Notes

Any Multicentre Evaluation of Dosiomics Capabilities Reproducibility, Balance and Sensitivity.
At the time of writing, our fine-tuned models ranked 1st among all monocular methods on the KITTI 2015 benchmark, and outperform all published methods on the Sintel Final benchmark. More importantly, we demonstrate the generalization capability of DistillFlow in three aspects framework generalization, correspondence generalization and cross-dataset generalization.Text is a new way to guide human image manipulation. Albeit natural and flexible, text usually suffers from inaccuracy in spatial description, ambiguity in the description of appearance, and incompleteness. We in this paper address these issues. To overcome inaccuracy, we use structured information (e.g., poses) to help identify correct location to manipulate, by disentangling the control of appearance and spatial structure. Moreover, we learn the image-text shared space with derived disentanglement to improve accuracy and quality of manipulation, by separating relevant and irrelevant editing directions for the textual instructions in this space. Our model generates a series of manipulation results by moving source images in this space with different degrees of editing strength. Thus, to reduce the ambiguity in text, our model generates sequential output for manual selection. In addition, we propose an efficient pseudo label loss to enhance editing performance when the text is incomplete. We evaluate our method on various datasets and show its precision and interactiveness to manipulate human images.In this paper, we explore the mask representation in instance segmentation with Point-of-Interest (PoI) features. Differentiating multiple potential instances within a single PoI feature is challenging, because learning a high-dimensional mask feature for each instance using vanilla convolution demands a heavy computing burden. To address this challenge, we propose an instance-aware convolution. It decomposes this mask representation learning task into two tractable modules as instance-aware weights and instance-agnostic features. The former is to parametrize convolution for producing mask features corresponding to different instances, improving mask learning efficiency by avoiding employing several independent convolutions. Meanwhile, the latter serves as mask templates in a single point. Together, instance-aware mask features are computed by convolving the template with dynamic weights, used for the mask prediction. Along with instance-aware convolution, we propose PointINS, a simple and practical instance segmentation approach, building upon dense one-stage detectors. Through extensive experiments, we evaluated the effectiveness of our framework built upon RetinaNet and FCOS. PointINS in ResNet101 backbone achieves a 38.3 mask mean average precision (mAP) on COCO dataset, outperforming existing point-based methods by a large margin. It gives a comparable performance to the region-based Mask R-CNN with faster inference. Identifying mild-to-critical COVID-19 patients is important for early prevention and personalized treatment planning.It is well-known that expanding glioblastomas typically induce significant deformations of the surrounding parenchyma (i.e., the so-called ?mass effect?). In this study, we evaluate the performance of three mathematical models of tumor growth 1) a reaction-diffusion-advection model which accounts for mass effect (RDAM), 2) a reaction-diffusion model with mass effect that is consistent only in the case of small deformations (RDM), and 3) a reaction-diffusion model that does not include the mass effect (RD). The models were calibrated with magnetic resonance imaging (MRI) data obtained during tumor development in a murine model of glioma (n = 9). We obtained T2-weighted and contrast-enhanced T1-weighted MRI at 6 time points over 10 days to determine the spatiotemporal variation in the mass effect and tumor concentration, respectively. We calibrated the three models using data 1) at the first four, 2) only at the first and fourth, and 3) only at the third and fourth time points. Each of these calibrations were run forward in time to predict the volume fraction of tumor cells at the conclusion of the experiment. The diffusion coefficient for the RDAM model (median of 10.65 ? 10-3 mm2d-1) is significantly less than those for the RD and RDM models (17.46 ? 10-3 mm2d-1 and 19.38 ? 10-3 mm2d-1, respectively). The tumor concentrations for the RD, RDM, and RDAM models have medians of 40.2%, 32.1%, and 44.7%, respectively, for the calibration using data from the first four time points. The RDM model most accurately predicts tumor growth, while the RDAM model presents the least variation in its estimates of the diffusion coefficient and proliferation rate. This study demonstrates that the mathematical models capture both tumor development and mass effect observed in experiments.Regulation of reward signaling in the brain is critical for appropriate judgement of the environment and self. In Drosophila, the protocerebral anterior medial (PAM) cluster dopamine neurons mediate reward signals. Here, we show that localized inhibitory input to the presynaptic terminals of the PAM neurons titrates olfactory reward memory and controls memory specificity. The inhibitory regulation was mediated by metabotropic gamma-aminobutyric acid (GABA) receptors clustered in presynaptic microdomain of the PAM boutons. Cell type-specific silencing the GABA receptors enhanced memory by augmenting internal reward signals. Strikingly, the disruption of GABA signaling reduced memory specificity to the rewarded odor by changing local odor representations in the presynaptic terminals of the PAM neurons. The inhibitory microcircuit of the dopamine neurons is thus crucial for both reward values and memory specificity. Maladaptive presynaptic regulation causes optimistic cognitive bias.Etuaptmumk or Two-Eyed Seeing (E/TES) is foundational in ensuring that Indigenous ways of knowing are respected, honoured, and acknowledged in health research practices with Indigenous Peoples of Canada. This paper will outline new knowledge gleaned from the Canadian Institute of Health Research and Chronic Pain Network funded Aboriginal Children's Hurt & Healing (ACHH) Initiative that embraces E/TES for respectful research. We share the ACHH exemplar to show how Indigenous community partners take the lead to address their health priorities by integrating cultural values of kinship and interconnectedness as essential components to enhance the process of community-led research. E/TES is conceptualised into eight essential considerations to know in conducting Indigenous health research shared from a L'nuwey (Mi'kmaw) perspective. L'nu knowledge underscores the importance of working from an Indigenous perspective or specifically from a L'nuwey perspective. L'nuwey perspectives are a strength of E/TES. The ACHH Initiative grew from one community and evolved into collective community knowledge about pain perspectives and the process of understanding community-led practices, health perspectives, and research protocols that can only be understood through the Two-Eyed Seeing approach.
Compare community integration, quality of life, anxiety and depression of people with chronic spinal cord injury (SCI) living in the community before the outbreak of coronavirus SARS-CoV-2 disease (COVID-19) and during it.

