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Associations Between Occupational Stress, Disordered Eating, and Obesity Among Police Officers in North Carolina
Get PDFObesity is a major public health concern among police officers, yet the links between occupational stress, disordered eating, and obesity remain unclear. This cross-sectional study examined 496 North Carolina officers to (1) assess severity of occupational stress (posttraumatic stress disorder [PTSD] symptoms, anti-police sentiment, fear of victimization), disordered eating (binge eating and loss-of-control eating), and obesity by county type, region, and sex; (2) evaluate associations between occupational stress and disordered eating; and (3) explore relationships between disordered eating and weight-related measures. Officers completed online surveys, and trained staff measured body mass index (BMI), waist and hip circumferences, and waist-to-hip ratio. Nearly 60 percent of officers were classified as obese (BMI ≥ 30 kg/m2), and over 20 percent reported moderate to severe binge eating. Rural officers reported higher PTSD symptoms, binge eating, and loss-of-control eating than those in urban or suburban areas. Coastal Plain and Piedmont officers had higher BMI and larger waist and hip circumferences than those in the Mountain region. Higher occupational stress was linked to more severe disordered eating, which was associated with greater BMI and adiposity, although the effect sizes were modest. Findings support targeted interventions addressing occupational stress and disordered eating to prevent obesity and enhance officer well-being
Defining minimum image quality criteria for common diagnostic point‐of‐care ultrasound images: A position statement of the Society of Hospital Medicine
Get PDFBACKGROUND: Point-of-care ultrasound (POCUS) use continues to expand across multiple clinical subspecialties, and the need for standardization of training and quality assurance has become increasingly important. Despite the need for training, there are currently no widely accepted multispecialty criteria to define an acceptable quality POCUS image for common POCUS applications used by clinicians. Without such criteria, discrepancies in rating POCUS image quality occur, leading to inconsistencies in training and quality assurance, which can ultimately compromise patient care and safety. METHODS: To address this gap, the Society of Hospital Medicine (SHM) Point-of-care Ultrasound Task Force convened an expert panel of 32 national POCUS experts trained in hospital medicine (n = 24), critical care (n = 4), emergency medicine (n = 3), radiology (n = 2), and cardiology (n = 1) and employed a modified-Delphi approach to develop minimum image quality criteria for five common POCUS applications: heart, lungs, abdomen, lower extremity veins, and skin/soft tissues. RESULTS: After three rounds of voting and group discussion, the panel achieved consensus on a comprehensive list of 215 items to define standard image quality criteria in five different body systems. CONCLUSIONS: These POCUS image quality criteria offer a structured, consensus-based framework for evaluating POCUS images and establish a minimum standard for defining an acceptable quality image. Use of these criteria can improve inter-rater reliability and advance standardization of POCUS imaging, which affects training, quality assurance, and credentialing/privileging practices
Strategies for offering an m-out-of-n policy for multi-peril catastrophe insurance
Get PDFA company with n geographically widely dispersed sites seeks an insurance policy that pays off if m out of the n sites experience rarely occurring catastrophes (e.g., earthquakes) during a year. This study compares three strategies for an insurance company wishing to offer such an m -out-of- n policy, assuming the existence of markets for insurance on the individual sites with coverage periods of various lengths of a year or less. Strategy A is static: at the beginning of the year it buys a reinsurance policy on each individual site covering the entire year and makes no later adjustments. By contrast, Strategies S and C are dynamic and adaptive, exploiting the availability of individual-site policies for shorter periods than a year to make changes in the coverage on individual sites as quakes occur during the year. Strategy S uses the payoff from reinsurance when a quake occurs at a particular site to increase coverage for the remainder of the year on the sites that have not yet had quakes. Strategy C buys individual-site policies covering successive time periods of fixed length, observing the system at the beginning of each period and using cash on hand plus cash obtained from a reinsurance payoff (if any) during the previous period to decide how much cash to retain and how much reinsurance to purchase for the current period. The study relies on expected utility to determine indifference premiums and compare the premiums and loss probabilities for the three strategies
The deal.II library, version 9.7
Get PDFThis paper provides an overview of the new features of the finite element library deal.II , version 9.7
Readability and performance of AI chatbot responses to frequently asked questions in maxillofacial prosthodontics
Get PDFSTATEMENT OF PROBLEM: Patients seeking information about maxillofacial prosthodontic care increasingly turn to artificial intelligence (AI)-driven chatbots for guidance. However, the readability, accuracy, and clarity of these AI-generated responses have not been adequately evaluated within the context of maxillofacial prosthodontics. PURPOSE: The purpose of this study was to assess and compare the readability and performance of chatbot-generated responses to frequently asked questions about intraoral and extraoral maxillofacial prosthodontics. MATERIAL AND METHODS: A total of 20 frequently asked intraoral and extraoral questions were collected from 7 maxillofacial prosthodontists. These questions were submitted to 4 AI chatbots: ChatGPT, Gemini, Copilot, and DeepSeek. A total of 80 responses were evaluated. Readability was assessed using the Flesch-Kincaid Grade Level (FKGL). Seven maxillofacial prosthodontists were calibrated to score the chatbot responses