Clinical Variables Associated with Successful Treatment of Depression or Anxiety in Collaborative Care.

Collaborative Care, an evidence-based model, has proven effective in treating depression and anxiety in healthcare settings. However, limited attention has been paid to exploring treatment outcome differences by clinical variables and diagnosis within this model. While previous research suggests that early and frequent contacts and swift treatment access lead to positive outcomes for depression and anxiety, these aspects have not been comprehensively examined in Collaborative Care. This study investigates the impact of clinical variables on treatment completion in patients primarily diagnosed with anxiety or depression who received collaborative care treatment as a treatment program. Analysis was completed as an observational study of patients (n =2018) with behavioral health diagnoses spanning from 2016 to 2023. Classification analysis offers insights into optimal practices for implementing Collaborative Care across diverse healthcare populations from pediatric to geriatric. Identifying clinical characteristics associated with successful treatment in Collaborative Care has far-reaching implications for model adoption and enhancing patient outcomes. Across all results, patients who received more clinical support and had shorter enrollment durations showed a strong association with successful treatment completion.

Futility Interim Analysis Based on Probability of Success Using a Surrogate Endpoint.

In clinical trials with time-to-event data, the evaluation of treatment efficacy can be a long and complex process, especially when considering long-term primary endpoints. Using surrogate endpoints to correlate the primary endpoint has become a common practice to accelerate decision-making. Moreover, the ethical need to minimize sample size and the practical need to optimize available resources have encouraged the scientific community to develop methodologies that leverage historical data. Relying on the general theory of group sequential design and using a Bayesian framework, the methodology described in this paper exploits a documented historical relationship between a clinical "final" endpoint and a surrogate endpoint to build an informative prior for the primary endpoint, using surrogate data from an early interim analysis of the clinical trial. The predictive probability of success of the trial is then used to define a futility-stopping rule. The methodology demonstrates substantial enhancements in trial operating characteristics when there is a good agreement between current and historical data. Furthermore, incorporating a robust approach that combines the surrogate prior with a vague component mitigates the impact of the minor prior-data conflicts while maintaining acceptable performance even in the presence of significant prior-data conflicts. The proposed methodology was applied to design a Phase III clinical trial in metastatic colorectal cancer, with overall survival as the primary endpoint and progression-free survival as the surrogate endpoint.

Synthesis of sexual selection: a systematic map of meta-analyses with bibliometric analysis.

Sexual selection has been a popular subject within evolutionary biology because of its central role in explaining odd and counterintuitive traits observed in nature. Consequently, the literature associated with this field of study became vast. Meta-analytical studies attempting to draw inferences from this literature have now accumulated, varying in scope and quality, thus calling for a synthesis of these syntheses. We conducted a systematic literature search to create a systematic map with a report appraisal of meta-analyses on topics associated with sexual selection, aiming to identify the conceptual and methodological gaps in this secondary literature. We also conducted bibliometric analyses to explore whether these gaps are associated with the gender and origin of the authors of these meta-analyses. We included 152 meta-analytical studies in our systematic map. We found that most meta-analyses focused on males and on certain animal groups (e.g. birds), indicating severe sex and taxonomic biases. The topics in these studies varied greatly, from proximate (e.g. relationship of ornaments with other traits) to ultimate questions (e.g. formal estimates of sexual selection strength), although the former were more common. We also observed several common methodological issues in these studies, such as lack of detailed information regarding searches, screening, and analyses, which ultimately impairs the reliability of many of these meta-analyses. In addition, most of the meta-analyses' authors were men affiliated to institutions from developed countries, pointing to both gender and geographical authorship biases. Most importantly, we found that certain authorship aspects were associated with conceptual and methodological issues in meta-analytical studies. Many of our findings might simply reflect patterns in the current state of the primary literature and academia, suggesting that our study can serve as an indicator of issues within the field of sexual selection at large. Based on our findings, we provide both conceptual and analytical recommendations to improve future studies in the field of sexual selection.

