We report a male Cerulean Warbler (Dendroica cerulea) singing a highly accurate version of another species' song (Hooded Warbler; Wilsonia citrina), as well as a typical Cerulean Warbler song. We ...performed playback experiments to examine the manner in which this bird used, and responded to, the different songs. He responded aggressively (wing flicks and garbled song), and with his Cerulean Warbler song, to recorded versions of two different types of Cerulean Warbler songs, including a type that he was not observed singing. He did not respond in any manner to playback of Hooded Warbler song.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We present a comprehensive study of the massive binary system HM1~8, based on
multi-epoch high resolution spectroscopy, $V$-band photometry and archival
X-ray data. Spectra from the OWN Survey, a ...high resolution optical monitoring
of Southern O and WN stars, are used to analyse the spectral morphology and
perform quantitative spectroscopic analysis of both stellar components. The
primary and secondary components are classified as O4.5~IV(f) and O9.7~V,
respectively. From a radial-velocity (RV) study we derived a set of orbital
parameters for the system. We found an eccentric orbit ($e=0.14 \pm 0.01$) with
a period of $P = 5.87820 \pm 0.00008$~days. Through the simultaneous analysis
of the RVs and the $V$-band light curve we derived an orbital inclination of
$70.0^{\circ} \pm 2.0$ and stellar masses of
$M_a=33.6^{+1.4}_{-1.2}~\text{M}_{\sun}$ for the primary, and
$M_b=17.7^{+0.5}_{-0.7}~\text{M}_{\sun}$ for the secondary. The components show
projected rotational velocities $v_1\sin{i}=105 \pm 14~\text{km~s}^{-1}$ and
$v_2\sin{i}=82 \pm 15~\text{km~s}^{-1}$, respectively. A tidal evolution
analysis is also performed and found to be in agreement with the orbital
characteristics. Finally, the available X-ray observations show no evidence of
a colliding winds region, therefore the X-ray emission is attributed to stellar
winds.
Health literacy is often defined as how individuals 'obtain, process, and understand basic health information and health services in order to make appropriate health decisions' (Ratzan and Parker, ...2000, p vi). Much health literacy research has focused on the functional skills of individuals (Lee et al, 2004; Guzys et al, 2015) and/or on the capacity of healthcare providers and health systems to support individuals with low health literacy (Baur, 2010). However, a growing body of empirical health literacy research looks beyond the individual level to the social structures in which people live (for example, dyads, families and social networks), acknowledging the role of support and resources from the social environment (Sentell et al, 2017). This literature spans diverse disciplines, topic areas and methods.
Synthesising such research is important, but challenging. The conceptualisation and operationalisation of health literacy has varied across time, disciplines, methods and research communities (Altin et al, 2014; Guzys et al, 2015). The field of health literacy continues to expand, despite lack of consensus on its central construct (Mackert et al, 2015). Likewise, the effect of social relationships on wellbeing is a broad area of research with a long history, ranging from studies of how an individual's social connections affect access to resources, to fields that focus on social structure (rather than the individual) as the unit of study (Lomas, 1998). Terms such as social networks, social support, social ties, social integration and social practice are distinct in theoretical literature, but are sometimes used 'loosely and interchangeably' in the empirical literature (Berkman et al, 2000, p 843).
Empowering parents to deliver evidenced-based interventions improves outcomes for children with or infants at risk of cerebral palsy (CP), by integrating repetition and contextual learning into daily ...routines. We aimed to identify the barriers and facilitators to parent-delivered interventions and suggest practice improvements guided by behaviour change models.
Eight electronic databases were searched to identify studies presenting parent and therapist perspectives on parent-delivered interventions in CP. Included studies were critically appraised using validated checklists. Barriers and facilitators to parent-delivered interventions were identified and categorised into subcomponents of The Capability Opportunity and Motivation Model of Behaviour (COM-B), the Theoretical Domains Framework (TDF) and the Behaviour Change Wheel to formulate appropriate practice recommendations.
Thirty-four studies were identified which mainly used qualitative or randomised control trial designs. Barriers to parent-delivery included insufficient parental knowledge, lack of confidence and time. Facilitators included staff continuity, empowering parents, efficient resource utilisation and flexible delivery. Practice recommendations emphasise realistic goal setting, tailored parental education and enhancing the coaching skills of therapists.
Fostering parent-delivered interventions requires addressing knowledge gaps, skill and capacity of parents and therapists. Therapists forming strong alliances with parents and setting collaborative realistic goals are key to successful parent-delivered interventions.
Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and ...non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wave of data collection, which examined short-term consequences for mental health, as reported during the first 4-6 weeks of social distancing measures being introduced.
Cross-sectional online survey.
Community cohort study.
N=3097 adults aged ≥18 years were recruited through a mainstream and social media campaign between 3 April 2020 and 30 April 2020. The cohort was predominantly female (n=2618); mean age 44 years; 10% (n=296) from minority ethnic groups; 50% (n=1559) described themselves as key workers and 20% (n=649) identified as having clinical risk factors putting them at increased risk of COVID-19.
