Florida Atlantic University

Objetivo: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. Método: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. Conclusão: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.

The fermion propagator is derived in detail from the model of fermion coupled to loop quantum gravity. As an ingredient of the propagator, the vacuum state is defined as the ground state of some effective fermion Hamiltonian under the background geometry given by a coherent state resembling the classical Minkowski spacetime. Moreover, as a critical feature of loop quantum gravity, the superposition over graphs is employed to define the vacuum state. It turns out that the graph superposition leads to the propagator being the average of the propagators of the lattice field theory over various graphs so that all fermion doubler modes are suppressed in the propagator. This resolves the doubling problem in loop quantum gravity. Our result suggests that the superposition nature of quantum geometry should, on the one hand, resolve the tension between fermion and the fundamental discreteness and, on the other hand, relate to the continuum limit of quantum gravity.

Aims Prolonged fire suppression in conifer forests of the Sierra Nevada Mountain range, California, USA, has led to ingrowth of conifer seedlings, converting the open heterogeneous structure into uniformly dense and layered forest. The threat of a stand‐replacing fire has increased because of fuel buildup in combination with rising drought and extreme heat frequency caused by climate change. With such high severity fire, there is also rising concern regarding conifer forest converting to shrublands as severe fire favors the establishment of large shrub patches altering landscape vegetation pattern and heterogeneity. However, a clear understanding of the effects of increased fire severity, size, and frequency on landscape‐scale heterogeneity and postfire patch dynamics is lacking, which is critical in implementing restoration and forest management activities. Our aim was to understand multiscale dynamics and spatial heterogeneity patterns of conifer forests and chaparral shrublands due to repeated mixed‐severity fire. Location A mosaic of burned and unburned patches spanning the boundary of Lassen and Plumas National Forests, CA, USA. Methods We used secondary geospatial landcover data classified by cover type before modern fires (1999) and after eight modern fires (2014). We calculated various landscape diversity and fragmentation metrics at patch and landscape scales using FRAGSTATS for comparison before and after fires. Results At the fire severity patch scale, high‐severity fire reduced vegetation cover type heterogeneity by half, but reburning at low to moderate severity nearly doubled cover type heterogeneity. At the full landscape scale mixed‐severity fire, including all burn severities, increased vegetation cover type heterogeneity. Fragmentation indexes confirmed that fire created larger patches of shrub and fragmented patches of conifer forest. Conclusions The effects of frequent large fire events on vegetation pattern and heterogeneity vary with the scale of analysis. Hence, heterogeneity and vegetation pattern change need to be evaluated at more than one scale to understand past and future ecological processes before prioritizing management actions for the conifer forests of the Sierra Nevada Mountain range.

Vasculitides represent the wide-ranging series of complex inflammatory diseases that involve inflammation of blood vessel walls. These conditions are characterized according to the caliber of the predominantly involved vessels. The work-up of vasculitides often includes imaging to narrow a differential diagnosis and guide management. Findings from CT and MR angiography in conjunction with a thorough history and physical exam are of utmost importance in making an accurate diagnosis. Further, imaging can be used for follow-up, in order to monitor disease progression and response to treatment. This wide-ranging literature review serves as the primary resource for clinicians looking to diagnose and monitor the progression of rare vascular inflammatory conditions. This article provides a comprehensive summary of the main findings on imaging related to each of these vasculitides. For each of the named vasculitis conditions, a thorough overview of the diagnostic modalities and their respective findings is described. Many specific hallmarks of pathology are included in this review article.

Rheumatoid arthritis (RA) involves several classes of pathogenic autoantibodies, some of which react with type-II collagen (COL2) in articular cartilage. We previously described a subset of COL2 antibodies targeting the F4 epitope (ERGLKGHRGFT) that could be regulatory. Here, using phage display, we developed recombinant antibodies against this epitope and examined the underlying mechanism of action. One of these antibodies, R69-4, protected against cartilage antibody- and collagen-induced arthritis in mice, but not autoimmune disease models independent of arthritogenic autoantibodies. R69-4 was further shown to cross-react with a large range of proteins within the inflamed synovial fluid, such as the complement protein C1q. Complexed R69-4 inhibited neutrophil FCGR3 signaling, thereby impairing downstream IL-1β secretion and neutrophil self-orchestrated recruitment. Likewise, human isotypes of R69-4 protected against arthritis with comparable efficiency. We conclude that R69-4 abrogates autoantibody-mediated arthritis mainly by hindering FCGR3 signaling, highlighting its potential clinical utility in acute RA.

