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Defining Psychological Resilience And Determining Long-Term Mental And Physical Health Outcomes In Male And Female West Point Graduates, Melissa Thomas

Yale Medicine Thesis Digital Library

We examined what defines psychological resilience in graduates of the United States Military Academy at West Point, a special population that was selected and trained to adapt and excel in the face of risk factors that can adversely affect mental and physical health. We also assessed self-reported mental and physical health in this population and compared these data to other veteran and civilian populations to lay the groundwork for further investigations into the relationship of resilience to health outcomes. The aims of this study were to: 1) employ a novel approach to operationalizing psychological resilience, defined as adapting well and …

The President's Emergency Plan For Aids Relief And Adult Mortality: A Replication Study Of Hiv Development Assistance Effects In Sub-Saharan African Countries, Nicholas A. Hein, Danstan Bagenda, Jiangtao Luo

Journal Articles: Anesthesiology

The US budget for global health funding, which was by far the largest of similar funding in the world, increased from US $1.3 billion in 2001 to more than US $10 billion in recent years. More than 54% of this funding was allocated to the Global Fund to Fight HIV/AIDS through the US President's Emergency Plan for AIDS Relief (PEPFAR) in Africa. However, recent studies indicate contradictory results regarding the effectiveness of PEPFAR. One by Bendavid, Holmes, Bhattacharya, and Miller shows positive effects of PEPFAR in reducing adult mortality in Africa, while another by Duber, Coates, Szekeras, Kaji, and Lewis …

Structural Equation Modeling To Detect Correlates Of Childhood Vaccination: A Moderated Mediation Analysis, Abraham Degarege, Karl Krupp, Vijaya Srinivas, Boubakari Ibrahimou, Purnima Madhivanan

Journal Articles: Epidemiology

OBJECTIVES: This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination.

METHODS: A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one …

Single Cell Transcriptomics Implicate Novel Monocyte And T Cell Immune Dysregulation In Sarcoidosis, Lori Garman, Richard C. Pelikan, Astrid Rasmussen, Caleb A. Lareau, Kathryn A. Savoy, Umesh S. Deshmukh, Harini Bagavant, Albert M. Levin, Salim Daouk, Wonder P. Drake, Courtney G. Montgomery

Public Health Sciences Articles

Sarcoidosis is a systemic inflammatory disease characterized by infiltration of immune cells into granulomas. Previous gene expression studies using heterogeneous cell mixtures lack insight into cell-type-specific immune dysregulation. We performed the first single-cell RNA-sequencing study of sarcoidosis in peripheral immune cells in 48 patients and controls. Following unbiased clustering, differentially expressed genes were identified for 18 cell types and bioinformatically assessed for function and pathway enrichment. Our results reveal persistent activation of circulating classical monocytes with subsequent upregulation of trafficking molecules. Specifically, classical monocytes upregulated distinct markers of activation including adhesion molecules, pattern recognition receptors, and chemokine receptors, as well …

Getting The Gist Of A Schwannoma, Rishabh Gulati, Joshua A. Hanson, Gulshan Parasher, Daniel Castresana

Pathology Research and Scholarship

A small subepithelial esophageal lesion was seen 21 cm from the incisors in an otherwise unremarkable examination. Subsequent upper-EUS examination revealed a 14 mm by 21 mm well-circumscribed, hypoechoic lesion originating from the muscularis propria (layer 4). The initial EUS impression was suggestive of a GI stromal tumor, however, examination of EUS-guided fine-needle biopsy specimens showed a haphazard arrangement of spindle cells in a fibrotic stoma.

