Lignite reduces odour from broiler farms without reducing production performance.

An unavoidable consequence of chicken meat production is the generation of substantial quantities of spent litter. This poses several environmental and social challenges, as broiler farms become hotspots for odour emissions. The main source of odour from broiler litter is the microbial decomposition of organic material. Thus, lignite's previously shown capacity to reduce microbial activity in broiler litter was expected to reduce odour emissions from broiler housing. The effect of lignite on odour emission rate (OER) (ou/s) was investigated using dynamic olfactometry over two consecutive summer broiler grow-out cycles in Victoria, Australia, with lignite applied at 3.5 kg/m2. The air quality dispersion model, AERMOD, was used to investigate how lignite's effect on OER influenced the predicted odour dispersion distances and concentrations in the context of various Australian regulatory requirements. Additionally, the effect of lignite on bird production performance was also determined. This study showed that lignite reduced the OER from commercial broiler housing by an average of 56% over both grow-outs. This effect was observed for the duration of the trial. The observed reduction in OER reduced the required separation distances by 44-53% according to the state odour criteria for Victoria, New South Wales, Queensland and South Australia. There were no observed differences in feed conversion ratio, bird live weight or mortality throughout either grow-out. This study demonstrated the capacity of lignite to reduce odour emissions from commercial broiler housing without reducing bird production performance.

Artificial intelligence innovations in neurosurgical oncology: a narrative review.

PURPOSE: Artificial Intelligence (AI) has become increasingly integrated clinically within neurosurgical oncology. This report reviews the cutting-edge technologies impacting tumor treatment and outcomes. METHODS: A rigorous literature search was performed with the aid of a research librarian to identify key articles referencing AI and related topics (machine learning (ML), computer vision (CV), augmented reality (AR), virtual reality (VR), etc.) for neurosurgical care of brain or spinal tumors. RESULTS: Treatment of central nervous system (CNS) tumors is being improved through advances across AI-such as AL, CV, and AR/VR. AI aided diagnostic and prognostication tools can influence pre-operative patient experience, while automated tumor segmentation and total resection predictions aid surgical planning. Novel intra-operative tools can rapidly provide histopathologic tumor classification to streamline treatment strategies. Post-operative video analysis, paired with rich surgical simulations, can enhance training feedback and regimens. CONCLUSION: While limited generalizability, bias, and patient data security are current concerns, the advent of federated learning, along with growing data consortiums, provides an avenue for increasingly safe, powerful, and effective AI platforms in the future.

The FDA Enhancing Quality Using the Inspection Program (EQUIP) Breast Imaging Quality Initiative. 5-Year Clinical Experience.

OBJECTIVES: To evaluate the effects of the Enhancing Quality Using the Inspection Program (EQUIP) on quality control (QC) and quality assurance (QA) at an academic medical center. METHODS: EQUIP audit logs for technologist image quality review as well as mammography unit QA and QC formed the basis for study data. One randomly selected screening mammogram was evaluated by the lead interpreting physician (LIP) using EQUIP criteria for each technologist for each imaging site worked, initially semiannually and then monthly. One randomly selected screening mammogram interpreted by each interpreting physician (IP) for each imaging site was evaluated on a semiannual basis. Quarterly, the LIP reviewed QA and QC logs for each mammography unit with deficiencies further investigated. RESULTS: Of 214 965 eligible screening mammograms performed, 5955 (2.8%) underwent EQUIP image quality review. Five were found to be technically inadequate (0.08%, 5955/214 965). The LIP identified 20 significant interpretive differences compared with the clinical interpretation resulting in 10 biopsies and 7 previously undetected malignancies, with supplemental cancer detection rate of 1.2/1000 cases reviewed. Two hundred ninety mammography unit QA/QC reviews identified 31 potential deficiencies, 29 of which were due to human documentation error (93.4%). CONCLUSION: EQUIP review of both IP and technologists' quality and mammography unit QA/QC logs as performed identified few deficiencies. EQUIP policies should be evaluated at each institution and modified to best utilize resources and provide opportunities for meaningful quality improvement. Although not an EQUIP focus, supplemental cancer detection was observed as might be expected with double reading.