Near-wall regions in wall-bounded turbulent flows experience intermittent ejection of slow-moving fluid packets away from the wall and sweeps of faster moving fluid towards the wall. These extreme events play a central role in regulating the energy budget of the boundary layer, and are analyzed here with the help of a three-dimensional (3D) Convolutional Neural Network (CNN). A CNN is trained on Direct Numerical Simulation data from a periodic channel flow to deduce the intensity of such extreme events, and more importantly, to reveal contiguous three-dimensional salient structures in the flow that are determined autonomously by the network to be critical to the formation and evolution of ejection events. These salient regions, reconstructed using a multilayer Gradient-weighted Class Activation Mapping (GradCAM) technique proposed here, correlate well with bursting streaks and coherent fluid packets being ejected away from the wall. The focus on explainable interpretation of the network's learned associations also reveals that ejections are not associated with regions where turbulent kinetic energy (TKE) production reaches a maximum, but instead with regions that entail extremely low dissipation and a significantly higher tendency for positive TKE production than negative production. This is a key finding of the study, and indicates that CNNs can help reveal dynamically important three-dimensional salient regions using a single scalar-valued metric provided as the quantity of interest, which in the present case is the ejection intensity. While the current work presents an alternate means of analyzing nonlinear spatial correlations associated with near-wall bursts, the framework presented is sufficiently general so as to be extendable to other scenarios where the underlying spatial dynamics are not known a-priori. 2

Objective The aim was to identify hospital and county characteristics associated with variation in breadth and depth of hospital partnerships with a broad range of organizations to improve population health. Data Sources The American Hospital Association Annual Survey provided data on hospital partnerships to improve population health for the years 2017–2019. Design The study adopts the dimensional publicness theory and social capital framework to examine hospital and county characteristics that facilitate hospital population health partnerships. The two dependent variables were number of local community organizations that hospitals partner with (breadth) and level of engagement with the partners (depth) to improve population health. The independent variables include three dimensions of publicness: Regulative, Normative and Cultural‐cognitive measured by various hospital factors and presence of social capital present at county level. Covariates in the multivariate analysis included hospital factors such as bed‐size and system membership. Methods We used hierarchical linear regression models to assess various hospital and county factors associated with breadth and depth of hospital‐community partnerships, adjusting for covariates. Principal Findings Nonprofit and public hospitals provided a greater breadth (coefficient, 1.61; SE, 0.11; p < 0.001 and coefficient, 0.95; SE, 0.14; p < 0.001) and depth (coefficient, 0.26, SE, 0.04; p < 0.001 & coefficient, 0.13; SE, 0.05; p < 0.05) of partnerships than their for‐profit counterparts, partially supporting regulative dimension of publicness. At a county level, we found community social capital positively associated with breadth of partnerships (coefficient, 0.13; SE, 0.08; p < 0.001). Conclusions An environment that promotes collaboration between hospitals and organizations to improve population health may impact the health of the community by identifying health needs of the community, targeting social determinants of health, or by addressing patient social needs. However, findings suggest that publicness dimensions at an organizational level, which involves a culture of public value, maybe more important than county factors to achieve community building through partnerships.

In this correspondence, we explain the reasoning for invalidity of the analysis choices by Kolberg et al., and provide the results produced using correct statistical procedures for their study design. Reassuringly, we could verify the original conclusions. That is, results of the corrected statistical models are similar to the results of the original analysis. Regardless of the magnitude of difference that corrected statistical methods make, results and conclusions that are derived from invalid methods are unsubstantiated. By verifying the results, we allow the readers to be assured that the published conclusions in the study by Kolberg et al. now rest on a sound evidential basis.

