Study Reports Research Articles

The strengthened role of new predictors of Indian Ocean Dipole (IOD) during the recent decades of weakened ENSO-IOD relationship

Indian Ocean Dipole (IOD) is the major interannual ocean-atmosphere interaction phenomena in the Indian Ocean (IO) and is influenced by external forcing such as El Nino Southern Oscillation (ENSO). Meanwhile, its co-occurrence and stronger relationship with ENSO have decreased during recent decades. The IOD variability also reduced after 2000, accompanied by a shift of the western pole to central IO extending further southward. The study reports that the boreal fall (SON, September, October, November) season IOD has an intensified relationship with the previous winter Subtropical Indian Ocean dipole (SIOD) and spring season equatorial north tropical Atlantic (NTA) SST anomalies., while the ENSO relationship is reduced from its pre-2000 value. It is found that the persistent warming (cooling) in the western side of positive (negative) SIOD during the previous winter induces easterly (westerly) wind anomalies in the equatorial IO during the following summer and fall, leading to positive (negative) IOD events. These IOD events have the western pole shifted to south-central IO instead of the canonical northwestern warming. The spring season NTA SST anomalies induce stronger summer season circulation and SST gradient in the equatorial Pacific, like ENSO. During the SON season, this pattern is associated with cooling and easterly wind anomalies in the tropical eastern IO and IOD. These two patterns explain the major mode of IOD variability after 2000. While the IOD associated with NTA have co-occurring ENSO during summer and fall, the SIOD-induced IOD events are independent of ENSO in the Pacific. Thus, these two predictors provide long-lead predictability (2-3 seasons ahead) of IOD for both ENSO co-occurring and non-ENSO IOD events. However, the IOD predictability of seasonal prediction models mainly depends on the ENSO-IOD relationship, resulting in reduced IOD skills for many of them after 2000. The models such as COLA-CCSM4, which has improved skill have stronger than observed ENSO-IOD relationship than the pre-2000 period. A linear regression model including SIOD and NTA SST indices of the previous winter and spring season respectively as predictors simulates IOD with a skill of around 0.65 during the recent period, indicating the necessity of seasonal prediction models to capture the variability in the southern IO and NTA and their teleconnections for better prediction of IOD in the recent period of reduced ENSO skill.

Enhanced clustering-based differential expression analysis method for RNA-seq data

RNA-seq is a tool for measuring gene expression and is commonly used to identify differentially expressed genes (DEGs). Gene clustering has been widely used to classify DEGs with similar expression patterns, but rarely used to identify DEGs themselves. We recently reported that the clustering-based method (called MBCdeg1 and 2) for identifying DEGs has great potential. However, these methods left room for improvement. This study reports on the improvement (named MBCdeg3). We compared a total of six competing methods: three conventional R packages (edgeR, DESeq2, and TCC) and three versions of MBCdeg (i.e., MBCdeg1, 2, and 3) corresponding to three different normalization algorithms. As MBCdeg3 performs well in many simulation scenarios of RNA-seq count data, MBCdeg3 replaces MBCdeg1 and 2 in our previous report.● MBCdeg3 is a method for both identification and classification of DEGs from RNA-seq count data.● MBCdeg3 is available as a function of R, which is common in the field of expression analysis.● MBCdeg3 performs well in a variety of simulation scenarios for RNA-seq count data.

Protocol for Conducting a Systematic Review on Diagnostic Accuracy in Clinical Research

In the landscape of modern medicine, the ability to accurately diagnose various clinical conditions is paramount. As new diagnostic tools continue to emerge, their accuracy must be rigorously assessed before clinical implementation. This paper introduces a systematic review protocol tailored for diagnostic accuracy studies, drawing inspiration from a review on dysphagia screening in post-stroke patients. The protocol, designed with precision and transparency at its core, facilitates a thorough synthesis of evidence, employing tools such as the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and the Standards for Reporting of Diagnostic Accuracy Studies (STARD) checklist for robust evaluation. The protocol emphasizes registration with the PROSPERO database and adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic search approach encompasses a comprehensive exploration of databases and precise keyword combinations. Distinctive inclusion and exclusion criteria, coupled with a dual-reviewer methodology, ensure the selection of high-quality studies. This framework has the potential to serve as a benchmark for systematic reviews in diagnostic accuracy, highlighting the importance of standardization, transparency, and adaptability in clinical research. This approach paves the way for a research methodology that delves deeper into diagnostic tools across various clinical scenarios, promoting evidence-based advancements in patient care.

