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Late maturity alpha‐amylase (LMA) and preharvest sprouting (PHS) lead to elevated alpha‐amylase in wheat (Triticum aestivum L.) grain. Risk of poor end‐product quality due to elevated alpha‐amylase is detected in the wheat industry using the Hagberg–Perten falling number (FN) method. In breeding programs, selection for PHS and LMA tolerance requires higher throughput methods requiring a smaller sample size than the 7 g required for the FN method. Specifically, LMA can only be screened only using detection of alpha‐amylase activity or protein after cold treatment of individual wheat spikes at a specific stage of grain development resulting in very small samples (≤1 g). This study developed and evaluated a high throughput 96‐well method for the Phadebas alpha‐amylase enzyme assay for small wheat grain samples and compared this method to FN and the Megazyme Alpha‐Amylase SD (Sprout Damage) Assay Kit performed on the automated Awareness Technology ChemWell‐T Analyzer. In parallel, the efficacy of low‐cost small‐scale milling methods was evaluated relative to traditional larger scale mills. The Phadebas enzyme activity was highly reproducible and showed a strong correlation to the SD enzyme assay and FN method regardless of which mill was used to process the grain. The SD assay offers simpler standardization and calculation of enzyme activity, whereas the Phadebas assay offers higher sensitivity and lower expense. Both the 96‐well Phadebas and automated Megazyme SD assays are suitable for alpha‐amylase detection from small samples, and the use of low‐cost coffee grinders to process small samples did not significantly impact assay performance. Core Ideas High throughput 96‐well Phadebas enzyme assays provided data in the linear range of detection for small samples. The 96‐well Phadebas assay run in plasticware had similar sensitivity to the original glass tube method. The Phadebas assay generated highly reproducible data over time and when performed by multiple users. There were strong positive correlations between Phadebas and SD enzyme assays. There were strong correlations between FN and enzyme activity regardless of milling method or assay chemistry.

This paper examines the current state of Ladino as a spoken everyday language of communication. Research has shown that there are very few competent speakers of the language under the age of sixty throughout the world. Negative language attitudes as well as assimilation into the dominant cultures and choice of the dominant language(s) are contributing factors to this decline. However, this decline in linguistic skills does not reflect the promotional efforts on behalf of Ladino and Sephardic culture which are discussed at length in the paper. The end result is that language loss does not mean the decline of Sephardic ethnicity and culture, which are presently thriving.

The optimal timing of anticoagulation for patients with acute ischaemic stroke with atrial fibrillation is uncertain. We investigated the efficacy and safety of early compared with delayed initiation of direct oral anticoagulants (DOACs) in patients with acute ischaemic stroke associated with atrial fibrillation. We performed a multicentre, open-label, blinded-endpoint, parallel-group, phase 4, randomised controlled trial at 100 UK hospitals. Adults with atrial fibrillation and a clinical diagnosis of acute ischaemic stroke and whose physician was uncertain of the optimal timing for DOAC initiation were eligible for inclusion in the study. We randomly assigned participants (1:1) to early (ie, ≤4 days from stroke symptom onset) or delayed (ie, 7–14 days) anticoagulation initiation with any DOAC, using an independent online randomisation service with random permuted blocks and varying block length, stratified by stroke severity at randomisation. Participants and treating clinicians were not masked to treatment assignment, but all outcomes were adjudicated by a masked independent external adjudication committee using all available clinical records, brain imaging reports, and source images. The primary outcome was a composite of recurrent ischaemic stroke, symptomatic intracranial haemorrhage, unclassifiable stroke, or systemic embolism incidence at 90 days in a modified intention-to-treat population. We used a gatekeeper approach by sequentially testing for a non-inferiority margin of 2 percentage points, followed by testing for superiority. OPTIMAS is registered with ISRCTN (ISRCTN17896007) and ClinicalTrials.gov (NCT03759938), and the trial is ongoing. Between July 5, 2019, and Jan 31, 2024, 3648 patients were randomly assigned to early or delayed DOAC initiation. 27 participants did not fulfil the eligibility criteria or withdrew consent to include their data, leaving 3621 patients (1814 in the early group and 1807 in the delayed group; 1981 men and 1640 women) in the modified intention-to-treat analysis. The primary outcome occurred in 59 (3·3%) of 1814 participants in the early DOAC initiation group compared with 59 (3·3%) of 1807 participants in the delayed DOAC initiation group (adjusted risk difference [RD] 0·000, 95% CI –0·011 to 0·012). The upper limit of the 95% CI for the adjusted RD was less than the non-inferiority margin of 2 percentage points (pnon-inferiority=0·0003). Superiority was not identified (psuperiority=0·96). Symptomatic intracranial haemorrhage occurred in 11 (0·6%) participants allocated to the early DOAC initiation group compared with 12 (0·7%) participants allocated to the delayed DOAC initiation group (adjusted RD 0·001, –0·004 to 0·006; p=0·78). Early DOAC initiation within 4 days after ischaemic stroke associated with atrial fibrillation was non-inferior to delayed initiation for the composite outcome of ischaemic stroke, intracranial haemorrhage, unclassifiable stroke, or systemic embolism at 90 days. Our findings do not support the current common and guideline-supported practice of delaying DOAC initiation after ischaemic stroke with atrial fibrillation. British Heart Foundation.