Inter-organizational alignment and implementation outcomes in integrated mental healthcare for children and adolescents: a cross-sectional observational study.

BACKGROUND: Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOA in general and implementation context factors are associated with implementation outcomes in integrated SBMH. METHODS: SBMH clinicians from community-based organizations (CBOs; nclinician = 27) and their proximal student-support school staff (nschool = 99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes. RESULTS: The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors. CONCLUSIONS: This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.

Associations among educators' beliefs, intervention fidelity, and student outcomes in school-wide positive behavior interventions, and supports: A school-level moderated mediation analysis.

Existing literature has established the effectiveness of school-wide positive behavioral interventions and supports (SWPBIS) for improving school-level student behavioral and academic outcomes. Implementation of SWPBIS in uncontrolled settings is often suboptimal, leading to lackluster outcomes. Researchers have developed and validated several implementation strategies to improve individual-level implementation determinants (e.g., educators' supportive beliefs) to promote the successful delivery of universal programs (e.g., SWPBIS). However, empirical studies are needed to explore the mechanisms of change through which school-level educators' beliefs influence their delivery of SWPBIS. This school-level quasi-experimental study tested a mediational mechanism of change where changes in educators' beliefs work through their intervention fidelity of SWPBIS to influence student outcomes. We delivered the Supportive Belief Intervention (a school-wide implementation strategy used before training to promote educators' supportive beliefs about SWPBIS) and then Tier 1 SWPBIS training to 81 elementary schools serving diverse student populations. At the start of the academic year, school-level educators' beliefs were assessed before the Supportive Belief Intervention. At the end of the academic year, educators' beliefs, intervention fidelity, and rates of student reading proficiency and suspension were assessed. Conditional process analyses with nonparametric bootstrapping (mediational and first stage moderated mediational models) revealed that, at the school level, a larger increase in educators' supportive beliefs was associated with enhanced SWPBIS fidelity and better corollary student outcomes (increased reading proficiency and reduced suspension), while student socioeconomic status moderated the size of the mediation effect. Implications for research and practices about the implementation of SWPBIS and school context were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluations are inherently comparative, but are compared to what?

Understanding how objective quantities are translated into subjective evaluations has long been of interest to social scientists, medical professionals, and policymakers with an interest in how people process and act on quantitative information. The theory of decision by sampling proposes a comparative procedure: Values seem larger or smaller based on how they rank in a comparison set, the decision sample. But what values are included in this decision sample? We identify and test four mechanistic accounts, each suggesting that how previously encountered attribute values are processed determines whether they linger in the sample to guide the subjective interpretation, and thus the influence, of newly encountered values. Testing our ideas through studies of loss aversion, delay discounting, and vaccine hesitancy, we find strongest support for one account: Quantities need to be subjectively evaluated-rather than merely encountered-for them to enter the decision sample, alter the subjective interpretation of other values, and then guide decision making. Discussion focuses on how the present findings inform understanding of the nature of the decision sample and identify new research directions for the longstanding question of how comparison standards influence decision making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Helping Educational Leaders Mobilize Evidence (HELM): The iterative redesign of the Leadership and Organizational Change for Implementation (LOCI) intervention for use in schools.