A Head-To-Head Comparison Of The Efficacy And Safety Of Ixekizumab And Adalimumab In Biological-Naïve Patients With Active Psoriatic Arthritis: 24-Week Results Of A Randomised, Open-Label, Blinded-Assessor Trial., Philip Mease, Josef S Smolen, Frank Behrens, Peter Nash, Soyi Liu Leage, Lingnan Li, Hasan Tahir, Melinda Gooderham, Eswar Krishnan, Hong Liu-Seifert, Paul Emery, Sreekumar G Pillai, Philip S Helliwell

Articles, Abstracts, and Reports

OBJECTIVES: To compare efficacy and safety of ixekizumab (IXE) to adalimumab (ADA) in biological disease-modifying antirheumatic drug-naïve patients with both active psoriatic arthritis (PsA) and skin disease and inadequate response to conventional synthetic disease-modifying antirheumatic drug (csDMARDs).

METHODS: Patients with active PsA were randomised (1:1) to approved dosing of IXE or ADA in an open-label, head-to-head, blinded assessor clinical trial. The primary objective was to evaluate whether IXE was superior to ADA at week 24 for simultaneous achievement of a ≥50% improvement from baseline in the American College of Rheumatology criteria (ACR50) and a 100% improvement from baseline in the …

Development And Validation Of A Model For Individualized Prediction Of Hospitalization Risk In 4,536 Patients With Covid-19, Lara Jehi, Xinge Ji, Alex Milinovich, Serpil Erzurum, Amy Merlino, Steve Gordon, James B. Young, Michael W. Kattan

All publications

Background: Coronavirus Disease 2019 is a pandemic that is straining healthcare resources, mainly hospital beds. Multiple risk factors of disease progression requiring hospitalization have been identified, but medical decision-making remains complex.

Objective: To characterize a large cohort of patients hospitalized with COVID-19, their outcomes, develop and validate a statistical model that allows individualized prediction of future hospitalization risk for a patient newly diagnosed with COVID-19.

Design: Retrospective cohort study of patients with COVID-19 applying a least absolute shrinkage and selection operator (LASSO) logistic regression algorithm to retain the most predictive features for hospitalization risk, followed by validation in a temporally …

Implementation Of A Medical Student-Run Telemedicine Program For Medications For Opioid Use Disorder During The Covid-19 Pandemic, Marcus Castillo, Brianna Conte, Sam Hinkes, Megan Mathew, C J Na, Ainhoa Norindr, David P. Serota, David W. Forrest, Amar R. Deshpande, Tyler S. Bartholomew, Hansel E. Tookes

All publications

Objectives: The COVID-19 pandemic led to the closure of the IDEA syringe services program medical student-run free clinic in Miami, Florida. In an effort to continue to serve the community of people who inject drugs and practice compassionate and non-judgmental care, the students transitioned the clinic to a model of TeleMOUD (medications for opioid use disorder). We describe development and implementation of a medical student-run telemedicine clinic through an academic medical center-operated syringe services program.

Methods: Students advertised TeleMOUD services at the syringe service program on social media and created an online sign-up form. They coordinated appointments and interviewed patients …

Statewide Implementation Of Virtual Perinatal Home Visiting During Covid-19, Jennifer Marshall, Laura Kihlström, Acadia Buro, Vidya Chandran, Concha Prieto, Rafaella Stein-Elger, Keryden Koeut-Futch, Allison Parish, Katie Hood

All publications

Purpose: This evaluation describes efforts taken by MIECHV administrators and staff during the pandemic using data collected from 60 MIECHV staff surveys and nine statewide weekly focus groups.

Description: The Florida Maternal, Infant and Early Childhood Home Visiting (MIECHV) Initiative funds perinatal home visiting for pregnant women and families with infants throughout the state. Florida MIECHV has shown resilience to disasters and times of crises in the past, while generating a culture of adaptation and continuous quality improvement among local implementing agencies. Florida MIECHV responded to the COVID-19 pandemic crisis within the first few days of the first reported case …

Combined Abdominal Heterotopic Heart And Aorta Transplant Model In Mice, Hao Dun, Li Ye, Yuehui Zhu, Brian W Wong

Open Access Publications

BACKGROUND: Allograft vasculopathy (AV) remains a major obstacle to long-term allograft survival. While the mouse aortic transplantation model has been proven as a useful tool for study of the pathogenesis of AV, simultaneous transplantation of the aorta alongside the transplantation of another organ may reveal more clinically relevant mechanisms that contribute to the pathogenesis of chronic allograft rejection. Therefore, we developed a combined abdominal heart and aorta transplantation model in mice which benefits from reducing animal and drug utilization, while providing an improved model to study the progressive nature of AV.