Ablation of Small Liver Metastases Presenting as Foci of Diffusion Restriction on MRI-Results from the Prospective Minimally Invasive Thermal Ablation (MITA) Study.

PURPOSE: Liver metastases presenting as small hyperintense foci on diffusion-weighted imaging (DWI) pose a therapeutic challenge. Ablation is generally not possible since these lesions are often occult on ultrasound and CT. The purpose of this prospective study was to assess if small liver metastases (≤10 mm) detected on DWI can be successfully localized and ablated with the Hepatic Arteriography and C-Arm CT-Guided Ablation technique (HepACAGA). MATERIALS AND METHODS: All consecutive patients with small liver metastases (≤10 mm), as measured on DWI, referred for ablation with HepACAGA between 1 January 2021, and 31 October 2023, were included. Re-ablations and ablations concomitant with another local treatment were excluded. The primary outcome was the technical success rate, defined as the intraprocedural detection and subsequent successful ablation of small liver metastases using HepACAGA. Secondary outcomes included the primary and secondary local tumor progression (LTP) rates and the complication rate. RESULTS: A total of 15 patients (26 tumors) were included, with liver metastases from colorectal cancer (73%), neuro-endocrine tumors (15%), breast cancer (8%) and esophageal cancer (4%). All 26 tumors were successfully identified, punctured and ablated (a technical success rate of 100%). After a median follow-up of 9 months, primary and secondary LTP were 4% and 0%, respectively. No complications occurred. CONCLUSION: In this proof-of-concept study, the HepACAGA technique was successfully used to detect and ablate 100% of small liver metastases identified on DWI with a low recurrence rate and no complications. This technique enables the ablation of subcentimeter liver metastases detected on MRI.

Appraising critical success factors in sustainable housing projects: A comparative study of PPP modalities in Saudi Arabia.

This study examines the critical success factors (CSFs) crucial for the effective deployment of public-private partnership (PPP) models in sustainable housing projects in the Kingdom of Saudi Arabia (KSA), underpinning the nation's Vision 2030. Through a robust methodology that incorporates a profound literature review, structured interviews, and a survey involving key stakeholders, the study prioritizes fourteen significant CSFs integral to PPP efficacy. Employing Analytical Hierarchy Process analysis, key outcomes underscore the paramount importance of technical aspects with an emphasis on sustainability, tailoring risk-sharing and allocation to encompass green technologies and eco-friendly practices, and economic stability in the light of long-term environmental sustainability in fostering successful sustainable housing projects. Notably, the Build-Operate-Transfer (BOT) model is categorized as the most effective PPP modality, attaining a mean importance score of 4.07. This model is contrasted with other modalities such as Design-Build-Operate (DBO) and Build-Own-Lease-Transfer (BOLT), which scored lower in effectiveness. This comprehensive evaluation provides crucial insights for policymakers and practitioners, emphasizing the strategic selection of PPP modalities and the prioritization of CSFs to enhance the sustainability and effectiveness of housing projects in KSA.

Individual and team performance in cricket.

Advancements in technology have recently allowed us to collect and analyse large-scale fine-grained data about human performance, drastically changing the way we approach sports. Here, we provide the first comprehensive analysis of individual and team performance in One-Day International cricket, one of the most popular sports in the world. We investigate temporal patterns of individual success by quantifying the location of the best performance of a player and find that they can happen at any time in their career, surrounded by a burst of comparable top performances. Our analysis shows that long-term performance can be predicted from early observations and that temporary exclusions of players from teams are often due to declining performances but are also associated with strong comebacks. By computing the duration of streaks of winning performances compared to random expectations, we demonstrate that teams win and lose matches consecutively. We define the contributions of specialists such as openers, all-rounders and wicket-keepers and show that a balanced performance from multiple individuals is required to ensure team success. Finally, we measure how transitioning to captaincy in the team improves the performance of batsmen, but not that of bowlers. Our work emphasizes how individual endeavours and team dynamics interconnect and influence collective outcomes in sports.