Synthesis and Controlled Cargo Release of Novel Photoresponsive Polysiloxane‐based Single‐chain Nanoparticles

Synthesis and Controlled Cargo Release of Novel Photoresponsive Polysiloxane‐based Single‐chain Nanoparticles

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.

A One-Year Retrospective Study for the Evaluation of Correlation between Vitamin D and Cholesterol Levels: A Preliminary Report

Vitamin D is a fat-soluble vitamin that plays an important role in bone metabolism and seems to have some anti-inflammatory and immune-modulating properties. Cholesterol is the precursor of very important biochemical pathways including bile salts and other steroidogenic molecules like adrenal gland hormones, reproductive hormones, and vitamin D. In the present study, cholesterol and vitamin D test results from 13,150 patients admitted to our laboratory were analyzed over a one-year period retrospectively from the Laboratory Information System. In our study, we aimed to investigate the association between low cholesterol levels and vitamin D levels. Analyzed data revealed that low cholesterol levels (<200 mg/dl) were detected in 6,355 patients. In these patients, mean cholesterol level was 164.3 mg/dl while median vitamin D value was 20.4 ng/ml. There was a significant correlation (r=0.064, p<0.001) between low cholesterol levels and low vitamin D levels in the study group. The study group was divided into three subgroups according to age (<18, 18-35 and >35) and a significant correlation was detected between low cholesterol levels and low vitamin D (r=0.06, p<0.001) in patients >35 years of age. In this retrospective study, we determined a weak but significant correlation between vitamin D and cholesterol levels in particular >35 years of age. We think that this study data can be considered as a preliminary report for comprehensive studies that will determine the relationship between vitamin D and cholesterol levels in the general population.

Seeking Validation and Creating Meaningful Interactions

Infancy, a formative period for development, has been identified as an advantageous time to provide family-centered support for children with delays. Families should be included as stakeholders during development of such interventions to ensure social value. We describe a preliminary randomized controlled trial evaluating Infant Achievements (IA), an 8-week (16-session) parent-mediated intervention for parents of infants 8–12 months old with social and communication delays. This study reports our qualitative examination of the intervention's social validity. We conducted focus groups with seven IA parent participants and analyzed their responses using conventional content analysis. Five themes emerged: (a) difficulty identifying resources to address concerns; (b) seeking validation of concerns; (c) seeking support to enhance children's development; (d) experiencing a supportive coaching relationship; and (e) creating meaningful interactions to support children's communication and social skills. Our results emphasize the necessity of partnering with families in the development of evidence-based, family-centered interventions for infants with developmental delays to maximize their social value.

A study to untangle the puzzle of urinary incontinence and frailty co-occurrence among older adults: The roles of depression and activity engagement.

To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China. Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence. What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence. The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. No patient or public contribution.

Stereotactic ultrahypofractionated MR-guided radiotherapy for localized prostate cancer – Acute toxicity and patient-reported outcomes in the prospective, multicenter SMILE phase II trial

