Briar Cliff University

Abstract Primary aldosteronism (PA) has two major subtypes: unilateral (uPA) and bilateral (bPA). Although several diagnostic models for subtype classification have been reported, the optimal combination of algorithms and clinical features remains unclear. This study aimed to identify machine learning models and clinical features that contribute to PA subtype prediction. A total of 274 PA patients who underwent successful adrenal venous sampling (AVS) at a single center were analyzed. Overall, 196 endocrine features were comprehensively collected and classified into four categories: A, PA-related features; B, challenge tests; C, general biochemistry; and D, urinary steroid profile. Five machine learning algorithms were applied; predictive performance of the models as well as predictive contribution of features and categories were evaluated. Among the models, the random forest model achieved the highest predictive accuracy (91.3%). The most contributing feature in the RF model was plasma aldosterone concentration after the captopril challenge test (CCT90-PAC). Category B showed the greatest contribution to RF, followed by Categories A, D, and C. Combining Categories A and B improved predictive performance. These findings indicate that machine learning models, particularly RF, are effective for PA subtype prediction, with challenge test–related features in Category B making a major contribution.

A saúde no sistema prisional vem sendo discutida e garantida desde a década de 80 com a Lei de Execução Penal, estabelecendo que toda a pessoa privada de liberdade tem direito a assistência religiosa, judiciária, educacional e em saúde. Porém na atualidade o que se observa é uma grande dificuldade em se levar saúde até esses locais. Com isso se observa o crescente número de doenças infectocontagiosas, com destaque para as infecções sexualmente transmissíveis. Um instrumento que pode garantir que isso ocorra são os protocolos, manuais e cartilhas. Assim o objetivo desse trabalho é criar uma cartilha para estabelecer os fluxos dos atendimentos das infecções sexualmente transmissíveis na Penitenciária Estadual de Santa Maria. Trata-se de um estudo metodológico com ênfase na produção e caracterizado pelo processo de desenvolvimento e criação de um novo produto. Sendo que a construção dessa tecnologia em forma de cartilha irá facilitar a prática desses profissionais.Descritores: Instrução para Enfermeiro, Enfermagem, Penitenciária. Creation of cartilage for the prison system regarding sexually transmitted infections Abstract: Health in the prison system has been discussed and guaranteed since the 1980s with the Penal Execution Law, which established that all persons deprived of liberty have the right to religious, legal, educational and health care. However, what is currently observed is great difficulty in bringing health care to these places. As a result, there is a growing number of infectious diseases, especially sexually transmitted infections. One instrument that can ensure this occurs is protocols, manuals and booklets. Thus, the objective of this work is to create a booklet to establish the flows of care for sexually transmitted infections in the Santa Maria State Penitentiary. This is a methodological study with an emphasis on production and characterized by the process of development and creation of a new product. The construction of this technology in the form of a booklet will facilitate the practice of these professionals.Descriptors: Instruction for Nurse, Nursing, Penitentiary. Criação de cartilha para sistema prisional acerca de infecciones sexualmente transmisible Resumen: La salud en el sistema penitenciario ha sido discutida y garantizada desde la década de 1980 con la Ley de Ejecución Penal, estableciendo que toda persona privada de libertad tiene derecho a la atención religiosa, jurídica, educativa y de salud. Sin embargo, actualmente lo que se observa es una gran dificultad para llevar la atención médica a estos lugares. Como resultado, hay un número creciente de enfermedades infecciosas, con énfasis en las infecciones de transmisión sexual. Un instrumento que puede garantizar que esto ocurra son los protocolos, manuales y folletos. Por ello, el objetivo de este trabajo es crear una cartilla para establecer el flujo de atención de infecciones de transmisión sexual en la Penitenciaría Estatal de Santa María. Este es un estudio metodológico con énfasis en la producción y caracterizado por el proceso de desarrollo y creación de un nuevo producto. La construcción de esta tecnología en forma de folleto facilitará la práctica de estos profesionales.Descriptores: Instrucción para Enfermero, Enfermería, Penitenciario.

The online version contains supplementary material available at 10.1007/s40617-024-00995-1.

