Missouri State University

Objectives Palliative care (PC) is an interdisciplinary approach aimed at improving the physical, psychological, and spiritual well-being of patients and families affected by life-threatening diseases. This study aimed to investigate the need for PC among critically ill patients and their quality of life (QOL) in low-income groups in Bangladesh. Methods This cross-sectional study was conducted at four healthcare facilities from March to April 2023, involving 553 registered patients with advanced chronic conditions. After applying inclusion and exclusion criteria, 183 patients in the advanced stage of illness were included. We collected data on sociodemographic, comorbidities, disabilities, and the 10-item African Palliative Outcome Scale (APOS). The Supportive and Palliative Care Indicators Tool (SPICT) was used to identify individuals requiring PC. The study investigated patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 3–4, indicating significant functional impairment, and explored QOL across four domains: physical health, psychological health, social relationships, and environmental factors. Results The mean age of the 183 patients was 53.8 (± 14.53) years, with 69.5% being female. We found that 10.3% of patients with chronic illness required PC, particularly cancer patients (87%) and those with chronic kidney disease (CKD) (53.3%). The APOS scores indicated that family anxiety (48.6%) was the most burdensome issue, followed by severe pain (15.5%), severe worry about illness (22.4%), and feelings of life being unworthy (9.4%). Patients with severe functional limitations (ECOG 3–4) were significantly more likely to need PC (58%) compared to those with moderate or no limitations (ECOG 0–2) (24%). Among those requiring PC, 70.1% rated their QOL as poor or very-poor, while only 23.8% of patients not needing PC reported similar ratings. Female patients had poorer QOL than males across all domains, and those facing financial hardships also experienced significantly lower QOL. Conclusion In Bangladesh’s low-income communities, a significant proportion of patients with chronic illnesses require palliative care (PC) due to advanced conditions. The findings emphasize the importance of integrating PC early in the treatment process for cancer and CKD patients, as it can greatly improve their QOL and provide essential support for both patients and families. The results advocate for a holistic approach to PC that addresses physical, psychological, social, and environmental factors affecting patients’ QOL.

The increase in homelessness in the US has prompted several responses, including the development of tiny house villages. Initial efforts were made in 2019 to establish a national database of these villages. While the geographical locations, physical and social characteristics of these villages have been well documented, there remains a gap in understanding the spatial distribution of these villages, and the contextual factors that underly their establishment. Building on the 2019 database, this study developed a more user-friendly interactive online map to facilitate public contribution and enhance data collection on tiny house villages for the homeless. The study also employed a density-based clustering tool using ArcGIS to analyze the spatial distribution of tiny house villages across the US. A pronounced clustering was found along the West Coast, especially in states like Washington, California, and Oregon. In terms of political leanings, Blue (Democratic) states were found to have a higher clustering of these villages compared to Red (Republican) states. The study recommends fostering stronger partnerships to address regulatory barriers and ensure the equitable distribution of tiny house villages, particularly in regions with high homelessness rates but fewer resources for affordable housing solutions.

In this article, we empirically test the extent to which the VICEX fund, a portfolio of companies benefiting fromhuman vices (i.e., alcohol, gambling, and smoking), outperforms a variety of benchmarks. One pair ofbenchmarks consist of Vanguard’s 500 Index Fund and a portfolio of all funds in the same Morningstar stylecategory based on company size. On a more focused basis we compare the performance of the VICEX fund totwo popular dividend-oriented mutual funds, because of the propensity of several VICEX fund components tooffer large dividend yields. Using a wide array of return, risk, and risk-adjusted measures we find limitedsupport for human vice-based investing over an extended period of time. Over the recent 2008-2009 period, theVICEX fund has underperformed these alternatives.

The performance of country exchange-traded funds and closed-end funds is investigated over the 2002 to 2011 period. Operating characteristics (i.e., expense ratios and portfolio turnover) and investment results (i.e., return, risk, and risk-adjusted return) are studied for investment funds with at least ten years of data. We find that although exchange-traded funds have significantly lower expenses, their performance is statistically worse than those of closed-end funds. Despite their accurate, widely-advertised claims to have lower annual expenses, investors would be wise to stay focused on the higher return (after deducting expenses) afforded by closed-end funds.

Exchange-traded funds have experienced rapid growth in the last twenty years. We compare the performance of these funds to competing closed-end funds in the international equity investment setting. Expense ratios, turnover, risk, and return are examined over a ten year period ending in 2012. The expenses and turnover rates for exchange traded funds were significantly lower. However, closed-end fund returns after deducting expenses were significantly higher both unconditionally as well as on a risk-adjusted basis. Our findings suggest that unless the tax consequences of higher turnover are extreme, investors should forego the much hyped-lower expenses of exchange-traded funds and focus on the higher returns produced by closed-end funds.