METHODS: The middle of the infrarenal aorta of the …

Distinct Inflammatory Profiles Distinguish Covid-19 From Influenza With Limited Contributions From Cytokine Storm, Philip A Mudd, Jackson S Turner, Daniel Reynolds, Diane Bender, Adrianus C M Boon, Stacey L House, Kenneth E Remy, Richard S Hotchkiss, Rachel M Presti, Jane A O'Halloran, William G Powderly, Ali H Ellebedy, Et Al

Open Access Publications

We pursued a study of immune responses in coronavirus disease 2019 (COVID-19) and influenza patients. Compared to patients with influenza, patients with COVID-19 exhibited largely equivalent lymphocyte counts, fewer monocytes, and lower surface human leukocyte antigen (HLA)-class II expression on selected monocyte populations. Furthermore, decreased HLA-DR on intermediate monocytes predicted severe COVID-19 disease. In contrast to prevailing assumptions, very few (7 of 168) patients with COVID-19 exhibited cytokine profiles indicative of cytokine storm syndrome. After controlling for multiple factors including age and sample time point, patients with COVID-19 exhibited lower cytokine levels than patients with influenza. Up-regulation of IL-6, G-CSF, …

Comparison Of Smartphone Photography, Single-Lens Reflex Photography, And Field-Grading For Trachoma, John M Nesemann, Michael I Seider, Blake M Snyder, Robi N Maamari, Daniel A Fletcher, Berhan A Haile, Zerihun Tadesse, Nicole E Varnado, Sun Y Cotter, Elizabeth Kelly Callahan, Paul M Emerson, Todd P Margolis, Thomas M Lietman, Jeremy D Keenan

Open Access Publications

Conjunctival examination for trachomatous inflammation-follicular (TF) guides public health decisions for trachoma. Smartphone cameras may allow remote conjunctival grading, but previous studies have found low sensitivity. A random sample of 412 children aged 1-9 years received an in-person conjunctival examination and then had conjunctival photographs taken with 1) a single-lens reflex (SLR) camera and 2) a smartphone coupled to a 3D-printed magnifying attachment. Three masked graders assessed the conjunctival photographs for TF. Latent class analysis was used to determine the sensitivity and specificity of each grading method for TF. Single-lens reflex photo-grading was 95.0% sensitive and 93.6% specific, and smartphone …

Canonical Signaling By Tgf Family Members In Mesenchymal Stromal Cells Is Dispensable For Hematopoietic Niche Maintenance Under Basal And Stress Conditions, Joseph Ryan Krambs, Grazia Abou Ezzi, Juo-Chin Yao, Daniel C. Link

Open Access Publications

Mesenchymal stromal cells are an important component of the bone marrow hematopoietic niche. Prior studies showed that signaling from members of the transforming growth factor (TGF) superfamily in mesenchymal stromal cells is required for normal niche development. Here, we assessed the impact of TGF family signaling on niche maintenance and stress responses by deleting Smad4 in mesenchymal stromal cells at birth, thereby abrogating canonical TGF signaling. No alteration in the number or spatial organization of CXCL12-abundant reticular (CAR) cells, osteoblasts, or adipocytes was observed in Osx-Cre, Smad4fl/fl mice, and expression of key niche factors was normal. Basal hematopoiesis and stress …