Prospective observational cohort study.

In-person follow-up visits (before COVID-19 outbreak) to a rehabilitation hospital in Spain and on-line during COVID-19.

Community dwelling adults (≥ 18 years) with chronic SCI.

Hospital Anxiety and Depression Scale (HADS), Community Integration Questionnaire (CIQ) and World Health Organization Quality of Life (WHOQOL-BREF) were compared using the Wilcoxon ranked test or paired t-test when appropriate.

One hundred and seventy five people with SCI assessed on-line between June 2020 and November 2020 were compared to their own assessments before COVID-19. Participants reported significantly decreased Social Integration during COVID-19 compared to pre-pandemic scores (P = 0.037), with a small effect size (
 = -0.15). Depression (measured usieanwhile participants older than 55, were not.Montan resin (MR) is an industrial by-product or solid waste generated during the production of refined montan wax and is not typically reused. In this paper, a bio-modification method using three strains of microorganisms, Acinetobacter venetianus (AV), Pseudomonas aeruginosa (PA), and Phanerochaete chrysosporium (PC), was studied to promote the performance and bio-function of MR so that MR could be recycled. MR can be degraded by these three microorganisms, and their weight loss rates were similar over the treatment period of 15 days. Compared with the original MR, the hydrophilicity of modified MRs was improved, which was related to the increase in apparent oil-water partition coefficients (Kows) and oxygen-containing and hydrophilic groups in modified MRs based on IR and GC-MS analysis. The bio-function of modified MRs by the three strains in terms of promoting maize seed germination and seedling growth was greater compared with untreated MR. Overall, these findings indicate that biomodified MRs might have useful agriculture applications.Implications An environmentally-friendly method using microorganisms to achieve recycle of solid waste, montan resin (MR) was established in this study. Through this bio-treatment, the performance and bio-function of MR were both improved, that is the appearance and hydrophilicity of modified MRs were better than thoes in before, and the modified MRs treated by three strains showed the better promoting effects on maize seed germination and seedling growth than untreated MR, indicating the modified MRs have the certain potential of agricultural utilization in the future.Many professional chaplaincy organizations in the United States have board certified healthcare chaplains since the 1920s and documented how they have adapted their process as the profession has grown. In 2019, the Association of Professional Chaplains and the National Association of Catholic Chaplains sought the perspectives of key stakeholders about professional chaplaincy board certification. This study reports the results from 50 semi-structured interviews with certification candidates, certification committee members, and chaplaincy managers in the United States. Participants discussed the preparation of the certification application, the certification interview, the ease and difficulty of certification competencies, and the evolving workforce. This study demonstrated divergent views on many aspects of board certification, but participants predominately respected and valued the process. Chaplains with varying levels of experience discussed how board certification strengthens multidisciplinary respect and collaboration. Participants reported difficulties with competencies that required translating between theory and practice.Recycling of valuable metals from spent catalysts in a green way is gaining extensive interest for economic and environment reasons. In this study, we developed novel hydrophobic deep eutectic solvents to extract Mo from spent catalysts. The hydrophobic DESs have been designed and synthesized by mixing one molar of the quaternary ammonium salt and two molars of various saturated fatty acids with different carbon chain lengths. The extraction ability and extraction mechanism of these DESs were studied, some factors influencing the extraction efficiency, including the structure of hydrogen bond acceptors and hydrogen bond donors, initial aqueous pH, reaction time and temperature, phase ratios were investigated. It is found that the synthesized hydrophobic DESs exhibit excellent extraction performance towards Mo, where the Mo distribution ratio is more than 2200 in the presence of other metals, corresponding to extraction efficiency of 99% at optimal reaction conditions. This work reveals a distinct class of materials, guiding an effective and green way for spent catalyst treatment. ImplicationsNovel hydrophobic deep eutectic solvents have been developed to extract Mo from spent catalysts, the synthesized hydrophobic DESs possess several advantages such as green, low price, low toxicity, biodegradable. It exhibits excellent extraction performance under an optimized extraction condition. This work reveals a distinct class of materials, guiding a promising way for green and economical utilization of spent catalysts.The purpose of this study was to investigate the benefits and challenges of the tele-speech therapy from the perspective of patients who stutter, and their parents. Semi-structured interviews were conducted with 12 patients and three parents in two rehabilitation centers. Data were analyzed using a qualitative content analysis approach proposed by Graneheim and Lundman. Seven categories were determined accessible treatment, motivation of comfort in tele-speech therapy, challenges of tele-therapy, satisfaction, virtual competency, lower quality compared to face-to-face therapy, and uncertainty about the effectiveness of tele-speech therapy. The participants had a two-sided perspective regarding tele-speech therapy. Positive experiences included benefitting from more qualified therapists at multiple locations, faster access to treatment, and saving cost and time. Negative experiences and challenges consisted of low-quality of technology infrastructure for rehabilitation including low quality of shared images and videos, ineffective communication, insufficient sympathy, indirect communication, and technology incompetency. Findings showed that the participants were interested in the application of tele-speech therapy, as this method could increase their accessibility and provide the opportunity to choose proper therapists. The determined benefits and challenges can provide the policy-makers with beneficial information to implement tele-speech therapy.Transactional sex is a topic within HIV research that is relatively undertheorised and lacking consensus. In this study, it is understood as the implicit, non-marital, non-commercial exchange of sex for material goods or social status, and we examine the phenomenon among youth. Within the existing literature, the paradigms of sex-for-survival and sex-for-consumption emerge, representing differing senses of agency, particularly among young women. Based on interviews with human service providers in Kampala, Uganda, we consider the latter paradigm, examining how providers frame transactional sex against the political-economic backdrop of consumer culture, including the mainstreaming of communication technology in youths' lives. We also examine providers' depictions of available models of response, focused mainly on HIV prevention, in the context of international and national policies and politics. This study aims to situate analyses of transactional sex within political-economic context, considering how structural shifts toward neoliberalism have shaped both this phenomenon of behavioural health, and the existing models of response.Objective To investigate the possible changes in the mechanical properties of the orofacial and neck muscles in patients with temporomandibular disorders (TMD).Methods The study included a total of 98 females. Females were divided into three groups as myogenous TMD, mixed TMD, and healthy controls. The frequency (indicator of muscle tone), stiffness, and decrement (related to muscle elasticity) values of the sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were measured using a portable myotonometer.Results The frequency, stiffness, and decrement values of the masseter muscle were higher in the mixed and myogenous TMD groups than those of the control group (p less then 0.017). The mixed TMD group had higher frequency and stiffness values in the upper trapezius muscle compared with the control group (p less then 0.017).Discussion The results suggest that the mechanical properties of the oral and neck muscles may be affected in patients with TMD.Background Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited.Objective This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP).Methods A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging.Results The LBP group had a significantly smaller degree of right hemidiaphragm thickness change (P = .001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP.Conclusion We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP.
To determine postural changes in relation to mandibular position in maximum intercuspation and at rest in adult patients of both sexes.