Abtract Equine-assisted psychotherapy and therapeutic riding for veterans with posttraumatic stress disorder ( PTSD ) has been increasingly studied but not meta-analyzed. We identified 2,609 records from database, backward (i.e., reference), and forward (i.e., citation) searches to identify 18 studies addressing effectiveness. The studies were published from 2013–2021 with sample sizes ranging from 5–85 and quality ratings medium – high. Equine-assisted services show large significant effects for change during treatment ( n = 14, d = 1.156), follow-up ( n = 6, d = 0.994), and compared to waitlist control ( n = 1, d = 0.842), and medium effects compared to treatment-as-usual ( n = 3, d = 0.465). Examination of these four types of evidence suggests promise for the use of equine-assisted services with veterans for reduction of PTSD symptomatology and a need for more controlled studies, particularly in relation to other specialized treatments also assessed as effective in treating PTSD in veterans.

An animal’s diet breadth is a central aspect of its life history, yet the factors determining why some species have narrow dietary breadths (specialists) and others have broad dietary breadths (generalists) remain poorly understood. This challenge is pronounced in herbivorous insects due to incomplete host plant data across many taxa and regions. Here, we develop and validate machine learning models to predict pollen diet breadth in bees, using a bee phylogeny and occurrence data for 682 bee species native to the United States, aiming to better understand key drivers. We found that pollen specialist bees made an average of 72.9% of their visits to host plants and could be predicted with high accuracy (mean 94%). Our models predicted generalist bee species, which made up a minority of the species in our dataset, with lower accuracy (mean 70%). The models tested on spatially and phylogenetically blocked data revealed that the most informative predictors of diet breadth are plant phylogenetic diversity, bee species’ geographic range, and regional abundance. Our findings also confirm that range size is predictive of diet breadth and that both male and female specialist bees mostly visit their host plants. Overall, our results suggest we can use visitation data to predict specialist bee species in regions and for taxonomic groups where diet breadth is unknown, though predicting generalists may be more challenging. These methods can thus enhance our understanding of plant-pollinator interactions, leading to improved conservation outcomes and a better understanding of the pollination services bees provide.

This paper explores teachers’ experiences of using only Persian language in Iranian schools and its consequences. To do this qualitative method and phenomenological approach was employed. Participants included all teachers of K-12 across Sanandaj and fifteen experienced teachers (8 male and 7 female) were selected via purposive sampling. A semi-structured interview was conducted to gather data. Using the Braun & Clarke (Braun and Clarke in Cooper et al.Camic et al.Long et al.Panter et al.Rindskopf et al.Sher (eds), APA handbook of research methods in psychology, American Psychological Association, Washington DC, 2012) framework, thematic analysis was applied for analyzing the data. Despite teachers emphasizing the significance of the mother tongue in various aspects such as Cultural Identity, Sense of Belonging and Communication Knowledge and Skills, they perceive that the educational system enforces a monolingual policy (Persian) through Educational Centralization, Cultural Assimilation, and A Policy of Denying or Neglecting Linguistic Rights. They also highlighted potential consequences of this policy, including Students’ Identity and Cultural Crisis, Intensifying Cultural Duality and Hindered Learning. These findings prompt policymakers to consider language minorities in educational planning.

In studies of efficacies of intervention modalities, outcomes measured in ordinal scales such as Quality of Life (QOL) outcomes are routinely used as primary endpoints. The standard data analysis strategy computes composite (average) overall and domain scores and conducts a mixed-model analysis for evaluating efficacy or monitoring medical conditions as if these scores were in continuous metric scale. However, assumptions of parametric models like continuity and homoscedasticity can be severely violated in these cases. Furthermore, it is more challenging when there are missing values on some of the variables. In this chapter, we propose a purely nonparametric approach in the sense that meaningful and, yet, nonparametric effect size measures are developed. We propose estimator for the effect size and develop the asymptotic properties. Our methods are shown to be particularly effective in the presence of some form of clustering and/or missing values. Inferential procedures are derived from the asymptotic theory. The Asthma Randomized Trial of Indoor Wood Smoke data will be used to illustrate the applications of the proposed methods. The data were collected from a three-arm randomized trial which evaluated interventions targeting biomass smoke particulate matter from older-model residential wood stoves in homes that have children with asthma.