Higher Iron Stores And The Hfe 187c>G Variant Delay Onset Of Peripheral Neuropathy During Combination Antiretroviral Therapy, Asha R. Kallianpur, Wanqing Wen, Angelika L. Erwin, David B. Clifford, Todd Hulgan, Gregory K. Robbins

Open Access Publications

OBJECTIVE: People with HIV (PWH) continue to experience sensory neuropathy and neuropathic pain in the combination antiretroviral therapy (cART) era for unclear reasons. This study evaluated the role of iron in a previously reported association of iron-loading hemochromatosis (HFE) gene variants with reduced risk of neuropathy in PWH who received more neurotoxic cART, since an iron-related mechanism also might be relevant to neuropathic symptoms in PWH living in low-resource settings today.

DESIGN: This time-to-event analysis addressed the impact of systemic iron levels on the rapidity of neuropathy onset in PWH who initiated cART.

METHODS: Soluble transferrin receptor (sTFR), the sTFR-ferritin …

Prehospital Use Of A Modified Heart Pathway And Point-Of-Care Troponin To Predict Cardiovascular Events, Jason P. Stopyra, Louis Fornage, Et Al.

Open Access Publications

CLINICAL TRIAL REGISTRATION: clinicaltrials.gov (NCT02709135).

The Baby Bridge Program: A Sustainable Program That Can Improve Therapy Service Delivery For Preterm Infants Following Nicu Discharge, Roberta Pineda, Elizabeth Heiny, Patricia Nellis, Joan Smith, Jaqueline M. Mcgrath, Margaux Collins, Abigail Barker

Open Access Publications

OBJECTIVE: The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program.

METHODS: The Baby Bridge program was developed to promote timely, consistent and high quality early therapy services for high-risk infants following neonatal intensive care unit (NICU) discharge. Key features of the Baby Bridge program were defined as: 1) having the therapist establish rapport with the family while in the NICU, 2) scheduling the first home visit within one week of discharge and continuing weekly visits until other services commence, 3) conducting comprehensive assessments to inform targeted interventions …

Focused Ultrasound For Safe And Effective Release Of Brain Tumor Biomarkers Into The Peripheral Circulation, Lifei Zhu, Arash Nazeri, Christopher Pham Pacia, Yimei Yue, Hong Chen

Open Access Publications

The development of noninvasive approaches for brain tumor diagnosis and monitoring continues to be a major medical challenge. Although blood-based liquid biopsy has received considerable attention in various cancers, limited progress has been made for brain tumors, at least partly due to the hindrance of tumor biomarker release into the peripheral circulation by the blood-brain barrier. Focused ultrasound (FUS) combined with microbubbles induced BBB disruption has been established as a promising technique for noninvasive and localized brain drug delivery. Building on this established technique, we propose to develop FUS-enabled liquid biopsy technique (FUS-LBx) to enhance the release of brain tumor …

Ige And T Cell Reactivity To A Comprehensive Panel Of Cockroach Allergens In Relation To Disease, Anna Pomés, Véronique Schulten, Jill Glesner, Ricardo Da Silva Antunes, Aaron Sutherland, Leonard B Bacharier, Avraham Beigelman, Paula Busse, April Frazier, Alessandro Sette

Open Access Publications

IgE sensitization to cockroach allergens is associated with development of allergic diseases, such as asthma. To understand the relevance of different cockroach allergens for diagnosis and immunotherapy, a comprehensive analysis of IgE antibody levels and T cell reactivity to an expanded set of cockroach allergens and their relationship to disease was performed in a cohort of USA cockroach sensitized patients. IgE antibody levels to recombinant chitinase and hemocyanin were measured for 23 subjects by custom-made ImmunoCAPs and compared with IgE levels to eight cockroach allergens we previously reported for the same cohort.