Depression, anxiety and stress scores.
Mean scores for depression (Formula: see text =7.69, SD=6.0), stress (Formula: see text =6.48, SD=3.3) and anxiety (Formula: see text = 6.48, SD=3.3) significantly exceeded population norms (all p<0.0001). Analysis of non-modifiable factors hypothesised to be associated with mental health outcomes indicated that being younger, female and in a recognised COVID-19 risk group were associated with increased stress, anxiety and depression, with the final multivariable models accounting for 7%-14% of variance. When adding modifiable factors, significant independent effects emerged for positive mood, perceived loneliness and worry about getting COVID-19 for all outcomes, with the final multivariable models accounting for 54%-57% of total variance.
Increased psychological morbidity was evident in this UK sample and found to be more common in younger people, women and in individuals who identified as being in recognised COVID-19 risk groups. Public health and mental health interventions able to ameliorate perceptions of risk of COVID-19, worry about COVID-19 loneliness and boost positive mood may be effective.
IMPORTANCE: Perineural invasion (PNI) is an adverse risk feature in cutaneous squamous cell carcinoma (CSCC) that affects patient prognosis and disease management. However, research comparing ...different PNI patterns on patient outcomes is limited. OBJECTIVE: To compare 4 assessments of PNI in CSCC, their associations with poor outcomes, and implications for their inclusion in the Brigham and Women’s Hospital (BWH) staging system. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was performed at a single tertiary care institution and compared 4 PNI assessments: nerve caliber, number of involved nerves per section, PNI maximal depth, and PNI location with respect to tumor. Patients with primary, localized, invasive CSCC with PNI diagnosed between January 1, 2000, and December 31, 2017, were identified via an electronic in-house database. Available pathology slides were secondarily reviewed by study authors. Relevant patient and tumor characteristics and outcomes were abstracted from the medical record. Data analysis was performed between September 6 and October 20, 2022. MAIN OUTCOMES AND MEASURES: Risks of recurrence, disease-specific death, and a composite end point (any poor outcome) were calculated via multivariable stepwise Fine and Gray competing-risks regression. Considered revisions to the BWH staging system were assessed via receiver operating characteristic curves and test characteristics. RESULTS: This study included 140 patients with CSCC, with a mean (SD) age of 75.1 (11.2) years. More than half of the patients were men (93 66.4%), and most identified as White (132 94.3%). Of the 4 PNI assessments studied, only involvement of multiple nerves was associated with poor outcomes. Perineural invasion of 5 or more distinct nerves (extensive PNI ePNI) was independently associated with local recurrence (subhazard ratio SHR, 13.83 95% CI, 3.50-54.62; P < .001), disease-specific death (SHR, 6.20 95% CI, 1.59-24.21; P = .009), and any poor outcome (SHR, 10.21 95% CI, 2.88-36.15; P < .001). A revised BWH staging system with substitution of ePNI for large-caliber PNI resulted in improved area under the curve and test characteristics compared with current BWH staging criteria that use nerve caliber as the measure of PNI. CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that ePNI is the best prognostic measure of PNI. Because ePNI obviated the need for a micrometer and had superior prognostic capacity to nerve caliber in this cohort, ePNI should be considered for inclusion in CSCC tumor staging. Inclusion of ePNI as a high-risk factor in CSCC staging systems may optimize patient selection for primary treatment and adjuvant interventions.
Hyperparathyroidism is a common endocrine disorder that occurs secondary to abnormal parathyroid gland functioning. Depending on the type of hyperparathyroidism, surgical extirpation of ...hyperfunctioning parathyroid glands can be considered for disease cure. Intraoperative parathyroid hormone (IOPTH) monitoring improves outcomes in patients undergoing surgery for primary hyperparathyroidism, but studies are needed to characterize its institutional adoption and its role in surgery for secondary and tertiary hyperparathyroidism, as these entities can be difficult to cure. Hence, we will perform a cross-sectional survey study of surgeon rationale, operational details, and barriers associated with IOPTH monitoring adoption across North America. We will utilize a convenience sampling technique to distribute an online survey to head and neck surgeons and endocrine surgeons across North America. This survey will be distributed via email to three North American professional societies (i.e., Canadian Society for Otolaryngologists–Head and Neck Surgeons, American Head and Neck Society, and American Association of Endocrine Surgeons). The survey will consist of 30 multiple choice questions that are divided into three concepts: (1) participant demographics and training details, (2) details of surgical adjuncts during parathyroidectomy, and (3) barriers to adoption of IOPTH. Descriptive analyses and multiple logistic regression will be used to evaluate the impact of demographic, institutional, and training variables on the use of IOPTH monitoring in surgery for all types of hyperparathyroidism and barriers to IOPTH monitoring adoption. Ethics approval was obtained by the Hamilton Integrated Research Ethics Board (2024-17173-GRA). These findings will characterize surgeon and institutional practices with regards to IOPTH monitoring during parathyroid surgery and will inform future trials aimed to optimize the use of IOPTH monitoring in secondary and tertiary hyperparathyroidism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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