Though the growth of the gig economy has coincided with increased economic precarity in the new economy, we know less about the extent to which gig work (compared with other self-employment arrangements and non-gig work) may fuel economic insecurity among American households. We fill this gap in the literature by drawing on a sample of 4,756 workers from a unique national survey capturing economic hardships among non-standard workers like app- and platform-based gig and other self-employed workers during the COVID-19 pandemic. Results from generalized boosted regression modeling, utilizing machine learning to account for potential endogeneity, demonstrated that gig workers experienced significantly greater economic hardship than non-gig and other self-employed workers during the pandemic. For example, gig workers were more likely to experience food insecurity, miss bill payments, and suffer income loss compared with non-gig and other self-employed workers during the pandemic. While household liquid assets endowment prior to the pandemic reduced the effect of gig work on experiencing economic hardships, having dependent children in the household increased this effect. Thus, contrary to democratizing entrepreneurship opportunities, these findings suggest that the expansion of the gig economy may exacerbate labor market inequality, where wealth-endowed families are protected against adverse economic consequences of the gig economy. We discuss the implications of these findings for inequality-reducing labor market policies, including policies that account for the interconnectedness of family and the labor market.

Healthy brains display a wide range of firing patterns, from synchronized oscillations during slow-wave sleep to desynchronized firing during movement. These physiological activities coexist with periods of pathological hyperactivity in the epileptic brain, where neurons can fire in synchronized bursts. Most cortical neurons are pyramidal regular spiking (RS) cells with frequency adaptation and do not exhibit bursts in current-clamp experiments (in vitro). In this work, we investigate the transition mechanism of spike-to-burst patterns due to slow potassium and calcium currents, considering a conductance-based model of a cortical RS cell. The joint influence of potassium and calcium ion channels on high synchronous patterns is investigated for different synaptic couplings (gsyn) and external current inputs (I). Our results suggest that slow potassium currents play an important role in the emergence of high-synchronous activities, as well as in the spike-to-burst firing pattern transitions. This transition is related to the bistable dynamics of the neuronal network, where physiological asynchronous states coexist with pathological burst synchronization. The hysteresis curve of the coefficient of variation of the inter-spike interval demonstrates that a burst can be initiated by firing states with neuronal synchronization. Furthermore, we notice that high-threshold (IL) and low-threshold (IT) ion channels play a role in increasing and decreasing the parameter conditions (gsyn and I) in which bistable dynamics occur, respectively. For high values of IL conductance, a synchronous burst appears when neurons are weakly coupled and receive more external input. On the other hand, when the conductance IT increases, higher coupling and lower I are necessary to produce burst synchronization. In light of our results, we suggest that channel subtype-specific pharmacological interactions can be useful to induce transitions from pathological high bursting states to healthy states.

Oral squamous cell carcinoma (OSCC) is a common malignant disease associated with a high mortality rate and heterogeneous disease aetiology. Cyclin dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B‐AS1), is a long noncoding RNA that has been shown to act as a scaffold, sponge, or signal hub to promote carcinogenesis. Here, we attempted to assess the effect of CDKN2B‐AS1 single‐nucleotide polymorphisms (SNPs) on the susceptibility to OSCC. Five CDKN2B‐AS1 SNPs, including rs564398, rs1333048, rs1537373, rs2151280 and rs8181047, were analysed in 1060 OSCC cases and 1183 cancer‐free controls. No significant association of these five SNPs with the risk of developing OSCC was detected between the case and control group. However, while examining the clinical characteristics, patients bearing at least one minor allele of rs1333048 (CA and CC) were more inclined to develop late‐stage (stage III/IV, adjusted OR, 1.480; 95% CI, 1.129–1.940; p = 0.005) and large‐size (greater than 2 cm in the greatest dimension, adjusted OR, 1.347; 95% CI, 1.028–1.765; p = 0.031) tumours, as compared with those homologous for the major allele (AA). Further stratification analyses demonstrated that this genetic correlation with the advanced stage of disease was observed only in habitual betel quid chewers (adjusted OR, 1.480; 95% CI, 1.076–2.035; p = 0.016) or cigarette smokers (adjusted OR, 1.531; 95% CI, 1.136–2.063; p = 0.005) but not in patients who were not exposed to these major habitual risks. These data reveal an interactive effect of CDKN2B‐AS1 rs1333048 with habitual exposure to behavioural risks on the progression of oral cancer.

