Effect of structure on sensing performance of nitro explosives with high sensitivity and mechanism of two Tb(III) coordination polymers.

The use of a conjugate N-containing ligand resulted in the decreasing of structural dimensions from 2D network of [Tb(2-pyia)(Ac)(H2O)] (CP1) to 1D chain [Tb(2-pyia)(Ac)(IDP)] (CP2) (2-H2pyia = 5-(pyridin-2-ylmethoxy) isophthalic acid and IDP=imidazo[4,5-f]-[1,10] phenanthroline). Both of them exhibit the characteristic luminescence of Tb ions and could have high fluorescence sensing properties for cefixime and fluridine. The different sensing properties for nitro explosives are manifested as CP1 for nitrobenzene and CP2 for 4-nitrophenol due to the difference in structure. Furthermore, CP2 exhibits the ratiometric fluorescence sensing for Fe3+ ion with a low detection limit of 0.405 µM. The fluorescence sensing mechanism of the two Tb complexes for different analytes was investigated using experimental methods and theoretical calculations. CP1 was used for the detection of Flu residues in the actual system and better results were obtained. The work shows the introduction of the chelated ligand might affect the structural and sensing performance changes of coordination polymers.

Visibility of esophageal squamous cell carcinoma under iodine staining on texture and color enhancement imaging.

Objective: Iodine staining on white light imaging (WLI) is the gold standard for detecting and demarcating esophageal squamous cell carcinoma (ESCC). We examined the effects of texture and color enhancement imaging (TXI) on improving the endoscopic visibility of ESCC under iodine staining. Methods: Twenty ESCC lesions that underwent endoscopic submucosal dissection were retrospectively included. The color difference between ESCC and the surrounding mucosa (ΔEe) on WLI, TXI, and narrow-band imaging was assessed, and ΔEe under 1% iodine staining on WLI and TXI. Furthermore, the visibility grade determined by endoscopists was evaluated on each imaging. Result: The median ΔEe was greater on TXI than on WLI (14.53 vs. 10.71, respectively; p < 0.005). Moreover, the median ΔEe on TXI under iodine staining was greater than the median ΔEe on TXI and narrow-band imaging (39.20 vs. 14.53 vs. 16.42, respectively; p < 0.005 for both). A positive correlation in ΔEe under iodine staining was found between TXI and WLI (correlation coefficient = 0.61, p < 0.01). Moreover, ΔEe under iodine staining on TXI in each lesion was greater than the corresponding ΔEe on WLI. The visibility grade assessed by endoscopists on TXI was also significantly greater than that on WLI under iodine staining (p < 0.01). Conclusions: The visibility of ESCC after iodine staining was greater on TXI than on WLI.

The minimal clinically important difference of two multifaceted fatigue evaluation questionnaires in chronic stroke.

PURPOSE: This research sought to ascertain the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and Chalder Fatigue Questionnaire-11 (CFQ-11) as two important concepts for the clinical interpretation of the results in chronic post-stroke population. METHODS: A total of 128 subjects with chronic post-stroke completed the MFSI-SF and CFQ-11 before and after six weeks of intervention. The MCIDs were derived using both anchor- and distribution-based methods; however, only anchor-based methods were used to estimate RCIDs. RESULTS: Anchor-based MCIDs for MFSI-SF and CFQ-11 were in the range of -5 to -6.28 and -2 to -4.56, respectively. Distribution-based MCIDs in MFSI-SF and CFQ-11 were calculated in the range of -4.17 to -24.05 and -1.72 to -7.68, respectively. RCID ranges of -10 to -15 were obtained for the MFSI-SF and -6 to -7.33 for the CFQ-11. CONCLUSION: These findings may have implications for clinical experts in the clinical interpretation of fatigue changes observed in MFSI-SF and CFQ-11 in individuals with chronic stroke.

Lake ecological restoration of vegetation removal mitigates algal blooms and alters landscape patterns of water and sediment bacteria.