A descriptive observational clinical study was carried out in 76 patients. Using an analyzer and the Meersseman test, the necessary dermal points for postural analysis were located.

The authors found significant differences in the posture adopted by the patient between maximum intercuspation and mandibular rest in the frontal, sagittal, and dorsal planes. Foot support in the right foot went from cavus to normal in 6% of the sample, and from flat to normal in 2.5% of the sample in the jaw rest position.

Postural changes were observed in various segments, with clinical and statistical significance at cervical level in the frontal plane, in the biscapular variable in the dorsal plane, and at the level of the lower limbs in the bipopliteal and bimalleolar variables.
Postural changes were observed in various segments, with clinical and statistical significance at cervical level in the frontal plane, in the biscapular variable in the dorsal plane, and at the level of the lower limbs in the bipopliteal and bimalleolar variables.We draw from a number of theoretical perspectives and frameworks on the life course, age and gender scholarship to argue their value in furthering critical discussions on work-life balance policies and their contributions to women's employment and economic security in later life. Using OECD and other big data sets, we examine the patterns of women's employment over the life course in Japan, Sweden and the United States, as three illustrated cases of welfare states with different nation's work-life balance policies. We summarize findings before offering concluding thoughts to advocate for women's security in later life.
To assess potential cow-level risk factors for clinical mastitis during the dry period in cows infused with internal teat sealant (ITS) alone at drying off, and associations with elevated somatic cell counts (SCC) at the first herd test, or clinical mastitis in the subsequent lactation.

Ten herds reporting an incidence of clinical mastitis during the dry period of >3% amongst cows infused with ITS alone at the end of the 2018/2019 lactation were enrolled. Cow data collected included age, breed, milk yield and SCC at the last herd test before drying off, drying off date, clinical mastitis records during the dry period and in the subsequent lactation, and SCC at the first herd test following calving.