Background: Few "intervention agnostic" strategies have been developed that can be applied to the broad array of evidence-based practices (EBPs) in schools. This paper describes two studies that reflect the initial iterative redesign phases of an effective leadership-focused implementation strategy-Leadership and Organizational Change for Implementation (LOCI)-to ensure its acceptability, feasibility, contextual appropriateness, and usability when used in elementary schools. Our redesigned strategy-Helping Educational Leaders Mobilize Evidence (HELM)-is designed to improve principals' use of strategic implementation leadership to support the adoption and high-fidelity delivery of a universal EBP to improve student outcomes. Method: In Study 1, focus groups were conducted (n = 6) with 54 district administrators, principals, and teachers. Stakeholders provided input on the appropriateness of original LOCI components to maximize relevance and utility in schools. Transcripts were coded using conventional content analysis. Key themes referencing low appropriateness were summarized to inform LOCI adaptations. We then held a National Expert Summit (Study 2) with 15 research and practice experts. Participants provided feedback via a nominal group process (NGP; n = 6 groups) and hackathon (n = 4 groups). The research team rated each NGP suggestion for how actionable, impactful/effective, and feasible it was. We also coded hackathon notes for novel ideas or alignment with LOCI components. Results: Study 1 suggestions included modifications to LOCI content and delivery. Study 2's NGP results revealed most recommendations to be actionable, impactful/effective, and feasible. Hackathon results surfaced two novel ideas (distributed leadership teams and leaders' knowledge to support educators EBP use) and several areas of alignment with LOCI components. Conclusion: Use of these iterative methods informed the redesign of LOCI and the development of HELM. Because it was collaboratively constructed, HELM has the potential to be an effective implementation strategy to support the use of universal EBP in schools.

Our research team designed a strategy (HELM) for school principals to improve the support they provide to staff to implement practices proven to work in research for improving student outcomes. We designed HELM by conducting focus groups with school district administrators, principals, and teachers. Participants were asked for their feedback on how to adapt an existing leadership strategy (LOCI) to the school context. After collecting this feedback, we held a meeting with 15 research and practice experts. During this meeting, the group of experts reviewed the focus group feedback and decided how to incorporate it into the design of the HELM strategy. We believe that collecting this feedback and involving research and practice experts in interpreting and integrating participant feedback into the HELM strategy will make HELM a more effective strategy for supporting school principals' in implementing supports in their schools.

Radical Stereochemistry: Accounting for Diastereomers in Kinetic Mechanism Development.

Recent work in combustion and atmospheric chemistry has revealed cases in which diastereomers must be distinguished to accurately model a reacting flow. This paper presents an open-source framework for introducing such stereoisomer resolution into a kinetic mechanism. We detail our definitions and algorithms for labeling and enumerating the stereoisomers of a molecule and then generalize our system to describe the transition state (TS) of a reaction. This allows for the stereospecific enumeration of reactants and products while accounting for "fleeting" stereochemistry that is unique to the TS. We also present the AutoMech Chemical Identifier (AMChI), an InChI-like string identifier that accounts for stereocenters omitted by InChI. This identifier is extended to describe the TSs of reactions, providing a universal lookup key for specific reaction channels. The final piece of our methodology is an analytic formula to remove redundancy from a stereoresolved mechanism when its enantiomers exist as a racemic mixture, making it as compact as possible while fully accounting for the differences between diastereomers. In applying our methodology to two subsets of the NUIGMech1.1 mechanism, we find that our approach reduces the extra species added for large-fuel oxidation from 2231 (133%, full expansion) to 694 (41%, nonredundant expansion). We also find that for pyrolysis more than a quarter of the species in the expanded mechanism cannot be properly described by an InChI string, requiring an AMChI string to communicate their identity. Finally, we find that roughly one-quarter of the large-fuel oxidation reactions and one-third of the pyrolysis reactions include fleeting TS stereochemistry, which may have relevant effects on their kinetics.

Shoulder Pain in a Pediatric Throwing Athlete.

Pediatric avulsion fractures most commonly occur at sites of secondary ossification and are often associated with chronic stress from repetitive movements. Because of a variety of risk factors, youth athletes place higher stress on ossification centers, and their activities may predispose them to injury. This case report describes a 12-year-old female softball player who presented with pain at the distal acromion, worsened by her overhead throwing motion. Further questioning revealed improper throwing mechanics placing extenuated stress on the shoulder. Plain radiograph imaging showed an avulsion fracture of the distal acromion; conservative management with decreased mobilization and cessation of activity was recommended. Reimaging four weeks later revealed a bone-on-bone healing, and the patient was gradually allowed to return to function. This report's discussion details the unusual location for a common injury, the mechanism of injury, an association of throwing mechanics with a shoulder injury, and recommended treatment strategies for pediatric avulsion fractures.

Protocol for a hybrid type 3 effectiveness-implementation trial of a pragmatic individual-level implementation strategy for supporting school-based prevention programming.