ABSTRACTUsing a restricted set of behavioral responses, corals must obtain sufficient light to maximize photosynthesis while simultaneously avoiding predation and molecular damage from UV radiation. This study investigates the polyp behavioral response of the Caribbean octocoralBriareum asbestinumto shading, and how this response influences reactions to a simulated predator cue. In experiment I, we measured changes in polyp extension before and after a shade structure was placed over colonies on a shallow patch reef in the Florida Keys. In experiment II, changes in polyp extension were measured following a simulated predator cue for both shaded and un-shaded colonies. Experiment I demonstrates thatB. asbestinumpossesses a mechanism for detecting changes in light intensity and responds by manipulating the extension of its polyps. Following polyp retraction due to a predator cue in experiment II, the temporal pattern of polyp re-extension differed between shaded and non-shaded colonies, and at the end of the observation period, shaded colonies had a greater proportion of extended polyps than non-shaded colonies, consistent with the results of experiment I. This research provides novel and valuable insights into the behavior of a common and important Caribbean octocoral and will serve as a foundation for future research pertaining to the physiological processes involved.

Contemporary advanced models for aspect-targeted opinion word extraction (ATOWE), which predominantly utilize BERT-based encoders at a word level, have shown limited advancements when integrated with graph convolutional networks (GCNs) for syntactic tree assimilation. Recognizing the prowess of BERT subwords in encapsulating rare or context-poor words, this study pivots from syntactic trees to BERT subwords, omitting GCNs from the structural framework. Our approach, named Aspect-Enhanced Wordpiece Extraction Model (AEWEM), focuses on refining aspect representation during encoding. We propose an input format of paired sentence-aspect, diverging from traditional single-sentence inputs. AEWEM demonstrates superior performance on benchmark datasets, establishing a robust foundation for future explorations in this domain.

Background: Autonomic dysfunction is an important component in congestive heart failure (CHF) pathophysiology. The combined effects of reduced ejection fraction and advanced CHF Class on baroreceptor function in CHF have not been well investigated. Methods: A single center prospective study included 118 consenting patients, 68.3 ± 14.2 years old, 50 females (42.3%), BMI of 30.1 ± 8.5 kg/m 2 , with histories of HTN in 97 (82.2%), CAD in 64 (54.2%), diabetes in 49 (41.5%), and COPD or asthma in 39 (33.1%). Class I or II CHF were documented in 32 (27.1%), class III in 53 (44.9%), and class IV in 33 (28%) patients. Mean LV EF was 44.5+/-13.9%, HFrEF was present in 41 (34.7%) patients. Baroreceptor function was assessed by measuring resting and lowest heart rates (HR) during voluntary breath holding. Results: Despite treatment with beta-adrenergic blockers in 92 (78%) and non-dihydropyridine calcium channel blockers in 7 (5.9%) patients, increased CHF class was associated with significantly increased resting (71.7 ± 14.4 bpm in Class I-II, 73.1 ± 13.6 bpm in Class III, and 80.8 ± 16.9 bpm in Class IV, p=0.027) and breath holding HR (68.9 ± 15.3 bpm in Class I-II, 69.9 ± 12.2 bpm in Class III, and 80 ± 16.1 bpm in Class IV, p=0.002). In addition, when compared to the rest of the cohort, HFrEF patients manifested with increased resting (80.9 ± 14.5 vs. 71.6 ± 14.6 bpm, p=0.001) and breath holding HR (77.6 ± 13.9 vs. 69.7 ± 14.7 bpm, p=0.006). In multivariate analysis, both increased CHF NYHA class and reduced LVEF retained statistically significant independent effects on resting (p=0.037 and p=0.001, respectively) and breath holding HR (p=0.005, each). Conclusion: Decreased LV ejection fraction and increased CHF class independently and significantly contribute to autonomic dysfunction in CHF patients. Heart rate changes indicating abnormal baroreceptor function in CHF patients are apparent despite treatment with medications affecting chronotropic response.