Access to oral health services is a problem for all segments of the U.S. population, and especially problematic for vulnerable populations, such as rural and underserved populations. The many challenges to improving access to oral health services include the lack of coordination and integration among the oral health, public health, and medical health care systems; misaligned payment and education systems that focus on the treatment of dental disease rather than prevention; the lack of a robust evidence base for many dental procedures and workforce models; and regulatory barriers that prevent the exploration of alternative models of care.This volume, the summary of a three-day workshop, evaluates the sufficiency of the U.S. oral health workforce to consider three key questions:What is the current status of access to oral health services for the U.S. population?What workforce strategies hold promise to improve access to oral health services?How can policy makers, state and federal governments, and oral health care providers and practitioners improve the regulations and structure of the oral health care system to improve access to oral health services?

The universally accepted best practice protocol for monitoring patients who receive intravenous thrombolysis for acute ischaemic stroke was established in the 1990s. However, the protocol is burdensome for nurses, disrupts the sleep of patients, and is potentially less relevant in patients at low risk of symptomatic intracerebral haemorrhage. We aimed to assess whether implementing a low-intensity monitoring protocol would be as safe and effective as standard high-intensity monitoring for patients with acute ischaemic stroke at low risk. OPTIMISTmain was an international, pragmatic, multicentre, stepped-wedge, cluster-randomised, controlled, non-inferiority, blinded-endpoint trial conducted at hospitals (clusters) in eight countries. It was designed to test the non-inferiority of a low-intensity monitoring protocol to a standard protocol among consecutive adults with acute ischaemic stroke who were clinically stable with mild to moderate neurological impairment (score <10 on the National Institutes of Health Stroke Scale) within 2 h of initiation of intravenous thrombolysis according to local guidelines. Participating hospitals were randomly allocated to three sequences of implementation across four periods, stratified by country and projected numbers of participants, in which sites switched from standard monitoring (control) to low-intensity monitoring (intervention) in a stepped manner. The low-intensity monitoring protocol included assessments of neurological and vital signs every 15 min for 2 h, every 2 h for 8 h (vs every 30 min for 6 h for standard monitoring), and every 4 h (vs every 1 h for standard monitoring) until 24 h after thrombolysis. The primary outcome was the proportion of participants with an unfavourable functional outcome defined by a score from 2 (indicating some disability) to 6 (death) on the modified Rankin Scale at 90 days, measured by research staff masked to group allocation. The non-inferiority margin was set at 1·15 for the risk ratio (RR) in the intention-to-treat population. A generalised linear mixed model was used for analysis with adjustments for cluster (hospital site) and time (6-month periods from April, 2021), and imputation of missing outcome data. This trial is registered at Clinicaltrials.gov (NCT03734640) and the Australian New Zealand Clinical Trial Registry (ACTRN 12619001556134p) and is completed. Of 181 hospitals assessed for eligibility, 120 hospitals agreed to join the trial and were randomly allocated between April 28, 2021, and Sept 30, 2024; however, one hospital withdrew, one was not activated, and four did not enrol any patients. Overall, 4922 participants were enrolled at 114 hospitals, with 2789 participants assigned to the low-intensity monitoring group and 2133 to the standard monitoring group. 809 (31·7%) of 2552 participants in the low-intensity group and 606 (30·9%) of 1963 in the standard monitoring group had a modified Rankin Scale score of 2–6 at 90 days (RR 1·03 [95% CI 0·92–1·15], pnon-inferiority=0·057). Symptomatic intracerebral haemorrhage occurred in five (0·2%) of 2783 patients in the low-intensity group and eight (0·4%) of 2122 patients in the standard monitoring group. The numbers of participants with a serious adverse event were similar between the low-intensity monitoring group (309 [11·1%] of 2789) and the standard monitoring group (240 [11·3%] of 2133). OPTIMISTmain provides weak evidence that low-intensity monitoring is non-inferior to standard monitoring in patients with a mild or moderate level of neurological impairment who receive thrombolysis treatment for acute ischaemic stroke. Hospitals could consider incorporating this approach into stroke services according to local circumstances. National Health and Medical Research Council of Australia; New South Wales Health Investigator Development Grant; University of New South Wales Medicine Non Communicable Diseases Theme Early–Mid Career Research Seed Grant Scheme; Medical Research Future Fund (for conduct in Australia); and Genentech (for conduct in the USA).