BACKGROUND: For approximately one in five children who have social, emotional, and behavioral (SEB) challenges, accessible evidence-based prevention practices (EBPPs) are critical. In the USA, schools are the primary setting for children's SEB service delivery. Still, EBPPs are rarely adopted and implemented by front-line educators (e.g., teachers) with sufficient fidelity to see effects. Given that individual behavior change is ultimately required for successful implementation, focusing on individual-level processes holds promise as a parsimonious approach to enhance impact. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a pragmatic, multifaceted pre-implementation strategy targeting volitional and motivational mechanisms of educators' behavior change to enhance implementation and student SEB outcomes. This study protocol describes a hybrid type 3 effectiveness-implementation trial designed to evaluate the main effects, mediators, and moderators of the BASIS-T implementation strategy as applied to Positive Greetings at the Door, a universal school-based EBPP previously demonstrated to reduce student disruptive behavior and increase academic engagement. METHODS: This project uses a blocked randomized cohort design with an active comparison control (ACC) condition. We will recruit and include approximately 276 teachers from 46 schools randomly assigned to BASIS-T or ACC conditions. Aim 1 will evaluate the main effects of BASIS-T on proximal implementation mechanisms (attitudes, subjective norms, self-efficacy, intentions to implement, and maintenance self-efficacy), implementation outcomes (adoption, reach, fidelity, and sustainment), and child outcomes (SEB, attendance, discipline, achievement). Aim 2 will examine how, for whom, under what conditions, and how efficiently BASIS-T works, specifically by testing whether the effects of BASIS-T on child outcomes are (a) mediated via its putative mechanisms of behavior change, (b) moderated by teacher factors or school contextual factors, and (c) cost-effective. DISCUSSION: This study will provide a rigorous test of BASIS-T-a pragmatic, theory-driven, and generalizable implementation strategy designed to target theoretically-derived motivational mechanisms-to increase the yield of standard EBPP training and support strategies. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05989568. Registered on May 30, 2023.

Catalytic oxidation of lignite by Pt/TiO2 can enhance cadmium adsorption capacity.

Addressing global warming necessitates innovative strategies in fossil fuel management. This study evaluates lignite, a low-rank coal with limited calorific value, exploring applications beyond its use as fuel. Utilizing Pt/TiO2 catalytic oxidation, the research aims to enhance the cadmium adsorption capacity of lignite in wastewater. Lignite, treated with 0.5% Pt/TiO2 at 125 °C for 2 h, demonstrated a threefold increase in cadmium adsorption capacity. Characterization using TGA-DSC confirmed the modification process as exothermic and self-sustainable. Spectroscopic analysis and Boehm titration revealed significant alterations in pore structure, surface area, and oxygen-containing functional groups, emphasizing the effectiveness of catalytic oxidation. Adsorption mechanisms such as complexation, cation exchange, and cation-π interactions were identified, enhancing Cd adsorption. Techniques, including the d-band model, H2-TPR, and O2-TPD, indicated that dissociative adsorption of molecular O2 and the subsequent generation of reactive oxygen species introduced additional oxygen-containing functional groups on the lignite surface. These findings provide essential strategies for the alternative use of lignite in environmental remediation, promoting sustainable resource utilization and enhancing cost-effectiveness in remediation processes. ENVIRONMENTAL IMPLICATION: This study innovates in using lignite to reduce cadmium (Cd) contamination in wastewater. Employing Pt/TiO2 catalytic oxidation, lignite is transformed, enhancing its cadmium adsorption capacity. This process, being exothermic, contributes to decreased energy consumption. The approach not only mitigates the hazardous impacts of cadmium but also aligns with sustainability by reducing greenhouse gas emissions and energy use, showcasing a multifaceted environmental advancement.

Quantum and anharmonic effects in non-adiabatic transition state theory.