BackgroundDue to superior image quality and daily adaptive planning, MR-guided stereotactic body radiation therapy (MRgSBRT) has the potential to further widen the therapeutic window in radiotherapy of localized prostate cancer. This study reports on acute toxicity rates and patient-reported outcomes after MR-guided adaptive ultrahypofractionated radiotherapy for localized prostate cancer within the prospective, multicenter phase II SMILE trial. Materials and methodsA total of 69 patients with localized prostate cancer underwent MRgSBRT with daily online plan adaptation. Inclusion criteria comprised a tumor stage ≤ T3a, serum PSA value ≤ 20 ng/ml, ISUP Grade group ≤ 4. A dose of 37.5 Gy was prescribed to the PTV in five fractions on alternating days with an optional simultaneous boost of 40 Gy to the dominant intraprostatic lesion defined by multiparametric MRI. Acute genitourinary (GU-) and gastrointestinal (GI-) toxicity, as defined by CTCAE v. 5.0 and RTOG as well as patient-reported outcomes according to EORTC QLQ-C30 and -PR25 scores were analyzed at completion of radiotherapy, 6 and 12 weeks after radiotherapy and compared to baseline symptoms. ResultsThere were no toxicity-related treatment discontinuations. At the 12-week follow-up visit, no grade 3 + toxicities were reported according to CTCAE. Up until the 12-week visit, in total 16 patients (23 %) experienced a grade 2 GU or GI toxicity. Toxicity rates peaked at the end of radiation therapy and subsided within the 12-week follow-up period. At the 12-week follow-up visit, no residual grade 2 GU toxicities were reported and 1 patient (1 %) had residual grade 2 enteritic symptoms. With exception to a significant improvement in the emotional functioning score following MRgSBRT, no clinically meaningful changes in the global health status nor in relevant subscores were reported. ConclusionDaily online-adaptive MRgSBRT for localized prostate cancer resulted in an excellent overall toxicity profile without any major negative impact on quality of life.

Kinesophobia and its related factors in patients after percutaneous coronary intervention: A cross-sectional study.

To explore the postoperative kinesophobia of patients after percutaneous coronary intervention (PCI) and its related factors. Percutaneous coronary intervention is an effective method to treat coronary heart disease (CHD), and cardiac rehabilitation is an important auxiliary method after PCI. However, the compliance of patients with cardiac rehabilitation after PCI is not good, among which kinesophobia is an important influencing factor. A descriptive cross-sectional design was implemented, and the high-quality reporting of the study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology Statement. In total, 351 inpatients who underwent PCI in three tertiary grade-A hospitals in China were selected by convenient sampling method. We use one-way ANOVA and multiple linear regression analysis to determine the relevant related factors. The kinesophobia of patients after PCI was negatively correlated with chronic illness resource utilization and sense of personal mastery, and positively correlated with illness perception. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery entered the regression equation, which could explain 78.1% of the total variation. The level of kinesiophobia of patients after PCI is high. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery are the related factors of kinesiophobia of patients after PCI. By reducing the level of exercise fear of patients after PCI, patients are more likely to accept and adhere to the cardiac rehabilitation plan, thus improving their prognosis and improving their quality of life. The patient underwent PCI in the research hospital. Researchers screen them according to the inclusion criteria and invite them to participate in this study. If they meet the requirements, participants will answer the research questionnaire face to face after signing the informed consent form.

Successful Treatment of Sperm DNA Fragmentation Through Ayurveda Rasayana Therapy: A Case Study

Background: Sperm DNA fragmentation (SDF) can affect fertilization rate and embryo development, making it a useful measure for assessing male fertility. Available evidence supports the association between high sperm DNA fragmentation and poor outcomes, with regard to natural conception. Several treatment options are being adopted with varying degrees of success. Some of the commonly used treatment options are the intake of oral antioxidants, varicocele repair, and techniques like micro-manipulation-based sperm selection and use of testicular sperm for intracytoplasmic sperm injection.
 Case Presentation: Studies have shown that around 29% of couples depend on complementary and alternative medicine (CAM) modality for the treatment of infertility. However, there is a lack of substantial evidence regarding its efficacy in treating various aspects of infertility in couples. The current case report is about a 44 year-old male patient with infertility, who has a known diagnosis of sex chromosome abnormalities. Meanwhile, the SDF study reports indicated the presence of chromosomal abnormalities. This patient was treated exclusively with Ayurveda therapy aimed towards qualitative improvement in reproductive tissues (Shukra Dhatu as per Ayurveda). Patient was assessed periodically for changes in chromosomal abnormality. After four months of treatment, the evaluations demonstrated the presence of completely normal chromosomes.
 Conclusion: This case study indicates the potential of Ayurveda therapy in treating cases of male infertility caused by DNA fragmentation. Furthermore, observations and systematically designed clinical trials are warranted to establish a stronger level of evidence before making further clinical recommendations.