Elucidating the influences of ecological restoration measure of lakeshore vegetation removal on water quality and biological community is an important but underestimated subject. We adopted molecular and statistical tools to estimate ecological restoration performance in a plateau lake receiving vegetation removal and simultaneously investigated variabilities of bacterial communities in water and sediment. Significant decreases in lake trophic level and algal bloom degree followed notable decreases in water total nitrogen and total phosphorus after vegetation removal. Non-significant changes in sediment nutrients accompanied remarkable variabilities of abundance and composition of nutrient-cycling functional genes (NCFGs) of sediment bacteria. Taxonomic and phylogenetic α-diversities, functional redundancies, and dispersal potentials of bacteria in water and sediment decreased after vegetation removal, and community successions of water and sediment bacteria were separately significant and non-significant. There were opposite changes in ecological attributes of bacteria in water and sediment in response to vegetation removal, including niche breadth, species replacement, richness difference, community complexity, and community stability. Species replacement rather than richness difference affected more on taxonomic ß-diversities of bacteria in water and sediment before and after vegetation removal, and determinism rather than stochasticity dominated bacterial community assemblage. Our results highlighted vegetation removal mitigated algal bloom and affected differently on landscapes of water and sediment bacteria. These findings point to dominant ecological mechanisms underlying landscape shifts in water and sediment bacteria in a disturbed lake receiving vegetation removal and have the potential to guide lake ecological restoration.

Monitoring molecular events during photo-driven ubiquinone pool reduction in PufX+ and PufX- membranes from Rhobobacter capsulatus by time-resolved FTIR difference spectroscopy.

The PufX protein is found in the photosynthetic membranes of several purple bacteria and is involved in ubiquinol-ubiquinone exchange at the QB site of the reaction center. We have studied quinone pool reduction in chromatophores from PufX+ and PufX- strains of Rhodobacter capsulatus by time-resolved FTIR difference spectroscopy under and after continuous illumination. To our knowledge, it is the first time that quinone pool reduction has been directly followed in real time in Rba. capsulatus membranes. Thanks to the availability in the literature of IR marker bands for protein conformational changes, ubiquinone consumption, ubiquinol production, Q---QH2 quinhydrone complex formation, as well as for RC-bound QA- and QB- semiquinone species, it is possible to follow all the molecular events associated with light-induced quinone pool reduction. In Rba. capsulatus PufX + chromatophores, these events resemble the ones found in Rba. sphaeroides wild-type membranes. In PufX- chromatophores the situation is different. Spectra recorded during 22.7 s of illumination showed a much smaller amount of photoreduced quinol, consistent with previous observations that PufX is required for efficient QH2/Q exchange at the QB site of the RC. Q consumption and QH2 formation are rapidly associated with QA- formation, showing that the structure of the RC-LH1 complex in PufX- membranes does not provide efficient access to the QB site of the RC to a large fraction of the quinone pool, evidently because the LH1 ring increases in size to impair access to the RC. The presence of a positive band at 1560 cm-1 suggests also the transient formation, in a fraction of chromatophores or of RC-LH1 complexes, of a Q---QH2 quinhydrone complex. Experiments carried out after 2-flash and 10-flash sequences make it possible to estimate that the size of the quinone pool with access to the QB site in PufX- membranes is ≥ 5 ubiquinone molecules per RC. The results are discussed in the framework of the current knowledge of protein organization and quinone pool reduction in bacterial photosynthetic membranes.

Rapid on-site analysis of soil microplastics using miniaturized NIR spectrometers: Key aspect of instrumental variation.

Contamination by microplastics, a global environmental concern, demands effective monitoring. While current methods focus on characterizing the smallest particles, their low throughput hinders practical assessment. Miniaturized near-infrared (NIR) spectroscopy offers high-throughput capabilities and rapid on-site analysis, potentially filling this gap. However, diverse sensor characteristics result in significant differences among handheld NIR spectrometers. This study characterizes the analytical performance of these instruments for identifying soil microplastics, comparing miniaturized devices MicroNIR 1700ES, NeoSpectra Scanner, microPHAZIR, nanoFTIR-NIR, NIR-S-G1, and SCiO sensor against a reference benchtop instrument, the NIRFlex N-500. Detection of common polymers, ABS, EVAC, HDPE, LDPE, PA6, PMMA, POM, PET, PS, PTFE, and SBR, at low concentrations (0.75 % w/w) was possible without sample preparation. Sensor selection proved crucial; FT instruments N-500 and NeoSpectra Scanner provided the most accurate analysis, while other handheld instruments faced various challenges. Covariance analysis, Principal Component Analysis (PCA), and mid-level data fusion revealed that miniaturized NIR spectrometers can successfully screen microplastics on-site. However, the ability of each sensor to discriminate certain groups of polymers strongly depends on its spectral characteristics. This study demonstrates the importance of sensor selection in the development of portable NIR spectroscopy for environmental monitoring of microplastics.