Pneumatic retinopexy for primary rhegmatogenous retinal detachment: from a clinical trial to the real-life experience.

BACKGROUND: To report real-world outcomes of patients with primary Reghmatogenous Retinal Detachment (RRD) treated with Pneumatic Retinopexy (PnR) according to the indications of the Pneumatic Retinopexy versus Vitrectomy for management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) trial. METHODS: Multicenter, retrospective study. Patients treated with PnR for RRD between 2021 and 2023 and a follow-up of at least 6 months were included. Single-procedure anatomical success, final anatomical success, complications, causes of failures, best corrected visual acuity (BCVA) after surgery, and the vision-related quality of life using the 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were reported. RESULTS: A total of 76 eyes of 76 patients were included. Mean age was 60 ± 8.1 years. Primary anatomic reattachment was achieved by 84.3% of patients and final anatomical reattachment after pars plana vitrectomy was obtained in 100% of patients. BCVA improved from 0.32 (20/40) to 0.04 (20/20) logMar (p < 0.001) at 6 months. The main cause of failure was related to the presence of additional (likely missed) retinal breaks (66.6% of cases). Also, primary PnR failure was more frequent in eyes of patients with older age, macular involvement, worse baseline BCVA, greater extent of the RRD, and increased duration from diagnosis to treatment. Overall, the mean NEI-VFQ 25 composite score was 93.9% ± 6.4 at 6 months. CONCLUSIONS: The criteria of the PIVOT trial can be applied to real-world scenarios in the decision-making process for the treatment of primary RRD, with excellent anatomical and functional outcomes.

Adolescent behavioral problems, preterm/low birth weight children and adult life success in a prospective Australian birth cohort study.

BACKGROUND: Preterm and/or low birthweight (PT/LBW) is predictive of a range of adverse adult outcomes, including lower employment, educational attainment, and mental wellbeing, and higher welfare receipt. Existing studies, however, on PT/LBW and adult psychosocial risks are often limited by low statistical power. Studies also fail to examine potential child or adolescent pathways leading to later adult adversity. Using a life course framework, we examine how adolescent problem behaviors may moderate the association between PT/LBW and a multidimensional measure of life success at age 30 to potentially address these limitations. METHODS: We analyze 2044 respondents from a Brisbane, Australia cohort followed from birth in1981-1984 through age 30. We examine moderation patterns using obstetric birth outcomes for weight and gestation, measures of problem behaviors from the Child Behavioral Checklist at age 14, and measures of educational attainment and life success at 30 using multivariable normal and ordered logistic regression. RESULTS: Associations between PT/LBW and life success was found to be moderated by adolescent problem behaviors in six scales, including CBCL internalizing, externalizing, and total problems (all p < 0.01). In comparison, associations between LBW and educational attainment illustrate how a single-dimensional measure may yield null results. CONCLUSION: For PT/LBW, adolescent problem behaviors increase risk of lower life success at age 30. Compared to analysis of singular outcomes, the incorporation of multidimensional measures of adult wellbeing, paired with identification of risk and protective factors for adult life success as children develop over the lifespan, may further advance existing research and interventions for PT/LBW children.

Comparison of Conventional and Digital Workflows in the Fabrication of Fixed Prostheses: A Systematic Review.