Safety of Planned Dental Extractions Immediately after Radiation Therapy: First Report of a Prospective Observational Study

Safety of Planned Dental Extractions Immediately after Radiation Therapy: First Report of a Prospective Observational Study

ILK inhibition reduces osteophyte formation through suppression of osteogenesis in BMSCs via Akt/GSK-3β/β-catenin pathway.

Osteophyte development is a common characteristic of inflammatory skeletal diseases. Elevated osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) participates in pathological osteogenesis. Integrin-linked kinase (ILK) positively regulates the osteoblastic differentiation of osteoprogenitors, but whether the ILK blockage prevents osteophytes and its potential mechanism is still unknown. Furthermore, the low-dose tumor necrosis factor-α (TNF-α) promotes osteogenic differentiation, but a lack of study reports on the relationship between this cytokine and ILK. OSU-T315 is a small ILK inhibitor, which was used to determine the effect of ILK inhibition on osteogenesis and osteophyte formation. The osteogenesis of BMSCs was evaluated using Alizarin red S staining, alkaline phosphatase, collagen type I alpha 2 chain, and bone gamma-carboxyglutamate protein. The expression and phosphorylation of protein were assessed through western blot. Immunofluorescence was employed to display the distribution of β-catenin. microCT, hematoxylin-eosin, and safranin O/fast green staining were utilized to observe the osteophyte formation in collagen antibody-induced arthritis mice. We found that ILK blockage significantly declined calcium deposition and osteoblastic markers in a dose- and time-dependent manner. Furthermore, it lowered osteogenesis in the TNF-α-induced inflammatory microenvironment by diminishing the effect of ILK and inactivating the Akt/ GSK-3β/ β-catenin pathway. Nuclear β-catenin was descended by OSU-T315 as well. Finally, the ILK suppression restrained osteophyte formation but not inflammation in vivo. ILK inhibition lowered osteogenesis in TNF-α-related inflammatory conditions by deactivating the Akt/ GSK-3β/ β-catenin pathway. This may be a potential strategy to alleviate osteophyte development in addition to anti-inflammatory treatment.

Perception of undergraduate students of Nigeria’s premier university on the use of emergency remote teaching during Covid-19

This study reports preliminary findings on undergraduate students’ perception of the Emergency Remote Teaching (ERT) at the University of Ibadan, Nigeria, during Covid-19. Proportional to size sampling was used in obtaining the sample size of 366, while respondents were selected using convenience sampling. Data collection was through a structured questionnaire containing both open and closed ended questions and data was collected on the factors - attitude, affect, motivation; perceived behavioural control (accessibility, self-efficacy, ease of use,); and cognitive engagement. Findings showed that students’ positive attitude towards face-to-face learning was significantly higher than towards ERT and correlation analysis showed a relationship between preference for face-to-face learning and struggling with ERT. Also, the average difference in students’ motivation for learning before and after commencement of ERT was not statistically significant. Students reported more frequent use of educational technologies after ERT commenced than before and the difference was statistically significant. Increase was reported in all the self-efficacy and cognitive engagement constructs. Positive changes reported were mainly acquisition of additional hobbies as well as business, social and technology skills. Challenges to online learning included poor power supply, cost of data subscription, network disruptions and distractions from family and friends.

Surgical outcomes and predictive value for major complications of robot-assisted radical cystectomy of real-world data in a single institution in Japan.