A pH-responsive dual-emission composite for fast detection of BAs and visual monitoring seafood freshness with large luminescence color difference.

Sensing biogenic amine (BAs) content is very important for assessing food freshness. To address the limitations such as small color difference values (ΔE) and complex preparation of probes for visualizing the freshness of seafood, a pH-responsive ratiometric fluorescent probe (EnEB) was prepared by Eu(NO3)3, trimeric acid (BTC), and hydrochloric acid norepinephrine (Enr). EnEB emitted blue (446 nm) and red fluorescence (616 nm) originating from Enr and Eu3+, respectively, and exhibiting a fluorescence wavelength difference up to 170 nm. The ratiometric fluorescent signals of EnEB showed a linear correlation with pH in the range of 5.5-8.0. Thus, EnEB can rapidly and precisely detect BAs, such as histamine, tyramine, and spermine, with detection limits and response times of 1.14 µmol/L (3 s), 1.04 µmol/L (8 s), and 0.41 µmol/L (2 s), respectively. Furthermore, an EnEB aerogel was prepared by loading EnEB in a matrix formed by polyvinyl alcohol (PVA) and agarose (AG). EnEB aerogel exhibited excellent acid-base gas-sensing properties. The fluorescence color of EnEB aerogel can change significantly with the deterioration of seafood. When seafood changed from fresh to decayed, the ΔE value of EnEB aerogel was as high as 80.9. Importantly, the results of seafood freshness by naked eye using EnEB aerogel was consistent well with the TVB-N content and the freshness standard stipulated by national food standard, indicating EnEB aerogel can accurately visually and real-time monitor seafood freshness. Furthermore, the strategy for sensing food freshness based on EnEB aerogel also offered multiple color variations to indicate fine freshness levels of seafood. This work provided a convenient, efficient, and accurate approach to assessing the freshness of seafood. Additionally, EnEB also has promising applications in security and anti-counterfeiting.

Early appearance concerns after burns: Investigating the roles of psychological flexibility and self-compassion.

Few qualitative studies have explored appearance concerns soon after burn injuries. This study aimed to understand the early experiences of appearance concerns after burns, through the lens of psychological flexibility and self-compassion. Template analysis informed data collection and analysis. Fifteen adults (nine female, six male) with appearance concerns were interviewed within three months of their burns. Three superordinate themes were identified: (1) Need for social connection; (2) Distress through difference; and (3) Experiential avoidance and self-criticism in response to early appearance concerns. Findings highlighted that early appearance concerns are influenced by the need for social acceptance and the desire to conform to societal ideals. Internalised gender and appearance ideals and concerns about rejection and stigma were activated by the burn, and individuals had difficulty responding to their early appearance concerns with psychological flexibility and self-compassion. Instead, attempts to avoid distress (experiential avoidance) occurred. Self-criticism in response to distress was evident which, for some, extended to the event leading to their burns. Early interventions to enhance psychological flexibility and self-compassion (e.g., acceptance and commitment therapy, mindful self-compassion), to help individuals respond to appearance concerns with less experiential avoidance and self-criticism, would likely promote adjustment to changes in appearance after burns.

The Ambulatory Diabetes Outreach Program (ADOP): Rigorous Evaluation of a Pharmacist and Nurse-Led Care Model.