on 5 domains, relevance, clarity, depth, focus, and coherence, using a 5-point scale. The obtained data were analyzed using 2-way ANOVA with post hoc Tukey tests, Pearson correlation analyses, and intraclass correlation coefficients (ICCs) (α=.05). RESULTS: FKGL scores differed significantly among chatbots (P=.002). DeepSeek had the lowest FKGL, indicating better readability, while ChatGPT had the highest. Word counts, relevance, clarity, content depth, focus, and coherence varied significantly among platforms (P<.005). ChatGPT, Gemini, and DeepSeek consistently scored higher, while Copilot had the lowest scores across all domains. For questions on intraoral prostheses, FKGL scores negatively correlated with word count (P=.013). For questions on extraoral prostheses, word count positively correlated with all qualitative metrics except for FKGL (P<.005). CONCLUSIONS: Significant differences were found in both readability and response quality among commonly used AI chatbots. Although the DeepSeek and ChatGPT platforms produced higher-quality content, none consistently met health literacy guidelines. Clinician oversight is essential when using AI-generated materials to answer frequently asked questions by patients requiring maxillofacial prosthodontic care
The Necessity of Diversity, Equity and Inclusion Training for Obstetrics and Gynecology: A Department-Wide Needs Assessment of an Academic Obstetrics and Gynecology Department
Get PDFIntroduction: The persistent disparities in the field of obstetrics and gynecology (OBGYN) have become increasingly visible in the public eye, while at the same time public discourse regarding the appropriateness and efficacy of diversity, equity and inclusion (DEI) education has become increasingly politically polarized. Background: While it has long been accepted that DEI training is an essential component of curricula offered in academic OBGYN departments, there remains a great deal of uncertainty regarding the best practices for developing and provisioning such training. Methods: In this article, the authors outline lessons learned from the process of developing an evidence-based department-wide needs assessment in order to evaluate the knowledge, attitudes, and behavior of members of a large academic OBGYN department, including an evaluation of the impact of prior DEI educational programming. Results: Of the 113 clinicians, nurses and administrative staff, the majority desired more DEI training and endorsed significant barriers to accessing it. There were also significant opportunities for improvement of health equity knowledge and clinical practice. Discussion: Although DEI training has been lauded for addressing health inequities, the findings of this needs assessment highlight existing gaps between desired and actual outcomes. It is essential that academic departments design, implement, and evaluate DEI strategies that are inclusive of the entire medical team, offer iterative and ongoing training opportunities, provide support for minoritized groups within the department, and involve a variety of stakeholders to improve our ability to provide equitable reproductive health care for all
Case Report: A complex case of neuropathy and temporomandibular disorders manifesting as otalgia
Get PDFPatients with temporomandibular disorders (TMDs) often present with otological symptoms as their primary complaint. Nervus intermedius neuropathy is a rare condition characterized by paroxysmal episodes of sharp, deep ear pain. The presence of overlapping symptoms of TMD and nervus intermedius neuropathy, associated with psychological comorbidities and sleep disturbances, poses significant diagnostic and management challenges for clinicians. Therefore, we report the case of a young female patient who presented to the orofacial pain clinic with debilitating ear pain affecting her quality of life. The patient responded partially to medications and conservative therapies. Adding psychosocial interventions along with botulinum toxin provided notable relief in refractory pain characteristics. In conclusion, although nervus intermedius neuropathy is uncommon in clinical practice, it may coexist with painful TMD and sleep and psychological problems. In such cases of refractory chronic pain, botulinum toxin injections may serve as a critical component for effective patient management
Sale of critically endangered sharks in the United States
Get PDFIn the United States, shark meat is sold in grocery stores, seafood markets, and online. The meat is often mislabeled as another species or generically labeled as “shark”. The ambiguity of these generic labels makes it challenging to assess the conservation implications of this practice and for consumers to avoid high trophic-level species that often have high mercury concentrations in their tissues. We purchased and DNA barcoded 29 shark products in the United States to determine their species identity. Our samples consisted of 19 filets sold in grocery stores, seafood markets, and Asian specialty markets (mostly in North Carolina) and 10 ordered online as “jerky”. Ninety three percent of samples (27 of 29) were ambiguously labeled as shark or mako shark but not as a specific species. Of the two samples that were labeled to species, one was mislabeled (e.g., shortfin mako shark labeled as blacktip shark) and the other was correctly labeled. Barcoding indicated that the 29 samples included 11 different species of shark, including three species listed by the IUCN as Critically Endangered: great hammerhead, scalloped hammerhead, and tope. Previous studies have found that the first two species contain very high levels of mercury, illustrating the implications of seafood mislabeling for human health. The availability of shark meat in U.S. grocery stores is surprising given the dramatic decline of shark populations globally. Moreover, the fact that nearly all shark meat is labeled ambiguously or incorrectly amplifies the problem. Accurate, verified product labels for shark meat would benefit consumers and shark conservation efforts, and should be a priority for the seafood industry
Ethylene-independent modulation of root development by ACC via downregulation of WOX5 and group I CLE peptide expression.