When considering dental restorations, the use of fixed partial dentures is one of the most widely accepted treatment options. In the past, fabrication was done using traditional techniques and the conventional workflow was by far the popular method; however, nowadays digital workflows are being used as a means to produce the prosthesis. This systematic review aims to compare the workflows by considering their respective qualities, such as precision, efficiency, cost-effectiveness, and clinical performance. A complete search has been carried out to incorporate any relevant studies published between the years 2012 and 2023 in databases such as Scopus, Web of Science, PubMed, ScienceDirect, and Cochrane Library. Two independent reviewers screened articles for inclusion and assessed the studies' methodological quality rating via the NIH Tool. A total of 22 relevant articles were reviewed after a systematic search strategy. The main outcome of the review was digital workflows were found to reduce working time, eliminate the selection of trays, minimize material consumption, and enhance patient comfort and acceptance. The studies also showed that digital workflows resulted in greater patient satisfaction and higher success rates than conventional workflows. Workflows for digital dentistry demonstrated to be better than traditional ones due to the cost-effectiveness, accuracy, and time optimization for the fabrication of fixed prostheses.

Procedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry.

BACKGROUND: The association between hospital and physician procedure volume outcome has not been well evaluated for atrial fibrillation (AF) ablation in contemporary practice. OBJECTIVE: To determine the association between hospital and physician AF ablation volume and procedural success (isolation of all pulmonary veins) and major adverse events (MAE). METHODS: Procedures reported to the NCDR AFib Ablation Registry between July 2019 and June 2022 were included. Hospital and physician procedural volumes were annualized and stratified into quartiles (Q) to compare outcomes. Three level hierarchical (patient, hospital and physician) models were used to assess the procedural volume outcome relationship. RESULTS: A total of 70,296 first-time AF ablations at 186 U.S. hospitals were included. Overall, procedural success and MAE rate were 98.5 % and 1.0% respectively. With hospital volume (Q4) as a reference, the likelihood of procedural success was lower for Q1 (OR 0.44, 95%CI 0.29-0.68), Q2 (OR 0.50, 95%CI 0.33-0.75) and Q3 (OR 0.60, 95%CI 0.40-0.89); the results were similarly signifant for physician volume. With MAE for hospitals, there was an inverse procedural volume relationship for Q1 (OR 1.78, 95%CI 1.26-2.51) but not for Q2 (OR 1.06, 95%CI 0.77-1.46) or Q3 (OR 1.19, 95%CI 0.89-1.58) and similarly for physicians in Q1 and Q2, not in Q3. An adjusted MAE ≤ 1% was predicted by an annual volume of approximately 190 for hospitals and 60 for physicians. CONCLUSION: In this national cohort, hospital and physician AF ablation procedural volumes were directly related to acute procedural success and inversely related to rates of MAE.

The effect of breastfeeding education given through the teach-back method on mothers' breastfeeding self-efficacy and breastfeeding success: a randomized controlled study.