Overall, 2,401 cows were infused with ITS alone and 196/2,401 (8.2%) cows were diagnosed with clinical mastitis during the dry period. In the final multivariable model for risk of clinical mastitis there was an interaction between age and milk yield at the last herd test (p < 0.001), with cows aged > of elevated SCC in the subsequent lactation. This was an observational study so no causal inferences can be made, however herdowners and veterinarians should follow current recommendations regarding management of milk yield before drying off, and selection of cows for treatment with ITS alone.
The risk of clinical mastitis in the dry period following infusion of ITS alone at the end of lactation was associated with cow age, milk yield before drying off and timing of drying off. Cows diagnosed with clinical mastitis over the dry period had a higher risk of clinical mastitis and of elevated SCC in the subsequent lactation. This was an observational study so no causal inferences can be made, however herdowners and veterinarians should follow current recommendations regarding management of milk yield before drying off, and selection of cows for treatment with ITS alone.It is not yet clear which response behavior requires self-regulatory effort in the moral dilemma task. Previous research has proposed that utilitarian responses require cognitive control, but subsequent studies have found inconsistencies with the empirical predictions of that hypothesis. In this paper, we treat participants' sensitivity to utilitarian gradients as a measure of performance. We confronted participants (N = 82) with a set of five dilemmas evoking a gradient of mean utilitarian responses in a 4-point scale and collected data on heart rate variability and utilitarian responses. We found positive correlations between tonic and phasic HRV and sensitivity to the utilitarian gradient in the high tonic group, but not in the low tonic group. Moreover, the low tonic group misplaced a scenario with a selfish incentive at the high end of the gradient. Results suggest that performance is represented by sensitivity correlated with HRV and accompanied with a reasonable placement of individual scenarios within the gradient.High-income country (HIC) trainees are participating in research in low- and middle-income countries (LMIC) in increasing numbers, yet the ethical challenges they face have not been well described. We conducted a mixed methods study of U.S. graduate and undergraduate students who conducted research in LMIC, including an online survey and semi-structured interviews. Among 123 online survey respondents, 31% reported ethical challenges and nearly two-thirds of respondents did not feel well prepared to deal with ethical challenges. Qualitative analysis of the 17 semi-structure interviews and narrative survey responses revealed many themes of 'ethics in practice' challenges in setting research priorities, navigating relationships with host country partners, scope of research practice, and human subject protections. Respondents reported that pre-departure trainings were not reflective of ethical frameworks or research contexts in LMIC, and few described seeking host mentor help in addressing ethical challenges. These results suggest a need for improvements in training, oversight and mentorship of trainee researchers, and to further engage both HIC and LMIC institutions, educators and researchers in addressing ethical issues.
The purpose of this study was to explore the subjective experience of non-suicidal self-injury (NSSI) among female Chinese university students in Hong Kong.

Interpretative phenomenological analysis was used.

Seven female students participated in the study, two engaged in biting and scratching, and three in cutting.

The majority of them indicated negative attitudes towards NSSI and saw no particular meaning attached to it. However, they all persisted with their behaviours, which suggested that they were unable to stop. Students found themselves in a paradoxical situation whereby although they saw no real benefit of NSSI, they still engaged in it to cope with distress. Feelings characterised by this distress were about entrapment and issues with academia, intimacy, loneliness, insecurity, negative self-worth, regulating distressing emotions, increasing positive physical sensations, healing oneself, and feeling alive.

The experience of hurting themselves persistently for these female students symbolised their struggle with academic or relationship difficulties, self-acceptance, emotional regulation and survival without self-injury.
The experience of hurting themselves persistently for these female students symbolised their struggle with academic or relationship difficulties, self-acceptance, emotional regulation and survival without self-injury.
To investigate the link between malocclusions and temporomandibular disorders (TMD) with a focus on iatrogenic malocclusion. Other etiologies of TMD (oral parafunctions) were also assessed.

The prevalence of malocclusions was correlated in two groups patients with TMD (case group) and patients without TMD (control group). Malocclusions involving dental care were specified. Parafunctions in the case group were assessed.

A statistically significant association between TMD and overbite >4 mm, interferences in laterotrusion, and absence of Angle Class I was shown. A potential deleterious effect of iatrogenic malocclusions was highlighted.