Introduction Rice, particularly Basmati rice, holds significant global importance as a staple food. The indiscriminate use of phosphate-based fertilizers during rice production has led to high residual levels of these chemicals in soil, impacting soil health and fertility. This study aimed to address this challenge by investigating the potential of phosphate solubilizing bacteria (PSB) in improving soil fertility and boosting the growth of Basmati rice. Methods Using amplicon-based 16S rDNA sequencing, bacterial isolation and cultivation, conducting greenhouse and field experiments, and PSB localization, we optimized the search for PSB inoculants to enhance Basmati rice growth. Results and discussion Rice rhizosphere prokaryote communities showed significant differences in microbial diversity and composition between between basmati and non-basmati rice cultivated areas. Dominant bacterial phyla included Proteobacteria, Acidobacteria, Actinobacteria, and Firmicutes, with Actinobacteria and Proteobacteria playing a crucial role in nutrient recycling. Isolation and optimization of PSB strains, including Acinetobacter sp. MR5 and Pseudomonas sp. R7, were carried out and soil microcosm studies confirmed their efficacy in increasing soil available phosphorus concentration. Response surface methodology revealed the relative importance of factors such as pH, inoculum density and incubation temperature in maximising phosphate solubilization. Microplot experiments demonstrated the effectiveness of optimized PSB inoculants in promoting Basmati rice growth, with significant increases in plant height, tiller number, biomass, and grain yield compared to uninoculated controls. A consortium of PSB proved superior to single-strain inoculants, even with reduced chemical fertilizer application. Field trials at several rice growing sites confirmed the positive impact of the PSB consortium on grain yield, soil phosphorus availability, and plant phosphorus uptake. The competence and persistence of the inoculated strains in the rhizosphere was confirmed by FISH and BOX Polymerase Chain Reaction (BOX-PCR). This work highlights the potential of PSB-based biofertilizers to improve soil fertility, promote sustainable rice production and reduce the negative environmental impacts of chemical fertilizers. Future research would focus on scaling up these findings for widespread adoption in agriculture and exploring their applicability to other crops and agroecosystems.

Introduction Longer periods between headache episodes (interictal periods) may provide greater time for the nervous system to reset from a previous episode, potentially improving disease status and health-related quality of life. This post hoc analysis evaluated this hypothesis by associating patients’ longest interictal periods with improvements in patient-reported outcomes. Methods PROMISE-2 (NCT02974153) was a double-blind, placebo-controlled study evaluating eptinezumab for preventive treatment of chronic migraine (N = 1072). Daily electronic diary data from Weeks 1–12 and Weeks 1–24 were used to identify interictal periods, defined as days between headache episodes. For each patient, the longest interictal period within these intervals was identified and categorized (1–4, 5–9, 10–14, > 14, and > 21 days). For each category, the following patient-reported outcomes were assessed: 6-item Headache Impact Test (HIT-6), Patient Global Impression of Change (PGIC), and patient-identified most bothersome symptom (PI-MBS). Results Excluding interictal periods with > 10% missing data (resulting in 1010 patients with sufficient data), the mean (SD) of longest interictal periods over Weeks 1–12 was 9.4 (11.0) days. A ≥6-point HIT-6 reduction was observed in 78% (56/72) vs 26% (91/351) of patients with a > 21-day vs 1–4-day longest interictal period, respectively; much or very much improvement per PGIC was reported in 90% (65/72) vs 25% (87/348), respectively, and per PI-MBS was reported in 88% (63/72) vs 26% (92/348), respectively. Similar results were observed for Weeks 1–24. Conclusion Longer interictal periods were associated with more patients indicating positive changes in headache-related life impact, disease status, and symptomology. Trial registration: ClinicalTrials.gov (identifier: NCT02974153; registered: 2016-11-23)

Antimicrobial compounds play a critical role in combating microbial infections. However, the emergence of antibiotic and antifungal resistance and the scarcity of new antibiotic developments pose a significant threat and demand the discovery of new antimicrobials for both bacterial and fungal pathogens. Our previous work described the first generation (G1) of organoantimony-based compounds that showed antimicrobial activity against several bacterial and fungal pathogens. Here, we present our efforts in modifying these compounds by replacing the tetraphenyl backbone in G1 compounds with a trimethyl group, thereby generating a new series of compounds we refer to as “generation 2”, G2. In addition to the novel backbone structure, we introduced three new anionic chloro-cyanoxime ligand groups, namely 2,4-diCl-PhCO−, 2,6-diCl-PhCO− and 2Cl-PhCO−, which were found to be biologically active in the past. Nine new compounds of SbMe3L2 composition were obtained in high yields and characterized by NMR, IR spectroscopies, thermogravimetric TG/DSC and X-ray single crystal analyses. The antibacterial activity of the cyanoximates was tested against three bacterial (Pseudomonas aeruginosa PAO1, Escherichia coli S17 and methicillin-resistant Staphylococcus aureus (MRSA) NRS70) and two fungal (Candida albicans strain SC5314 and Cryptococcus neoformans strain H99) pathogens. Two compounds, SbMe3(MCO)2 and SbMe3(2,4-diClPhCO)2, were active against bacterial strains and inhibited the growth of PAO1 and MRSA with MICs of 50 and 100 µg/mL, respectively. Three compounds, SbMe3(MCO)2, SbMe3(ECO)2 and SbMe3(TCO)2, were active against fungal strains and inhibited either one of or both C. albicans and C. neoformans at MICs of 2.6–66.67 μg/mL. In addition, SbMe3(TCO)2 and SbMe3(MCO)2 were fungicidal at MFC 33.33–66.67 μg/mL. Ultra-thin-layer TEM imaging suggested that SbMe3(MCO)2 targets the integrity of bacterial membranes. Overall, four of the studied G2 series compounds possess antimicrobial activity against a broad range of microbial pathogens, with particular potential against fungal pathogens, which will be explored in further studies.