In this study, we investigated the optical characteristics of CuCl grown on Si (001) and Si (111) substrates using both empirical and theoretical methods. We selected CuCl from the family of cuprous halides, for its nearly flawless lattice match with Si (0.4%), despite its lackluster hygroscopic qualities. We employed molecular beam epitaxy (MBE) to cultivate single crystalline CuCl on Si (001) and Si (111) substrates, and utilized high-resolution X-ray diffraction (HR-XRD) to examine the orientation and crystal purity of the CuCl structure. We measured and compared the photoluminescence (PL) spectra of CuCl on both types of Si substrates, noting that the PL peaks registered at 365 nm for CuCl (001) and 375 nm for CuCl (111). Our findings suggest that larger PL peaks are observed in the (111) CuCl samples. Theoretical computations corroborated our experimental results, hinting that the discrepancies in the PL spectra can be ascribed to the crystal structure and orientation of CuCl on the Si substrates. Our research yields vital insights into the fundamental optical properties of CuCl on Si substrates, offering valuable data for the creation of advanced optoelectronic devices with enhanced performance.

An essential weakness of existing personalized recommender systems is that the learning is biased and dominated by popular items and users. Existing methods, particularly graph-based approaches, primarily focus on the “heterogeneous interaction” between user-item, leading to a disproportionately large influence of popular nodes during the graph learning process. Recently, popularity debiasing models have been proposed to address this issue, but they excessively concentrate on considering cause-effect or re-weighting the item/user popularity. These approaches artificially alter the nature of the data, inadvertently downplaying the representation learning of popular items/users. Consequently, balancing the trade-off between global recommendation accuracy and unpopular items/users exposure is challenging. In this paper, we advocate the concept of “homogeneous effect” from both user and item perspectives to explore the intrinsic correlation and alleviate the bias effects. Our core theme is to simultaneously factorize user-item interactions, user-user similarity, and item-item correlation, thereby learning balanced representations for items and users. To pursue well-balanced representations, we propose a Consensus factorized Graph Convolution neural Network (ConGCN), which leverages graph-based nonlinear representation learning and manifold constraints to regulate the embedding learning. An inherent advantage of ConGCN is its consensus optimization nature, where item-item and user-user relationships ensure that unpopular items are well preserved in the embedding space. The experiments on four real-world datasets demonstrate that ConGCN outperforms existing single-task-oriented methods on two typical tasks with opposite goals (global recommendation and popularity debiasing recommendation), indicating that our model can perform a balanced recommendation with both higher global and debiasing recommendation accuracy with greater long-tail item/user exposure.

Anthropogenic islands have become important alternative nesting sites for wading birds by providing habitat where natural sites are degraded or absent. However, anthropogenic islands have higher elevations and experience more disturbance than natural sites, which may alter nest predation risk. Yet, little is known about the degree to which wading bird productivity varies between colony types. We used a generalized linear model approach to determine the effect of colony type and resource availability on the species-specific productivity of wading birds at Lake Okeechobee from 2010 to 2019. Great Egret (Ardea alba) productivity did not vary by colony type, whereas Snowy Egret (Egretta thula) and Tricolored Heron (Egretta tricolor) on average produced 0.2 and 0.7 more chicks per hatched nest at natural marsh island colony-sites (n = 6) than at anthropogenic island colony-sites (n = 4), respectively. This suggests that anthropogenic island colony-sites provide lower quality nesting habitat for these species than do marsh colony-sites. However, anthropogenic islands provide nesting habitat in years when marsh colony-sites are limited, and thus increase long-term productivity. Constraints on the ability of anthropogenic islands to support wading bird nesting can be relaxed by optimizing island location and structure during their creation.

How do human beings make sense of their relation to the world and realize their ability to effect change? Applying modern concepts and methods of coordination dynamics, we demonstrate that patterns of movement and coordination in 3 to 4-mo-olds may be used to identify states and behavioral phenotypes of emergent agency. By means of a complete coordinative analysis of baby and mobile motion and their interaction, we show that the emergence of agency can take the form of a punctuated self-organizing process, with meaning found both in movement and stillness.