BACKGROUND: An individualized education using visual aids, allowing the woman to demonstrate what she has learned, and providing the opportunity for the woman to ask questions are important in terms of breastfeeding self-efficacy, breastfeeding success, and the sustainability of the education. This study is original in evaluating the effectiveness and sustainability of breastfeeding education provided through the teach-back method in terms of breastfeeding self-efficacy and success in a short period of time. Therefore, the aim of this study is to examine the impact of teach-back method on mothers' breastfeeding self-efficacy and breastfeeding success. MATERIALS AND METHODS: This is a randomized controlled study. The population of this study consisted of women who gave birth in the obstetrics and gynecology department of a state hospital located in Çorlu, in the northwest region of Turkey, between March 2022 and August 2022. The sample of this study consisted of a total of 100 postpartum women, with 50 participants in the experimental group and 50 participants in the control group, who gave birth in the obstetrics and gynecology department of Çorlu State Hospital. Computer-assisted simple randomization was employed to ensure the homogeneous distribution of the women into the experimental and control groups. The women in the experimental group received education and counseling services using the Teach-Back Method, based on the content of the prepared Breastfeeding Education Guide. The control group mothers, on the other hand, received standard breastfeeding education and counseling services. The data were collected through face-to-face interviews during the first 24 h postpartum and at the 1-month follow-up visits. In the study, the data collection tools used were a Personal Information Form, LATCH Breastfeeding Assessment and Evaluation Scale, Postpartum Breastfeeding Self-Efficacy Scale (short form), and the Teach-Back Observation Tool. In the evaluation of the research findings, the SPSS (Statistical Package for the Social Sciences) version 25.0 (IBM Corp., Armonk, NY, USA) program was used for statistical analyses. Descriptive, graphical, and statistical methods were employed to examine whether the scores obtained from each continuous variable followed a normal distribution. The Kolmogorov-Smirnov test was used to assess the normality of the scores derived from a continuous variable using statistical methods. RESULTS: In the study, no significant difference was found in the distribution of the socio-demographic characteristics of the participants according to the study groups. In the experimental group, which received training with the tell-what-you-learned method, the mothers' average EÖYÖ scores before the training, at the 24th hour after the training and at the 1st month after the training were 46.41 ± 11.26, respectively; It was determined to be 66.23 ± 6.94 and 67.84 ± 6.27. In the measurements made during the follow-up, it was determined that there was a significant difference in the study group's EÖYÖ score averages (p < 0,001). For mothers in the experimental group, the average LATCH score of the mothers before training, 24 h after training and 1 month after training was 7.73 ± 1.81, respectively; It was determined that these values were 8.66 ± 1.61 and 9.95 ± 0.30, and there was a significant difference in the mean LATCH scores of the study group in the measurements made during the follow-up (p < 0.001). CONCLUSIONS: Breastfeeding education provided through the teach-back method is more effective in increasing both breastfeeding success and breastfeeding self-efficacy when compared to standard breastfeeding education. TRIAL REGISTRATION: Iran Randomized Clinical Trial Center IRCT20220509054795N2 Date of first registration: 10/11/2022.

Exploring the relationship between grit scores and academic potential in baccalaureate nursing students.

BACKGROUND: An ongoing nursing shortage poses significant challenges to the healthcare industry, prompting nursing education programs to find ways to increase nurse graduates. Unfortunately, the problem of attrition in nursing education is significant. Despite many years of attrition research, educators still seek to find answers to determine what factors cause some students to succeed and others to fail in nursing programs. Noncognitive variables, like grit, have been largely overlooked as potential solutions to the problem of attrition. PURPOSE: The purpose of this study was to explore the extent to which grit predicts academic potential in baccalaureate nursing students. METHODS: This cross-sectional study included a total of 63 baccalaureate nursing students in their first semester of a four-semester nursing program at a mid-sized public university in East Texas. Participants took an electronic survey reporting demographic information, completing the Short Grit Scale (Grit-S), and consenting to release of their pre-admission science grade point average (sGPA), ATI Test of Essential Academic Skills (TEAS) exam scores, and first-semester nursing GPA (nGPA). RESULTS: When added to sGPA and TEAS scores, grit scores were not a statistically significant predictor of nGPA. Students with high grit scores were just as likely to experience attrition as those with low scores, and grit did not statistically significantly predict first-semester attrition. CONCLUSIONS: Nurse educators are encouraged to pursue strategies to address attrition in nursing education. Traditional selection criteria of sGPA and TEAS exam scores were shown to be predictors of nGPA. Additional research is warranted to explore the relationship between noncognitive variables, especially grit, and nursing student academic potential.

"I Was Almost in Disbelief" - Qualitative Analysis of Experiences and Expectations Among Psoriasis Patients Undergoing Biologic Treatment with Secukinumab.