Us-County Level Variation In Intersecting Individual, Household And Community Characteristics Relevant To Covid-19 And Planning An Equitable Response: A Cross-Sectional Analysis, Taylor Chin, Rebecca Kahn, Ruoran Li, Jarvis T. Chen, Nancy Krieger, Caroline O. Buckee, Satchit Balsari, Mathew V. Kiang

All publications

Objectives: To illustrate the intersections of, and intercounty variation in, individual, household and community factors that influence the impact of COVID-19 on US counties and their ability to respond.

Design: We identified key individual, household and community characteristics influencing COVID-19 risks of infection and survival, guided by international experiences and consideration of epidemiological parameters of importance. Using publicly available data, we developed an open-access online tool that allows county-specific querying and mapping of risk factors. As an illustrative example, we assess the pairwise intersections of age (individual level), poverty (household level) and prevalence of group homes (community-level) in US counties. …

Recognizing And Addressing Mathematics Anxiety In Female Students, Amanda Sost

West Chester University Master’s Theses

Mathematics anxiety is a prevalent concern in the world of education. As a female mathematician myself, my own personal experiences led me to research the reasons why mathematics anxiety affects more girls than boys. Specifically this paper explores the basics of anxiety including its definition and causes. This definition provides a meaning behind discussing the authoritarian model of education and the importance behind creating a free democratic society, not only in the classroom but in the world. Specifically, the authoritarian style of pedagogy has many affects on students who are learning mathematics, which will be explored as one of the …

Diagnostic Accuracy Of Chest Computed Tomography Scans For Suspected Patients With Covid-19: Receiver Operating Characteristic Curve Analysis, Lianpin Wu, Qike Jin, Jie Chen, Jiawei He, David Brett-Major, Jianghu James Dong

Journal Articles: Epidemiology

BACKGROUND: Computed tomography (CT) scans are increasingly available in clinical care globally. They enable a rapid and detailed assessment of tissue and organ involvement in disease processes that are relevant to diagnosis and management, particularly in the context of the COVID-19 pandemic.

OBJECTIVE: The aim of this paper is to identify differences in the CT scan findings of patients who were COVID-19 positive (confirmed via nucleic acid testing) to patients who were confirmed COVID-19 negative.

METHODS: A retrospective cohort study was proposed to compare patient clinical characteristics and CT scan findings in suspected COVID-19 cases. A multivariable logistic model with …

Colorectal Cancer Screening Uptake: Differences Between Rural And Urban Privately-Insured Population, Mesnad Alyabsi, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50-64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits …

Healthcare Practitioners’ Views Of Social Media As An Educational Resource, Adam G. Pizzuti, Karan H. Patel, Erin K. Mccreary, Emily Heil, Christopher M. Bland, Eric Chinaeke, Bryan L. Love, P Brandon Bookstaver

Faculty Publications

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® …

An Examination Of Factors That Impact The Choices Of Female Athletes In Pursuit Of A Career In Collegiate Sports Leadership, Gloria Lynn Bradley

Wayne State University Dissertations

Abstract

The Social Cognitive Career Theory was applied to examine how the desire to coach or administrate are impacted by self-efficacy, occupational valence, perceived hindrance, and role model influence. This study was conducted to address the underrepresentation of females in collegiate sports leadership positions. The study examined if being coached by males or if males in leadership positions is preferred. Women coach less than half, (40.2%) of women’s sports and women account for 19.6% percent of administrators in college athletic departments. Hypothetically, the results of this study will support and enhance the NCAA college sports model by revealing quantitative data …

Mapping Language Function With Task-Based Vs. Resting-State Functional Mri, Ki Yun Park, John J. Lee, Donna Dierker, Laura M. Marple, Carl D. Hacker, Jarod L. Roland, Daniel S. Marcus, Mikhail Milchenko, Michelle M. Miller-Thomas, Tammie L. Benzinger, Joshua S. Shimony, Abraham Z. Snyder, Eric C. Leuthardt

Open Access Publications

BACKGROUND: Use of functional MRI (fMRI) in pre-surgical planning is a non-invasive method for pre-operative functional mapping for patients with brain tumors, especially tumors located near eloquent cortex. Currently, this practice predominantly involves task-based fMRI (T-fMRI). Resting state fMRI (RS-fMRI) offers an alternative with several methodological advantages. Here, we compare group-level analyses of RS-fMRI vs. T-fMRI as methods for language localization.