The multifactorial etiology of TMD was confirmed because an association between TMD and three malocclusions was found, and all case patients had parafunction(s). Current recommendations advising first a reversible treatment, TMD care should start with a behavioral re-education to remove parafunctions. However, it is essential to avoid creating iatrogenic malocclusion during dental care.
The multifactorial etiology of TMD was confirmed because an association between TMD and three malocclusions was found, and all case patients had parafunction(s). Current recommendations advising first a reversible treatment, TMD care should start with a behavioral re-education to remove parafunctions. However, it is essential to avoid creating iatrogenic malocclusion during dental care.This paper presents the results of predicting nutrients in rivers on national level by the use of two artificial intelligence methodologies. Artificial neural network (ANN) and support vector machine (SVM) were used to predict annual concentration of nitrate and phosphate in rivers of eleven European countries. For creation of an optimal model of prediction, 23 industrial, economical and agricultural parameters were used for the period from 2000 to 2011. The data from 2000 to 2010 was used for training, while the data for 2011 was used for model validation. Optimization of different parameters of ANN and SVM was conducted in order to obtain the model with the best performances. Results of created models were evaluated by using statistical performances indicator named coefficient of determination (R2). The obtained results showed that ANN has better results in predicting nitrate and phosphate compared to SVM models. These results suggest that ANN model is a promising tool for prediction of nutrients in rivers.Biomass-derived activated carbon was prepared from the agro waste materials, (wild sugarcane (WS) and saw dust (SD)) by chemical activation using phosphoric acid. The crystallinity, morphology, functional groups of the synthesized activated carbon were investigated. The effects of contact time (10-60 min), mass of adsorbent (0.05-0.2 g) and concentrations of CO2 (1 × 10-4 to 10 × 10-4 M) were analysed and the optimum adsorption conditions were found. Freundlich, Langmuir, Temkin, Dubinin-Radushkevich and Sips isotherm were used to analyse the adsorption data. The adsorption process was fitted with the Freundlich model. Adsorption capacity of agro waste-based sorbent was 5.225 × 10-3 mol/g. Thermodynamic parameters, such as ΔH0, ΔG0, ΔS0 , were calculated and it was found that the present system was a spontaneous process. From the kinetic studies, it was inferred that the Pseudo-second-order kinetics describes the kinetics of CO2 on AC-WSSD with an equilibrium point attained at 50 minutes with a high R2 value of 0.9602. The Brunauer Emmett Teller (BET) surface area of 1220 m2/g and an iodine value of 1360 m2/g were better indications for adsorption process. The interaction between CO2 and functional groups on the surface of the activated carbon was confirmed by FTIR. Desorption studies were carried out for three cycles with an efficiency of 93.2%.Standard Western demographic survey protocols fail to capture dynamics, such as circular migration and support networks, that profoundly influence the health of non-Western domestic social groups, typically called households. Enhanced protocols are needed because survey data provide the primary evidence base for health policy and planning globally. We present the participatory development, implementation and analysis of a novel demographic survey protocol, that aimed to better capture domestic social dynamics in rural Eswatini, southern Africa. The multiple-method study incorporated participatory health research about a community affected by HIV/AIDS, of which the survey formed part, and an ethnography of the participatory survey development process. Analysis of the data revealed limitations in the reliability and validity of standardised survey questions for measuring household membership, in contexts where circular migration and polygamy are common. Standard survey protocols potentiate double-counting members and misclassifying 'child-headed' and 'female-headed' households. They neglect social and economic dynamics that are known to influence health. Our novel demographic survey protocol provides a simple alternative method for capturing core data about circular migration and its impact on health. The study illustrates the contributions participatory and ethnographic research can make to enhancing demographic surveys.The genesis of the concept of intersectionality was a call to dismantle interlocking systems of oppression - racial, sexual, heterosexual, and class-based - in order to realise liberation of Black women and other women of colour. Intersectionality holds the radical potential to amplify collective efficacy, community solidarity, and liberation. The extension of intersectionality into stigma research has resulted in an increased focus on intersectional stigma in quantitative research. This raises questions regarding how the radical and liberatory potential of intersectionality is applied in stigma research. Specifically, empowerment-based perspectives may be overlooked in quantitative intersectional stigma research. We conducted a scoping review to document if and how empowerment-based perspectives were included in intersectional stigma quantitative studies. We identified and included 32 studies in this review that examined varied stigmas, most commonly related to race, gender, HIV and sexual orientation. In total 13/32 (40.6%) of these studies reported on empowerment-based factors; most of these examined social support and/or resilience. Taken together, findings suggest that the quantitative intersectional stigma research field would benefit from expansion of concepts studied to include activism and solidarity, as well as methodological approaches to identify the protective roles of empowerment-based factors to inform health and social justice-related programmes and policy.The Nepali population is among those most vulnerable to the health impacts of climate change. We conducted a systematic literature review to document the health effects of climate change in Nepal and identify knowledge gaps by examining vulnerability categories related to health. Three databases were searched for journal articles that addressed health and vulnerability related to climate change in Nepal from 2010 onwards. Of the 1063 articles identified, 37 were eligible for inclusion. The findings suggested the health of the population was affected mostly by food insecurity, floods, droughts, and reduced water levels. Studies revealed both morbidity and mortality increased due to climate change, with the most impacted populations being women, children, and the elderly. At greatest risk for impacts from climate change were those from poor and marginal populations, especially impoverished women. The public health sector, healthcare, and potable water sources were some of the least mentioned vulnerability subcategories, indicating more research is needed to better understand their adaptation capacities. We propose that identifying vulnerabilities and areas of limited research are critical steps in the prioritization of health policy and interventions for the most vulnerable populations in Nepal.In order to explore the effect of CaO on the ecological risk of chromium (Cr), copper (Cu) and zinc (Zn) in Oily sludge (OS), the incineration experiments of OS with and without calcium oxide (CaO) additive were carried out respectively in a horizontal tube furnace at the temperature ranging from 800 °C to 1000 °C. Furthermore, the ecological risk based on Risk Assessment Code (RAC) of Cr, Cu and Zn in OS, bottom ash from OS incineration (OSA) and bottom ash from OS incineration in the presence of CaO additive (OSA-CaO) were investigated in this work. The results showed that most of the Cr and Cu in OS remained in bottom ash, while Zn volatilized with the flue gas. At the same time, the RAC of Cr, Cu and Zn in OS decreased significantly after incineration. Compared with OSA, CaO obviously promoted the stabilization of Cr and Cu in OSA-CaO, but had little effect on the behavior of Zn. Moreover, CaO also reduced the RAC of Cu and Zn in samples, and reduced its harm to ecosystem. This study supplied essential data and theoretical support for the industrial treatment of OS, and was of great help to the harmless treatment of OS.Vaccine confidence reflects social, individual, and political factors indicating confidence in vaccines and associated health systems. In Japan, the government ceased proactive recommendation of the human papillomavirus (HPV) vaccine in June 2013, only several months after the recommendation had begun. Seven years later, as of October 2020, the suspension persists and vaccine coverage has precipitously declined, resulting in many young women being continually exposed to the risk of preventable HPV-related diseases. Accordingly, understanding stakeholder opinions on HPV vaccination issues is critical for informing strategies to improve HPV vaccine confidence and acceptance. In October 2019, we performed a nationwide, web-based survey of 1646 mothers of HPV-vaccination-eligible girls, 562 female adolescents aged 15-19 years, and 919 healthcare professionals (HCPs) in Japan. This survey captured key elements of vaccine confidence (i.e., importance, effectiveness, and safety of the HPV vaccine), awareness, and the willingness to receive (in HPV-vaccination-eligible girls) or recommend (in HCPs) the HPV vaccine, and the factors responsible for these decisions. HPV vaccine confidence was generally higher among HCPs than among mothers or female adolescents. Nearly half of all stakeholders were neutral regarding their willingness to receive/recommend the HPV vaccine. The seriousness of cervical cancer and the HPV vaccine's effectiveness or safety were important deciding factors for receiving/recommending the HPV vaccine. Besides these factors, sufficient information and free vaccination were crucial. Our results suggest several factors that could help shape public policy and communication strategies to improve HPV vaccine confidence and acceptance in Japan.In this study, our aim is to investigate the effect of dimer procyanidin B2 [epicatechin-(4β-8)-epicatechin] (PB2) on porcine skeletal myofiber gene expression in vitro. Our data showed PB2 promoted the protein expression of slow myosin heavy chain (MyHC) in porcine myotubes, concomitant with the increases in mRNA levels of MyHC I, MyHC IIa and Tnni1. We also found PB2 activated AMPK signaling in porcine myotubes. NRF1 and CaMKKβ that are two important upstream factors of AMPK, and Sirt1 and PGC-1α that are two major downstream factors of AMPK, were also up-regulated by PB2. The mechanism study showed the effect of PB2 on slow-twitch myofiber gene expression was abolished by AMPK inhibitor compound C or by AMPKα1 siRNA. Together, we found PB2 induced porcine skeletal slow-twitch myofiber gene expression by AMPK signaling pathway.
The advanced audiology-led service is designed to triage and manage children who are referred to Ear Nose and Throat (ENT) outpatient services with middle ear or hearing concerns. This service has resulted in shorter waiting times for children to receive ENT treatment, and improved ENT capacity. The aim of this study was to explore parental satisfaction with the advanced audiology-led ENT service and to determine if there were cultural or process factors affecting satisfaction.

