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The authors of [Ann. Henri Poincaré 16 (2015) 691-708] introduced a multi-species version of the Sherrington-Kirkpatrick model and suggested the analogue of the Parisi formula for the free energy. Using a variant of Guerra's replica symmetry breaking interpolation, they showed that, under certain assumption on the interactions, the formula gives an upper bound on the limit of the free energy. In this paper we prove that the bound is sharp. This is achieved by developing a new multi-species form of the Ghirlanda-Guerra identities and showing that they force the overlaps within species to be completely determined by the overlaps of the whole system.

The Parisi formula for the free energy in the Sherrington-Kirkpatrick and mixed p-spin models for even p ≥ 2 was proved in the seminal work of Michel Talagrand [Ann. of Math. (2) 163 (2006) 221-263]. In this paper we prove the Parisi formula for general mixed p-spin models which also include p-spin interactions for odd p. Most of the ideas used in the paper are well known and can now be combined following a recent proof of the Parisi ultrametricity conjecture in [Ann. of Math. (2) 177 (2013) 383-393].

The bizarre elaboration of sexually selected traits such as the peacock’s tail was a puzzle to Charles Darwin and his 19th century followers. Ronald A. Fisher crafted an ingenious solution in the 1930s, positing that female preferences would become genetically correlated with preferred traits due to nonrandom mating. These genetic correlations would translate selection for preferred traits into selection for stronger preferences, leading to a self-reinforcing process of ever-elaborating traits and preferences. It is widely believed that Fisher provided only a verbal model of this “runaway” process. However, in correspondence with Charles Galton Darwin, Fisher also laid out a simple mathematical model that purportedly confirms his verbal prediction of runaway sexual selection. Unfortunately, Fisher’s model contains inconsistencies that render his quantitative conclusions inaccurate. Here, we correct Fisher’s model and show that it contains all the ingredients of a working runaway process. We derive quantitative predictions of his model using numerical techniques that were unavailable in Fisher’s time. Depending on parameter values, mean traits and preferences may increase until genetic variance is depleted by selection, exaggerate exponentially while their variances remain stable, or both means and variances may increase super-exponentially. We thus present the earliest mathematical model of runaway sexual selection.

X-ray ptychography is a high-resolution imaging technique capable of resolving nanoscale structures and probing chemical states. However, despite advances, most conventional X-ray ptychography systems have been designed to operate within a single energy regime, such as hard (> 5 keV), soft (< 2 keV) or tender (2–5 keV) X-rays. We have developed a high-efficiency achromatic ptychographic measurement system on beamline BL10U at NanoTerasu, a 3 GeV synchrotron radiation facility in Japan, that incorporates advanced Kirkpatrick–Baez focusing mirrors and a high-speed CITIUS detector. Utilizing this innovative system, we have successfully reconstructed phase images with a spatial resolution exceeding 50 nm from 200 nm-thick tantalum test charts at X-ray energies of 2.5, 5.0 and 7.5 keV. We have performed energy scans around the Ca and S K edges on CaSO 4 ·2H 2 O particles to demonstrate the spectromicroscopic capabilities of the system. The reconstructed images provide spatially resolved X-ray absorption spectra, revealing distinct edge features. This system not only enables element-specific imaging across the tender to hard X-ray spectrum but is also particularly advantageous for light-element materials, which benefit from enhanced phase contrast in the tender X-ray range. This advancement opens up new possibilities for in situ imaging of complex chemical environments in energy devices and biological specimens.

To develop a training program on cancer pain management for pharmacists and to evaluate the effectiveness of the training. The program developed a well-structured curriculum and subsequent evaluation of training effectiveness, guided by the Kirkpatrick four-tier evaluation model, including reaction, learning, behavior, and results. The training approach incorporated mentoring, study groups, and problem-based learning to create an immersive and impactful learning experience. Fifty-three pharmacists participated in the survey. The reaction evaluation results showed that the cumulative percentage of \"satisfied\" and \"very satisfied\" with each of the nine statements exceeded 85%. The findings from the learning level assessment revealed that the cumulative percentage of accurate responses to the 13 items on the Cancer Pain Management Questionnaire was 57.7% before training. This percentage rose to 64.2% following the training, showcasing a statistically significant improvement (p=0.014). The behavioral scoring results showed that 53 trainees scored an average of more than 15 points on all four behavioral benchmarks. The pass rate for the trainees was 86.8%. The percentages of trainees who scored proficient, good, and excellent were 18.9% (10/53), 50.9% (27/53), and 17.0% (9/53), respectively. The evaluation of the results showed that all the respondents were engaged in cancer pain management practices. Of these participants, 85.7% (42/49) were members of a multidisciplinary cancer pain management team, and 53.1% (26/49) performed a cancer pain consultation or attended an outpatient clinic. Study results suggested that the training program was effective in all dimensions defined by the Kirkpatrick model. This collective achievement indicates a substantial enhancement in the comprehension and proficiency of pharmacists regarding cancer pain management.

