Subsequent Years Research Articles

Evaluation of the awareness of Western Australian SunSmart campaigns between 2008 and 2022.

It is unknown whether SunSmart health promotion campaigns in Western Australia are still effectively reaching their target audience of young people (under 45 years). This study examined trends over time in awareness, relevancy and believability of SunSmart advertisements and identified socio-demographic characteristics and risk factors associated with campaign awareness. Linear regression and log-binomial modelling were undertaken using data from the annual SunSmart post-campaign evaluation surveys between 2008/2009 and 2021/2022. SunSmart campaigns were analysed and categorised into the following themes: (1) personal real-life stories; (2) daily activities/sun exposure leads to skin cancer; or (3) cartoon/animated. Between 2008 and 2022, there were declines in total awareness (74.2% to 20.4%), unprompted awareness (33.7% to 4.9%) and relevancy (89.5% to 54.8%) of SunSmart advertisements (representing annual percent decreases of 3.6%, 3.1% and 1.8%, respectively). However, believability remained high over time (>94% in each annual survey). Trends were inconsistent between the awareness of campaign themes and socio-demographic characteristics and risk factors. Several campaigns had greater awareness in their subsequent years, compared with the first campaign year. In more recent years, SunSmart advertisements and campaigns may not have reached their target audience. In addition to socio-demographic characteristics, particularly age, advertisement factors may also affect the awareness of specific campaigns. SO WHAT?: Given the changing advertising landscape and its rising costs, ongoing funding is pertinent to increase the reach of future SunSmart campaigns. Increasing advertisements on alternative platforms and designing campaigns which separately target adolescents and adults need to be considered.

The Association of County-level Prostate-specific Antigen Screening with Metastatic Prostate Cancer and Prostate Cancer Mortality

Background and objectiveThere exists ongoing debate about the benefits and harms of prostate-specific antigen (PSA) screening for prostate cancer. This study sought to evaluate the association of county-level PSA screening rates with county-level incidence of metastatic prostate cancer and prostate cancer mortality in the USA. MethodsThis ecological study used data from the 2004–2012 Behavioral Risk Factor Surveillance System (BRFSS) to build a multilevel mixed-effect model with poststratification using US Census data to estimate county-level PSA screening rates for all 3143 US counties adjusted for age, race, ethnicity, and county-level poverty rates. The exposure of interest was average county-level PSA screening rate from 2004 to 2012, defined as the proportion of men aged 40–79 yr who underwent PSA screening within the prior 2 yr. The primary outcomes were county-level age-adjusted incidence of regional/distant prostate cancer during 2015–2019 and age-adjusted prostate cancer mortality during 2016–2020. Key findings and limitationsA total of 416221 male BRFSS respondents aged 40–79 yr met the inclusion criteria and were used in the multilevel mixed-effect model. The model was poststratified using 63.4 million men aged 40–79 yr from all 3143 counties in the 2010 Decennial Census. County-level estimated PSA screening rates exhibited geographic variability and were pooled at the state level for internal validation with direct BRFSS state-level estimates, showing a strong correlation with Pearson correlation coefficients 0.77–0.90. A 10% higher county-level probability of PSA screening in 2004–2012 was associated with a 14% lower county-level incidence of regional/distant prostate cancer in 2015–2019 (rate ratio 0.86, 95% confidence interval [CI] 0.85–0.87, p < 0.001) and 10% lower county-level prostate cancer mortality in 2016–2020 (rate ratio 0.90, 95% CI 0.89–0.91, p < 0.001). Conclusions and clinical implicationsIn this population-based ecological study of all US counties, higher PSA screening rates were associated with a lower incidence of regional/distant prostate cancer and lower prostate cancer mortality at extended follow-up. Patient summaryUS counties with higher rates of prostate-specific antigen (PSA) screening had significantly lower rates of metastatic prostate cancer and prostate cancer mortality in subsequent years. These data may inform shared decision-making regarding PSA screening for prostate cancer.