BACKGROUND: Although several systematic reviews found that ambulatory diabetes mellitus (DM) interventions involving pharmacists generally yielded better outcomes than the ones that did not, existing studies have limitations in rigor and study design. OBJECTIVE: To examine the intention-to-treat effects of the Ambulatory Diabetes Outreach Program (ADOP) on participants' A1c values and healthcare utilization over a 52-month follow-up period. DESIGN: Difference-in-differences with staggered adoption. Specifically, we employed the Callaway and Sant'Anna's "group-time average treatment effect" estimator using not-yet treated as controls adjusting for patient's age, BMI, sex, race, comorbidity, payor, and socio-economic status. PARTICIPANTS: All patients with at least one ADOP treatment encounter from July 2017 to October 2021, regardless of program completion or length of exposure to the program. INTERVENTION: ADOP, a collaborative population health program led by pharmacists and nurse specialists to provide individualized type 2 DM management and education within a large and diverse health system. MAIN MEASURES: Patients' A1c values and healthcare utilization, including inpatient admission, inpatient days, and numbers of visits to the emergency department, urgent care, and primary care in recent 6 months. KEY RESULTS: ADOP participation was associated with an overall average reduction of 1.04 percentage points (95%CI - 1.12, - 0.95) in A1c level. Similar A1c reductions were also observed in the subgroups by sex and race/ethnicity. An average of 2 months were required to reach the overall average effect, which persisted over 4 years. Compared to the respective utilization levels pre-intervention, participants also had average reductions in inpatient admissions by 32.4%, inpatient days by 81.6%, visits to the emergency department by 21.6%, and primary care by 17.9%. CONCLUSIONS: The results suggest that a collaborative model of pharmacist and nurse-led type 2 DM intervention was effective in improving A1c outcomes and reducing healthcare utilization in the long term.

Mastering meta-analysis in Microsoft Excel with MetaXL add-in: A comprehensive tutorial and guide to meta-analysis.

RATIONALE: Meta-analysis, a powerful technique for combining effect estimates from multiple studies, enhances statistical power and precision. However, its adoption can be hindered by challenges in statistical interpretation and the complexity of specialized software. MetaXL, a freely available Microsoft Excel add-in, aims to mitigate these barriers by providing comprehensive support and facilitating seamless integration of meta-analytical results into research publications. AIMS AND OBJECTIVES: This tutorial illustrates the practical application of MetaXL for synthesizing meta-analytical evidence, with a focus on common effect sizes and their presentation. METHOD: This paper reintroduce MetaXL's functions and provide concise explanations of common effect sizes employed in meta-analysis. The tutorial delves into fundamental concepts such as the selection of appropriate effect sizes for pooling and the choice of meta-analytical models. Eight illustrative examples are presented, incorporating diverse effect sizes and data formats, including scenarios involving incidence rate ratios, weighted and standardized mean differences, hazard ratios, and prevalence. Additionally, key concepts in network meta-analysis are discussed, along with their implementation in MetaXL. MetaXL provides convenient access to data formatting templates tailored to various data types and effect sizes encountered in included studies. RESULTS AND CONCLUSION: This tutorial offers researchers, particularly those with limited resources, detailed explanations and insights into commonly used methodologies for pooling effect sizes. Furthermore, it introduces the new Excel functions that comes with the MetaXL add-in. Accurate population of this function and adherence to the correct format are essential to ensure error-free analyzes.

Finite Difference Modeling and Experimental Investigation of Cyclic Thermal Heating in the Fused Filament Fabrication Process.

Fused filament fabrication (FFF) is one of the most popular additive manufacturing (AM) processes due to its simplicity and low initial and maintenance costs. However, good printing results such as high dimensionality, avoidance of cooling cracks, and warping are directly related to heat control in the process and require precise settings of printing parameters. Therefore, accurate prediction and understanding of temperature peaks and cooling behavior in a local area and in a larger part are important in FFF, as in other AM processes. To analyze the temperature peaks and cooling behavior, we simulated the heat distribution, including convective heat transfer, in a cuboid sample. The model uses the finite difference method (FDM), which is advantageous for parallel computing on graphics processing units and makes temperature simulations also of larger parts feasible. After the verification process, we validate the simulation with an in situ measurement during FFF printing. We conclude the process simulation with a parameter study in which we vary the function of the heat transfer coefficient and part size. For smaller parts, we found that the print bed temperature is crucial for the temperature gradient. The approximations of the heat transfer process play only a secondary role. For larger components, the opposite effect can be observed. The description of heat transfer plays a decisive role for the heat distribution in the component, whereas the bed temperature determines the temperature distribution only in the immediate vicinity of the bed. The developed FFF process model thus provides a good basis for further investigations and can be easily extended by additional effects or transferred to other AM processes.

Influence of preheating and water storage on the color, whiteness, and translucency of modern resin-based composites.