PURPOSE: To contrast RS-fMRI vs. T-fMRI as techniques for localization of language function.

METHODS: We analyzed data obtained in 35 patients who had both T-fMRI and RS-fMRI scans during the course of pre-surgical evaluation. The RS-fMRI data were analyzed …

Should The Pbl Tutor Be Present? A Cross-Sectional Study Of Group Effectiveness In Synchronous And Asynchronous Settings, Samuel Edelbring, Siw Alehagen, Evalotte Mörelius, Annakarin Johansson, Patrik Rytterström

Research outputs 2014 to 2021

Background: The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor's support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups' effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI). This study's aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for …

"The Island Has Two Sides": Female Subjectivity In Postcolonial Adaptation, Teah Goldberg

CGU Theses & Dissertations

My dissertation is entitled: “The Island has two sides: Female Subjectivity in Postcolonial Adaptation.” In it I will argue that many postcolonial narratives either consciously or unconsciously adapt Shakespeare’s The Tempest in an effort to resurrect repressed female narratives of resistance. Through an examination of Elizabeth Nunez’s Prospero’s Daughter (2006), J.M. Coetzee’s Foe (1986), Maryse Condé’s I, Tituba, Black Witch of Salem (1988), and Jean Rhys’s Wide Sargasso Sea (1966), this dissertation will contribute to the fields of feminist and postcolonial studies by arguing that the kinds of female critical voices that we find embedded within these postcolonial texts, either …

Female Small Business Owners: Strategies For Success, Betsy J. Peterson

Walden Dissertations and Doctoral Studies

In 2015, 30.2 million small businesses existed in the United States; the Small Business Administration predicted that only half would survive beyond 5 years. Female business owners who do not establish practices to gain a competitive advantage in the small business marketplace may experience poor business performance. Grounded in trait theory, the purpose of this qualitative multiple case study was to explore the business strategies female small business owners use to succeed in a small business beyond 5 years. Participants included 3 female owners of successful small businesses in Northern California who have been in continual operation for more than …

Coaching Women On The Impact Of Alcohol Intake On Mental Well-Being: A Systematic Literature Review, Amy Maloney

All Graduate Theses, Dissertations, and Other Capstone Projects

Alcohol intake among women has increased in recent years. Women’s bodies metabolize alcohol differently when compared to men and are at increased risk for adverse effects, both physically and mentally. The purpose of this systematic literature review is to explore the evidence related to the impact of coaching in primary care on drinking behaviors and over-all well-being of women. Four databases including PsycInfo, Academic Search Premier, CINAHL Plus with full text, and Gender Studies Database were searched using a variety of key words. Studies were included if they focused on female alcohol use and abuse, interventions specific to female alcohol …

Do Cognitive Distortions And Coping Skills Predict Scar Acceptance And Body Esteem In Women With Implantable Cardioverter Defibrillators Or Pacemakers?, Nora Brier

PCOM Psychology Dissertations

The purpose of this study was to examine whether cognitions and coping skills predict scar acceptance and body esteem in women 18 years and older with implantable cardioverter defibrillators (ICDs) or pacemakers. A convenience sample of 272 individuals responded to a Facebook post. The measures were a demographic questionnaire, the Social Problem Solving Inventory-Revised (Short) (SPSI-R:S), the Body Esteem Scale for Adolescents and Adults, the Patient Scar Assessment Questionnaire (PSAQ), the Florida Patient Acceptance Survey, and the Inventory of Cognitive Distortions (ICD). Pearson correlation coefficient results revealed a moderate negative correlation between Negative Problem Orientation (NPO) and Body Esteem (Weight), …