Grades and Employer Learning

This study examines the labor-market returns of skill signals. We identify the labor-market effect of grade point averages (GPA) by leveraging a nationwide change in the scaling of grades in Danish universities. Results show that a reform-induced increase in GPA that is unrelated to ability causes higher earnings immediately after graduation, but the effect fades in subsequent years. The effect at labor-market entry is largest for individuals with fewer alternative signals and the earnings adjustment occurs both within and across firms. Although employers initially screen candidates based on skill signals, our findings suggest that they rapidly learn about worker productivity.

“I Remember Feeling Pretty Darn Lucky”: Crafting Family Resilience in Response to a Medical Emergency

ABSTRACT Through a combination of autoethnographic reflections and oral history interviews with my parents, I explore the ways in which we enacted resilience throughout my father’s unexpected hospitalization, rehabilitation, and his subsequent years of recovery, both individually and communally. Using communication theory of resilience (CTR) as a framework, I identify the ways in which we engaged in the five processes outlined by the theory: crafting normalcy, emphasizing action while backgrounding negative feelings, affirming identity anchors, relying on communication networks, and employing alternative logics. I then propose three additional processes of enacting resilience that emerged from my family’s insights: enacting performative resilience, connecting to broader experience, and emphasizing perspective-taking. To conclude, I reflect on the value of these communicative processes and the combination of research practices I engaged in the paper, as well as the practical benefits of CTR and my additions to the theory.

Effects of a Follow-up PD with Distance-based Peer Instructional Coaching on Secondary Science Teachers’ Inquiry-based Teaching Practices in Rural Schools

ABSTRACT Research has highlighted the significant decline in teachers’ implementation of newly acquired teaching practices following professional development (PD), primarily attributed to the absence of follow-up support. Even science teachers who have participated in intensive PD programs often encounter challenges in integrating new teaching practices into their classrooms. This study investigated the impact of a follow-up PD (PD 2) on 16 rural middle and high school science teachers and their students’ outcomes after their participation in an intensive PD the previous year (PD1). The findings showed that the teachers’ inquiry knowledge and confidence levels in teaching science remained stable or slightly improved up until the end of year 2, comparable to the levels measured at the end of year 1. Moreover, teachers who initially showed lower levels of knowledge and confidence were more likely to revert to their initial status after reaching a certain level during PD1. Regarding student outcomes, the posttest effect sizes for middle school students were substantial and statistically significant in both year 1 and year 2, compared to their pretest scores. While the effect sizes for high school students in year 1 were small, they became larger and significant in year 2. The findings suggest the practical advantages of implementing follow-up PD to provide continued support for teachers’ implementation in subsequent years. Additionally, this study presents a sustainable and cost-effective approach to deliver follow-up support to teachers, namely through a short-term PD accompanied by distance-based peer instructional coaching.

Peak ADAMTS13 activity to assess ADAMTS13 conformation and risk of relapse in immune-mediated thrombotic thrombocytopenic purpura

AbstractPrevious studies have demonstrated that >38% of patients with immune-mediated thrombotic thrombocytopenic purpura in remission with activity >50% had an open ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13) conformation. We assessed ADAMTS13 conformation in remission (ADAMTS13 activity >60%), focusing on peak ADAMTS13 activity levels and longitudinal assessment in 420 samples across 157 patients. Fewer cases had an open conformation at peak ADAMTS13 activity than unselected remission samples with ADAMTS13 activity >60% (23% vs 43%). Patients with a closed ADAMTS13 conformation at peak ADAMTS13 activity had an eightfold lower relapse rate in the subsequent year (9% vs 46%) and a fivefold lower relapse rate within 2 years (23% vs 62%) compared with cases with an open conformation. Patients with an open conformation at peak ADAMTS13 activity required preemptive anti-CD20 treatment earlier than those with a closed conformation (median, 10 vs 25 months). Longitudinally, an open conformation was evident at, and often preceded relapse. When the conformation was already open before relapse, an increase in the conformation index at relapse was seen despite the undetectable anti-ADAMTS13 immunoglobulin G (IgG) antibody. In cases with detectable anti-ADAMTS13 IgG antibody, these became undetectable before achieving a closed conformation, highlighting the relapse risk even with undetectable anti-ADAMTS13 IgG antibody and the clinical utility of open/closed during monitoring. To our knowledge, this is the first study to show an association between relapse risk and ADAMTS13 conformation when activity levels are at a peak. The open conformation identifies antibody-mediated subclinical disease that is not detectable by the current ADAMTS13 testing.