OBJECTIVES: To evaluate the influence of preheating and water storage on color, whiteness, and translucency of one-shaded, group-shaded, and multi-shaded resin-based composites. MATERIALS AND METHODS: A total of 270 samples were fabricated from one-shaded (Omnichroma), group-shaded (Optishade MD), and multi-shaded (Enamel Plus HRI) resin-based composites and divided into six groups: no heating (control) and 1-5 heatings (test) (n = 15). The CIE L*, a*, b*, C*, and h° color coordinates were registered over white, black, and gray backgrounds with a spectrophotometer before and after 24, 72, 144 h water storage. Kruskal-Wallis test was used to evaluate differences in the color coordinates, whiteness index, and translucency parameter (α = 0.05). The Mann-Whitney U test was performed with a Bonferroni correction (p < 0.001) for pairwise comparisons. CIEDE2000 color, whiteness, and translucency differences between groups and subgroups were evaluated using their respective 50%:50% perceptibility and acceptability thresholds. RESULTS: Preheating influenced color coordinates, whiteness index, and relative translucency parameters (p < 0.001). Although color differences were below the acceptability threshold for all materials, translucency differences were above the acceptability threshold for Omnichroma. Water storage significantly influenced the whiteness index of Optishade MD (p < 0.001). CONCLUSIONS: Preheating had a more considerable effect on the color, whiteness, and translucency of one-shaded resin-based composite, while water storage influenced group-shaded resin-based composite more importantly. CLINICAL SIGNIFICANCE: Preheating influences the color, whiteness level, and translucency of the resin-based composites, but the variations remain generally clinically acceptable; however, practitioners should be aware that the modifications in translucency for one-shaded resin-based composites could be more important than for group-shaded and multi-shaded resin-based composites.

Genistein mitigates diet-induced obesity and metabolic dysfunctions in gonadectomized mice with some sex-differential effects.

Background: Obesity is associated with insulin resistance (IR) and metabolic dysfunction-associated steatotic liver disease (MASLD). Genistein, an isoflavone, is a promising natural compound for preventing and treating obesity and metabolic dysfunctions. We aimed to investigate the sex-specific protective effects of genistein on obesity, IR, and MASLD in a murine model of sex hormone deprivation with diet-induced obesity (DIO), mimicking postmenopausal women or aging men with metabolic syndrome. Methods: Gonadectomized and sham-operated C57BL/6NJcl mice were fed a high-fat high-sucrose diet for 4 weeks to induce obesity (7 mice per group). In gonadectomized mice, genistein (16 mg/kg/day) or vehicle (7.5% dimethyl sulfoxide) was orally administered for 45 days. We assessed glucose homeostasis parameters, hepatic histopathology, and hepatic gene expression to investigate the effects of gonadectomy and genistein treatment. Results: Gonadectomy exacerbated adiposity in both sexes. Ovariectomy diminished the protective effects of female gonadal hormones on the homeostatic model assessment for insulin resistance (HOMA-IR), serum alanine transaminase levels, hepatic steatosis score, and the expression of hepatic genes associated with MASLD progression and IR, such as Fasn, Srebf1, Saa1, Cd36, Col1a1, Pck1, and Ppargc1a. Genistein treatment in gonadectomized mice significantly reduced body weight gain and the hepatic steatosis score in both sexes. However, genistein treatment significantly attenuated HOMA-IR and the expression of the hepatic genes only in female mice. Conclusion: Genistein treatment mitigates DIO-related MASLD in both male and female gonadectomized mice. Regarding hepatic gene expression associated with MASLD and IR, the beneficial effect of genistein was significantly evident only in female mice. This study suggests a potential alternative application of genistein in individuals with obesity and sex hormone deprivation, yet pending clinical trials.

From policy to practice: How China's emissions trading scheme shapes ESG greenwashing at the firm level?