Purpose: Psoriasis is a highly debilitating chronic inflammatory disease. Increased understanding of its pathophysiology has enabled development of targeted treatments such as biologics. Several medical treatments have been shown to be influenced by patients' experiences and expectations. However, only little is known about patients' experiences with and expectations towards biologics. Our objectives were to identify patients' treatment experiences and treatment expectations and assess their trajectories over the course of treatment with the IL-17A inhibitor secukinumab. Moreover, we aimed to document effects of psoriasis, factors that influence symptomatology, and prior treatment experiences. Patients and Methods: We conducted semi-structured interviews with n = 24 patients with moderate-to-severe plaque psoriasis and employed a qualitative content analysis to derive thematic and evaluative codes. Findings were validated via peer debriefings with experienced dermatologists. Results: Patients reported burdensome physical and psychological psoriasis symptoms and identified factors that can improve or worsen symptomatology, including stress and self-efficacy. Prior treatment experiences were mostly negative. Past barriers to effective treatment included time constraints or limited access. Concerning secukinumab, patients initially expected complete to partial remission of symptoms and occurrence or absence of side effects. Closer inspection of expectations and experiences revealed three trajectories. For most patients, initial expectations were met and future expectations remained unchanged. For the other patients, however, the experience did not match their initial expectation. One group then adapted their future expectations according to their experience, while the other group did not. Conclusion: To our knowledge, this is the first qualitative study to assess expectations towards treatment effectiveness and side effects, their trajectories, and interplay with experiences among psoriasis patients. Our findings highlight the value of further research on the subject in order to optimize care for psoriasis patients and to learn more about the trajectories and influence of treatment expectations in general.

Patients' expectations towards a certain treatment can influence how well it will work and whether side effects occur or not. Such effects have been shown for a wide range of conditions, including dermatological ones. For patients suffering from psoriasis, a chronic inflammatory skin disease, modern biologics offer promising treatment options. Therefore, modern biologics are likely associated with high expectations by patients. Yet, the roles of treatment expectations and the experiences of patients undergoing biologic treatment have only received little attention to date. With this qualitative study, we aimed to understand patients' perspectives on these treatments, the symptoms they suffer from, expectations towards treatment effectiveness and side effects as well as treatment experiences in the past and over the course of treatment with a modern biologic. To this end, we conducted and transcribed interviews with 24 patients after several months of biologic treatment. We then analyzed interview transcripts to determine underlying categories and summarized these in a common framework. We found that patients' debilitating physical and psychological symptoms were often not well controlled in past treatments. Still, patients had positive expectations with regard to biologic treatment. For a large group of patients, their actual experiences met their expectations, leaving them with unchanged expectations for the future. Another important finding was the good understanding of factors influencing their symptomatology that patients had, like stress and self-efficacy. The reported findings may aid doctors in their clinical work, to further improve care for psoriasis patients.

Impact of Pre-Admission Grade Point Averages on Anesthesiologist Assistant Student Performance at Emory University School of Medicine.

Purpose: The Anesthesiologist Assistant career is gaining significant popularity in the health professions in the United States. Given that this medical occupation is relatively young, there is limited information regarding student success in this demanding graduate-level program. Assessing if pre-admission metrics influence how students perform during the curriculum is essential to recruiting the appropriate candidates. Grade point averages have been shown to correlate with student success in medical education programs for both medical students and physician assistant students, but there is currently no information regarding anesthesiologist assistant students. Methods: Pre-matriculation science and cumulative grade point averages were accessed in a deidentified manner for Emory University Anesthesiologist Assistant Students, and 2-tailed Pearson coefficients were calculated to see if there was a correlation with performance during the science/didactic curriculum of our program and with the clinical curriculum of the program. Results: The 2-tailed Pearson coefficients showed a moderately strong positive correlation between pre-admission science and cumulative grade point averages and performance during the science curriculum of the Emory program (r=0.522). Data also suggested a moderate correlation with grade point averages at graduation from our program (r=0.484). Similar results were found with cumulative grade point averages as well. Conclusion: Given the limited information, we have regarding pre-admission metrics and performance in an Anesthesiologist Assistant program, our study shows that pre-admission science scores and grades in general in undergraduate studies does in fact mimic the information found from studies of other health profession students. Further studies are needed to elucidate how to choose the most appropriate candidates for admission to anesthesiologist assistant programs.

Substantial parallel mediation contribution by cognitive domains in the relationship between adolescents' physical fitness and academic achievements: the Cogni-Action Project.