Quantitative descriptions of non-adiabatic transition rates at intermediate temperatures are challenging due to the simultaneous importance of quantum and anharmonic effects. In this paper, the interplay between quantum effects-for motion across or along the seam of crossing-and anharmonicity in the seam potential is considered within the weak coupling limit. The well-known expression for quantized 1-D motion across the seam (i.e., tunneling) in the linear terms approximation is derived in the thermal domain using the Lagrangian formalism, which is then applied to the case when tunneling is distributed along the seam of crossing (treating motion along the seam classically). For high-frequency quantum modes, a vibrationally adiabatic (VA) approach is developed that introduces to the non-adiabatic rate constant a factor associated with high-frequency wavefunction overlap; this approach treats the high-frequency motion along the seam quantum mechanically. To test these methodologies, the reaction N2O ↔ N2 + O(3P) was chosen. CCSD(T)-F12b/cc-pVTZ-F12 explorations of the 3A'-1A' seam of N2O revealed that seam anharmonicity has a strong effect on the rate constant (a factor of ∼20 at 2000 K). Several quantum effects were found to be significant at intermediate/lower temperatures, including the quantum N-N vibration that was coupled with seam anharmonicity using the VA approach. Finally, a 1-D approximation to non-adiabatic instanton theory is presented to estimate the validity limit of the linear terms model at low temperatures (∼250 K for N2O). We recommend that the assumptions built into many statistical theories for non-adiabatic reactions-harmonic behavior, classical motion, linear terms, and weak coupling-should be verified on a case-by-case basis.

Theoretical Kinetics Predictions for Reactions on the NH2O Potential Energy Surface.

Recent modeling studies of ammonia oxidation, which are motivated by the prospective role of ammonia as a zero-carbon fuel, have indicated significant discrepancies among the existing literature mechanisms. In this study, high-level theoretical kinetics predictions have been obtained for reactions on the NH2O potential energy surface, including the NH2 + O, HNO + H, and NH + OH reactions. These reactions have previously been highlighted as important reactions in NH3 oxidation with high sensitivity and high uncertainty. The potential energy surface is explored with coupled cluster calculations, including large basis sets and high-level corrections to yield high-accuracy (∼0.2 kcal/mol 2σ uncertainty) estimates of the stationary point energies. Variational transition state theory is used to predict the microcanonical rate constants, which are then incorporated in master equation treatments of the temperature- and pressure-dependent kinetics. For radical-radical channels, the microcanonical rates are obtained from variable reaction coordinate transition state theory implementing directly evaluated multireference electronic energies. The analysis yields predictions for the total rate constants as well as the branching ratios. We find that the NO + H2 channel contributes 10% of the total NH2 + O flux at combustion temperatures, although this channel is not included in modern NH3 oxidation mechanisms. Modeling is used to illustrate the ramifications of these rate predictions on the kinetics of NH3 oxidation and NOx formation. The present results for NH2 + O are important for predicting the chain branching and formation of NO in the oxidation of NH3 and thermal DeNOx.

Sustainably sourced components to generate high-strength adhesives.

Nearly all adhesives1,2 are derived from petroleum, create permanent bonds3, frustrate materials separation for recycling4,5 and prevent degradation in landfills. When trying to shift from petroleum feedstocks to a sustainable materials ecosystem, available options suffer from low performance, high cost or lack of availability at the required scales. Here we present a sustainably sourced adhesive system, made from epoxidized soy oil, malic acid and tannic acid, with performance comparable to that of current industrial products. Joints can be cured under conditions ranging from use of a hair dryer for 5 min to an oven at 180 °C for 24 h. Adhesion between metal substrates up to around 18 MPa is achieved, and, in the best cases, performance exceeds that of a classic epoxy, the strongest modern adhesive. All components are biomass derived, low cost and already available in large quantities. Manufacturing at scale can be a simple matter of mixing and heating, suggesting that this new adhesive may contribute towards the sustainable bonding of materials.

Artificial Intelligence Applications in Breast Imaging: Current Status and Future Directions.