Role Models in Movies: The Impact of Queen of Katwe on Students’ Educational Attainment

Abstract This paper presents experimental evidence on the impact of a role model on secondary school students’ exam performance in Uganda. Students were individually randomized to see either a movie featuring a female role model, Queen of Katwe, or to see a placebo movie. I find that treatment with the role model immediately before an important national exam leads to students performing better on their exams, particularly in math, with effects largest for female students. Female students exposed to the role model are more likely to remain in education in subsequent years, closing the gender gap with their male peers.

Taxonomic and functional-trait metrics track recovery of demersal fish and shrimp communities following system collapse

Monitoring programs that integrate both structural and functional ecosystem components play integral roles in ecosystem management and conservation planning. In the early 1990’s, the marine ecosystem of the waters surrounding Newfoundland and Labrador (NL) underwent a regime shift. Several demersal and pelagic fish stocks collapsed simultaneously, and this had significant ecological and socioeconomic consequences. As this regime shift impacted numerous commercial and non-commercial species, assessments based on individual species would be insufficient. We explored a variety of metrics that capture different facets of diversity across multiple species to provide a more robust ecosystem assessment. These were species richness, evenness, community-weighted means of maximum body length and trophic level (i.e., the mean maximum body size or trophic level of the species present in a community), and functional dispersion (FDis). The objectives of this study were 1) to assess trends in community structure of the NL demersal community during the post-collapse period (1995-2018), 2) explore how the various community-level metrics differ or are redundant, and 3) investigate how these metrics are associated with important covariates. Several metrics were redundant and displayed strongly positive, temporal trends being consistent with expectations for a recovery encompassing the entire demersal community. In particular, unweighted community-weighted means of body length and trophic level displayed nearly equal temporal patterns, showing increasing trends throughout the study period which were most prominent in the northern study area and within a limited depth range at the upper shelf break. Corresponding biomass-weighted metrics were also correlated with each other but only showed similar increasing tendencies after the first decade. In contrast, species richness did not show any temporal increase. Evenness and biomass-weighted FDis showed similar temporal patterns, decreasing during the first decade followed by strong increases during subsequent years, patterns that were directly linked to variation in Northern shrimp and Atlantic cod biomass. This study demonstrates how a variety of community metrics can provide insight into different aspects of the post-collapse recovery of the demersal community and help us better understand the complexity of the changes the ecosystem is undergoing.

Unintended consequences of school accountability reforms: Public versus private schools

In this paper, we show that the public provision of information on Australian schools’ average national test score outcomes via the My School website, launched in 2010, resulted in poorly performing schools testing fewer students in subsequent years. This increased non-participation in testing was driven primarily by formal parental withdrawal, and poorly performing students were much more likely to be withdrawn from testing. This phenomenon is consistent with schools attempting to ‘game’ the system to improve published test scores. We also provide weaker evidence that withdrawal responded more strongly to initial poor performance in independent private schools than in government schools.

Exploring the Nexus between Women's Literacy Rates and Family Size: A Case Study of Nepal