Background Restricting parturient women in healthcare facilities from choosing positions that provide the greatest comfort and benefit during labor is a global barrier. Several complex factors, including caregiver preference and medical intervention, shape the limitation. Therefore, a practical need exists to train midwives on the knowledge and skills to change this condition. Methods The study used a parallel, single-blind, randomized controlled trial at a provincial maternity and child health hospital in Fujian, China, from June 1 to December 31, 2019. The midwives in a birth suite were selected and randomly enrolled in a one-month simulation-based hybrid training or face-to-face teaching in September 2019. The four-level Kirkpatrick’s model, including reaction, learning, behavior, and results , was used to evaluate training effects before and after the program. Data were analyzed with SPSS 25.0 using Student’s t -test, Spearman’s correlation test, Mann–Whitney U test, Wilcoxon signed-rank test, and chi-square test analysis of variance. The significance level was set at p  < 0.05. Results Forty-two midwives were initially randomized to either the virtual simulation group or the face-to-face group. One midwife was excluded from the analysis due to intervention discontinuation, resulting in a final analysis of 41 midwives (n1 = 21, n2 = 20). Post-intervention, the virtual simulation group exhibited higher satisfaction and learning effects compared to the face-to-face group, while the rate of perineal incision in primiparas was lower ( p <0.05). No significant changes or differences were observed in self-rated behavior between the two groups ( p >0.05). The virtual simulation group demonstrated an increase in non-supine birth rate ( p  = 0.030) and a decrease in perineal incision rate among primiparas compared to pre-intervention ( p  = 0.035). Moreover, knowledge performance was associated with the duration of virtual simulation ( r  = 0.664, p  = 0.001). Conclusions Virtual simulation is a fascinating innovation that enables midwives to develop birthing positions without practicing on real pregnant women and is one solution to achieve work competency within a shortened training period.

Aim: This study evaluated an advanced care planning (ACP) training program incorporating online skills in shared decision making (SDM). Method: The New World Kirkpatrick Model was employed to assess the efficacy of the training program at four levels: reaction, learning, behavior, and results. Reaction measured the participants’ satisfaction and difficulty with the training program alongside the status of support received from workplaces engaging in ACP. Learning evaluated the changes in SDM skills. Behavior assessed the changes in the relationship between patients and healthcare professionals when the latter were involved in the SDM process. Results evaluated whether the participants were willing to participate in ACP educational programs as a facilitator and whether their motivation for continuous learning changed through throughout the training program. The relationships among patients, healthcare providers, and third-party roles were analyzed in SDM role-playing via structural equation modeling (SEM). Results: Between September 2020 and June 2022, 145 multidisciplinary participants completed the entirety of the training program. The most common responses to the training were “satisfied”, “slightly difficult”, and “I received some support from my workplace”. The SDM skills significantly improved from the first to the third workshop, evaluated using the Wilcoxon rank-sum test. In the first workshop, SDM was primarily performed by healthcare providers; however, in the third workshop, patient-centered SDM was adopted. Of the participants who completed the program, 63% intended to participate in future ACP educational programs as ACP education facilitators. Conclusion: This study ascertained the validity of this training.

Commercialized since 2019, emicizumab (Hemlibra) was available only in French hospital pharmacies for prophylaxis of hemophilia A with or without inhibitors. Since June 15, 2021, patients can choose between a hospital and community pharmacy. These changes in the care pathway have important organizational consequences for patients, their relatives, and health professionals. Two training programs are available for community pharmacists: the \"HEMOPHAR\" training program proposed by the national reference center for hemophilia and the Roche training program proposed by the laboratory that markets the product. The PASODOBLEDEMI study aims to evaluate the direct impact of the training programs provided to community pharmacists in the context of the dispensing of emicizumab, and to evaluate patients' satisfaction with their treatment whether they choose dispensation from a community pharmacy or retained dispensation from the hospital pharmacy. We designed a cross-sectional study based on the 4-level Kirkpatrick evaluation model: the immediate reaction of community pharmacists following training (Reaction), the knowledge acquired during the training (Learning), the professional practice of community pharmacists during dispensing of the product (Behavior), and patients' satisfaction related to the treatment whether it is dispensed from a hospital or from a community pharmacy (Results). Considering that single outcome measures cannot adequately reflect the complexity of this new organization, the Kirkpatrick evaluation model provides 4 distinct outcomes: the immediate reaction after the HEMOPHAR training program, the level of knowledge acquired after the HEMOPHAR training program, the impact of training on professional practice, and patient satisfaction with access to emicizumab. We developed specialized questionnaires for each of the 4 levels of the Kirkpatrick evaluation model. All community pharmacists involved in dispensing emicizumab, whether they have followed the HEMOPHAR or the Roche training program or neither, were eligible for inclusion. All patients with severe hemophilia A were eligible, irrespective of inhibitor use, age, treatment with emicizumab, and whether they chose dispensation from a community pharmacy or retained dispensation from a hospital pharmacy. The new organization for dispensing emicizumab to patients with hemophilia A in French community pharmacies must be accompanied by optimal safety and quality conditions due to the risk of serious and urgent bleeding situations in the management of rare bleeding diseases. The elaboration of the PASODOBLEDEMI protocol has already a positive impact with the commitment of all health professionals, physicians, hospital and community pharmacists, and the patient community. The results will be disseminated among the French authorities and will enable, if necessary, proposing this access model to other rare diseases. ClinicalTrials.gov NCT05449197, https://clinicaltrials.gov/ct2/show/NCT05449197?term=NCT05449197; ClinicalTrials.gov NCT05450640, https://clinicaltrials.gov/ct2/show/NCT05450640?term=NCT05450640. DERR1-10.2196/43091.

Members of the boy band O-Town and Chris Kirkpatrick of ’N Sync performed together at Westfield Montgomery Mall in Bethesda, Md., on April 1.

We consider a spin system obtained by coupling two distinct Sherrington-Kirkpatrick (SK) models with the same temperature and external field whose Hamiltonians are correlated. The disorder chaos conjecture for the SK model states that the overlap under the corresponding Gibbs measure is essentially concentrated at a single value. In the absence of external field, this statement was first confirmed by Chatterjee [Disorder chaos and multiple valleys in spin glasses (2009) Preprint]. In the present paper, using Guerra's replica symmetry breaking bound, we prove that the SK model is also chaotic in the presence of the external field and the position of the overlap is determined by an equation related to Guerra's bound and the Parisi measure.