Get PDFIn seed plants, the canonical role of 1-aminocyclopropane-1-carboxylic acid (ACC) is to serve as the precursor in the biosynthesis of the phytohormone ethylene, and indeed, ACC treatment is often used as a proxy for ethylene treatment. Increasing evidence suggests that ACC can also act independently of ethylene to regulate various aspects of plant growth and development. Here, we explore the effects of ACC on Arabidopsis thaliana root growth and the mechanisms by which it acts. ACC inhibits growth of the primary root in Arabidopsis seedlings when ethylene signaling is blocked, which becomes evident after 36 h of treatment with ACC. This reduced root growth is in part the result of suppressed cell proliferation in the root meristem resulting from altered expression of a key regulator of stem cell niche activity, WOX5. ACC also promotes lateral root (LR) development, in contrast to ethylene, which inhibits LR formation. Transcriptomic analysis of roots revealed no significant changes in gene expression after 45 min or 4 h of ACC treatment, but longer treatment times revealed a large number of differentially expressed genes, including the downregulation of the expression of a small group of phylogenetically related CLE peptides. Reduced expression of these group 1 CLEs in response to ACC leads to the activation of a transcription factor, LBD18, which promotes LR development. These results suggest that ACC acts to modulate multiple aspects of Arabidopsis root growth independently of ethylene via distinct transcriptional effects in the root meristem and LR precursor cells
Physeal‐sparing anterior cruciate ligament reconstruction provides better initial joint biomechanics than complete transphyseal reconstruction in an early adolescent porcine model
Get PDFPurpose: The aim of this study was to compare initial joint kinematics and tissue forces following complete transphyseal, partial transphyseal and physeal-sparing anterior cruciate ligament (ACL) reconstruction (ACLR) in an early adolescent porcine model. Methods: Eighteen early adolescent porcine knees were tested using a six-degree-of-freedom robotic testing system at 40° and 60° of flexion. An 80 N anterior-posterior (AP) force, 120 N compression force and 4 N m varus-valgus torque were applied to the tibia in intact, ACL transected and ACLR states. Complete transphyseal, partial transphyseal, and physeal-sparing surgical techniques were performed (n = 6 legs/technique). Kinematics under applied loads were recorded to assess joint stability and compared across each state. Individual tissue forces were calculated using the principle of superposition. For comparisons between surgical techniques, both joint stability and tissue forces were normalized to intact control data from the same joints. Results: At 40° of flexion, the increase in AP tibial translation following physeal-sparing ACLR was 3.8 mm smaller than the complete transphyseal (p = 0.02). Under anterior tibial loading, the anterior force taken by the reconstructed ACL graft significantly decreased similarly following reconstruction by each technique, which shifted to the medial collateral ligament (MCL). The increase in anterior MCL forces following complete transphyseal reconstruction was 283% higher than that after physeal-sparing reconstruction (p = 0.04). Under valgus torque, the change in compression force in the lateral meniscus following physeal-sparing reconstruction was 82% smaller than that after partial transphyseal reconstruction (p = 0.02). At 60° of flexion, the average increase in ATT under compression following partial transphyseal and physeal-sparing reconstruction was 5.0 and 6.9 mm smaller than following complete transphyseal reconstruction (p ≤ 0.001 for each). Conclusion: In early adolescent porcine joints, the physeal-sparing technique led to better initial joint stability with less anterior force shifted to the MCL compared to the complete transphyseal technique