Attempts to use computers to aid in the detection of breast malignancies date back more than 20 years. Despite significant interest and investment, this has historically led to minimal or no significant improvement in performance and outcomes with traditional computer-aided detection. However, recent advances in artificial intelligence and machine learning are now starting to deliver on the promise of improved performance. There are at present more than 20 FDA-approved AI applications for breast imaging, but adoption and utilization are widely variable and low overall. Breast imaging is unique and has aspects that create both opportunities and challenges for AI development and implementation. Breast cancer screening programs worldwide rely on screening mammography to reduce the morbidity and mortality of breast cancer, and many of the most exciting research projects and available AI applications focus on cancer detection for mammography. There are, however, multiple additional potential applications for AI in breast imaging, including decision support, risk assessment, breast density quantitation, workflow and triage, quality evaluation, response to neoadjuvant chemotherapy assessment, and image enhancement. In this review the current status, availability, and future directions of investigation of these applications are discussed, as well as the opportunities and barriers to more widespread utilization.

Needing everything (or just one thing) to go right: Myopic preferences for consolidating or spreading risks.

Succeeding at a task often depends on the success or failure of component events. Such multicomponent risks can take one of two general forms. Disjunctive risks require the success of just one such component; conjunctive risks, all of them. Seven studies converge to show people prefer to consolidate disjunctive risks into fewer components and to spread conjunctive risks across more components, independent of the objective or subjective implications for the probability of overall success. These tendencies were reflected in preferences for how to approach potential investors, decisions about how much to invest in different business opportunities, and gamble valuations. Such preferences were specific to multicomponent risks as compared to single-component risks whose overall prospects for success were yoked to participants' own perceptions of a matched multicomponent risk. Participants confronted multicomponent risks myopically, swayed by whether positive or disappointing news would likely be delivered at a single point in time instead of by the overall prospects for success. Supporting this account, these preferences for consolidating or spreading risks were reduced when the components' outcomes would be revealed at once. Anticipated confidence while proceeding through the risk (even controlling for perceived probabilities of success) explained these preferences. After all, these preferred risk structures actually do allow people to traverse a multicomponent risk with more confidence that the next piece of news they receive will be positive (or not negative), though such myopic perspectives neglect just how many components will offer a chance for success (disjunctive risks) or the potential for failure (conjunctive risks). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Organic geochemical evidence of human-controlled fires at Acheulean site of Valdocarros II (Spain, 245 kya).

Among the outstanding questions about the emergence of human-controlled fire is the systematic recurrence between the geochemical remains of fire and its preservation in the archaeological record, as the use of fire is considered a technological landmark, especially for its importance in food cooking, defensive strategies, and heating. Here we report fossil lipid biomarkers associated with incomplete combustion of organic matter at the Valdocarros II site, one of the largest European Acheulean sites in Spain dated to marine isotopic stage (MIS) 8/7 (~ 245 kya) allowing a multiproxy analysis of human-controlled fire use. Our results reveal isolated cases of highly concentrated and diverse polycyclic aromatic hydrocarbons (PAHs) and alkylated PAHs (APAHs), along with diagnostic conifer-derived triterpenoids in two hearth-like archaeological structures. The presence of combustion byproducts suggests the presence of anthropogenic (controlled) fires at Valdocarros-one of the oldest evidence of fire use in Europe-in association with Acheulean tools and bones. Hominins possibly used fire for two main activities, as a means of defense against predators and cooking. Our results help to better delineate major gaps in our current knowledge of human-controlled fire in the context of the Middle-Pleistocene in Europe and suggest that human ancestors were able to control fire before at least 250 kya.

Reducing the number of catheter-associated urinary tract infections at an inpatient rehabilitation facility: A quality improvement project.

During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of healthcare-associated infections (HAIs), including catheter-associated urinary tract infections (CAUTIs), increased significantly across the country. This report describes a quality improvement project aimed at reducing the incidence of CAUTIs at an inpatient rehabilitation facility.

Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale.