The objective of the study was to describe the surgical outcome of robot-assisted radical cystectomy and predictive factors for major complications in real-world clinical practice at a single institution in Japan. We retrospectively analyzed 208 consecutive patients undergoing robot-assisted radical cystectomy at our institution between 2019 and 2023. Patient and disease characteristics, intraoperative details, and perioperative outcomes were reviewed. Postoperative complications were defined as minor complications (Clavien-Dindo grades 1-2) or major complications (grades 3-5). Predictors of complications were examined using multivariable logistic analysis. Overall, 147 men and 61 women, median age 70 years (interquartile range, 62-77), were included in this study. Median operative time and estimated blood loss were 8.4 h and 185 mL, respectively; 11 patients (5%) received intraoperative blood transfusions. For urinary diversions, ileal conduit, neobladder, and cutaneous ureterostomy were performed in 153 (74%), 49 (24%), and 6 (3%) patients, respectively. Urinary diversions were primarily performed with extracorporeal urinary diversion. In total, 140 complications occurred in 111 patients (53%) within 30 days. Of these patients, 31 major complications occurred in 28 patients, and one perioperative death (0.5%) with a postoperative cardiovascular event. Multivariable analysis showed only prolonged operative time (odds ratio: 4.34, 95% confidence interval: 1.82-10.35, p < 0.01) was the independent risk factor for major complications. This study reports surgical outcomes at our single institution. Prolonged operative time was a significant prognostic factor for major complications. As far as we know, this study reports the largest number of robot-assisted radical cystectomy cases at a single center in Japan.

"Window of Opportunity" in Ocular Graft-Versus-Host Disease Treatment: Results of a Longitudinal Study and Case Reports.

To perform a longitudinal study for determining the development of ocular graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplant (HSCT) and report cases that illustrate the "window of opportunity" concept in oGVHD treatment. Patients (n=61) were examined at prescheduled clinic visits before HSCT and three-month intervals after HSCT for 2 years. The presence or absence of oGVHD was determined using the international chronic oGVHD consensus group diagnostic criteria. Ocular surface washings (OSW) were obtained at each visit and analyzed for cytokine levels. In the longitudinal study, 26.2% (n=16; progressed group) developed either probable (11.5%, n=7) or definite oGVHD (14.8%, n=9). In the progressed group, clinically significant changes in signs (corneal staining and Schirmer I test) and symptoms at the post-HSCT visit as compared with the pre-HSCT visit occurred at 9 months. Significant differences in clinical signs and symptoms (whether average post-HSCT values or changes in values over pre-HSCT levels) between the progressed and nonprogressed groups occurred at a 9-month visit or later. In the progressed group, 55.6% of eyes that had negative matrix metalloproteinase 9 (MMP-9) test at pre-HSCT turned MMP-9 positive at 3 to 6 months post-HSCT. In the progressed group, interleukin 8 levels in OSW were significantly increased at 6 months post-HSCT. In the case reports, the "window of opportunity" was detected by MMP-9 turning positive, early corneal staining, interleukin 8 increase in OSW, and peripheral corneal epithelial thinning, which resolved with treatment initiation. A "window of opportunity" exists before patients developing symptomatic tear-deficient dry eye after HSCT for initiating treatment that may preempt oGVHD development; however, larger-scale longitudinal studies are needed for definitive recommendations.

How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities.

For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90years, engaged in StandingTall, a home-based balance exercise program proven to reduce falls in the community. The perception of aging, physical activity in older age, and the delivery of exercise were identified as major themes, with the perception of aging an overarching theme influencing both preferences for physical activity in older age and exercise delivery. Findings demonstrate the importance of considering the role of aging, the influence aging has on physical activity and exercise behavior, and how aging influences the delivery and design of exercise programs including falls prevention activities for older people.

Degradation of SDS by psychrotolerant Staphylococcus saprophyticus and Bacillus pumilus isolated from Southern Ocean water samples.