Objective: To determine how cognitive domains mediate the link between fitness components, their global score (GFS), and adolescents' academic achievement (ACA) across various school subjects. Methods: In this study, 1,296 adolescents aged 10-14 participated. GFS was computed by three fitness components (strength, muscular, and cardiorespiratory fitness) through the ALPHA-fitness test battery. ACA was determined by five school subjects (Language, English, Mathematics, Science, and History) and two academic scores (a) "Academic Average" (five subjects) and (b) "Academic-PISA" (Language, Mathematics, and Science). A principal component analysis was performed to establish four factors (working memory [WM], cognitive flexibility [CF], inhibitory control [IC], and fluid reasoning [FR]). A parallel mediation approach was implemented with 5,000 bootstrapped samples controlled for sex, maturity, central obesity, having breakfast before cognitive tasks, schools, and school vulnerability. Total, direct, indirect effects, and mediation percentages were estimated. Results: Overall, the finding showed a full parallel mediation effect for Language (92.5%) and English (53.9%), while a partial mediation for Mathematics (43.0%), Science (43.8%), History (45.9%), "Academic Average" (50.6%), and "Academic-PISA" (51.5%). In particular, WM, IC, and FR mediated all school subjects except mathematics, where IC was not significant. CF has not mediated any relationship between GF and academic performance. Conclusion: This study underscores the pivotal role of cognitive domains, specifically WM, IC, and FR, in mediating the link between physical fitness and academic performance in adolescents. These insights have relevant implications for educational and public health policies.

A Randomized Study Comparing Ultrasound-Guided Internal Jugular Vein Cannulation Using Two Techniques: Short-Axis Out-of-Plane With Dynamic Needle Tip Positioning Versus Long-Axis In-Plane.

Introduction Internal jugular vein (IJV) cannulation is a routine procedure in operating rooms, critical care units, and perioperative settings. Ultrasound guidance has notably increased the success rates of IJV cannulation. A modified ultrasound technique known as the short-axis out-of-plane method with dynamic needle tip positioning (DNTP) allows for continuous visualization of the needle tip throughout the procedure. This study aims to compare the first-pass success rate of IJV cannulation using the DNTP and long-axis in-plane (LAIP) approaches. Methods One hundred patients between 18 and 70 years undergoing elective surgery requiring IJV cannulation were recruited. Patients were assigned randomly to the DNTP group (n = 50) or the LAIP group (n = 50). We recorded the first-pass success rate, time to achieve successful cannulation, number of skin punctures, overall success rate within five minutes, and potential complications such as pneumothorax and hematoma. Results The first pass success rate was higher in the DNTP group (48/50, 96%) as compared to the LAIP group (38/50, 76%, relative risk, 1.67; 95% confidence interval, 0.039-0.707; p = 0.008). The cannulation time was shorter in DNTP (116.98 ± 22.90 seconds) versus the LAIP group (213.04 ± 52.08 seconds; p < 0.001). No complications like pneumothorax or hematoma were noted in both groups. Conclusion We conclude that the ultrasound-guided DNTP technique for IJV cannulation, as compared with the LAIP technique, may significantly improve the first attempt cannulation, number of attempts, and cannulation time.

Slow-exploring captive red knots were quicker to find food in a social setting than fast explorers.

Individuals foraging in groups face increased competition but can benefit from social information on foraging opportunities that can ultimately increase survival. Personality traits can be associated with food-finding strategies, such as shyer individuals scrounging on the food discoveries of others. How personality and foraging strategy interact in a social foraging context with different group compositions received less attention. Here, we conducted experiments to investigate the relationship between exploratory personality, group size (1-4 birds) and foraging success (i.e. speed of finding a food patch) in wild-caught red knots. We found that faster explorers, when foraging alone, discover food patches quicker than slower explorers. In groups, however, slower-exploring birds became quicker at finding food than fast explorers. This shows that slower-exploring individuals benefit from group foraging. They seem to be more perceptive to social cues, and in contrast to faster explorers, they become quicker at finding food when they are in a group than when foraging alone. We discuss how individuals with different personalities and foraging strategies can coexist in a social foraging context with different costs and benefits associated with their strategies.