The literacy rate of a nation serves as a pivotal indicator of its developmental trajectory across the globe . However, in many developing countries, including those in South Asia, a notable gender disparity persists in literacy rates, with women lagging behind men. This study focuses on Nepal, a representative country in this region, utilizing data spanning thr ee decades from the National Population Census (1991 to 2021). The findings reveal a considerable rise in women's literacy rates over the thr ee decade period, marking a noteworthy shift from the substantially low rates observed in 1991. The trend consisten tly ascended in subsequent years 2001, 2011, and 2021 indicating a positive trajectory in female literacy. Crucially, an intriguing relationship emerged between women's literacy rates and family size. Historically, when female literacy rates were considera bly lower, the national average family size tended to be higher. However, with the progressive increase in female literacy rates in recent y ears, a marked shift toward smaller, nuclear family sizes, averaging around four members, was observed. This shift i mplies that literate women exhibit heightened self awareness regarding family planning, influencing the move toward maintaining smaller nuclear families. Notably, while male literacy rates exceeded 50% even three decades prior, solely bolstering male liter acy did not correlate with maintaining nuclear family sizes. The study emphasizes the unique effectiveness of female literacy in shaping and mainta ining the transition toward smaller nuclear family structures. These findings underscore the critical role of women's education in influencing family planning and size, marking a pivotal factor in shaping societal structures and developmental paradigms.

Progress in site-specific cancer mortality in Canada over the last 70 years

In Canada, the absolute number of cancer deaths has been steadily increasing, however, age-standardized cancer mortality rates peaked decades ago for most cancers. The objective of this study was to estimate the reduction in deaths for each cancer type under the scenario where peak mortality rates had remained stable in Canada. Data for this study were obtained the Global Cancer Observatory and Statistics Canada. We estimated age-standardized mortality rates (ASMR, per 100,000) from 1950 to 2022, standardized to the 2011 Canadian standard population. We identified peak mortality rates and applied the age-specific mortality rates from the peak year to the age-specific Canadian population estimates for subsequent years (up to 2022) to estimate the number of expected deaths. Avoided cancer deaths were the difference between the observed and expected number of cancer deaths. There have been major reductions in deaths among cancers related to tobacco consumption and other modifiable lifestyle habits (417,561 stomach; 218,244 colorectal; 186,553 lung; 66,281 cervix; 32,732 head and neck; 27,713 bladder; 22,464 leukemia; 20,428 pancreas; 8863 kidney; 3876 esophagus; 290 liver). There have been 201,979 deaths avoided for female-specific cancers (breast, cervix, ovary, uterus). Overall, there has been a 34% reduction in mortality for lung cancer among males and a 9% reduction among females. There has been a significant reduction in cancer mortality in Canada since site-specific cancer mortality rates peaked decades ago for many cancers. This shows the exceptional progress made in cancer control in Canada due to substantial improvements in prevention, screening, and treatment. This study highlights priority areas where more attention and investment are needed to achieve progress.

Reappraising the construction of Yogi Bhajan’s Kundalini Yoga

ABSTRACT This piece revisits my 2012 article for Sikh Formations titled ‘From Maharaj to Mahan Tantric,’ which gave a revised history of Yogi Bhajan’s Kundalini Yoga, and narrates its reception and influence in subsequent years, especially since 2020 with revelations of abuse by Yogi Bhajan and within 3HO institutions. It argues that ‘From Maharaj to Mahan Tantric’ played a role as both a threat to legitimacy and then a tool of crisis management for 3HO, and the reception of the article highlights the importance of Yogi Bhajan’s yoga and claimed titles during the longer history of 3HO through the present moment.

Performance Metrics of Screening Digital Breast Tomosynthesis Based on Years Since a Prior Breast Cancer Diagnosis.