Prospective cross-sectional study using a modified Visit-Specific Satisfaction Questionnaire (VSQ-9) survey.

One hundred and thirteen parents of children consecutively attending a first appointment in the advanced audiology-led service recruited between October 2016 and October 2017.

There were a total of 100 valid responses (rate of 88.5%). The survey showed high levels of satisfaction. Satisfaction scores were significantly higher for items related to interactions with the audiologist compared to items related to waiting times. There were no differences in satisfaction across cultural groups. Parents were equally satisfied with the service whether their child was managed independently by the audiologist or required another appointment for medical input.

The advanced audiology-led service had high levels of satisfaction from parents attending with their children.
The advanced audiology-led service had high levels of satisfaction from parents attending with their children.
The presence of endolymphatic hydrops (ELH) in patients with Meniere's disease (MD) is considered a pathological hallmark.

We aimed to conduct a quantitative volumetric measurement of inner ear ELH in patients with unilateral MD (uMD). The values of uMD with and without herniation into the posterior semi-circular canal (h-PSC) and the lateral semi-circular canal (h-LSC) were compared using 3 D magnetic resonance imaging.

This study included 130 individuals (47 controls and 83 patients with uMD). We measured the total fluid space (TFS) and endolymphatic space (ELS) volumes. We also evaluated the ELS/TFS volume ratios (%).

The ELS/TFS volume ratios in the inner ear, cochlea, and vestibule were significantly different between the affected and contralateral sides in patients with h-PSC. Moreover, the ELS/TFS volume ratios of the inner ear, vestibule, and semi-circular canals in the affected ear were significantly higher in patients with h-PSC than in those without h-PSC. The vestibular ELS/TFS volume ratio in the affected ear was significantly higher in patients with h-LSC than in those without h-LSC.