Landing force reveals new form of motion-induced sound camouflage in a wild predator.

Predator-prey arms races have led to the evolution of finely tuned disguise strategies. While the theoretical benefits of predator camouflage are well established, no study has yet been able to quantify its consequences for hunting success in natural conditions. We used high-resolution movement data to quantify how barn owls (Tyto alba) conceal their approach when using a sit-and-wait strategy. We hypothesized that hunting barn owls would modulate their landing force, potentially reducing noise levels in the vicinity of prey. Analysing 87,957 landings by 163 individuals equipped with GPS tags and accelerometers, we show that barn owls reduce their landing force as they approach their prey, and that landing force predicts the success of the following hunting attempt. Landing force also varied with the substrate, being lowest on man-made poles in field boundaries. The physical environment, therefore, affects the capacity for sound camouflage, providing an unexpected link between predator-prey interactions and land use. Finally, hunting strike forces in barn owls were the highest recorded in any bird, relative to body mass, highlighting the range of selective pressures that act on landings and the capacity of these predators to modulate their landing force. Overall, our results provide the first measurements of landing force in a wild setting, revealing a new form of motion-induced sound camouflage and its link to hunting success.

Higher education finance and success rate in US states: An insight from state-level data.

We investigate the nexus between education spending and education success measured through attainment rate for 50 US states. Our emphasis is mainly to use state-level data on education spending which occur in general and specific terms. The outcome from our finding can be summarized as follows. One, education spending constitutes a significant factor that motivates people for higher education and it is a motivating factor that ensures completion. Two, we establish further emphasis with the types of spending and its differing stance on education success. While general spending plays important roles in this regard, specific (particularly spending on capital project) is found to reverse the success rate. This suggests that capital spending on education necessarily needs to reach a defined threshold to incite positive check in the current nexus. Three, the magnitude of impact for total spending is lower than when general spending is used, which make the impact of capital spending more conspicuous. Lastly, we also establish asymmetric impact of spending across differing categories between Black Belt and Non-Black Belt states. While the spending pattern is significant for both regions, the magnitude is higher for the Black Belt region indicating the tendency of the region to benefit more when spending improves. We further offer important policy stance.

Adult telomere length is positively correlated with survival and lifetime reproductive success in a wild passerine.

Explaining variation in individual fitness is a key goal in evolutionary biology. Recently, telomeres, repeating DNA sequences capping chromosome ends, have gained attention as a biomarker for body state, physiological costs, and senescence. Existing research has provided mixed evidence for whether telomere length correlates with fitness, including survival and reproductive output. Moreover, few studies have examined how the rate of change in telomere length correlates with fitness in wild populations. Here, we intensively monitored an insular population of house sparrows, and collected longitudinal telomere and life history data (16 years, 1225 individuals). We tested whether telomere length and its rate of change predict fitness measures, namely survival, lifespan and annual and lifetime reproductive effort and success. Telomere length positively predicted short-term survival, independent of age, but did not predict lifespan, suggesting either a diminishing telomere length-survival correlation with age or other extrinsic factors of mortality. The positive association of telomere length with survival translated into reproductive benefits, as birds with longer telomeres produced more genetic recruits, hatchlings and reared more fledglings over their lifetime. In contrast, there was no association between telomere dynamics and annual reproductive output, suggesting telomere dynamics might not reflect the costs of reproduction in this population, potentially masked by variation in individual quality. The rate of change of telomere length did not correlate with neither lifespan nor lifetime reproductive success. Our results provide further evidence that telomere length correlates with fitness, and contribute to our understanding of the selection on, and evolution of, telomere dynamics.