This study provides new insights into the causal relationship between implementing Emission Trading Schemes (ETS) and corporate behaviors related to Environmental, Social, and Governance (ESG) greenwashing from 2009 to 2022. Utilizing a concise empirical framework, our findings substantiate the catalytic role of China's ETS in reducing ESG greenwashing activities. However, the effectiveness of this mitigation varies depending on firm's size, governance quality, and pollution nature. Notably, the impact of the ETS also differs based on cohort, calendar times, and exposure duration. Furthermore, our analysis explores the complex mechanisms through which ETS influences ESG greenwashing across four key dimensions, revealing that factors like innovation (including R&D and green innovation) and supply chain dynamics enhance the scheme's ability to curb greenwashing. Conversely, financial constraints and the digital divide can undermine the effectiveness of China's ETS, potentially leading to increased greenwashing practices.

Do China's ecological civilization advance demonstration zones inhibit fisheries' carbon emission intensity? A quasi-natural experiment using double machine learning and spatial difference-in-differences.

China's National Ecological Civilization Demonstration Zone (NECDZ) policy has a significant role in ensuring national ecological security, and it is essential to investigate how the NECDZ policy affects the carbon emissions intensity of fisheries (CEIF) to advance China's commitment to reducing carbon emissions. This study evaluates the CEIF in 30 Chinese provinces from 2007 to 2021 using ecological civilization demonstration areas as a quasi-natural experiment and double machine learning (DML)to examine the impact and internal mechanisms of NECDZ implementation on the CEIF. We also explore spatial spillover effects using a spatial difference-in-differences approach. The results reveal that NECDZ implementation has a significantly negative impact on the CEIF and this effect continues over time. NECDZ policy potentially affects the CEIF through technology development, industrial structure improvement, and reduced energy consumption. Further investigation reveals that NECDZ implementation has spillover effects and inhibits the CEIF in surrounding regions. Therefore, it is essential to focus on developing the NECDZ policy to enhance fisheries' industrial structure, encourage low-carbon innovation in fishery technologies, and increase energy consumption efficiency. This could be supported by facilitating exchanges and cooperation with other areas, considering regional disparities, and assigning common but distinct responsibility for reducing the CEIF.

Simulation an effective light trapping structure for boosting photoelectrocatalytic water splitting.

Solar energy converted by photoelectrochemical (PEC) cells showcases significant potential for addressing the energy crisis. However, limitations stemming from photoelectrode structure have hindered the efficiency improvements of PEC cells. In this work, we utilized the finite-time domain difference method to simulate the PEC performance of GaAs photoanode in a PEC cell. Through finite element analysis, we determined the thickness of GaAs photoanode to be 265 nm and subsequently designed the concave-structured photoanode. Comparison of cross-sectional photoelectric characteristic between flat and concave structured photoanodes revealed significant improvements in the latter. Specifically, the absorption of concave structure increased by 30.61 % compared to flat structure, accompanied by 2.7 times increase in Pmax and 2.2 times increase in JSC. Further analysis of the impact of depth-to-width ratio and inner surface area on light-trapping characteristics demonstrated their influence on absorption and photoelectrical performance. Interestingly, concave structures presented a 14.70 % higher absorption compared to flat structures, translating to 1.48 times increase in surface area absorption rate. Moreover, the Pmax increase was 3.08 times greater than the increase in surface area. We anticipate that our structural simulation findings will offer valuable theoretical insights for the design of light-trapping structures, thereby enhancing the performance of PEC cells.

Association between serum level of uric acid in Japanese young patients with coronary spastic angina receiving coronary angiography.

Endothelial dysfunction may trigger coronary spastic angina (CSA). However, the risk factors for CSA in young patients remain unclear. This study aimed to investigate the age-dependent role of serum uric acid levels in patients with CSA. We enrolled 423 patients who underwent an ergonovine tolerance test during coronary angiography for the CSA evaluation. We categorized the patients as (1) young (age ≤ 65 years) CSA-positive (n = 33), (2) young CSA-negative (n = 138), (3) elderly (age > 66 years) CSA-positive (n = 42), and (4) elderly CSA-negative (n = 210) groups. In the young groups, the smoker proportion (57.6 vs. 38.4%, p = 0.04) and serum uric acid levels (6.3 ± 1.4 vs. 5.4 ± 1.5 mg/dl, p = 0.006) were significantly higher in the CSA-positive compared with the CSA-negative group. Conversely, in the elderly group, the male proportion (66.6 vs. 47.1%, p = 0.02) and alcohol consumption level (40.5 vs. 21.0%, p = 0.01) were significantly higher in the CSA-positive compared with the CSA-negative group. The multivariate analysis in young groups revealed the independent association between the serum uric acid level (p = 0.02) and the presence of CSA. Our results indicate that elevated serum uric acid levels may affect CSA development in young patients.