ObjectiveClinical education and collaboration are critical components of developing student physical therapists (SPTs) into safe and competent clinicians. While students may find themselves in various settings upon entering the workforce, working alongside a physical therapist assistant (PTA) is highly likely. With the rise in demand for therapy services, realistic and comprehensive training in SPT-SPTA (student PTA) collaboration is needed to support quality health care.ModelA student-run pro bono clinic hosted within a Midwestern DPT Program uses a peer-to-peer model that provides the space for collaborative learning between SPTs and SPTAs. Serving as a clinical rotation site for 4 weeks, the pro bono clinic schedules an SPTA alongside a pair of SPTs.DiscussionSPTs gain early experience in decision-making related to delegating tasks to SPTAs with various skill levels, engaging in intraprofessional communication and reporting improvements in confidence levels. Qualitative reporting from the SPTAs and their host institution’s faculty indicate that the team approach to learning has become a preference among their students. Furthermore, students feel more comfortable learning and working with fellow young professionals, showing more significant interactions with clients and more opportunities for clinical growth.Clinical relevanceThis model combines two previously described beneficial approaches to learning: a program attached pro bono clinic and a PT/PTA team learning environment. Integrating these concepts may catalyze intraprofessional education of SPTs and SPTAs.

The current study analyzed the effects of three frames of reward magnitude-quantity, volume, and duration-on the rate at which college students discounted hypothetical, delayed monetary rewards. Hypothetical scenarios were presented using the fill-in-the-blank discounting questionnaire and participants made choices between immediate and delayed hypothetical monetary rewards. Scenarios framed the monetary choices as (a) quantity of dollar bills, (b) height (inches) of a stack of dollar bills, and (c) duration of time spent in a hypothetical cash machine to collect dollar bills. For each scenario, participants' subjective values were used to calculate the area under the curve (AuC). Framing resulted in a moderate effect size: The duration frame yielded significantly smaller AuC values compared to the quantity and volume frames. Thus, the framing of reward magnitude was a significant variable in controlling discounting rates for hypothetical, delayed monetary rewards. Subsequent investigations should be aware of the independent effects of the reward magnitude frames on delay discounting rates.

BackgroundBloom’s Taxonomy is a hierarchical model designed to categorize course learning objectives based on the complexity of learning associated with the task. Little is known about performance and abilities of entry‐level allied health students related to Bloom’s Taxonomy within anatomy education.ObjectiveThe objective of this assessment was to use exam reviews from 2018’s PAS 501 Applied Anatomy course to re‐create exam items at higher levels of Bloom’s learning. Cohort performance at the “Remembering” level of Bloom’s was compared to 2019 reconstructed questions to determine if graduate‐level PA students are most capable of memorizing anatomy or interpreting more detailed applications.MethodsFour “Remembering” questions were selected from the 2018 PAS 501 Abdomen written exam. The regional concepts in these questions were reframed in clinical scenarios and questions where regional anatomy needed to be applied at higher levels of thinking. Statistics of cohort performance in the form of the DI, PBC and the DisI were used to compare the lower‐ and higher‐level Bloom’s questionsResultsTwo questions reframed as clinical scenarios and demonstrated decreases in the DI and an increase in the PBC. Two questions were initially written as basic definition questions and reconstructed to represent a discussion of regional anatomy that required the student to understand and reinterpret the information. One of these questions displayed an increase in the DI and the PBC.ConclusionsHigher level Bloom’s questions framed as clinical scenarios (N=2) displayed noted increases in the PBC implying these questions are quality discriminators for students who do well overall and those who do not. Reframing “Remembering,” definition questions to “Understanding” level questions may increase item success for clinically‐minded graduate‐level students. Additional work is required to draw meaningful conclusions from this pilot data.Support or Funding InformationN/A

ABSTRACTThe illustrations of sixteenth-century Algonquian-speaking peoples of present-day North Carolina by Theodore de Bry and John White are among the most recognisable images associated with European colonisation, and reading the differences between the two sets in the light of contemporary travel literature clarifies the commercial interests of England’s colonisation promoters. De Bry attenuated “native” characteristics like ritual tattooing and made his female subjects appear healthier and more robust by emphasising their youth. Explorers like Thomas Harriot and Arthur Barlowe reinforced de Bry’s images, and reports and pictures of flora and fauna indicated that Algonquian women were as fertile as their lands. Depictions of Native American women as under-clothed and uncivilised allowed Europeans to cast colonisation as a religious endeavour to “civilise” and clothe them. Native American bodies and lands were distorted to convince English people to leave their overpopulated and deforested island for a better home across the Atlantic.