This study analyzed student characteristics that impact persistence among first-year students attending a large, metropolitan community college. The Cooperative Institutional Research Program (CIRP) Freshmen Survey was administered to first-time students during orientation. Factor analysis was used to classify students' personality and behavioral characteristics and discriminant function analysis was used to predict retention or attrition. The discriminant model accurately predicted retention in 78.8% of the cases. Findings suggested that student characteristics impacting persistence can be classified into three categories: barriers, motivations and aspirations, and expectations. Among the strongest predictors of attrition were the number of developmental classes required, the intention to transfer to a four-year institution, and the expectation that English as a second language could be a problem for college students. Among the strongest predictors of persistence were being African American or Latino, cumulative GPA, and the length of time students plan to spend at the college. Recommendations are shared for how community college administration, faculty, and staff can work with students and the community to raise student expectations, motivation, and preparation long before they become first-year college students.

In the United States as well as in Israel, Judeo-Spanish is rapidly declining as the daily language of communication. The domains for the spoken language have been reduced to use with older people, for humorous & expressive purposes (jokes, stories, songs), as a secret language, & in certain situations such as the work place, where it is used with non-Sephardic Spanish speakers. In other words, Judeo-Spanish is not being transmitted to the young generations as the language of primary socialization. Sociolinguistic/sociological reasons for the loss of conversational use as well as the non-transmission of Judeo-Spanish are discussed in this paper. Characteristic linguistic traits of the present spoken language in both the United States & Israel are also examined. References. Adapted from the source document

Community college students often find themselves in challenging situations and circumstances that extend far beyond the physical boundaries of the campus. This chapter examines issues of safety on an open campus, including situations that may blur physical and intellectual borders of community college campuses wherein the potential for violence arises. It focuses on issues related to safety and the community college campus. AACC describes the average community college student as female, enrolled part time, 29 years of age or older, and uses English as the second language. National and local crime statistics are critical in comprehending the importance of providing a safe community college campus environment. Consequently, ASJA members at community colleges should work closely with law enforcement officers to identify, report, and prevent crime to assure all students that the institution is actively involved in protecting the safety of their students while keeping them informed regarding the process.

After 13 years she went on to serve as the assistant vice president and business relationship manager at Wells Fargo Bank Alaska, N.A. \"My aunt was a vault teller at First National Bank of Amarillo when I was growing up and she told me that if I got into banking, they'd keep me forever,\" Harris said. Whether a customer is looking for a new auto loan, home loan, checking account, business loan or the latest in electronic banking technology, National Bank & Trust is ready to serve its guests with innovative products and a staff who work diligently to understand their needs and help achieve the customer's financial goals. At the end of each school year, the students have the opportunity to pay a visit to National Bank & Trust and experience various bank stations, cash checks and receive a bag of shredded money valued at $20, courtesy of the Federal Reserve Bank, Houston branch.