H-LSC is present in extended vestibular ELH. However, this is a result of ELH progression in the inner ear.
H-LSC is present in extended vestibular ELH. However, this is a result of ELH progression in the inner ear.This Further Reflections piece was invited by the Editors of the journal to provide additional consideration of some of the significant issues under study in "Culture Moderates the Relation Between Gender Inequality and Well-Being" (Li et al., 2021) available online at https//doi.org/10.1177/0956797620972492 and on pages 823 to 835 of this issue. Further Reflections are not commentaries on a particular article, though they are inspired by one. Rather, they provide broader perspectives on issues considered in Research Articles, beyond those that authors are able to provide in the Introduction and Discussion sections of their articles. The Editors' objective with Further Reflections is that they will raise the level of conversation around psychological issues of societal importance. Further Reflections are by invitation only.Programmatic assessment as a concept is still novel for many in clinical education, and there may be a disconnect between the academics who publish about programmatic assessment and the front-line clinical educators who must put theory into practice. In this paper, we clearly define programmatic assessment and present high-level guidelines about its implementation in competency-based medical education (CBME) programs. The guidelines are informed by literature and by lessons learned from established programmatic assessment approaches. We articulate five steps to consider when implementing programmatic assessment in CBME contexts articulate the purpose of the program of assessment, determine what must be assessed, choose tools fit for purpose, consider the stakes of assessments, and define processes for interpreting assessment data. In the process, we seek to offer a helpful guide or template for front-line clinical educators. We dispel some myths about programmatic assessment to help training programs as they look to design-or redesign-programs of assessment. In particular, we highlight the notion that programmatic assessment is not 'one size fits all'; rather, it is a system of assessment that results when shared common principles are considered and applied by individual programs as they plan and design their own bespoke model of programmatic assessment for CBME in their unique context.
The study aims to examine the effects of interruptions in major phases (i.e., problem-identification, alternative-development, and evaluation-and-selection) of complex decision-making tasks.

The ability to make complex decisions is of increasing importance in workplaces. Complex decision-making involves a multistage process and is likely to be interrupted, given the ubiquitous prevalence of interruptions in workplaces today.

Sixty participants were recruited for the experiment to complete a procurement task, which required them to define goals, search for alternatives, and consider multiple attributes of alternatives to make decisions. Participants in the three experimental conditions were interrupted to respond to messages during one of these three phases, whereas participants in the control condition were not interrupted. The impacts of interruptions on performance, mental workload, and emotional states were measured through a combination of behavioral, physiological, and subjective evaluations.

Onlase information can be either provided by users or inferred from coarse-grained interaction activities with decision-making information systems.
This article presents a systematic literature review of the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in the adult psychiatric population.

Three databases were searched using keywords relating to ADHD and psychiatric disorders. Fifteen studies published before May 2020 met inclusion criteria.

Prevalence rates ranged from 6.9 to 38.75%. There was considerable heterogeneity with regards to the assessment methods of ADHD and comorbidities, the sampling as well as inclusion and exclusion of psychiatric comorbidities. Research concluded that ADHD is underdiagnosed in this population. Gender ratios also varied between 1.81 and 12.5 (malefemale).

All ADHD prevalence rates for the psychiatric population were considerably higher than the 2.8% estimated for the general adult population. ADHD should be kept in mind for psychiatric patients to ensure accurate diagnosis and optimal treatment options.Key PointsADHD is considerably underdiagnosed in the psychiatric populationGender ratios between 1.81 and 12.5 (malefemale) reported in researchMore research is needed to ascertain if the use of ADHD screening instruments would improve the recognition and treatment of adult ADHD in the psychiatric population.
All ADHD prevalence rates for the psychiatric population were considerably higher than the 2.8% estimated for the general adult population. ADHD should be kept in mind for psychiatric patients to ensure accurate diagnosis and optimal treatment options.Key PointsADHD is considerably underdiagnosed in the psychiatric populationGender ratios between 1.81 and 12.5 (malefemale) reported in researchMore research is needed to ascertain if the use of ADHD screening instruments would improve the recognition and treatment of adult ADHD in the psychiatric population.
Upper limb (UL) function is one of the health outcomes that matters the most for women with breast cancer. However, a better understanding of the factors contributing to UL dysfunctions in the late stage after breast cancer surgery is needed. This study explores associations between impairment-related and cognition-related factors and UL function in women with pain and myofascial dysfunctions at the affected UL region in this late stage after breast cancer surgery.