Background: The Evidence-Based Practice Attitudes Scale (EBPAS) is widely used in implementation research, but it has not been adapted and validated for use among general education teachers, who are most likely to deliver evidence-based prevention programs in schools, the most common setting where youth access social, emotional, and behavioral health services. Method: School-based stakeholders and a research team comprised of experts in the implementation of evidence-based practices in schools adapted the EBPAS for teachers (the S-EBPAS). The adapted instrument was administered to a representative sample (n = 441) of general education teachers (grades K-5) to assess the reliability and internal consistency via factor analyses. The S-EBPAS included two forms (i.e., EBP-agnostic and EBP-specific item referents), therefore, a multiple-group confirmatory factor analysis (CFA) was also performed to establish measurement invariance between the two forms. Results: After adaptation and refinement, a 9-item, 3-factor structure was confirmed, with the final model supporting three first-order factors that load onto a second-order factor capturing attitudes toward adopting evidence-based practices. Multiple-group CFA analyses of measurement invariance indicated there were no significant differences between the two forms. Conclusions: Overall, this study provides a brief, flexible instrument capturing attitudes toward adopting EBPs that has high reliability and internal consistency, which support its use among general education teachers in school settings implementing evidence-based practices. Plain Language Summary: The Evidence-Based Practice Attitudes Scale (EBPAS) is a popular instrument for measuring attitudes toward evidence-based practices (EBPs). This instrument provides valuable information during implementation initiatives, such as whether providers or front-line implementers have favorable attitudes toward a given practice. The EBPAS has been used in many different settings, such as in community-based mental health clinics, medical hospitals, and in child welfare. However, it's use in schools has been limited, and it has not yet been tested with general education teachers, who are key implementers of evidence-based practices in schools. In order to trust that the scores from an instrument are accurate, it needs to be evaluated when scaling it out to new populations and settings. One popular method to determine this is to use factor analysis, which was employed in this study. This study fills the identified gap by assessing the reliability (i.e., accuracy) and internal consistency of the EBPAS among a representative sample of general education teachers. Findings from this study indicate that the school-adapted EBPAS (S-EBPAS) is a brief, nine-item instrument that provides a reliable estimate of teachers' attitudes toward evidence-based practices. Our results also provide evidence that the S-EBPAS can be used to capture attitudes toward specific EBPs as well as attitudes toward EBP-agnostic. This study provides a flexible instrument that can be used by school-based implementation researchers, practitioners, and intermediaries at multiple phases of implementation projects, such as when exploring a new EBP to adopt.

The Effect of Probable COVID-19 Infection on the National Football League Players' Performance and Endurance During the 2020 Season.

Objective The objective of this study was to assess whether the National Football League (NFL) players with probable coronavirus disease 2019 (COVID-19) during the 2020 season experienced a decline in athletic performance and endurance. Methods All players who were listed on the NFL's COVID-19 Injury Reserve (COVID-IR) list were screened for inclusion. Players were included in the study if they had spent ≥10 days on the COVID-19 IR list (which indicated a positive PCR test based on the NFL COVID-19 policies), had played in at least two games before and after going on the IR list, and primarily played an offensive or defensive position. The mean number of snaps played per game and Pro Football Focus (PFF) score per game were collected for each athlete, which served as surrogate measures of endurance and performance, respectively. The results were analyzed with players grouped by position, and then all players grouped as a whole. Within-group comparisons were performed via t-tests. Results A total of 78 players met the criteria for inclusion in the study. The overall mean PFF score pre-COVID-19 infection was 62.15 (SD: 6.93), while it was 61.73 (SD: 7.42) post-COVID-19 infection, showing a decrease of 0.42 after infection (n=78, p=0.33). The mean number of snaps played per game pre-COVID-19 infection was 38.99 (SD: 16.46) while it was 38.10 (SD: 17.05) post-COVID-19 infection, showing a decrease of 0.89 after infection (n=78, p=0.30). When grouped by position, statistically significant differences were seen with Defensive Backs' mean snaps played per game decreasing by 18.30 (n=6, p=0.03) and Defensive Linemen's mean PFF score decreasing by 3.77 points (n=21, p=0.03). Conclusion Based on our findings, COVID-19 infection negatively impacted endurance in Defensive Backs, and performance in Defensive Linemen. However, there was inconclusive evidence to show whether COVID-19 infection negatively impacted other positions when analyzed separately or all positions when analyzed together. Further studies with more participants are needed to fully assess the effects of COVID-19 on performance and endurance in elite athletes.