Gender Differences in Variability in Intimate Relationship Satisfaction: A Secondary Analysis and Meta-Analysis.

There is a long-standing interest in gender differences in satisfaction in intimate relationships. Whereas prior research has focused on gender differences in central tendency (i.e., means), we conducted two studies - a secondary analysis of data from a probability sample of Australian married couples and a meta-analysis - to examine gender differences in variability (i.e., variances). We hypothesized that compared to males, females would demonstrate greater variability in intimate relationship satisfaction (i.e., greater female variability hypothesis), particularly at lower levels of relationship satisfaction. Results from a secondary analysis of data from 2,711 married couples in the Household, Income and Labour Dynamics in Australia (HILDA) survey and from a meta-analysis of 20 years of research (k = 171, N = 84,976), including independent samples from 33 countries, indicated that relative to males, females reported greater variability in relationship satisfaction. Obtained effect sizes (female-to-male variance ratios [VRs] of 1.42 for the HILDA sample and 1.19 for the meta-analysis) were larger than proposed cutoffs for meaningful group differences in variability. Analysis of tail ratios (ratios of the relative proportion of females divided by the relative proportion of males in the distributional tail regions) in the HILDA sample indicated that gender differences in variability were greater at lower (versus higher) levels of satisfaction. Findings support the greater female variability hypothesis and suggest that by focusing only on gender differences in means, the existing literature has underestimated gender differences in intimate relationship satisfaction.

Do health care quality improvement policies work for all? Distributional effects by baseline quality in South Africa.

Health care quality improvement (QI) initiatives are being implemented by a number of low- and middle-income countries. However, there is concern that these policies may not reduce, or may even worsen, inequities in access to high-quality care. Few studies have examined the distributional impact of QI programmes. We study the Ideal Clinic Realization and Maintenance program implemented in health facilities in South Africa, assessing whether the effects of the program are sensitive to previous quality performance. Implementing difference-in-difference-in-difference and changes-in-changes approaches we estimate the effect of the program on quality across the distribution of past facility quality performance. We find that the largest gains are realized by facilities with higher baseline quality, meaning this policy may have led to a worsening of pre-existing inequity in health care quality. Our study highlights that the full consequences of QI programmes cannot be gauged solely from examination of the mean impact.

Singing Voice Handicap Index-10 Minimal Clinically Important Difference: A Prospective Determination.

BACKGROUND/OBJECTIVES: The Singing Voice Handicap Index-10 (SVHI-10) is a validated patient-reported outcome measure (PROM) that assesses patients' perception of handicap related to singing voice. A normative value has been established with a score ≥20 being abnormal. However, there is no defined minimal clinically important difference (MCID). This study prospectively determines the MCID of SVHI-10 among a diverse group of singers. METHODS: 103 adult singers with and without voice complaints completed SVHI-10 twice, 30 days apart. MCID for the SVHI-10 was determined using distribution-based receiver-operating characteristic (ROC) curve analysis. RESULTS: Twenty-two men (1 transgender), 75 women (1 transgender), and 6 nonbinary individuals participated. The most frequently reported singing genres were classical (44.7%), musical theater (17.5%), and pop (10.7%). Mean initial SVHI-10 score was 13.05 (standard deviation 7.397), and mean follow-up SVHI-10 was 13.13 (7.994). There was a significant positive correlation between initial and follow-up SVHI-10 scores (r = 0.879, p < 0.001). SVHI-10 scores were significantly higher among participants who reported voice changes in the past year (p < 0.001) or sought voice treatment (p = 0.001) compared with participants who did not. SVHI-10 scores varied significantly based on singing type. The area under the ROC curve for SVHI-10 was 0.700 (p = 0.003). The SVHI-10 MCID was determined to be 9.5. CONCLUSIONS: An SVHI-10 score change ≥10 should be considered clinically meaningful. This definition has been missing from the literature and will improve understanding of patients' responses to treatment, which will help advance clinical care and track research outcomes. LEVEL OF EVIDENCE: 4 Laryngoscope, 2024.