BACKGROUND The long-term efficacy and safety of hyaluronic acid fillers injected into the neck have yet to be analyzed in a prospective trial in the United States. OBJECTIVE Analyze the long-term efficacy and safety of a hyaluronic acid filler for static horizontal neck rhytids. MATERIALS AND METHODS Twenty-six subjects were enrolled in the study. Six subjects were randomized to receive saline and 20 subjects were randomized to receive HA RR. All subjects were randomized to use a cannula on 1 side and needle on the other with optional retreatment on day 30 and optional crossover treatment with different assignment on day 60. The subjects were graded using the Transverse Neck Line Scale, Canfield photography, and the Global Aesthetic Improvement Scale on day 360. RESULTS A significant improvement from baseline on day 360 was achieved on the Transverse Neck Line Scale according to the blind evaluator, subjects, and investigator without any delayed-onset or prolonged side effects. There was no significant difference in the average improvement from the short-term analysis on day 60 to the long-term analysis on day 360. CONCLUSION HA RR achieved significant long-term improvement in static horizontal neck rhytids without any long-term side effects.

The study aimed to investigate the impact of posterior element and ligament removal on the maximum von Mises stress, and maximum shear stress of the eight-layer annulus for treating stenosis at the L3-L4 and L4-L5 levels in the lumbar spine. Previous studies have indicated that laminectomy alone can result in segmental instability unless fusion is performed. However, no direct correlations have been established regarding the impact of posterior and ligament removal. To address this gap, four models were developed: Model 1 represented the intact L2-L5 model, while model 2 involved a unilateral laminotomy involving the removal of a section of the L4 inferior lamina and 50% of the ligament flavum between L4 and L5. Model 3 consisted of a complete laminectomy, which included the removal of the spinous process and lamina of L4, as well as the relevant connecting ligaments between L3-L4 and L4-L5 (ligament flavum, interspinous ligament, supraspinous ligament). In the fourth model, a complete laminectomy with 50% facetectomy was conducted. This involved the same removals as in model 3, along with a 50% removal of the inferior/superior facets of L4 and a 50% removal of the facet capsular ligaments between L3-L4 and L4-L5. The results indicated a significant change in the range of motion (ROM) at the L3-L4 and L4-L5 levels during flexion and torque situations, but no significant change during extension and bending simulation. The ROM increased by 10% from model 1 and 2 to model 3, and by 20% to model 4 during flexion simulation. The maximum shear stress and maximum von-Mises stress of the annulus and nucleus at the L3-L4 levels exhibited the greatest increase during flexion. In all eight layers of the annulus, there was an observed increase in both the maximum shear stress and maximum von-Mises stress from model 1&2 to model 3 and model 4, with the highest rate of increase noted in layers 7&8. These findings suggest that graded posterior element and ligament removal have a notable impact on stress distribution and range of motion in the lumbar spine, particularly during flexion. CITATION Lin M, Doulgeris J, Dhar UK, O'Corner T, Papanastassiou ID, Tsai C-T and Vrionis FD (2023), Effect of graded posterior element and ligament removal on annulus stress and segmental stability in lumbar spine stenosis: a finite element analysis study.

Tropical macroalgae serve importance ecological roles on coral reefs but can supplant corals in phase shifts as shown worldwide. Thus, it is important to understand their fundamental photophysiology and effects on calcification mechanisms. We examined organic δ13C, inorganic CaCO3 δ13C and δ18O, and organic %C, %N, C:N of abundant macroalgae on Little Cayman Island (LCI) reefs across a broad light gradient (5–2,000 μmol photons m−2 s−1). We hypothesized that LCI macroalgae utilize greater CO2 in low light environments as carbon concentration mechanisms (CCMs) to take up HCO3− have high energetic costs. We proposed that calcification mechanisms are also influenced by light and Ci-use strategies. LCI macroalgae had organic δ13C values (-12‰ to -25‰) indicative of CCMs and exhibited only a 1–3‰ δ13C depletion under irradiances < 5 μmol photons m−2 s−1. Light and phyla were significant in a mixed model explaining ~ 80% of variance in organic δ13C. Organic δ13C was a weak predictor and light insignificant in explaining inorganic δ13C values of thalli carbonates. Biogenic carbonate δ13C values were taxa-specific based on cluster analysis of δ13C:δd18O ratios, an indication of diverse calcification mechanisms. LCI macroalgal photosynthesis utilized CCMs across a broad range of irradiances, thus greater CO2 availability under ocean acidification is not likely to enhance community dominance of macroalgae of concern (e.g., Lobophora sp.) due to shifts in photophysiology. The mechanisms of Ci sequestration for photosynthesis appeared to be mostly uncoupled from calcification mechanisms that were diverse across phyla, likely due to distinct macroalgal forms, sites of calcification and carbonate structure.