BACKGROUND. Mammography surveillance protocols after breast cancer treatment vary widely. Some practices recommend performing diagnostic mammography for a certain number of years or indefinitely, whereas others recommend returning immediately to screening. OBJECTIVE. This study's objective was to determine performance metrics of screening digital breast tomosynthesis (DBT) in patients who resume screening mammography immediately after breast cancer treatment, based on the number of years since the breast cancer diagnosis. METHODS. This retrospective study included screening DBT examinations performed from January 2013 to June 2019 in patients who resumed screening mammography immediately after a prior breast cancer diagnosis. Multivariable logistic regression models with generalized estimating equations were used to evaluate associations between screening performance metrics and years since the prior breast cancer diagnosis, controlling for age, race and ethnicity, breast density, presence of a prior screening mammogram, and interpreting radiologist. RESULTS. The study included 8090 patients (mean age, 65 ± 11 [SD] years) with a prior breast cancer diagnosis who underwent 30,812 screening DBT examinations during the study period. The cancer detection rate (CDR) was 8.6 per 1000 examinations (265/30,812), abnormal interpretation rate (AIR) was 5.7% (1750/30,812), PPV1 was 15.1% (265/1750), sensitivity was 80.3% (265/330), specificity was 95.1% (28,997/30,482), and false-negative rate was 2.1 per 1000 examinations (65/30,812). CDR showed a significant independent positive association with years since breast cancer diagnosis (adjusted OR, 1.03; 95% CI, 1.01-1.05; p < .001), being lowest more than 2 to up to 3 years after diagnosis (4.9 per 1000 examinations) and highest more than 8 to up to 9 years after diagnosis (11.2 per 1000 examinations). AIR showed a significant independent negative association with years since breast cancer diagnosis (adjusted OR, 0.99; 95% CI, 0.98-1.00; p = .01), being highest 1 year or less after diagnosis (7.5%) and lowest more than 5 to up to 6 years after diagnosis (5.0%). CONCLUSION. Among 8090 patients with a prior breast cancer diagnosis, even though the AIR was higher during the year after diagnosis compared with subsequent years, the AIR remained acceptably low (< 10%) in all years. CLINICAL IMPACT. These results support the study institution's mammographic surveillance protocol for patients with a prior breast cancer diagnosis of returning immediately to DBT screening.

Clinical case of delayed diagnosis of celiac enteropathy

Clinical case of delayed diagnosis of celiac enteropathy

Biological therapy of severe bronchial asthma in a child

Currently, bronchial asthma is a global health problem, due to its high prevalence, economic component, as well as a violation of the social adaptation of children suffering from this disease. This article is devoted to a detailed analysis of the clinical case of a patient born in 2009 with an established diagnosis of Bronchial asthma, atopic form, severe persistent partially controlled course, which initiated therapy with a genetically engineered biological preparation of a humanized monoclonal antibody against IgE – omalizumab. However, in subsequent years, the patient’s condition was unstable, severe seizures were repeated, she was repeatedly hospitalized in the department where infusion therapy was performed and basic therapy was reviewed, dose adjustments and administration regimens of monoclonal antibodies to IgE (omalizumab) were carried out. A retrospective analysis of the results of objective, instrumental and laboratory examinations of the patient was also carried out over the past three years, when the child received the genetically engineered drug omalizumab without interruption. Taking into account the severe course of AD, the lack of control over the disease against the background of basic therapy with combined drugs in combination with therapy with monoclonal antibodies to IgE (omalizumab), it was decided to correct treatment and initiate therapy with a genetically engineered drug, recombinant human monoclonal antibody IgG4 (dupilumab). This clinical example once again shows how personalized the approach should be when prescribing therapy to patients with severe asthma, and also dictates the need to develop new diagnostic methods and management tactics for patients with uncontrolled forms of this disease.

Modern trends in the development of plant production under agrarian crises

Modern trends in the development of plant production under agrarian crises

Earliest records of the Asian longhorned tick (Acari: Ixodidae) in Staten Island, New York, and subsequent population establishment, with a review of its potential medical and veterinary importance in the United States.

Three Asian longhorned ticks (Haemaphysalis longicornis) were collected on Staten Island, Richmond County, New York, in 2014-2015 as part of a tick-borne disease surveillance program conducted by the New York City Department of Health and Mental Hygiene and the Defense Centers of Public Health - Aberdeen Tick-Borne Disease Laboratory. These records mark the earliest known occurrence of H. longicornis in New York State outside of quarantine areas, predating previously reported detections by several years. Robust populations of H. longicornis were collected in subsequent years at the Staten Island site where these few ticks were found, demonstrating that small infestations have the potential to proliferate quickly. Haemaphysalis longicornis is a 3-host ixodid tick native to eastern Asia but now established in the United States, as well as Australasia and several Pacific islands. Although H. longicornis has not yet been associated with human disease transmission in the United States, it warrants attention as a potential vector, as it is demonstrated to harbor various pathogens of medical and veterinary interest across its native and introduced range.

