%) patients had other complications like nerve pain, hematoma, infection, lead fracture, and bleeding. The mean follow-up was 6.62 ± 3.5 mo. Sixty-eight (93.2%) patients reported significant improvement of symptoms on follow-up evaluation. This study shows promising results with significant symptom improvement, good efficacy and good patient outcomes with low complication rates while using MRI compatible InterStim for FI. Further long-term follow-up and future studies with a larger patient population is recommended.

Atomically Dispersed Ce Sites Augmenting Activity and Durability of Fe-Based Oxygen Reduction Catalyst in PEMFC.

In the cathode of proton exchange membrane fuel cells (PEMFCs), Fe and N co-doped carbon (Fe-N-C) materials with atomically dispersed active sites are one of the satisfactory candidates to replace Pt-based catalysts. However, Fe-N-C catalysts are vulnerable to attack from reactive oxygen species, resulting in inferior durability, and current strategies failing to balance the activity and stability. Here, this study reports Fe and Ce single atoms coupled catalysts anchored on ZIF-8-derived nitrogen-doped carbon (Fe/Ce-N-C) as an efficient ORR electrocatalyst for PEMFCs. In PEMFC tests, the maximum power density of Fe/Ce-N-C catalyst reached up to 0.82Wcm-2, which is 41% larger than that of Fe-N-C. More importantly, the activity of Fe/Ce-N-C catalyst only decreased by 21% after 30000 cycles under H2/air condition. Density functional theory reveals that the strong coupling between the Fe and Ce sites result in the redistribution of electrons in the active sites, which optimizes the adsorption of OH* intermediates on the catalyst and increases the intrinsic activity. Additionally, the admirable radical scavenging ability of the Ce sites ensured that the catalysts gained long-term stability. Therefore, the addition of Ce single atoms provides a new strategy for improving the activity and durability of oxygen reduction catalysts.

Early and Midterm Outcomes of Endovascular Aortic Arch Repair Using In Situ Laser Fenestration.

The aim of this study is to present single-center outcomes in patients treated with in situ laser fenestration thoracic endovascular aortic repair (LFTEVAR) for various aortic arch pathologies and assess the impact of increasing experience. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was followed. A retrospective analysis of prospectively collected single aortic center data was conducted, including baseline information and peri- and post-operative outcomes of consecutive patients managed with LFTEVAR for aortic arch pathologies. Patients were enrolled from April 1, 2017 to January 31, 2023. The cohort was dichotomized to compare early (2017-2019) and late experience (2020-2023). Primary outcomes were peri-operative mortality and cerebrovascular morbidity. Thirty patients were included (63.3% males, mean age 69.8±9.6 years); 21.4% presented with aortic ruptures. Aortic aneurysm involving the aortic arch was the most frequent pathology (53.3%). Forty target vessels (TVs) were revascularized, including 19 left subclavian arteries (47.5%) and 17 left common carotid arteries (42.5%). Double fenestrations were performed in 10 patients. The proximal landing zone was Ishimaru zone 0 in 5 patients (16.7%) and zone 1 in 13 patients (43.3%). Technical success was 93%. No spinal cord ischemia was recorded, and 3 patients (10%) suffered a post-operative stroke, of which 1 was major (3.3%). The median follow-up was 12 months (range=1-48 months). Thirty-day and follow-up mortality rates were 13.5% and 15.3%, respectively. Target vessel instability was 10%, of which 3.8% required reintervention. There was no statistically significant difference in outcomes between the early and late experience groups. Laser fenestration thoracic endovascular aortic repair of the aortic arch performed in experienced aortic centers is associated with low early mortality and stroke rates. It is a safe and effective therapeutic option in patients considered unfit for open repair. Custom-made devices for arch pathologies requiring urgent repair are not an option because of manufacturing delays. Off-the-shelf devices with single branch arch prostheses, and outside IFU techniques such as parallel-grafts and surgeon-modified endografts have been proposed in this setting. Another off-the-shelf alternative is in situ laser fenestration thoracic endovascular repair (LFTEVAR), which addresses many limitations of the other off-the-shelf options. Our study reports the outcomes of 30 patients treated with LFTEVAR, showing that it is a viable therapeutic option in patients considered unfit for open repair acknowledging that sufficient experience with complex endovascular aortic repair is mandatory to achieve acceptable outcomes in these high-risk patients with challenging aortic anatomies.