Bioremediation of surfactants in water bodies holds significant ecological importance as they are contaminants of emerging concern posing substantial threats to the aquatic environment. Microbes exhibiting special ability in terms of bioremediation of contaminants have always been reported to thrive in extraordinary environmental conditions that can be extreme in terms of temperature, lack of nutrients, and salinity. Therefore, in the present investigation, a total of 46 bacterial isolates were isolated from the Indian sector of the Southern Ocean and screened for degradation of sodium dodecyl sulphate (SDS). Further, two Gram-positive psychrotolerant bacterial strains, ASOI-01 and ASOI-02 were identified with significant SDS degradation potential. These isolates were further studied for growth optimization under different environmental conditions. The strains were characterized as Staphylococcus saprophyticus and Bacillus pumilus based on morphological, biochemical, and molecular (16S RNA gene) characteristics. The study reports 88.9% and 93.4% degradation of SDS at a concentration of 100 mgL-1, at 20°C, and pH 7 by S. saprophyticus ASOI-01 and B. pumilus ASOI-02, respectively. The experiments were also conducted in wastewater samples where a slight reduction in degradation efficiency was observed with strains ASOI-01 and ASOI-02 exhibiting 76.83 and 64.93% degradation of SDS respectively. This study infers that these bacteria can be used for the bioremediation of anionic surfactants from water bodies and establishes the potential of extremophilic microbes for the utilization of sustainable wastewater management.

Contributors to Physician Burnout and Well-Being in Forensic Psychiatrists in Canada.

The experience of burnout in forensic psychiatrists has not been well studied, with most studies focusing on the experiences of forensic nurses, the impact of vicarious trauma and compassion fatigue in forensic mental health professionals, and the risk of posttraumatic stress disorder related to workplace exposures. This study reports on a national survey (34% response rate) conducted with forensic psychiatrists across Canada to understand the rate of, and contributors to, burnout and professional fulfillment. Just over half of the physician respondents reported experiencing burnout, which is in line with other recent surveys in Canada that have indicated elevated levels of burnout since the onset of the pandemic. The highest rates were found among early-career psychiatrists and those whose values did not align with their workplace. Intellectual stimulation, the interface with the legal system, and flexibility in one's job were all strongly linked with professional fulfillment. The goal of this survey was not only to identify rates and variables affecting burnout and wellness in this population but also to expand the dialogue on potential interventions at institutional and systems levels that can reduce burnout, promote professional fulfillment, and enhance recruitment and retention in the field of forensic psychiatry.

Toward Sustainability in All‐Printed Accumulation Mode Organic Electrochemical Transistors

AbstractThis study reports on the first all‐printed vertically stacked organic electrochemical transistors (OECTs) operating in accumulation mode; the devices, relying on poly([4,4′‐bis(2‐(2‐(2‐methoxyethoxy)ethoxy)ethoxy)‐2,2′‐bithiophen‐5,5′‐diyl]‐alt‐[thieno[3,2‐b]thiophene‐2,5‐diyl]) (pgBTTT) as the active channel material, are fabricated via a combination of screen and inkjet printing technologies. The resulting OECTs (W/L ≈5) demonstrate good switching performance; gm, norm ≈13 mS cm−1, µC* ≈21 F cm−1 V−1 s−1, ON–OFF ratio &gt; 104 and good cycling stability upon continuous operation for 2 h. The inkjet printing process of pgBTTT is established by first solubilizing the polymer in dihydrolevoglucosenone (Cyrene), a non‐toxic, cellulose‐derived, and biodegradable solvent. The resulting ink formulations exhibit good jettability, thereby providing reproducible and stable p‐type accumulation mode all‐printed OECTs with high performance. Besides the environmental and safety benefits of this solvent, this study also demonstrates the assessment of how the solvent affects the performance of spin‐coated OECTs, which justifies the choice of Cyrene as an alternative to commonly used harmful solvents such as chloroform, also from a device perspective. Hence, this approach shows a new possibility of obtaining more sustainable printed electronic devices, which will eventually result in all‐printed OECT‐based logic circuits operating in complementary mode.