The DECam Ecliptic Exploration Project (DEEP). II. Observational Strategy and Design

We present the DECam Ecliptic Exploration Project (DEEP) survey strategy, including observing cadence for orbit determination, exposure times, field pointings and filter choices. The overall goal of the survey is to discover and characterize the orbits of a few thousand Trans-Neptunian objects (TNOs) using the Dark Energy Camera (DECam) on the Cerro Tololo Inter-American Observatory Blanco 4 m telescope. The experiment is designed to collect a very deep series of exposures totaling a few hours on sky for each of several 2.7 square degree DECam fields-of-view to achieve approximate depths of magnitude 26.2 using a wide V R filter that encompasses both the V and R bandpasses. In the first year, several nights were combined to achieve a sky area of about 34 square degrees. In subsequent years, the fields have been re-visited to allow TNOs to be tracked for orbit determination. When complete, DEEP will be the largest survey of the outer solar system ever undertaken in terms of newly discovered object numbers, and the most prolific at producing multiyear orbital information for the population of minor planets beyond Neptune at 30 au.

Different Immunologic Profiles Are Associated With Distinct Clinical Phenotypes in Longitudinally Observed Patients With Systemic Lupus Erythematosus.

The aim of this study was to determine the immunologic profile associated with disease flares in patients with systemic lupus erythematosus (SLE) and to investigate the clinical significance of any differences observed between patients during and following a flare. Multiparameter flow cytometry was used to examine 47 immune populations within the peripheral blood of 16 healthy controls, 25 patients with clinically quiescent SLE, and 46 patients with SLE experiencing a flare at baseline and at 6- and 12-month follow-up visits. Unsupervised clustering was used to identify patients with similar immune profiles and to track changes over time. Parametric or nonparametric statistics were used when appropriate to assess the association of cellular phenotypes with clinical and laboratory parameters. Five clusters of patients were identified that variably contained patients with active and quiescent SLE, and that had distinct clinical phenotypes. Patients characterized by increased T peripheral helper, activated B, and age-associated B cells were the most likely to be flaring at baseline, as well as the most likely to remain active or flare over the subsequent year if they acquired or retained this phenotype at follow-up. In contrast, patients who had increased T helper (Th) cells in the absence of B cell changes, or who had increased Th1 cells and innate immune populations, mostly developed quiescent SLE on follow-up. A significant proportion of patients with SLE had depletion of many immune populations at flare and only showed increases in these populations post-flare. Cellular phenotyping of patients with SLE reveals several distinct immunologic profiles that may help to stratify patients with regard to prognosis and treatment.

Age-time-specific transmission of hand-foot-and-mouth disease enterovirus serotypes in Vietnam: A catalytic model with maternal immunity

Hand, foot and mouth disease (HFMD) is highly prevalent in the Asia Pacific region, particularly in Vietnam. To develop effective interventions and efficient vaccination programs, we inferred the age-time-specific transmission patterns of HFMD serotypes enterovirus A71 (EV-A71), coxsackievirus A6 (CV-A6), coxsackievirus A10 (CV-A10), coxsackievirus A16 (CV-A16) in Ho Chi Minh City, Vietnam from a case data collected during 2013–2018 and a serological survey data collected in 2015 and 2017. We proposed a catalytic model framework with good adaptability to incorporate maternal immunity using various mathematical functions. Our results indicate the high-level transmission of CV-A6 and CV-A10 which is not obvious in the case data, due to the variation of disease severity across serotypes. Our results provide statistical evidence supporting the strong association between severe illness and CV-A6 and EV-A71 infections. The HFMD dynamic pattern presents a cyclical pattern with large outbreaks followed by a decline in subsequent years. Additionally, we identify the age group with highest risk of infection as 1-2 years and emphasise the risk of future outbreaks as over 50% of children aged 6-7 years were estimated to be susceptible to CV-A16 and EV-A71. Our study highlights the importance of multivalent vaccines and active surveillance for different serotypes, supports early vaccination prior to 1 year old, and points out the potential utility for vaccinating children older than 5 years old in Vietnam.