Oral intake of solid medications in patients with post-stroke dysphagia. A challenge for nurses?

To provide a comprehensive overview of how stroke nurses manage solid medication (SM) delivery to patients with post-stroke dysphagia. Cross-sectional study. A self-administered online survey was carried out among nurses in German-speaking countries between September and December 2021. Out of a total of 754 responses, analysis was conducted on 195 nurses who reported working on a stroke unit. To identify swallowing difficulties in acute stroke care, 99 nurses indicated routinely administering standardised screenings, while 10 use unvalidated screenings, and 82 are waiting for a specialist evaluation. Regardless of whether screening methods are used or not, most preferred a non-oral route of medication administration for patients with suspected dysphagia. None of the respondents reported administering whole SMs orally to patients. If screening methods indicate dysphagia, approximately half of the respondents would modify SMs. Participants who stated to use the Gugging Swallowing Screen managed the SM intake guided by its severity levels. One-third of the group who awaited assessment by the dysphagia specialist provided modified medication before the consultation. Most of the nurses on stroke units use swallowing screens and avoid the administration of whole SMs in post-stroke dysphagia. In addition to the non-oral administration, SMs are modified if dysphagia is suspected. Precise guidance on the administration of SM is needed, based on screening tests and prior to expert consultation. ClinicalTrials.gov: Registration ID: NCT05173051/ Protocol ID: 11TS003721. The present paper serves to alert nurses to the issue of patient safety when administering medication for acute stroke-induced dysphagia. SM delivery after acute stroke-induced dysphagia is often neglected. While nurses are aware of the risk associated with dysphagia and would not give whole SMs to patients, the modification of tablets and their administration with semisolids are common. This study was reported according to the Checklist for Reporting of Survey Studies (CROSS).

Toward Multidimensional Message Tailoring to Address COVID-19 and Influenza Vaccine-Hesitancy: A Latent Profile Analysis Approach

ABSTRACT Vaccines remain the best strategy as the COVID-19 pandemic enters into later stages and governments begin to shed pandemic-control measures. Vaccine hesitancy continues to be a major obstacle in efforts to end the pandemic. This study reports formative evaluation research that adopted a multidimensional approach using latent profile analysis to audience segmentation and message targeting. Within the framework of the integrated behavioral model, data were collected from a US national survey to explore the dimensions in which vaccine-confident vs. -hesitant individuals differed significantly across the topics of COVID-19 and influenza. Latent profile analyses were performed to identify subgroups and establish measurement invariance between COVID-19 and influenza vaccines. Matching message strategies were proposed for the distinctive characteristics of the subgroups for both topics and to be tested in future research.

Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey.

The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared. The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112). The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.

Application of HLA molecular level mismatching in ethnically diverse kidney transplant recipients receiving a steroid-sparing immunosuppression protocol

Defining HLA mismatch at the molecular compared with the antigen level has been shown to be superior in predicting alloimmune responses, although data from across different patient populations are lacking. Using HLA-Matchmaker, HLA-EMMA and PIRCHE-II, this study reports on the association between molecular mismatch (MolMM) and de novo donor-specific antibody (dnDSA) in an ethnically diverse kidney transplant population receiving a steroid-sparing immunosuppression protocol. Of the 419 patients, 51 (12.2%) patients had dnDSA. De novo DSA were seen more frequently with males, primary transplants, patients receiving tacrolimus monotherapy, and unfavorably HLA-matched transplants. There was a strong correlation between MolMM load and antigen mismatch, although significant variation of MolMM load existed at each antigen mismatch. MolMM loads differed significantly by recipient ethnicity, although ethnicity alone was not associated with dnDSA. On multivariate analysis, increasing MolMM loads associated with dnDSA, whereas antigen mismatch did not. De novo DSA against 8 specific epitopes occurred at high frequency; of the 51 patients, 47 (92.1%) patients with dnDSA underwent a pretreatment biopsy, with 21 (44.7%) having evidence of alloimmune injury. MolMM has higher specificity than antigen mismatching at identifying recipients who are at low risk of dnDSA while receiving minimalist immunosuppression. Immunogenicity consideration is important, with more work needed on identification, especially across different ethnic groups.