nurse educators are appointed to leadership positions.
 There must be collaboration between nurse educators and health policymakers to strengthen cordial relationships as well as foster disciplinary procedures on incivility. Clear policy on disciplinary procedures focusing on mitigating various forms of uncivil behaviours is imperative. Nurse educator leaders' training on management skill should also be strengthened and made mandatory before nurse educators are appointed to leadership positions.Bendamustine + rituximab (BR) is the current first-line standard-of-care for chronic lymphocytic leukaemia (CLL) in fit patients aged 66-70 years, whereas chlorambucil + CD20 antibody is recommended in older patients with co-morbidities.  https://www.selleckchem.com/products/ex229-compound-991.html  This retrospective real-world study investigated whether risk-adapted BR was safe and effective in elderly patients. All 141 CLL patients in the Stockholm region (diagnosed from 2007 to 2016, identified from regional registries) who had received BR as first (n = 84) or later line (n = 57) were analysed. Median age was 72 years, 49% had Binet stage C, 40% had Cumulative Illness Rating Scale (CIRS) score ≥ 6, 20% Eastern Cooperative Oncology Group (ECOG) score 2. None had del(17p). Only 15% of patients aged ≥80 years received full-dose bendamustine and 65% of them postponed rituximab until cycle 2. Corresponding numbers in patients 73-79 years were 21% and 36% and in less then 73 years, 63% and 33%. Overall response rate was 83% (first line) and 67% (later line) (P less then 0·022) equally distributed between age subsets. ECOG, immunoglobulin heavy chain variable region (IGHV) mutational status and cytogenetics, but not treatment line and age, were significant factors on progression-free survival (PFS) in multivariate analysis. Infections and neutropenia/thrombocytopenia (≥grade 3) were similar across age subgroups. In summary, BR was well tolerated even in patients ≥80 years, with similar efficacy and safety as in less old patients, provided that carefully adapted dosing was applied.
  Carabelli is a nonmetric dental trait variably expressed as a small pit to a prominent cusp in the maxillary molars of modern humans. Investigations on the occurrence and expression rates of this trait have been conducted extensively, tracing its origin to genetic sources. However, there remains a lack of understanding about its potential role in chewing. In this study, we examine molar macrowear with the aim of reconstructing Carabelli trait occlusal dynamics occurring during chewing.
 
  We have examined 96 deciduous and permanent maxillary molars of children and young adults from Yuendumu, an Australian Aboriginal population that was at an early stage of transition from a nomadic and hunter-gatherer way of life to a more settled existence. We apply a well-established method, called Occlusal Fingerprint Analysis, which is a digital approach for analyzing dental macrowear allowing the reconstruction of jaw movements required to produce wear pattern specific to each tooth.
 
  Carabelli trait slightly enlarges rait in modern human dentition.The balance between avoiding severe acute respiratory syndrome coronavirus-2 contagion and reducing wider clinical risk is unclear for gestational diabetes mellitus (GDM) testing. Recent recommendations promote diagnostic approaches that limit collection but increase undiagnosed GDM, which potentially increases adverse pregnancy outcome risks. The most sensitive approach to detecting GDM at 24-28 weeks beyond the two-hour oral glucose tolerance test (OGTT) is a one-hour OGTT (88% sensitivity). Less sensitive approaches use fasting glucose alone (≥5.1 mmol/L misses 44-54% GDM) or asking ~20% of women for a second visit (fasting glucose 4.7-5.0 mmol/L (62-72% sensitive)). Choices should emphasise local and patient decision-making.
  Toxoplasmosis in sheep has negative impacts on reproductive performance. This study aimed to estimate the prevalence in Toxoplasma gondii infection in the South Australian sheep population, and assess any association between within-flock prevalence and reproductive efficiency (measured by lamb marking percentage), climatic region and rainfall.
 
  A total of 875 individual mixed-age breeding ewes from 29 South Australian properties were blood sampled with an average of 30.2 ewes per property (min 28, max 32). Sera were tested for T. gondii-specific IgG antibody using a commercial Modified Agglutination Test kit.
 
  Overall, 209 of 875 (23.9%; 95% confidence interval [CI] 16.3% to 31.4%) of individual ewes tested seropositive for T. gondii-specific IgG antibodies, with a flock level seroprevalence of 28/29 (96.6%, 95% CI 96.6% to 100%). On individual farms, the seroprevalence ranged from 0% to 93.3%. Analysis showed that Kangaroo Island properties had significantly higher mean seroprevalence than any mainland climatic regions, and that the mainland regions did not significantly differ from each other. Linear regression revealed a significant association between seroprevalence and lamb marking percentage, with a slope of -5.4% lamb marking per +10% seroprevalence.
 Overall, 209 of 875 (23.9%; 95% confidence interval [CI] 16.3% to 31.4%) of individual ewes tested seropositive for T. gondii-specific IgG antibodies, with a flock level seroprevalence of 28/29 (96.6%, 95% CI 96.6% to 100%). On individual farms, the seroprevalence ranged from 0% to 93.3%. Analysis showed that Kangaroo Island properties had significantly higher mean seroprevalence than any mainland climatic regions, and that the mainland regions did not significantly differ from each other. Linear regression revealed a significant association between seroprevalence and lamb marking percentage, with a slope of -5.4% lamb marking per +10% seroprevalence.
  Prenatal development is a time when the brain is acutely vulnerable to insult and alteration by environmental factors (e.g., toxins, maternal health). One important risk factor is maternal obesity (Body Mass Index>30). Recent research indicates that high maternal BMI during pregnancy is associated with increased risk for numerous physical health, cognitive, and mental health problems in offspring across the lifespan. It is possible that heightened maternal prenatal BMI influences the developing brain even before birth.
 
  The present study examines this possibility at the level of macrocircuitry in the human fetal brain. Using a data-driven strategy for parcellating the brain into subnetworks, we test whether MRI functional connectivity within or between fetal neural subnetworks varies with maternal prenatal BMI in 109 fetuses between the ages of 26 and 39weeks.
 
  We discovered that strength of connectivity between two subnetworks, left anterior insula/inferior frontal gyrus (aIN/IFG) and bilateral prefrontal cortex (PFC), varied with maternal BMI.