In forty-one women, UL function (dependent variable) was evaluated by the Disabilities of Arm, Shoulder and Hand questionnaire. As independent impairment-related factors, relative excessive arm volume (perimetry), pain intensity (maximum score on the visual analogue scale past week) and humerothoracic elevation and scapular lateral rotation (kinematic analysis) were assessed. As independent cognition-related factors, pain catastrophizing (Pain Catastrophizing Scale) and pain hypervigilance (Pain Vigilance and Awareness Questionnaire) were evalufunctions in the late stage after breast cancer, assessing pain beliefs is needed.
Pain intensity and cognition-related factors are significantly associated with UL function in women with pain and myofascial dysfunctions, indicating the need of assessing pain beliefs in women in the late stage after breast cancer surgery.IMPLICATIONS FOR REHABILITATIONPain intensity and pain-related beliefs, including pain attention and catastrophizing, are related to the severity of upper limb dysfunctions in the late stage after breast cancer surgery.Impairments such as lymphedema and movement restrictions seem not related to upper limb function in the assessed sample.To understand upper limb dysfunctions in the late stage after breast cancer, assessing pain beliefs is needed.Two of the multiple limitations of phytoextraction efficiency (PE %) of TSW polluted soils are (i) low growth of plant performance, (ii) poor bioavailability of excessive essential and heavy metals (ascribed as Category-I and II metals respectively) The current study reports biostimulant role of allochthonous Trichoderma harzianum (F1) and autochthonous Trichoderma pseudokoningii (F2) in growth of Tagetes patula L. and uptake of Category-I & II metals from TSW-soil (0, 5 & 10%). Significantly higher growth (27.5-47.8% dry wt. than Control) and highly significantly higher uptake of Category-I & II metals (72-80% Ca, 32-69% K, 72-76% Na & 73-86% Cd, 63-100% Cr, 72-77% Cu, 73-78% Fe, 43-77% Mg, 22-33% Ni, 70-73% Zn) was observed in T. patula applied with F1 + F2 treatment. The PE (%) parameters viz.specific extraction yield, tolerance and translocation index of Category-I & II metals were higher in plants cultivated on fungal inoculated TSWsoil. The Trichoderma spp. acted as strong biostimulants for enhancing plant growth and conc. of catalase (CAT, 44-52% than control), superoxide dismutase (SOD, 37-43%), soluble proteins (37-68%) and total chlorophyll (10-26%) in T. patula during metal phytoextraction of TSWsoil. Novelty statement Due to multiple socio-economic constraints for effective management of tannery solid waste (TSW), the heavy metal phytoextraction seems to be one of the promising approaches. However, due to complex composition of TSW, that is, with more than 37 components, high pH, multiple types and high conc. of metals; there lies huge challenge of enhancing phytoextraction efficiency (PE %). This can be done by enhancing growth of hyperaccumulator plants and increasing bioavailable fraction of metals. The current study suggests application of selected fungal biostimulants for increasing growth of T. patula while improving bioavailable fraction of the total metal contents of the TSW soil.
To explore patient perspectives of the integrated intervention (intervention arm) of a recent randomised clinical trial that found clinically relevant and sustained benefits of a physiotherapist delivered integrated stress inoculation training (SIT) and exercise for people with acute whiplash-associated disorders (WAD) and at risk of poor recovery.

Twelve patients from the 53 who participated in the SIT and exercise arm of a randomised controlled trial (StressModex RCT) participated in semi-structured interviews. Data were analysed using inductive thematic analysis.

Five main themes were identified "balance between the physical and psychological components," "dealing with stress," "coping with the injury," "pain relief and return to function," and "elements enhancing therapeutic alliance."

The majority of patients found the SIT techniques to be helpful in managing stress and pain, coping with their injury, and returning to function. The patients also found the exercises useful and acknowledged the imponent and exercise as assisting them with their stress, pain, and recovery.Physiotherapists could consider including strategies targeting early stress responses in their management of patients with acute WAD.The concentrations of elemental and volatile components in wine and the effect of biological, meteorological, and anthropogenic factors on their levels are important for authentication and quality assurance. Sample preparation for atomic absorption and inductively coupled plasma spectrometries for elemental analysis as well as chromatographic and electronic nose (EN) analytical methods for volatile compounds are reviewed. The International Organization of Vine and Wine (OIV) and countries that produce and import wine developed methods and set limits on metal abundance to ensure that all metal concentrations are well below toxic threshold limits. With the use of data analysis tools, elemental analysis can enable wines to be traced back to their geographic region of origin. When paired with volatile and isotopic analysis the accuracy of this authentication greatly improves. Tracing studies are reviewed to demonstrate the capabilities of these analyses.Given the politicization of abortion, professionals working in U.S. health departments (HDs) may not be receptive to communications about abortion, despite often regulating abortion facilities. This paper reports results of a randomized, prospective, observational study to test the effects of e-mail language when disseminating evidence on abortion to HD professionals. Our sample was 302 HD employees who oversee healthcare facilities inspection/regulation in all 50 U.S. state HDs, clustered by HD and randomized into two study groups. In November-December 2019, we sent biweekly e-mails containing links to a website summarizing evidence on abortion facility regulation. E-mails/headers sent to one group emphasized public health values and did not include the word abortion; e-mails/headers to the other group used the word abortion. Primary outcome measures were e-mail open rates and click-through rates. Among 221 participants to whom e-mails were deliverable, the overall open rate was 36%. Open rate was 25% for PH values and 46% for abortion groups (p less then .
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